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Hormone Balance for Men and Women An Introduction to Age Management Medicine Paul Navar M.D.
Age Management Medicine:  A New Paradigm ,[object Object],[object Object],[object Object],[object Object],[object Object]
Where are you on the Health span Curve? Optimum Health Sub-optimum Health Undiagnosed Conditions Development Vitality Degeneration Morbidity Reserve Capacity (% of Maximum Function)
Morbidity Extension  keeps you alive… with  your diseases Morbidity Extension Reserve Capacity (% of Maximum Function)
Morbidity Compression  maximizes vitality & ‘health span’ Morbidity Compression Vitality Extension Reserve Capacity (% of Maximum Function)
Age Management Medicine:  A New Paradigm ,[object Object],[object Object],[object Object],[object Object],[object Object]
Orthomolecular vs. Pharmaceutical Medicine ,[object Object],[object Object],[object Object]
The Problem with Pharmaceuticals ,[object Object],[object Object],[object Object]
Bioidentical Hormones ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conventional Medicine ,[object Object],[object Object],[object Object]
Age Management Medicine:  A New Paradigm ,[object Object],[object Object],[object Object],[object Object],[object Object]
Conventional View of Hormones and Aging ,[object Object],[object Object],[object Object],[object Object]
Against the Conventional View ,[object Object],[object Object],[object Object],[object Object]
Age Management Medicine:  A New Paradigm ,[object Object],[object Object],[object Object],[object Object],[object Object]
Conventional Thinking:  The Tyranny of the Lab Report ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Age Management Medicine:  A New Paradigm ,[object Object],[object Object],[object Object],[object Object],[object Object]
Common Sense Regarding “Class Effect”  ,[object Object],[object Object]
Components of Age Management Diet Hormone   Therapy Conventional  Treatments Exercise Supplements Lifestyle
Age Management Medicine  5 Basic Principles: ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Hormones ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Hormonal Decline With Aging ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endocrine Deterioration of Aging ,[object Object],[object Object],[object Object],[object Object],[object Object]
Common Sense Hormone Replacement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BHRT is Smart Medicine ,[object Object],[object Object],[object Object]
Hormone Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hormonal Deficiency Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Seven Dwarves of Menopause
Menopause ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Progesterone Deficiency/Estrogen Dominance Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Estrogen Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Testosterone Deficiency in Women ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Long Term Effects of Combined Sex-Hormone Deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Known Benefits of Estradiol Replenishment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Benefits of  Bio-identical Progesterone  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Testosterone for Women ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hormone Replenishment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Hormone Replenishment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Osteoporosis ,[object Object],[object Object],[object Object],[object Object],Speroff L, Fritz M Clinical  Gynecologic Endocrinology and Fertility, 7 th  Ed.
Osteoporosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Speroff L, Fritz M Clinical Gynecologic Endocrinology and Fertility, 7 th  Ed.
The Mighty Thyroid ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosing Hypothyroidism ,[object Object],[object Object]
Thyroid Optimization:  Not Just for Quality of Life ,[object Object],[object Object],[object Object],[object Object],[object Object]
Age Management Approach to Thyroid Replacement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Andropause
Andropause in Men  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Testosterone Levels and Age
Testosterone and the Heart ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Testosterone and the Prostate ,[object Object],[object Object],[object Object],[object Object],[object Object]
Testosterone and prostate cancer ,[object Object],[object Object],[object Object]
Testosterone Replacement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods of Replacement ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rhoden, E. L. et al. N Engl J Med  2004;350:482-492
Growth Hormone
Growth Hormone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Growth Hormone vs. Age
Expected Benefits of HGH restored  to 30 year old level ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conventional Endocrinology & Age Management Medicine agree up to a point! ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods of Replacement ,[object Object],[object Object],[object Object],[object Object],NOTE:
BHRT—A New Science ,[object Object],[object Object],[object Object],[object Object],[object Object]
What I do: Diet Hormone   Therapy Conventional  Treatments Exercise Supplements Lifestyle
Morbidity Compression  maximizes vitality & ‘healthspan’ Morbidity Compression Vitality Extension Reserve Capacity (% of Maximum Function)
Maintaining Quality of Life
Thank you for attending The Center for Optimal Health Paul Navar MD  166 N. 300 W. Suite #3 St. George, Utah 84770 (435) 688-8582 Email: pnavar@infowest.com www.agemanagementmedicine.net
 
 
DHEA-S levels vs. Age
Worst Side Effect?
.
 

