Advanced takeaways from A4M’s September event in Boston – featuring the BHRT Symposium, Peptide Therapy Certification, IV Peptide Masterclass, and Module III.

Boston hosted an intensive weekend of continuing medical education from September 11 to 13, bringing together practitioners for four specialized programs: the BHRT Symposium, Module III: Holistic Longevity and Environmental Detox, Peptide Therapy Certification: Module I, and IV Peptide Therapy: Unique Drip Treatments Masterclass.

Each course offered its own specialized curriculum spanning hormone restoration, peptide therapeutics, and environmental detox; together, the program explored the most effective systems-level approaches to modern clinical practice. While we can’t share the full scope of pearls in a blog recap, our curated selection of lecture notes below highlights a few of the trailblazing perspectives shared throughout the weekend.

The BHRT Symposium: Addressing The Hormone Dysfunction Epidemic

The modern hormone dysfunction epidemic presents increasingly complex and prevalent imbalances that require advanced restoration protocols targeting environmental and lifestyle factors behind widespread endocrine disruption.

Treating the Whole Patient: Lifestyle, Diet, and Endocrine Disruptors | Carrie Jones, ND, FABNE, MPH, MSCP

Dr. Carrie Jones brings over two decades of expertise as a naturopathic physician specializing in hormone optimization and functional medicine. Board-certified by the American Board of Naturopathic Endocrinology (FABNE), Dr. Jones has become a leading authority on the impact of environmental toxicology on endocrine function, pioneering protocols that address hormonal dysfunction through detoxification and lifestyle interventions.

During her lecture, Dr. Jones reframed hormonal imbalance as a multisystem issue requiring extensive intervention that addresses root causes and provides complete restoration. Her presentation emphasized the critical role of mitochondrial health, environmental toxin exposure, and lifestyle factors in driving endocrine disruption, positioning hormone restoration as part of a larger health optimization strategy.

From Our Lecture Notes:

• Mitochondria drive hormone production and maintain cellular health. Research shows “increasing evidence to support that mitochondrial dysfunction drives ovarian aging.” Mitochondria function as cellular sensors: “Mitochondria sense and respond to changes in the cellular environment. By sensing safety and danger, mitochondria act as fundamental regulators of the cell danger response.”
  → Mitochondrial support is essential for sustained hormone balance.
• Environmental toxins target mitochondria. High lipid content enables hormone production but creates susceptibility to lipophilic compounds, including polyaromatic hydrocarbons, alkylating agents, organophosphates, lead, cadmium, mercury, and amphiphilic xenobiotics.
  → Environmental detoxification is a crucial component of and prerequisite for hormone replacement therapy protocols.
• Endocrine-disrupting chemicals saturate environments. Over 4,000 possible EDCs “mimic endocrine action” by binding hormone receptors and “interfere with natural hormone synthesis, secretion, metabolism, binding, elimination, and transport.” Consumer Reports research confirms “growing research shows that they are endocrine disruptors, which means that they can interfere with the production and regulation of estrogen and other hormones.”
  → Even minor disruptions can increase the risk of cardiometabolic disease, certain cancers, congenital disabilities, neurodevelopmental disorders, and infertility.
• Nine foundational interventions create optimal cellular environments. Nutrition, hydration, movement, lifestyle, detoxification, stress/nervous system balance, joy, sleep/circadian rhythm, community/safety, and environmental toxicant reduction.
  → These elements enable hormone therapy to achieve optimal outcomes.

Genetic Blueprints & Hormonal Balance: A New Era of Personalized Health | Yael Joffe, PhD, RD

Dr. Yael Joffe, a leading authority in nutritional genomics, demonstrated genetic applications that reshape hormone therapy decision-making. Her lecture exposed how specific variants in detoxification enzymes, methylation pathways, and inflammatory genes directly dictate hormone metabolism and patient safety.

The objective: converting genetic data into immediate treatment decisions that eliminate adverse reactions while amplifying therapeutic results through precision targeting.

