Agenda April 2020

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Wednesday April 22nd

Practice Management Workshop: Launching and Growing a Successful Age Management Practice

Many attendees of the AMMG conferences are attracted to the field of Age Management Medicine, but do not feel qualified, or empowered with the necessary tools, to successfully transition from the well-established structure of disease-based medicine or from the traditional insurance-based reimbursement system into a system which relies to a significant degree upon direct pay. This workshop is for those physicians and management staff. Attendees will be guided through the process of evaluating their professional goals, and then be helped to create a successful strategy to achieve those goals. Our goal is for the attendee to be equipped with the basic tools for making the decision whether to consider moving into an Age Management Medicine practice, and if so, to create a successful transition into this exciting field.

Non-CME Course

Time
Presentation
1:00 – 1:45 pm What Does Direct Pay Practice Ownership Mean?
Kenneth Janson, M.D., FACS
Chief Medical Officer, Precision Health by Science
Attendees will be asked to create their vision of the ideal Age Management Practice they wish to develop. Understand what Direct Pay actually is, learn the best practices for this type of practice and transcend the fear of moving from insurance-based to direct pay practice.
1:45 – 2:30 pm Creating the Effective Business Map for One Year, Three Years, and Beyond: The Medical Services and Procedures Planning Process
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science
Practice Business Models: Legal and Operational Considerations You Don’t Want to Get Wrong
2:30 – 3:15 pm Location Can Make or Break Your Practice
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science
Critical Considerations When Choosing a Clinic Site
3:15 – 3:30 pm Break
3:30 – 4:15 pm Developing the Branding and Internal Marketing of Your Center
Cynthia Rilling, M.A.
Chief Operating Officer, Precision Health by Science
Culture of Excellence Starts with The Right Team: Clinical Staffing Model Determination – Engaging your team in the promotion to your current patients and prospects of your practice objectives, products and services.
4:15 – 5:00 pm External Marketing: Promotion and Branding of Your Services
Cynthia Rilling, M.A.
Chief Operating Officer, Precision Health by Science
What Business Are You Really In? Understanding and defining your practice scope of services utilizing social media, marketing, advertising, and public relations in order to generate greater demand for your products and services with the objective of increasing revenue and profits.
5:00 – 6:30 pm Working Dinner
Clinic Startup: “I Want Only the BEST but NOT to go Broke”

Dinner provided by Universal Arts Compounding Pharmacy & DEXAPLUS

  • DEXA, Equipment, Supplies, and Other Patient Care Service Options – Tony Orlando, President, DEXAPLUS
  • Choosing the Right Compounding Pharmacy to Partner with Your Practice – Tyler Harrold, PharmD, Universal Arts Compounding Pharmacy
  • Choosing the Appropriate Laboratory Services – Cynthia Rilling, M.A., Chief Operating Officer, Precision Health by Science
6:30 – 6:45 pm Break
6:45 – 7:45 pm Bringing It All Together
Kenneth Janson, M.D., FACS
Chief Medical Officer, Precision Health by Science
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science

  • Business Plan and Pro Forma Development: Strategies for Pricing and Staying Compliant
  • Geometric Growth of Your Practice: Three Ways to Strategically Grow your Business
  • Building a National Professional Support Network of Like-minded Physicians
7:45 – 8:30 pm WATCH OUT! Practice Landmines to Avoid
Kenneth Janson, M.D., FACS
Chief Medical Officer, Precision Health by Science
Kent Rilling, PA-C
Chief Executive Officer, Precision Health by Science
Cynthia Rilling, M.A.
Chief Operating Officer, Precision Health by Science

  • 5 Risk Management Dangers You Must Prevent
  • 5 Marketing Landmines
  • 5 Top Reasons Age Management Centers Fail and How to Best Position Your Practice for Success
8:30 – 9:00 pm Open Forum Q and A

Thursday, April 23rd

Certification: Essential Knowledge in the Clinical Use of Peptides for Age Management Medicine

The use of Peptides and Peptide Therapies has experienced exponential growth over the past few years. Their uses range from impacting hormonal change, to antibiotic properties, to treatments for conditions of aging such as cancer, cardiovascular health, memory & brain health and sexual function. AMMG in conjunction with the Clinical Peptide Society have an educational mandate is to fill knowledge gaps for physicians and healthcare professionals. This course is a focused track on essential knowledge in the clinical use of peptides for Age Management including a final examination for Certification.

In conjunction with the Clinical Peptide Society

3-Part Process to complete the Peptide Certification Course of Study:
  1. Home Study Online - 8.25 hrs: Clinical Use of Peptides and Peptides Therapy - Full Course
    • Complete at your own pace. Completion of the online course is a prerequisite to certification.
    • Course Access: After registering you will receive an email with your username and password to access the online course. NOTE: It can take up to 5 days to process.
    • Review Questions: You will receive an additional email with review questions to be answered after viewing each video. These question must be submitted to AMMG prior to the live training.

  2. Live Training at AMMG Conference - 7 hrs: Essential Knowledge in the Clinical Use of Peptides for Age Management Medicine
    • This full day live course will be held April 23 at the AMMG Conference in Miami, Florida.

  3. Comprehensive Final Exam: The final exam will be given Immediately following the last lecture at the live course which will be held April 23 at the AMMG Conference in Miami, Florida.

COMPLIANCE DISCLOSURE: AMMG has made every effort to have all lectures and statements made regarding Peptides comply with all FDA and State and Local laws. There are some Peptides which the FDA has not approved for compounding. This is a new and potentially changing area of medicine and we encourage you to frequently check for new policies, laws and rules which may apply to your practice and to strictly adhere to all laws which apply

