integrated approach & nutritional supplement in meno ...€¦ · nutritional supplement...
TRANSCRIPT
Integrated Approach amp Nutritional Supplement
in Meno amp Andropause
Hari Kesehatan Angkatan Laut
City Walk Jakarta 3 Oktober 2015
CV bull Education and Credentials
Board certified in Anti Aging Medicine Chicago ILUSA 2011 Medical Specialist in Clinical Nutrition UI Jakarta 2006 Master of Science in Clinical Nutrition UI Jakarta 2005 Clinical Metal Toxicologist The International Board of Clinical Metal
Toxicology CA USA 042002 Certified in Chelation and iv Nutrition ACNEM112014
Diploma in Cosmetic Science Society of Cosmetic Scientists Surrey UK 1999 Diploma International CIDESCO (Comite International Drsquoethetique Et De
Cosmetologie) Zurich 1998 Doktor der Medizin (Doctoral Program dissertation ) Freie Universitaet Berlin
Germany 1989 MD Freie Universitaet Berlin Germany 1987
Professional Experience
bull Medical Director Gracia Patricia Specialist Clinic Jakarta since 2009
bull Medical Specialist in Clinical Nutrition Naval General Hospital RSAL Dr Mintohardjo Jakarta since May
2007 Affiliations
bull Treasurer of Indonesian Physician Nutrition Specialist Association (PDGKI)
bull Head of Scientific Division Indonesian Society of Anti Aging Wellness and Regenerative Medicine
(PERDAWERI)
bull Vice chairman Department of Inter institutional Relationship Indonesian Medical Association IDI DKI
Jakarta
bull Treasurer of Indonesian Association of Healthy Aging (IAHA)
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals ampHerbs Iv nutrition therapy
Healthy (A) and sickly (B) trees It is important to see the benefits and limitation of our current allopathic system and realize that science alone will not meet all the complex needs of our patients
Indonesia Age Structure
bull Age structure 0-14 years 262 (male 33854520female 32648568) 15-24 years 171 (male 22067716female 21291548) 25-54 years 423 (male 54500650female 52723359) 55-64 years 79 (male 9257637female 10780724) 65 years and over 65 (male 7176865female 9308056) (2014 est)
bull Definition This entry provides the distribution of the population according to age Information is included by sex and age group (0-14 years 15-64 years 65 years and over) The age structure of a population affects a nations key socioeconomic issues Countries with young populations (high percentage under age 15) need to invest more in schools while countries with older populations (high percentage ages 65 and over) need to invest more in the health sector The age structure can also be used to help predict potential political issues For example the rapid growth of a young adult population unable to find employment can lead to unrest
Population Pyramid
In Indonesia approximately 288 million people or 1134 percent of the population in 2020 will be aged over 60 up from 24 million (97) in 2010 and 113 million (74) in 2000
Aging Population lsquowill place burden on RIrsquo Elly Burhaini Faizal The Jakarta Post Jakarta Saturday April 7 2012
World Health Day
Integrated bull The job of the physician is to cure sometimes
heal often support always- Hippocrates
bull ldquoa state of complete physical mental and social well-being and not merely the absence of disease or infirmityrdquo
ndash Health Definition WHO
Integrative Therapy Stress reduction Hormonal imbalances Nutrition Nutraceutical Other Therapies
Light Therapy
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
CV bull Education and Credentials
Board certified in Anti Aging Medicine Chicago ILUSA 2011 Medical Specialist in Clinical Nutrition UI Jakarta 2006 Master of Science in Clinical Nutrition UI Jakarta 2005 Clinical Metal Toxicologist The International Board of Clinical Metal
Toxicology CA USA 042002 Certified in Chelation and iv Nutrition ACNEM112014
Diploma in Cosmetic Science Society of Cosmetic Scientists Surrey UK 1999 Diploma International CIDESCO (Comite International Drsquoethetique Et De
Cosmetologie) Zurich 1998 Doktor der Medizin (Doctoral Program dissertation ) Freie Universitaet Berlin
Germany 1989 MD Freie Universitaet Berlin Germany 1987
Professional Experience
bull Medical Director Gracia Patricia Specialist Clinic Jakarta since 2009
bull Medical Specialist in Clinical Nutrition Naval General Hospital RSAL Dr Mintohardjo Jakarta since May
2007 Affiliations
bull Treasurer of Indonesian Physician Nutrition Specialist Association (PDGKI)
bull Head of Scientific Division Indonesian Society of Anti Aging Wellness and Regenerative Medicine
