8:00 AM - 8:50 AM
Functional Nutrition: a Hormone Healthy Meal Plan
Steven C. Masley, M.D., FAHA, FACN, FAAFP, CNS
President, Masley Optimal Health Center, St. Petersburg, FL
CEO, Heart Tune-Up, LLC
Medical Director, Ten Years Younger Program™
Clinical Assistant Professor, University of South Florida, Tampa, FL
Special Program Instructor, Eckerd College and the University of Tampa
Lecture Description:
Physicians routinely are asked by patients to address supplement and nutrient questions, but the majority of physicians have little or no formal education in nutrition and often are forced to rely upon inadequate clinical information. Nutrition related health issues impact four of the most important causes of mortality and morbidity in a major way, namely cardiovascular disease, cancer, obesity, and diabetes. The objectives for this talk will be to:
1. Clarify the importance of nutrition for hormone health;
2. Identify the Top Ten Most Important Nutritional Deficiencies that Impact Clinical Outcomes;
3. Propose EB Recommendations to Correct These Highly Important Deficiencies;
4. Clarify dosage recommendations for fiber, vitamin D, fish oil, vitamin K, calcium, magnesium
8:50 AM - 9:40 AM
Decreasing the Risk of Cognitive Decline with Hormone Optimization: The Under Recognized Critical Missing Link
Kenneth Janson, M.D., FACS
Senior Attending Physician, Northwestern Lake Forest Hospital
Lecture Description:
Cognitive decline is now emerging in epidemic proportions in the aging population. Many new pharmaceutical products are being developed to slow the progression of cognitive decline and Alzheimer’s disease, but results have been limited at best. The medical literature has focused on many genetic and environmental etiologies and proposed therapies, but there is scant clinical literature focusing on the association of hormone decline and cognitive decline. This presentation will review laboratory data and clinical experience that demonstrates the apparent protective effect of hormone optimization on cognitive function, as well as the potential reversibility of cognitive decline if detected early in the disease process.
9:40 AM - 10:30 AM
Testosterone Replacement Therapy: How to Administer Expert TRT
John K. Crisler, D.O.
President, Founder & CMO, Superior Age Management, AllThingsMale Center for Men's Health, Lansing, MI
Dept. of Community & Family Medicine, Michigan State University College of Osteopathic Medicine, East Lansing, MI
Lecture Description:
Start-to-finish, through everything needed in order to administer not just competent, but expert Testosterone Replacement Therapy (TRT). The talk begins with diagnosing the disease of hypogonadism, including laboratory panels, then moves into the various treatment options, and finally the general strategy behind TRT. Next comes Dr. Crisler’s revolutionary HCG Protocol, generally accepted as the most advanced TRT protocol yet devised. This lecture is truly a “Recipe for Success” in TRT medicine.
10:30 AM - 10:45 AM
Break
10:45 AM - 11:30 AM
Stress and Toxins: The Two Inconvenient Neuro-Immune-Hormonal Disruptors
Shanhong Lu, M.D., Ph.D.
Owner, Mt. Shasta Integrative Medicine, Mt. Shasta, CA
Owner, Redding Integrative Medicine, Redding, CA
Executive Director, Orenda International, Tempe, AZ
Lecture Description:
Modern science, research, and conventional medical paradigms have seriously compartmentalized human body, wellbeing, and sickness. The effort of finding that one magical pill for each of our intracellular organelles, various cells, tissues, organs, and systems has been a long but fruitless journey. I walked away confused and overwhelmed after many trips to CMEs, hormone conferences, nutritional seminars, and emotional/energetic/spiritual workshops about just where we should all start. I did make many attempts to incorporate individual supplements and hormones with unsustainable long lasting results. As a stressed, insomniac, premenopausal woman myself 7 years ago, I was struggling with compartmentalized symptoms and challenges. I discovered the root causes for 80-90% of modern life issues are chronic stress and environmental pollution. This lecture is designed to introduce to the busy practicing physician the following topics: (1) how chronic stress disrupts the “house of wisdom”—the hypothalamic-pituitary axis—leading to the silent epidemic of neuroendocrine decline and aging; (2) how chronic stress also disrupts the effective communication and collaborative hormonal functions of the adrenal, thyroid, and reproductive glands; (3) the main groups of modern-life endocrine disruptors and neurotoxins encountered in our daily lives and a few examples of their effects on receptor-ligand availability and their competitive disruption of natural hormone effects; (4) the effects of
stress and toxins together on our digestive system and the consequences of leaky gut; (5) a working proposal with a simple solution—a 4-step approach to foundational health transformation; (6) case discussions as time allows.
11:30 AM - 12:15 PM
Focus On The Brain: Are We Missing the Cure for Alzheimer's and Dementia?
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
Lecture Description:
Hormones can affect memory, dementia, Alzheimer's, and brain preservation in both positive and negative ways. The WHI Trial proved that hormones increased the risk of Alzheimer's disease. Unfortunately that was misstated. In the final analysis, HRT was proved to increase dementia which was inappropriately claimed to be Alzheimer's, whereas it was actually a vascular dementia and not Alzheimer's. Most doctors think otherwise.
The pharmaceutical industry struggles to find a cure for Alzheimer's with nothing in sight per most recent literature search. Nevertheless the scientific literature now supports a decrease in beta-amyloid protein via various hormonal substrates. This evidence based review introduces the research demonstrating not only the protection against the beta-amyloid protein deposition but also the reversal of the plaque from the neurons that is the pathology in causing Alzheimer's. No other research has proved this with any medicine, yet the evidence we do have is ignored as well as the mechanism for removal of the plaque by alpha secretase. Awareness of this data and the various strategies presented should be at the forefront of preventive medicine.
