Dr. Shah’s Favorite Anti-Aging Supplements


A healthy diet and regular exercise are of course the most important habits to maintain in order to feel as good as possible as the years go by. Dietary fads come and go, but a diet consisting primarily of fruits and vegetables (and avoidance of processed sugar) will always be important no matter what the current trend.

Keeping your body moving is also important not only for your physical health, but also for your mental health. Regular aerobic exercise, the kind that gets your heart pumping and makes you sweat, appears to boost the size of the hippocampus, the brain area involved in verbal memory and learning according to a study at the University of British Columbia. As we age, it’s also important to incorporate exercises that improve your balance. Walking is good. Cycling, rebounding, and Tai Chi are even better.

That being said, Dr. Shah believes that supplements can also play an important role in helping the brain and body adapt to stress and meet the challenges associated with aging. He takes a few supplements to be at his best physically and mentally with his busy life as a doctor and father of three. If you are interested in supplementation, you can pick and choose from the following categories if there are particular areas you’d like to focus on.

For overall health: A food based multivitamin/multimineral. Even if you are eating plenty of fruits and vegetables, typically the farm land on which they’ve been grown has been tilled for so many decades that it’s depleted of nutrients. Vitamins and minerals perform a wide range of functions in the body that encompass mood, metabolism, cardiac health, bone and skin health, and more. Vitamin C, for example, plays a role in collagen production in the skin to keep it looking firm. And unfortunately, unless you are preparing all your meals from your own garden, it is difficult to achieve optimum vitamin and mineral levels from the food you eat alone. People often have low levels of certain nutrients, commonly vitamin D and magnesium. A food based multi will contain a complex of nutrients that work together to increase absorption so Dr. Shah recommends them over cheaper multivitamins such as Centrum(TM).

Antioxidants: A multivitamin will contain the antioxidants vitamins C, E, and the mineral selenium. Antioxidants help to prevent oxidative damage to your cells that occurs naturally as by-products of normal body processes, from certain medications, and from air pollution. For even stronger anti-oxidant protection, Dr. Shah also takes astaxanthin. Astaxanthin has also been proven to improve eye health and reduce inflammation. (Buy only astaxanthin sourced from microalgae.) You can learn more about free radical damage, antioxidants, and astaxanthin HERE.

For brain health: Beginning an Omega-3 regimen as early in life as possible is helpful for optimizing brain function and preventing memory loss. Omega 3’s are also important for cardiac support and cell permeability to help the cells absorb nutrients. You can learn more about omega 3’s HERE. If you feel you need extra support with brain function or memory, a Lion’s Mane mushroom supplement is a great addition to an Omega-3 supplement.

For mood: Omega-3 supplements and the vitamin D and B vitamins found in a multi-vitamin are also helpful for mood. If you feel you need additional mood support for mild depression or anxiety, St. John’s wort has been shown to be effective for some people although it may take 1 – 3 months for it to take effect so be patient. St. John’s wort should not be taken with birth control pills, antidepressants, HIV medications, or blood thinners so if you are on any of these medications you should try 5-HTP instead.

Stress/adrenal health: Excess daily stress causes an ongoing “fight or flight” response whereby the stress hormones adrenaline, norepinephrine, and cortisol can become elevated causing excess wear on the body and also causing the body to hold on to fat stores. Trouble sleeping through the night is another effect. If you feel you lead a particularly stressful life and could benefit from some extra adrenal support, you can try holy basil, rhodiola, or ashwaganda (or an adrenal formula containing one or more of these). Rhodiola is especially good to take before workouts to promote endurance or try holy basil if you suffer from anxiety or sleeplessness.

For high altitude locations such as here in Denver, Colorado, you may want to try a chlorophyll supplement to help oxygenate the blood. Especially if you feel fatigued or experience dizziness, sleeplessness, or headaches.

IMPORTANT NOTE: It’s important to always buy quality supplements. Buying from a reputable health food store is recommended as they have high quality standards that their suppliers must meet. Buying supplements from other retailers or online outlets may be cheaper but unfortunately can be risky in terms of the quality, potency, or even authenticity of product you may be getting.