(PERDAWERI)
bull Vice chairman Department of Inter institutional Relationship Indonesian Medical Association IDI DKI
Jakarta
bull Treasurer of Indonesian Association of Healthy Aging (IAHA)
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals ampHerbs Iv nutrition therapy
Healthy (A) and sickly (B) trees It is important to see the benefits and limitation of our current allopathic system and realize that science alone will not meet all the complex needs of our patients
Indonesia Age Structure
bull Age structure 0-14 years 262 (male 33854520female 32648568) 15-24 years 171 (male 22067716female 21291548) 25-54 years 423 (male 54500650female 52723359) 55-64 years 79 (male 9257637female 10780724) 65 years and over 65 (male 7176865female 9308056) (2014 est)
bull Definition This entry provides the distribution of the population according to age Information is included by sex and age group (0-14 years 15-64 years 65 years and over) The age structure of a population affects a nations key socioeconomic issues Countries with young populations (high percentage under age 15) need to invest more in schools while countries with older populations (high percentage ages 65 and over) need to invest more in the health sector The age structure can also be used to help predict potential political issues For example the rapid growth of a young adult population unable to find employment can lead to unrest
Population Pyramid
In Indonesia approximately 288 million people or 1134 percent of the population in 2020 will be aged over 60 up from 24 million (97) in 2010 and 113 million (74) in 2000
Aging Population lsquowill place burden on RIrsquo Elly Burhaini Faizal The Jakarta Post Jakarta Saturday April 7 2012
World Health Day
Integrated bull The job of the physician is to cure sometimes
heal often support always- Hippocrates
bull ldquoa state of complete physical mental and social well-being and not merely the absence of disease or infirmityrdquo
ndash Health Definition WHO
Integrative Therapy Stress reduction Hormonal imbalances Nutrition Nutraceutical Other Therapies
Light Therapy
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals ampHerbs Iv nutrition therapy
Healthy (A) and sickly (B) trees It is important to see the benefits and limitation of our current allopathic system and realize that science alone will not meet all the complex needs of our patients
Indonesia Age Structure
bull Age structure 0-14 years 262 (male 33854520female 32648568) 15-24 years 171 (male 22067716female 21291548) 25-54 years 423 (male 54500650female 52723359) 55-64 years 79 (male 9257637female 10780724) 65 years and over 65 (male 7176865female 9308056) (2014 est)
bull Definition This entry provides the distribution of the population according to age Information is included by sex and age group (0-14 years 15-64 years 65 years and over) The age structure of a population affects a nations key socioeconomic issues Countries with young populations (high percentage under age 15) need to invest more in schools while countries with older populations (high percentage ages 65 and over) need to invest more in the health sector The age structure can also be used to help predict potential political issues For example the rapid growth of a young adult population unable to find employment can lead to unrest
Population Pyramid
In Indonesia approximately 288 million people or 1134 percent of the population in 2020 will be aged over 60 up from 24 million (97) in 2010 and 113 million (74) in 2000
Aging Population lsquowill place burden on RIrsquo Elly Burhaini Faizal The Jakarta Post Jakarta Saturday April 7 2012
World Health Day
Integrated bull The job of the physician is to cure sometimes
heal often support always- Hippocrates
bull ldquoa state of complete physical mental and social well-being and not merely the absence of disease or infirmityrdquo
ndash Health Definition WHO
Integrative Therapy Stress reduction Hormonal imbalances Nutrition Nutraceutical Other Therapies
Light Therapy
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Indonesia Age Structure
bull Age structure 0-14 years 262 (male 33854520female 32648568) 15-24 years 171 (male 22067716female 21291548) 25-54 years 423 (male 54500650female 52723359) 55-64 years 79 (male 9257637female 10780724) 65 years and over 65 (male 7176865female 9308056) (2014 est)
