General Session on Hormones, Transgender Medicine, Hyperbarics and Stem Cells, Hemp and CBD, Gut Health, and Hair Restoration

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FREE LECTURE: Free AMMG Sample - The Etiology of Aging is Now Understood By Leonard Hayflick

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Titles:

  1. Testosterone and Prostate Cancer: Latest Concepts and Advances
    Abraham Morgentaler, MD, FACS
    Associate Professor, Harvard Medical School
    Staff, Beth Israel Deaconess Medical Center
    For decades the greatest obstacle preventing wide adoption of testosterone therapy was the fear that it would cause aggressive prostate cancer or cause rapid prostate cancer progression. This lecture will review the origins of this erroneous belief and review the latest evidence, including results of testosterone therapy in men who have undergone prior treatment for prostate cancer with surgery or radiation, and in men on active surveil-lance. The limited data regarding testosterone therapy in men with more advanced disease will be reviewed as well. Guidance will be provided for attendees as to when it may be safe to offer testosterone therapy to men at risk for prostate cancer, or with a history of prostate cancer.
  2. Keynote Lecture: Testosterone, Science, and Human Dignity
    Abraham Morgentaler, M.D.
    Associate Professor, Harvard Medical School
    Staff, Beth Israel Deaconess Medical Center
    In this lecture I will share lessons I have learned over 30 years of research and clinical work using testosterone therapy. Those lessons include understanding why testosterone use was almost non-existent for more than 60 years, why it continues to be mistrusted by mainstream medicine, and how study results showing efficacy and safety are distorted by the media. Most importantly, by sharing several unique cases from my practice I will show how the key to being a great healthcare provider is by optimizing quality of life for individual patients.
  3. Controversy: Clinical Use of Estrogen In Men
    Neal Rouzier, M.D.
    Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
    Recent studies have demonstrated that elevated estrogen (estradiol) levels in men are associated with an increased risk of heart disease. A plethora of data supports this contention. Unfortunately, these are only observational studies that do not prove that elevated levels of estrogen cause any increase in harm, rather it is only an association and does not prove causation. In order to prove causation, interventional trials must be done in order to establish causation. There are a multitude of studies that prove high estrogen levels are protective and beneficial and certainly not harmful as we have been falsely misled to believe. The purpose of this lecture is to review the most recent literature that proves high levels of estradiol are protective against cardiovascular disease, cancer, and osteoporosis. This is in contrast to current recommendations to keep estrogen levels low in men. Various observational studies will be compared to interventional trials to gain a better understanding of the difference in pow-er between the two and the importance of not relying on just observation to prove causation. Observing that high baseline levels of estrogen are harmful in men and extrapolating that to indicate that raising estradiol levels by giving testosterone is also harmful is entirely incorrect and can lead to harm if estrogen is blocked. So much of the beneficial effect of testosterone is in the conversion (aromatization) into estradiol. Over 70 years of studies where testosterone is prescribed to men, that simultaneously raise estradiol levels, have proven beneficial. Not one study shows harm when estradiol is raised via aromatization of testosterone. The importance of estrogen in men will be reviewed as well as the harm of blocking the aromatization into estradiol. No study has ever demonstrated benefit to lowering estrogen levels. Every study demonstrates harm in blocking estrogen aromatization with aromatase inhibitors. Unfortunately, most physicians remain unaware of this data and continue to prescribe aromatase inhibitors to block estrogen formation.
  4. Gender Bias in Medicine: Lazy Science and Bad Medicine
    Benjamin Gonzalez, M.D.
    Medical Director, Atlantis Medical Wellness Center, Silver Spring, MD
    This is a powerful discussion of how our current medical system ignores women. The system believes women are done with life at the age of 52. There is a built-in gender-bias that has shaped the health care system and educated generations of physicians. You will learn how for generations women were kept out of medical studies, how men were used in primary studies for uterine cancer, how women were left out of long-term studies on aging, and how the medical system chooses bandaids over prevention in the management of aging women. This discussion will teach you how to recognize gender bias in medicine and begin to be the solution for decreasing the rate of the top 5 killers of women. You will learn how to transition from this built-in gender bias in the post graduate medical education system to evidence-based, gender-focused care of your female patient.
