smThe ‘Anti-Aging’ Spa Experience
The New Model for Anti-Aging Health Care
Two hour CME course
American Academy of Anti-Aging Medicine
Venetian Hotel, Las Vegas Nevada
December 14, 2001
Edward M. Lichten, M.D., founder, U.S. Doctor Resources, L.L.C.
Robert P.K. Keller, M.D., founder, Skin Institute of America at Pebble Beach Spa
Health care is practiced by every society in the world. Although very different, there is a
commonality that includes Western Medicine, Homeopathy and Eastern Medicine.
1. Western Medicine makes diagnosis by mechanical testing.
2. Western Medicine treats with F.D.A. approved pharmaceutical products.
3. Homeopathic and Natural Medicine makes the diagnosis by applied kinesiology,
observation and experience.
4. Homeopathic practitioners treat with herbal products or multiple dilutants of the
alleged toxic agents that have „precipitated‟ the disease.
5. Eastern Medicine makes the diagnosis by examining the pulses, tongue and nail
appearance. Treatment is with acupuncture, moxibustion and herbs. smWe see the “Anti-Aging” SPA Experience as total health care that utilizes all
modalities and incorporates all the new breakthroughs we discover in medicine.
From 20 years of clinical practice as a Western Medicine physician, I (as well as my
colleagues) have felt that the key to staying healthy is by manipulating anabolic hormonal
medications. The Anabolic Hormonal Therapies include:
1. Thyroid replacement:
a. Thyroxin (T4): Synthetic thyroid
b. Tri-iodothyronine (T3): Sustained release T3
c. Armour Thyroid (T4&T3): Combination 2/3 T4, 1/3 T3
d. Bi-iodothyronine (T2): Compounded for USDOCTORs
2. Menopause (Estrogen replacement): Female
a. Bi-estrogen & Estradiol: Prescription & compound pharmacy
b. Estradiol pellets: Available for USDOCTORs
3. Viropause (Testosterone replacement): Male
a. Testosterone 10% gel: Compound pharmacy tm b. Testopel75,100, 200mg: Available for USDOCTORs
a. DHEA 10-50mg twice daily Compound pharmacy
b. Cortisol 10-50mg daily
5. Growth Hormone Deficiency: HGH replacement by daily injection
Compounded prescriptions are often the superior and physiologically the best tolerated
forms of anabolic hormonal replacement. However, products differ from manufacturer to
compounding pharmacist. Test blood levels after a course of 6-12 weeks to determine if
the product is beneficial. We have not found any benefit to the well-advertised oral
growth hormone products. My personal experience was disastrous. Using a topical
„growth hormone‟ in lieu of the pharmaceutical injectable product resulted in my family
member being hospitalized with high output heart failure. Know your pharmacist and his
expertise and check blood levels to provide your patients with the best form of anabolic
Our program at USDOCTOR RESOURCES, LLC is based on my personal research over
the last 25 years. Our breakthroughs in hormonal therapy have been through the use of
hormonal manipulation and supplementation in more than twelve different medical
conditions listed below. Note that there is a 10 lecture CD-ROM available that explains
the research, physiology, and success in treating each of these conditions. The CD-ROM
is available at the American Academy of Anti-Aging Medicine booth#607 or at the
website: http://www.usdoctor.com or by calling Dr. Lichten at (248) 358-HELP.
TREATING WOMEN TREATING MEN
Danazol & Testosterone Testosterone & Growth Hormone
1. Menstrual Pain 7. Viropause
2. Endometriosis 8. Erection Dysfunction
3. Menstrual migraine 9. Angina & Heart Failure
4. Fibromyalgia 10.Bone Non-fusion
5. Osteoporosis 11. Crohn‟s‟ disease
6. Muscle wasting 12. Diabetes Mellitus
For example, the keynote lecture this morning by Dr. Lichten features his research with
testosterone in the treatment of diabetes in adult men.
1. Insulin dependent adult diabetic men TM monthly a. Testosterone replacement with 750mg of Testopel
b. Reduced need for insulin by an average of 50%
2. Adult Onset Diabetic Men
a. „Burned-out‟ is confirmed if diabetic for more than 3-4 years
b. No benefit to prescribing sulfonylureas as there is no insulin response
c. Testosterone reduced HgB A1c by 3-5mg/ml in half the men treated
3. Continuing research shows positive anabolic effects on the heart and hemoglobin
of dialysis patients. These men show increase in lean body mass, increase in bone
and muscle density and an improved mental and sexual attitude.