12:15 PM - 1:30 PM
Lunch Break
1:30 PM - 2:20 PM
The Science of Growth Hormone Secretagogue Technology
Mark L. Gordon, M.D.
Medical Director, Millennium-TBI & The Millennium Health Centers, Encino, CA; CBS Studios;
USC, Keck School of Medicine, Department of Family Medicine, Los Angeles, CA
Medical Director of Education, Access Medical Laboratories, Jupiter, FL
Member, AMMG Conference Planning Committee
Life Member, AMMG
Lecture Description:
The recognition and acceptance of non-peptide, synthetic complexes as potent growth hormone (GH) secretagogues has been less than positive due to a number of perceived limitations. These perceptions were based upon our lack of scientific evidence to support the supposition that something other than a complex peptide, such as growth hormone releasing hormone (GHRH) could increase a hormone’s production. Additionally, we lacked the scientific knowledge about flexible receptors that could accept a broad range of chemical structures that would lead to the stimulated production or suppression of a hormone. Finally, we are starting to understand more about the complex influences that hormones, peptides, and amino acids have on the hypothalamic-pituitary axis. Firstly, past research data was based upon small test groups of individuals that were given large quantities of mixed amino acids designed to enhance GH production and release. Although many of these compounds demonstrated a measurable elevation in the GH/insulin-like growth factor 1 (IGF-1) axis, many were also associated with osmotic diarrhea, making it a difficult pill to swallow. Secondly, delivery of amino acids by mouth has a poor bioavailability due to its destruction and inactivation by gastric acid. A large compensatory dose is then needed to correct for this diminished availability, thereby leading to the side-effect of diarrhea. Thirdly, since the action of a secretagogue is to increase the amplitude and duration of
intrinsic GH secretion, the normal regulatory or homeostatic mechanism (positive feedback and negative feedback) is preserved. When a secretagogue elevates the intrinsic production of GH above the body’s inherent set-point, Somatostatin release (also known as somatotrope release inhibiting factor [SRIF]) causes the suppression of intrinsic GH production. This, in turn, can lead to the waxing and waning of GH/IGF-1 levels, making it difficult to accurately assess the net effect. These issues have generated the majority of resistance to the use of secretagogue in healthy individuals with low GH, IGF-1, and insulin-like growth factor binding protein 3 (IGFBP-3) levels. This presentation will provide current, evidence-based scientific literature, and clinical results to support the use of a secretagogue as a logical “first step” approach to the treatment of GH deficiency in healthy individuals.
2:00 PM - 7:00 PM
Exhibits Open
2:20 PM - 3:10 PM
Men’s Sexual Health: The Hormone Connection
Jeffry S. Life, M.D., Ph.D.
Clinic Physician, Apeiron, Charleston, WV
Board Certified, Family Medicine
Diplomate, American Board of Family Practitioners
Fellow, American Academy of Family Physicians
Lecture Description:
Male Sexual Health: Since the early 1800s sexuality in America has been very controversial. Doctors and nurses who were among the first advocates of birth control and family planning were thrown into jail while the majority of medical schools provided little or no training in contraception. It wasn’t until the mid-1900s with the first issue of Playboy and the FDA approval of “the Pill” that sexuality became a social movement. With the development of erectile enhancement drugs there have been radical changes in the way Americans view sexuality and the role men play in this paradigm shift. This male sexual health talk describes the shift in the way physicians have been trained to look at sexual function. How sexual function can be a barometer of overall health will also be reviewed. In addition, this talk will include the importance of testing and evaluating sexual function in men, how to develop treatment strategies to detect any underlying health abnormalities related to sexual dysfunction, and what to do about it.
3:10 PM - 3:55 PM
Break - Visit Exhibits
3:55 PM - 4:40 PM
Adult Growth Hormone Deficiency
Edwin N. Lee, M.D., FACE
Assistant Professor of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL
Founder, Institute for Hormonal Balance
Member, AMMG Conference Planning Committee
Lecture Description:
Growth hormone is an essential hormone in lowering body fat, improving on lipids, keeping muscles healthy and improving on bone density. These and other benefits from the use of growth hormone will be covered. In addition, adult growth hormone deficiency symptoms will be reviewed, as well as the role of growth hormone deficiency increasing inflammation, and the association of higher mortality with growth hormone deficiency. The normal physiology and role of IGF-1, IGF Binding Protein 3 will be discussed. Clinical trials with recombinant growth hormone will be covered. The diagnosis of adult growth hormone protocols will be reviewed, as will the treatment of recombinant growth hormone, IGF-1 and with IGF-1 and IGF BP-3.
4:40 PM - 5:30 PM
Looking Younger Through Hormonal Balance
Edwin N. Lee, M.D., FACE
Assistant Professor of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL
Founder, Institute for Hormonal Balance
Lecture Description:
In this lecture you will learn about the pathway of aging, which comes down to chronic inflammation and excessive oxidative stress. (The production of excessive free radicals increases oxidative stress and chronic inflammation that will damage DNA and or the mitochondria. Eventually, further DNA damage will lead to premature aging, chronic disease, cancer and death.) Data on the effects of altering this pathway of reducing chronic inflammation/ oxidative stress will be presented on certain areas in Endocrinology. The use of bioidentical hormones, which has been a controversial issue, will also be reviewed. Also, data regarding the effects of hormonal balance on protecting the DNA will be discussed.
5:30 PM - 7:00 PM
AMMG Welcome Reception
8:00 AM - 9:00 AM
The Integrative Business Approach as a Strategy for a Successful Age Management Practice
Derrick M. DeSilva, Jr., M.D.
