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What is longevity medicine?
We talked with Dr. Erica Oberg, ND, MPH, an integrative and natural medicine specialist whose clinical practice focuses on preventing, reversing, and taming chronic disease, neuro-regeneration, and anti-aging. Dr. Oberg has practiced integrative and natural medicine for nearly 20 years and has held leadership positions in medical schools, NIH research, public health, and clinical practice. She specializes in nutrition and lifestyle-based therapies, intravenous micronutrient therapy, and identifying the underlying causes of disease using advanced testing.
Dr. Oberg received her doctorate in naturopathic medicine from Bastyr University, where she also did her residency. She was awarded an NIH fellowship at the University of Washington where she conducted and published research on health behavior change, nutraceuticals, and health system innovation in pursuit of shifting the focus from disease treatment to health creation. She is the author of more than 30 peer-reviewed research papers. A former university medical director, she now has a concierge clinical practice and is opening a second location, VitaLab, which will be a research hub for regenerative and anti-aging natural therapies.
PinnacleCare (PC): How would you define longevity medicine?
Dr. Erica Oberg (EO): It’s a preventative, proactive approach to medicine. When I talk to clients about longevity medicine, it’s often because they have watched people in their lives or have themselves experienced the negative effects of aging. They feel that their bodies or minds are not keeping up with the way they’re used to living. They’re not able to thrive and live a full life anymore. Longevity medicine seeks to help patients find areas where they can regain function and activate regeneration signals in the body so that they can regain the vitality they had when they were younger.
PC: Describe your approach to longevity medicine.
EO: I use lab testing and a detailed medical history to figure out how we’re going to get the most value from treatment. We start with a detailed conversation so I understand the patient’s health and family history. This gives us some insight into genetics and what we should focus on first.
We all age differently, so I think about five categories of function where we can work on anti-aging and longevity—metabolic function, immune response, energy production, regenerative cell signals, and hormonal optimization.
I run an extensive and unique blood panel to look at aging factors. We want to understand which of these categories are most appropriate to tackle first. Then we’ll sit down, review the test results together, and create a treatment plan. The plan may include specific nutrients to be administered intravenously or as oral supplements. It may also include botanical medicine, dietary modification, exercise, and stress management strategies. Sometimes it also includes strategic use of prescription medications.
Most people first age metabolically. The signs of metabolic aging often include diabetes, high cholesterol, and being overweight. When those conditions are causing aging, our first step is to try and reverse those processes and teach the metabolism to be most thrifty. When people have an excess of food, body weight, glucose, or insulin, the cells get lazy. Our longevity goal is to teach those cells to run more efficiently and to draw upon the excess resources that have been stockpiled. This slows down the aging process.
PC: At what age should people start working on their metabolic health?
EO: It’s much easier to treat these issues preventatively. The sooner the better. If you aren’t paying attention to this by the time you’re 50, you may already require some catching up.
PC: What is the next category where people most experience aging?
EO: The energy production system in our bodies. We make energy in the mitochondria of our cells. It’s a long biochemical process that involves many vitamin and mineral co-factors. Ultimately, it involves a key co-factor called NAD, which stands for nicotinamide adenine riboside. This is made from vitamin B3 and it’s the fuel that helps the mitochondria make energy.
Over time, we become low in NAD and other nutrients through poor diet and an increased need for NAD in a less efficient body. When we don’t have enough NAD, we’re not making energy and people start to lose muscle mass and get weak. They experience lethargy and their mood is not as good. People start to develop brain fog and feel tired all the time. Energy production is a big piece of these symptoms and we address this by making sure that people don’t have nutrient deficiencies that are limiting their ability to make cellular energy.
PC: How do you determine what a patient’s nutrient deficiencies are?
EO: I always rely on blood tests to document and measure my results, especially for nutrient deficiencies that affect cognition. For example, choline and serine deficiencies contribute to cognitive aging but there is little awareness of the day-to-day dietary intake of these nutrients.
PC: How do you repair those nutrient deficiencies?
EO: We help people identify what foods they can increase in their diet to get specific nutrients. I also use IV micronutrient repletion because it delivers the highest doses of nutrients in fastest and most efficient manner. This approach is especially helpful for people with digestive issues; for people who have difficulty absorbing nutrients from food. Even if their diet is good, they could still be experiencing malabsorption.
PC: What are some of the other factors that contribute to aging?
EO: Hormonal health. Women experience menopause and men go through a similar process, though the decline for men happens a bit more gradually. Aging accelerates when we lose hormones and one of the major symptoms we see is loss of muscle mass and gaining weight. When I’m helping patients with anti-aging, we talk about bio-identical hormone replacement and stimulating the body’s own hormonal processes with peptides that stimulate growth hormone production.
PC: What role does the immune system play in healthy aging?
EO: We don’t want the immune system to be too active because that leads to autoimmune problems and uses up a lot of energy in the body, which can accelerate the aging process. We also don’t want the immune system to be underactive because we might get sick. After I identify a patient’s immune balance, we discuss ways we can modulate the immune process. I often use natural immune regulators like chaga mushrooms, but this is also where patients ask questions about off-label therapies like rapamycin.
PC: What can people do to start the process of increasing longevity?
EO: The most potent thing anyone can do is exercise. If somebody does not have an exercise program and is not working towards improving their physical fitness, they’re not doing everything they can to keep themselves healthy. After that, I encourage an individualized process because no two people are alike. In my practice, we specialize in this customized approach with lab testing and precision-focused anti-aging strategies that have the highest likelihood of success for each individual.