(Part 2)
The buzz of excitement from the A4M September Symposium in Los Angeles is still in the air and rippling through our practices, inspiring new approaches and refining existing ones. As we continue to process and apply the vast array of clinical pearls presented, we’re excited to share the second installment of our Symposium To-Go series.
Rounding out essential lessons learned at the event, these practical takeaways offer a valuable window into the latest advancements in integrative and anti-aging medicine, including even more developments in endocrine system optimization and functional fertility interventions. Synthesized from hours of detailed presentations by expert practitioner-educators, the insights below are designed to provide immediately applicable information and timely expertise.
More Learning Highlights For Your Practice
Dive into this second part of digestible, actionable learning from the A4M LA Symposium. These key insights are ready to enhance your practice and benefit your patients, no matter where you are.
Endocrine Balance and Bio-Identical Hormone Restoration Symposium
The Expanding Realm of Men’s Hormonal Wellness
“Male Hormone Evolution: Current Evidence and Future Directions” – Joel Heidelbaugh, MD, FAAFP, FACG
Dr. Joel Heidelbaugh, a recognized expert in men’s health and a member of key urology guideline panels, presented on “Male Hormone Evolution: Current Evidence and Future Directions.” Dr. Heidelbaugh’s lecture provided valuable pearls and insights into testosterone deficiency, focusing on current evidence-based strategies to diagnose and manage the increasingly prevalent condition.
Lecture Takeaways
• Testosterone levels naturally decline with age; however, symptomatic hypogonadism needs to be addressed.
• The benefits of TRT often extend beyond sexual function, including improvements in body composition, mood, and cognitive function.
• The testosterone-cardiovascular health relationship is complex and requires careful consideration in treatment decisions.
• Individualized treatment plans based on overall health status, risk factors, and patient goals are the gold standard for treating testosterone deficiency.
Practical Pearls
• When screening for testosterone deficiency, look for symptoms like fatigue, decreased libido, erectile dysfunction, increased body fat (especially abdominal), decreased muscle mass, and mood change or depression.
• Conduct comprehensive hormone evaluations, including total and free testosterone, estradiol, SHBG, LH, FSH, prolactin, and thyroid panel.
• Consider starting testosterone replacement therapy (TRT) when appropriate. Start with lower doses and titrate based on symptoms and lab results. Monitor hematocrit, PSA, and estradiol levels during treatment.
• Implement lifestyle interventions to support hormonal health:
Recommend resistance training exercise
Advise on sleep hygiene to support natural testosterone production
Suggest dietary changes to support hormone balance (e.g., adequate healthy fats, zinc-rich foods)
• Address potential TRT Side Effects:
Be aware of sleep apnea risk and potential cardiovascular impacts, especially in older patients.
Consider aromatase inhibitors if estradiol levels elevate during treatment.
The Future of Pediatric Medicine
Genomics in Pediatric Primary Care and Health Optimization
“Genomics and Precision Pediatrics” – Sharon Hausman-Cohen, MD
Dr. Sharon Hausman-Cohen, a distinguished genomics and precision medicine expert, presented groundbreaking insights into applying genomic testing in pediatric care. Her lecture at the Future of Pediatric Medicine Symposium highlighted how understanding a child’s genetic makeup can revolutionize treatment approaches, particularly in neurodevelopmental and behavioral disorders. Dr. Hausman-Cohen’s work bridges the gap between complex genetic data and practical, personalized interventions, offering new hope for children with challenging conditions.
Lecture Takeaways
• Genomic variants can significantly impact how children respond to environmental toxins, nutrients, and medications.
• A single nucleotide polymorphism or SNP is a change in one nucleotide within a DNA stretch or a gene. SNPs can help predict an individual’s response to different drugs, susceptibility to exogenous factors, and risk of developing disease.
• Genetic factors heavily influence the microbiome-gut-brain axis.
• Genetic testing can help identify children at higher risk for certain conditions, allowing for earlier intervention.
Practical Pearls
• Consider genomic testing for children with:
ADHD symptoms
Anxiety disorders
Autism spectrum disorders
Unexplained developmental delays
• Use genomic data to guide interventions:
Tailor vitamin B supplementation based on MTHFR variants.
Adjust zinc and magnesium supplementation based on genetic markers.
DHA, NAC, and l-theanine can lower glutamate and dopamine (ADORA2A).
Vitamin D, SAMe, tryptophan, specific probiotics, and 5-HTP can be used to address serotonin pathways (TPH1, RGS2).
• Implement detoxification protocols based on genetic susceptibility:
Focus on supporting glutathione production for children with GSTP1 and GPX1 variants.
Consider targeted support for children with genetic susceptibility to heavy metal toxicity.
• Personalize treatment approaches for ADHD:
Use genomic data to guide medication choices (e.g., stimulants vs. non-stimulants).
Implement targeted nutritional interventions based on dopamine-related gene variants.
Peptide Therapy Certification: Module II
Latest Innovations: Small Molecules, Peptides
“The Future of Peptides and Small Molecule Therapeutics” – James LaValle, RPh, CCN, MT
His comprehensive presentation detailed future directions and advancing science in the field, highlighting increasing applications and efficacy practitioners must stay abreast of to remain competitive in the market. LaValle offered a thorough understanding of the current state and future potential of peptide and small molecule therapeutics, providing practitioners with new tools to address various clinical presentations.