Conclusion: Hormonal replacement therapy (HRT) is for both men and women in Western Medicine. Recent research by USDOCTORs and others show that HRT is
applicable to a multitude of diseases. We have used DHEA, thyroid, cortisol,
testosterone, growth hormone, testosterone derivatives and natural estrogen because they
are ANABOLIC! Anabolic therapy encourages cellular regeneration and repair.
Therefore, reestablishing anabolic processes is today‟s key to Anti-Aging Medicine!
Catabolic processes are the cause of aging. Catabolic processes suppress anabolic
1. Excess cortisol:
a. Lowers DHEA, thyroid, testosterone and growth hormone.
b. Cortisol excess contributes to insulin resistance and increased inlet cell
release of insulin.
2. Excess insulin:
a. Lowers testosterone, HGH, DHEA and thyroid
b. Contributes to METABOLIC SYNDROME
c. Including: diabetes, heart disease, obesity, hypertension & Dyslipidemia
3. Excess thyroid:
a. Catabolic process
b. Osteopenia and osteoporosis.
USDOCTOR research is clarifying the fact that Anabolic supplementation can balance
and reverse (to some extent) catabolic processes. As documented in the medical
1. Increase testosterone: Hormonal Effects
a. Decreases insulin, cortisol and bio-available thyroid
b. Diabetic men: reduced insulin requirements, less „stress‟
c. Testosterone increases sex hormone binding globulin (SHBG) that
increases all binding proteins. Increased thyroid binding lowers bio-
available thyroid and especially T3.
2. Increase testosterone: Cellular Effects
a. Increases new tissue formation and repair in muscle, bone, red blood cells,
and blood vessels while reducing central abdominal fat stores.
b. Increases aerobic metabolism.
What we have learned is that the Endocrine System has to be balanced. The catabolic
hormones of insulin, cortisol and thyroid (excess) are balanced by DHEA, testosterone
(estrogen & progesterone in women) and growth hormone. When there is imbalance,
these hormones affect all the other hormonal organs:
1. Hypothalamus: Cortrosin Stimulaitng hormone, GHRH, TRH, LRH, FSH
2. Pituitary/Brain: Growth hormone, serotonin, melatonin
3. Thyroid: Thyroxin (T4), tri-iodothyroine (T3), and T2
4. Gonadal: Testosterone, Estradiol, Progesterone
5. Adrenal: Cortisol, DHEA, epinephrine, aldosterone
6. Pancreas: Insulin and glucagons
The endocrine system is one of the six major organ systems that Western Medicine treats.
The list includes:
6. Brain/ endocrinology and tissue support
But over the years we have learned that hormonal supplementation upset‟s the body‟s
homeostasis. The addition of oral contraceptives decreases the levels of testosterone and
a woman‟s libido and increases her need for B6 and B12 vitamins. In USDOCTOR
studies, the addition of testosterone lowers estrogen levels but also increases the
consumption of minerals, vitamins, protein and essential fatty acids.
Hormonal supplementation affects every system in the body!
1. Endocrine System: HRT affects the balance between anabolic and catabolic
2. Organ Systems: HRT can have profound effects on other organs
[testosterone on heart, obesity, for example[
3. Cellular Systems: HRT can increase consumption of vital minerals, induce
cell wall changes and improve even oxygen exchange!
Remember, every function that we associate with an organ and Health can be identified at
the Cellular Level. The cell functions and their corresponding organ functions are:
1. Energy/circulation a.k.a. heart
2. Oxygenation a.k.a. lung
3. Metabolism/immunity/repair a.k.a. liver
4. Waste removal a.k.a. kidney
5. Digestion a.k.a. gastro-intestinal tract
6. Organization, reproduction a.ka. Brain, endocrine, support system
The concept is sooo simple! If the cell is health so is the whole body!
There has to be balance at the cellular level, organ level and hormone level for there to be
health and repair!
We have learned from seven years of research with testosterone in men and diabetes that
testosterone (and to a lesser extent growth hormone and T3) supplementation shifts
anaerobic to aerobic metabolism. So, this year we have shifted our focus from the
hormonal manipulation to cellular physiology and cellular supplementation!
This is the paradigm shift that I bring to you today. We now look not at the hormonal
and organ system of disease but also at the cellular level!
1. Since ENERGY is the key to life (Chi- in Eastern Medicine)
a. Aerobic metabolism (Kreb‟s cycle) is 18x more efficient in producing
ATP than anaerobic metabolism.
b. The Kreb‟s cycle depends on minerals, amino acids and vitamins
2. Anabolic hormones accelerate aerobic metabolism in the Kreb‟s cycle:
a. Testosterone, growth hormone
b. Thyroid hormones
3. Anabolic hormones increase utilization of minerals and vitamins.
4. Mineral deficiencies can precipitate Adrenopause and shift metabolism back to
anaerobic with resultant worsening of lactic acidosis and chronic disease.
