BHRT Series – Part II

Mastering The Protocols for Optimization of Bio-identical Hormone Replacement Theory

BHRT Series – Part II

$675.00$1,195.00

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Course Description

Part Two follows the Part One series with advanced concepts and up-to-date research. This two and one-half day seminar will keep you current on the appropriate skills needed to manage everyday problems. It will serve as a short refresher, including important new therapies, clinical pearls, tricks of the trade, advanced techniques and difficult case management sessions. The field of age management medicine continues to grow at a rapid rate, making it difficult to stay abreast of all the changes. Included in Part Two is an hour-long lecture that reviews the scientific literature giving credence for this type of practice. Over 200 peer-reviewed articles, the foundation for Dr. Rouzier’s advanced course, will be provided as a reference for the participant. This is the same lecture Dr. Rouzier gives to medical academies to inform physicians of the health benefits of age management therapies.

Accreditation: AMA PRA Category 1  CME Statement 

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Course Objectives

Upon completion of this workshop, the healthcare professional will be able to

  • 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 and the potential benefits of hormones.
  • Discuss literature citing new indications, risks, benefits and complications of estrogen, progesterone and testosterone 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.
  • Identify various new therapies for erectile/sexual dysfunction in men and women.
  • Evaluate 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, niacin, 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 fractionation components.
  • 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) in addition to, implementing 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.
  • Provide insightful and clinically meaningful cases to better help clinicians improve their practice and patient outcomes.

Speakers

Neal Rouzier, MD

Faculty Chairman

Neal Rouzier, MD

Dr. Neal Rouzier is a pioneer in the bio identical hormone replacement field, practicing almost since its inception in the early 1990’s. He has dedicated his life’s work to uncovering the medical literature that supports safe and effective protocols for unique and personalized patient care. He is the Director of the Preventive Medicine Clinics of the Desert, specializing in the medical management of aging and preventive care for men and women. He has treated more than 2,000 patients with natural hormone replacement therapy and is recognized as a renowned leader and expert in the field. Additionally, Dr. Rouzier is the author of Natural Hormone Replacement for Men and Women: How to Achieve Healthy Aging. He has over 16 years of experience as an educator and practicing physician, and 29 years of Emergency Medicine experience at Queen of the Valley Hospital in West Covina, CA.

Agenda

7:30 AM  –  8:00 AM 

Registration

8:00 AM  –  9:00 AM 

Section 1

Making sense out of the many HRT studies, the critiques, and the rebuttals.

A commentary as to why estrogen is not harmful in most circumstances.

A critique of the WHI trial and a meta-analysis demonstrating opposite conclusions of the WHI.  Putting the pieces together will make you an expert on all ifs, ands, or buts.  It is the knowledge and command of this scientific literature (that your colleagues will never know) that makes you the expert.  Estrogen replacement is so very complex and a full understanding of all the studies and data is necessary to prescribe and defend HRT.  Having a command of the literature will enable you to explain when estrogen is indicated, which one, and why, the safety of estradiol and potential harm of CEE, the harm of not utilizing estrogen and estrogen depravation, and the harm of assuming and extrapolating the harm of CEE to E2.

9:00 AM  –  10:00 AM 

Section 2

Bio-identical HRT:  A review of all the evidence both for and against BHRT with the positives and negatives (E2 vs. E3).  And which natural estrogen is worthless and which one is very protective as per EBM.  Let the literature and science guide us as to which one to use, and how much, and which one should be avoided.  We will disprove the concept that estriol is the safe estrogen.  E3 does not protect against breast cancer or any other estrogen related deficiency. We’ll prove that E2 is the safe and most beneficial estrogen.  Do not make unsubstantiated claims about E3.

10:00 AM  –  10:15 AM

Break

10:15 AM  –  12:15 PM

Section 3

Review the hormone paradox and the myths and controversies of the oncogenic effects of hormones as to whether they are causative or protective against cancer.  A literature review of HGH & testosterone in men will show benefits of protecting against cancer as opposed to the incorrect common opinion of testosterone causing cancer.  As for women, estrogen and progesterone are also accused of causing cancer in spite of the literature support for the contrary.  Studies will be reviewed that evaluate whether they cause cancer or protect against cancer and how optimization protects against cancer. Well review all the literature that proves MPA ≠ OMP. Finally, testosterone is second to progesterone in protecting against breast cancer.  Can estrogen be safely used in cancer survivors?   Over 40 studies prove it can and should be used.  Not replacing hormones increases morbidity and mortality which proves the oncologic world doesn’t know their own literature. What level of progesterone is best for breast cancer protection and what level of testosterone is most appropriate?  All hormones have been demonstrated to protect against cancer and it is the loss of hormones that increases that risk.  Only one hormone increases cancer risk and that is a drug and not a hormone.  It is amazing what medical experts do not know or understand about hormones and will make incorrect assumptions to avoid HRT whereas doing so increases morbidity and mortality.  They cause harm by not utilizing HRT but they don’t understand that they don’t know.