Chairman, AMMG Conference Planning Committee
Senior Attending Staff, Dept. of Medicine, Raritan Bay Medical Center, Perth Amboy, NJ
Teaching Faculty, JFK Medical Center, Edison, NJ
Lecture Description:
Some simple and basic strategies will be reviewed on how to make your age management medicine practice truly profitable. I will review what "sales strategies" and marketing strategies I have used over the past 20 years in my age management medicine practice to stay profitable.
9:00 AM - 9:50 AM
Adapt-or-Die Time: How Medical Practices Can Use New Marketing Tools to Thrive in an Industry Transformed by the Affordable Care Act
Raquel Baldelomar
Founder & Managing Director, Quaintise, Los Angeles, CA
Lecture Description:
Today, many healthcare providers—especially small practices—find themselves in an adapt-or-die situation. The shared-responsibility provision of the Affordable Care Act will present a huge opportunity to those providers equipped to take advantage of it, but most will have to adapt to do so: Many more Americans will soon have healthcare coverage, and to capture a significant share of this influx of new patients, offices will need to develop new patient-interfacing tools to improve patient experience, convenience, and education, and to help their practices stand apart from the competition. In this lecture, I’ll address:
· Examples of such tools, and how the healthcare providers I’ve worked with have built and now utilize them;
· How patient-interfacing tools are likely to evolve going forward; and
· The ways in which these tools can help healthcare offices leverage Big Data—the biggest driver of value in the wider marketing industry—by targeting messaging to specific demographic segments and stretching limited marketing budgets.
9:50 AM - 10:30 AM
How to Utilize Ancillary Wellness Staff to Create a Successful Integrative Healthcare Practice
Linda M. Haggard, MPAS, PA-C
Certified Physician Assistant, Sedona Integrative Medical Clinic, Sedona, AZ
Eric A. Haggard, PT
Physical Therapist, Sedona Integrative Medical Clinic, Sedona, AZ
Lecture Description:
This session will address utilizing providers such as Physician Assistants, Nurse Practitioners, Physical Therapists, Psychologists, Physical Trainers and Nutritionists within the Age Management practice to provide increased patient care and education, expertise, and profits for the practice. We will include a basic plan with very specific examples of utilization.
10:30 AM - 10:45 AM
Break
10:45 AM - 11:30 AM
Transforming Lives – One Patient at a Time: Designing Patient Experiences that Improve Patient Outcomes and Differentiate You from the Competition
Gregory W. Petersburg, D.O.
Owner & Medical Director, Renascence, Tucson, AZ
Owner, Living Younger Lifestyle & Proactive Aging Medicine System
Lecture Description:
Defining experiences are what catapult us from our current course in life to a new one, and they provide the momentum to continue along this new course long-term. Understanding the relationships between personal experiences to initiating significant life changes, and applying this knowledge in a clinical setting with patients can improve the likelihood of their achieving and sustaining healthful lifestyles. Personal experiences, as an economic offering, are also largely untapped in the medical profession. While widely understood in many industries this topic is relatively new territory to the medical profession, but has particular relevance to the specialty of age management medicine. This presentation gives the clinician an overview of the subject of ‘designed patient experiences’, including principles for practical application to the clinical and business sides of medicine.
11:30 AM - 12:15 PM
The 2012 NECC Meningitis Outbreak Tragedy: What Happened? What is Happening in Congress and in the States Affecting Practitioners, Patients and Compounding Pharmacists?
Sarah Dodge-Palmer
Vice President Government Affairs, International Academy of Compounding Pharmacists (IACP)
Lecture Description:
Lecture will cover the background on the NECC tragedy and failures of the system that led to the problems which occurred. Since that time there have been a number of State and Federal remedies both legislative and regulatory as well as enforcement which will be discussed. Most importantly physicians need to know how to create a collaborative relationship with a compounding pharmacy based on quality and reputation.
12:15 PM - 1:30 PM
Lunch Break
1:30 PM - 2:15 PM
Transitioning Medical Aesthetics into an Age Management Practice
Gregory Allen, M.D.
Medical Director & Aesthetic Provider, Desert Aesthetic & Lifestyle, Mesa, AZ
Preceptor, A.T. Still University, Mesa, AZ and Grand Canyon University, Phoenix, AZ
Lecture Description:
Dr. Allen will simplify the transition by discussing additional aesthetic services with minimal expense utilizing auxiliary staff. He will discuss each office-based aesthetic service, the training involved, start-up expense, suitable provider and additional revenue generated per month. Topics will include the use and incorporation of Botox, Fillers and Micro Needling. These treatments are in demand and have low start-up cost and great patient retention rates.
2:00 PM - 7:00 PM
Exhibits Open
2:15 PM - 3:00 PM
Essential Qualifications and Knowledge for the Age Management Physician – The Advantages of Specialized Training and Certification
Jeffrey P. Leake, M.D., ISSA-CPT
Senior Institute Physician, Course Director for Physician Training and Certification in Age Management Medicine, Cenegenics Medical Institute, Las Vegas, NV
Lecture Description:
This lecture will discuss and outline areas of essential knowledge that physicians must be familiar with in order to adequately treat age management patients including the evaluation of the patient and those clinical areas which would be included in treatment plans. He will also outline what areas of expertise the physician should obtain in order to adequately manage the patient, and the types of training available at this time.
3:00 PM - 3:45 PM
Break - Visit Exhibits
3:45 PM - 4:45 PM
Insuring the Age Management Medicine Physician: Beyond the Basics
John J. Rush, M.D., FACEP, MBA, MHA
Age Management Physician, Washington, D.C.
