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7:00 AM - 7:45 AM
Sleep Quality and Inflammatory Biomarkers: What is the link for cardio-metabolic disorders?
Presented by Preetam Schramm, Ph.D., RPSGT
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by SleepImage
8:00 AM - 9:00 AM
Featured Speaker - The Role of Resolution of Inflammation in the Aging Process
Barry Sears, Ph.D.
Founder & President, Inflammation Research Foundation, Marblehead, MA
President, Zone Labs, Marblehead, MA
Lecture Description:
It is becoming accepted that the aging process can be viewed as a consequence of systemic inflammation that drives the development of chronic diseases. There are two distinct parts to the inflammatory response. The first is the initial initiation phase of inflammation and the second is the resolution phase of inflammation. If these two phases of inflammation are balanced, then the body returns to homeostasis. However, if the initiation phase is too exaggerated or the resolution phase is too muted, then the result is low-level chronic inflammation that will accelerate the aging process. Anti-inflammatory nutrition can have a unique role in modulating both phases of the inflammatory process. It can reduce an exaggerated initiation response by modulating the inflammatory gene transcription factor nuclear factor-kappaB (NF-?B). It can also enhance the resolution process by increasing the production of resolvins derived from omega-3 fatty acids. The dietary factors that enhance NF-?B activity are excess omega-6 fatty acids, excess saturated fats, excess carbohydrates, and excess calorie consumption. The dietary factors that can inhibit NF-?B activity include omega-3 fatty acids and polyphenols by their activation of the anti-inflammatory gene transcription factor PPAR-?. How these dietary factors alter inflammatory gene expression and the levels required will be discussed in this lecture as well as the clinical markers that allow the optimization of a structured anti-inflammatory
dietary program. Examples of their use in the treatment of neuroinflammation will be described.
9:00 AM - 9:45 AM
Biomarkers of Inflammation
Dipnarine Maharaj, MB.ChB, M.D., FRCP (Edin.), FRCP (Glas.), FRCPath, FACP
Medical Director, The Maharaj Institute of Immune Regenerative Medicine, Boynton Beach, FL
Lecture Description:
Inflammaging is an umbrella term covering a multitude of phenomena which involve aberrant glycosylation as well as tissue damage. This damage is reflected in increasing amounts of mitochondrial DNA in the periphery which correlate with levels of inflammatory biomarkers. The characteristics of inflammaging and its contribution to the development of age-associated chronic diseases in humans will be discussed in this presentation. In addition, immune senescence as it relates to aging and inflammation will be presented.
Stem cell aging contributes to immune dysfunction. An individual’s own stem cells can be safely transplanted without being rejected by the body’s immune system to treat immune dysfunction. Autologous stem cell therapy is an established treatment for immune dysfunction of blood cancers. In the future it is believed that the need for autologous stem cell therapy will increase as it may offer remedies for strokes and neurodegenerative conditions such as Parkinson’s and Alzheimer’s diseases and chronic diseases such as heart disease as well as diabetes.
This presentation will focus on clinical aspects of the use of autologous stem cells for regenerative medicine with emphasis on strategies for optimizing their function by reducing inflammation and improvement of immune dysfunction.
10:00 AM - 10:45 AM
Amplifying the Glutathione System for Chemical and Heavy Metal Detoxification to Reduce Inflammation Stress
Christopher W. Shade, Ph.D.
President, Quicksilver Scientific, Lafayette, CO
Lecture Description:
Toxic metals have a number of adverse biological effects including endocrine disruption and generation of inflammation and oxidative stress. Thus, successful anti-aging protocols need to address metals toxicity. However, the methods for metals detoxification are often quite challenging for the body and involve toxic substances (e.g. DMSA, DMPS). Fortunately, mechanisms for xenobiotic metabolism (detoxification) can be upregulated with a variety of natural compounds. The glutathione system is the body’s natural metal detoxification system, and that system can be harnessed and amplified for powerful yet safe metals removal. Fortunately, there is an exciting body of research showing that certain phytonutrients (plant compounds) have the ability to upregulate the detoxification/chemoprotection systems, including intracellular antioxidant production, through a mechanism called the Keap1/Nrf2 protein. Coupling use of these compounds with advances in liposomal and nanoemulsion delivery of nutritional compounds (e.g. glutathione and lipoic acid) can create powerful natural approaches for body-wide detoxification and antioxidant protection.
10:45 AM - 11:30 AM
The Neuropermissive Environment
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:
Traumatic brain injury has an overt primary phase of damage that might be represented histologically by “focal” anatomical lesions, such as laceration, contusion, intracranial hemorrhage, diffuse axonal injury, and cavitation, all creating differing degrees of cerebral edema. In response to the typically short-lasting primary injury mechanism, there is a second wave of long-lasting pathological changes called the secondary injury mechanism. This consists of metabolic changes (acidosis), neuroinflammation, axonal injury, vascular abnormalities, and neuronal and glial cell death. Metabolic changes include abnormal levels of oxygenation (increasing free radicals such as ROS), altered cell metabolism, disrupted energy production (mitochondrial damage), diminished systemic hormonal secretion, and an upregulation of inflammatory activity. The secondary damage (biochemical, delayed), produced by these complex processes, is initiated at the moment of injury and with the death of the first brain cell be it astrocyte, neuron, microglia or oligodendrocyte. Additionally, peripheral damage to the limbs, abdomen or thorax creates another avenue for the production of inflammatory molecules (IL-6, specifically) that passes through a disrupted blood-brain barrier (BBB) to cause additive damage and biochemical havoc. These processes are subversive to the brain’s ability to recover, having a net effect of subclinical pathologies that can take minutes, hours, days, weeks, months or even years to
appear. This “silent epidemic” or “stealth syndrome” represents multiple cascades of inflammation that occur in response to damaging stimuli, triggering the release and activation of cytokines and chemokines, and the activation and proliferation of microglia and astroglia in the central nervous system (CNS). Vascular abnormalities are marked by aberrations in the water content of the brain parenchyma, dysregulation of water channels, and further compromise of the BBB. These primary and secondary injury processes may lead to a range of neuro-psychiatric symptoms, including various forms of memory and learning deficits, anxiety, and depression.
