Part 1 Objectives

Upon completion of this seminar, the primary care provider will be able to:

• Demonstrate a proficiency in the medical literature that supports biologically identical hormone replacement in contrast to chemically altered hormones and realize that "all hormones are not the same" as demonstrated in the literature.
• Describe the diagnosis and treatment of adult onset growth hormone deficiency.
• Identify the techniques used to administer acceptable levels of Human Growth Hormone (HGH).
• Examine and discuss possible side effects of HGH and how to properly adjust dosing.
• Distinguish the different types of secretagogues and evaluate their effectiveness as an alternative to HGH therapy.
• Implement therapeutic management of andropause based on studies reported in prestigious medical journals.
• Identify the types, doses and methods to administer testosterone to men and women.
• Determine the uses of testosterone for men and women, including complications, precautions, side effects and monitoring.
• Discuss the uses of Finasteride, Dutasteride, Arimidex in the management of testosterone.
• Identify the uses of melatonin including correct dosing and monitoring.
• Determine how DHEA and pregnenolone benefit the physical and mental well-being of patients and overall quality of life.
• Demonstrate new evidence that contradicts the WHI Study on estrogen treatment in women.
• Demonstrate an understanding of the health benefits of estrogen and progesterone in contrast to the health detriments of synthetic estrogen and progestin.
• Describe the types, doses and methods used to administer estrogen and progesterone.
• Review and discuss recent literature, questions and answers that demonstrate the beneficial effects of hormones in improved function and healing and a better quality of life.
• Explain current concepts of thyroid replacement and compare and contrast different types of thyroid as supported in the medical literature.
• Recognize various methods of testing for thyroid deficiencies and what labs and approaches are best.
• Explain current concepts of thyroid replacement and compare and contrast their efficacy as supported in the medical literature.
• Recognize various methods of testing for thyroid deficiencies and what labs and approaches are best.
• Discuss and analyze interesting cases in Bio Identical Hormone Replacement Therapy.
• Recognize the difference between "normal levels" and "optimal levels" of hormones and the benefits or detriments as demonstrated by current medical studies.
• Apply current prescribing strategies for hormones to maintain adequate levels.
• Implement best clinical practices in diagnosing, prescribing, monitoring and adjusting of BHRT for improved function and quality of life.
• Develop and apply business management principles to set up a preventive medicine practice.
• Analyze and review treatment protocols in case management and trouble shooting techniques used in BHRT.
• Utilize the knowledge gained to improve patient outcomes in BHRT.
• Describe how to write prescriptions for compounded hormones to pharmacies, and how different formulations can affect absorption, efficacy and side effects.
• Adjust any inaccurate or inappropriately prescribed hormone therapy to conform to scientific standards as seen in medical literature.
• Implement current strategies into your practice to improve the level of care and patient compliance in the treatment of adult hormone deficiencies.
• Assure that prescribed hormones meet industry standards based on attaining adequate serum levels and symptom improvement.

Part 2 Objectives

Upon completion of this seminar, the primary care provider will be able to:

• Review and outline key elements in age management presented in Part I: Mastering the Protocols for Bio Identical Hormone Replacement Therapy.
• Identify important issues in the relationship between hormones and cancer: cause, provocation or protection.
• Outline problem solving techniques for difficult cases presenting with multiple disease processes.
• Discuss literature citing new indications, risks, benefits and complications of estrogen and progesterone therapy.
• Determine advanced treatment modalities and dosing strategies for estrogen and progesterone, including new and specific approaches to these therapies.
• Describe important aspects of the WHI findings: identify the experts that refute this study, and other factors not included in the trials that would change the conclusions.
• Determine advanced treatment modalities, including new and specific approaches to HGH, thyroid and testosterone in age management and disease prevention.
• Discuss over 40 articles that demonstrate thyroid replacement does not cause osteoporosis, even in TSH suppressive doses.
• Distinguish various new therapies for erectile/sexual dysfunction in men and women.
• Demonstrate the epidemiology of cardiovascular disease and diabetes and the various treatment strategies as they pertain to medication, diet, exercise, lifestyle change and nutritional supplements.
• Explore the role of omega 3 fatty acids, antioxidants and glucose and their influence on insulin, inflammation, disease progression and atherosclerosis.
• Describe the strategies for using the new cardiovascular risk markers, inflammation markers, new lipid parameters and how to make sense of all the new lipid fraternization components.
• Explore the role of niacin in diabetes and atherosclerosis.
• Identify rational approaches to vitamins and supplements with a review of the medical literature supporting their use in wellness as well as citing any harmful effects and interactions.
• Determine current screening methods and management strategies of the most common pre-menopausal hormone disorder, Polycystic Ovary Syndrome (PCOS).
• Implement diagnostic and treatment strategies for PCOS.
• Apply diagnostic and treatment strategies for hirsutism and hair loss
• Implement strategies for treating osteoporosis using hormone replacement therapy.
• Discuss interesting cases in Bio Identical Hormone Replacement Therapy.
• Identify current indications, risks and benefits of using cortisol for the treatment of chronic fatigue.
• Determine rational approaches for the evaluation of fatigue with emphasis on cellular hypofunction as it pertains to thyroid hormone.
• Describe, based on the literature, when to use oral vs. saliva testing.
• Utilize the knowledge gained to improve patient outcomes in BHRT.