Founder & Chairman, Longevity Physicians Insurance Company
John Palmer
Vice President, Oceanus Insurance Company, Charleston, SC
Lecture Description:
At past AMMG Conferences, Dr. Rush and Mr. Palmer have talked about the basic insurance products you need to protect your business. So, whether you're starting an age management medicine practice or already have a growing one and want to protect it, this session will present a lively discussion about all the things that can (and some will!) go wrong. Without adequate insurance, your practice’s financial health could be seriously compromised. Imagine, for example, if you had to deal with any of these situations: Several of your employees file a lawsuit alleging discrimination. A trusted employee embezzles from the practice. The government investigates alleged overbilling of Medicare services. An employee sues over alleged pension mismanagement. A hacker demands payment under a threat to publicize proprietary patient information. A disgruntled employee carries out a violent attack in the workplace. We will discuss and update you on all of the insurance options available to protect you and your practice.
4:45 PM - 5:30 PM
Q & A Session on Practice Management
Lecture Description:
Panel Discussion with Derrick DeSilva, Jr., M.D., Linda M. Haggard, MPAS, PA-C, Raquel Baldelomar, Sarah Dodge, Jeff Leake, M.D., John Rush, M.D., Gregory Petersburg, D.O., Greg Allen, M.D., Eric A. Haggard, PT
5:30 PM - 7:00 PM
AMMG Welcome Reception
8:00 AM - 8:05 AM
Opening Remarks
Derrick M. DeSilva, Jr., M.D.
Chairman, AMMG Conference Planning Committee
Senior Attending Staff, Dept. of Medicine, Raritan Bay Medical Center, Perth Amboy, NJ
Teaching Faculty, JFK Medical Center, Edison, NJ
8:05 AM - 8:30 AM
Presentation of the Alan P. Mintz, M.D. Award
8:30 AM - 9:30 AM
Lp-Pla2: The PLAC Test, in Clinical Practice and Patient Management
Cesar M. Pellarano, M.D.
Preventive Cardiologist, Miami, FL
President, Founding Partner and Chief Medical Officer, Hillstar Health LLC, Miami, FL
Lecture Description:
Lp-Pla2, also known as the PLAC test is now widely available in most commercial laboratories, yet it is clearly underused because clinicians are not aware of its important clinical value. This inflammatory marker is highly specific for vascular inflammation, therefore identifying the presence of vulnerable and ruptured plaques even in the asymptomatic patient. In this lecture I will demonstrate how the test is to be used and interpreted. I will also inform the physicians on how to utilize the test in their clinical practice and in the management of their patients.
9:30 AM - 10:15 AM
Break - Visit Exhibits
10:15 AM - 11:15 AM
The Implications and Impact of Poly-Pharmacy on Aging
Derrick M. DeSilva, Jr., M.D.
Chairman, AMMG Conference Planning Committee
Senior Attending Staff, Dept. of Medicine, Raritan Bay Medical Center, Perth Amboy, NJ
Teaching Faculty, JFK Medical Center, Edison, NJ
Lecture Description:
Many of our patients are on multiple prescription medications. How do these medications impact the aging process and what can be done to counteract these potentially deadly side effects and nutrient depletions caused by all of the prescription medications?
11:15 AM - 12:00 PM
Clinical Genomics for Age Management Medicine
L. Stephen Coles, M.D., Ph.D.
Lecturer, Molecular Biology Institute, Department of Chemistry and Biochemistry, UCLA
Co-Founder, Los Angeles Gerontology Research Group
Lecture Description:
Following the sequencing of the human genome in 2003, the public was told to expect a flood of advances would soon find their way to the clinic. But this has not happened at the pace we were led to expect. Although the translation of genomics to clinical medicine is accelerating as costs continue to decline (in a pattern consistent with Moore's Law) and sequencing hardware has enabled us to generate a sequence in about 25 hours (previously at the level of the exome [~22,000 genes = 2 percent of our DNA], and now at the level of the entire genome [3.1 GBP's]), a bottleneck remains in interpretation of the data by an attending physician. The application of genomic approaches to screening and disease prevention raises complex issues beyond those encountered in normal diagnostic laboratory testing. Interpretation of an unusual SNP in the absence of an abnormal phenotype raises many challenges in terms of clinical utility, such as costs of testing and insurance coverage, costs of medical follow-up for abnormal tests, storage of information and its retrieval at a time when it is needed for the care of a patient, maintenance of privacy and confidentiality (encryption) consistent with US Government HIPAA regulations. The healthcare workforce will also need to adapt, both in terms of laboratory analysis and interpretation of data and in terms of its implementation at the point of care (either in the hospital or at the bedside at home). It is likely that the future of medical care will
evolve rapidly through the convergence of two disruptive technologies -- computer science and human genetics.
12:00 PM - 1:15 PM
Lunch Break - Visit Exhibits
12:00 PM - 1:00 PM
Physician Opportunities in Age Management Medicine: Your Path to a Successful Age Management Medicine Practice
John E. Adams
President and CEO, Cenegenics
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Cenegenics Elite Health
1:15 PM - 1:50 PM
Clinical Genetics and Epigenetics: The Emergence of Precision Medicine for Age Management
Florence Comite, M.D.