Time
Presentation
7:00 – 7:45 am New FDA Prescribing and Treatment Information in Treating Adult Growth Hormone Deficiency
Presented by Eric Braverman, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 8:30 am Introduction of Peptides (which hormones are peptides, with which receptors do they interact, history of the discovery of peptides, and understand that peptides have a pleiotropic effect)
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, Orlando, FL
Member, AMMG Conference Planning Committee
Co-Founder, Clinical Peptide Society
The world of peptides therapy is a growing field in medicine ranging from improving skin care, to growth hormone, to one’s immune system, to name a few. On Pub Med there are over 2.5 million articles on peptides. It is estimated that humans have over 250,000 peptides and we only understand a fraction of them. Peptides are chains of amino acids linked together by a polypeptide bond. The formation of a polypeptide bond by a dehydration synthesis will be reviewed. The difference between a peptide and a protein will be delineated. In addition the mechanism of action on how peptides work will be reviewed. The history of peptides will be covered and also knowing which hormones are peptides will be reviewed. Peptides have pleotropic effects and during the conference this subject will be addressed.
8:30 – 9:30 am Peptides to Increase Growth Hormone (CJC 1295, Ipamorelin, Tesamorelin, GHRP-6 and others) and Case Studies
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, Orlando, FL
Member, AMMG Conference Planning Committee
Co-Founder, Clinical Peptide Society
Growth hormone is an essential hormone in lowering body fat, improving on lipids, keeping muscles healthy and improving on bone density. Adult growth hormone deficiency symptoms will be reviewed and the association of higher mortality with growth hormone deficiency. Unfortunately the treatment with recombinant human growth hormone is not covered under most insurance plans, and it is cost prohibitive for most people. There is an alternative to the expensive recombinant human growth hormone most commonly used for boosting IGF-1 and it has the advantage of inducing all five of the hGH isoforms rather just the one that is found in the synthetic form. CJC-1295, Ipamorelin, GHRP-6, Teslomorelin and others are peptides that have been shown to help improve IGF-1 levels.
9:30 – 10:15 am Review Thymosin Alpha 1 and Thymosin Beta 4. Literature Review, Data of the Safety of Each of the Peptides and Case Studies
Luis Martinez, M.D., MPH
President, XanoGene Clinic, San Juan, Puerto Rico
President, Regenera Global
The thymosins are a group of peptides originally associated with the thymus gland. They possess pleiotropic effects on in humans. Thymosin Alpha 1 has long been studied for its immune enhancing properties, with regulatory approvals in the management of certain viral diseases and cancers. On the other hand, Thymosin Beta 4 has been shown to improve regeneration in multiple tissues.
10:15 – 10:30 am Break
10:30 – 11:15 am Peptide BPC-157 – Total Body Healing Peptide Including Literature Review and Case Studies
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, Orlando, FL
Member, AMMG Conference Planning Committee
Co-Founder, Clinical Peptide Society
BPC-157 was discovered in the 1990s in gastric juice. However I give credit to Dr. Pavlov in Russia in the early 1900s since he was manufacturing gastric juice from dogs to help heal many alignments. At that time they did not have the technology to detect BPC-157. BPC-157 has been studied extensively in animals and has been shown to improve on healing the body. Studies with BPC-157 have been shown to heal a severed tendon, nerve, and also ulcers. Although there are no human clinical trials the body builders has been using BPC-157 experimentally to repair their torn muscles, tendons and ligaments. In this lecture the published studies of BPC-157 ranging from colitis, inflammatory bowel disease, systemic steroid impaired muscle healing, bone defect, periodontitis, and others will be reviewed. Although the FDA has not approved this peptide, BPC-157 has been used worldwide.
11:15 am – 12:00 pm Peptides for Autoimmune Conditions, Literature Review and Case Studies
Luis Martinez, M.D., MPH
President, XanoGene Clinic, San Juan, Puerto Rico
President, Regenera Global
Millions of Americans suffer from autoimmune diseases. Immune dysregulation, a universal characteristic of autoimmune diseases, can be targeted through the use of specific peptides. This lecture will present the rationale for utilizing peptide therapy in the management of autoimmune diseases. T cell modulation, cell predominant shifts, OGF axis and other mechanisms of action will be highlighted. VIP, thymosins and other peptides will be covered. Cases and protocols will be discussed.
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by TBD
1:30 – 2:15 pm Cancer Peptides: Includes Case Studies of Cancer Cases Using Peptides
Luis Martinez, M.D., MPH
President, XanoGene Clinic, San Juan, Puerto Rico
President, Regenera Global
Advances in peptide biology have shed light on multiple pathways which can be targeted for therapeutic interventions with the use of peptides. These can be incorporated as part of a comprehensive cancer management approach. The lecture will discuss peptide classes, mechanisms of action and proposed protocols for incorporating peptide therapy in the treatment of cancer patients. Peptides including Met-Enkephalin, PNC 27, P18 among others will be discussed. Oncostatic and oncolytic characteristics will be reviewed.
2:15 – 3:00 pm Neuroregenerative Peptides: Includes Literature Review and Case Studies
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, Orlando, FL
Member, AMMG Conference Planning Committee
Co-Founder, Clinical Peptide Society
An estimated 6 million Americans have Alzheimer’s disease, 10 million people worldwide with Parkinson’s, 3 million Americans suffer from traumatic brain injury (TBI), and approximately 800,000 will suffer from a stroke each year. There are peptides that have been shown to have neuroregenerative properties that have clinical studies in strokes, traumatic brain injury, Parkinson’s and in Alzheimer’s disease. There are many mechanisms that are involved with neurodegenerative diseases to traumatic brain injury. Inflammation in the brain, excessive oxidative stress, mitochondrial impairment, and excitotoxicity are common theme that can lead to damage or death of the neuron or myelin. Peptides have been shown to reduce inflammation, reduce oxidative stress, increase the production of brain derived neurotrophic factor and also increase the production of neurons. The peptides of Thymosin Beta 4, BPC-157, Cerebrolysin, Dihexa and Semax will be covered.
2:30 pm Exhibits Open
3:00 – 3:45 pm Break / Visit Exhibits
3:45 – 4:15 pm Peptide PT 141, Melanotan and Epithalon with Case Studies
Luis Martinez, M.D., MPH
President, XanoGene Clinic, San Juan, Puerto Rico
President, Regenera Global
Alpha melatonin stimulating hormone analogues, including PT 141 and Melanotan, can act on multiple melanocortin receptors. As such, they have been studied and are currently being used for multiple indications, including increasing libido, altering skin pigmentation and modulating food intake. Epitalon is a pineal peptide, originally studied in Russia. It has been shown to activate telomerase, restore melatonin secretion and reduce mortality in users. This lecture will review both pineal and pituitary physiology as they relate to these peptides. Melanocortin receptors and neuropetides will be discussed.
4:15 – 5:00 pm Question and Answer Session with Faculty
Edwin Lee, M.D., FACE & Luis Martinez, M.D., MPH
5:00 – 5:30 pm Peptides Certification Examination  (non-CME)
Mary Corry, R.N. — Exam Proctor
Medical Education Specialist, Worldlink Medical, Salt Lake City, UT
Member, AMMG Conference Planning Committee
Member, Sigma Theta Tau International Honor Society of Nursing
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, April 23rd

Certification: Essential Knowledge in the Science and Potential of Extracellular Vesicles (commonly referred to as Exosomes) for Age Management Medicine

The use of extracellular vesicles has experienced exponential growth over the past 5-10 years. Their uses range from impacting pain management, cardiovascular disease, autoimmune disease, neurodegenerative conditions, cancer therapeutics to treatments for conditions of aging such as aesthetics, hair restoration, orthopedics and sexual function.  AMMG  has an educational mandate to fill knowledge gaps for physicians and healthcare professionals. This course is a focused track on the Essential Knowledge in the Science and Potential of Extracellular Vesicles (commonly referred to as Exosomes) for Age Management Medicine including a final examination for Certification.

3-Part Process to complete the Extracellular Vesicles Certification Course of Study:

  1. Home Study Online - 8.0 CME hrs: Extracellular Vesicles (Exosomes): The Next Generation of Biologic Medicine - Full Course.
    • Complete at your own pace.
    • The online course is included in the program registration cost. Completion of the online course is a prerequisite to certification.
    • Course Access: After registering you will receive an email with your username and password to access the online course. NOTE: It can take up to 3 days to process.

  2. Live Training at AMMG Conference -3.75 hours of CME Accredited Lectures and 3.25 hrs Non-CME lectures, 7 hrs total: Essential Knowledge in the Science and Potential of Extracellular Vesicles (commonly referred to as Exosomes) for Age Management Medicine.
    • This full day live course will be held April 23 at the AMMG Conference in Miami, Florida.

