Agenda April 2019

Thursday

April 11, 2019

7am: Complimentary Breakfast
8am – 12pm: Conference Sessions
12pm: Complimentary Lunch
1:30pm – 5:30pm: Conference Sessions
5:30pm – 7pm: AMMG Welcome Reception

Friday

April 12, 2019

7am: Complimentary Breakfast
8am – 12pm: Conference Sessions
12pm: Complimentary Lunch
1:30pm – 5:30pm: Conference Sessions
5:30pm: Reception Introducing Training & Certification

Saturday

April 13, 2019

8am – 12pm: Conference Sessions
12pm: Complimentary Lunch
1:30pm – 5:30pm: Conference Sessions

Sunday

April 14, 2019

8am – 10am: Conference Sessions
10am – 10:15am: Break
10:15am – 1:30pm: Conference Sessions

CONFERENCE Agenda | APRIL 10-14, 2019

Wednesday April 10th

Practice Management Workshop

Discover the best practices for adding Age Management Medicine to your existing practice, whether it’s part- or full-time. This open-forum workshop lays it all out for you, helping you ensure you comply with legal and insurance requirements, develop marketable programs, understand the process of transitioning into Age Management Medicine and how to build market share and protect your practice. This is an opportunity to listen to and speak with professionals in the industry.

Non-CME symposium sponsored by AMMG

Time
Presentation
6:00 pm – 6:45 pm Legal Issues in Age Management Medicine: A Discussion of Legal Compliance for Age Management Physicians
Paul D. Werner, Esq
Member, Buttaci, Leardi & Werner Law Firm, Princeton, NJ
This workshop will provide critical information and effective mitigation strategies for the most common compliance risks threatening age management physicians and their practices. These include: HIPAA/HITECH privacy and security requirements, including enforcement initiatives of the Office of Civil Rights; and Corporate Compliance issues, including OIG enforcement of the Stark law, the Anti-kickback Statute, and relevant state-based statutes and regulations. The focus of this workshop will be risk management and liability avoidance through internal policy development, self-auditing, and other proactive risk prevention strategies. The Stark law, the Anti-kickback statute, and the Anti-Inducement provisions of HIPAA are a source of confusion for most lawyers, lets alone physicians. This seminar will provide a summary of each law – and their state-based equivalents – in plain English.
6:45 pm – 7:30 pm Selecting and Implementing the Right Weight Loss Program for Your Patients and Maintaining Results:
Finding Your New Normal

Teresa Gabiola Shelton, MPAS, PA-C
Advanced Practitioner, Healthy Habits Welllness Clinics, Idaho
Co-author of the book, Evidence Based Medicine: An Interprofessional Approach
Member, AMMG Conference Planning Committee
Kimball Lundahl, D.C.
Vice President, Business Development, Healthy Habits Medical Business Consultants
In this session, you will learn how to use a medical history to choose a detox regimen, as well as a functional medicine approach to interpret metabolic labs for assessing nutritional needs. The seminar includes information on a meal-based plan with recipes for liver detoxification with an expected 10-15 pound weight loss in the first 2 weeks, followed by one of three options for a lifestyle regimen to continue and maintain weight loss long-term.
7:30 pm – 8:00 pm Risk Management: Insurance Coverage and Issues – A Discussion of Malpractice Insurance Cases
John J. Rush, M.D., FACEP, MBA, MHA
President & CEO, Age Management Insurance and Longevity Physicians Insurance Companies
President, Cenegenics, Washington, D.C.
Chairman & CEO, Healthcare Media
Dr. Rush is a practicing Age Management clinician and owner of an insurance company insuring Age Management physicians. He will discuss Risk Management and how to reduce liability exposure in your practice using actual cases and incidents as a learning tool.
8:00 pm – 8:45 pm Successful Transition to Age Management / Concierge from an Insurance Based Practice
Christopher J. Davis, M.D., FACC
Founder and CEO, Reveal Vitality, Bradenton, FL
Tony Orlando
President, Complete Medical Services
Owner, Fit Body 360
Set your practice up for a successful transition, implementation, and growth into the Age Management space. Session will analyze and compare how different practices and groups successfully made the complete transition. You will walk away with a much better understanding of the specific steps that are needed as you transition your practice away from the traditional insurance-based medical practice into an Age Management / Concierge focused practice. This topic will be good for those who are new to Age Management, and those who have already transitioned but are looking for ways to best put their new practice on the path to successful growth.
8:45 pm – 9:00 pm Open Forum Q &A for All Speakers

Thursday, April 11th

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 am – 7:45 am What You Need to Know About Compounding
Presented by David J. Metayer
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 am – 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 am – 10:00 am Basic Hormone Replacement/Replenishment for Women
Anna Cabeca, D.O.
Women’s Health Expert
Best Selling Author of “The Hormone Fix”
Board Certified OB-GYN
Medical Director, Vida Pura Health, Golden Isles Medical, Inc., St. Simons Island, GA
There are many periods in a womans 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 am – 10:15 am Break
10:15 am – 11:15 am Clinical Use of Supplements in an Age Management Medicine Practice
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
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
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 also cost prohibitive for most people. There is an alternative to the expensive recombinant human growth hormone most commonly used for boosting IGF-1 and 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. In addition the diagnosis of adult onset growth hormone deficiency and the use of human Growth Hormone will be reviewed.
12:00 pm – 1:30 pm Lunch Break
12:00 pm – 1:00 pm The Most Common Dysfunctions of the Standard American Gut in Chronic Illness
Presented by Dr. Tom Bayne
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Microbiome Lab
1:30 pm – 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 pm – 3:00 pm Compliance with Federal and State Regulations as You Begin Your Age Management Practice
Paul D. Werner, Esq
Founding 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 pm – 3:40 pm Break / Visit Exhibits
3:40 pm – 4:30 pm Age Management Medicine Clinical Recommendations for Diet and Weight Loss
Robert L. True, M.D.. FACOG, FACS
Private Practice Specializing in Cosmetic Surgery, Anti-Aging ,and GYN, Colleyville, TX
Obesity has gained epidemic proportions and is now the leading cause of chronic medical illnesses that occurs 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 pm – 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 pm – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, April 11th

Exosomes: The Next Generation of Biologic Medicine

Exosomes are tiny, subcellular, membrane-bound vesicles that are released by a wide variety of cell types and cancer cells and that can carry membrane and cellular proteins, as well as DNA, microRNA (miRNA), and various other types of RNA, including mRNA fragments, representative of the cell of origin. This session will explore the evidence-based science behind Exosomes and their use in a variety of areas in Clinical Age Management Medicine such as biomarkers, ways of treating disease, and use as targeted delivery vehicles for therapeutic molecules.

