30th Clinical Applications On-Demand Agenda

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Day 1


45 minutes The Endocrine/Neuroendocrine Laboratory of Age Management Medicine
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
The optimization of laboratory testing for our patients has always been a challenge. Understanding the differences between the technologies used to assess our hormonal well-being as well as what constitutes an optimal hormone level is the focus of this lecture. Looking at the differences between Salivary, Serum and Urine testing aligned with the gold standards of medical communities, can create a legal dilemma based upon the lack of research standards for some of these testing formats. We will discuss the technical formats, selection of lab protocols, and the interpretation of the results all to optimize the patients outcome. Just having a numerical result that fits within the standardized range does not guarantee optimal benefits or risks. In the past 20 years, my practice at Millennium has focused on raising the patients hormonal levels to the 50th – 75th percentage of the accepts medical community’s parameters. It has been within this paradigm shift that we have achieved the greatest amount of benefits for our patients.
45 minutes Natural Aromatase Inhibitors
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
One of the most dangerous enemies to men when it comes to boosting testosterone is the Aromatase enzyme. This destructive enzyme’s main role is to convert testosterone into the female hormone estrogen.
It goes without saying that men who want to keep their testosterone at optimal levels need to take measures to keep this enzyme at reasonable levelsbecause this will ensure that they are protecting testosterone and not allowing it to be converted into estrogen.
Of course, we can control aromatase activity with the use of prescription medications but what about the potential nutrient depletion and the side effects from the prescription drugs.
There are “natural aromatase inhibitors” that have well documented effects without the side effects and have the potential for “side benefits” vs side effects.
We will review these natural aromatase inhibitors along with some of the other potential side benefits that these natural compounds process.
2 hours Testosterone Therapy in Men with Prostate Cancer: A Revolution in Understanding
Abraham Morgentaler, M.D.
Associate Professor, Harvard Medical School
Staff, Beth Israel Deaconess Medical Center
History of the concern re T and prostate cancer (PCa). Current status of the contraindication to use T therapy in men with PCa. Does testosterone cause PCa?  Do men with higher levels of T have greater risk than men with low levels? Do men on T therapy have higher risk of developing PCa. The saturation model. Evidence in men following radical prostatectomy or radiation. Evidence in men on active surveillance. My recent experiences in men with metastatic prostate cancer. How I treat. Recommendations for treatment, monitoring, and medico-legal concerns. 
15 minutes 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
45 minutes Post Finasteride Syndrome
William Clearfield, D.O., FAAMA, DABMA, FAARFM
Medical Director, Clearfield Family Medicine, Reno, NV
Executive Director, American Osteopathic Society of Rheumatic Diseases
Approved in 1992 to reduce benign prostatic hypertrophy, finasteride competitively inhibits type II and type III isozymes of 5a-reductase, resulting in reduced dihydrotestosterone (DHT). Elevated DHT is the primary driver of testosterone-related issues in men and women. DHT causes benign prostatic hypertrophy and androgenic alopecia. A not so funny thing happened on the way to a bushy head of hair and better urinary flow, however. Termed “Post Finasteride Syndrome (PFS),” an estimated to be 3-5 % of all finasteride users, repre-senting nearly 400,000 patients in 2018 alone, began reporting a constellation of severe adverse effects persisting long after discontinu-ing finasteride use. Symptoms included sexual and neurologic disorders, including decreased or complete loss of sex drive, erectile dysfunction, impotence, chronic anxiety, depression, and an altered gut microbiome. Many patients claim these symptoms are perma-nent. Etiologies of PFS include changes in penile vascular architecture, interference, and reduction of the neurosteroid that influences GABA, the calming neurotransmitter production, allopregnanolone. We discuss finasteride in detail, the symptoms of PFS, along with recommended laboratory studies and a remedial program. Finasteride is frequently cited in AMMG’s TBI program as a drug to avoid due to long-lasting behavioral and mood changes. Our goal is to explore the growing problem of PFS in depth.
45 minutes The Emergence of Epigenetic Methylation for Aging and Preventive Medicine Interventions
Luis Martínez, M.D., MPH
President, XanoGene Clinic, San Juan, Puerto Rico
President, Regenera Global, Ponce, Puerto Rico
It has always been a challenge for the clinician to fully assess the impact of Anti-aging/Age Management interventions. These have always been difficult to measure due to the lack of adequate biological age measurements. However, with the recent advances in methylation testing, biological age can now be measured in a precise manner. Through epigenetic methylation testing, we now have a valuable biomarker which correlates the most (when compared to other biomarkers) to age related diseases such as Alzheimer’s, cardio-vascular disease, cancer and even death. Additionally, and unlike genetics, these DNA markers can evolve over time. This allows for a truly personalized, preventative, and real-time approach to treatment. The information obtained from measuring Epigenetic methylations makes it an essential clinical tool that goes beyond aging and becomes an important piece of a “multi-omic” picture. We are already using this test to formulate treatment plans aimed at improving healthspan and lifespan. As an example, reducing the biological age of everyone in the world by 7 years, would cut morbidity in half. Moreover, epigenetic methylation can highlight which patients may be at an increased risk of diseases and accelerated aging, despite presenting with otherwise optimal lab results. In this lecture we will discuss how to use this biomarker in order to achieve the best clinical outcomes. 
45 minutes The Future of Cardiology: The End of the Coronary Artery Calcium Score; Using Artificial Intelligence Phenotyping of Coronary Arteries to get a Reversible Plaque Score
George Shapiro, M.D.