CEO & Founder, Comite Center for Precision Medicine, New York, NY
Member, AMMG Conference Planning Committee
Lecture Description:
Precision Medicine is the natural extension of personalized prevention that allows for the ideal practice of age management. Genetic screening is an essential component to this practice and is increasingly available. Obtaining the genetic make-up of individuals can help to identify potential disorders of aging. However, the genetic blueprint is not absolute, nor is it a predestined outcome. Genes do not dictate destiny, as it has become increasingly evident that Epigenetics has an impact on the expression of genetic make-up. Of additional import is the understanding that DNA switches can act to turn on or off the production of proteins that affect multiple actions that may dictate the advent of Type 2 Diabetes or hair loss among other multiple and complex actions that occur as individuals age. Genetic testing is rapidly being actualized in practice; the clinician should be comfortable with the interpretation and the value of diagnostic screening. Patients deserve a solid understanding of the relationship between their genes and disorders of aging. It is vital that the clinician understands how to integrate the various modalities that allow for the precise analysis of factors that may have a deleterious affect on the healthspan, and is prepared to balance, discuss, and position the possible outcomes in relaying test results. Overall, screening adds much to our ability to identify underlying influences that might tilt the scales toward various disorders of aging. At the same
time, it strengthens our ability to manage and motivate successfully. Further, it allows the clinician to set interventional priorities and weigh the risk-benefit scale of options. Precision Medicine for Age Management provides more guidance with respect to subsequent diagnostic tests and procedures as well as interventions, ranging from lifestyle to supplements and medications.
1:50 PM - 2:20 PM
The Telomere/Telomerase System in Autoimmune and Systemic Immune-Mediated Diseases
Keith A. Fleischman, D.O.
Associate, Robert Wood Johnson Medical School, New Brunswick, NJ
Senior Partner, Cenegenics, New York, NY
Lecture Description:
Review of the findings relating to telomeres and telomerase in autoimmune and systemic immune-mediated diseases. Oxidative stress, inflammation, and increased cell renewal accelerate the ongoing shortening of chromosomal telomeres. The telomere/telomerase system has been revealed to be involved in many pathophysiologic processes. There is evidence that there is modification of both telomere length and telomerase activity in systemic immune-mediated disease and that these modifications have a link to premature immunosenescence. Through attention to reducing accelerants of telomere shortening and through the use of supporters and activators of telomerase activity we may be able to exert influence on the prevention and treatment of these diseases.
2:20 PM - 2:50 PM
Break - Visit Exhibits
2:50 PM - 3:30 PM
How and Why to Use Telomere in your Clinical Practice: Telomeres 101
Elaine Chin, M.D., MBA
Founder, Executive Health Centre, Toronto, Canada
Lecture Description:
Telomere biology has provided healthcare professionals with a treasure trove of practical information to counsel patients about how to prevent chronic diseases. It’s on the rise and telomeres can help motivate all to get serious about reducing disease risk factors by ridding ourselves of bad lifestyle habits and adopting healthier ones. Understanding the root cause of premature telomere shortening is important. That’s why physicians should learn how to monitor their patients’ glycation, inflammation and oxidative stress risks and maintain hormonal balance. At the end of this session you will understand basic telomere biology, how to measure their length and what variables can slow down its premature shortening.
3:30 PM - 4:15 PM
The Nutrigenomic Solution: A New Paradigm for Enhanced Clinical Outcomes
Christine Houghton, B.Sc., D.C., R.Nutr., Ph.D. Cand.
Ph.D. Researcher, School of Human Movement Studies, University of Queensland, Brisbane, Australia
Co-author, Educational Program Translational Nutrigenomics, Manuka Science, Durban, South Africa
Managing Director, Cell-Logic Pty Ltd, Queensland, Australia
Lecture Description:
Chronic disease accounts for 63% of all deaths globally, primarily represented by cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. Many lines of converging evidence reveal that chronic oxidative stress underpins most if not all diseases as well as the ageing process. Where so-called ‘antioxidant’ vitamins can reduce markers of oxidative stress, the clinical evidence does not support their role in preventing disease or retarding ageing. Even their safety in high doses is now in doubt. So, after 60 years of dedication to a largely flawed theory, what do we do now? The evolving science of Nutrigenomics highlights ways in which human cells defend themselves against disease and premature ageing. Our endogenous cellular defence mechanisms rely on an intricate web of molecular signalling, markedly influenced by factors such as diet, exercise and mood. Overwhelming the cell with excessive antioxidant supplements inhibits these defences, a finding with enormous clinical implication and one which calls for clinicians to be more vigilant in their critical review of the technical data often used to support the available nutraceutical supplements. Without due consideration of bioavailability, nutrigenomic potential, clinically effective dose and relevance of the referenced data to the clinical environment, clinicians may misplace their confidence in worthless prescriptions. This presentation will review clinically relevant elements of the science of
Nutrigenomics, illustrating why this new paradigm in Nutritional Medicine provides clinicians with a greater range of tools for personalising treatment plans for their patients. Of the many diseases underpinned by the oxidative stress which disrupts cellular defence systems, discussion of nutrigenomic solutions will include autism, asthma, hormonal issues, hypertension, psoriasis, type 2 diabetes and cardiovascular disease. Nutrigenomics has direct implication in age management medicine, given its fundamental role in regulating and optimising endogenous cellular defenses.
4:15 PM - 5:30 PM
Genetics & Telomere Case Presentations & Panel Discussion
Florence Comite, M.D.
CEO & Founder, Comite Center for Precision Medicine, New York, NY
Member, AMMG Conference Planning Committee
L. Stephen Coles, M.D., Ph.D.
Lecturer, Molecular Biology Institute, Department of Chemistry and Biochemistry, UCLA
Co-Founder, Los Angeles Gerontology Research Group
Keith A. Fleischman, D.O.