Time
Presentation
7:00 am – 7:45 am What You Need to Know About Compounding
Presented by David J. Metayer
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 am – 8:05 am Introduction of Exosome Track
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
8:05 am – 8:45 am Regenerative Medicine 101; Exosomes and Stem Cells
Ian White, Ph.D.
Chief Scientific Officer, IMAC Regeneration Centers, Miami, FL
Chairman of the Scientific Committee, American Academy of Stem Cell Physicians
President, BioFirma, LLC
Our bodies retain a robust ability to repair and regenerate throughout the entire course of our lives. Each and every day our bodies lose millions of cells, which must be constantly replenished from pools of stem cells lest we rapidly expire. Aging, chronic pain and chronic injury result from a progressive increase in the demand for stem cells while we experience a concurrent decline in stem cell availability and function. The symptoms of aging and the causes of pain can be treated with modern therapies derived from younger, allogeneic sources. Umbilical cord blood-derived mononuclear cells and MSC-derived exosomes are a potent source of regenerative proteins and RNAs. They can be administered therapeutically in an off-the-shelf manner due to their immune privileged state and used effectively as a flowable allograft without pathological rejection. As we continue to develop these new perinatal products it is important to understand the foundational biology of these cells in order to innovate and utilize their potential in the safest and most effective ways.
8:45 am – 9:15 am Exosomes & Cardiovascular Disease
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
Abstract TBD
9:15 am – 10:00 am Clinical Experience Using Cell Therapy Derived From Placental Cells
Robert 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
Abstract TBD
10:00 am – 10:15 am Break
10:15 am – 11:00 am Exosome Therapy for Infectious Disease and Chronic Inflammation
Marvin Sponaugle, M.D.
Founder & President, North Pinellas Anesthesia, Oldsmar, FL
Abstract TBD
11:00 am – 11:30 am Innovative Uses of Exosomes and Peptides with a Focus on CNS
Kathy O’Neil-Smith, M.D., FAARM
Private Internal, Integrative and Regenerative Medicine Practice, Newton, MA
Exosomes are small membranous entities of endocytic origin. Their production by a wide variety of cells in eukaryotes implicates their roles in the execution of essential processes, especially cellular communication. Exosomes are secreted under both physiological and pathophysiological conditions, and their actions on neighboring and distant cells lead to the modulations of cellular behaviors. The characterization of exosomes, provides information on aberrant processes, and thus, exosome analysis has many clinical applications. Because they are associated with the transport of different cellular entities across the blood-brain barrier (BBB), exosomes might be useful for delivering drugs and other therapeutic molecules to brain. We will look at exosomes in the literature and review the roles exosomes play in different neurodegenerative diseases.
11:30 am – 12:00 pm Exosomes Therapy for Erectile Dysfunction
Paul Thompson, M.D.
Private Practice, Fort Worth, TX
Present state of erectile dysfuntion treatment. Extracorporeal low-intensity shock wave therapy, PRP, stem cells, Exosomes. Benefits and risks. How do Exosomes benefit the patients with ED, and Peyrones benefits and risks.
12:00 pm – 1:30 pm Lunch Break
12:00 pm – 1:00 pm The Most Common Dysfunctions of the Standard American Gut in Chronic Illness
Presented by Dr. Tom Bayne
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Microbiome Lab
1:30 pm – 2:15 pm Exosomes Therapy in Combination with Laser Ablation for Prostate Cancer Surgery
Daniel Sperling, M.D.
Medical Director & Chief of Interventional Uroradiology, Sperling Prostate Center, Florida & New York
Medical Director, Sperling Medical Group, Florida
Medical Director, Sperling Neurosurgery Associates, Florida
Recent discoveries have newly revealed that almost all types of cells produce extracellular vehicles (EVs) to communicate with each other. One type of EV, exosomes, transport cargo that regulates cell processes such as the production of protein. The cargo may differ based on the cell of origin, but can include molecules such as messenger RNA, microRNA, membrane proteins, etc. Scientific excitement is rapidly increasing over the promising ability application of exosomes for diagnostic, therapeutic, and regenerative purposes. This presentation will explain exosomes, identify the areas of greatest potential use, and explain how exosomes can facilitate healing and boost cancer immunity following Focal Laser Ablation (FLA) for the treatment of prostate cancer.
2:15 pm – 2:45 pm Exosome Related Age Management Medicine Clinical Cases
Michale “Mickey” Barber, M.D.
CEO, CMO, Better Life Carolinas, Charleston, SC
Recent evidence shows that part of the regenerative potential of stem cells are due to exosomes and their potential for healing through cell to cell communication, regulating inflammation and immune response. A number of case presentations using exosomes with platelet rich plasma for erectile dysfunction, post stroke and other clinical challenges will be presented.
2:30 pm Exhibits Open
2:45 pm – 3:30 pm Break / Visit Exhibits
3:30 pm – 4:15 pm Treating “Untreatable” Retinal and Optic Nerve Conditions – The Stem Cell Ophthalmology Treatment Studies
Jeffrey Weiss, M.D.
Staff, Department of Surgery, North Broward Medical Center, Pompano Beach, FL
Board of Directors & Staff, Park Creek Surgery Center, Coconut Creek, FL
Staff, Al Zahra Hospital, Al Barsha, Dubai, U.A.E.
The Stem Cell Ophthalmology Treatment Study (SCOTS) is the largest ophthalmology stem cell study registered with the National Institutes of Health – www.clinicaltrials.gov Identifier NCT 01920867. SCOTS is Institutional Review Board (IRB) approved and utilizes autologous bone marrow derived stem cells (BMSC) in the treatment of optic nerve and retinal diseases. SCOTS is an open label, non-randomized, efficacy study. There is no placebo or sham arm. All patients meeting eligibility criteria and enrolled in the study receive active treatment. Bone Marrow aspirated from the posterior Iliac Crest is separated to provide Bone Marrow Derived Stem Cells (BMSC) within the stem cell concentrate. The treatment protocols in SCOTS have been continued in the Stem Cell Ophthalmology Treatment Study II (SCOTS 2) also IRB approved and registered with NIH Identifier NCT 03011541.
4:15 pm – 4:45 pm Exosomes and Cancer
Edwin Lee, M.D.
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
The American Cancer Society predicts that the global burden of cancer will be 26.1 million new cancer cases per year and 13 million annual deaths by 2030, up from and 13.2 million cases and 8.2 million deaths in 2013. Unfortunately there is no early detection test for cancer. In the past decade there has been an explosion on the research of exosomes and cancer. Exosomes have a role in cancer in regards to promotion of tumor growth, tumorigenesis, tumor angiogenesis, tumor immune escape, drug resistance, and metastasis. In addition exosomes have a role for a cancer biomarker and may become the standard for early detection or surveillance marker for cancer. Finally exosomes have a role in the future as a cancer therapeutic agent.
4:45 pm – 5:30 pm Exosomes as a Novel Therapeutic Approach in Gastrointestinal Diseases
Rebecca Murray, APRN, FNP-BC, CDE
Endocrine Nurse Practitioner, Institute for Hormonal Balance, Orlando, FL
Medical Director, Ward-Murray HealthCare Consulting, Groton, CT
The incidence of Gastrointestinal Diseases, including Crohn’s Disease and Ulcerative Colitis, is growing at an epidemic rate. The mainstay of present treatment includes high dose steroids and if not effective, the addition of “immune-modulating” medications including biologics that decrease the overall immune system and carry an increased risk for early onset cancer. In many cases, this treatment is not effective and the person has to resort to the removal of part of or their entire colon, altering their life forever. Research in the area of exosomes has clarified that these “non cell vesicles” have a beneficial biologic and physiologic function in immune-regulation and inflammation in the autoimmune process. Although there remains to be seen major studies published in the use of exosomes in specifically Inflammatory Bowel Disease (IBD), much research has been carried out in the animal model for IBD, also in human studies regarding autoimmune diseases. This presentation will review the literature of the beneficial outcomes from the use of exosomes in IBD and autoimmunity and how this knowledge can be applied to the treatment of IBD refractory to other treatment options.
5:30 pm – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Thursday, April 11th

Spanish Language Track: Age Management Medicine for Spanish Language Physicians and Healthcare Professionals

This track is designed to bring a cross section of evidence-based topics in Age Management Medicine to physicians and healthcare professionals for whom Spanish is their primary language. Every lecture in this track will be done in Spanish and attendees are welcome to participate in question and answer sessions, also in Spanish, with faculty.