11:30 AM - 12:00 PM
The Role that Diet and Supplements Play in Inflammation
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:
There is no question that diet and nutrients/supplements play a critical role in the exacerbation and preventing of the inflammatory process. There are common supplements like Omega-3 fatty acids and turmeric that have numerous studies to support their support anti-inflammatory role. But what about some of the new and more exotic nutrients that reduce inflammation? There are also various foods that reduce inflammation. But what about the foods that accelerate the inflammatory process? This lecture will focus on the combined role that diet and supplements play in reducing the inflammatory process.
12:00 PM - 1:30 PM
Lunch Break
12:00 PM - 1:00 PM
Understanding the Root Cause of Aging Based on Telomerase Activation Science
Presented by Ron Rothenberg, M.D.
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by T.A. Sciences
1:30 PM - 2:15 PM
Using Cellular Design Elements to Support Protective Levels of Inflammation Within Each Life Stage
Scott Minton, M.S., Ph.D.
Scientific Advisor, Nordic Naturals, Watsonville, CA
Lecture Description:
Organs and organ systems do not operate in isolation from each other. Because cells, tissues, organs and organ systems are integrated on multiple structural, spatiotemporal and functional scales, a nutritional strategy that addresses multiple physiologic axes and biochemical pathways—at the same time—may significantly promote the process of enhancing health, improving quality of life, and optimizing the aging process. Given the current crisis and socioeconomic burden of chronic degenerative/inflammatory disease, a paradigm shift in managing health and wellness is required that addresses the very core of integrative systems biology. In this presentation, we will discuss the biochemical evidence supporting the use of several important nutrients to modulate inflammation and other critical cell signaling pathways. We will also explore several methods to evaluate an individual’s need for specific nutrients, and several research-based therapeutic concepts that may help improve clinical outcomes throughout the aging process.
2:00 PM - 7:00 PM
Exhibits Open
2:15 PM - 3:00 PM
Endothelial Dysfunction and Inflammation: What Can We Do About It?
Keith A. Fleischman, D.O.
Associate, Robert Wood Johnson Medical School, New Brunswick, NJ
Senior Partner, Cenegenics, New York, NY
Lecture Description:
Endothelial cells have significant importance in cardiovascular health and function. The declines in endothelial function are one of the earliest factors in the development of cardiovascular disease. These declines can show up in patients as early as in their thirties. Endothelial inflammation is a significant cause of declines in endothelial function and health. Understanding the ways in which endothelial inflammation and function can be measured, and the treatment modalities utilized in reducing it should be the goal of every comprehensive medical practice.
3:00 PM - 3:30 PM
Break / Visit Exhibits
3:30 PM - 5:30 PM
Pathogenic Inflammation and Innovative Regenerative Biological Therapies (4 segments)
Jonathan S. Wilensky, M.D., FACS
Co-Founder, Southern California Institute for Regenerative Medicine (SoCal IRM)
Alan Yang Wu, M.D., CTBS, FAACS, FACS
Faculty, University of California at Riverside, Stem Cell Research Center
Managing Partner, Surgimed Biosciences, Cathedral City, CA
Dennis Lox, M.D.
Owner, Sports and Regenerative Medicine Centers, Tampa Bay, FL and Washington, D.C.
Ron Shane, N.D., Ph.D., O.M.D., MFA
Research Scholar, University of California-San Diego
Professor, University of Natural Medicine in Body & Mind Consciousness Studies and Naturopathic Medicine
Lecture Description:
The overexpression of inflammatory interleukins is the pathologic basis of a bevy of conditions ranging from osteoarthritis (OA) to autoimmune conditions. Current therapies in many instances are both ineffective and fraught with debilitating side effects. We are now in a time where there are many innovative treatment strategies which are emerging, derived from stem-cell protocols that are effective, and devoid of problematic complications. Dr. Wilensky will discuss the biology of inflammatory cytokine overexpressionwhich engenders degenerative and pathophysiological conditions. Dr. Wu will discuss the human bacterial flora microbiome health interaction: gut instinct suggesting promising new therapies based on recent studies with a direct relationship between bacterial flora within the gut of obese and diabetic individuals and epigenetic modification of inflammatory genes. Dr. Lox will speak on Clinical Regulation of Cytokine Inflammatory Pathways with Autologous Stem Cell Therapy. The role of cytokine anabolic and catabolic pathways that influence the degenerative cascade will be discussed. Associated inflammatory conditions that may exacerbate the underlying degradative process will be addressed. The clinical utilization of Regenerative Medicine through growth factors and stem cells will be discussed as related to patient care and treatment. Dr. Shane will lecture on how cytokines from human embryonic stem cells (hESCs) can be synergistic with stromal vascular fraction (SVF)
as well as placenta extract to ameliorate joint-related OA as well as the systemic interleukin inflammatory overexpression.
