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A Note from Dr. Rouzier

A Note from Dr. Rouzier: Beyond Hormones

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NEAL ROUZIER, M.D.

Dear Fellow Colleagues,

In addition to learning about dysbiosis and all the effects that probiotics play on health and wellness, I thought that it would be interesting to learn and review from an expert all that we should know about gut flora, health and wellness.  I personally have been on 8 different potent IV antibiotics since January and have completely messed up my intestines, only to be saved by gut healing supplements and probiotics.  Dr. Dirk Parvus will review how he assisted me in recovering.  Eric Serrano sent a care package to my home with all of the necessary elements to heal my leaky gut and put me back to normal.  What a tough road it’s been, but I’m finally back to normal thanks to these docs.  I’ll review their treatments that led to my healing when nothing conventional worked.  And I’m sure you’re interested in hearing where I’ve had stem cells injected, why, and the results.  Although you may never administer stem cells, we feel it is extremely important that you become aware of the modality, what it can be used for, and when you should utilize it. Dr. Herman Pang will enlighten us with everything you should know about stem cells and where to refer your patients for the various treatments with PRP and stem cells, as well as where I sent my own patient that had an ejection fraction of 15% with class IV CHF.

The administration of growth hormone has always been complex and confusing, and many practitioners and zealots still try to convince everyone that growth hormone is illegal to prescribe based on their misinterpretation and misunderstanding of some law they say applies to growth hormone.  Fortunately,  it’s up to the law makers to enact laws and the courts to interpret them, and NOT the FDA or pundits that claim to.  We’ll review case law on legalities of HGH and put the false claims to rest that are intended to scare practitioners away from prescribing HGH.  If it is illegal to prescribe HGH, then I know about 10,000 doctors that are breaking the law.  Really?  Are all of us breaking the law?  Nope, not to worry, I’m not going to turn you in because you prescribed HGH.  However, I will discuss the various cases that I’ve had to defend (medical board cases), issues regarding the use of HGH, and how to prescribe and document so that you will never have any concern with prescribing growth hormone for medical reasons.  Don’t make the mistakes that others are making.

We will review 100 studies on diagnosing, prescribing, monitoring and troubleshooting HGH.  Old landmark articles will be reviewed, as well as the most recent literature showing benefits.  We’ll review tricks to maximize response and raise IGF-1 levels.  We’ll also review various types, costs, where to go to prescribe for best cost, alternatives to HGH, and the important facts that you need to document when you prescribe growth hormone for off-label use.  Ever hear of ipramoralin, tesamorilin, or ibutamorin?  We’ll review both injectable HGH and PO secretagogues, which ones work and for how long. The use and clinical utility of pharmaceutical secretogogues and the lack of efficacy of non-pharmaceutical secretogogues will be reviewed. Recent evidence proves significant protection against Alzheimer’s disease by HGH and various secretagogues.  Just how illegal is it to prescribe growth hormone?  I’ll review the reasons why I don’t prescribe growth hormone, as well as the reasons why I DO prescribe growth hormone.  We’ll review supply and demand, cost and availability, andeverything else you need to know before prescribing growth hormone, including the necessary verbiage for documenting and defending its use.  It may take me several hours to get through the material, but I hope to cover everything of importance that I feel you should know about HGH. And of course, it goes without saying:  WWYLYLTB?

Five years ago, I put together a lecture on the brain that I gave at AMMG.  Three years later I added a second lecture that consisted ofnewer articles not included in the first lecture.  Earlier this year I put together a third lecture from all recent data that addresses the various treatments for dementia and Alzheimer’s disease.  It is thoroughly amazing that the experts who write the articles on Alzheimer’s disease and dementia have no understanding of the pathophysiology of hormones on the brain.  They just don’t get it.  However, you will by the time I finish the third lecture.  I will convince you of how bad estrogen is for the brain, and the same goes for testosterone.  Then, in my usual style, I will show you all the bad effects of not using hormones to protect the brain. Recently there have been several studies proving the harm of estrogen in older women, as well as demonstrating the harm in having high baseline levels of estradiol that have been associated with an increase in Alzheimer’s disease and dementia. That is absolutely true as you can’t argue the results, only the extrapolation. But in fact, their conclusion couldn’t be further from the truth.  Unfortunately, researchers still don’t understand that association does not prove causation.  We will review the medical literature that demonstrates protection of the brain with various hormones for both men and women.  After 20 years and billions of dollars of research we are no better off in treating Alzheimer’s disease.  Aricept and Namenda have been disappointing in treating symptoms, and no drug reverses the disease process as it progresses. We will review all the EBM that medical academies and pharmaceutical companies ignore, which instruct us on how to prevent dementia as opposed to treating once the disease becomes established. Can/should we treat Alzheimer’s disease with estrogen?  Yes, absolutely, if you want to reverse the disease process. Unfortunately, the pharmaceutical industry fails to read and appreciate all the data for the various hormones in preventing the disease in the first place.  There is definitive evidence that CEE≠E2 and MP≠MPA, particularly when it comes to the brain and this is demonstrated in SPECT scans.  Finally, there is only one drug that reverses (removes) beta amyloid plaque from neurons, which is what the pharmaceutical industry has been searching for to treat AD.  Well, we found it, but we are going to keep it a secret!  It doesn’t make me any less sarcastic, but it does make me think clearer so that I can be even more sarcastic.