Time
Presentation
7:00 am – 7:45 am What You Need to Know About Compounding
Presented by David J. Metayer
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 am – 8:45 am Hormone Replacement for Men: Testosterone, Estrogen & DHEA
Luis Martínez, M.D., MPH
President, XanoGene Clinic, Rio Piedras, Puerto Rico
President, Regenera Global
Co-Founder, Clinical Peptide Society 
Hormone Replacement Therapy is a cornerstone of Age Management Medicine. Male patients can often go underdiagnosed due to gradual onset of symptoms and refusal to seek medical interventions. This lecture will cover the fundamentals of HRT for men. Testosterone, Estrogen and DHEA testing and dosing protocols will be discussed. Case examples will be reviewed, emphasizing patient continuity and proper follow up.
8:45 am – 9:30 am Hormone Replacement for Women: Estrogen & Testosterone
Alma C. Pontón Nigaglioni, M.D., FACOG
Assistant Professor of Obstetrics and Gynecology Department, University of Puerto Rico
Founder and President,
Caribbean Gyn Institute, Caguas, Puerto Rico
This lecture will cover the interactions and biological effects of hormones in female patients, how to test for imbalances on hormone levels and how to identify candidates for hormone replacement therapy (HRT). The benefits, side effects and variety of methods for HRT will also be discussed with emphasis placed on treatment strategies with bio-identical HRT.  
9:30 am – 10:15 am Hormonal Optimization Effects on Physical Fitness Biomarkers and the Relationship with Health and Longevity
Ángel Durántez, M.D., Ph.D.
Owner and Medical Director, Clinica Dr. Durantez, Madrid, Spain.
Hormonal optimization, nutrition, nutraceuticals, exercise, stress control, brain training, detox, longitudinal control of health and longevity biomarkers… All of them are different approaches for a healthy and functional aging. All of them interact with the others. The hormonal decline through life provokes a known amount of signs and symptoms that matches with the signs and symptoms of the aging process; fatigue, low vitality, foggy mind, loss of lean body mass, loss of bone density, increase of body fat, loss of libido and sexual function. It is well known that hormonal optimization reverses most of these signs and symptoms. On the other hand, the physical fitness level correlates with morbimortality and longevity. The physical fitness level declines through life due to the aging process but we know that with a proper exercise program, it is possible to maintain physical fitness on youthful levels. But hormonal optimization is needed for most of our patients to do a proper exercise program. In this lecture we will have a look at the latest publications about the effects of optimization of the main hormones on physical fitness biomarkers and their relation with health and longevity.
10:15 am – 10:30 am Break
10:30 am – 11:15 am Testosterone and the Heart
Cesar M. Pellerano, M.D.
Member AMMG Planning Committee, Chair AMMG Spanish Track
Preventive Cardiologist, Miami, FL
President, Founding Partner and Chief Medical Officer, Hillstar Health LLC, Miami, FL
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.
11:15 am – 12:00 pm Women’s Sexual Health: Cutting Edge Issues
Anna Cabeca, D.O.
Women’s Health Expert
Best Selling Author of “The Hormone Fix”
Board Certified OB-GYN
Medical Director, Vida Pura Health, Golden Isles Medical, Inc., St. Simons Island, GA
This lecture will address Hot Topics in Women’s Sexual Health, which include Brain Gut connection of course! Lecture will highlight hormonal physiology and the connection to behavior, vaginal androgen therapy for vaginal restoration, and the modern day woman’s predominant issue of stress and how it affects us.
12:00 pm – 1:30 pm Lunch Break
12:00 pm – 1:00 pm The Most Common Dysfunctions of the Standard American Gut in Chronic Illness
Presented by Dr. Tom Bayne
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Microbiome Lab
1:30 pm – 2:15 pm Integrative Medical Approach for Wellness and Vibrant Aging
Beatriz Rodriguez Olson, M.D., FACP
Assistant Clinical Professor of Medicine, Yale School of Medicine
Associate Staff, Yale Endocrinology Group
Private Practice, Endocrinology, Middlebury, CT
With this background I come to you to tell you some of the lessons I’ve learned about wellness and health care. This general lecture will focus on Diet, Sleep, Exercise, consistency in life routines including hormones, and meaningful connection to others as cornerstones of wellness. The American Diet is responsible for many of the health conditions that the American medical system pays heavily to treat. I’ll show you what it did to me after six months in America. I will also discuss how conventional medicine let down many women. Hormone replacement after menopause was considered, “giving women breast cancer” based on flawed data from non-bioidentical hormone replacement. We can do better with careful assessment of risk and individual benefit. From the perimenopause to the menopause, as women’s hormones fall, we should maintain their normal physiological levels and prevent the metabolic changes that happen due to estrogen loss. Maintaining normal healthy hormone levels can add quality of life, but the management is not simple. The route, the dose, the mechanics of administration all involve thoughtful, individualized decisions between doctor and an educated patient.
2:15 pm – 3:00 pm Nutrigenomics Portfolios as a Clinical Tool
Bernard Esquivel, M.D., Ph.D., MHA
President, Latin American Association for Personalized Medicine
As the genomics era goes forward, we understand a little more about the correlation between the genetic and environmental factors and its importance in the balance of health and disease. Many environmental aspects can epigenetically trigger the genetic information of patients expressing phenotipicaly as diseases. One of the best ways to modulate the epigenetic stimuli is by implementing personalized nutrigenomic protocols. Nutrigenomics can be defined as the study of the effects of food and food constituents on gene expression, and how genetics variations affect the nutritional environment. In this lecture we will discuss potential nutrigenomic portfolios and their utilities in cardiometabolic diseases.
2:30 pm Exhibits Open
3:00 pm – 3:45 pm Break / Visit Exhibits
3:45 pm – 4:30 pm Metabolic Rehabilitation: Strategies to Improve the Physiological Flexibility/Resiliency and the Metabolic Reserve as a Preventive Mechanism in Cognition and Longevity
Paula Martin-Marfil, M.D., MSc
Anti-Aging & Stress Management Medicine (Europe-Middle East)
Stress is defined as “a disharmonic or compromising state of physiological homeostasis,” that is, of the equilibrium of the internal environment. It is a condition that triggers a specific biological phenomenon that is the “adaptive response to stress.” This response was designed to keep us alive in the face of a physiological challenge or a threat, however, the excessive, prolonged or inadequate regulation of this response to stress has health consequences. There are two important terms that need to be known in relation to the stress response: (1) Homeostasis: which is the physiological state of balance that is sensitive to a variety of both intrinsic and extrinsic stressors (real or perceived); (2) Allostasis: the return to stability through change or after the reaction to stress. The existence of both phenomena, homeostasis and allostasis, require the existence of a metabolic reserve (vitamins, minerals, amino acids, neurosteroids, etc.) that supports the body to have a greater physiological resilience. A failure in the allostasis, can trigger a depletion of the metabolic reserves because, as we said, the response to stress mobilizes resources and changes the metabolic function to face the current demand for survival, with the cost of reducing the storage of material that can cause a metabolic dysfunction in the long term, especially if stress becomes chronic and ends up exhausting all the reserves of the tissues. These metabolic dysfunctions, expressed in the form of chronic diseases, occur because the metabolic resources that have been mobilized to cope with the crisis are controlled by the same metabolic pathways that are used to manage metabolic resources in non-crises. Stress then “forces” the physiological resilience and consumes the metabolic reserve of each tissue. When we expose tissues to this constant demand with little time to recover, some of these tissues will simply not be able to bear the burden, beginning the dysfunction that will become, if not prevented, a chronic disease. The cost of surviving repeated stressful events is the potential depletion of reserves in all tissues. The challenge for today’s clinician is to measure the status of an individual’s stress response system and relate that status to the individual clinical presentation of each individual. The main objectives of the treatment of Stress Medicine are the increase of the physiological resilience and the metabolic reserve to face the demands of the environment, as well as the regeneration of the tissues affected by the chronic response to stress. The integration of Stress Medicine as a basis for the management and prevention of chronic diseases begins to take its first steps and is postulated as a potential standard in the change of the approach of the patient in 21st century medicine.
4:30 pm – 5:15 pm Hair Restoration: Treating the Scalp
Bertica M. Rubio, M.D.
Medical Director, Antiaging Regenerative Medicine Clinic, Redlands, CA
Medical Advisor, Rejuvenate Image Restoration, Refine and AQ Skin Solutions
Find out about all the available advancements in the hair restoration field. The use of Growth Factors, PRP, microneedling and transplants. How to diagnose each patient and plan a successful restoration program. This is an exciting emerging field.
5:15 pm – 5:30 pm Panel with Q & A
Luis Martínez, M.D., MPH
Alma C. Pontón Nigaglioni, M.D., FACOG
Dr. Ángel Durántez
Cesar Pellerano, M.D.
Beatriz Rodriguez Olson, M.D., FACP
Bernard Esquivel, M.D., Ph.D., MHA
Bertica M. Rubio, M.D.
Paula Martin-Marfil, M.D., MSc
Anna Cabeca, D.O.
5:30 pm – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

PRECURSO EN ESPANOL: Medicina Preventiva del Manejo del Envejecimiento para medicos y profesionales de la salud en español

Esta sesión está diseñada para llevar una sección transversal de temas basados ​​en medicina del manejo de la edad a médicos y profesionales de la salud para quienes el español es su idioma principal. Cada conferencia en esta sesión se realizará en español y los asistentes podrán participar en las sesiones de preguntas y respuestas en español con la facultad.

