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The Life Extension Revolution

June 2005

By Matt Sizing

Restoring Youthful Hormone Levels

Because “hormonal decline is a primary factor in the aging process,” separate chapters are devoted to sex hormones (such as progesterone, estrogen, estradiol, and testosterone) and to thyroid and growth hormone.

Although bioidentical hormone replacement therapy offers extraordinary benefits for men and women entering middle age, the public at large remains shockingly ignorant about the readily correctable effects of age-diminished hormone levels. Dr. Miller clearly distinguishes between desirable bioidentical hormones and thoroughly discredited, side effect-prone synthetic versions. It is important to work with an anti-aging doctor to develop and periodically reevaluate individually customized dosages, thus ensuring a natural and optimal balance between various hormones.

Detailed female and male protocols for bioidentical sex hormone replacement are included, as well as a discussion of the benefits of hormone-modulating herbs and phyto-estrogens for women and of prostate-protecting nutrients for men. The book clarifies common misconceptions about anti-aging treatments (such as the overlooked role of testosterone in women and progesterone in men), as well as those concerning the causes of and remedies for estrogen dominance in men. Precautions for those with hormone-sensitive cancers are noted, as are recommended nutrients and herbs for relieving menopausal symptoms (black cohosh, licorice root extract, dong quai) and protecting prostate health (nettle extract, pygeum extract, and lycopene).

Thyroid and Growth Hormone

Two other hormone systems merit evaluation in a comprehensive anti-aging program: the familiar but largely misunderstood thyroid hormone, and the somewhat more mysterious and controversial human growth hormone. “Both thyroid and growth hormone are fundamental to maintaining a youthful, healthy body as you grow older,” says Dr. Miller.

Symptoms of underactive thyroid function include weight gain, constipation, insomnia, fatigue, susceptibility to colds and flu, cold hands and feet, sleepiness, and dry or flaky skin. Yet suboptimal thyroid function is frighteningly common, under-diagnosed, and under-treated. Endocrinologists estimate that one in five women and one in 10 men over 60 suffer from underactive thyroid. Astonishingly, one study found that 40% of patients who were already taking thyroid medication still had abnormally high levels of TSH (thyroid stimulating hormone), an indicator of low thyroid function. Because even “normal” TSH levels increase heart disease risk, Dr. Miller advises testing for TSH and other blood markers of thyroid function, and working with an anti-aging doctor to bring these values into the “optimal” range signifying peak thyroid function.

Human growth hormone (HGH) is responsible for the remarkable growth spurts seen in childhood, and later for repair and regeneration of tissues and organs in grown adults. According to Dr. Miller, “Growth hormone also works throughout life to maintain bone strength, muscle tone, brain function, and the integrity of the hair and skin.” Signs associated with diminished HGH include thinning bones, decreased muscle strength, fat accumulation, impaired heart and immune function, wrinkled skin, and thinning hair. Like other hormones, HGH declines with age; by the age of 60, HGH levels are just 25% of youthful levels. Although supplementing with injectable exogenous (outside the body) HGH remains somewhat controversial, Dr. Miller argues strongly in favor of considering it as part of a comprehensive anti-aging program. Alternatively, nutrients such as L-arginine, L-glutamine, L-ornithine, lysine, glycine, and niacin are known to increase the body’s endogenous (internal) release of growth hormone, as are activities such as regular exercise.

Strategies for Maximizing Brainpower

Developing “maximum brainpower for life” concludes the discussion of body- and mind-rejuvenating therapies in The Life Extension Revolution. As Dr. Miller notes, “Even a minor loss of cognitive function is a serious matter, and one that can cause a great deal of emotional distress. Our minds are the thing that makes us most uniquely us, the means by which we interact with the world around us and make our mark in that world. The thought that this might somehow slip away from us as we get older is very disturbing.”

Growing knowledge of the biochemical and energy-producing processes that underlie brain function affords us the opportunity to support those processes through a strategy of lifestyle and behavioral changes, diet, and supplements. Six critical ways to support optimal brain function are: increasing circulation and oxygenation to the brain; enhancing energy production in the brain; promoting neurotransmitter production; maintaining the structural integrity of the neuronal membranes; increasing the size and complexity of the neuronal network; and protecting the brain from oxidative damage.

Along with a program of basic nutritional support and “targeted” brain nutrients such as phosphatidylcholine, ginkgo biloba extract, and acetyl-L-carnitine, Dr. Miller incorporates critical elements such as physical exercise, hormone balancing, mental exercise, and stress reduction in his comprehensive program for promoting brain health. Also included is a discussion of so-called “smart drugs.” While virtually ignored in the US, these drugs are widely used in Europe to treat neurodegenerative disorders and improve brain function. Some, such as L-deprenyl and hydergine, are approved for off-label use in the US, while others, such as piracetam, adrafinil, and modafinil, have yet to gain FDA approval. Dr. Miller offers advice, cautions, and strategies for those interested in obtaining these drugs.