5:30 PM - 7:00 PM
AMMG Welcome Reception
7:00 AM - 7:45 AM
Sleep Quality and Inflammatory Biomarkers: What is the link for cardio-metabolic disorders?
Presented by Preetam Schramm, Ph.D., RPSGT
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by SleepImage
8:00 AM - 9:00 AM
Adrenal Fatigue – Myth or Mystery?
Mark P. Menolascino, M.D., MS, ABIHM, ABAARM, IFMCP
Medical Director, Meno Clinic, Center for Advanced Medicine, Jackson Hole, WY
Lecture Description:
Fatigue, insomnia, weakness, hormone imbalance, moodiness, weight gain, immune dysfunction, bone loss and low libido are all linked to weak adrenals. The adrenal gland is the home of the fight or flight stress response and works in synergy with the thyroid hormones for energy and weight regulation. The relationship to stress and high cortisol levels can exacerbate any condition and prevent true healing. The adrenal hormones DHEA and Cortisol are involved in regulating all aspects of hormone metabolism and become critical as we age to maintain optimal health. Many physicians are unaware of the need to identify adrenal fatigue and to support the balance of these important hormones.
9:00 AM - 10:00 AM
What to do BEFORE Testosterone Replacement Therapy
Rob Kominiarek, D.O., FACOFP
President and Medical Director, ReNue Health, Springboro, OH
Assistant Clinical Professor, Ohio University College of Osteopathic Medicine
Lecture Description:
Testosterone replacement therapy has grown rapidly over the past several years. In 2009 there were approximately 4 million prescriptions written for testosterone products and in 2013 there were 7.5 million prescriptions written. But, does every man with low levels of testosterone need testosterone replacement therapy? It is well known that as we age hormone production and nutrient status decline each decade and daily our bodies are assaulted by various environmental toxins, pollutants, chemicals, and stress that further impacts our hormones. However, it is possible to naturally regain appropriate levels of free testosterone in individuals with an intact H-P-G axis and functional liver. This lecture will provide attendees an overview of the steps necessary to take to help the individual produce testosterone naturally, detoxification of the liver, removal of negative environmental influences, priming the patient with the necessary supplements, vitamins, and minerals; and personalized nutrition plans that provide either healing, nourishing, or performance nutrition. Attendees will further learn appropriate screening laboratories, food sensitivity testing, nutrient level testing, and examples of restoring the free testosterone level through real patient cases.
10:00 AM - 10:15 AM
Break
10:15 AM - 11:00 AM
The Validity and Clinical Relevance of Testing Hormone Levels by Serum, Saliva, Urine or Blood Spot
Sonia Kapur, Ph.D., HCLD
Laboratory Director, ZRT Laboratory, Beaverton, OR
Lecture Description:
With the continued popularity of hormone therapy there is a greater need to understand testing methods to aid in optimizing therapeutic goals while reducing possible risks. Health practitioners involved with any type of hormone replacement need to understand the pros and cons of the different methods for measuring hormone levels and to determine which method is the most appropriate clinically. Hormone testing has been regarded with some skepticism, but with the right methodology it is a necessary tool to optimize patient therapeutic outcomes on hormone replacement. Learn the differences between the various methods for testing hormones, and how to determine the most appropriate test to optimize your patients’ response to hormones.
11:00 AM - 12:00 PM
Bioidentical Hormone Replacement Therapy: Metrics and Methods of Administration
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
12:00 PM - 1:30 PM
Lunch Break
12:00 PM - 1:00 PM
Understanding the Root Cause of Aging Based on Telomerase Activation Science
Presented by Ron Rothenberg, M.D.
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by T.A. Sciences
1:30 PM - 2:15 PM
Hormones and Weight Management
Florence Comite, M.D.
CEO & Founder, Comite Center for Precision Medicine, New York, NY
Member, AMMG Conference Planning Committee
Nicole M. McDermott, RPA-C
Physician Assistant, ComiteMD Center for Precision Medicine, New York, NY
Lecture Description:
More than one-third of U.S. adults are obese. Obesity is the leading cause of preventable deaths in this country. Interventions to reverse obesity are rarely successful in part due to a one-size-fits-all approach despite the multifactorial mechanisms leading to obesity. It is essential to establish a personalized foundation of care in order to systematically manage weight loss for favorable long-term outcomes. To achieve successful weight loss it is important to incorporate a detailed analysis of the individual patient who typically has numerous underlying etiologies leading to fat gain. Underlying etiologies must explore genomics, metabolomics, lifestyle (such as sleep and stress), family history, medication use, as well as other disease entities. Our system is based on an emerging discipline, which we define as Precision Medicine. We investigate various dynamics for effective weight loss. This methodology benefits both the patient and the clinician and almost universally leads to significant fat loss relatively quickly. Obese individuals in our practice often lose as much as 50 to 60 pounds in their first year of management. Most important are the longer-term outcomes that are our goal, such as the reversal or prevention of diabetes, cardiovascular disease, stroke, cancer and other disorders of aging. There is a direct relationship between declining hormones and obesity-related conditions such as Type 2 diabetes, cardiovascular disease, and cerebrovascular disease, along wi
with other chronic conditions. While our hormones fluctuate throughout our life span, and even throughout the day and night, aging brings about a specific age-related hormonal decline that is considered acceptable according to the “normal range.” This is despite the fact that alterations in the hormonal and metabolic milieu are known precursors to common diseases of aging. By comprehensively addressing the endocrine system through the harmonization and optimization of hormones such as thyroid, testosterone, cortisol, amylin, and incretin, we proactively prevent disorders associated with aging, therefore extending health span and inducing significant weight loss. The ideal path to optimal health is designing a systematic process with precise individualized methods for weight loss; specifically focused on fat loss and lean muscle gain.