Hora
PISTA DE LENGUA ESPAÑOLA
7:00 am – 7:45 am Lo que necesitas saber sobre la composición
Presentado por David J. Metayer
Abierto a todos los asistentes e incluye desayuno de cortesía.
No-CME symposium patrocinado por University Compounding Pharmacy
8:00 am – 8:45 am Reemplazo hormonal para hombres: testosterona, estrógeno y DHEA
Luis Martínez, M.D., MPH
Presidente, Clínica XanoGene, Río Piedras, Puerto Rico
President,
Regenera Global
Cofundador,
Clinical Peptide Society
La terapia de reemplazo hormonal es una piedra angular de la medicina para el manejo de la edad. Los pacientes masculinos a menudo pueden pasar por un diagnóstico insuficiente debido a la aparición gradual de los síntomas y al rechazo a buscar intervenciones médicas. Esta conferencia cubrirá los fundamentos de la TRH para hombres. Se discutirán los protocolos de prueba y dosificación de testosterona, estrógeno y DHEA. Se revisarán los ejemplos de casos, enfatizando la continuidad del paciente y el seguimiento adecuado.
8:45 am – 9:30 am Reemplazo hormonal para mujeres: estrógeno y testosterona
Alma C. Pontón Nigaglioni, M.D., FACOG
Profesora Asistente del Departamento de Obstetricia y Ginecología, Universidad de Puerto Rico
Fundadora y Presidente, Instituto Caribbean Gyn, Caguas, Puerto Rico.

Esta conferencia cubrirá las interacciones y los efectos biológicos de las hormonas en pacientes de sexo femenino, cómo detectar desequilibrios en los niveles hormonales y cómo identificar candidatos para la terapia de reemplazo hormonal (TRH). También se discutirán los beneficios, los efectos secundarios y la variedad de métodos para la TRH, con énfasis en las estrategias de tratamiento con la TRH bioidéntica.
9:30 am – 10:15 am Efectos de la optimización hormonal en los biomarcadores de la aptitud física y su relación con la salud y la longevidad
Ángel Durántez, M.D., Ph.D.
Propietario y director médico, Clínica Dr. Durantez, Madrid, España
Optimización hormonal, nutrición, nutracéuticos, ejercicio, control del estrés, entrenamiento cerebral, desintoxicación, control longitudinal de la salud y biomarcadores de longevidad … Todos ellos son enfoques diferentes para un envejecimiento saludable y funcional. Todos ellos interactúan con los demás. El declive hormonal a lo largo de la vida provoca una cantidad conocida de signos y síntomas que coincide con los signos y síntomas del proceso de envejecimiento; fatiga, baja vitalidad, mente nublada, pérdida de masa corporal magra, pérdida de densidad ósea, aumento de la grasa corporal, pérdida de la libido y función sexual … Es bien sabido que la optimización hormonal revierte la mayoría de estos signos y síntomas. Por otro lado, el nivel de aptitud física se correlaciona con la morbimortalidad y la longevidad. El nivel de condición física disminuye a lo largo de la vida debido al proceso de envejecimiento, pero sabemos que con un programa de ejercicios adecuado, es posible mantener la condición física en los niveles de nuestra juventud. Pero la optimización hormonal es necesaria, para la mayoría de nuestros pacientes, para realizar un programa de ejercicios adecuado. En esta conferencia, veremos las últimas publicaciones sobre los efectos de la optimización de las hormonas principales en los biomarcadores de aptitud física y su relación con la salud y la longevidad.
10:15 am – 10:30 am Break
10:30 am – 11:15 am Testosterona y el corazón
Cesar M. Pellerano, M.D.
Cardiólogo Preventivo, Miami, FL
Presidente, Socio Fundador y Director Médico, Hillstar Health LLC, Miami, FL

Ha habido una gran cantidad de controversia con respecto a los efectos de la terapia con testosterona en las enfermedades del corazón. Este ha sido un tema importante en nuestros medios de comunicación nacionales, así como en la comunidad médica. Desafortunadamente, los informes han llevado a una cantidad significativa de información errónea, así como a la incertidumbre tanto en la mente de los médicos como de los pacientes. ¿La terapia con testosterona lleva a enfermedades del corazón? ¿Es segura la terapia con testosterona? ¿Hay un individuo en riesgo porque él o ella estaba en terapia de testosterona en el pasado? Esta conferencia ofrecerá una revisión de la literatura médica y permitirá que el médico y el paciente tomen la decisión correcta e informada con respecto a la terapia con testosterona.
11:15 am – 12:00 pm Introducción a la Terapia de reemplazo de hormonas en mujeres y su salud sexual
Anna Cabeca, D.O.
Experta en salud de la mujer, Obstetra Ginecóloga Certificada por la Junta
El autor más vendido de “The Hormone Fix”
Directora Médico, Vida Pura Health, Golden Isles Medical, Inc., St. Simons Island, GA

La salud sexual es un factor crucial en la salud femenina a cualquier edad, especialmente en la perimenopausia y la menopausia ya que se ve afectada significativamente por el equilibrio hormonal y es un factor importante en la salud de las relaciones. En esta conferencia, se revisarán los cambios hormonales que conducen a la pérdida del libido, trastornos vulvares y vaginales. Se discutirán las intervenciones terapéuticas clínicas, tanto hormonales como no hormonales. Estas terapias tienen un impacto positivo en la salud sexual. Se recomienda realizar más investigaciones para documentar la eficacia, la dosis y la duración del tratamiento de los tratamientos hormonales vaginales.
12:00 pm – 1:30 pm Lunch Break
12:00 pm – 1:00 pm Las disfunciones más comunes del intestino americano estándar en enfermedades crónicas
Presentado por el Dr. Tom Bayne
Abierto a todos los asistentes e incluye un almuerzo complementario.
No-CME symposium patrocinado por Microbiome Lab
1:30 pm – 2:15 pm Enfoque médico integrador para el bienestar y el envejecimiento vibrante
Beatriz Rodriguez Olson, M.D., FACP
Profesora Clínica Asistente de Medicina, Escuela de Medicina de Yale
Personal asociado, Grupo de endocrinología de Yale Práctica privada Endocrinología, Middlebury, CT