Mommy Makeover – What You Need to Know

Motherhood, with its ups and downs, provides the satisfaction of knowing that you have the opportunity to leave a good impression on this planet through the child you raise. However, one universally acknowledged downside of motherhood happens to be the toll it takes on the body.  For women who decide that they no longer want to live with the changes resulting from childbirth, there is the Mommy Makeover. The Mommy Makeover procedure consists of several procedures that address changes to the breasts and abdominal areas as the result of pregnancy and childbirth.


Breasts can change significantly during the process of pregnancy and breast-feeding. Breasts can get large, stretch out, involute (shrink), or stay the same size.  Areolae can stretch out and change shape.  Many women complain of a loss of fullness in the upper pole (upper part of breasts).  All these changes permanently alter the aesthetics of the breasts. While some of these changes can be camouflaged with bras and clothing, the limitations of these maneuvers mean that women still may have difficulty finding clothes that fit well and that they may still not be comfortable with the appearance of their breasts when naked.

Procedures such as breast augmentation with either implants or fat can revolumize the breasts providing fullness and better shape.  If the breasts hang too low, a mastopexy or breast lift operation can be performed to tighten the breast envelope placing the breasts higher on the chest wall in a more compact space.  A smaller percentage of women end up with large breasts after multiple pregnancies due to the amount of pregnancy hormone exposure.  For these women, excess breast tissue can lead to both aesthetic and functional problems.  Breast reduction surgery is an incredibly successful option to both reduce the size of breasts and lift/shape them.


The most obvious area of change from childbirth is the abdomen.  As a baby grows inside the womb, and the body responds to pregnancy hormones, the abdomen changes by stretching out the rectus abdominus (“6-pack”) muscles and thin out support structures like ligaments, etc.  After delivery, most women are left with some amount of loose skin and split musculature.  The greater the number of pregnancies, the worse the situation becomes.  Unfortunately, all the sit-ups in the world won’t fix this.

An abdominoplasty or tummy tuck operation is designed to improve this situation. This procedure involves removal of excess skin of the abdominal wall via an incision low on the tummy and around the belly button.  If the rectus muscles are split, then they can be repaired at the same time.  Repair of the muscles creates a corset effect tightening lax abdominal wall.

Excess fat

Lots of things happen both during pregnancy and in the years to follow.  For many women, the day to day aspects of living often make it so that their needs take a back seat to the needs of others.  Stress, poor nutrition, aging, etc. result in changes to the body.  The most common change is an increase in body fat.  When this can’t be corrected through diet, exercise, and changes in lifestyle, the options of surgical liposuction and non-surgical fat removal are available to those healthy enough for aesthetic intervention.

There are lots of options for liposuction and are well-described here.

Stretch marks

Stretch marks are definitely a problem for many women both before and after pregnancy.  Hormonal changes and stretching of the skin can result in breaks in the skin called striae, or stretch marks.  In the past there were few options for improving the stretch marks.  Nowadays, patients have a good number of options to help reduce the appearance of stretch marks.  In my practice, we offer the  Venus Viva, which is an RF (radiofrequency) microneedling device that can be used to tighten loose skin and rebuild collagen in the broken skin that leads to the development of stretch marks.  Several treatments are required, but the results tend to be very satisfying.

As you may have surmised by now, a Mommy Makeover is a very personal procedure custom-designed for each patient.  Some women will need only one procedure, while other women will need several procedures to achieve their goals. If you would like more information about the Mommy Makeover procedure, give us a call at 303-708-8234 or visit us at http://drmanishshah.com.

Antioxidants: Things You May Already Know And Some Things You Probably Don’t!

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Antioxidants protect the body from damage caused by free radicals. What’s a free radical you ask? A free radical is a harmful molecule that causes damage to the body’s cells and may contribute to aging. Some experts believe that this damage also plays a role in the development of some diseases including atherosclerosis and cancer. Free radicals come from a variety of sources. They come about naturally as by-products of normal body processes or when certain medications are metabolized. You are also exposed to free radicals through pollutants in the air.