bull Definition This entry provides the distribution of the population according to age Information is included by sex and age group (0-14 years 15-64 years 65 years and over) The age structure of a population affects a nations key socioeconomic issues Countries with young populations (high percentage under age 15) need to invest more in schools while countries with older populations (high percentage ages 65 and over) need to invest more in the health sector The age structure can also be used to help predict potential political issues For example the rapid growth of a young adult population unable to find employment can lead to unrest
Population Pyramid
In Indonesia approximately 288 million people or 1134 percent of the population in 2020 will be aged over 60 up from 24 million (97) in 2010 and 113 million (74) in 2000
Aging Population lsquowill place burden on RIrsquo Elly Burhaini Faizal The Jakarta Post Jakarta Saturday April 7 2012
World Health Day
Integrated bull The job of the physician is to cure sometimes
heal often support always- Hippocrates
bull ldquoa state of complete physical mental and social well-being and not merely the absence of disease or infirmityrdquo
ndash Health Definition WHO
Integrative Therapy Stress reduction Hormonal imbalances Nutrition Nutraceutical Other Therapies
Light Therapy
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Population Pyramid
In Indonesia approximately 288 million people or 1134 percent of the population in 2020 will be aged over 60 up from 24 million (97) in 2010 and 113 million (74) in 2000
Aging Population lsquowill place burden on RIrsquo Elly Burhaini Faizal The Jakarta Post Jakarta Saturday April 7 2012
World Health Day
Integrated bull The job of the physician is to cure sometimes
heal often support always- Hippocrates
bull ldquoa state of complete physical mental and social well-being and not merely the absence of disease or infirmityrdquo
ndash Health Definition WHO
Integrative Therapy Stress reduction Hormonal imbalances Nutrition Nutraceutical Other Therapies
Light Therapy
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
In Indonesia approximately 288 million people or 1134 percent of the population in 2020 will be aged over 60 up from 24 million (97) in 2010 and 113 million (74) in 2000
Aging Population lsquowill place burden on RIrsquo Elly Burhaini Faizal The Jakarta Post Jakarta Saturday April 7 2012
World Health Day
Integrated bull The job of the physician is to cure sometimes
heal often support always- Hippocrates
bull ldquoa state of complete physical mental and social well-being and not merely the absence of disease or infirmityrdquo
ndash Health Definition WHO
Integrative Therapy Stress reduction Hormonal imbalances Nutrition Nutraceutical Other Therapies
Light Therapy
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Integrated bull The job of the physician is to cure sometimes
heal often support always- Hippocrates
bull ldquoa state of complete physical mental and social well-being and not merely the absence of disease or infirmityrdquo
ndash Health Definition WHO
Integrative Therapy Stress reduction Hormonal imbalances Nutrition Nutraceutical Other Therapies
Light Therapy
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Perimenopause A transitional stage 10 or more yrs before actual menopause begins bull mid to late 30s and early 40s can begin to
experience PMS-like symptoms irritability depression bloating weight gain
and food cravings bull Often these symptoms are not recognized as
being hormonally-based expensive diagnostic tests misdiagnosed problems are all in their minds and prescribed medications like Oxycontinreg or XanaxregProzacreg bull Diagnostik
A saliva test (FSH) blood test
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Menopause Chinese medicine has a philosophical way of looking at menopause
bull A woman is giving birth to herself now that the obligation to her children is gone
bull They look at cycles of seven
bull And at 49 years of age
when menopause often begins
bull They say
One-half of her lifespan is complete
The next half of the lifespan is for self-growth
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Management of
Middle-aged
Man With Low
Testosterone in
Obesity Clinic
Andropause
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Dietary Supplement
US Dietary Supplement Health and Education Act (DSHEA) 1994
bull product (other than tobacco) that is intended to supplement the diet that bears or contains one or more of the following dietary ingredients