Lecture Takeaways
• Despite historical challenges in the use of peptides and similar small molecule therapeutics, including high costs, limited availability, poor delivery mechanisms, and short half-lives, continual evolution in the field has contributed to recent advancements making these therapies more viable and accessible.
• Several recent advancements in peptide and small molecule therapeutics have made waves within the domain, such as improvements in bioavailability and stability, novel delivery systems – including nanocarrier and liposomal technology – and genetic engineering developments.
• Looking ahead, there is a strong focus on ongoing research and development, potential shifts in the regulatory landscape, hope for numerous new clinical applications, and an increased focus on personalized medicine across the system that will help optimize these therapies.
Practical Pearls
• Combine peptides and small molecules with lifestyle interventions for optimal results.
• Monitor patients closely when implementing these therapies and adjust based on individual responses.
• Examples of small molecule dietary supplements for protocol integration and their intended benefits include:
OS-01: An AMPK activator with potential applications in metabolic health and longevity
Benefits: Metabolic support, glucose homeostasis, weight management
Dosage: 100mg orally daily for 4-6 weeks
Rg3 Ginsenoside: Consider for cognitive impairments and cardiovascular health
Benefits: Neuroprotective, anti-aging, metabolic syndrome support
Rb1 Ginsenoside: Best to use synergistically with Rg3
Benefits: Neuroprotection, anti-obesity, antidepressant effects
Dosage: 6mg Rb1 with 6mg Rg3 as oral liposomal, twice daily
EGCG: Green tea-derived polyphenols
Dosage: 50-200mg BID, or 21mg oral liposomal tab daily
Benefits: Neuroprotective, cardioprotective, anxiolytic, antioxidant
Glutathione: Tripeptide composed of glutamic acid, cysteine, glycine
Benefits: Detoxification and antioxidant
Form: S-Acetyl-L-glutathione for better bioavailability
Dosage: 15mg oral liposomal, twice daily
Berberine: Plant-derived anti-inflammatory compound used in management of diabetes, high cholesterol, and hypertension
Benefits: Antibacterial, antifungal, glucose regulation, gut health, cardiovascular function
Dosage: 250-500mg daily (std. 97%) for Candida treatment
Fertility Certification Course
Improving Fertility Outcomes In Older Mothers
“Egg Quality, POI, and Fertility Over 40” – Jaclyn Smeaton, ND
Dr. Jaclyn Smeaton, the nation’s leading specialist in fertility and reproductive health and program chair of the Fertility Certification Course, presented several sessions on critical topics throughout the course. During her lecture “Egg Quality, POI, and Fertility Over 40,” she addressed the unique challenges faced by women who seek to conceive later in life and offered evidence-based strategies to support fertility in this population. This topic has gained increasing relevance as societal shifts lead more women to delay conception efforts. Her approach emphasizes that while fertility does decline with age, targeted interventions focusing on egg quality, hormonal balance, and overall health enhancement can significantly improve outcomes for women over 40.
Lecture Takeaways
• Time is of the essence. Early intervention in this demographic is essential; initiating fertility-supporting treatments as soon as possible can lead to better outcomes.
• Enhancing mitochondrial function is crucial for improving egg quality in women over 40.
• Mitochondrial support can improve embryo quality and increase chances of successful conception.
• Oxidative stress plays a significant role in age-related fertility decline, although targeted antioxidant therapy and lifestyle modifications can help mitigate oxidative damage to eggs and reproductive tissues. Addressing hormonal imbalances, particularly related to thyroid function and sex hormones, is essential for optimizing fertility.
• Chronic, subclinical infections, such as endometritis, can significantly impact fertility. Identifying and treating these “hidden” infections can improve pregnancy outcomes.
Practical Pearls
• Supplement with CoQ10 (100-600mg qd) to support mitochondrial function and egg quality.
• Recommend r-Alpha-lipoic acid (1200-1800mg qd) for mitochondrial function and antioxidant support.
• Inositol is another valuable nutrient in fertility treatment, particularly in older patients and those with PCOS. It improves ovulatory function, decreases serum androgens, decreases hypertension, and improves oocyte quality in women with PCOS.
Dosage recommendations: 4g daily
• Prescribe melatonin (3mg at bedtime) to improve oocyte quality. Positive trends in clinical pregnancy rate and implantation rate have been reported in patients undergoing IVF who supplemented with melatonin.
• Consider DHEA supplementation for women with low ovarian reserve:
Dosage: 25 mg three times daily
Particularly beneficial for women with low ovarian reserve
Monitor testosterone levels to avoid over-supplementation
• For all patients, a Mediterranean-style diet is recommended to support overall fertility, achieve healthy weight, and optimize reproductive outcomes. Encourage exercise and a high intake of plant foods, food-based antioxidants, and aromatase inhibitors.
Continuing Our Journey
While these takeaways offer a snapshot of the Symposium’s valuable content, they capture only a fraction of the in-depth knowledge shared. We hope they serve as a springboard for further exploration and integration into your practice.
By implementing the latest evidence-based revelations, you’re not only enhancing patient outcomes on an individual level – you’re contributing to a broader shift towards more effective, personalized healthcare.
To help achieve this vision, A4M and our global community stand ready to support your ongoing education and professional development.
With upcoming events such as the October Symposium in Boston and the highly anticipated LongevityFest 2024 on the horizon, you will find ample opportunities to deepen your expertise and connect with fellow practitioners who share a commitment to redefining modern medicine.