1:15 PM  –  2:15 PM

Section 3 cont.

Review the hormone paradox and the myths and controversies of the oncogenic effects of hormones as to whether they are causative or protective against cancer.  A literature review of HGH & testosterone in men will show benefits of protecting against cancer as opposed to the incorrect common opinion of testosterone causing cancer.  As for women, estrogen and progesterone are also accused of causing cancer in spite of the literature support for the contrary.  Studies will be reviewed that evaluate whether they cause cancer or protect against cancer and how optimization protects against cancer. Well review all the literature that proves MPA ≠ OMP. Finally, testosterone is second to progesterone in protecting against breast cancer.  Can estrogen be safely used in cancer survivors?   Over 40 studies prove it can and should be used.  Not replacing hormones increases morbidity and mortality which proves the oncologic world doesn’t know their own literature. What level of progesterone is best for breast cancer protection and what level of testosterone is most appropriate?  All hormones have been demonstrated to protect against cancer and it is the loss of hormones that increases that risk.  Only one hormone increases cancer risk and that is a drug and not a hormone.  It is amazing what medical experts do not know or understand about hormones and will make incorrect assumptions to avoid HRT whereas doing so increases morbidity and mortality.  They cause harm by not utilizing HRT but they don’t understand that they don’t know.

2:15 PM  –  3:15 PM

Section 4

Interesting articles and facts on HRT:  A literature review of what the experts don’t tell you about risks and benefits of HRT.  Don’t ignore the world’s literature-the WHI does not negate all prior studies.  Become conversant in all the other studies in opposition to WHI.  Don’t assume or extrapolate the harm of CEE/MPA to E2/P4. It is amazing what medical experts do not know or understand about hormones and will make incorrect assumptions to avoid HRT whereas doing so increases morbidity and mortality.  They cause harm by not utilizing HRT but they don’t realize that they truly don’t know or understand hormones.

3:15 PM  –  3:30 PM

Break

3:30 PM  –  4:30 PM

Section 5

Progesterone optimization: Oral vs. transdermal vs. SL.  Multiple studies prove that transdermal cream is worthless and can be harmful in suboptimal levels yet it is still the most often (incorrectly) prescribed form of progesterone.  We’ll review the harm of relying just on saliva testing for monitoring which is fraught with error.  The BHRT industry makes claim that they use hormones that protect against cancer whereas they are actually increasing the risk and incidence of uterine cancer.

Scientific studies prove where your levels should be for maximum protection cancer and where they should not be due to risks.  Case studies with labs show which levels are protective and which are not and we’ll see what happens with sub-optimal levels.  Further literature review demonstrates all the benefits of progesterone but only if physiologic levels are maintained.

4:30 PM  –  5:30 PM

Section 6

Testosterone’s risks and benefits from JCEM and NEJM meta-analysis, new guidelines, and alternative methods of prescribing testosterone for men and women. Learn all the alternative methods of raising testosterone levels besides transdermal creams. When to avoid transdermal, when to avoid IM, when to use HCG vs. clomiphene, and when to use oral testosterone? Which are the cheapest, which are the best, and which ones should be avoided. Basically everything you could possibly ever need to know about optimizing testosterone. A literature review (EBM) will support the many alternative methods to raising testosterone.

7:30 AM  –  8:00 AM

Registration

8:00 AM  –  9:00 AM

Section 6 cont.

Testosterone’s risks and benefits from JCEM and NEJM meta-analysis, new guidelines, and alternative methods of prescribing testosterone for men and women. Learn all the alternative methods of raising testosterone levels besides transdermal creams. When to avoid transdermal, when to avoid IM, when to use HCG vs. clomiphene, and when to use oral testosterone? Which are the cheapest, which are the best, and which ones should be avoided. Basically everything you could possibly ever need to know about optimizing testosterone. A literature review (EBM) will support the many alternative methods to raising testosterone.