a vitamin a mineral an herb or other botanical an amino acid a dietary substance for use by man to supplement the diet by increasing the total daily intake
a concentrate metabolite constituent extract
combinations of these ingredients
bull Intended for ingestion in pill capsule tablet or liquidform
bull Not represented for use as a conventional food or as the sole item of a meal or diet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Nutraceutical
Defined as a food (or a part of food) that provides medical or health benefits including prevention or treatment of a disease
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Concern
bull Product standardization
bull Definition of optimal dosing regimen
bull Potential side effects
bull Drug interactions
bull Need for evidence-based indications
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis
bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
The Emerging Maturity Crisis
bull Midlife crisis is a term first coined by Elliott Jaques referring to
A critical phase in human development during the 40s to early 60s
Based on the character of change points or periods of transition
The period is said to
vary among individuals
vary between men and women bull Elliott Jaques Death and the Midlife Crisis International Journal of
Psychoanalysis 1965
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Making an unusual choice
Go through a teenage-like rebellionldquo ldquo blow up your liferdquo
These may include
bull Drinking more
bull Having an affair
bull Leaving the family
bull Feeling that his life no longer fits
bull Concerned about appearance
bull More desire for excitement and thrills
Men suddenly started buying new convertibles dating 20-something models and piercing their ears
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Aesthetic Concern
bull Alopecia bull Wrinkle bull Hyperpigmentation bull Skin tag bull Sagging bull Skin dryness bull Gynaekomastia bull Fat Bulging around
the middle section bull Muscle atrophy
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
to Health concern
bull Top Health Concern is preventable Heart disease Cancer Erectile dysfunction
Poor bedroom performance Loss of bone and muscle strength Depression Moodiness Weight gain Loss of mental clarity Lack of sex drive
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Solution
bull Every year stress bull Environmental toxins
bull lose the ability to bull maintain good hormone balance
Consultation
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Theories of Aging
Giacomoni PU Rein G Factors of skin ageing share common
mechanisms Biogerontology 20012219ndash29 doi 101023A1013222629919
Until today more than 300 theories of aging have been
proposed
bull Theory of cellular senescence
bull Decreased proliferative capacity and telomere shortening
bull Mitochondrial DNA single mutations
bull Free radical theory
bull Neuroendocrine theory of aging
none of which can fully explain all changes observed in aging
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
bull 5000 Times More Effective than Vitamin C bull Research demonstrates that PQQ is 30 to 5000 times more efficient at reducing oxidation
than other common antioxidants such as vitamin C60 bull In a revealing 2010 study scientists reported that similar protection of mitochondrial
function that is seen with some other compounds (such as quercetin hydroxytyrosol and resveratrol) at high dietary concentrations measured in millimoles occurs with PQQ at dietary concentrations measured in nanomoles66 In other words it takes a million times more of these other compounds to have a mitochondria-protective effect equivalent to PQQ
bull The revelation of its ability to favorably affect system-wide cell development metabolism and mitochondrial biogenesis helps explain the wealth of data on PQQrsquos neuroprotective and cardioprotective benefits
bull PQQ has now been shown to block the development of abnormal proteins linked with neurodegenerative diseases For example it prevents cellular damage and demise due to accumulation of amyloid beta protein associated with Alzheimerrsquos disease6768 and of the alpha-synuclein protein that is associated withParkinsonrsquos disease5769
bull In humans supplementation with 20 milligrams a day of PQQ significantly improved cognitive function in middle-aged and elderly people These results were amplified when the subjects also took 300 milligrams per day of CoQ1070
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