Con estos antecedentes, vengo a contarles algunas de las lecciones que he aprendido sobre el bienestar y la atención médica. Esta conferencia general se centrará en la dieta, el sueño, el ejercicio, la consistencia en las rutinas de la vida, incluidas las hormonas, y la conexión significativa con los demás como piedras angulares del bienestar. La dieta estadounidense es responsable de muchas de las condiciones de salud que el sistema médico estadounidense paga en gran medida por tratar. Te mostraré lo que me hizo después de seis meses en Estados Unidos. También discutiré cómo la medicina convencional decepcionó a muchas mujeres. Reemplazo hormonal después de considerar la menopausia, “dar a las mujeres cáncer de mama” sobre la base de datos erróneos de reemplazo hormonal no bioidéntico. Podemos hacerlo mejor con una evaluación cuidadosa del riesgo y el beneficio individual. Desde la perimenopausia hasta la menopausia, a medida que caen las hormonas de las mujeres, debemos mantener sus niveles fisiológicos normales y prevenir los cambios metabólicos que ocurren debido a la pérdida de estrógeno. Mantener niveles normales de hormonas saludables puede agregar calidad de vida, pero el manejo no es simple. La ruta, la dosis, los mecanismos de administración implican una decisión reflexiva e individualizada entre el médico y un paciente educado.
2:15 pm – 3:00 pm Nutrigenómica
Bernard Esquivel, M.D., Ph.D., MHA
Presidente, Asociación Latinoamericana de Medicina Personalizada
A medida que avanza la era de la genómica, entendemos un poco más acerca de la correlación entre los factores genéticos y ambientales y su importancia en el equilibrio de la salud y la enfermedad. Muchos aspectos ambientales pueden desencadenar epigenéticamente la información genética de pacientes que expresan fenotipicalmente como enfermedades. Una de las mejores maneras de modular los estímulos epigenéticos es mediante la implementación de protocolos nutrigenómicos personalizados. La nutrigenómica se puede definir como el estudio de los efectos de los alimentos y los constituyentes de los alimentos en la expresión génica, y cómo las variaciones genéticas afectan el entorno nutricional. En esta conferencia, discutiremos posibles portafolios nutrigenómicos y sus utilidades en enfermedades cardiometabólicas.
2:30 pm Exhibits Open
3:00 pm – 3:45 pm Break / Visit Exhibits
3:45 pm – 4:30 pm Rehabilitación metabólica: estrategias para el aumento de la flexibilidad/resiliencia fisiológica y de la reserva metabólica como mecanismos de prevención de las enfermedades crónicas 
Paula Martin-Marfil, M.D., MSc
Medicina antienvejecimiento y para el manejo del estrés (Europa-Medio Oriente)
El estrés es definido como “Un estado disarmónico o de compromiso de la homeostasis fisiológica,” esto es, del equilibrio del medio interno. Es una condición que desencadena un fenómeno biológico específico que es la “respuesta adaptativa al estrés.” La respuesta al estrés fue diseñada para mantenernos con vida ante un desafío fisiológico o ante una amenaza, sin embargo, la excesiva, prolongada o inadecuada regulación de esta respuesta al estrés va a suponer consecuencias para la salud. Hay dos términos importantes que es necesario conocer en relación a la respuesta al estrés: (1) Homeostasis: que es el estado fisiológico de balance que es sensible a una variedad de estresores tanto intrínsecos como extrínsecos (reales o percibidos); (2) Alostasis: es la vuelta a la estabilidad tras el cambio o tras la reacción al estrés. La existencia de ambos fenómenos, la homeostasis y la alostasis, precisan de la existencia de una reserva metabólica (vitaminas, minerales, aminoácidos, neuroesterorides, etc) que va a apoyar al organismo para que tenga una mayor resiliencia fisiológica. Un fallo en la alostasis, puede desencadenar un agotamiento de las reservas metabólicas pues, como decíamos, la respuesta al estrés, mueve recursos y cambia la función metabólica para hacer frente a la demanda actual de supervivencia, con el coste de reducir el almacén de material que puede provocar una disfunción metabólica en el largo plazo, sobre todo, si el estrés se cronifica y acaba agotando todas las reservas de los tejidos. Estas disfunciones metabólicas, que se manifiestan en forma de enfermedades crónicas, se producen porque los recursos metabólicos que se han movilizado para hacer frente a la crisis, son controladas por las mismas vías metabólicas que se usan para manejar los recursos metabólicos en las no crisis. El estrés “fuerza” entonces la resiliencia fisiológica y consume la reserva metabólica de cada tejido. Cuando nosotros exponemos a los tejidos a esta constante demanda con poco tiempo para recomponerse, algunos de estos tejidos no podrán simplemente soportar la carga, siendo entonces el comienzo de la disfunción que llegará a ser, si no se le impide, una enfermedad crónica. El coste de sobrevivir a repetidos eventos estresantes es la potencial depleción de las reservas en todos los tejidos. El desafío para el clínico de hoy es medir el estatus del sistema de respuesta al estrés de un individuo y relacionar ese estatus con la presentación clínica de cada individuo. Los objetivos principales del tratamiento de la Medicina del Estrés son el aumento de la resiliencia fisiológica y de la reserva metabólica para hacer frente a las demandas del entorno, así como la regeneración de los tejidos afectados por la respuesta crónica al estrés. La integración de la Medicina del Estrés como base para el manejo y prevención de las enfermedades crónicas comienza a dar sus primeros pasos y se postula como un potencial estandarte en el cambio del abordaje del paciente en la medicina del siglo 21.
4:30 pm – 5:15 pm Restauración del cabello: tratamiento del cuero cabelludo
Bertica M. Rubio, M.D.
Director Médico, Clínica de Medicina Regenerativa Antiaging, Redlands, CA
Medical Advisor, Rejuvenate Image Restoration, Refine y AQ Skin Solutions

Infórmese sobre todos los avances disponibles en el campo de la restauración del cabello. El uso de Factores de Crecimiento, PRP, microneedling y trasplantes. Cómo diagnosticar a cada paciente y planificar un programa de restauración exitoso. Este es un campo emergente emocionante.
5:15 pm – 5:30 pm Preguntas y respuestas con la facultad
Luis Martínez, M.D., MPH
Alma C. Pontón Nigaglioni, M.D., FACOG
Dr. Ángel Durántez
Cesar Pellerano, M.D.
Beatriz Rodriguez Olson, M.D., FACP
Bernard Esquivel, M.D., Ph.D., MHA
Bertica M. Rubio, M.D.
Paula Martin-Marfil, M.D., MSc
Anna Cabeca, D.O.
5:30 pm – 7:00 pm Recepción de bienvenida de AMMG
Abierto a todos los asistentes a la conferencia, cónyuges e invitados.
Celebrado en el Centro de Exposiciones y Redes de Conferencias

Thursday, April 11th

Traumatic Brain Injury: A Clinical Approach to Diagnosis and Treatment

This full-day program, TBI – A Clinical Approach to Diagnosis and Treatment, will provide to the attendees overwhelming information culled from peer-reviewed articles on Traumatic Brain Injury as the causative factor for personality changes, cognitive impairment and mood disorders leading up to suicide. The attendees will be walked through the literature discussing the effects of primary trauma and the secondary effects of inflammation and oxidative stress on functionality.

In conjunction with the Warrior Angels Foundation, a 501(c)(3) non-profit organization
A portion of the proceeds from this course will be donated to the Warrior Angels Foundation as they work towards their goal of providing personalized assessment and treatment for U.S. Military service members and veterans who have sustained Traumatic Brain Injury (TBI) while in the line of duty.

Course Faculty (all sessions in this track)
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

Time
Presentation
7:00 am – 7:45 am What You Need to Know About Compounding
Presented by David J. Metayer
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by University Compounding Pharmacy
8:00 am – 8:30 am An Introduction to Traumatic Brain Injury
A 30-minute overview of trauma, inflammation, and how it impacts the cognitive and emotional functionality of the brain.
8:30 am – 9:30 am Neurology, Neuropathology and Neuroendocrinology in Traumatic Brain Injury
60-minute discussion based upon literature about the specific cellular and biochemical cascades that are initiated by neuro-trauma. Expanding discussion on the indolent and stealth progression of the initial injury (primary) and the years of damage produced by the secondary injury.
9:30 am – 10:15 am The Laboratory of Traumatic Brain Injury
The assessment of neurotrauma using trophic, neurosteroids, and neuroactive steroids as markers for hormonal deficiencies that are caused by both the primary and secondary injuries associated with neurotrauma (TBI). The literature supported view that the “standard reference” ranges and “normal” reference ranges are not relative to the patient. Interpretation of the lab results using the Median Theory of optimal levels.
10:15 am – 10:30 am Break
10:30 am – 11:30 am Traumatic Brain Injury and Neurobehavior
The impact of neurosteroid deficiencies on both personality and mental abilities is clearly discussed in peer-reviewed articles. Those same articles provide support for mood and anxiety disorders developing from loss of the regulatory effects of many of the neurosteroids that are produced in the brain.
11:30 am – 12:00 pm Supplementation for Traumatic Brain Injury – Part I
The major impact of trauma is the production of secondary injury precipitated by free radicals and oxidative stress. The use of specific anti-oxidants and the regeneration of the glutathione system in the brain can help to regain a neuro-permissive environment that can allow for cellular repair and regeneration.
12:00 pm – 1:30 pm Lunch Break
12:00 pm – 1:00 pm The Most Common Dysfunctions of the Standard American Gut in Chronic Illness
Presented by Dr. Tom Bayne
Open to all attendees and includes a complimentary lunch
Non-CME symposium sponsored by Microbiome Labs
1:30 pm – 2:30 pm Supplementation for Traumatic Brain Injury – Part II
Continuation of the 5th lecture with specific application and treatment of traumatic brain injury. A number of cases will be discussed.
2:30 pm – 3:30 pm Case Studies – Part I
15 comprehensive cases will be dissected and presented with attendees’ participation as a means of consolidating the information that will be shared throughout the day.
2:30 pm Exhibits Open
3:30 pm – 4:10 pm Break / Visit Exhibits
4:10 pm – 5:30 pm Case Studies – Part II
Continuation of the cases with attendee participation and Q & A. The goal of these cases is to allow the audience an opportunity to work out with the lecturer the initial evaluation of the patient, laboratory testing, interpretation of the test results, and selection of an optimal treatment protocol.
5:30 pm – 7:00 pm AMMG Welcome Reception
Open to all conference attendees, spouses, and guests
Held in Conference Networking and Exhibits Center