  3. Comprehensive Final Exam: The final exam will be given Immediately following the last lecture at the live course which will be held April 23 at the AMMG Conference in Miami, Florida.
COMPLIANCE DISCLOSURE: AMMG has made every effort to have all lectures and statements made regarding Extracellular Vesicles comply with all FDA and State and Local laws. This is a science and knowledge based course, and Extracellular Vesicles is a new and potentially changing area of medicine. Currently Extracellular Vesicles can only be used in conjunction with an IRB with a FWA plus and IND/BLA, meaning FDA approval for a phase 1 clinical trial must be granted. We encourage you to frequently check for new policies, laws and rules which may apply to your practice and to strictly adhere to all laws which apply.
Time
Presentation
7:00 – 7:45 am New FDA Prescribing and Treatment Information in Treating Adult Growth Hormone Deficiency
Presented by Eric Braverman, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 8:45 am Introduction of Extracellular Vesicles (History, Definition, Exosomes and other Extracellular Vesicles)
Mari Mitrani, M.D., Ph.D.
Co-founder, American Cellular & Anti-Aging Center, Quito, Ecuador
Chief Science Officer and Co-founderOrganicell Regenerative Medicine
The presence of vesicles outside cells was first identified 50 years ago and were originally thought to be waste products released via shedding of the plasma membrane. It was not until 1987 that the term ‘exosome’ was coined for these extracellular vesicles (EVs) and the endocytic origin was established. Exosomes are unique from other extracellular vesicles not only due to their nanoparticle size (50-200nM) but also because of their endosome origin. Larger EVs such as apoptotic bodies (800-5000nm), and cell membrane vesicles (100-1000nm) are formed from outward budding of the cell surface membrane whereas exosomes are formed from within the cell’s early endosome structures and released during exocytosis fusion to the cell membrane. The distinct origin of exosomes promotes the packaging of many endosome associated proteins as well as an array of intracellular proteins and genetic material. Exosomes function as intercellular communication structures that facilitate the transmission of molecules between cells. In this process exosomes transfer proteins, lipids, mRNA, miRNA and DNA to the recipient cells. It is this delivery system that has elucidated exosomes as an ideal carrier for drugs because they are composed of cell membranes and a lipid bilayer that can deliver cargo inside the cells. A number of cell-based therapies have been tested in the clinic as regenerative tools for the prevention and reversal of degenerative disease. Although clinical efficacy has been variable, these tests have interpreted the role of cell derived secretomes and exosomes as a major mechanistic player in clinical effect. Therefore, exosome therapies are now being explored as an alternative therapeutic tool rather than the cells themselves.
8:45 – 9:30 am Extracellular Vesicle Sources vs Stem Cell Sources
George Shapiro, M.D.
Adjunct Assistant Professor Clinical Medicine, New York Medical College, Valhalla, NY
Founding Partner
, Cenegenics, New York City
Member
, AMMG Conference Planning Committee
Regenerative Therapies including stem cells and extracellular vesicles have taken a center stage in the past several years, in order to remain up to date with these new technologies the clinician should have a basic knowledge of the various types of biologic therapies and the sources of those therapies. The current lecture will review and compare autologous vs allogeneic sources and include discussions on platelet rich plasma, adipose and Bone marrow derived cells, perinatal sources such as amnion, chorion, cord blood and placental tissue. Evidence from RCTs will be reviewed along with advantages and disadvantages of each source of regenerative therapy.
9:30 – 10:15 am Molecular Characterization and Sterilization of Perinatal Extracellular Vesicles
Michael A. Bellio, Ph.D.
Assistant Scientist, Interdisciplinary Stem Cell Institute, Clinical Research Cell Manufacturing Program, University of Miami Miller School of Medicine, Miami, FL
Laboratory and Lead Scientific Director, Organicell Regenerative Medicine

Extracellular vesicles are being studied extensively in various models of degenerative diseases and are rapidly entering the clinic as novel regenerative therapeutics. Thus, the development of clinical-grade manufacturing procedures to isolate extracellular vesicles for therapeutic use is required for the development of potent and safe therapies. There are several bioengineering challenges that need to be overcome to successfully and aseptically isolate clinical sized doses of extracellular vesicles. These challenges include the ability to reproducibly quantify, qualify, and characterize the exosome product. As with all other cell therapies, extracellular vesicles are complex units that contain a wide variety of proteins and genetic material that participate in a synergistic regenerative effect. Therefore, all components of the extracellular vesicles should be analyzed to fully elucidate the drug components. In this lecture, we will discuss the various manufacturing techniques that have been developed to produce extracelluar vesicle products. We will also discuss the molecular techniques that are most often used to characterize the extracellular vesicle products and qualify the product for clinical use.
10:15 – 10:30 am Break
10:30 – 11:15 am Medical research studies are a crucial step in developing new medicines and treatments. Extracelluar Vesicles Therapy is relatively new and the best way to advance the field is by actively participating in research studies. Due to the many sources of extracelluar vesicles and varieties of pathologies that they can potentially aid, it’s very important to conduct studies to understand their efficacy. The Institutional Review Board (IRB) is an organization that protects the rights and welfare of human research subjects that are recruited to participate in research conducted under the authority of the institution with which it is affiliated. The IRB is intended to minimize risks to human research subjects by using procedures that are consistent with sound research design and procedures, which may already be performed on subjects for diagnosis or treatment purposes. Under FDA regulations, IRB is an appropriately constituted group that has been formally designated to review and monitor biomedical research involving human subjects. In accordance with FDA regulations, an IRB has the authority to approve or disapprove research. Food and Drug Administration (FDA) approval is needed to bring any new drug to the market. An Investigational New Drug (IND) process serves as the primary mechanism in the process to bring a new drug to the market. An IND requires completion of 3 requirements that include: the details of the study, details of the investigator and the study location, and registering the study in the national database of clinical trials. Federal law requires a drug be approved before it is transported across state lines. An IND is required for:

  1. Studies involving a drug or biologic that is not approved for marketing by the FDA.
  2. Studies involving an approved drug or biologic that is being tested to support a new indication or significant change in labeling of the drug or biologic.
  3. Studies involving an approved drug or biologic that is being used or tested in a new route of administration, new dosage level, or new patient population that may increase the risks (or decrease the acceptability of the risks) of the drug or biologic.
11:15 am – 12:00 pm Clinical Uses of Extracellular Vesicles and Protocols
George Shapiro, M.D.
Adjunct Assistant Professor Clinical Medicine, New York Medical College, Valhalla, NY
Founding Partner
, Cenegenics, New York City
Member
, AMMG Conference Planning Committee
Extracellular Vesicles have an endosomal origin and are released by many different cell types. They subsequently participate in different physiological and/or pathological processes. Depending on their origin, they can alter the fate of recipient cells according to the information transferred. There is a tremendous therapeutic potential of extracellular vesicles and their applications represent the newest frontier in clinical medicine. Early clinical research for treatment of osteoarthritis, pain, hair restoration, COPD, CHF, CAD, ED, pulmonary artery hypertension, pulmonary fibrosis, and age-related decline are in progress. Research continues to show a possible role of Extracellular Vesicles in the Diagnosis and Prognosis of Various Diseases. Extracellular vesicles contain partially overlapping contents and shared mechanisms for communication and function. Investigations into a broad variety of diseases—oncologic, cardiometabolic, neurologic, and infectious—support a functional and potentially therapeutic role for extracellular vesicles. The results of additional studies suggest that extracellular vesicles may be useful as biomarkers of disease progression or therapeutic response. Hopes on the regenerative effect of extracellular vesicles extends to several organs. Considering pre-clinical data, extracellular vesicles, especially from mesenchymal stem cells, hold great promises for the regeneration of several organs including heart, lungs, bones, liver, skin, pancreas and kidneys. Scientific protocols that will be implemented in clinical studies utilizing these various sources of perinatal tissue for some of the above conditions will be reviewed.
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Bio-Botanical Research
1:30 – 2:15 pm Exosomes in Immune, Inflammatory and Neurodegenerative Disorders  (non-CME)
John Sanderson, M.D.
CEO, XOStem, Irvine, CA
Exosomes have emerged as nano-sized, mRNA enriched, packets of information that allow cells within a tissue to network and coordinate their “states”. Although the precise physiological and pathological functions are in early stages of discovery, a strong body of evidence indicates their pivotal roles in immune regulation. Exosomes may be involved in inflammatory processes that play a pivotal role in a large number of pathologic states including cancer, inflammatory bowel diseases, diabetes, obesity, rheumatoid arthritis, osteoarthritis, and neurodegenerative diseases. Conversely, these same nano-packet networks can be co-opted to deliver an anti-inflammatory phenotypic agenda – therapeutic cargoes capable of reversing diseases and promoting regeneration. We explore in this lecture the art of engineering exosomes to express novel cargoes and thus fashion powerful anti-inflammatory therapeutics fine-tuned to specific anatomic structures, including our own work in diabetes, MS, Alzheimer’s, and Lyme disease.
2:15 – 3:00 pm Exosomes and Hair Restoration  (non-CME)
Alan J. Bauman, M.D., ABHRS
Founder & Medical Director, Bauman Medical Group, Boca Raton, FL
In Regenerative Medicine, the “troika” of cells, signals and scaffolds make up the foundation of what clinicians and scientists have in their toolbox. Leveraging the power of this triad is the goal of physicians looking to influence the form and function of our largest organ, the skin, to accelerate healing as well as halt or reverse the signs of aging, including hair loss.  In cosmetic surgery, redistribution of MSC-rich adipose tissue, primarily to replace lost volume, has been observed to exert additional anti-aging benefits to the overlying skin as well as enhance hair follicles when applied into the scalp. Similar to the research on platelet rich plasma, these observed hair growth effects are often attributed to growth factors which have been recognized in playing a role in the chronobiologic activity of the hair follicle. If the “work” of these MSC cells can be fully derived from the paracrine messages sent via their cellular secretome, including exosomes and the material they contain, the hope is that eventually FDA-approved off-the-shelf products can reproduce these beneficial effects without the need for cumbersome tissue transfer at the bedside. The author will review cellular sources of exosomes, research on exosome contents (including growth factors, cytokines, miRNA) and their presumed effect on hair follicle function, controversies and challenges in exosome purification and quantification, in addition to the latest published and other reports on their effect on hair growth.
2:30 pm Exhibits Open
3:00 – 3:45 pm Break / Visit Exhibits
3:45 – 4:15 pm Exosomes in Topical, Aesthetic and Sexual Regenerative Medicine  (non-CME)
John Sanderson, M.D.
CEO, XOStem, Irvine, CA
Exosomes may be described as elegantly packaged and precisely labeled complex molecular cargoes, exported by producing cells for import by consuming cells either near or distant. Epithelial tissues including skin and its appendages are constantly shedding and regenerating, with exosomal biosignals playing a major role in structural integrity (dermis), barrier functions (epidermis) and the maintenance of homeostasis. As progenitor and stem cell populations decline and take on senescent phenotypes, we observe a shift in intercellular biosignaling that correlates with alterations in human physiologic function and appearance. In this lecture we explore aging appearance and age-related dysfunctions and the potential for altering these through exosome cargo “engineering” with an emphasis on integument (skin and its appendages) as both from an aesthetic and therapeutic viewpoint, as well as life cycle functional impairments associated with aging (menopause and andropause) and their sequelae.
4:15 – 5:00 pm Case Studies and Question and Answer Session with Faculty  (non-CME)
George Shapiro, M.D., Mari Mitrani, M.D., Alan Bauman, M.D., John Sanderson, M.D., Michael Bellio, Ph.D.
Various case studies will be presented and discussed for several clinical conditions that would benefit from regenerative therapies.
5:00 – 5:30 pm Certification Examination on Essential Knowledge in the Science and Potential of Extracellular Vesicles for Age Management Medicine (non-CME)
John Rush, M.D. — Exam Proctor
Member, AMMG Planning Committee
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, April 23rd