We age because our cell age
Telomere shortening
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Inflammation bull An adaptive response triggered by noxious stimuli and
conditions such as chemical or physical injury
bull Activates cellular and systemic components of the immune
system
bull The initial response involves
Immune cells
macrophages mast cells and dendritic and natural killer cells at the
site of injury
Subsequent release of chemical mediators
cytokines and ROS to control pathogens andor tissue repair
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda bull What is
Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Low Grade Inflammation as a Pathogenetic event of the MetS
Weight increase
bull Initiating factor of low-grade inflammation
bull Adipocyte hypertrophy is produced as a response to excess energy intake
bull TNF-α production in the adipose tissue
bull Stimulates the production of chemotactic factors
Adipose tissue infiltrated by pro inflammatory macrophages
production of IL-6 and IL-1
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Different Standard
bull Overweight obese bull WHO standard BMI 25-
2999gt30
bull WHO Asia-Pacific guideline for Asian adults BMI 230-274275
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Health Consequences All begin to decrease
bull Dopamine
bull Oxytocin
bull Vasopressin
bull HGH
bull Melatonin
bull Pregenolone
bull Testosterone
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Testosterone and Aging
bull From about age 40 testosterone levels decrease about 03 - 1 Massachusetts Male Aging Studylt cross sectionallt random sample of 1709 men (40-70 yrs)
bull Young men
under stress from school jobs and family suppressed testosterone
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Profile hypogonadism
HEAD bull Hair loss bull Pale fatigue look bull Wrinkles around eyes ( eye bags) mouth amp
cheeks
BODY
bull Gynaecomastia bull Flabby belly ( darrmuscle volume
and strength) visceral fat uarr bull Lean body massdarr especially
legs MOOD amp Physical strength
bull Anxious hyperemotional irritability
bull Diminished cognitive function bull Reduce libido and sexual
function bull Reduction in energy and body
strength
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
T DEFICIENCY QUESTIONNAIRE Signs and Symptoms of
Deficiency No
Never
Not Much
Sometime
s
In Moderaration
Regularly
A Lot
Often
Tremendousl
y
Constantly
1 My face has gotten slack
and more wrinkled 0 1 2 3 4
2 Irsquove lost muscle tone 0 1 2 3 4
3 My belly tends to get fat 0 1 2 3 4
4 Irsquom constantly tired 0 1 2 3 4
5 I feel like making love less
often than I used to 0 1 2 3 4
6 My breasts are getting
fatty
0 1 2 3 4
7 I feel less self confident
and more hesitant 0 1 2 3 4
8 My sexual performance is
poorer than it used to be 0 1 2 3 4
9 I have hot flashes and
sweats
0 1 2 3 4
10 I tire easily with
physical activity
0 1 2 3 4
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Bio-Identical Hormone Replacement Therapy
(BHRT) bull These are hormones which
are IDENTICAL to your own hormones
bull There are NO side effects bull Feel the benefits of having
hormone levels when you were 20-30 yrs old
bull Men amp Women using BHRT have consistently improved Quality of Life
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Natural Progesterone Men amp Women
bull May protect against breast ovarian amp prostate ca
bull Helps balance estrogens bull Lowers cholesterol amp blood
pressure bull Increases metabolic rate amp
reduce body fat bull Improves sleep
antidepressant amp calming effect anti-anxiety
bull Increase scalp hair increase hydration
bull 2nd most abundant hormone in our body
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Oral vs Transdermal Estrogens
bull Oral Estrogens (especially Premarin) increase inflammation as measured by CRP
bull Transdermal Estrogens do not
Decensi A et al Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women Circulation 2002 Sep 3106(10)1224-8
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Testosterone Replacement Therapy in Women
bull Women produce 10 T as compared to men bull T needed for sense of well being bull Strength especially upper body bull Increased Libido amp sensitivity bull T usually decreased in perimenopausal and
menopausal women bull Body composition ndash reduce fat increase lean mass bull Bone density
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Estrogen dominance bull The hormonal imbalance between two particular