A useful metaphor to understand antioxidants and free radical damage is to think of the paint on an old car. As the paint is exposed to the elements, it slowly breaks down or becomes oxidized and you can see the effects of the oxidation in the way the finish looks faded and dull. Think of free radical damage as having a similar oxidative effect on your cells, and antioxidants as protection from that damage which happens on a continuous basis through daily living.

Vitamin C and vitamin E are considered antioxidants as is the mineral selenium and plant based nutrients known as flavonoids. Of course, eating lots of fruits and vegetables are a good source of these antioxidants. Berries in particular are high in antioxidants (especially blackberries and blueberries). Also notably high in antioxidants are apples, plums, prunes, grapes, raisins, oranges, peaches, mangoes, melons, and artichoke hearts. Walnuts and pecans are also high in antioxidants and of course dark chocolate is famously high in antioxidants. But there are also many culinary herbs that are incredibly potent antioxidants, so the more of these herbs you add to your food the better! Many of them have other added benefits as well. Some examples of antioxidant herbs that do double duty…

  • Cloves have antimicrobial properties and are the strongest of all the antioxidant culinary herbs
  • Cinnamon is a potent antioxidant and also helps metabolize sugar
  • Oregano has antibacterial and antioxidant properties and can speed up the production of white blood cells
  • Turmeric and ginger are potent anti-inflammatory and antioxidant herbs

Other culinary herbs that are good sources of antioxidants are cumin, dried parsley, curry, sage, mustard seed, black pepper, thyme, marjoram, and chili powder so spice it up! India is known for having a lower incidence of most diseases, possibly because of the heavily spiced foods common in the Indian diet. So make your way to Bombay Clay Oven or Little India here in Denver for some curry or masala. Or better yet, learn to cook some delicious Indian dishes at home! Onward with our antioxidant discussion….

Dr. Shah’s favorite antioxidant is astaxanthin which is a red carotenoid. It is a uniquely superior antioxidant because it filters into every cell of the body. And its unique molecular lipophilic and hydrophilic properties allow it to saturate the entire cell, protecting both the fat soluble and water soluble parts of the cell. A 2007 study found it to be 6,000 times stronger than vitamin C, 800 times stronger than CoQ10, and 550 times stronger than green tea.

Astaxanthin is what makes salmon, shrimp, lobster, and crab pink or red in color. Astaxanthin also has a variety of other benefits in addition to being a great antioxidant. A naturally derived supplement made from microalgae is the best way to get all of the benefits. Eating the seafood mentioned above gives you a little but doesn’t give you enough to be considered a therapeutic dose. There have been hundreds of medical research experiments showing the health benefits of astaxanthin supplements sourced from microalgae as well as extensive safety trials. And unlike beta-carotene, an orange carotenoid, astaxanthin never becomes pro-oxidant or damaging to the body in higher doses. Just make sure you are taking a supplement with only microalgae as the source of astaxanthin. 12 mg per day is an optimal dose, however it is expensive so you may want to take less.

The other benefits of super-antioxidant astaxanthin:

Relieving pain and inflammation—Similar to the often prescribed drug Celebrex for arthritis and acute pain, Astaxanthin has been proven to block the COX2 enzymes responsible for pain signaling but without the risk of addiction, heartburn, or GI bleeding. It has also been proven to reduce C-reactive protein (CRP) by more than 20 percent in only 8 weeks. (CRP is a marker for inflammation and the American Heart Association names it as a key indicator of heart disease.)

Eye health—Astaxanthin has the unique ability to reach your retina with its antioxidant goodness. Clinical trials have shown that it helps with retinopathy, macular degeneration, eye strain, and even helps you read fine print. Dr. Shah has noticed the improvement in his eyesight since taking Astaxanthin.

Great skin and sunscreen protection—there are consistent studies showing that Astaxanthin is excellent for helping maintain skin moisture, smoothness, and elasticity. And it actually reduces UV damage from the sun so take it with you (along with your sunscreen, of course) to the beach or your favorite Colorado hiking trails!

So there you have it, folks! Hopefully you have learned something you didn’t already know about the wonderful world of antioxidants. If you have any questions about antioxidants or nutrition, please drop us a line at info@drmanishshah.com. (Note: Dr. Shah has no financial interest in the manufacture or sale of any astaxanthin products.)

Omega-3’s… What are they and why are they good for you?