Recently while in China, I read about another promising Alzheimer’s disease drug that failed to improve AD or reverse beta-amyloid plaque deposition.  After 50 years and billions of dollars spent, there is no successful treatment or preventive drug therapy for AD.  And now we have good data to show the harm of HRT which logically calls for yanking out ovaries, heuvos, and your pituitary gland.  Fortunately, those are all observational studies that suggest harm of hormones, in contrast to RCT’s that show and prove protection.  This then leads us to another section where we will learn how to evaluate medical journal articles and interpret their results, which are usually the opposite of what the real data shows.  We will review a multitude of studies whereby the ultimate results are different than what the authors originally claimed.  I hope to make you better students by teaching you how to interpret and review studies for bias, political correctness and economic agendas.

I have also invited two hormone experts, both internationally recognized, that have completely opposite opinions on HRT.  You will find their debate on hormones enlightening and be amazed how two experts can have  completely different views of HRT.  Listening to them both will give you a new perspective on life.

Lastly, I have found the most profound article on BHRT that I have ever seen or read.  Finally, someone has published exactly what I have been teaching and preaching on thyroid administration for the last 20 years. In spite of the fact that it’s in the bible of endocrinology not to suppress TSH, endocrinologists, ENT surgeons, and psychiatrists suppress TSH with impunity, but you can’t.  Regardless of this right of certain physicians to suppress TSH, a landmark study reviewed why and how we came to fear suppression of TSH.  Unfortunately,  all of the studies that showed harm of TSH suppression were from extrapolation from Grave’s disease which causes harmful effects due to an autoimmune disorder and not from elevated levels of thyroid hormone.  Years of studies of suppressing TSH by endocrinologists, psychiatrists using high doses of T3 for depression, and ENT surgeons suppressing TSH for treatment of DTC, none showed any harm.  We will review this study and recent other studies showing the benefits of thyroid optimization and lack of harm with TSH suppression. In fact, proper treatment involves TSH suppression. I could not sleep after reading this article and I’m sure that you will feel the same.

We’ll review all the articles that review PCV vs erythrocytosis, as well as review outcome studies. High hematocrit is predictive of stroke and heart attacks but only in patients with PCV, not erythrocytosis.  Got that?  Well most don’t got it and here’s why.  Fifty years of study prove no harm to physiologic erythrocytosis.  Don’t assume and don’t extrapolate but everyone does because they don’t get it. However you’ll get it.  Need studies, documentation that erythrocytosis is harmless, need to understand why checking a CBC is in the endocrine guidelines? No I don’t go by (incorrect) endocrine guidelines.

We’ll review the physiology of erythrocytosis that the hematology world doesn’t comprehend, and look at how and why they confuse PCV with erythrocytosis.  The mechanism and physiology of erythrocytosis is thoroughly amazing and none of my hematologists know or understand the physiology behind normocytosis, erythrocytosis, and extreme erythrocytosis, as well as when, and when not, to phlebotomize each.   I’ve saved interesting cases of PCV with lab reviews.

How to analyze a medical study:  Examples of studies that state one thing and prove another.  Review and critique a study before even reading it.  DBRCT’s, RCT’s, prospective studies, retrospective studies, observational studies and confabulation.  How to design a study to prove or disprove anything that you want by using sensitivity, specificity, relative risk vs. absolute risk, number to treat, underdiagnose and overdiagnosis.  We’ll make it fun!

Hope to see you in October!

Sarcastically yours, Neal

P.S.  I just heard from Einstein and he’s coming all the way from Tokyo.

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