From Our Lecture Notes:

• Inflammatory gene variants impair hormone signaling and metabolism. CRP, TNF-alpha, and IL-6 variants create cascades disrupting normal hormone function. Genetically upregulated inflammatory pathways reduce hormone receptor sensitivity and compromise hormone clearance. → High inflammatory genetic load requires anti-inflammatory interventions before hormone therapy effectiveness, explaining conventional approach failures.
• Estrogen and histamine create self-perpetuating cycles intensified by genetic variants. The hormone-histamine cycle illustrates how estrogen stimulates mast cells to release histamine, while uncleared histamine stimulates further estrogen production, creating feedback loops that DAO and HNMT genetic variants exacerbate.
  → Apparent hormone imbalances require simultaneous histamine pathway support in genetically susceptible patients, explaining hormone replacement failures in specific phenotypes.
• Methylation efficiency affects estrogen detoxification and neurotransmitter balance through genetic variants in folate cycle genes. MTHFR, COMT, and methylation pathway variants directly impact catechol estrogen processing and neurotransmitter balance. “COMT catalyzes methylation reactions to detoxify catechol estrogens, reducing oxidative stress and preventing estrogen-related DNA damage.”
  → Slow COMT variants require modified estrogen formulations and enhanced methylation support, preventing harmful estrogen metabolite accumulation.
• Factor V Leiden and prothrombin variants increase blood clot risk when combined with estrogen therapy. “Up to 30-50 x higher VTE risk for women with Factor V Leiden on estrogen therapy” compared to baseline population risk. These genetic variants impair natural anticoagulation mechanisms.
  → Genetic testing for clotting variants becomes standard practice before estrogen-containing therapy, fundamentally changing risk-benefit calculations and delivery method selection.
• Genetic variants provide clinical insight, not predetermined outcomes. “There are no good or bad gene variants. Rather, they provide information and insight into how key biological pathways may be impacted.”
  → This reframes genetic testing as a clinical tool for understanding patient-specific physiology rather than fatalistic prediction, enabling truly personalized hormone protocols.

IV Peptide Therapy: Unique Drip Treatments Masterclass

This intensive masterclass explored advanced intravenous peptide protocols that maximize bioavailability and therapeutic impact through targeted delivery systems for complex patient presentations.

IV Treatments: Amino Acids for Gut-Brain-Immune-Thyroid-Pancreas | Gordon Crozier, DO

Renowned specialist in functional and regenerative medicine, Dr. Gordon Crozier, shared his extensive experience in intravenous amino acid therapeutics with our Masterclass attendees. Dr. Crozier’s lecture on amino acids exposed how nutrient deficiencies in modern diets systematically undermine cellular function across all physiological systems. He demonstrated specific amino acid deficiency patterns that create diagnostic clues for practitioners, ranging from tyrosine deficiency, which promotes iron deficiency, to alterations in methionine and taurine that drive autoimmune conditions.

From Our Lecture Notes:

• Modern diets often lead to widespread nutrient deficiencies, affecting every physiological system. “Research demonstrates significant nutrient depletion in modern foods compared to historical levels.” “Every physiological system requires adequate nutrition, making nutritional assessment relevant across all healthcare specialties.”
  → IV amino acid therapy addresses oral supplementation failure to achieve therapeutic levels needed for systemic restoration.
• The extracellular matrix determines cellular health. “The quality of life of the cell is directly related to the purity of its direct environment since it is the area where it takes its nutrition and energy.”
  → Practitioners must optimize the cellular environment through targeted IV interventions.
• Amino acid deficiencies create specific clinical patterns that practitioners can identify and address. “Tyrosine deficiency promotes iron deficiency,” and “deficiency or altered metabolism of methionine and taurine are related to allergies and autoimmune diseases.”
  → These relationships provide diagnostic clues guiding targeted IV amino acid selection, enabling precision protocols.
• Arginine’s cardiovascular effects include comprehensive vascular protection. Arginine “inhibits platelet and leukocyte adhesion, inhibits the expression of adhesion molecules of endothelial cells, and inhibits the proliferation of smooth muscle cells.”
  → Multi-target mechanism positions arginine as cornerstone therapy for cardiovascular protection, addressing inflammation, thrombosis, and arterial remodeling simultaneously.
• IV amino acid therapy requires an understanding of individual amino acid functions and their synergistic combinations. “Amino acids allow the vitamins and minerals to be absorbed and assimilated so that they can do their work, a fact that only happens with the presence of the respective amino acids.”
  → Amino acids become the foundation, enabling other therapeutic interventions to achieve optimal efficacy.