Friday, April 12th

General Session Curriculum

Time
Presentation
7:00 am – 7:45 am How to Build a Successful Structured Weight Loss Business with Eating Plans and Lipo Laser
Presented by Kimball Lundahl, D.C.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by Healthy Habits Medical Business Consultants
8:00 am – 8:05 am Opening Remarks
8:05 am – 9:00 am The Dangers of Inhibiting Estrogen in Men
Rob Kominiarek, D.O., FACOFP
Member, AMMG Planning Committee
Director, ReNue Health, Springboro, OH
Assistant Clinical Professor, Ohio University College of Osteopathic Medicine
Estradiol is a pleiotropic hormone that has instrumental influence over numerous critical functions related to the cardiac and vascular system, bone and mineral metabolism, cognition, memory, mood, balance, age related neurodegenerative disorders and lipolysis of fat. Evidence suggests that estradiol has neurotrophic and neuroprotective properties and promotes the survival and viability of intimate brain structures. The benefits of estradiol on neuroprotection are attributed to genomic and non-genomic signaling, regulation of mitochondrial energy and antioxidant action. Damaged neurons increase the production of aromatase, the enzyme that is responsible for the conversion of androgens into estradiol. Our own astrocytes after suffering trauma increase aromatase expression to exert the numerous benefits of estrogen to these intimate structures. Knowing all this to be an evident truth, why then do some clinicians insist on blocking the aromatization of testosterone into the ever-important, pleiotropic hormone estradiol? Attendees will learn the importance of allowing the natural aromatization of testosterone into estradiol to occur and how blocking this important conversion will do long-term harm to these numerous systems.
9:00 am – 10:00 am Pearls and Pitfalls of Testosterone Boosting Modalities
Eugene Shippen, M.D.
Medical Consultant Lead Toxicology, Exide Technologies
The primary reason for low testosterone in younger aging males, and for some older aging males as well, is low gonadotrophin output, particularly LH. Leydig cells decline with aging and persistently low gonadotrophins and some diseases, i.e., hemochromatosis, hypothyroidism, etc. If boosting methods fail, then primary hypogonadism is present and replacement modalities are required. Reasons for low gonadotrophins today may be related to xeno-estrogens in diet and environmental intake. Additionally, obesity with increased endogenous estrogens, drugs and poor health or co-morbid diseases add to the long list that requires investigation. In this regard, we can do much to change negative patterns, but along with these changes we can add great benefits through boosting testosterone through increasing gonadotrophins or giving them directly. In my experience, boosting should be the first diagnostic and treatment intervention before direct replacement of testosterone is initiated, particularly under the age of 65. The three most common methods are: (1) Through the use of SERMS, such as clomiphene or analogues; (2) Suppression of endogenous conversion of androgens into estrogens within the hypothalamus with reversible aromatase inhibitors like anastrozole or femara; and (3) hCG – Chorionic Gonadotrophin, a direct LH containing natural compound with a very long history of safe, effective uses. My discussion will cover the background literature and my long use of all three modalities and some observations on potential problems and benefits of these approaches. Some of the unique benefits are poorly known and, sadly, under-utilized. Questions and answers will be welcomed depending on time constraints.
10:00 am – 10:30 am Break / Visit Exhibits
10:30 am – 11:15 am The Big T; Testosterone from Testy to Tired – What Testosterone Means in Women’s Health
Cheryl Burdette, N.D.
Director of Education and Residency, Progressive Medical Clinics
Consultant, Dunwoody Labs & LabCorp
Testosterone is given credit for building muscle mass and improving libido, but is often under discussed outside of these areas. Testosterone receptors on the brain and in the bone are critical for so much more in terms of optimal function in our system. Testosterone does have the potential to be naturally modulated, through botanicals and nutrients. We will review research that indicates which therapies are most effective. Testosterone also plays a role in enzymatic activity such as Cystathionine-β-synthase or CBS so is involved in methylation cycles and homocysteine control. Testosterone, while only a tenth of the level in women that it is in men, is still pivotal to well-being in women’s health. We will review some of the distinctions between testosterone activity in men and women, and where our focus should be for healthy testosterone management. Testosterone is emerging as a key player in fertility and a role in breast cancer as well. We will examine these areas, and move through the research to find the evidence that best supports effective testosterone management in men and women.
11:15 am – 12:15 pm Women’s Sexual Health: Cutting Edge Issues
Anna Cabecca, D.O.
Women’s Health Expert
Best Selling Author of “The Hormone Fix”
Board Certified OB-GYN
Medical Director, Vida Pura Health, Golden Isles Medical, Inc., St. Simons Island, GA
This lecture will address Hot Topics in Women’s Sexual Health, which include Brain Gut connection of course! Lecture will highlight hormonal physiology and the connection to behavior, vaginal androgen therapy for vaginal restoration, and the modern day woman’s predominant issue of stress and how it affects us.
12:15 pm – 1:30 pm Lunch Break / Visit Exhibits
12:15 pm – 1:15 pm Bridging the Gap Between Microvascular Dysfunction and Cognitive Impairment
Presented by Absalom H. Tilley, M.D.
Open to all attendees and includes a complimentary breakfast
Non-CME symposium sponsored by Cardiology Institute of America
1:30 pm – 2:15 pm Estrogen Dominance
Neal Rouzier, M.D.
Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA
ED is a term commonly mentioned in lectures at AMMG. However, what does the term really mean? ED is commonly misunderstood, misstated, and inappropriately used to denigrate any use of estrogen. This lecture will review EBM that provides credence for the use of estrogen and the benefit in protecting against heart disease and breast cancer, not cause it. I will use the medical literature to demonstrate the importance of the use of estrogen to TREAT estrogen dominance, which is a completely over-utilized and incorrectly utilized term that should be discarded in place of a more appropriate term: IR.
2:15 pm – 3:00 pm Update on the Latest Research in Hormone Replacement Therapy
Robert L. True, M.D.. FACOG, FACS
Private Practice Specializing in Cosmetic Surgery, Anti-Aging ,and GYN, Colleyville, TX
Hormone replacement therapy has been given a bad rap from many physicians who have not kept up with the literature. Most lay-people, many physicians, and the FDA still do not understand the immense benefit versus risks that hormone therapy can provide. Hormones are one of the best methods to decrease the risk of developing age-related degenerative diseases if started early and taken for over ten years. Moreover, they have the potential to improve patient’s quality of life with better stamina, muscles, sex life, and much more. Fears of heart disease, stroke, breast cancer and prostate cancer from hormones have been proven to be non-founded, while benefits continue to remain high. Hormone therapy, particularly hormone pellet therapy, should be considered an essential therapy by age management physicians to help patients live longer and with better quality of life.
3:00 pm – 3:30 pm Break / Visit Exhibits
3:30 pm – 4:30 pm What the Testosterone Class Action Lawsuits and Federal hGH Law Mean for Age Management Practitioners
Rick Collins, JD, CSCS
Law Partner, Collins Gann McCloskey & Barry PLLC, Mineola, NY
Testosterone replacement therapy (TRT) has taken some hits in recent media headlines, reporting FDA’s public safety alert in 2014 about “the risk of stroke, heart attack, and death in men taking FDA-approved testosterone products” and then the change in testosterone labelling requirements in 2015 to include a warning of possible increased cardiovascular risks. Class action lawyers followed by filing more than 7,700 lawsuits against drug companies, many on behalf of men who allegedly suffered injuries, including heart attack, stroke, deep vein thrombosis, and pulmonary embolism, as a result of TRT. Other lawsuits target false marketing efforts, such as marketing testosterone treatments for “off label” uses not approved by the FDA. If government bureaucrats, law enforcers and members of medical licensing boards read and are influenced by these headlines, what effect can be expected to trickle down to practitioners prescribing testosterone or growth hormone? Rick Collins will share his insights based on 20 years concentrating his defense practice in the area where wellness and performance collide with the law.
4:30 pm – 5:30 pm Hormones & Hair Loss: Stratagems for Managing Androgenetic Alopecia in the Presence of Androgen Replacement Therapy
Alan J. Bauman, M.D., ABHRS
Founder & Medical Director, Bauman Medical Group, Boca Raton, FL
Hereditary hair loss or Androgenetic Alopecia affects approximately 40 million men in the United States. In 2017 it was estimated that 2.3 million American men receive testosterone replacement therapy. Numerous clinical trials have supported and confirmed that the progression of hair loss is an often-unwanted sign of aging and a significant trigger for decreased Quality of Life in the affected population. In men, the chronic progressive miniaturization of hair follicles and hair loss in response to an inherited sensitivity to endogenous, normal levels of dihydrotestosterone (DHT) can begin to occur soon after puberty, and eventually affecting more than half of all men by the time they age to 50. Because DHT, the primary trigger for androgenetic alopecia, is created from testosterone through the 5-alpha reductase pathway, actions/activities and treatments that are designed to beneficially replace or enhance testosterone levels are often associated with accelerated hereditary hair loss as DHT levels rise. Unwanted, unexpected and accelerated hair loss may be a barrier for continued androgen replacement therapy, resulting in patient’s cessation of therapy. An understanding of the stratagems used to elucidate risk factors, diagnose, measure/monitor signs and symptoms, as well as the initiation of therapeutic interventions for Androgenetic Alopecia, can be used to avoid and-or manage this increasingly common unintended and unwanted consequence of androgen replacement therapy and ensure continued patient compliance with their androgen replacement therapy regimen.
5:30 pm Reception Introducing AMMG’s Training and Certification in Age Management Medicine
Presentation by TBD
Open to all conference attendees