Adrenopause is the most common cause of chronic fatigue, exhaustion and decreased
tissue oxygenation and resultant disease today! This is the natural progression of
testosterone replacement in men. Women seem to tolerate stress much better so they th as often as men. show Adrenopause about 1/10
smThe Basis of the Anti-Aging Spa Experience is that we first diagnose and the treat at the Cellular Level!
There are six functional actions and potential deficiencies in the cell. There function
parallels the organ functions we commonly recognize:
7. Energy/circulation a.k.a. heart
8. Oxygenation a.k.a. lung
9. Metabolism/immunity/repair a.k.a. liver
10. Waste removal a.k.a. kidney
11. Digestion a.k.a. gastro-intestinal tract
12. Organization, reproduction a.ka. genetic deficiencies & endocrinology
The Equipment we use in the Diagnosis Cellular Dysfunction
1. Pulse Oximeter
2. EKG Treadmill Stress Test
3. Pulmonary Function Test
5. Acoustic cardiograph
The pulse oximeter is used to evaluate every patient. It gives the pulse and the tissue pO. 2
We understand that the cardiac output is the product of heart rate and stroke volume. If
the heart is very healthy, it will increase stroke volume with exercise and pulse remains
the same. However, as the heart becomes older and responds to various catabolic stresses,
it will lose its ability to increase stroke volume. Therefore, first there is an increase in pulse, then a decrease in pOuntil the pO drops and the pulse rises even at rest. The 22cause is often adrenal overload and Adrenopause related fatigue.
The pulse oximeter measures tissue oxygenation as pO. The shift from anerobic to 2aerobic metabolism increase the use of anaerobic metabolism, increases tissue acidosis,
and this causes a decrease in disassociation of oxygen from the hemoglobin. The stressed
cell suffers from both increased acidosis and decreased oxygenation.
We use the standard EKG machine to approximate VOmax. Although a direct 2measurement can be performed with expensive equipment, indirect measurements are
more than adequate since you have the pH of the tissue and pO measured directly. 2
Indirect measurements of VOMAX is calculated from a field test of timing a 1.5 miles. 2
But the standard EKG gives other measures that are important in the evaluation of
premature aging. These measurements are maximum blood pressure, heart rate &
recovery. reference Astrand I. Aerobic capacity-age. ActaPhsyiol Scan. 1960;169:1-92.
1. Charts show normal maximal heart rate in the EKG stress.
correlates with age. 2. Chart shows pO2
3. Charts show normal maximal systolic and diastolic blood pressure.
Pulmonary Function Test
The third piece of equipment uses is the standard Pulmonary Function Test. Standard
machines are set to desired age: 35, 50 or 60. By designating the individual as a smoker,
the computerized reads out the result of Forced Vital Capacity, Forced Expiratory
Volume, and 25-75% FEF.
The lung vital capacity is the single best study of longevity. Therefore, we use the FVC
and FEV to determine mild or moderate bronchial obstruction. It seems to correlate that
a decrease in pO and increase in blood pressure and a sign of a shift to anerobic 2metabolism that decrease repair, raises the hemoxamine-collage ratio (increase fibrosis).
All these processes worsen intercellular transport of oxygen through the supportive tissue.
In Eastern Medicine, having no „wind‟ is the same as low CHI. The idea of all three
modalities is to improve energy production and flow.
1. Pulmonary function is cheap, simple and reproducible and in your office. For
those requesting to establish an anti-aging program, the first major evaluation
should be vital capacity. This is the single best diagnostic test of anemia.
a. Forced Tidal Volume
b. Forced Expiratory Volume
c. F.E.F. 25-75%
sm The newest addition to our Anti-Aging Spa Experience is the BL-5000 which I call the
Zee-machine. This equipment is able to evaluate the electronic potential of living tissue
from blood, saliva and urine. I feel this is the ultimate measurement of aging. We know
that a young child has almost unlimited potential to generate energy (CHI). With aging,
that drops. We are developing a protocol that measures just how much energy remains
within the system after exercise. The energy potential is going to correlate best with „time
left‟ or aging. We are using this test to determine how much we can „reverse‟ the aging
process by building up the CHI and we have a means to do so with the Zee-machine.