Pre-Conference Track 1: Introduction to Core Issues in Age Management Medicine

Course is designed to familiarize physicians and healthcare professionals with the basics of Age Management Medicine. Covers evidence-based use of nutrition, supplements, fitness, hormones—including a specialized lecture on hGH and assessment protocols—and legal basics, with some of the newest medical science on aging that may be in use now or in the near future; including relevant case presentations and discussion.

Time
Presentation
7:00 – 7:45 am New FDA Prescribing and Treatment Information in Treating Adult Growth Hormone Deficiency
Presented by Eric Braverman, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 9:00 am Basic Hormone Replacement/Replenishment for Men
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
Prescribing hormones for men is simple and straightforward. However, dealing with the problems and complications is not. This lecture will address common problems, complications, side effects, monitoring, understanding levels, erythrocytosis vs. polycythemia, prostate cancer and elevated PSA, use of 5 alpha reductase inhibitors, and aromatase inhibitors.
9:00 – 10:00 am Hormone Supplementation for Women
Kathryn Retzler, N.D.
Private Practice, HormoneSynergy Clinic LLC, Portland, OR
There are many periods in a woman’s life that challenge her physiologically, mentally, and spiritually, the most notable often being the times of greatest hormonal fluctuations such as with menarche, post partum and menopause. These hormonal fluctuations can be a simple transition or cause for many symptoms, physical complaints, sexual dysfunction, medical illness, and other challenges. As a healthcare provider, this can be challenging. Necessary tools to alleviate and ease hormonal transition include appropriate diagnostic tools, physical exam, and an armamentarium of treatments to recreate hormonal balance on many levels, including the sex steroids, adrenal and neurotransmitter support, as well as dietary and lifestyle modifications.
10:00 – 10:15 am Break
10:15 am – 11:15 am Use of Supplements: Are They Effective?
Rebecca 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
As practitioners in functional medicine and “age management,” our patients expect that we have and utilize the best options to guide them to optimize their health and protect them from the common problems associated with aging such as heart failure, stroke, osteoporosis, and cognitive impairment. Contrary to the standard RDA for nutrients, various factors that contribute to a person’s actual needs include: decreased ability to absorb nutrients, medications that many deplete the body of certain nutrients, and environmental factors that contribute to a greater need. This presentation will provide an overview of the mechanism of action of nutraceuticals and supplements in the protection from the untoward effects of inflammation, oxidative damage, endothelial dysfunction and how they can be applied in your practice for the prevention and treatment of common medical conditions seen in the aging population.
11:15 am – 12:00 pm Improving Growth Hormone With and Without Growth Hormone
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
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. In 2017, research showed that 61% of individuals with treatment resistant depression had a Growth hormone deficiency which resolved when corrected. 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. In this lecture you will learn (1) the importance of GH and its related growth factors in body functioning, restoration, and protection, (2) how to detect deficiency and perform a Glucagon Stimulation Test, and (3) the myth about GH causing cancer, and (4) treatment protocols using secretagogues and growth hormone in combination.
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Bio-Botanical Research
1:30 – 2:15 pm Use of Fitness & Exercise in an Age Management Medicine Practice
Mary Corry, R.N.
Medical Education Specialist, Worldlink Medical, Salt Lake City, Utah
Member, AMMG Conference Planning Committee
Member, Sigma Theta Tau International Honor Society of Nursing
One of the key components to Age Management Medicine is exercise. During this presentation, we will discuss the benefits of exercise and how to build an effective exercise program for beginner and advanced patients.
2:15 – 3:00 pm Compliance with Federal and State Regulations as You Begin Your Age Management Practice
Paul D. Werner, Esq.
Member, Buttaci, Leardi & Werner Law Firm, Princeton, NJ
Recognize when relevant Federal and State regulations are implicated within your age management practice and measure and evaluate necessary steps to ensure compliance with these statutes and regulations. This workshop will focus on one essential element; compliance as an ongoing process. Compliance with Federal and State regulations depend entirely upon a provider’s willingness to be motivated, alert, and self-critical. Compliance and compliance plans are a risk management tool that should address each and every area of potential exposure. Good faith efforts to focus on and implement thorough compliance mechanisms evidences a provider’s commitment to compliant and ethical practice and therefore undermines any allegation of intentional malfeasance. Compliance with Federal and State regulations is not only important when beginning a new practice, but is an essential element to the ongoing success of that practice. Continual monitoring of compliance “hot spots,” which requires a comprehensive understanding of the relevant regulatory framework, helps identify issues before they escalate into problems that could result in liability.
2:30 pm Exhibits Open
3:00 – 3:40 pm Break / Visit Exhibits
3:40 – 4:30 pm Age Management Medicine Clinical Recommendations for Diet and Weight Loss
Rob Kominiarek, D.O., FACOFP 
Member, AMMG Planning Committee
Director, ReNue Health, Springboro, OH
Assistant Clinical Professor, Ohio University College of Osteopathic Medicine
Obesity has gained epidemic proportions and is now the leading cause of chronic medical illnesses that occur as we age. Correcting obesity should therefore be paramount for every physician who practices age management medicine. Old concepts of weight-loss, such as low-fat diets, have been shown to actually increase cardiovascular risks. The Mediterranean diet has been proven to have beneficial effects on health but, per se, may not provide a good option for losing weight. Newer concepts such as higher fat diets, ketogenic diets and fasting mimicking diets have accumulated a plethora of evidence that suggests these appear to be preferred options for patients to lose weight. Physicians should consider this new evidence when recommending weight-loss options.
4:30 – 5:30 pm Assessing the Age Management Patient
Michale “Mickey” Barber, M.D.
CEO & CMO, Better Life Carolinas, Charleston, SC & Charlotte, NC
This lecture will focus on the many aspects of a patient’s health and fitness that should be evaluated as part of the initial assessment. This assessment should provide the patient and clinician with information about the patient’s health and disease history, nutritional patterns, sensitivities and supplement history. An assessment of fitness, strength and balance are also considered to be essential to setting up goals for a healthy aging program. The measurement and interpretation of key aging biomarkers including hormones will be discussed. The impact of stress on our health and longevity is well known and should also be assessed from day one of beginning an age management program. Attendees should leave this lecture with a good understanding of a basic as well as advanced age management assessment protocol.
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, April 23rd