Part 3 Objectives

Upon completion of this seminar, the primary care provider will be able to:

• Review and outline key elements in age management presented in Part II: Mastering the Protocols for Bio Identical Hormone Replacement Therapy.
• Discuss the most current literature for Bio Identical Hormone Replacement Therapy (BHRT), Human Growth Hormone (HGH), thyroid, testosterone, Dehydroepiandrosterone (DHEA), pregnenolone, melatonin, estrogen and progesterone.
• Determine the risks and benefits of transdermal estrogen.
• Discuss new research demonstrating estrogen's protective effects in men.
• Examine current recommendations for hormone replacement therapy by the North American Menopause Society (NAMS) and American College of Obstetricians and Gynecologists (ACOG).
• Describe rational approaches to the use of hormones in cancer patients, including recent studies that demonstrate progesterone's protection against breast cancer as well as the adverse effects of progestins.
• Discuss new therapies for prostate cancer.
• Identify the medications that cause erectile dysfunction and advanced treatment strategies for ED.
• Outline optimal treatment modalities in hormone therapy for chronic fatigue syndrome.
• Discuss treatment strategies for preventing hair loss in women.
• Determine current management strategies for preventing loss of pregnancy in Polysystic Ovary Syndrome (PCOS).
• Describe the clinical evaluation including laboratory analysis and treatment of Vitamin D deficiency.
• Examine literature reviews as to what level of Vitamin D protects against cancer, CAD, osteoporosis, dementia, type II DM and AMD.
• Demonstrate the importance of sex hormone binding globulin (SHBG).
• Review the pathophysiology of vaginal atrophy and the use of rings, tabs, troches and creams.
• Discuss the importance of sex hormone binding globulin (SHBG) in men and women and why it is most predictive of CAD, MS and cancer.
• Describe the data demonstrating that androgen suppression therapy, as well as estrogen deprivation, is associated with poor survival in men in comparison with placebo.
• Outline advanced treatment protocols for over 100 clinical cases based on clinical presentation, history and complications.
• Discuss the inverse relationship of estrogen and prostate cancer.
• Develop an understanding of treatment rationale through case studies.
• Describe the lack of efficacy of estriol in spite of purported benefits.
• Discuss the recent recommendations from Family Practice Recertification on the use of IGF-1 instead of the ITT to diagnosis GH deficiency.
• Discuss recent studies demonstrating IGFBP-3 induces apoptosis in prostate cancer and breast cancer.
• Analyze the antiproliferative, oncostatic, immuno-stimulatory and thrombopoetic effects of melatonin.
• Describe the difference in clotting between conjugated estrogens, medroxyprogesterone (MPA) and micronized progesterone.
• Examine data proving that oral progesterone decreases clotting risk and inflammation as opposed to Provera® that increases these risks.
• Interpret the data demonstrating that only certain types of estrogen reduce fatty acid synthesis thereby resulting in protection against atherosclerosis.
• Recognize the importance of maintaining low levels of aldosterone.
• Demonstrate an understanding of the importance of body weight in determining which type of HRT to prescribe.
• Describe the data demonstrating that testosterone both decreases and increases CAD in women and learn to decipher the correct approach.
• Identify the two mechanisms by which estrogen treats and protects against prostate cancer.
• Utilize current protocols in Hormone Replacement Therapy to improve patient outcomes.