The age-related endocrine processes and systems that will be discussed include:
• The pancreas: impact of impaired glucose metabolism
• Adrenal glands: impact of elevated cortisol
• Thyroid: impact of thyroid hormone dysfunction
• Gonads, Testes and Ovaries: impact of testosterone, estradiol and progesterone
• Vitamin D: impact on immune, cardiac function and bone
• Human Growth Hormone: impact of deficiency
Individualization for each patient is necessary to achieve optimal metabolism that will allow hormone harmonization to promote health, prevent and reverse disease, and extend health span.
2:00 PM - 7:00 PM
Exhibits Open
2:15 PM - 3:00 PM
Estrogen Metabolism and the Effects of Xenoestrogens
Filomena F. Trindade, M.D., MPH
Private Practice, Capitola, CA
Professor, Fellowship in Metabolic & Nutritional Medicine, Morsani School of Medicine, University of South Florida
Faculty, Hormone Module, Institute for Functional Medicine, Gig Harbor, WA
Lecture Description:
In order to successfully accomplish Bio-identical Hormone Replacement Therapy we must personalize our approach according to each patient’s individual differences. These differences include genetic as well as environmental factors that can affect potential cancer risk. Estrogen metabolism must be assessed and optimized. This includes both phase 1 and phase 2 metabolism pathways with particular attention to potential single nucleotide polymorphisms that can occur. We must not only assess, but also optimize the metabolism and excretion of the downstream metabolites of the metabolism pathways in order to minimize potential risks. In addition, xenoestrogens and toxin exposure will affect the metabolism of estrogen and must be evaluated at length in each patient and a plan devised to lower the exposures as well as help the excretion of those already present in the body.
3:00 PM - 3:45 PM
Break / Visit Exhibits
3:45 PM - 4:45 PM
Update on Growth Hormone 2014
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 fetal body’s production of growth factors (GH, IGF-1, IGF-II) allow for the development and growth of each organ system from brain to bones. As our body takes on a more adult form the production of Growth Hormone diminishes over the years. Once thought to be the sole benefactor to linear growth (gigantism) has been found to participate in the optimal production and functioning of all hormones. Growth hormone works with vitamin D in the kidneys to independently produce 25 (OH) Vitamin D, GH provides a stimulus for the conversion of T4 to T3, GH working with Testosterone enhancing memory at the level of the hippocampus, GH and Testosterone as well as Estradiol improve upon endothelial functioning and repair of the basilar membrane, IGF-1 produced by GH signaling improves protein synthesis by up regulating the 40-70S unit of the Ribosomes, rebuilds the tau protein based microtubules destroyed by Amyloid-Beta in Alzheimer’s disease, lowers homocysteine, cytokines and interleukins thereby reducing inflammation. Knowing how best to detect alterations in growth hormone and its by-products will allow for comprehensive preventative programs of wellness to be developed. Understanding the legal requirements for justifiable prescribing of growth hormone will allow the physicians to provide uncompromising services to and for the patient.
4:45 PM - 5:30 PM
Safer Estrogen Metabolism – Looking Through New Eyes
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:
For two decades, clinicians have evaluated the relative quantities of estrogen metabolites present in urine as a means of interpreting the patient’s risk of estrogen-related disease, typically breast cancer. Newer data associated with the precise way in which estrogens and other steroids are metabolized significantly expands our understanding of the process. It appears that the comparative metabolic pathways clinicians have relied on are incomplete; more so, the therapies which have been employed do not reflect current findings. Genome profiling as an emerging clinical tool may assist the clinician to better predict those patients at greater risk of suboptimal estrogen metabolism. The genes associated with key enzymes in estrogen metabolism can be readily evaluated for aberrant forms, both homozygous and heterozygous. A number of these key genes are readily modulated by certain micronutrients and nutrigenomically-active phytochemicals. Likewise, drugs commonly used in hormonal modulation can be shown to integrate into these same pathways. This thought-provoking presentation will provide an update on the relevant biochemical pathways, identifying key enzymes and the genes governing their synthesis. This background will be used to highlight those clinical strategies capable of optimizing estrogen metabolism.
5:30 PM - 7:00 PM
AMMG Welcome Reception
7:00 AM - 7:45 AM
Evidence Based Review of Common Myths in Hormone Replacement – Debunking the Opinion that Testosterone Causes Blood Clots or Polyeythemia: PCV versus Erythrocytosis and What the Literature Recommends
Presented by Neal Rouzier, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME breakfast symposium sponsored by MedQuest Pharmacy
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
Keynote Lecture - Emerging Technology in Personalized Genomics
Robert J. Hariri, M.D., Ph.D.