  5. Surgical and Post Surgical Implications for Transgender Patients
    Jonathan Keith, M.D., FACS
    East Coast Advanced Plastic Surgery
    Clinical Associate Professor, Rutgers New Jersey Medical School
    Population studies suggest that 0.5 to 1% of the population identifies as transgender or gender non-conforming. As availability and insurance coverage of surgical procedures to treat gender dysphoria expands, it is important for medical professionals to understand the surgical indications, procedures and consequences of gender affirming surgery. This lecture will introduce important concepts in modern gender affirming surgery. Perioperative considerations for top surgery (chest) and bottom surgery (genital) for male to female, female to male and gender non-conforming/non-binary patients will be discussed. Indications, complications and outcomes for specific procedures such as facial feminization, chondrolaryngoplasty (tracheal shave), chest masculinization, breast augmentation, phalloplasty, metoidioplasty and robotic vaginoplasty will be described. Physicians and clinicians will gain invaluable insight into the perioperative care of the transgender patient and their role in the multidisciplinary approach to modern gender affirmation.
  6. Gender Affirming Hormone Therapy for the Aging Transgender and Gender Nonbinary Patient
    Dana Delgado, FNP
    Primary Care Medical Provider, CAN Community Health, Essex, NJ
    Gender affirming hormone therapy helps transgender and gender nonbinary individuals feel congruent, and reduces the intensity of gender dysphoria. The lack of trained providers to address the specialized medical needs of this community, including the need for medically necessary gender-affirming hormone therapy, maintains the health disparities that affect this population. To close this gap, attendees will receive an overview of gender-affirming hormone therapy (GAHT) and will learn common dosing regimens based on the present clinical guidelines. The benefits and risks associated with providing GAHT, as well as aging-related considerations, will be discussed.
  7. Treatment and Management of the Transgender Patient. Case Presentation of a Clinician’s Approach
    Cesar Pellerano, M.D., P.A.
    Member, AMMG Planning Committee
    The transgender patient is becoming more prevalent in our society. Yet few if any of us, have had any formal training in the management of these patients. These individuals often seek help from physicians that do not feel competent or comfortable in their management. As a result, these patients often are left to fend for themselves. In this case presentation I will show how with no training in transgender medicine but with confidence in my age management skills and excellent communication with the patient, I was able to successfully manage and help a transgender woman. I hope that this lecture will inspire the audience to do the same when given the opportunity.
  8. Evidence Based Use of Hyperbaric Oxygen Therapy (HBOT) to Increase Stem Cells, Balance Hormones and Reduce Inflammation
    Jason Sonners, D.C., Ph.D., DCBCN, DIBAK, CHP
    Board Member, International Hyperbaric Association
    Faculty, Medical Academy of Pediatric Special Needs (MAPS) & International Board of Undersea Medicine
    Owner & Clinic Director, Core Therapies Family Wellness Center, New Jersey HBOT, Hyperbaric & Function Medicine Clinic, HBOT USA
    In the United States hyperbaric oxygen therapies (HBOT) have been used very effectively for a short list of severe conditions ranging from osteomyelitis, osteonecrosis, gangrene, non-healing wounds, diabetic neuropathy, crush injuries & radiation burns. This therapy is relatively noninvasive, safe and effective for improving patient’s recovery and healing times from these acute and severe conditions. Chronic inflammatory illnesses on the other hand, which affect 6/10 Americans and are the driving force behind the $3.8 trillion health care costs in the US, destroy our quality of life and reduce our ability to be contributing members of society. Some of these conditions include autoimmunity, neurodegenerative, musculoskeletal degenerative, cancer and many others. Initial studies on hyperbaric therapy point to specific mechanisms of action at work when used for 14 traditional insurance based hyperbaric indications. There is evidence which suggests that the mechanisms for these “on label” acute and severe cases would be similar or even identical to the mechanisms required by most chronic illnesses to also improve their outcomes and recovery times. Hyperbaric can be delivered a number of ways, from mild pressure to high pressure and lower oxygen levels to higher oxygen levels. The exact amount of pressure, oxygen and frequency of dives required for improvement is not known for the majority of hyperbaric indications. Current hyperbaric research also shows that intermittent and relative hyperoxia-hypoxia is a strong stimulator of many cell signaling and epigenetic signaling cascades used for the promotion of healing and adaptation to an accelerated regenerative response. Hyperbaric has the ability to help rebalance hormones, improve healing times, stimulate stem release and is finally finding its place within the field of regenerative medicine.
  9. How Prescription Medication Accelerates Aging
    Derrick M. DeSilva, Jr., M.D.