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February is Heart Health Month!

Should I take an Omega-3 supplement for my heart or should I just eat more fish? What if I am vegetarian or vegan? And what are the other benefits of Omega-3’s?

No doubt by now you’ve heard a lot about Omega-3’s. You may have wondered—should I take a supplement? If so, does it really matter which brand I choose? Or should I just incorporate more Omega-3’s into my diet? What exactly do they do? What if I’m vegetarian or vegan and don’t want to eat fish or take a fish oil supplement?

Well, wonder no more! Here’s an all-inclusive look at how Omega-3’s function in the body and what diseases they may help you to stave off, as well as information about increasing your Omega-3 intake whether you are vegetarian/vegan or not.

Omega-3 fatty acids regulate cellular processes as well as producing and balancing hormones. Hormones are critical to the proper functioning of all the body’s systems. Think of them as messengers who tell the body and the brain what to do as far as metabolizing food, sleeping, mood, reproduction, and so on. Omega-3’s also increase cell membrane permeability for better nutrient absorption into the cells and they also help keep toxins out of your cells for better cell health and longevity. Healthy fats are also important in helping the body absorb fat soluble vitamins A, D, and E, and K (from food or from supplements).

Your body does not produce Omega-3’s, they come only from your diet or from supplements. There are two Omega 3’s, known as EPA and DHA. In addition to their role in hormone production and cell permeability, Omega-3’s are also anti-inflammatory. Inflammation is the source of almost all disease including heart disease so increasing your Omega-3 intake is a great way to lower your risk of heart and other diseases.

The potential heart health benefits of Omega 3’s:

  •  Helps with lowering blood pressure
  • Helps with lowering LDL (bad) cholesterol
  •  Helps with keeping the heart beating regularly
  •  Helps reduce the risk of a heart attack
  •  Helps reduce the risk of stroke by thinning the blood

Some additional potential benefits of Omega 3’s:

  •  Can help with balancing blood sugar which helps curb sugar and carb cravings thereby lowering the risk of diabetes and obesity
  •  Supports myelin sheath strength (the fatty acid layer that covers nerve fibers in the brain)–this helps with brain synapse function for better mental focus and brain health
  • Can help with memory and with reducing the risk of Alzheimer’s disease which is again related to inflammation
  • Can help with ADD, ADHD, and dyslexia
  • Can help maintain a positive mood
  • Can help with mood disorders such as depression and bipolar disorder– for mood disorders, you should take a high EPA fish oil supplement
  • DHA supplementation was shown in one study to reduce stress and aggression
  • Can help with osteoarthritis and rheumatoid arthritis– for arthritis, it is best to take an Omega 3-6-9 combination supplement
  • Can help with gastro intestinal issues such as constipation, IBS, colitis, and Crohn’s disease—for GI problems, it is best to take an Omega 3-6-9 supplement

Consuming more wild caught fish, grass fed meat, and nuts (especially walnuts) is a great way to increase your Omega-3 intake although taking a supplement is an easy way to get a consistent, optimal dose. A 1000 mg. daily dose of fish oil (usually one soft gel) is probably sufficient if you don’t have a particular health problem although you can do up to 4000 mg. daily for maximum benefit or if you have a specific health condition. Fish oil soft gels can be frozen if stomach upset or “fish burps” occur.

If you decide to take a supplement, it’s important to take a high quality supplement. With cheaper brands, it’s likely that the oil was not kept cool during processing which causes it to oxidize and degrade. Once fish oil becomes rancid, it becomes pro-inflammatory rather than anti-inflammatory. Natural FactorsTM manufactures a cost effective, high quality Omega-3 supplement if cost is a concern. There are many other brands of high quality fish oil, however.

TIP! Take Vitamin C with your fish oil! It’s an inexpensive antioxidant that will help keep the fish oil fresh for maximum benefit as it travels through your digestive tract. And Vitamin C has the added benefit of helping build collagen to keep your skin looking firm and your blood vessels, muscles, and bones stronger!