Adjunct Associate Professor of Pathology, Mt. Sinai School of Medicine, New York, NY
Founder and Executive Chairman, MYOS Corporation, Cedar Knolls, NJ
Co-Founder and Vice-Chairman, Human Longevity, Inc., San Diego, CA
Founder and Chairman, Celgene Cellular Therapeutics, Summit, NJ
9:30 AM - 10:15 AM
Break / Visit Exhibits
10:15 AM - 11:15 AM
The Power of Precision Medicine in Practice: The Future of Medicine, Today
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 the physician to reverse or prevent disorders of aging. Cardiovascular disease, diabetes, cancer, degenerative disorders are generally multifactorial, and arise due to numerous triggers, from lifestyle to family history, driven by metabolic and hormonal factors. Currently, genetic screening has become available as a relevant and essential component to identify risk for the individual. The genetic make-up of individuals can help prospectively to detect 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 progressively evident that genetic expression may be variable. Epigenetic factors have an impact on the expression of genetic make-up. Of additional importance 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 significance 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 effect on the health span, and is prepared to balance, discuss, and position the possible outcomes in relaying test results. Overall, screening adds great value 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 precise and personal guidance with respect to subsequent diagnostic tests and procedures as well as interventions, ranging from lifestyle, addressing sleep, stress, nutrition and exercise, to supplements and medications.
11:15 AM - 12:00 PM
Epigenetics and Aging: What Would Happen If We Removed the Methylation Cloak of Aging?
Alan Yang Wu, M.D., CTBS, FAACS, FACS
Faculty, University of California at Riverside, Stem Cell Research Center
Managing Partner, Surgimed Biosciences, Cathedral City, CA
Lecture Description:
Methylation is a process whereby DNA bases of predominantly Cytosine- and Guanine-rich regions become alkylated with methyl groups. This molecular process is one way in which genes can become “cloaked” or turned off. With aging comes global methylation of DNA. In some cases site-specific methylation of helpful genes like p16 and PTEN lead to cancer formation. If this is one of the many ways in which the human cell exhibits “age”, the speaker challenges delegates to wonder… what would happen if we were able to remove the methylation cloak? Is methylation merely a measurable phenomenon of aging or is this a biochemical process that allows for possible age reversal or life extension? Some early preclinical and unpublished work and data will be presented to help explain the fundamental yet relevant biology as it relates to age management and extrapolate in terms of possible future therapeutic options.
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
Presented by John E. Adams, President and Chief Executive Officer & John Rush, M.D., Chief Operating Officer, Cenegenics
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Cenegenics
1:15 PM - 2:05 PM
Does Estrogen Truly Increase the Risk of Dementia and CVD? An Evidence-based Review
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
Lecture Description:
Recently there have been studies published which question whether we should or should not prescribe hormones. More so, articles have appeared that mislead us, our peers, and our patients to believe that HRT is harmful and should be avoided. In Neurology February 2014, an article was published that showed high estradiol levels in older women were associated with a higher risk for dementia, perhaps leading us practitioners to avoid administering estrogen. This has been one of many studies that consist of statistically manipulated associations with no hope or intent of establishing causation. Unfortunately these studies are all observational studies which do not prove causation. However the RCTs demonstrate that estrogen administration has a protective effect against Alzheimer’s disease and vascular dementia. This lecture will be a review of different studies which will be analyzed so that the practitioner will be able to determine which studies have more predictive power, which studies should be trusted in proving causation, and which studies should be ignored based on lack of proof of causation. In the end we will review the interventional data supporting early and continuous use of HRT to protect our brain and heart.
2:05 PM - 2:55 PM
Advancements in Nitric Oxide Diagnostics and Therapeutics: Combatting Sexual Dysfunction for Men and Women
Nathan S. Bryan, Ph.D.
Professor, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
Lecture Description:
Nitric oxide (NO) is a multifunctional signaling molecule, intricately involved with maintaining a host of physiological processes including but not limited to host defense, neuronal communication and the regulation of vascular tone. The endothelium-derived NO plays a crucial role in regulating a wide spectrum of functions in the cardiovascular system, including vasorelaxation, inhibition of leukocyte-endothelial adhesion, vascular smooth muscle cell (SMC) migration and proliferation, as well as platelet aggregation. In this regard, NO is a potent vasodilator as well as a powerful anti-platelet and anti-leukocyte factor. NO is one of the most important signaling molecules in our body. Loss of NO function is one of the earliest indicators or markers of disease. Experimental and clinical studies provide evidence that defects of endothelial NO production, referred to as endothelial dysfunction, is not only associated with all major cardiovascular risk factors such as hyperlipidemia, diabetes, hypertension, erectile dysfunction, smoking and severity of atherosclerosis, but also has a profound predictive value for future atherosclerotic disease progression. Emerging published literature reveals that NO insufficiency may manifest itself differently in different patients but first presents primarily as sexual dysfunction in both men and women. Thirty plus years after its discovery and over 12 years since a Nobel Prize was awarded for its discovery, there have been no hallmark
therapeutic breakthroughs. We will review the current state of the science surrounding nitric oxide in the etiology of a number of different disease states and reveal the latest technology to safely and effectively restore nitric oxide in patients. The audience will learn the challenges and opportunities that exist in understand NO homeostasis in their patients and how this may translate into better management of their patients.
2:55 PM - 3:20 PM
Break / Visit Exhibits
3:20 PM - 4:05 PM
Endocrine Disruptors
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:
Endocrine disruption from environmental toxins has been linked to metabolic syndrome, obesity, hypothyroidism, autoimmune thyroid disease, low testosterone, estrogen dominance, and diabetes. Toxicants like polychlorinated biphenyls in coolants, perchlorate in rocket fuel, BPA in plastic bottles, heavy metals and other toxins will be covered in this talk. The role of environmental toxins being the root cause of endocrine diseases is underappreciated in clinical practice. Diagnosis and treatment will be reviewed.
4:05 PM - 4:45 PM
Legal Aspects of Using Testosterone in an Age Management Practice
Al Augustine, J.D.