    Teaching Faculty, JFK Medical Center, Edison, NJ
    Co-Chair, Department of Complimentary Medicine and Senior Attending Staff, Raritan Bay Medical Center, Perth Amboy, NJ
    Over 60% of the US population over the age of 50 is on at least one prescription medication. A significant number of children are also on various medications, from asthma drugs to digestive aids. There is no question that prescription medications play a definite role in health but at what “cost”.
    As a result of the nutrient depletion from the prescription medication various disease states may be accelerated. For example, the depletion of magnesium from proton pump inhibitors (PPI) could predispose individuals to cardiac arrhythmias and then cause an entire cascade for the use of other drugs that many deplete more nutrients and potentially accelerate the aging process. Being aware of these depletions and correcting the depletions ahead of time plays a critical role not only to the predisposition of other disease but also improving the quality of life for our patients. During the presentation we will discuss the role of prescription medications, along with helping resolve some of the “confusion” about the key role that supplements play in our health.
  10. Low Dose Naltrexone
    William Clearfield, D.O., FAAMA, DABMA, FAARFM
    Medical Director, Clearfield Family Medicine, Reno, NV
    Executive Director, American Osteopathic Society of Rheumatic Diseases
    Naltrexone, an FDA-approved drug indicated for relief of addiction to opiate drugs, such as heroin or morphine, inhibits inflammatory pathways that involve Toll-Like Receptors. In 1985, spurred by the AIDS crisis, and with little else to treat the horrendous infections developing in their patients, several enterprising physicians surmised that naltrexone’s anti-inflammatory properties could be harnessed at a more local level diluting its potency, thereby shortening its duration of action. The result? A powerful new anti-inflammatory agent was born. Diluted at first to 10%, then eventually as low as 2% of its original potency, “low dose” naltrexone proved to be a boon to chronic fatigue, multiple sclerosis, CFS/ME, autoimmune thyroid diseases, and various cancers. Seasoned clinicians might be skeptical about how a single entity could exact benefit from such a wide range of pathologies. Still, a careful study of LDN’s properties reveal it is effective against dozens of inflammatory intermediaries such as interleukin (IL)-1?, IL-1Ra, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p40, IL-12p70, IL-15, IL-17A, IL-27, interferon (IFN)-?, transforming growth factor (TGF)-?, TGF-?, tumor necrosis factor (TNF)-?, and granulocyte-colony stimulating factor (G-CSF). This lecture will explore the history, indications, mechanism of action, dose schedules, side effects, and evidence-based studies using low-dose naltrexone. The audience participant will have a firm grasp of the appropriate uses of low-dose naltrexone and its contraindications and idiosyncrasies. We will briefly touch on ultra-low-dose naltrexone for use in specialty situations. Lastly, we will explore a case study to highlight LDN’s usefulness as a therapeutic modality.
  11. Envisioning Self-Care as a Gateway to Authentic Health for Us Doctors and Our Patients
    Beatriz Olson, M.D., FACP
    Private Practice, Integrative Endocrinology and Healthy Aging
    Past Clinical Faculty, Yale University
    The experiential course will create awareness, inspiration, and education for participants to develop or evolve structures for lasting personal change that creates authentic and sustainable health.The 45 minute session will be a new and different professional and personal experience for AMMG participants. The focus is about our own self care as AMMG health practitioners who aim to enhance health span in the lifespan of others. Dr. Olson will lead a discussion on what is authentic health and invite you to reflect upon and live in the questions. This self inquiry experience will create calm awareness and expand the sense of wholeness you can own and bring to patients / clients.
  12. Sarcopenia
    Jeff Life, M.D., Ph.D.
    Founder, CEO, CMO, The Life Center for Healthy Aging, South Charleston, WV
    Sarcopenia, the age-related loss of skeletal muscle mass and function, is believed to be a normal and inevitable consequence of aging. Evans and Rosenberg, in their book Biomarkers published in 1992, consider it to be the most important variable determining the quality of an individual’s life. They list muscle mass and strength as the top two biomarkers of the aging process. Loss of muscle mass and strength are major factors in the placement of individuals in a nursing home. This talk describes the many causes of sarcopenia along with its progression and consequences as people age. The devastating impact of sarcopenia on our current and future healthcare system is also discussed.