Pre-Conference Track 2: Complex Case Studies and Discussion in Age Management Medicine

This session is designed for clinicians currently practicing Age Management Medicine either full or part time who would benefit from in depth, interactive discussions of cases involving various areas and clinical aspects of Age Management Medicine. This session will not include didactic lecture but focus exclusively on case presentations and interactive discussions. Presenters will be asked to provide a basic SOAP Note history of the patient case, and work through initial laboratory assessments, laboratory results, possible diagnoses, and development of an individual treatment plan of action.

Time
Presentation
7:00 – 7:45 am New FDA Prescribing and Treatment Information in Treating Adult Growth Hormone Deficiency
Presented by Eric Braverman, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 – 9:00 am The Difficult Testosterone Patient
Rob Kominiarek, D.O., FACOFP 
Member, AMMG Planning Committee
President & Medical Director, ReNue Health, Springboro, OH
Assistant Clinical Professor, Ohio University College of Osteopathic Medicine
This lecture will explore the basics of testosterone therapy for men, starting with initial laboratories and exploring the numerous treatment options available to the physician for resolution of symptoms associated with partial androgen deficiency. We will further explore how to deal with unanticipated, new, awful, frightening, and frustrating anxiety disorders, panic attacks and their often-disabling symptoms. What happened after you started therapy? This lecture will explain the mechanisms by which underlying, unexposed anxiety issues can be manifested after the addition of testosterone. Dealing with the increase of serotonin re-uptake transporter protein, decreasing magnesium levels, MOA snp’s and progesterone, DHEA and pregnenolone decline. Attendees will be able after this lecture to implement these strategies in their daily practice to immediately benefit their patients.
9:00 – 10:00 am Complex Case Studies – Remarkable Healing of Incurable Diseases with High Dose Testosterone
Eugene Shippen, M.D.
Author, “The Testosterone Syndrome”
The remarkable story of the Jens Mohler Medical Clinic in Denmark. Mohler used very high doses of Testosterone in men and women to halt the progression and promote healing in serious cases of diabetic gangrene. Pictorial proof of these remarkable cases. And Induction of full remission in poorly controlled Ulcerative Colitis cases with Testosterone treatment. Case presentation and discussion.
10:00 – 10:15 am Break
10:15 am – 12:00 pm Complex Cases for Male and Female Patients
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
Prescribing testosterone to men and women is easy in 90% of the time. However, it is the other 10% that requires skill, experience, insight, and command of the medical literature to appropriately treat complex cases. This lecture will review several complex cases and scenarios that will enable the experienced clinician to handle those difficult cases. A literature review will be provided to support why we do what we do in complex cases. Critical thinking and command of the literature is required to understand treatment of these complex cases.
12:00 – 1:30 pm Lunch Break
12:00 – 1:00 pm TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Bio-Botanical Research
1:30 – 2:15 pm Healing the Most Difficult and Complex Cases with Nutritional Supplementation, Peptides, and Exosomes
Rebecca Murray, APRN, FNP-BC, CDE
Endocrine Nurse Practitioner, Institute for Hormonal Balance, Orlando, FL
Medical Director, Ward-Murray HealthCare Consulting, Orlando, FL
Scientific Advisory Board, Designs for Health
I will take my most difficult cases (ones that I have seen that have not found answers through conventional  medicine) and will walk through their history (including risk factors), the work- up and evaluation process, targeted replacement of nutrient deficiencies, utilization peptide therapy to act as signaling molecules and immune modulators, and when exosomes would be beneficial for the healing process.
2:15 – 3:00 pm “I’m Losing My Mind”: Finding the Treatment for Early Dementia, and “I’m Afraid I’ll Get Prostate Cancer”: Putting it in Perspective
Michale “Mickey” Barber, M.D.
CEO & CMO, Better Life Carolinas Charleston, SC & Charlotte, NC
It is often forgotten that the prime directive of life is successful reproduction, and few understand the critically important role played by the newly discovered Endocannabinoid System, in support of reproductive health. The Endocannabinoid System is an all-encompassing lipid signaling complex linking female reproduction with the collaborative functions of cognitive, emotional, metabolic, and immune health, ensuring optimal female fertility when all is in homeostatic balance. This lecture will provide an overview of the myriad ways in which the endocannabinoid system supports female reproduction and overall health and will review the female disease states which manifest with endocannabinoid system dysregulation. Health care providers will be provided the tools to enhance the health of the female endocannabinoid system and when needed, to safely and appropriately utilize plant-based cannabis to optimize female health and fertility.
2:30 pm Exhibits Open
3:00 – 3:40 pm Break / Visit Exhibits
3:40 – 4:35 pm Treating the Sex Reassignment Surgery Patient
Cesar Pellerano, M.D.
Preventive Cardiologist, Miami, FL
President, Founding Partner and Chief Medical Officer, Hillstar Health LLC, Miami, FL
Gender Identification Disorder is becoming a more common diagnosis. It is estimated that 1 million people in the USA suffer from this disorder. In some of these patients Sex Reassignment Surgery is performed, and this procedure is becoming more commonplace. There is very little in the literature about the hormonal treatment of these patients. The few “guidelines” that are available, appear blurry at best. For physicians in the Age Management field, this is a topic that is bound to reach most of your practices at some point. Yet there is very little information in the literature to light the way. In this presentation I will discuss the treatment of a Male to Female Sex Reassignment Surgery patient in my practice. The discussion will involve how I approached the patient and my thinking behind the therapy. I will be happy to hear from other participants on possible different ways of treating and approaching this patient.
4:35 – 5:30 pm Complications of Hormone Therapy: Focus on Physical Exam & Nutrient Deficiencies
Derrick 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
Sometimes the obvious is not so obvious. How many of you have forgotten how to do a physical exam and really look at obvious clinical signs of disease and various nutrient deficiencies? We give our patients hormones BUT do we really know how to manage the complications of hormone therapy? During this case presentation we will look at the physical signs of various nutrient deficiencies. We will also look at some simple ways to treat some of the complications from hormone therapy.
5:30 – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Friday, April 24th