Saturday, April 13th

General Session Curriculum

Time
Presentation
8:00 am – 8:45 am Umbilical Cord Wharton’s Jelly Mesenchymal Stem Cells – The Next Future
Steven E Warren M.D.
Medical Director, Regenerative Wellness Center, Bountiful, UT
This presentation will focus on what stem cells are, the different types, the criteria for selection of stem cells, and how they work. During the presentation the application of umbilical cord mesenchymal stems will be explained for a multitude of conditions such as orthopedic diagnoses, aesthetic symptoms, and auto immune illnesses as well as the application for healthy aging. In order to be highly effective and provide the longest benefits, the lecture will look at aging and some of the causes of this disease. The inability of our bodies to maximize autophagy processes, allow chronic inflammation, and maintain senescence cells in our bodies contribute to this aging process. The combination of using senolytic protocols, revving up the autophagy pathways, and then introducing healthy live mesenchymal stem cells to our body is one of the keys to promoting a longer and healthier life.
8:45 am – 9:30 am Nutrigenomics Portfolios as a Clinical Tool
Bernard Esquivel, M.D., Ph.D., MHA
President, Latin American Association for Personalized Medicine
As the genomics era goes forward, we understand a little more about the correlation between the genetic and environmental factors and its importance in the balance of health and disease. Many environmental aspects can epigenetically trigger the genetic information of patients expressing phenotipicaly as diseases. One of the best ways to modulate the epigenetic stimuli is by implementing personalized nutrigenomic protocols. Nutrigenomics can be defined as the study of the effects of food and food constituents on gene expression, and how genetics variations affect the nutritional environment. In this lecture we will discuss potential nutrigenomic portfolios and their utilities in cardiometabolic diseases.
9:30 am – 10:15 am Cosmeceutical Peptides
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
Skin aging is a natural process that is caused by intrinsic changes and extrinsic damage. Over time there is a decrease in type 1 collagen, increase in fragmentation of collagen and accumulation of elastin material which causes the skin to wrinkle, increase in age spots, and have a leathery appearance. Growth factors and cytokines have been used in the cosmetic products to help with the aging skin. However, their large size of >15,000 Da limits their ability to penetrate the skin. Peptides offer the advantage of growth factor-like activities with better skin penetration due to their smaller molecular size and also with their signaling effects. Several peptides, including GHK, GEKG, KTTKS and others will be reviewed. Also the pleotrophic effects of GHK copper will be covered
10:15 am – 10:45 am Break / Visit Exhibits
10:45 am – 11:30 am A Case Study in Peptides for Brain Health
Paul D. Thompson, M.D.
Private Practice, Fort Worth, TX
Peptides and brain health: An ongoing look at TBI and the benefits of peptides, synapsin and various hormones and supplements Update on case presented in Tucson with a description of all treatment modalities used, and results.
11:30 am – 12:15 pm Single Nucleotide Polymorphisms (SNPs) and Peptides Unlock a New Paradigm for Health
Robert Willix, Jr. M.D.
CEO/Founder of Enlightened Living Medicine, Boca Raton, FL
CME, Hippocrates Health Institute
CME, LiqulVida Lounge
Can the knowledge of epigenetic SNPS in combination with the utilization of peptides introduce a novel approach to treat autoimmune disease, insomnia, depression, and IBS as well as other types of inflammation? Single Nucleotide Polymorphisms (SNPs) can mutate and activate the gene expression in different ways. Metabolic pathways including DNA repair and Methylation, Acetylation and Phosphorylation as well as de-phosphorylation play a critical role in the inflammatory process. This is the underlying cause of all diseases and now with the ability to affect and understand the downstream metabolic paths we can alter disease outcomes. This Epigenetic knowledge combined with the use of a variety of new peptides that can alter the metabolic functions promises to unveil an entire new brand of medicine. When you combine basic knowledge of how the SNPs upregulate and downregulate DNA, with how peptides affect the mitochondrial repair and function – a new paradigm is unveiled.
12:15 pm – 1:30 pm Lunch Break / Visit Exhibits
1:30 pm – 2:30 pm Physical Fitness Biomarkers in Health, Prevention and Longevity: Latest Data
Ángel Durántez, M.D., Ph.D.
Owner and Medical Director, Clinica Dr. Durantez, Madrid, Spain.
Physical Activity and Exercise is probably the most important approach for a healthy and functional life. Even more, there is a vast amount of scientific data that correlates the physical fitness level with morbimortality and longevity. The quantification of the physical fitness level should be a “must” in the evaluation of an Age Management Medicine Program. There are several components of Physical Fitness; CRF cardiorespitatory fitness, strength, body composition and flexibility. This lecture will present the latest scientific data about which should be the optimal levels, the goals for these physical fitness biomarkers in an Age Management Medicine Program.
2:30 pm –3:10 pm Trouble Shooting Testosterone Pellets for Women
Kathy Maupin, M.D
Owner & President, BioBalance Health, St. Louis, MO
Are testosterone pellets a mystery to you? Dr. Kathy Maupin’s presentation reviews the prevention, management and treatment of difficult female testosterone pellet patients. This discussion includes how to avoid problems associated with every facet of T pellet insertion, patient complaints concerning side effects, dosage and how to maintain T pellets for the long term patient. Dr. Maupin has gathered information contained in this presentation from treating thousands of female pellet patients over 17 years in her practice. Her goal is to share what she has learned through her review of vast medical research, her own practice and the feedback she hears every day from her own patients. In properly trained hands, bio-identical testosterone pellets are the most effective, safest and have the best compliance of any form of T for women. Success with T pellets only takes knowledge and attention to the individual patient by asking the right questions and trouble shooting their complaints. Patients want easy efficient care so they can feel wonderful and get on with their busy lives. Dr. Maupin will present her successful method of T pellet management that brings women from all over the world to her practice, BioBalance Health® in St. Louis and Kansas City.
3:10 pm – 3:45 pm Break / Visit Exhibits (exhibits close 3:45 pm)
3:45 pm – 4:30 pm Problems with Gastrointestinal Pathology and its Clinical Implications 
Hala M.T. El-Zimaity, M.D.
Surgeon, Markham Stouffville Hospital & Etobicoke General Hospital, Branpton, ON Canada
Gastrointestinal Pathology Consultant, Dynacare Medical Laboratories, Brampton, ON Canada
Digestive diseases are a heavy burden on health care, but they also play a central role in chronic diseases. Increasingly, the treatments for these diseases have their side-effects, many of which mimic other relatively common chronic diseases. There is an ever-growing number of pharmacologic agents that can cause gastrointestinal mucosal injury simulating common diseases. This talk will focus on being aware of, and navigating, diseases that either cause or mimic, other common gastrointestinal diseases, so that for those in clinical practices it can facilitate their diagnosis as well as minimize the risk of making an incorrect diagnosis. The lecture will cover the causes and mimics of common digestive disorders such as esophageal and gastric injury, celiac disease, and inflammatory bowel diseases.
4:30 pm – 5:30 pm Mind Over Aging: The Role of Stress and Stress Reduction in Age Management Medicine
Robert H. Schneider, M.D., FACC
Dean, College of Integrative Medicine
Director, Institute for Natural Medicine and Prevention, Fairfield, IA
Research in clinical gerontology over the last ten years has yielded a plethora of insights into how behavior influences aging biology and clinical outcomes. Basic science and clinical studies demonstrate that psychosocial stress contributes to neuroendocrine dysfunction, inflammation, oxidative stress, shortened telomeres, chronic disease progression and premature mortality. These psychosocial stress factors include: vital exhaustion, burnout, anxiety, anger, hostility and depression. On the other hand, there are protective behaviors that social support, meaning, purpose and spirituality contribute to resilience. The first part of this talk will review psychosocial stress factors that are empirically associated with aging. The second part of this talk will review effects of stress reduction with meditation on physiological and clinical correlates of aging. As an example, we will review one of the most widely researched forms of meditation, the Transcendental Meditation (TM) technique and compare it to with other stress reduction practices, such as mindfulness-based stress reduction (MBSR) and relaxation. The American Heart Association and American College of Cardiology, amongst others have issued scientific statements on the value of meditation in clinical practice relevant to age management medicine. In particular, these and other systematic reviews point out that Transcendental Meditation and MBSR are associated with significant reductions in anxiety and anxiety-related disorders. In addition, randomized controlled trials and meta-analyses report that TM practice reduces traditional cardiovascular disease risk factors and surrogate markers including hypertension, metabolic syndrome, left ventricular hypertrophy and carotid atherosclerosis. Two independently conducted RCT’s show that patients who were randomly assigned to meditation practice, in addition to usual care showed 30-48% lower risk of all-cause mortality, myocardial infarction and stroke. Potential mechanisms for these clinical effects of meditation include changes in the sympatho-adrenal axis, hypothalamic-pituitary adrenal axis, inflammation, insulin resistance, gene expression and telomere function. Brain electrophysiological patterns appear to distinguish between different forms of meditation. These neurophysiological makers may correlate with comparative clinical effectiveness studies. These data will aid clinicians in their understanding of the role of stress in their patients’ aging process and the utilization of appropriate stress reduction tools in the clinical setting.

