People have consistently desired longer, healthier lives. Over 2,000 years ago Cicero stated, “We must look after our health”. Alchemists searched for the aqua vitae: an extraordinarily potent liquid (often containing ethanol) that might even offer immortality.
Elderly, frail, important people, including popes, suckled milk from hired wet nurses.
The Pharmaceutical Society in 1843 strove to advance chemistry and pharmacy and their education. From the 1910s to 1930s, radioactive remedies were available, including bath salts that made you “glow with health”.
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In the 1960 novel ‘Trouble with Lichen’, the science fiction writer John Wyndham speculated that a biochemical from a rare lichen could extend life.
Western biomedicine using the scientific method strove to improve the health and length of life. The Methuselah Foundation encourages lengthening life using scientific principles and research, including offering prizes towards this. CRISPR interference is one recent powerful tool for specific gene knockdown.
Today, pharmacists, as professionals, profess expert knowledge on some bounty of the therapeutic revolution. Examples are analgesics, anaesthetics, antibiotics, anticoagulants, anticonvulsants, antidepressants, antiemetics, antifungals, antihistamines, antipsychotics, antivirals, bronchodilators, corticosteroids, cytotoxics, diuretics, hormones, hypoglycaemics, immunosuppressants, statins and vaccines.
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Problems have also occurred; thalidomide and birth defects are perhaps the best-known illustration. Another is diethylene glycol. It replaced or contaminated the excipient glycerin during pharmaceutical manufacture. Many deaths occurred in several countries; lessons learned included improvements in quality assurance and good manufacturing practice. More bad things, as yet unimagined, may occur.
Pharmacists also deal with medicaments for which there is less natural scientific evidence claiming to enhance or lengthen human life. Examples are ginseng, ginkgo, lion’s mane and multivitamin or mineral supplement tablets. Confession time: I routinely self-medicate with the latter.
My diet may be deficient. The wheat in my bread, say, has grown in a soil deficient in selenium. Moreover, every day I drink two cups of of Napoli espresso coffee liquor, extracted at 15 bar, firmly tamped and polished, with an equal volume of hot semi-skimmed milk. I drink with relish and smack my lips. I suspect this ritual represents caffeine addiction.
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I also like nuts. Walnuts contain omega-3 fatty acids, which play a role in brain health and mood regulation. Walnuts also contain tryptophan, an amino acid that releases the hormone serotonin which has a calming and mood-boosting effect. Some studies suggest that a handful of walnuts eaten on the day of an examination boosts cognitive performance.
One research topic is the axolotl, a salamander that does not metamorphose which is unusual for an amphibian. Axolotls appear to stop ageing after four years and can regenerate their limbs. Could that be adapted to humans?
Moving further into the mainstream, pharmacological studies have shown that metformin extends life, at least in mice. The TAME (Targeting Aging with Metformin) study is the first (human) clinical trial targeting ageing approved by the USA’s Food and Drug Administration (FDA).
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It will test whether metformin can also prolong human lifespan. Running a trial over say 90 years would be impracticable; instead, as proxies, the TAME study measures the onset of age-related ailments such as cancer and dementia.
The American Federation for Aging Research (AFAR) is a non-profit organisation founded in 1981 to advance biomedical research on ageing and age-related diseases. AFAR has given millions of dollars of grants to support scientists exploring the biology of ageing.
In a proposed competition called ‘The Enhanced Games’, athletes could earn a million dollars for breaking world records using performance-enhancing drugs. Such doping would normally disqualify them. The endeavour to achieve a long life and splendid health feels as if it is nudging towards the mainstream. A deluge of investment helps. Silicon Valley trillionaires and politicians are interested.
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What does this mean for pharmacists? The recent prescribing and dispensing of weight loss GLP-1 receptor agonist drugs could be a harbinger of those drugs in the pipeline that extend human life. Wegovy generated interest, but age-extension drugs would ignite a frenzy, like comparing a local farmers’ market to a gold rush.
Prodigious profits may follow. Initially, only the wealthy may have access to such astonishing blockbuster drugs. Would such drugs spur counterfeits, a black market and public disorder? Societal ramifications could prove colossal.
Dr Malcolm E. Brown is a retired community, hospital and industrial pharmacist, and is a sociologist and honorary careers mentor at the University of East Anglia.