General Session Curriculum

Time
Presentation
7:00 – 7:45 am My Secrets to Financial Freedom in Medicine
Presented by Steven Hotze, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by Physicians Preference Pharmacy
8:00 – 8:05 am Opening Remarks
8:05 – 9:10 am Food as Medicine
John E. Lewis, Ph.D.
Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL
This lecture will feature some of the latest nutrition science information, starting with some of the basic facts and principles around nutrition and dietary behaviors, the links between inadequate nutrition and chronic diseases, the benefits of dietary supplementation, the importance of bioavailability of active ingredients, and why certain polysaccharides are crucial for health. Dr. Lewis will discuss the results of his extensive line of research on how polysaccharides modulate the immune system and other organ systems in the context of patients with Alzheimer’s, HIV, MS, non-alcoholic fatty liver disease, and healthy adults. Having a proper understanding of the evidence base of nutrition and dietary supplementation and their relationships to chronic disease is important for all allied health practitioners and wellness industry professionals, especially considering all of the marketing hype around diet, food, and dietary supplements. Dr. Lewis’s lecture provides attendees an evidence-based review of nutrition science that emphasizes some recent important findings that have an impact on health and quality of life.
9:10 – 10:00 am Evidence-based Review of the Impact of the Mediterranean Diet on Heart Health, Cognitive Function, Longevity and Weight Control
Steven C. Masley, M.D., FAHA, FAAFP, FACN, CNS, CCD
President, Masley Optimal Health Center, St. Petersburg, FL
The World Health Organization has recommended that planet-wide, people should follow a Mediterranean diet as populations that follow the Mediterranean diet, even outside the Mediterranean region, have longer lifespans and better overall health than those who adhere less. In 2020 US News and World Report listed the Mediterranean diet as the #1 overall best diet, #1 best diet for diabetes, #1 best diet for health, and #1 easiest diet to follow, and the #2 diet for heart health. Multiple randomized clinic trials show that if properly followed, the Mediterranean diet will reduce rates of cardiovascular disease, dementia rates, extend both lifespan and health span, and help with long term weight loss. Plus, the food is delicious, simple to prepare, and easy to find in a local grocery store, increasing long-term adherence. Yet there are myths regarding the Mediterranean diet that should be corrected, and physicians generally lack evidence based nutritional recommendations that are effective, and easy to implement, and this talk will help bridge that gap.
10:00 – 10:30 am Break / Visit Exhibits
10:30 – 11:15 am Nutrigenomics and Epigenetics: How environmental factors and nutrient deficiencies affect our genetic expression
Derrick 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
Epigenetics is the study of heritable phenotype changes that do not involve alterations in the DNA sequence. Epigenetics has controls over our genes. This is achieved through (a) nature: epigenetics is what determines a cell’s specialization (e.g., skin cell, blood cell, hair cell, liver cells, etc.) as a fetus develops into a baby through gene expression (active) or silencing (dormant); and (b) nurture: environmental stimuli can also cause genes to be turned off or turned on. What you eat, where you live, who you interact with, when you sleep, how you exercise, even aging– all of these can eventually cause chemical modifications around the genes that will turn those genes on or off over time. Additionally, in certain diseases such as cancer or Alzheimer’s, various genes will be switched into the opposite state, away from the normal/healthy state. During this presentation we will look at how environmental facts and various nutrient deficiencies affect gene expression.
11:15 am – 12:00 pm One for the Ages: a practical lifestyle plan/protocol for everyone
Michele L. Neil-Sherwood, D.O.
Mark Sherwood, N.D.
When discussing protocols, many practitioners may be wondering “where to start”. Do you start in the gut, with hormones, or adrenal management? What about sleep, nutrition, and exercise? Age management protocol prescriptions can be a bit overwhelming. However, there are several principles that truly fit for everyone. By examining “what we do know” and considering what the majority of persons can/can’t do, there is much common ground. Understanding this common ground, combined with systems biology and functional medicine principles, one is able to deliver a general protocol in which everyone can benefit. When developing a protocol, it is important to look at all aspects of life – physical, emotional, intellectual, and spiritual. When one includes all of these critical factors, development of a protocol is both possible and actionable. This lecture will provide the explanation for and rational behind a foundationally sound protocol that nearly everyone can employ immediately. The protocol includes nutrition, supplementation, stress management, sleep, and hormone optimization. Moreover, measurables (biomarkers) will be detailed along with a very clear “how to” program describing all aspects of the “one for the ages” age management protocol with the clear objective being able to functionally and fully employ on Monday morning.
12:00 – 12:15 pm Why Undergo Certification in Age Management Medicine
Derrick 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
12:15 – 1:30 pm Lunch Break / Visit Exhibits
12:15 – 1:15 pm Navigating the Gluten-Free Minefield: How GF Diets Miss the Mark and What You Can Do to Help
Presented by Tom Bayne, D.C.
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Microbiome Labs
1:30 – 2:30 pm Systems Approach to Age Rejuvenation
Daniel L. Stickler, M.D.
Co-Founder, Apeiron Center for Human Potential, Austin, TX
CME & Co-Founder, Apeiron Academy Medicine Education and Technology
Reverse aging is no longer science fiction. Leading edge science and technological advancements have provided unprecedented discoveries in the field of aging and age rejuvenation. Recently, nine hallmarks of aging were identified—genomic instability, telomere shortening, epigenetic alterations, loss of proteostasis, dysregulated nutrient sensing, mitochondrial dysfunction, cell senescence, stem cell loss, and altered intercellular communication. These discoveries provide us with an opportunity to create interventions which mitigate the ravages of aging and importantly, provide the ability to rejuvenate the aging system to a place of youthful longevity. In order to achieve optimal age rejuvenation outcomes, a synergistic, stepwise approach is required.
2:30 – 3:15 pm Keynote Presentation
Legislative Update from Washington, D.C. by Congressman Buddy Carter, the Only Pharmacist in Congress
Congressman Earl L. “Buddy” Carter (R-GA)
U.S. Representative Georgia 1st Congressional District, 2015 to Present
Only Pharmacist in Congress
3:15 – 4:00 pm Break / Visit Exhibits
4:00 – 4:45 pm Viagra Surprise, 2.0: Biggest Breakthrough in Age Management Diseases and Mortality in the History of Medicine, an Encore Lecture with Expanded Discussion
Eugene Shippen, M.D.
Author, “The Testosterone Syndrome”
The PDE5 Inhibitors were developed initially for cardiovascular effects. The use for ED was discovered during the initial trials and the drugs were approved for this indication. However, multiple uses for these drugs were discovered over the many years since they were released. Amazingly, cardiovascular benefits included phenomenal improvement in function and reduction in both cardiovascular diseases and mortality. These reported findings were documented in several observational studies and showed greater benefits and mortality reduction than ever reported in the medical literature! The presentation will outline these studies and other aging disease benefits, including dementia, and will outline the basic science behind these remarkable benefits. This information can be utilized immediately in your practices for health and longevity in both men and women.
4:45 – 5:30 pm Igniting Libido in Men & Women: Beyond Testosterone
Kathryn Retzler, M.D.
Private Practice, HormoneSynergy Clinic LLC, Portland, OR
Low libido or sex drive is a common complaint in men and women. With half of single people having weekly sex vs only one-third of married people, and more single people being satisfied with their sex lives than those who are married, how does a couple keep the sex sizzle going? This lecture will cover the causes of low libido and options to help individuals and couples regain lost sexual interest.
5:30 – 7:00 pm Reception for AMMG Members, Faculty and VIPs
Please come and meet a distinguished member of our AMMG Faculty, Georgia Congressman Earl L. “Buddy” Carter, the only Pharmacist in Congress