Partner, Augustine, Kern & Levans, Ltd, Chicago, IL
Lecture Description:
Mr. Augustine will discuss the current status of testosterone prescribing and use, along with helpful ideas on how a doctor can avoid legal issues through the use of informed consents, good recordkeeping, and patient awareness.
4:45 PM - 5:30 PM
Testosterone and the Heart
Cesar M. Pellarano, M.D.
Preventive Cardiologist, Miami, FL
President, Founding Partner and Chief Medical Officer, Hillstar Health LLC, Miami, FL
Lecture Description:
There has been a significant amount of controversy regarding the effects of testosterone therapy on heart disease. This has been a major topic in our national media as well as the medical community. Unfortunately, the reports have led to a significant amount of misinformation as well as uncertainty both in the minds of doctors and patients. Does Testosterone therapy lead to heart disease? Is Testosterone therapy safe? Is an individual at risk because he or she was on testosterone therapy in the past? This lecture will offer a review of the medical literature and allow the physician and the patient to make the correct and informed decision regarding testosterone therapy.
7:00 AM - 7:45 AM
Working Within the Regulations for Growth Hormone – Options
Presented by Mark Gordon, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Specialty Drugs
8:00 AM - 8:50 AM
Stress and Inflammation
Anna Cabeca, D.O., FACOG, ABAARM
Medical Director, Vida Pura Health, Golden Isles Medical, Inc., St. Simons Island, GA
Lecture Description:
Science is pouring forth research that links chronic stress to a diversity of diseases including illnesses involving gastrointestinal, rheumatological, reproductive, sexual, neurological, and psychiatric systems among others. The common thread that links the diverse symptomatic and physical consequences of chronic stress and link to inflammation will be discussed as well as introducing a functional medicine approach to addressing the underlying processes with a practical clinical approach.
8:50 AM - 9:40 AM
Hormones and Psycho-Neuro-Behavior
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 peri-menopausal and menopausal women, and are conventionally treated with medications, particularly 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 an in-depth history and appropriate laboratory testing, they can be corrected with supplements (herbs, vitamins, minerals, amino acids) and bio-identical hormones.
9:40 AM - 10:15 AM
Break / Visit Exhibits
10:15 AM - 11:00 AM
SHBG: What is it Good For?
Scott Fogle, N.D.
Director of Clinical Information and Laboratory Services, Life Extension Foundation, Fort Lauderdale, FL
Lecture Description:
Sex Hormone Binding Globulin is often deemed a villain in the fight to increase free hormone levels, but does it deserve its bad reputation? This presentation will shed light on its role in human physiology and reveal if it is a friend or foe in the effort to optimize hormone levels. Its mechanism and strong impact on hormone levels will be revealed. This presentation will also show how SHBG can help identify disease states and how it can even aid in the recognition of one of the most undiagnosed conditions in medicine today. Optimal blood levels will be suggested for SHBG and using them in the context of other hormone levels will be discussed. Novel actions for SHBG beyond hormone regulation have also come to light in recent years and will be examined in detail. This surprising, and often misunderstood protein, is important and can help clinicians in powerful ways when working with patients.
11:00 AM - 12:00 PM
Putting it All Together: Hormones, Nutrition, Detoxification, Mind, Body
Sangeeta Pati, M.D., FACOG
Medical Director, SaJune Institute for Restorative and Regenerative Medicine, Orlando, FL
Board Certified, American Board of Obstetrics and Gynecology
Diplomat, Anti-Aging & Regenerative Medicine
Lecture Description:
In the process of restoring the body to its optimal state, we are constantly bombarded with a multitude of new interventions that carry great promise for our patients. The challenges we face include: Which intervention comes first? How do the hormones work together? Do I use progesterone first or thyroid first? When do we introduce estrogen or melatonin? Which nutritional interventions should we use? How about detoxification? Where do the mind and body interventions fit? In this lecture, you will learn the order of the interventions and the priorities through illustrative cases which include the diagnosis of fatigue, insomnia, anxiety, depression, osteoporosis and weight gain.
12:00 PM - 1:15 PM
Lunch Break / Visit Exhibits
1:15 PM - 2:15 PM
Ten Best Alternatives to Viagra
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:
Erectile dysfunction is a predictor of other inflammatory disorders in the body. ED is a predictor of not only heart disease but also “disease” in the body. In my opinion ED should be looked at as an early symptom of a much more serious “disease” that has to addressed. In this presentation we will review some of the best alternatives that ought to be tried before we start prescribing a drug with potentially dangerous side effects. One must also keep in mind that just because it is natural does not mean that it is necessarily safe. Some of the “alternative” therapies can also have some side effects that physicians must be aware of.
2:15 PM - 3:00 PM
Dietary Triggers of Pain and Inflammation; Putting Out the Fire: Nutraceutical Management of Inflammatory Diseases
Thomas O’Bryan, D.C., CCN, DACBN
Faculty, Institute for Functional Medicine and National University of Health Sciences
Owner, TheDr.com
Lecture Description:
Numerous pain syndromes and autoimmune diseases have been associated with both humoral and cell-mediated immune responses to food intake. From peripheral neuropathies to migraines and ataxia, from acute myocarditis to chronic pancreatitis, from Myasthenia Gravis to Primary Biliary Cirrhosis, in sensitive individuals, foods can initiate this response by up-regulating macrophage pro-inflammatory gene expression and cytokine production. As a result, extra-intestinal tissue is extremely vulnerable to the effects of excess cytokine production and may initiate an autoimmune attack through a process of cellular mimicry. This response may cause pain throughout the body and has been identified with brain and peripheral tissue, liver epithelial cells, thyroid cells, pancreatic beta-cells, bone cells, skin tissue, and myocardium. As an example, 57% of patients with neurological dysfunction of obscure etiology have elevated antibodies to gliadin (a protein in wheat). Only 35% of this group also have histological evidence of Celiac Disease. The remaining 65% have gluten sensitivity and elevated antibodies where the target organ is cerebellum or peripheral nerves, a situation analogous to that of the skin in Dermatitis Herpetiformis. It appears that foods can directly stimulate an autoimmune response in sensitive individuals.