Peptide Therapy Certification: Module I

The foundational module of our Peptide Therapy Certification introduces practitioners to expanding their services with peptide therapeutics, in accordance with the latest guidelines and regulations.

The Role of Peptides in Glucose and Insulin Regulation-Balancing the Seesaw | James LaValle, RPh, CCN, MT

In this session, James LaValle, RPh, CCN, MT, Chief Science Officer at LifeTime and functional metabolic medicine expert, revealed how peptide interventions can reverse the metabolic dysfunction driving America’s chronic disease epidemic through targeted glucose regulation and systemic inflammation control.

LaValle exposed the limitations of current diabetes management approaches and demonstrated how early glucose elevation predicts future disease risk, long before conventional diagnosis thresholds are met. He detailed the multisystem effects of GLP-1 agonists beyond glucose control, including cardiovascular protection and neuroprotection, while addressing important considerations for muscle preservation, management of nutrient depletion, and individualized dosing protocols.

From Our Lecture Notes:

• Metabolic crisis demands immediate intervention. Statistics reveal: “90% of medical costs in the United States are tied to chronic conditions,” with 130 million Americans diagnosed with diabetes or prediabetes, and over 350,000 children carrying diabetes diagnoses.
  → Fundamental shift toward chronic disease management positions practitioners to address root metabolic dysfunction and provide whole-patient care.
• Early glucose elevation predicts future risk of diabetes. A 2008 Kaiser study of 46,578 patients revealed “every point over 84 fasting glucose represented a 6% increased risk of becoming diabetic,” with vascular and kidney damage beginning at blood glucose levels of 90 mg/dL.
  → Current “normal” reference ranges mask early metabolic dysfunction, suggesting intervention at glucose levels traditionally considered benign.
• Metaflammation drives the insulin resistance cascade. “Chronic low-grade inflammatory sequela” that “increases aging processes and metabolic signaling issues,” creating self-perpetuating cycles where inflammation causes insulin resistance, generating more inflammation.
  → Addressing inflammation is as important as directly targeting glucose control, opening therapeutic windows for anti-inflammatory peptides and interventions.
• GLP-1 agonists demonstrate profound multisystem effects beyond glucose control. Scientific data show cardiovascular protection, reduced neuroinflammation, and “help regulate memory” while “promoting neurogenesis” and improving “glucose metabolism and insulin resistance in the brain.” → Neuroprotective effects position GLP-1 peptides as interventions for cognitive decline associated with metabolic dysfunction, expanding therapeutic applications.
• Nutrient depletion patterns require proactive management. Semaglutide therapy “is associated with depletions/deficiencies of protein, albumin, B12, zinc, vitamin D, calcium, and iron,” not through direct depletion but by “lowering food intake, causing GI side effects, or accelerating weight loss.”
  → Nutrient monitoring and targeted supplementation protocols become essential components of successful peptide therapy implementation.
• Dosing strategies require individualized titration approaches. For weight management with semaglutide, LaValle recommends starting at “100mcg weekly” and increasing “50mcg-100mcg weekly until 250-500mcg obtained or until desired endpoints are achieved.”
  → Slower titration schedules may improve tolerance and reduce discontinuation rates, particularly relevant given high cost and supply constraints.

Module III: Holistic Longevity and Environmental Detox

As part of the A4M Fellowship in Longevity Medicine (FILM) program, this advanced module examined the intricate relationships between environmental toxicity and neurological function, with a focus on detoxification protocols that promote longevity and cognitive health.