Associate, Robert Wood Johnson Medical School, New Brunswick, NJ
Senior Partner, Cenegenics, New York, NY
Christine Houghton, B.Sc., D.C., R.Nutr., Ph.D. Cand.
Ph.D. Researcher, School of Human Movement Studies, University of Queensland, Brisbane, Australia
Co-author, Educational Program Translational Nutrigenomics, Manuka Science, Durban, South Africa
Managing Director, Cell-Logic Pty Ltd, Queensland, Australia
Elaine Chin, M.D., MBA
Founder, Executive Health Centre, Toronto, Canada
Lecture Description:
Cases regarding telomere and genomics in the clinical context of age management medicine will be presented, audience interaction and participation is encouraged.
8:00 AM - 8:50 AM
Assessing the Female Patient
Anna Cabeca, D.O., FACOG, ABAARM
Medical Director, Vida Pura Health, Golden Isles Medical, Inc., St. Simons Island, GA
Lecture Description:
Lecture designed to walk physicians through the process of assessing the female age management patient. Discussion will include appropriate evidence-based testing protocols and interpretation of test results for use in designing individualized patient treatment plans.
8:50 AM - 9:40 AM
The Silent Killer: Women and Heart Disease
George C. Shapiro, M.D., FACC
Adjunct Assistant Professor Clinical Medicine, New York Medical College, Valhalla, NY
Founding Partner, Cenegenics, New York City
Member, AMMG Conference Planning Committee
Lecture Description:
Cardiovascular Disease is the leading cause of death in the United States in both men and women, resulting in over one-half million deaths per year. However, only about one half of women surveyed realized that CVD is the major threat to their health. While mortality rates for CVD have fallen for both men and women in recent decades, they have done so more rapidly for men. In addition, hospitalizations for heart failure have increased at a faster rate for women than for men. Coronary heart disease (CHD) and heart failure risk factors, presentation, and management are different in some respects in women; the similarities and differences will be discussed in this presentation.
9:40 AM - 10:15 AM
Break - Visit Exhibits
10:15 AM - 11:00 AM
Hormone Replacement Therapy in Women and the Treatment and Prevention of Osteoporosis
Elizabeth M. Prusak, M.D.
Gynecologist and Associate Professor, Lahey Medical Center, Peabody, MA and Tufts University, Boston, MA
Lecture Description:
Hormone replacement therapy (HRT), either estrogen only (ET) or estrogen plus progesterone (E+P) has a beneficial effect on the hip and spine and is an excellent treatment for menopausal and perimenopausal symptoms. The Women’s Health Initiative study demonstrated a reduction in hip and vertebral fractures with the use of HRT. However, this was not sufficient data to apply for osteoporosis treatment due to the fact that osteoporosis was not diagnosed by a DXA or a history of a fracture in the study. However, HRT is approved for the prevention of osteoporosis in women who are at increased risk of a fracture. HRT products that are approved for prevention include standard doses of oral HRT and transdermal patches. Deciding on the duration of HRT is a challenge because guidelines in the past have stressed the importance of using the lowest dose of HRT for the shortest amount of time. This time period is typically 5 years or less. With only ET it is speculated that up to 15 years can be utilized. Thus, the provider must work closely with the individual patient to determine what is in her best interest with regards to the timing and dose of HRT for the prevention of osteoporosis.
11:00 AM - 12:00 PM
Breast Cancer Risk Reduction: Combining the Assessment of “Cutting Edge” Genetic and Metabolic Markers with a Nutrigenomic Based Treatment Plan
Rebecca R. Murray, APRN, FNP-BC, CDE
Endocrine Nurse Practitioner, Institute for Hormonal Balance, Orlando, FL
Medical Director, Ward-Murray HealthCare Consulting, Groton, CT
Scientific Advisory Board, Designs for Health
Lecture Description:
Breast Cancer remains the leading cause of death in younger women and the number 2 killer of women of all ages. Only 5% of women with breast cancer are diagnosed to have the BRCA “high penetrance” genetic mutation. There are many factors involved in the progression of breast cancer in the majority of women including: newly identified “low penetrance” genetic mutations with increased risk of estrogen sensitive cancers, Cytochrome P450 mutations that affect the metabolism and detoxification of estrogens, environmental exposure to estrogen mimickers (xenoestrogens), and nutritional deficiencies that compound other coexisting problems. This presentation provides information on assessment of standard risk factors in conjunction with “cutting edge” genetic testing, estrogen metabolism evaluation, and identification of interventions based upon the principals of Nutrigenomics.
12:00 PM - 1:15 PM
Lunch Break - Visit Exhibits
12:00 PM - 1:00 PM
Bio G MicroTabs: Ingredients for Personalized Nutrition and Health
Mr. Wolfgang Roehr
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Roehr Pharmaceuticals
1:15 PM - 2:15 PM
The Clinical Use of Testosterone in Women
Leigh Erin Connealy, M.D.
Medical Director, Center for New Medicine, Irvine, CA
Lecture Description:
Many studies show that slightly increasing testosterone levels in aging women restores sexual drive, arousal, and frequency of sexual fantasies. Low testosterone in women of all ages seems to suppress libido and cause sexual dysfunctions. Restoring youthful testosterone in women has been shown to improve mood and wellbeing, and many other health enhancing-benefits such as motivation, assertiveness, a sense of power, and enhanced sex drive. Testosterone conveys powerful anti-aging effects. It turns fat into muscle, keeps skin supple, increases bone mineral density, and boosts the ability to handle stress. It supports cognitive functioning, and keeps the liver and blood vessels clean. Low testosterone levels have been associated with heart attack, Alzheimer's disease, osteoporosis, and depression. For women, a little bit of testosterone can go a long way in improving looks, figure, energy level, outlook on life, enjoyment of living, sex appeal, and sexual fulfillment.