Omega-6’s were mentioned earlier in reference to Omega 3-6-9 supplements. People are often confused about Omega-6’s. There are two, one called GLA and another called arachidonic acid. GLA is anti-inflammatory and most people do not get enough in their diet. Arachidonic acid is pro- inflammatory and most people get too much in their diet. So increasing both your Omega-3 and Omega-6 GLA intake helps to counteract the pro-inflammatory arachidonic acid that most people get too much of in their diet. Another benefit of GLA is that it’s great for your skin. It can help your skin stay moist in our dry climate here in Denver and can help with skin conditions such as acne, eczema, and psoriasis. Supplementation (borage or evening primrose oil) is the easiest way to increase your GLA intake although hemp seeds and hemp oil are good dietary sources of both Omega-3’s and GLA.

Finally, for people who are vegetarian or vegan it is even more important that you incorporate extra Omega-3’s into your diet as a vegetarian diet is typically low in Omega-3’s. In addition to the benefits already mentioned, the Omega-3 DHA is important for avoiding neurological disorders such as Parkinson’s disease which can be a higher health risk for vegetarians/vegans later in life. Eating lots of nuts can help, especially walnuts, as well as hemp seeds and hemp oil. And there are several vegetarian DHA supplements derived from algae although they are fairly expensive. Look for the brand name Ovega-3TM for a vegetarian supplement containing both DHA and EPA.

If you have any questions about Omega-3’s, you can send us an e-mail at info@drmanishshah.com.

What is Hyaluronic Acid? And Why Do You Want It?

Hyaluronic acid (HA) is a natural substance found in your own body as well as in topical serums and creams. Believe it or not, it is also the primary active ingredient in most injectable fillers used to replace lost volume in the face, for contouring purposes, or to fill in wrinkles and smooth the skin.

Hyaluronic acid is not an acid in the typical sense. It’s not a harsh chemical and it doesn’t strip your skin. In fact, it loves water. HA is a polysaccharide (complex sugar) that can absorb up to 1000 times its own weight in water. Application of HA-containing products leads to increased moisture in the skin which is especially great in dry climates.

In your body, HA is found in several places. It’s located in between skin cells, where it holds water keeping the skin plump and moist. It’s also found in the eyes and in joint spaces, providing lubrication and shock absorption. As we age, the amount of HA in our bodies is diminished. This leads to volume loss, dullness, and a more weathered appearance of the skin.

There are no skin conditions or skin types that cannot benefit from use of HA. In fact, most OTC beauty products that claim to be anti-aging will have at least a small amount of HA in them. Medical grade products, however, will contain higher levels and a higher quality grade of HA. HA serums and creams can be used under sunscreen and other products to humidify the skin and keep it plump and firm, reducing fine lines and wrinkles. Consistent, prolonged use leads to long-term support for the youthful appearance of the skin.

Shah Aesthetic Surgery recently launched Alchemy, our medical grade skin care product line containing HA. Our moisturizer for daytime use contains a high level of hyaluronic acid to increase water content in the skin, firming and plumping up the delicate tissues of the face where our skin needs the most support. Colorado’s semi-arid climate is very drying to the skin so it’s especially important to give it some extra support to keep it moisturized.

You can also find HA in pill form. Long term benefits of taking HA supplements are unknown. It may do you some good and there are no safety concerns, but using HA topically is a more sure fire way to benefit the skin.

As mentioned, HA is also found in injectable fillers such as RestylaneTM, BeloteroTM, JuvedermTM, and VolumaTM. These fillers have very consistent results in replacing lost volume in the face, contouring, filling in wrinkles, and smoothing the skin. HA fillers last between 6 and 24 months depending on which filler is used. At our office in Denver, Dr. Shah is an expert injector for these fillers and in using them is able to achieve significantly improved, natural looking results. Injectable fillers with HA are a very widely used non-surgical cosmetic treatment.

Another use of hyaluronic acid is in the treatment of osteoarthritis. Injections of HA into the joint can help improve shock absorption in joints affected by OA. Injections can also give temporary relief from joint pain, especially when combined with other treatments for OA.

With its many applications, use of hyaluronic acid is an important player in anti-aging both cosmetically and physically. If you are interested in use of HA in skin care or injectable fillers, contact us for more information.

Be careful about having your cosmetic surgery overseas!