Chief Medical Innovation Officer, Fountain Life
Adjunct Assistant Professor Clinical Medicine, New York Medical College, Valhalla, NY
Founding Partner, Cenegenics, New York City
Member, AMMG Conference Planning Committee
Current cardiovascular diagnostic approaches fail to identify patients at risk of heart attack. Symptom-driven evaluation assesses surrogates of dis-ease rather than the disease itself. The evaluation of coronary artery disease is the same as it was 50 years ago; and this approach does not reduce heart attacks. Discrimination of heart attack risk is from the type of plaque. I will reveal a new approach using artificial intelligence phenotyping as the most effective way to providing risk-guided care. Phenotype unifies and integrates the influence of all risk factors over a person’s life. Plaques that look differently behave differently. High risk plaques cause heart attacks, progress rapidly, have a poor response to medical therapy and cause ischemia. Low risk plaques do not cause heart attacks, progress slowly and are non-ischemic. Newer medical therapy treatments will also be dis-cussed for primary prevention that result in the transformation of high-risk into low-risk plaques thus stabilizing plaques reducing major adverse cardiac events.

Day 2


1 hour Food as Medicine
Arden Andersen, Ph.D., D.O., MSPH
Family and Occupational Medicine Physician, McDonough Medical Center, Gladstone, MO
Medicine is most often thought of strictly as manufactured synthetic substances limited to 1 or 2 specific physiologic functions, e.g. blood pressure or blood sugar. Food, though specific foods can target specific physiologic functions, e.g. ginger for gastritis, is generally thought of as related to the entire organism physiology or no physiology at all, just food. However, the Standard American Diet is the most disease causing diet on earth, is highly inflammatory – the initiating mechanism for most all chronic disease – and is rare discussed in the context of “medicine.”  Further, just as we are finding more and more medicines carrying/contaminated with undesirable substances – e.g. metformin and losartan – we find foods, especially conventionally grown foods to be contaminated with pesticides, heavy metal, and other undesirable contaminants that further adversely the consumer. Just a food causes chronic disease, different food can reverse and ameliorate chronic disease just as can “medicine.” Lastly, the third leading cause of death in the US is the medical system itself. A corollary would be that conventional agriculture – including the processing industry – is the number one contributor to death and disease via its lobbying and imposition of the SAD.
1 hour Food as Medicine: Updated Research on Carnosine, Beta-alanine
Jay R. Hoffman, Ph.D., FACSM, FNSCA
Professor, Dept. of Molecular Biology & Director of Health & Sport, Ariel University, Israel
β-alanine is a non-proteogenic amino acid that combines with histidine to form the dipeptide molecule carnosine. β-alanine is the rate-limiting precursor of carnosine formation, and supplementation with β-alanine increases muscle carnosine. Carnosine is found in high concentrations in both meat and fish. Carnosine is a H+ buffer that has an important role in muscle function and may impact ischemic events. In addition, carnosine has been suggested to have various other roles in the body, including acting as an antioxidant, antiglycating agent, and ion-chelator, which may have significant effects on aging and other health benefits. β-alanine supplementation has been shown to improve mood and reduce anxiety in both human and animal studies. This presentation will provide an overview of the health benefits known, and potential other benefits associated with elevations in both muscle and brain tissue carnosine levels.