Sunday, April 14th

General Session Curriculum

8:00 am – 9:00 am Full Spectrum Cannabis – Benefits Beyond THC & CBD
Betty Wedman-St Louis, Ph.D., RD
Assistant Professor, New York Chiropractic College
Adjunct Professor, Everglades University, Sarasota, FL
Adjunct Professor, South University-Tampa, FL
There is a lot more to cannabis than THC and CBD, its predominant cannabinoids. Terpenes are the fragrant oils that give cannabis its aromatic diversity. Flavonoids provide synthesis of antioxidant properties as potent inhibitors of cyclooxygenase enzymes and prostaglandin E2 production. The “entourage effect” identified by EB Russo, M.D. in 2011 offers medicinal properties beyond the efficacy of single cannabinoid effectiveness or a single CBD remedy for a specific disorder like seizure management. Whole plant medicine combines cannabinoids, terpenes and flavonoids to provide pain, sleep, gastro-intestinal, mood and behavior, and neurological benefits. The analysis of terpenes allows patients to determine correct strains for their symptom management. Of the more than 200 terpenes and 29 flavonoids found in cannabis, six primary terpenes and five flavonoids are key to selecting full spectrum cannabis products.
9:00 am – 10:00 am Reversal of Cognitive Decline: The Science, The Tools, and The Transformation
Kenneth S. Sharlin, M.D., MPH
Sharlin Health & Neurology Clinic, Ozark, MO
Dr. Sharlin harnesses the latest discoveries in neuroscience and applies them, using a functional medicine framework, to create a practical and actionable plan for the reversal of Alzheimer’s disease and cognitive decline. The presentation draws from his clinic-based protocol, Brain Tune Up!, which resulted in a recently published article in The Journal of Alzheimer’s and Parkinsonism entitled Reversal of Cognitive Decline: 100 Patients. Built around the story of one of Dr. Sharlin’s patients, the presentation is a hero’s journey into the workings of the brain. It integrates the individual pieces of the puzzle into a holistic view of how the brain works (or doesn’t), makes the complex understandable, and provides the tools needed to overcome the challenges faced by those suffering from cognitive decline. Finally, Dr. Sharlin takes the audience through the transformation of his patient, and others, in their remarkable recovery from this devastating disease.
10:00 am – 10:15 am Break
10:15 am – 11:00 am Benefits of Homeopathy As An Adjunct To Anti-Aging Procedures: PRP and Stem Cell
Payam Hakimi, D.O.
Medical Director, Body of Harmony Institute of Health & Healing, Beverly Hills, CA
Clinical Assistant Professor of Family Medicine, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences
Teaching Faculty, Center for Education & Development of Clinical Homeopathy
Homeopathic medications have been used for a variety of medical conditions. As medicine expands into different directions the application of Homeopathic medications are also adapting to this change. The role of Homeopathy has been established in aesthetics and surgical procedures for may years. This lecture describes the applications of Homeopathy in anti-aging procedures. After a brief description of Homeopathy Dr. Hakimi will discuss Homeopathic medication corresponding to joints, connective tissue, capillaries and his specific pre and post procedure Homeopathic medications. The focus will be on medications which have research and experimentation to validate their effectiveness.
11:00 am – 11:45 am Functional Medicine Approach to Reversing Mild Cognitive Impairment and Early Dementia
Kat Toups, M.D., DFAPA, IFMCP
Private Practice, Functional Medicine Psychiatry, Bay Area Wellness, Walnut Creek, CA
Distinguished Fellow, American Psychiatric Association
Certified Practitioner, Institute for Functional Medicine
Alzheimer’s Disease is a neurodegenerative disorder – but it is not a mysterious, untreatable brain disorder. It is a reversible multisystem illness that occurs due to toxins and infections and inflammation and lack of hormones and other diet and lifestyle factors. It has a strong auto-immune component as well. Neurodegeneration does not just happen. It happens for reasons, and when we can look at the big picture and address all of the driving factors, we can gain traction in stopping and sometime even reversing the degenerative process. Alzheimer’s Dementia is a multi-factorial disease, and it is rarely due to just one thing. In order to reverse dementia, we have to look at, and rectify, all of the factors that contribute:  metabolic, nutritional, toxic, inflammatory, infectious, autoimmune, and/or withdrawal of trophic support (like hormones and nutrients). Dr. Toups will discuss the Functional Medicine approach she used to reverse her own dementia, and how to evaluate patients with Mild Cognitive Impairment and Dementia using a Functional approach to determine the root causes of their illness.
11:45 pm – 1:30 pm Putting It All Together: The Essentials of an Age Management Bioidentical Hormone Replacement Program
William Clearfield, D.O., FAAMA, DABMA, FAARFM
Medical Director, Clearfield Family Medicine & Ageless Zone Medical Spa, Reno, NV
This lecture will synthesize the evidence-based concepts which you have been exposed to in this conference into a coherent package trying to bring together the essentials of an Age Management BHRT program. The participant, on Monday morning, can take the information in this lecture and apply it, in a coherent fashion, to his or her office routine. A review of the 5 main areas of inquiry—inflammation, nutrition, hormone optimization, mind and body—essential for a successful BHRT program. Lecture will review the essential laboratory studies, either serum, saliva or urine, including “normal” and “optimal” values to successfully and safely treat patients seeking relief from hormone deficiency symptoms, review the treatment strategies for 8 essential elements, c Reactive Protein, Blood Sugar, Insulin, Homocysteine, Vitamin D, the Sex Hormones, Growth Hormone, and Thyroid function, of a BHRT program. A review, with an eye toward implementing a simple office based 8-week Mind/Body program.