2:15 PM - 3:00 PM
Mood and Memory in the Perimenopausal and Menopausal Woman
Hyla Cass, M.D.
Former Assistant Clinical Professor of Psychiatry, UCLA School of Medicine
Faculty, Institute for Integrative Medicine, San Diego, CA
Advisory Board, Academy of Functional Medicine and Genomics, Folsom, CA
Medical Director, Bio Balance International, Pacific Palisades, CA
Lecture Description:
Anxiety, depression, insomnia, and memory imbalances are common in perimenopausal and menopausal women, and are conventionally treated with medications, especially antidepressants. However, from a biochemical standpoint, these conditions are most often related to imbalances in hormones, neurotransmitters, and their micronutrient co-factors. Properly diagnosed with a good history and appropriate laboratory testing, they can be corrected with the appropriate use of supplements (herbs, vitamins, minerals, amino acids) and bio-identical hormones.
3:00 PM - 3:45 PM
Break - Visit Exhibits
(exhibits close 4:30 PM)
3:45 PM - 4:45 PM
New Advances in Female Sexual and Menopausal Health
Jennifer Berman, M.D.
Director, Berman Women’s Wellness Center, Los Angeles, CA
Medical Director, Bermansexualhealth.com
Lecture Description:
Lecture is designed to equip physicians with fundamental knowledge of the causes of female sexual dysfunction and to instruct them on methods and protocols of medical and non medical treatments for women with decreased libido.
4:45 PM - 5:30 PM
Thyroid Hormones in the Perimenopausal and Menopausal Woman
Alan Christianson, N.M.D.
Medical Director & President, Integrative Healthcare, Scottsdale, AZ
Adjunct Professor, Southwest College of Naturopathic Medicine, Tempe, AZ
Lecture Description:
Thyroid disease affects 1 out of every 4 women over the course of their lives. The majority of cases manifest in women during the transitional years of perimenopause to menopause. This correlation is true for hypothyroidism, hyperthyroidism and thyroid cancer. Thyroid disease exists in the context of an endocrine system stressed by numerous factors of modern life. In the adult woman, thyroid disease can cause treatable symptoms up to 10 years before the diagnosis is apparent.
8:00 AM - 9:00 AM
Overcoming Weight Loss Resistance Due to Self Sabotage: A Novel and Effective Approach
Kyrin Dunston, M.D., FACOG
President & Medical Director, True Balance MD, Savannah, GA
Lecture Description:
Obesity and its secondary health disorders are at epidemic levels in the United States and have contributed substantially to the increase in morbidity and mortality rates of recent years. Effective and permanent weight loss methods have provided dismal results with most programs leading to only 6% successful weight loss at one year. This weight loss resistance is rampant in the United States, within our practices and among our patients. Self-sabotage is a primary obstacle thwarting successful weight loss and must be addressed to achieve significant progress in halting this lethal disorder. In treating people with weight loss resistance we are keenly aware of the primary major medical and biochemical issues that must be addressed to achieve successful and lasting weight loss. These include hormonal balancing of insulin, cortisol and thyroid as well as the sex hormones and correction of any nutritional deficiencies and toxicities, or inflammatory issues, that exist. Management of these factors has been detailed extensively elsewhere and will not be the focus of this discussion. If patients are able to follow a comprehensive functional medicine program that addresses these underlying issues then successful weight loss is assured. But in reality self-sabotage generally prevents this in most cases. A successful and novel approach to addressing self-sabotage is the use of a technology called transformative coaching. In direct opposition to traditional, or directive, coaching, this
particular type of coaching utilizes the science of metaphysics and the power of intention to direct the outcome of a given treatment regimen towards the desired result. Metaphysicists have clearly demonstrated that the intention of an observer changes the outcome of an experiment or treatment. Having patients concretely outline their intended outcome at the beginning of treatment significantly assists them in successfully achieving those results. This novel approach gains further validity by addressing all aspects of a person’s life; finances, relationships, career, creativity, fun, free time and spirituality. Studies have repeatedly shown that health challenges are directly proportional to challenges in these other areas of quality of life measures. With visioning there is an increased likelihood that their health will improve along with other parameters in their life. The defined path for health improvement is followed more easily and results are achieved more rapidly as well. The specific technologies of metaphysics, visioning and transformative coaching provide a novel and effective approach to combatting weight loss resistance due to self-sabotage. This talk defines the science behind this useful technology as well as the practical integration of these tools into every day practice.
9:00 AM - 10:00 AM
The Role of Blood Viscosity in Aging
Gregory D. Sloop, M.D.