The following tests are reported by the Zee-machine:
I. Acid-base balance: pH.
Living cells are extraordinarily sensitive to the pH in the body. Homeostasis is
carefully regulated because all biochemical reactions influence pH. The kidneys,
lungs and the buffer systems of the blood share responsibility, but it is the blood‟s
chemical buffering system that are the first line of defense against changes in pH.
1. Tissue Acidosis
a. Tissue acidosis is diagnosed by blood alkalosis (increase in blood pH).
b. Tissue acidosis can develop from:
i. Lactic acid from glucose
ii. Phosphoric acid from proteins
iii. Ketoacidosis from fats
iv. Organic Acids from different disorders of metabolic function.
2. Acidosis develops from chronic infectious processes
a. Bacteria and viruses interfere with normal cell function
b. The body‟s response to infection is to release extremely acidic hydrolases
from phagocytes and lysozymes to destroy invaders.
3. Contributors to acidosis
a. High carbohydrate diets
b. Chronic diarrhea and irritable bowel
c. Chronic stress, both physical and emotional
d. High consumption of acid forming foods
i. Red meats
ii. Carbonated beverages
e. Lack of regular exercise
f. Chronic sub-clinical dehydration
g. Diuretics and certain medications
Charts: blood pH increases with age
II. Oxidative Stress (rH2)
Oxidative stress is the result of cellular respiration. In the process of reducing
oxygen, two O- molecules are produced. These seek electrons. When they bind to a
molecule, they remove an electron. This is the same process of oxygen producing rust on
metal. The amount of free electrons determines the degree of oxidative stress.
1. Food is broken down into absorbable forms by the enzymes in the mouth and
2. The nutrients are absorbed, transported in the blood and incorporated into the
cells as either pyruvic acid or Acetyl CoA.
3. Pathways within the Krebs cycle release O-; i.e. oxidative stress.
4. Kreb‟s cycle catabolizes the intermediates into CO and ATP (energy) 2
5. The free electrons are donated to the mitochondria as part of the electron
The mitochondria generate 2 ATP molecules from the conversion of pyruvate to
lactic acid in the anaerobic metabolism cycle. It generates 38 ATP molecules from the
full cycle of the Kreb‟s cycle. Aerobic metabolism (Kreb‟s cycle) is 19 times more
efficient than anaerobic metabolism.
III. Resistivity (r) is the third measurement recorded by the Zee-machine. This measures the relative mineral content of the test sample whether it is blood, saliva or urine. Since
minerals are essential co-factor for enzymes, all functions of the body are affected.
Enzymes and minerals lock-and-key to function normally. Therefore, each of the eleven
steps of the Kreb‟s cycle, and each of the nine steps of the electron transport system are
affected by various mineral and enzyme deficiencies.
Resistivity is controlled by Ohm‟s Law. Ohm‟s Law states:
Current (l) = voltage (v) / resistance (r)
Therefore, the r value is inversely related to the amount of electrical current. The amount of electrical current across the membrane is called the membrane potential. In many cells
we are taught about potassium and calcium moving in opposite directions to generate the
membrane potential. From r we learn that a high resistivity lowers membrane potential.
Electrolytes must be in balance for energy to be generated by the cell!
Just as a battery can be measured for “low voltage”, we can now measure the membrane
potential (voltage) of a single cell!
In conclusion, the interpretation of the Zee-machine allows the physician to evaluate
Many aspects of cellular function including the following:
1. pH: Acid-base balance: Acidosis, dehydration, renal function
2. rH2: Oxidative Stress: Respiration, Toxicity, Leaky gut (malabsorption)
3. r: Resistivity: Mineral content, cell wall membrane potential
4. uW: Work Potential: Energy reserve, appropriate exercise threshold.
Remember that cellular function predicts organ function. The Zee-machine measures
cellular function of acidosis, dehydration, cell reproduction (general health, membrane
potential), oxidative stress, and toxicity. This relates directly to organ functions and
specifically to digestive health, hepatic function and renal function.
Quite interesting! Isn‟t it?!!
V. The fifth piece of equipment in the Anti-Aging Spa Experience is the Acoustic
Phonogram. Originally invented in 1922 to help his ailing son, Royal Lee had to divest
himself of the acoustic phonogram in 1961 because of the F.D.A. claiming this machine
created a vitamin monopoly. The acoustic phonogram is based on the fact that the heart
is the most sensitive muscle in the body. The heart sounds change with pH, mineral,
vitamin, protein, allergy, energy and fatty acid concentration.