  13. Brain Health for Patients Over 50
    Elliot Dinetz, M.D., ABFM, ABAARM
    Timeless Health, Miami, FL
    With Alzheimers being the 6th leading cause of death and cognitive decline affecting 1 in 9 people over age 45, brain health is rapidly becoming a leading health concern as we strive to live healthier and longer. While current medical guidelines offer little hope in terms of treatment, newer evidence points towards different sources of inflammation at its root cause. In targeting such, this may help both halt and even reverse cognitive impairment. We will explore the literature and fascinating clinical cases involving hormone balance, genetic risk factors that can be suppressed, and how nutrients & nutraceuticals may form a comprehensive approach to helping provide better answers for those who are at risk or struggling today.
  14. Insulin Resistance: We Need To Do Better
    Benjamin S. Gonzalez, M.D.
    Medical Director, Atlantis Medical Wellness Center, Silver Spring, MD
    A detailed look at how at how Heart Disease, Dementia, High Blood Pressure, Obesity, Pediatric Type II Diabetes, Sarcopenia, Arthritis, Fatty Liver, Stroke, Erectile Dysfunction, and many other disease processes have one thing in common: Insulin Resistance (IR). Dr. Gonzalez discusses how IR is a true disruptor of the endocrine system and how IR is the primary contributor to major disease processes. You will learn how to recognize IR early and what tools to use in the prevention of the top 5 Killer-Diseases in the U.S. You will leave with a better understanding of why you, as a medical provider, should be focusing on the early recognition and management of Insulin Resistance in treating all disease processes.
  15. Enteroimmunology & Endocrinology: How Dysbiotic Gut Inflammation Leads to Hormone Imbalances, and How Reversing Them is the Key to Resolving Chronic Illness
    Dushyant Viswanathan, MD, ABIM, ABoIM, AACE
    Chief Medical Officer, The Columbia Center for Integrative Medicine (CCIM)
    Gut dysbiosis is associated with inducing a chronic inflammatory state that affects every organ and is implicated in the pathogenesis of multiple chronic conditions in the scope of internal medicine. Here we articulate relevance, diagnostic/therapeutic concerns of translational mucosal immunology (“Enteroimmunology”) and articulate the impact on measured cortisone secretion patterns as demonstrated by 24 hour salivary cortisol test-ing. Inflammatory cytokines stimulate cortisol secretion, and over time, an endocrinopathy develops: dysfunctional diurnal cortisol secretion, depletion of beneficial hormones such as testosterone, DHEA, progesterone, pregnenlone, thyroid hormone, and sometimes estrogens (although elevations of estrogens due to impaired excretion is more common) occur. These physiologic events are implicit in the process of aging. We will de-scribe treatment approach and cases featuring gut microbiome repair and restitution of optimal hormone levels as essential to lessening physiologic/cellular aging and inflammation. We will review case studies including treatment of Crohns inducing remission, reversal of autoimmune inflammation, and reversal of prostate dis-ease.
  16. Continuous Glucose Monitoring (CCGM) in Precision Medicine: Leveraging Real-Time Data to Detect and Reverse Metabolic Abnormalities
    Florence Comite, M.D.
    Comite MD, New York City, NY
    Precision Medicine is bolstered by longitudinal ‘N-of-1′ data that enables the optimization of an individual’s health trajectory. While CGMs were initially intended for diabetes management following a diagnosis, they can be further utilized to detect and predict early signs of disease decades prior to emerging symptoms. The lecture will illustrate the various insights garnered from CGM analysis. We have harnessed these insights to extend our patients’ healthspans to match their lifespans today and into the future.
  17. Aerobic Performance & Body Composition in Precision Medicine
    Christopher Arboleda, MS, ACSM-CEP, NSCA-CSCS
    Manager Clinical Operations, Performance Lab
    Manager & Clinical Exercise Physiologist, ComiteMD, New York, NY
    Periodic surveillance of aerobic performance and body composition enable age management teams to track and assess intervention efficacy to lengthen the healthspan. The importance of maintaining op-timal cardiovascular fitness, muscle mass, and fat mass with age cannot be overstated. This presenta-tion highlights the role of these tests in Precision Medicine by examining patient data compiled into 12 sex-age groups. We conclude by summarizing the recommendations utilized to continually improve test scores. Audience members will learn how to introduce these techniques into their clinical practic-es, gaining valuable insights that can increase patient longevity and quality of life.
  18. The Role of Therapeutic Plasma Exchange (TPE) in the Prevention and Treatment of Age-Related Conditions
    Dobri Kiprov, M.D.
    Founder and President, Global Apheresis, Inc.