hormones progesterone and estrogen starts to seesaw during this time of life
bull Exhaustion of the adrenal glands as well as a lack of regular ovulation women in their mid 30s and early 40s stop ovulating
regularly They dont recognize that theyre not ovulating because
some of them are still having periods
bull Symptoms of estrogen dominance or lack of progesterone irritability allergies fatigue depression breast
tenderness terrible PMS low sex drive even thyroid dysfunction
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
TRT in Men
bull Deficient in male hormone
Quarterly injections
Loading phase after 6 weeks
Deep intramuscular slowly
Undecanoate Convenience not bi-weekly
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
T Conversion
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
5-alpha reductase inhibitor
bull Addition to TRT Phosphodiesterase 5 inhibitor
bull 5-alpha-reductase
converts testosterone to DHT
bull Inhibition of DHT conversion may be required to restore hormone ratios to physiological levels
Finadutasteride saw palmetto pygeum africanum
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Other Supplementation
bull DHEA DHEA supports natural testosterone production
because it is a precursor to testosterone which the body can convert into testosterone through several steps
produces DHEA naturally but it declines with age
The normal dosage for DHEA is 25 to 50 mg per day
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Learning from the Oldest
bull Okinawan population is characterized by reduced morbidity ampmortality
bull The greatest percentage of centenarians in the world lives in this island
bull It has been hypothesized that the long disability-free life expectancy of this population might be due to the diet based on vegetables grains soy fruits fish and seaweed and characterized by a low caloric intake (~20 less than the rest of Japan and ~40 less than United States)
bull It is noteworthy that this diet is very similar to the caloric restriction interventions designed for experiments in animal models
Restricting the calories of a laboratory mouse by 30 can increase its lifespan by 50
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Dietary Factors that promote or retard inflammation
bull Avoid Trans Fats
Partially hydrogenated and hydrogenated vegetable oils sources of trans fatty acids
Increase LDL lower HDL Increase the inflammatory response in the body
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
bull Abenavoli L Milic N Peta V Alfieri F De Lorenzo A Bellentani S Alimentary regimen in non-alcoholic fatty liver disease Mediterranean diet World J Gastroenterol 201420(45)16831ndash16840 doi 103748wjgv20i451683
Mediterranean Diet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
An American Style Mediterranean Diet
bull Dr Ozers lectures promoting ldquoaggressive prevention with conservative interventionrdquo draw plenty of positive feedback from his colleagues bullHis annual Cardiovascular Disease Prevention Symposium in Miami has attracted standing room-only audiences of professionals eager to learn about recent advances in prevention
ldquoEat a delicious meal of fish whole grains and fresh vegetables Drink a glass of red winerdquo
Benefits of the traditional Mediterranean diet
It can be adapted to the modern American lifestyle
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
An Asian style Mediterranean diet
Mediterrasean diet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals Herbs Iv nutrition
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Nutriceuticals as natural tools against AGEs
bull The free-radical
theory of aging suggests
Usage of
antioxidant supplements
Vit C
Vit E
Q10
Alpha lipoic acid
N-acetylcysteine
bull Oxidation steps are crucially involved in formation of many AGEs bull substances with antioxidative or metal chelating properties may also have
antiglycating activities
bull Acetyl-L-Carnitine-Arginate
bull Aspirin bull Carnosine bull Green Tea Extract bull Fish Oil bull Resveratrol
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Nutraceutical bull EPA DHA (fish and flaxseed oil)
bull The essential fats EPA and DHA bull Extremely valuable for hormone production including
testosterone Fish and flax seed oil beneficial for
Testosterone production Anti-inflammatory Cell membrane health Consume 3 to 5 grams per day
bull Zinc
bull Gonadal function
bull Aromatase inhibitor (chrysin)