This presentation will review:
• the frequency of food allergies
• the sequential pain-producing pathophysiology of food allergies beginning in the intestinal epithelium with:
1. an increase in zonulin levels
2. an apoptotic response of intraepithelial lymphocyte hyperplasia enabling paracellular translocation of gliadin and its subsequent interaction with macrophages in the intestinal submucosa triggering the cascade of immunological changes including an elevation in IFN-gamma (a crucial cytokine produced by gliadin-specific T cells in Celiac Disease pathogeny)
3. iNOS activation and a substantial increase in both NO production, NFk-B and TNF-alpha secretion, and
4. upregulation of natural killer receptors by high levels of IL-15,
• dietary and neutraceutical intervention strategies
3:00 PM - 3:45 PM
Break / Visit Exhibits (exhibits close 4:00 pm)
3:45 PM - 4:45 PM
The Devil’s In the Dose
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:
Complementary medicines now boast a large body of scientific evidence to support the observed medicinal effects of the many phytochemicals employed over centuries as traditional medicines. Many such products are not supported by human clinical data indicative of an effective dose.
The emerging field of Nutrigenomics has provided a framework on which to review the adequacy of dose in ensuring the expression of target genes. What is now apparent is that both the form and the dose of the product are often too low to achieve the claimed clinical effects.
With reference to specific de-identified formulations, find out how to evaluate the likely clinical worth of a product you may prescribe and learn:
• Why a practical understanding of Bioavailability is critical
• The significance of the Dose-Response relationship in determining the effective dose
• Why in vitro and animal studies are of limited value to a clinician, even though they are an important part of the development of any medicine.
• How to determine which scientific references are valid indicators of efficacy
• Whether a formulation is likely to be clinically efficacious
• That some well-known supplements simply cannot work as commonly administered
4:45 PM - 5:30 PM
Putting Science into Micronutrient Testing and Evaluation in a Primary Care Setting
Dale E. Alsager, D.O., Ph.D.
Interim Dean of Medicine and Health Sciences, International Cloud University, Seattle, WA
Guest Lecturer, Pacific NorthWest University of Health Sciences, College of Osteopathic Medicine, Yakima, WA
CEO & Medical Director, Osteopathic Medical Services, Inc., Maple Valley, WA
Lecture Description:
A large study assessed multivitamin use among 162,000 women over eight years. This study concluded long-term multivitamin consumption had no impact on the risk of cancers, cardiovascular disease, or overall mortality in postmenopausal women. Ironically, multivitamin consumption in the US remains popular, and represents a $20-billion industry that is growing impressively each year. This author reports on a retrospective review of 60 patients in a primary care practice in Western Washington using an intracellular analysis of eleven vitamins, four minerals, six essential amino acids/metabolites and seven anti-oxidants over ten years. The efficacy of specific micronutrient supplementation is discussed and suggests an indication for, and a cost benefit of, individualizing intracellular micronutrient testing to target specific micronutrient deficiencies in patients. Intracellular testing offers a more precise method of targeting micronutrient deficiencies and shows a strong correlation with positive health outcomes.
7:00 AM - 7:45 AM
The Effect of Topical Cytokines and Chemokines on Skin Regeneration
Presented by David Woynarowski, M.D., CPT
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by
Timeslip RG-Cell Cosmeceuticals and Cenegenics
8:00 AM - 9:00 AM
Brain Cancer: A Metabolic Disease with Metabolic Solutions
Thomas N. Seyfried, Ph.D.
Professor, Biology Dept., Boston College, Chestnut Hill, MA
Lecture Description:
Despite modest advances in the standard of care, malignant cancers persist as a major disease of morbidity and mortality in children and adults. Emerging evidence suggests that cancer is more of a mitochondrial metabolic disease than a disease of the nuclear genome (somatic mutation theory). As a metabolic disorder involving the dysregulation of respiration, malignant cancer can be managed through changes in metabolic environment. In contrast to most normal cells, which transition to ketone bodies (beta-hydroxybutyrate) for respiratory energy when glucose levels are reduced, malignant tumors are heavily dependent on energy production through non-oxidative substrate level phosphorylation. This dependence is due largely to structural and functional abnormalities in mitochondria according to the Warburg theory of cancer. Glucose and glutamine are major fuels for malignant cancer cells. The transition from glucose to ketone bodies as an energy source is an ancestrally conserved adaptation to food deprivation that permits the survival of normal cells during extreme shifts in nutritional environment. Only those cells with a flexible genome, honed through millions of years of environmental forcing and variability selection, can transition from one energy state to another. We propose a different approach to cancer management that exploits the metabolic flexibility of normal cells at the expense of the genetically defective and metabolically challenged tumor cells. This evolutionary
and metabolic approach to cancer management is supported from studies in orthotopic mouse brain tumor models and from case studies in patients with brain cancer. Calorie restriction and restricted ketogenic diets (R-KD), which reduce circulating glucose levels and elevate ketone levels, are anti-inflammatory, anti-angiogenic, and pro-apoptotic towards malignant brain tumor cells. The efficacy of some anti-cancer drugs and non-drug therapies (hyperbaric oxygen therapy) can be enhanced when administered together with the R-KD.