Saturday, April 25th

General Session Curriculum

Time
Presentation
7:00 – 7:45 am Increase Your Impact, Influence and Income with the help of Dr. Oz
Presented by Clint Arthur
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by Celebrity Entrepreneur
8:00 – 8:45 am Current Applications of Senolytics and Their Role in Age Management Medicine
Luis Martinez, M.D., MPH
President, XanoGene Clinic, San Juan, Puerto Rico
President, Regenera Global, Ponce, Puerto Rico
Will discuss interventions including the use of rapamycin, metformin and more recent approaches such as the dasatinib/quercetin combo. A senolytic (from the words “senescence” and “lytic” – destroying) is among the class of small molecules under basic research to determine if they can selectively induce death of senescent cells. The goal of those working to develop senolytic agents is to delay, prevent, alleviate, or reverse age-related diseases.
8:45 – 9:30 am Is Gene Therapy the Future of Anti-Aging Medicine? “It’s Here… and Now”
Patrick Ellison Sewell, Jr., M.D.
Founder, Owner, Sapheneia
Medical Consultant
Director of Clinical Trials, Integrated Health – Gene therapy
For millennia, people have dreamed of eternal youth and searched for elixirs to counteract the ravishes of age. This quest was seen as a fruitless fantasy until recently, but faith in modern science and technology is altering the public consciousness. Slowly, people are becoming more aware of efforts to combat aging. There is a growing expectation that a cure for aging may be within reach, and that in the near future significant and even radical life extension may be possible. Gene therapy is viewed as an essential tool in bringing this future about. We contend that this technology is mature enough to start turning back the clock today, and given proper informed consent, no one should be denied access to treatment with gene therapy because of the overly cautious regulatory environment in the U.S. and Europe. Gene therapies are being used to add copies of important genes, like follistatin, hTERT, and Klotho, to human cells in vivo. This results in increased production of youthful proteins which tend to diminish as we age, leading to:

  • Enhanced muscle mass and bone strength to combat frailty
  • Lengthened telomeres and protected chromosomes capable of replicating for longer periods of time
  • Improved kidney functions
  • Improved cognitive functions
  • Better quality of life

Gene editing techniques are also being employed, which use the CRISPR/Cas9 system to make changes to genes that are already present in cells. As of the first quarter of 2019, 372 clinical trials in humans were in progress to study gene therapies, and that number is expected to skyrocket over the next decade.

9:30 – 10:15 am Brain Age Management: Measurements & Reversals
Eric Braverman, M.D.
Private Practice, PATH Medical, New York, NY
Director, PATH Foundation NJ, Princeton, NJ
The human brain develops many skills in a heterogeneous manner from an age of 50 days in utero to age 50 i.e. multiple forms of language, memory, attention, and intelligence. The brain then loses these skills at an increasing rate after age 40 to 50 in a heterogeneous manner. As your brain comes from the womb it goes to the tomb. The border between dementia and neuropsychiatric decline is unclear, but has similar ranges like heart disease, from 40 year slow memory/cognitive decline to sudden death or brain attack. To manage, we have many brain measurements of different values with a current capacity to partially or totally reverse/ manage brain functional loss ! Since the brain is electromagnetic, our most valuable longitudinal and ipsative measurement has been the p300, which explains fetal and early infantile amnesia, steroid mood changes of puberty, peak intellectual performance at age 30, with full myelination. There is a loss of brain processing speed or voltage at a rate of 10 to 20 percent per decade. You have a 10th of a second to lose in the course of your life. Virtually all individuals who would live to age 90 are completely demented, but partial dementia can lead to death at an earlier age. Most 60 year old are partially but Significantly demented! To imagine an improvement in brain age management and re-skilling of America, we must increase, achieve stasis or stop intellectual function decreases. To achieve this goal extensive measurement and reversal of losses must be achieved. Hormone therapies I have the most significant impact thyroid estrogen, progesterone, testosterone DHEA, pregnenolone, HGH, parathyroid , etc. I will provide you with efficient medical tools to measure eventually organized by AI (1) history of cognitive, medical, medication, hormonal, nutritional, lifestyle, factor with verified behavioral , Functional intakes in history, etc.; (2) total life brain history, i.e. accidents, whiplash, drug/alcohol, concussion, infection, pathogens, vascular, pre-diabetes, etc.; (3) wide range of blood parameters, i.e. hormonal to genetic, immune allergic to inflammation, etc. all manageable; (4) current past, neuropsychiatric, cognitive symptoms measured by computer programs, i.e. CNSVS, WMS, MCMI, and MMSE, etc. provide various auditory, visual, and working memory data , matrix non abstract iq , pain , Behavorial scales, etc.; (5) measures of energy, learning, stability, sleep, mood, temperament, personality type, pain, with AI correlations and decision algorithms.
Adding additional imaging methods from the brain to the body (weak frame means weak brain), include 3t mri cortech program, which identifies atrophy in 40 regions of the brain in most adults, hypometabolism in 25% of adults by 2, 3 Dolph pet/ct and additional imaging agents and imaging methods of spect, dat, Meg, nirs, tcus, until the human connectome is completely measured, repaired, augmented, etc. We then fulfill a new order of brain age management that the founding fathers of the United States envisioned.
10:15 – 10:45 am Break / Visit Exhibits
10:45 am – 11:30 am Introduction to Traumatic Brain Injury
Mark L. Gordon, M.D.
Medical Director, Millennium-TBI & The Millennium Health Centers, Encino, CA; CBS Studios;
Consultant – Medical Board State of California
Medical Director of Education, Access Medical Laboratories, Jupiter, FL
Member, AMMG Conference Planning Committee
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 as well as 450 different cell types. 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. In 2017, research showed that 61% of individuals with treatment resistant depression had a Growth hormone deficiency which resolved when corrected. 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. In this lecture you will learn (1) the importance of GH and its related growth factors in body functioning, restoration, and protection, (2) how to detect deficiency and perform a Glucagon Stimulation Test, and (3) the myth about GH causing cancer, and (4) treatment protocols using secretagogues and growth hormone in combination.
11:30 – 12:15 pm The Estrogen Controversy: Estrogen vs No Estrogen in Men. What all clinicians should know about estrogen in men but don’t; a literature review in the use of aromatase inhibitors in men
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
It has become customary to use aromatase inhibitors to block formation of estrogen in men. Even though the use of AI’s is commonly taught, the utilization is not supported by the medical literature and can have significant adverse consequences on men’s health. The purpose of this lecture is to present the lack of need to block estrogen in men and the consequences of doing so. Using the medical literature, we will come to understand the importance of optimizing estrogen instead of blocking it. The medical literature, as it pertains to the harm of blocking estrogen and importance of optimizing E2, will be emphasized. The importance of following evidence-based standards, and not public opinion, will be explained and demonstrated.
12:15 – 1:30 pm Lunch Break / Visit Exhibits
12:15 – 1:15 pm