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Omega 3
bull Favoring anti inflammatory eicosanoids bull Favoring 2OH pathway of estrogen bull Fish oil (cold water such as sardines anchovies
mackerel) Long chainΩ3
FA EPADHA essential to cell membrane integrity fluidity signaling
bull ALA in flax seed oil
( LA Ω 6 and oleic acid Ω 9)
Curr Opin Clin Nutr Metab Care 2013 Mar16(2)124-32 doi 101097MCO0b013e32835c02c8n-3 fatty acids modulate adipose tissue inflammation and oxidative stressFan C1 Zirpoli H Qi K
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Agenda
bull What is Integrated Health care Nutritional Supplement Perimenopause Andropause
bull Emerging Maturity Crisis bull Aging Theory bull Low grade Inflammation bull Health consequences bull How to avoid
BIHT Food and Diet Nutraceuticals andHerbs
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Medicine cabinet
bull 2 baby aspirin (162 mg total) Reduction in heart attacks or ischemic strokes 13-36 Reduce arterial aging Reduce immune system aging
bull Drink a half glass of warm water before and after taking the pill
bull 600 mg DHA bull 1200 IU vit D3 bull Probiotic bull 600 mg Calcium citrate bull 200 mg Mg
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Fiber
bull Only plant foods (vegetables fruits legumes unrefined grains) contain dietary fiber
bull Soluble fiber Oat bran barley psyllium seeds flax seed meal
apples citrus fruits lentils and beans bull Effective in lowering total and LDL cholesterol bull Prebiotics non digestible food substrates that
promote the growth of intestinal bacteria that confer health benefits on the host
bull High-fat diet increases the proportion of Gram- to Gram+ microbes in the gut by favoring their growth and increases the
liberation of LPS (Lipopolysaccharide) which is responsible for inflammation
bull This effect can be suppressed with a prebiotic that specifically boosts growth of Gram+ microbes
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
IV Nutritional Therapy
bull An important part for many patients obtaining adequate nutrition orally is impossible due to the severity of their illness
bull Patients generally find their IV treatments to be painless and very effective
bull This method is particularly useful in patients with chronic fatigue adrenal hypofunction immune insufficiency gastrointestinal disorders neurological disorders such as Parkinsons migraines and cancer
bull An example of IV therapy is the Meyer Cocktail which contains the B-complex vitamins vitamin C magnesium calcium and other important nutrients
bull Additional nutrients such as the antioxidant glutathione can be added if necessary
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
Conclusion bull You really have to trust your body bull If your body is telling you something different then it would be to
your advantage to honor that and seek to adjust your intervention in an effort to optimize your health
bull Our genes and our telomeres are not necessarily our fate telomeres may lengthen to the degree that people change how they live
bull Research indicates that longer telomeres are associated with fewer illnesses and longer life
bull Starting early and preventing a severe illness is much easier than treating an established full-blown illness An ounce of prevention is worth a pound of cureldquo
bull test the hormone levels so a customized bio identical hormone program thatrsquos just right for you could be identified base on your own hormonal status
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
bull A personalized plan for your ongoing health
bull No prescribing synthetic drugs on a one-size-fits-all basis
bull Obesity
bull High Blood Pressure
bull High Cholesterol
bull T2DMMenopause
bull Andropause (Low Testosterone)
bull Hypothyroidism
bull Osteopeniaosteoporosis
bull GERDIndigestionAcid Reflux
bull Food Sensitivities and Food Allergies
bull Irritable Bowel and Intestinal ParasitesDysbiosis
bull Inflammatory Bowel Disease bull Migraines bull Anxiety and Depression bull Chronic Fatigue bull Arthritis bull Fibromyalgia bull Asthma bull Eczema
How much a disease can be reversed depends on how willing the patient is to implement the physicians suggestions how much damage has already been done how old the patient is what are the other contributing factors to the disease state
more questions wwwgraciaestetikanet doktergraciaestetikanet
more questions wwwgraciaestetikanet doktergraciaestetikanet