The Editor
The Straits Times
390 Kim Seng Road, Times House
Singapore 239495
8 September 1997

Dear Sir,
Re: ST article on 26.5.97: ”Doctor studies effectiveness of ‘youth’ hormones”.

I would like to clarify some of the points in the article which have inadvertently led to misunderstanding amongst my peers and
some relevant authorities.

The “study” as quoted in the article is purely an observational study as opposed to a treatment study. The drugs are being prescribed, supplied and modified by the patients own respective doctors in the United States. These patients are on a “rejuvenation program” by one of many such centres in the United States. They require close monitoring of their hormonal status so as to minimise side-effects, if any. But because they are unable to keep returning to the U.S. centres for their blood tests, they have approached me to perform these blood tests and to fax the results to the respective centres. I have found it an excellent opportunity to “study” these individuals with regards to observing the hormonal changes on treatment and to physiological and mental changes they experience. My function has been advisory on the doses they should be taking, but the final decision on treatment dose is still the responsibility of their primary physicians in the U.S. So far, small as the numbers may be, no one has had any adverse effects. Most have had noticeable difference in physical and mental abilities. These findings do not in any way confirm the beneficial properties of this kind of therapy, however, it does certainly warrant further investigation into its therapeutic or “rejuvenating”  properties.

The drug, DHEA is not registered for use in Singapore and I am glad that you had mentioned the possible side-effects of the drug. However, this drug can be easily bought over the counter in the U.S. and there are many well travelled and well-read individuals who have started self-medication. They have found the article very enlightening and now realise the need for physicians advice on its use. Some were taking large amounts with the mistaken idea that more was better. They have been advised to stop immediately. Like most drugs, when taken for the right indication and in the right amount they are helpful, but when taken indiscriminately or in large quantities they are bound to produce side-effects which only serves to damage the therapeutic reputation of the drug.

I was also quoted to have said, “By right, it should be the specialists in geriatric medicine who are studying such hormones...”. This statement had been construed by the geratricians as deprecatory. I have absolutely no intention to deprecate my colleagues and have the utmost respect for what they are doing. I wish to clarify that the answer given was in response to a question put forward to me as to why as a gynaecologist I have an interest in ageing. My response was to agree that most of the existing work intentionally were performed by Geriatricians. Unfortunately, in Singapore we have inadequate numbers of specialists involved in Gerontology. Their existing responsibilities in the care of the aged so inundate them that such a study would not be in their top list of priorities. It was unfortunate that the quote seemed to suggest that they were not doing what they should be doing. This was certainly not my intention.

I hope you will be able to help me set the record straight.

Yours sincerely,

Dr Paul S L Tseng
Consultant Obstetrician and Gynaecologist
TLC Gynaecology Practice

cc Dr Cheong Pak Yean
 Chairman, SMA Ethics Committee & President, 38th SMA Council