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Anti Aging Medicine

Notas do Editor

  1. Conventional medicine has always held the belief that aging is inevitable and that its progressive deterioration cannot be altered. Fortunately there is a new, exciting revolution in science and medicine that identifies aging as a disease. Age Management Medicine focuses on the prevention and delay of the aging process rather than simply the treatment of aging symptoms. Today, I’d like to start by giving you a brief description of what Age Management Medicine is and how it differs philosophically from the conventional medical approach to disease. Then, we’ll focus on a major facet of Age Management Medicine which is age related hormonal decline and its treatment, then at the end, I’d like to open up the discussion to your questions.
  2. This slide shows 5 differences between the disease based conventional medical approach, and the preventative, health based approach of Age Management medical practitioners.
  3. This is a graphical representation of what happens to us generally over the course of our lifetime. Explain graph
  4. The conventional medical approach has been quite effective to provide an extension of the morbidity phase in life. Disease is recognized and managed. The result is prolonged life, but diminished functioning and disability during the life extension.
  5. The preferred approach which is the preventative approach and what AMM is all about, is to intervene before reserve capacity and functioning have diminished to the point of conditions developing. The result is sustained vitality and compressed morbidity. And possibly longer life as well.
  6. How is that done? The first difference is the emphasis on orthomolecular treatments vs. pharmaceutical
  7. Allopathic (MD) Medical schools teach the pharmaceutical paradigm, and I spent well over 20 years practicing it. It does have its successes, but after years after seeing its shortcomings I favor the orthomolecular approach which seems more physiologic to me.
  8. What are bio-identicals? These are hormones or enzymes that are made to be exact chemical copies of what your body normally produces for its normal functioning. (Read the slide)
  9. Why doesn’t conventional medicine embrace the orthomolecular approach?
  10. The AMM approach is to treat aging as a disease rather than a normal inevitable process.
  11. This is the conventional view of hormones and aging:
  12. This is the Age Management View:
  13. Optimal range vs. “normal” range – what is meant by that? I’m referring here to laboratory tests and values, which both Age Management and conventional medicine often use to evaluate and guide therapy.
  14. But here’s the problem with the conventional way of thinking about laboratory normal ranges: (Give TSH and thyroid as an example)
  15. What do I mean by “class effect” ? Class effect refers to attributing the effects one particular drug or chemical to the whole “class” of substances. (Give example of Prempro vs. Provera and oral Premarin vs. transdermal estradiol)
  16. Age Management is about taking personal responsibility for your health and making better choices to prolong your quality of life Age Management medicine looks at the whole picture, offering a comprehensive treatment plan that includes diet modification, exercise, stress reduction/lifestyle changes, conventional pharmaceutical treatments if necessary, supplements such as vitamins minerals and herbs, and hormone replacement therapy, which will be the focus of our remaining discussion today.
  17. Here are some important basic principles of AMM. (Read slide) As you can see, there is a lot that could be said about the different aspects of these basic principles, but in the interest of time, today I’ll focus on age related hormonal decline, its symptoms, and treatment with bio-identical hormone replenishment.
  18. One of the most important therapies in the new specialty of Age Management Medicine is hormone supplementation. Because most physicians have been taught, and accept that age related hormonal declines are natural, and should not be tampered with, the medical community as a whole has been very slow to offer hormone replacement therapy to the aging community. Research has shown, however, that hormone deficiencies associated with aging are no different than those of younger persons with hormonal imbalances, and should be treated as quickly as other hormonally related complications and diseases. What are hormones? (Read Slide)
  19. What are the endocrine organs that produce various hormones that are involved in the regulation of body processes?
  20. I alluded to the fact earlier that most hormone levels decline with aging.
  21. Not only do levels of hormones decline, but the function of endocrine organs declines as well.
  22. So what do physicians normally do for hormone deficient disease states?
  23. Replenishment of hormonal levels to optimum physiologic levels has been shown to alleviate these age-related changes.
  24. Let’s start by talking about menopause. This is a slide from on of Suzann Somer’s books.
  25. The many symptoms associated with Menopause are typically characterized by varying deficiencies of estrogen, progesterone and testosterone.
  26. Typically as a woman ages, she first experiences erratic ovulation which results in a relative progesterone deficiency and the following symptoms:
  27. Later as she becomes menopausal, symptoms of estrogen deficiency due to ovarian failure become prominent:
  28. These are the Principles for hormone replenishment in symptomatic women: This is typically done with a combination of pills, patches and creams which could be the topic of a whole other lecture.
  29. Osteoporosis is an estrogen deficiency disease.
  30. What about the thyroid?
  31. I generally order 4 different thyroid tests when evaluating for hypothyroidism.
  32. Why is it important beyond symptom relief to optimize your thyroid status?
  33. Let’s turn our attention now to Men.
  34. Andropause refers to “male menopause” which is typically caused by decline in testosterone levels.
  35. Here are some quotes from the medical literature regarding testosterone supplementation and the prostate:
  36. What are the typical positive effects that most andropausal men experience with testosterone supplementation?
  37. Table 2. Potential Risks Associated with Testosterone-Replacement Therapy.
  38. I’m going to speak very briefly about growth hormone. It is a very controversial area, and unlike other hormones, its replacement is under the scrutiny and restriction of the government.
  39. Explain controversy.
  40. In summary:
  41. What I do with a patient is to look at the whole picture, offering a comprehensive and integrative treatment plan that includes diet modification, exercise guidance, stress reduction/lifestyle changes, conventional pharmaceutical treatments if necessary, supplements if needed such as vitamins, minerals and herbs, and hormone replacement therapy, when indicated.
  42. In this way I work toward maximizing your reserve capacity, increasing your years of vitality and life enjoyment.
  43. Aging is inevitable for everyone. However, increasing medical evidence suggests that many aspects of aging may be delayed, minimized or even avoided. Proper hormonal balance may offer significant benefits to men and women wishing to maintain or improve function, youthful vitality, and improve quality of life.