45 minutes Evidence-based Review of the Impact of the Mediterranean Diet on Heart Health, Cognitive Function, Longevity and Weight Contro
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.
45 minutes Nutrition Controversies in Patient Care
Betty Wedman-St Louis, Ph.D.
Nutritionist & Environmental Health Specialist, Pinellas Park, FL
Is Nanotechnology Safe in Foods? Nanotechnology in foods is used as a delivery system for colors, flavors, preservatives, nutrients and nutraceuticals. There is evidence that some of them can have harmful effects. Neither consumers, regulators nor medical personnel are fully aware of the toxicity + food products are not labeled as produced using nanotechnology. CDP-Choline as an Essential Nutrient, Cytidine 5-diphosphocholine is essential for cellular membranes, especially in phosphatidylcholine, and can be administered in intravenous or oral format. CDP choline increases cerebral metabolism and acts on neurotransmitters to increase noradrenaline and dopamine in CNS. Why is it not used in CVD, head traumas, and cognitive disorders?  Digestion of A1 vs A2 Milk, Food-derived peptides, especially from milk, may adversely affect gastrointestinal health and has been shown to increase the risk of insulin-dependent diabetes. Beta-casomorphin-7 (BCM-7) may function as an immunosuppressant and impair gut immune tolerance. Cow’s milk intolerance may be more than lactose intolerance caused from lactose malabsorption. Increasing evidence shows that A1 beta-casein (protein produced by European-origin cattle) is associated with milk intolerance compared to A2 beta-casein (Asian or African cattle). A1 beta casein increases production of dipepitidl peptidase-4 and the inflammatory marker myeloperoxidase compared to A2 beta casein.Risk Management Issues in Food Delivery Programs, In a pandemic world and after, food delivery options need to adhere to essential food safety requirements. We’ve come a long way from pizza delivery. Today consumers can order everything from shelf-stable ingredients to perishable produce/meat/poultry to prepared meals and meal kits. No regulations for food delivery exist to insure safety of cold foods (delivered below 40*F), hot foods (delivered above 135*F) or food tampering assurance.
45 minutes 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
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.
45 minutes Ketogenic Diets: Good or Bad?
Katrina J. Breece, MS
Clinical Exercise Physiologist, Better Life Carolinas
Ketogenic diets have been a hot topic in recent years, but it first gained popularity in the early 20th century for treatment of seizures in children. In present day, it is popular among various groups with or without serious medical conditions and is primarily used to lose body fat. Many medical “experts” feel that this approach is not healthy and remains controversial. The data demonstrates that ketogenic diets can not only improve your health but may be the ideal approach for fat-loss. In fact, ketogenic diets could produce significant declines in obesity and improve the projections for the current obesity epidemic we are experiencing, which is only predicted to continue. This is especially true when ketogenic diets are combined with intermittent fasting (IF). Many studies have confirmed benefits to improved disease outcome by using healthy ketogenic diets. These findings are even more dramatic when combined with IF. A summary of research data, as well as case studies, that support the use of appropriate ketogenic diets is presented.
45 minutes Age Management Medicine Clinical Recommendations for Diet and Weight Loss
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
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.