9:00 AM  –  10:00 AM

Section 7

A literature review of the battle and controversy over oral vs. transdermal estrogen, which type, how, when, why, and how the ESTHER study guides us. Knowledge is power when it comes to estrogen administration, the risks and benefits of both. Review of HRT and clotting and how to evaluate the risk and decrease the risk. And just what is that relative risk anyway that everyone always alludes to? Please don’t tell me the risk of clotting-rather give me the numbers. The importance of SHBG in prescribing E2 as it pertains to CA and CAD. Thrombophilia work-up, test panels with case examples of + labs and how patients should be treated. Develop a treatment plan that encompasses the foregoing but that requires in-depth knowledge of the vast literature and relative risks. Finally, OK, what to do when someone develops a clot while on HRT and has a negative work-up, or that has had a prior clot, even if provoked. Review the harm of transdermal estradiol and the null set.

10:00 AM – 10:15 AM

Break

10:15 AM – 11:15 AM

Section 8

Thyroid update and cardiovascular review articles of the importance of T3 optimization for cardiac disease prevention and lipid improvements. Thyroid replacement does not cause osteoporosis- an extensive literature review. So you think you know thyroid? More cases, labs, and articles. More literature support for optimizing T3 in spite of AACE recommendations to the contrary. U.S. Pharmacopia report on desiccated thyroid. Stock up now because desiccated thyroid is going away thanks to big Pharma.

11:15 AM – 12:15 PM

Section 9

Preventive cardiology or how to avoid CABG, stents, and MI when statins don’t work: A literature review of hormones, toxic blood markers, prediction of CVD, and treatment without using drugs. Preferential use of hormones, niacin, RYR, EFA, supplements, life style changes, and diet to prevent CVD and how to monitor effects via the NMR panel. The expert recommendations are to no longer monitory cholesterol levels as LDL may not predict CAD. Then what should we monitor and what is predictive? LDL particle number and small LDL particle numbers. We’ll look at the cases and outcomes

12:15 PM – 1:15 PM

Lunch

1:15 PM – 2:15 PM

Section 10

Cardiology cases: How to stop progression of the disease. Management when statins don’t lower LDL-P and small LDL-P. That which the cardiologists should use but don’t. Putting all the pieces together using the best preventive strategies to avoid succumbing to that which kills 90% of us. Use of NMR panel, LDL-P’s, apo-B, non-HDL cholesterol, cardiac markers, eicosinoids, insulin, and inflammatory cytokines. Does lowering cholesterol by means other than statins provide the same benefits?

2:15 PM – 5:30 PM

Section 11-13
11

Complex cases, labs, adjustments, fun and interesting cases, and lots of WWND (What Would Neal Do) cases. Lab updates that utilize the new reagents with comparisons with the old labs and reagents. Conversion to the new reference ranges.

12

Literature review of HRT, new and most recent that was not covered in Part I. Everyday there is something new and this is the venue that keeps us up to date.

13

Case Study Questions and Answers

3:15 PM – 3:30 PM

Break

5:30 PM – 6:00 PM

Question and Answer

7:30 AM – 8:00 AM

Registration

8:00 AM – 9:00 AM

Section 14

Polycystic Ovary Syndrome: Diagnosis and treatment of the most common pre-menopausal endocrinopathy that everyone fails to diagnosis. Never miss it again because if you don’t specifically look for it, then you won’t find it. PCOS increases risk of CAD, DM, breast cancer, & uterine cancer which further emphasizes the need for early detection and treatment. Assume that everyone has PCOS until you prove that they don’t. Unfortunately the most common treatments for PCOS don’t work. There is only one treatment that will work and that is the one that no one knows or appreciates. We’ll review the before and after labs demonstrating improvement. Quality of life and fertility relies on this one treatment.

9:00 AM – 10:00 AM

Section 15

Osteoporosis: Diagnosis and treatment using DEXA scan and NTX urine metabolites to monitor bone loss. Treatment of osteoporosis beyond bisphosphonates: HRT, Vitamin D, Vitamin K, strontium, ipraflavone. Measuring and monitoring improvements in NTX- a lab review.

Estrogen metabolites- do they or do they not predict breast cancer and should we waste money on testing. Lab review of 2 OH-E1 vs. 16α OH-E1. DIM? Do you really need it and does it really work? I didn’t know that estradiol caused cancer? A look at EBM and studies from JNCI that refute confabulation.

10:00 AM – 10:15 AM

Break

10:15 AM – 11:15 AM

Section 16

Estrogen and Progesterone in men: What the literature supports in so far as harmful effects of low vs. high levels. Use of aromatase inhibitors in men or how to increase the risk of CAD, CVD, dementia, osteoporosis, and ED by blocking estrogen. The harm of prescribing progesterone in men unless you want to increase the risk of MI or ED and inflammation. Use EBM to guide your therapy, not what someone theorizes.

11:15 AM – 12:15 PM

Section 17