    Member, Board of Directors, International Society For Apheresis (ISFA)
  19. Clinical Application of N-of-1 Precision Medicine
    Ashley Madsen, PA-C
    Comite Center for Precision Medicine & Health
    Precision medicine enables clinicians to predict and detect disease in early stages, thereby preventing disorders of aging. In this presentation, we will discuss the case of a 50-year-old Caucasian male presenting with occasional gastrointestinal discomfort and low energy. Using Advanced Precision Diagnostics, we uncovered various, previously undetected conditions and modifiable risk factors. Additional patient snapshots will emphasize how N-of-1 techniques can be harnessed to treat and reverse disease decades before symptoms emerge. Audience members will learn the benefits of precision medicine, an approach that has never been more important given the current health landscape and cost of healthcare.
  20. Hair Regrowth Without Surgery
    William Clearfield, D.O., FAAMA, DABMA, FAARFM
    Medical Director, Clearfield Family Medicine, Reno, NV
    Executive Director, American Osteopathic Society of Rheumatic Diseases
    By age 60, 65% of men and 80% of women, 56 million in the US alone, experience noticeable hair loss. Conventional wisdom dictates that the vast majority of hair loss is due to genetics. Nevertheless, as we have seen with so many other accepted scientific myths (does testosterone cause prostate cancer ring a bell?), what is accepted science many times just is not so. We begin with what is “normal,” the natural lifecycle of a single hair. From there, we extrapolate root causes of the three types of hair loss. 1. Androgenic alopecia, by far the most common, is typically thought of as “male pattern bald-ness.” 2. Alopecia areata is the loss of hair in discrete circular to oval areas in the scalp. 3. Telogen effluvium patients lose their mane from the metabolic components, thyroid disease, hormonal imbalances, other androgens, infections, immune-compromised hosts, stress, medications, or crash dieting. We review the patterns, including how to recognize them. We then propose treatment solutions for each hair type. We reveal what to do with the 30% “mixed” types. These are hair loss types that over-lap patterns. Lastly, we review diet and lifestyle changes we can enact to improve our chances of re-growing hair.
  21. The Biopsychosocial Model: Treating an Aging Population with Touch
    Jodi Scholes
    Certified Massage Therapist
    In 1977 Dr. George Engel wrote an article entitled, The Need for a New Medical Model: A Challenge for Biomedicine. In this article, he introduced the concept of the Biopsychosocial model. Dr. Engel was concerned about the alarming amount of treatment plans that excluded patient feedback, focused only on data points and lab results. Questions about mental stress or social pressures (family expectations, work deadlines) that could be affecting the patient seemed to be irrelevant. The results of such a singular focus? Treating just one aspect of a disease. Dr. Engel, who enjoyed appointments in the Dept. of Psychiatry and the Dept. of Medicine at the University of Rochester Medical Center, advocated for a more integrated approach: Examine the biology, but also consider the psychology and the social pressures of the patient. Dr. Engel called this the Biopsychosocial Model. It’s standard operating procedure to examine the biology. However, we also have the opportunity to ask questions about the mental state of the patient. Questions like, “Is there any unusual stress in your life?” Here’s the key: then we listen. During the pandemic many dentists caught on to this. Cracked molars indicate new and higher tension levels than normal. Tempromandibular Joint Pain can be a sign of stress related jaw clinching. Yes, a night guard is a good start. But what else is going on? Dr. Abraham Verghese in his TED talk says, “It may be heresy to say this at TED, but I’d like to introduce you to the most important innovation to come in the next 10 years and that is the power of the human hand, to touch, to comfort, to diagnosis and to bring about treatment.” Touch. Let me ask, do you have physical contact with your patients? In treating patients, how can we incorporate Dr. Engel and Dr. Verghese’s point of view? Using a more integrated approach, diagnosing the physical symptoms and being aware of the psychological and behavioral stressors that could be contributing to the con-dition. A client dealing with increased mental stress may respond well to more intentional directives to relax. Using a hot tub, attending a beginner meditation class, experiencing an all levels yoga class or even recommending a walk in nature…one study tells us.

This session is part of a set that includes the following sessions:

  1. Advanced Sexual Dysfunction workshop
  2. Fighting Cellular Aging, The Emerging Field of Senotherapeutics
  3. General Session on Hormones, Transgender Medicine, Hyperbarics and Stem Cells, Hemp and CBD, Gut Health, and Hair Restoration
  4. IV Nutrient Therapies for Age Management Medicine

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