Day 3


1 hour Evidence Based Health Measures to Deal with Covid-19 Virus
Joseph E. Bosiljevac, Jr., M.D., Ph.D., FACS
Senior Partner, Cenegenics
Viruses can never be eliminated and will mingle with humans as we live together in the same world. What lessons have we learned from CoVid-19?
I present health measures that have been useful in understanding and fighting this disease. This is from a medical standpoint as well as living in the epicenter in New York City. Personal hygiene such as masks and handwashing are important. Iodine spray can be used to kill virus before it penetrates the mucous membrane of the mouth and throat. Personal health is a big factor for resistance and recovery. Hormone optimization is a very important aspect to prevent and recover from this disease. Gut flora can be improved to boost the im-mune system using whole food sources as nutrition, probiotics, and/or the use of a breastmilk substitute. There is supplemental sup-port for resistance and recovery. These include melatonin monolaurin, vitamin D, curcumin, zinc and other trace mineral replacement. Stem cells have been used to treat patients with CoVid-19. Social measures such as the use of dogs to sniff out coronavirus contami-nated areas and ultraviolet light to eliminate the virus have been introduced. I expand what has been learned with this pandemic to in-clude upcoming viruses that may arise.
1 hour Building & Judging Disease Targeted Designer Nutrigenomics that Work
Daniel Purser, M.D.
Private Practice, Dan Purser MD, LLC
President, Physician Nutraceutical Design, LLC
Genetic errors many of us carry affect our lives in numerous ways — from causing low testosterone and other hormones to causing dementia. These transcription errors cause deficiencies or pathway problems. Ill patients often cannot eat enough to supply severe de-ficiencies (that have built up over time) of some of these errors. So they’ll need to supplement — with products that have been carefully designed to work around the errors or to offset them. Examples are given as to how you could judge or design some of these pathway supplements (my team and I have designed more than a hundred, some which are million plus bottle bestsellers, and some now wend-ing their way through FDA approvals — though none of these will be named, mentioned, or discussed.) This approach is critical to find-ing and using the correct supplement in your therapeutic approach.
45 minutes Using Stem Cell Therapy to Reboot Cell Function and the Immune System
Joseph E. Bosiljevac, Jr., M.D., Ph.D., FACS
Senior Partner, Cenegenics
In an age management practice, I soon found out that body parts wear out. I have 13 year experience with stem cell treatment starting with joint and musculoskeletal issues. My first patients were retired NFL and NBA players, and then treatment was expanded to military professional forces. As my experience grew I began to do systemic treatment. Many illnesses are the result of autoimmune imbalance. The anti-inflammatory aspects of stem cells and exosomes have been used to treat many autoimmune conditions. Treatment is accom-panied by wound healing principles to stimulate stem cell function and promote regeneration and healing.
1 hour How, Why, When to Enter the Sexual Health Arena
Carolyn DeLucia, MD., FACOG
Womens Intimate Health Clinic, NYC, NY
Board Certified in Obstetrics and Gynecology
Fellow, American College of Obstetrics and Gynecology
Member and Instructor, American Aesthetic Association
Member and Instructor, American Cosmetic Cellular Medicine Association
The field of sexual health has become one of the fastest growing areas in medicine. It encompasses the newest technologies, latest advancements in regenerative medicine and hormone therapy. Yet, there are only a few doctors comfortable to offer these life changing procedures. There is a need that must be met in this space but due to poor understanding of the technology or unease about the anatomy practitioners are not participating. Learn how to feel confident in adding sexual health into your practice.
45 minutes Using Genomics in Modern Medicine To Treat Complex and Refractory Cases
Eliot Dinetz, M.D., ABFM, ABAARM
Timeless Health, Miami, FL
In the 21st century Medical Doctors are now using genetic technology in the healthcare setting to drastically improve the quality of care. This has recently been shown to help prevent and even reverse conditions that were thought beyond the bounds of possibility just a few short years ago. Take a step into the future of medicine here now and learn how you may change the course of patient’s health & longevity. Dr. Dinetz will explore the evidence and case reports on how genetic variants (snps) are key to helping to address the risk of common and debilitating conditions from Migraines, Obesity, and even Cognitive Decline. The answer is in the code.
45 minutes The Steroidogenic Pathway
William Clearfield, D.O., FAAMA, DABMA, FAARFM
Medical Director, Clearfield Family Medicine, Reno, NV
Executive Director, American Osteopathic Society of Rheumatic Diseases
Strength, energy, glucose utilization and metabolism, weight control, inflammation, skin tone, sexual stamina, sexual desire, even cellulite accumulation (or lack thereof), are influenced by our hormones. Hormones do not exist or function in isolation. To understand hormones, their relationships to the workings of the body, and to each other, one must understand the “Steroidogenic Pathway.” The primary sex hor-mones, DHEA, progesterone, estrogen, testosterone, are synthesized in the liver from the demon seed, according to modern American medi-cine, itself, cholesterol. HDL or “good” cholesterol, manufactured in the liver, is the “grandmother” of the major sex hormones and the initiat-ing substrate for aldosterone to regulate vertigo, blood pressure and balance, cortisol, the stress hormone, and pregnenolone, the “memory” hormone. Cholesterol begets pregnenolone which, in turn, morphs into progesterone, aldosterone, cortisol, DHEA, testosterone, dihydrotes-tosterone, and the three estrogens. We will explore the steroidogenic pathway to obtain a deeper understanding of the hormones, their functions, and interactions.