In more than 33 years of medical practice, Philip Lee Miller, MD, has traversed the vastly different worlds of conventional and anti-aging medicine. Trained in emergency medicine and neurology, Dr. Miller was a board-certified ER physician before transitioning to anti-aging medicine following a close one-year association with Dr. Julian Whitaker of the Whitaker Wellness Institute in Newport Beach, CA.

Dr. Miller founded and today serves as medical director of the Los Gatos Longevity Institute, where he maintains an active anti-aging medical practice. He is a charter member of the American Academy of Anti-Aging Medicine and a fully certified diplomate of the American Board on Anti-Aging Medicine.

Life Extension sat down with Dr. Miller to discuss The Life Extension Revolution, his views on the current state of conventional and anti-aging medicine, and what lies ahead in the future.

Life Extension: Which, if any, personal experiences compelled you to write The Life Extension Revolution?

Dr. Miller: My own temporary ill health started me on my journey. As I note in the book, I developed a severe lipid imbalance that sent my cholesterol and triglycerides soaring—a condition I was able to correct not with drugs, but with a regimen of vitamins and antioxidants, dietary changes, and stress reduction. But anti-aging medicine is as much about improving many lives as it is about changing one patient’s life. This book is an opportunity to reach a wider audience and affect a greater number of lives.

LE: As far as individuals are concerned, what did you hope to accomplish by writing The Life Extension Revolution? What impact is the book likely to have on readers in terms of their own practice of life extension?

Dr. Miller: While I hope to make the practice of anti-aging medicine more accessible and understandable to a wider audience, the book is also intended to be a guide in developing, implementing, and maintaining a customized anti-aging plan. Anti-aging medicine already is a patient-driven phenomenon, and I hope the book motivates readers to demand more of their physicians in helping to prevent disease and optimize health.

LE: In the book, you describe how embracing an anti-aging lifestyle transformed the health and lives of many of your real-life patients. Does any one patient success story stand out?

Dr. Miller: It’s hard to cite one success story, simply because so many patients have been able to move to higher levels of wellness, energy, and motivation. My practice has been more like an accumulation of wonderful people whose lives have changed greatly for the better.

LE: How has your association with the Life Extension Foundation influenced your everyday practice of anti-aging medicine? How did your clinical practice influence the book’s content and overall message?

Dr. Miller: First, my relationship with the Foundation has strengthened my belief that dedicated, tenacious organizations like Life Extension can make a huge difference in both individual lives and how medicine is practiced on a broader level. There are very few organizations like Life Extension that are fighting for freedom of choice and a greater array of therapeutic approaches in health and nutrition, and that makes the Foundation all the more invaluable.

Second, Life Extension provides the scientifically based research and information needed for a rigorous, structured approach to anti-aging medicine. I combine that with a mastery of experience and intuition: the practice of objectively based medicine combined with art and compassion. I approach lab testing, for example, somewhat like a grand master might approach a game of chess: I try to see beyond the first move to the entire board, with a sense of purpose and strategy. My approach is goal oriented, not disease based.

LE: What impact do you hope The Life Extension Revolution will have on medicine as it is practiced today?

Dr. Miller: Medicine today is in a state of great transition. It truly is a revolution. What we know as modern medicine is being reshaped and redefined, from a focus on disease and pathology to functional medicine that is goal oriented and rejuvenating. Restoring function, energy, performance, and joy will be the goals of medicine in the future.

LE: What effect do you think the book will have on conventional physicians who are interested in practicing anti-aging medicine? What hurdles must be overcome to change how medicine is practiced today?

Dr. Miller: Change is not easy or welcomed. Today’s physicians are constrained by algorithm-based policies, bureaucracies, forms, and rules that restrict their very sense of autonomy. It will take great courage to change. But anti-aging medicine is liberating; it rekindles a sense of wonder and excitement among physicians when they realize that so much more can be done for patients than is currently allowed.

LE: On a broader societal level, what needs to happen before the anti-aging lifestyle can become mainstream? Do you think the life extension philosophy and lifestyle can prevent or minimize looming epidemics such as obesity and diabetes?

Dr. Miller: We must begin, first and foremost, with a sense of personal responsibility. We are not a society that generally accepts responsibility for our actions and circumstances. Once we change this mindset, the physician-patient relationship needs to be redefined as something like that of a coach and student—not the infantilizing parent-child type of relationship that so frequently characterizes physician-patient interactions today.

There are great social forces in play as well. Medicare is running out of money just as the first baby boomers begin to turn 65. Social and economic pressures will begin to force the change in mindset I’ve just described. My advice is to begin taking care of yourself, because the government and “the system” may not be able to do so in the future. Prepare yourself by maintaining your sense of self-sufficiency and independence. The process of nutritional medicine, supplementation, hormone restoration, and cognitive enhancement can help keep the entire population more energetic, productive, and happy. And these changes cut to the very heart of what defines a healthy, sustainable society.