So you have made the decision to have cosmetic surgery?  That is a great thing.  Now you have to figure out how to pay for it.  As you can imagine, the cost for cosmetic surgery typically isn’t cheap here in the U.S. Because of this, more Americans are contemplating going out of the country to have their procedures. Destination surgery is getting to be big business, and for the most part is fairly safe.

Here are some things that you must think about before you take the plunge:

1. While cheaper prices are attractive, it is important to factor in the cost of travel, hotel stays, care givers, “extras”, and return visits for check ups.  This can get quite pricey.  Video conferencing with sites like Skype can ease some of the postoperative burden.

2. Having a good support system to help you when you are recovering might be harder to find when you are far away from family and friends.  The cost of a plane ticket alone for a friend or family member could be enough to pay for another procedure.

3. Language barriers between you and your caregivers can leave you with a confusing picture of your surgical journey.

4. The training and credentials of the plastic surgeons in the foreign country may be difficult to reliably gauge and compare to the often superior training of surgeons in the U.S.

5. The state of surgical and perioperative facilities in these foreign countries may be less advanced than in the U.S., although international standards are being implemented in many countries as a way to level the playing field and ensure quality control.

6.  If you have a complication, it may be impossible to get back to the original surgeon to be evaluated and managed.  Patients with complications from surgery performed outside of the U.S. report finding it nearly impossible to get a U.S. surgeon to take up their continuing care.  If they do find such a surgeon, it tends to be very expensive.

With all the surgical talent here in the U.S. it is often hard to understand why a patient would want to go out of the country for their care.  If you are one of these patients, make sure you are armed with the necessary information to make the best decision you can prior to boarding that plane.  Cost should not be your sole motivating factor, no matter how much you think you are saving!

Summer Skin Care – The Basics of Looking Good!

Well here in Denver, Winter is about to be over!  Signs of Spring are all over the place.  I’ll be going up into the mountains for one last hurrah on the slopes with the family.  Summer is the next hurdle for patients of Shah Aesthetic Surgery.  Being a mile up in the air makes for some brutal skin aging.  The air is thinner, colder, and dryer.  The sun is definitely more intense.

People age much faster in my opinion in this alpine desert environment.  There are things you can do about it, so don’t fret!

Here is a list of simple options for great Summer Skin Care:

1. Water – drinking water keeps your skin cells plump and protected.  Summer in Denver means more outdoor activity.  This means more sweating, so keep your water intake high to protect your skin.

2. Sunblock – I am a big advocate for high SPF sunblock.  I personally use a 55 SPF sunblock with UVA/UVB blocking capabilities.  While sunblock in makeup is a good idea, it just really isn’t enough protection up here in Denver since we really get intense sun exposure more than 275 days per year.

3. Vitamin C – this vitamin is really the most important vitamin for making new collagen.  Since is it water soluble 1000-2000mg daily is a safe dose.

4. Exfoliant usage – I am a fan of topical exfoliant serum usage.  Retinols and Vit C/E serums top my list.  I personally prefer Vit C/E because it more gently treats my skin and is safer in sun exposed populations. That being said, Retinols are the superior serum.  Just remember to wear good sunblock and protect your face with a big hat.

5.  Chemical peels – Winter’s cold, dry air has done a number on your skin.  You can recapture some of the ground lost in the war on facial aging by getting a chemical peel.  A chemical peel uses different safe organic acids to gently loosen skin and have it peel off.  This is a more immediate result than the use of exfoliant serums alone.  Depending on the strength of the chemical peel, you can have one as often as on a monthly basis.  Skin looks brighter with a more even texture when you get a chemical peel.  Heck, I even gently peel my own face.  If you see me in person, you’ll realize why I am such a fan.  They are easy to do, easy to recover from, are low risk, and give results!

6.  Eat cleanly – this is a no brainer!  What you put in your body shows in your skin.  Here in Denver, there is no shortage of good food.  I eat both natural and organic as much as I can.  It is expensive, yes, but well worth it when done carefully.  But, even if you shop at a conventional grocery store, you can make healthy choices that will benefit your overall health.  And, everyone knows that Healthy is a lot sexier than Unhealthy!

Now get to it!