The sample and teaching reports show vitamin deficiencies in B, C, E metabolism,
Free Fatty acids, digestion, energy and increased adrenal stress. Mineral deficiencies and
even heart failure (secondary to increased systolic intervals) are identified. A report is
generated and interpreted within 10 minutes.
We have performed a large number of special organ tests through MetaMetrix and Great
Smokey Laboratories. Their tests include:
1. Gastro-intestinal: comprehensive digestive stool analysis (dysbiosis index)
2. Adrenal exhaustion: adrenocrotex stress profile
3. Hepatic function: caffeine stress test
4. Elementary mineral analysis of hair
5. Cellular energy profile.
We use these tests now on only special occasions since the Zee-machine and acoustic
phonogram give us on-site direction for the cellular cause of imbalance and suggested
The five diagnostic tools of the Anti-Aging Spa Experience include:
1. Pulse oximeter: screening tool for each patient, each visit
a. Pulse: response to need to increase cardiac output
b. Tissue oxygen level: related to tissue acidosis
2. Pulmonary Function:
a. Determine baseline forced vital capacity and forces expiratory volume.
b. Determine deterioration or improvement in energy function.
3. Stress EKG treadmill:
a. Maximum heart rate
b. Maximum blood pressure
c. Changes in ST depression, premature ventricular beats and endurance
are part of the standard EKG stress treadmill test.
a. Measures tissue pH, oxidative stress, resistivity and work potential
b. Correlates to tissue acidosis, mineral deficiency, membrane potential
5. Acoustic Phonogram:
a. Heart dysfunction, mineral and vitamin deficiency
b. Adrenal stress, poor energy, allergies, gastro-intestinal dysfunction
c. Electrolyte imbalance
Royal Lee‟s acoustic phonogram is based on the same principles of organ (energy)
flow as the ancient Chinese teachings of acupuncture. Absorption of nutrients begins
in the Gastro-intestinal tract. When the GI tract is overwhelmed by poor food or
infection, the toxic elements flow to the Liver that develops „congestion.‟ This
blocks the energy flow and the blood flow through the right side of the heart to the
lungs. With poorer oxygenation, the left side of the heart has restricted flow and
oxygenation. This can cause problems throughout the body and even stroke in the
brain. The acoustic phonogram is ideal because the tracings are reproducible and can
be kept for comparison and consultation in the future.
Another principle of Chinese medicine is to read tongues and nails. Note that the
white coating on the tongue shows overgrowth of candidiasis from GI malabsorption.
The cut down the middle is a sign of long-standing gastro-intestinal dysbiosis
(imbalance), the teeth marks a sign of dehydration, a pointed tongue a sign of
inherited or developing heart disease, and the red spots on the tip a sign of adrenal
excess (insomnia, nervousness, and secondarily hormonal problems including
thyroid). Thin ridges in the nails are signs of mineral deficiencies.
Recommendations for Good Health from the Chinese and American Nutritionists:
1. EAT PROPERLY. Chew food thoroughly. Digestion begins in the mouth.
a. Mechanical breakdown of food
b. Adequate saliva
c. Parotid enzymes
2. Drink 2.5 liters of distilled or purified water daily.
a. Water breaks down excessive acid
b. Water dilutes the waste end-products for removal 3. Eat an alkaline-ash diet
a. High in fresh vegetables and fruits
b. Minimize red meat to 2 servings per week
c. Avoid alcohol, cigarettes, refined sugar and carbohydrates
Recommendations for Good health from our extensive experience with the Acoustic
Phonogram and Zee-machine:
1. MINERAL SUPPLEMENTATION IS MANDATORY
a. Nutritional content of food is 40% below 20 years ago
b. Minerals are necessary for the Kreb‟s cycle
c. Minerals influence the cellular membrane potential and energy (Chi) 2. Absorption of mineral are best through the mouth
a. Digestion interference by candidiasis and lack of stomach acid
b. Secondary interference by bacteria and lack of enzymes 3. TREATMENT: IV MINERALS
a. IV VITAMINS based on John Myer‟s formula
b. Individualize based on specific mineral deficiencies
c. It worked for John Myers, M.D., the most famous doctor of the 1950s 4. TREATMENT: LACTOBACILLIS AND GREEN DRINKS
a. Lactobacillus after every meal
b. Increase in green drinks (two per day) 5. TREATMENT: NUTRITIONAL SUPPLEMENTS
a. Vitamin A and Beta-carotines
b. Vitamin B, complex
c. Vitamin C, E
d. Co-enzyme Q10
e. Essential amino acids
f. Essential fatty acids
ii. DHA and EPA