9:00 AM - 10:00 AM
The Role of Unstable Plaque as a Predictor of Unexpected Cardiovascular Events
Joseph Bosiljevac, M.D., Ph.D., FACS
Senior Partner, Cenegenics, New York, NY
Lecture Description:
Data is presented on a series of 50 patients including Doppler velocities, B-mode imaging, arteriograms, and then the path specimen from subsequent carotid endarterectomy. This information was collected in an attempt to demonstrate the correlation between the various diagnostics to identify what tests were helpful to make a decision for surgical intervention. Doppler velocities in the past have been the most accurate means to determine luminal stenosis since conventional arteriograms are two-dimensional. Velocities and waveform characteristics are valuable, but now we also have CT/MRI angiography to give a three dimensional image. However, many times symptoms do not correlate with degree of stenosis since there can be extensive collateral pathways. The purpose of this presentation is to demonstrate plaque characteristics on B-mode sonography and compare this with the pathology specimen. Current availability of advanced blood markers for chronic inflammation can identify patients at risk for plaque rupture. Looking at various operative specimens will support the current thinking of a dynamic process in sudden cardiovascular events. Calcified stable plaque will be compared to soft lipid plaque. A heterogeneous appearance on B-mode imaging can be correlated with intraplaque hemorrhage and unstable plaque. This is most often seen in those patients with symptoms or at risk for a sudden event due to plaque rupture. Despite a low risk classification according to the Framingham
criteria, 25% of patients can still suffer an unexpected cardiovascular event. This data will be expanded to define tests giving useful data to identify patients at risk for an unexpected event, even though they stratify as low risk using current criteria accepted as standard of care in conventional medicine. A good cardiovascular preventive program is a significant component of a quality age-management practice.
10:00 AM - 10:15 AM
Break
10:15 AM - 11:00 AM
New Data on Genomics and on the Oldest of the Old
L. Stephen Coles, M.D., Ph.D.
Lecturer, Molecular Biology Institute, Department of Chemistry and Biochemistry, UCLA
Co-Founder, Los Angeles Gerontology Research Group
Florence Comite, M.D.
CEO & Founder, Comite Center for Precision Medicine, New York, NY
Member, AMMG Conference Planning Committee
Lecture Description:
The "Oldest Man in the World" 2015 Guinness Book of World Records title has gone to a Polish scientist with a Ph.D. in Zoology. Dr. Alexander Imich lived in New York City for many years before his passing and had a strong life-long interest in parapsychology. What can we learn from his example of extreme male supercentenarian longevity, given that more than 90 percent of supercentenarians on GRG Table E are female?
11:00 AM - 11:50 AM
Why Every Physician Should Practice Age Management Medicine - The Three Most Important Outcomes from a Cardiologist’s Perspective
Ernst R. Schwarz, M.D., Ph.D.
Professor of Medicine, Cedars Sinai Medical Center at UCLA
Lecture Description:
Age management has been the focus of the public debate in recent years for several reasons but in particular the following two reasons:
1. Ethically and scientifically one believed that “anti aging” is non-existing.
2. The controversial uses of hormones or other controlled therapies without adequate medical supervision leading to abuse.
On the other hand, mainstream medicine slowly starts to recognize age management as part of a legitimate academic and clinical subject for the following reasons:
1. The baby boomer generation represents the majority of patients.
2. The physicans/cardiologists are the baby boomers.
Practicing age management for any physician subspecialty but in particular for cardiologists offers
1. Active clinical and scientific involvement and understanding of the processes of aging and geriatric medicine and cardiology.
2. Development of resources beyond the traditional world of changed and diminished quality of healthcare.
11:50 AM - 12:40 PM
Regenerative Medicine for Degenerative Diseases
Kristin Comella
Chief Scientific Officer, Bioheart, Inc., Sunrise, FL
Lecture Description:
The field of regenerative medicine is rapidly growing with an emphasis on stem cell therapies and the promise of cures for everything from acute injuries to chronic degenerative diseases. The list of indications is expanding as more studies are published to demonstrate safety and efficacy. Regenerative medicine is the process of replacing or regenerating human cells, tissues or organs to restore or establish normal function. The concept is that damaged tissue can be restored by using the body’s own healing mechanism to promote repair. This new branch of medicine may change the course of chronic diseases and standard clinical therapies. However, with any new therapies, this must be approached cautiously and with scientific data to support the treatment. This session will discuss the use of stem cell therapies in degenerative diseases and the challenges of bringing these products to market.
12:40 PM - 1:30 PM
EMF Radiation - How to Protect Yourself
Elizabeth Plourde, C.L.S., NCMP, Ph.D.
Adjunct Professor, San Diego University for Integrative Studies, San Diego, CA
Medical Researcher, Author and Lecturer, Specializing in Hormones, Toxins and the Environment
Lecture Description:
Thinking we can no longer live without cell phones, computers, Wi-Fi, and wireless devices is costing humanity a huge toll in our health and even threatens our very survival. This course teaches why we need to protect ourselves from the wireless revolution, explaining how these radiations are part of why cancers, Alzheimer’s, obesity, asthma, autoimmune diseases like MS, and infections such as Lyme disease have been rapidly increasing. It includes identifying the technologies that are harmful and aging to the body, and how to adopt lifestyles that promote healthier choices.
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