Chairman, Dept. of Pathology, Benefis Hospitals, Great Falls, MT
Laboratory Medical Director, Benefis Hospitals, Great Falls, MT
Adjunct Assistant Professor of Anatomic and Clinical Pathology, Touro University Nevada, Henderson, NV
Lecture Description:
Half of myocardial infarctions occur in patients with no overt hyperlipidemia, and 20% occur in the absence of any classic risk factor. For these reasons, we have evaluated the role of blood viscosity in cardiovascular (CV) diseases. This presentation reviews key epidemiologic studies linking blood viscosity to acute CV events and classic CV risk factors. Viscosity is modifiable by existing therapies, and an overview of studies demonstrating the anti-viscogenic effect of pharmacologic and nutritional therapies is provided as well as an introduction to the different methods that are used to measure blood viscosity in the clinical laboratory environment. Mechanisms linking blood viscosity with low-density lipoprotein (LDL) and high-density lipoprotein (HDL) are also presented. Blood viscosity was prospectively shown in the Edinburgh Artery Study to be significantly higher in patients with CV events than control patients. Indeed, all major risk factors for atherosclerosis are associated with increased blood viscosity. Because viscosity is inversely proportional to flow, hyperviscosity predisposes to thrombosis and arterial occlusion. LDL increases blood viscosity because it is large enough to span the minimum intercellular distance between erythrocytes and simultaneously bind two erythrocytes, increasing aggregation. HDL is too small to simultaneously bind two erythrocytes, and by competing with LDL for erythrocyte binding, decreases viscosity. Inhibiting cholesterol-ester
transfer protein, as by torcetrapib and dalcetrapib, increases the size of HDL particles to the point that they increase blood viscosity, causing increased mortality associated with their use. Blood viscosity is the only biomarker that explains many other observations: the region and site-specificity of atherosclerotic lesions; decreased risk of heart disease in premenopausal women; improved serum glucose associated with therapeutic phlebotomy in patients with metabolic syndrome; increased mortality in myocardial infarction patients who were transfused; decreased mortality in polycythemia vera patients with aggressive control of hematocrit; increased mortality associated with increased hematocrit noted in the Framingham Study; increased mortality associated with erythropoietin therapy; and the decreased cardiovascular mortality associated with blood donation.
10:00 AM - 10:15 AM
Break
10:15 AM - 11:00 AM
Age Gracefully by Quelling the Fire Within: Practical Evidence-Based Mind-Body Strategies
Pankaj Vij, M.D., FACP
Medical Director, Kaiser Medical Weight Management Program, Pleasanton, CA
Lecture Description:
Understanding the mind-body connection and the connection between chronic stress and accelerated aging. Patho-physiology of stress and aging.
• Recharging your batteries in 15 minutes or less
• Easy, practical, quick techniques to activate the relaxation response for busy people
• Comparison of different meditation techniques
• Mind-body skills for optimal wellness and peak performance
11:00 AM - 12:00 PM
Traumatic Brain Injury Mimics Alzheimer’s: Undetected TBI Revealed in PET Scans
Robert G. Carroll, M.D.
President, Quantitative Imaging, Largo, FL
Lecture Description:
Positron Emission Tomography using fluorine 18 deoxyglucose is an extremely sensitive and specific tool for the differential diagnosis of dementia and for the detection and staging of traumatic brain injury. About 20% of patients referred for worsening of Alzheimer's disease actually suffer from unreported, previously undiagnosed traumatic brain injury. The sudden worsening of mental status in patients with known Alzheimer's is frequently due to traumatic injury in the brain stem, midbrain, and thalamus. Injury to the cerebellum is almost universal in traumatic brain injury and is never seen in the common dementias. Additional tracers for the molecular diagnosis of amyloid deposition in the brain are commercially available. These amyloid tracers are unable to detect traumatic brain injury. Misdiagnosis of the true cause of mental status worsening results in inappropriate premature institutionalization when what the patient really needs is rehabilitation.
12:00 PM - 1:30 PM
Traumatic Brain Injury – Hormonal Dysfunction Syndrome: “The Stealth Syndrome”
Mark L. Gordon, M.D.
Medical Director, Millennium-TBI & The Millennium Health Centers, Encino, CA; CBS Studios;
USC, Keck School of Medicine, Department of Family Medicine, Los Angeles, CA
Medical Director of Education, Access Medical Laboratories, Jupiter, FL
Member, AMMG Conference Planning Committee
Life Member, AMMG
Lecture Description:
According to the CDC there are over 1.9 million cases of non-combatant Traumatic Brain Injury a year. Of that number 53,000 individuals die on the spot, 360,000 end up in a hospital and nearly 1.5 million deal with the injury at home never knowing that there is a potential time-bomb ticking inside them. Unique to mild, moderate, and severe head injuries is the unforeseen development of hormone deficiencies – the stealth syndrome. This is caused by the interruption of the control mechanism found within the brain in the Hypothalamus. It is this area that controls the master gland - the Pituitary. It is the Pituitary Gland that produces all the hormones that regulate the glands found throughout our body - Thyroid, Ovaries, Testicles, and Adrenal Glands. Traumatic Brain Injury is now being recognized as a causative factor for accelerated hormonal deficiencies. This can cause Psychological, Physiological, and Physical manifestations like: depression, anxiety, mood swings, memory loss, inability to concentrate, learning disabilities, sleep deprivation, increased risk for heart attacks, strokes, high blood pressure, diabetes, loss of libido, menstrual irregularities, premature menopause, obesity, loss of lean body mass, muscular weakness, and a number of other medically documented conditions. Studies have shown us that the use of conventional medications (antidepressants, antianxiety, antiseizure, and antipsychotic) do not improve upon the underlying cause creating the symptoms
associated with Traumatic Brain Injury (Post-Concussion Syndrome) because they do nothing to increase the missing hormones. Psychotherapy does nothing to increase deficient hormones; it only encourages you to accept a poor quality of life and to move on. The goal of this program is to provide you with (1) an understanding of the means by which all forms of neurotrauma (mild, moderate and severe) can lead to dysfunction of the Hypothalamic-Pituitary mechanism of hormonal homeostasis; (2) optimal utilization of laboratory testing to monitor the onset and progression of traumatic brain injury related hormonal dysfunction; (3) selection of neuroradiology studies to identify areas of damage; and, (4) to design and implement a strategy of hormonal intervention and replenishment.
1:30 PM - 1:30 PM
Conference Concludes
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