TBD
Presented by TBD
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by TBD

1:30 – 2:15 pm Why Patients Choose BHRT
Daved Rosensweet, M.D.      
Testifying Expert, National Academy of Science, Engineering and Medicine (NASEM) Committee on the Safety and Efficacy of cBHRT 2019
There’s nothing like the horrible sucking sound of silence! Sure some patients start coming in the door, but that practice-changing, catch-on-fire word-of-mouth, moment never seems to arrive. Why? We’re at a unique moment in time. 5 million women seek menopause treatment in America today, down from 18 million at its peak. That leaves 45 million more that would benefit! The change that the world may be on the verge of is that the fear-tsunami caused by the WHI may finally be subsiding. The National press, right now, is talking about the truth about risk. Yay! What if your entire practice is about to change? What if a new way of looking at your menopause practice and presenting it to the world, could lead you to more satisfaction, less burnout, healthier, happier patients, more time and a stronger bottom line! Today, we dive in.
2:15 –3:00 pm Effects of HRT in the Treatment of Osteoporosis in Women
Cesar Pellerano, M.D.
Preventive Cardiologist, Miami, FL
President, Founding Partner and Chief Medical Officer, Hillstar Health LLC, Miami, FL
At a time when the prevalence of osteoporosis and related fractures is increasing, initiation and continuation of pharmacologic therapies for prevention and treatment of postmenopausal osteoporosis have declined. This is often due to the reluctance of treatment because of the side effects of these agents. In this lecture I will show a group of over 20 women in my practice, where osteopenia and osteoporosis have been successfully treated with HRT. Documenting the data over a number of years using DEXA scans, we see improvement in all of these patients by treating them with BioIdentical Hormones. This treatment, not only arrested and improved a serious medical condition, but also significantly improved their quality of life.
3:00 – 3:45 pm Break / Visit Exhibits (exhibits close 3:45 pm)
3:45 – 4:45 pm What is Robbing My Patients of Hormonal Health
Andrew W. Campbell, M.D.
Editor-in-Chief, Alternative Therapies in Health and Medicine Medical Journal & Advances in Mind-Body Medicine Journal
Editorial Board, Integrative Medicine: A Clinician’s Journal
Medical Editor, Natural Solutions and Alternative Medicine Magazines
In this evidence-based lecture, I will discuss how aromatase, an enzyme responsible for catalyzing the last steps of estrogen biosynthesis from androgens such as testosterone, is affected by the chronic inflammation from molds and mycotoxins. Furthermore, I will review that certain mycotoxins are mycoestrogens, binding estrogen receptors, thereby confusing the pituitary gland and lowering the production. Adequate stores of estrogen are necessary for proper brain function, gut function, and sugar regulation in addition to the normal glandular requirements. In addition, too much estrogen causes estrogen dominance and progesterone deficiency, which can result in a host of problems, including weight gain, fatigue, brain fog, depression, and others. Lastly, the cause and treatment for non-thyroidal illness syndrome (NTIS) will be reviewed.
4:45 – 5:30 pm Using Mortality Science as the New Marker for Longevity 
Gary Brecka, Human Biologist
CEO, Streamline Wellness Anti-Aging & Rejuvenation Clinic
Director, NFL Alumni Association Signature Athletica, Health Initiatives Board
This lecture will, in only one hour, identify and define the 3 largest root causes of accelerated mortality, explaining why they are the same causes of decreased biometric function and how to diagnose, treat and remove them from our patient population. The physiology behind our “state, mood, energy level, cognitive function, immunity, methylation, waste elimination and mitochondrial function all have one common physiological root, OXYGEN, which is commonly overlooked in our quest to improve the health and biometric function of our patients. Using case studies and data to demonstrate how to use, (1) blood labs, (2) hormones and (3) common nutrient levels to stop and even reverse these deficiencies and improve the oxygen profile of our patients.

Sunday, April 26th

General Session Curriculum

Time
Presentation
7:00 – 7:45 am TBD
8:00 – 8:45 am Hair Rejuvenation
Joseph Greco, Ph.D., PAC
Greco Medical Group, Sarasota, FL
Faculty, George Washington University
A comprehensive review and updates of biologic therapy for the treatment of hair loss and hair loss diseases. The goal is to review the evolution of biologic treatments and share the latest protocols for Androgenic Alopecia, Alopecia Areata and Cicatricial Alopecias. Newer therapies include the use of exosomes and birth tissue including Amniotic Cells, Wharton’s Jelly and Medicinal Signaling Cells.
8:45 – 9:30 am Dangers of Vaping
Jordan Tishler, M.D.
Instructor of Medicine, Harvard Medical School
President, Association of Cannabis Specialists
CEO, InhaleMD
Vaporizing (or vaping) both cannabis and nicotine has been getting some scary press in recent months. As our patients use these substances and devices, it’s important that we understand the benefits and risks involved for them. It’s just not as simple as advising them not to do it (and that sort of advice undermines our credibility as trusted practitioners). We will discuss what is known about vaporization, how the substance and the device affect safety, and how to minimize risk for our patients.
9:30 – 10:15 am Cannabis Metabolomics
Betty Wedman-St. Louis, Ph.D.
Licensed Nutritionist & Environmental Health Specialist, St. Petersburg, FL
Cannabis metabolomics takes a look at the unique chemical fingerprint of Cannabis sativa with over 421 chemical compounds. A major focus will be on cannabidiol (CBD) and its “non-intoxicating” diverse benefits. Misconceptions have resulted from Merrick, et al. (2016) claim that CBD can be converted into THC. Grotenherman, et al. (2017) refuted this biological study. Health care professionals need to understand the functional properties of cannabis products in order to appropriately recommend and dose. Selecting full-spectrum, broad spectrum or isolate products can make significant difference in patient outcome. Physicians need to be aware of drug interactions and SAMHSA recommendations when discussing cannabis with their patients. Clinical Pearl: There is NO legal definition of “medical marijuana”.
10:15 – 10:30 am Break
10:30 – 11:15 am The Benefits and Dangers of Hyperbaric Oxygenation for Neurological Injury
James Raniolo, D.O., AOBFP, ABAARM, FAARFM  
Owner, Wyoming Center for Optimal Health, Jackson, WY
Founder, Chairman, CEO, Personalized Medical Group
Hyperbaric oxygen is one of the most promising therapies available for the treatment of localized neurological injury from both trauma and vascular insult, and can potentially help our clients to regain lost neurological function. Like any other therapy, a fundamental understanding of the underlying mechanisms of how intermittent hyperbaric therapy leads to permanent return of lost function will be reviewed. Additionally we will discuss the primary mechanisms of toxicity of hyperbaric oxygenation, so that prudent clinical decisions can be made including who are the best candidates for therapy, what is the proper timing, dose, and duration of therapy.
11:15 am – 12:00 pm Clinical Roadmap for the Treatment of Difficult or Recalcitrant SIBO Cases
Chris A. Kleronomos, FNP, DAOM, MSc
Comprehensive Pain and Functional Medicine Specialist
SIBO is an emerging problem gaining attention within the standard biomedical community though lack of in-depth clinical knowledge, lack of response to treatment, and high recurrence rates remain problematic. This presentation will provide an evidence based detailed protocol for therapeutic intervention outlined in an easy to follow, detailed, step by step process. It will include specific information on diet strategy (including elemental), supplements, prescription and herbal motility, and antimicrobial agents (pharmaceutical and natural), as well as novel therapies such as Peptides and Electro-Acupuncture for Vagal modulation. This is not a research update (though it is inclusive of current state of science) but specifically designed for clinicians to have a framework to reduce symptoms, address SIBO, associated secondary infections (dysbiotic flora, candida etc.), as well as Biofilms to improve outcomes.
12:00 – 12:45 pm The Top Ten Pellet Insertion and Dosing Mistakes: How to Avoid Common Pitfalls and Optimize Your Treatment
Angela DeRosa, D.O., MBA, CPE
Founder & President, Hormonal Health Institute, Scottsdale, AZ
Bio-identical hormone replacement therapy is a powerful tool in a clinician’s toolbox in treating patients’ symptoms of hormonal imbalances and deficiencies but also preventing chronic illness; addressing the desire for not only longevity but quality of life in our patients. Subcutaneous hormonal pellet therapy, specifically, provides the highest efficacy and most physiologic hormone response when properly dosed and implemented. In order to ensure proper response to these therapies, it is important to have proper training not only on the insertion techniques of pellets but the unique pharmacokinetic, physiologic and idiosyncratic nature of pellets and common pitfalls to avoid. This presentation will address the top ten most common mistakes clinicians make when inserting pellets procedurally (which affect extrusion and infection rates) but also the more important dosing considerations that can affect the patient’s overall response to therapy. In addition, the presentation will address how to best address consenting and documentation to protect one’s license from board actions and ensuring strong patient advocates.
12:45 – 1:30 pm Introduction to Bioidentical Hormone Replacement 
William Clearfield, D.O., FAAMA, DABMA, FAARFM
Medical Director, Clearfield Family Medicine, Reno, NV
Executive Director, American Osteopathic Society of Rheumatic Diseases
Lecture will review, and refute with peer reviewed literature, the 2009 position paper, review the rationale for a comprehensive BHRT program for men and women and review the three latest FDA approved BHRT medications released since 2016.