Brain Anatomy & Neurotransmitter Physiology: Depression, Anxiety, ADD, Autism, Schizophrenia with treatment protocols | Elizabeth Stuller, MD

In this session, Elizabeth Stuller, MD, board-certified psychiatrist with extensive training in SPECT neuroimaging and environmental medicine, demonstrated how neurotransmitter dysfunction underlies multiple psychiatric conditions through interconnected brain circuit disruptions rather than isolated chemical imbalances.

Dr. Stuller mapped the complex relationships between environmental toxins, genetic variants, and nutritional deficiencies that systematically disrupt neurotransmitter synthesis pathways across depression, anxiety, ADHD, autism spectrum disorders, and schizophrenia.

From Our Lecture Notes:

• Psychiatric conditions stem from dysfunction of the corticolimbic circuit across interconnected brain regions. Mood and anxiety disorders characterize a variety of neuroendocrine, neurotransmitter, and neuroanatomical disruptions. Identifying functionally relevant differences becomes complicated by the high degree of interconnectivity between neurotransmitter- and neuropeptide-containing circuits in limbic, brainstem, and higher cortical brain areas.
  → Systems-based approach fundamentally shifts treatment focus from symptom suppression to addressing underlying circuit imbalances through targeted neurotransmitter support and environmental detoxification.
• Depression represents a complex interplay of multiple neurotransmitter systems, including serotonin, norepinephrine, and dopamine deficiencies. Serotonin, norepinephrine, and dopamine are primary neurotransmitters involved in depression. The relationship between depression and neurotransmitters lies in an intricate interplay of chemicals regulating mood, emotions, and well-being.
  → Neurotransmitter testing allows practitioners to identify specific deficiencies and develop personalized protocols targeting multiple pathways simultaneously, providing superior therapeutic outcomes.
• GABA dysfunction underlies anxiety disorders and represents a vital therapeutic target. Gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter in the central nervous system, targets the treatment of anxiety disorders, insomnia, epilepsy, and other conditions.
  → Addressing GABA synthesis through targeted amino acid precursors, B-vitamin cofactors, and environmental toxin removal offers superior outcomes compared to benzodiazepine dependence.
• Dopamine system dysfunction connects multiple psychiatric conditions, including ADHD, autism spectrum disorders, and schizophrenia. Disturbances in dopamine neurotransmission are implicated in schizophrenia, psychosis, depression, Tourette syndrome, and attention-deficit hyperactivity disorder.
  → SPECT neuroimaging reveals dopamine circuit abnormalities, guiding targeted interventions using tyrosine precursors, methylation support, and mitochondrial restoration protocols.
• Environmental toxins disrupt neurotransmitter synthesis and receptor function across psychiatric conditions. Heavy metals, mold mycotoxins, and chemical exposures directly impact neurotransmitter production pathways and receptor sensitivity.
  → Systematic detoxification protocols must precede neurotransmitter restoration to achieve lasting therapeutic outcomes in conditions like autism spectrum disorders and treatment-resistant depression.
• Nutritional biomarker assessment reveals the metabolic foundation of psychiatric symptoms. Deficiencies in methylation cofactors, amino acid precursors, and mitochondrial nutrients directly correlate with patterns of neurotransmitter dysfunction.
  → Addressing nutritional deficiencies through targeted supplementation based on genetic polymorphisms and biomarker profiles creates a foundation for successful neurotransmitter restoration protocols.

Practitioners navigate an increasingly complex healthcare landscape marked by environmental toxicity, genetic variability, and metabolic dysfunction. Integrated approaches presented in Boston offer a path forward honoring both the complexity of human physiology and the interconnected nature of health and disease.

Missed us this September? We’re returning to Boston for another practice-elevating weekend from October 23-25, 2025. This time, we’re launching a brand-new course, Immune Code: Unlocking The Link Between Immunity & Chronic Disease, spearheading the future of pediatrics at The Pediatrics Reimagined Summit, diving into disease-specific therapeutics during the IV Nutrition in Longevity Symposium, and equipping the next generation of physicians to lead the weight management revolution during the Clinical Weight Management Certification Program. With less than a month remaining, seats are becoming increasingly limited. We highly encourage you to secure yours today by clicking here.