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BHRT Series – Part II

View Part II PDF Brochure 

Part Two follows the Part One series with advanced concepts and up-to-date research. This two and one-half day seminar will keep you current on the appropriate skills needed to manage everyday problems. It will serve as a short refresher, including important new therapies, clinical pearls, tricks of the trade, advanced techniques and difficult case management sessions. The field of age management medicine continues to grow at a rapid rate, making it difficult to stay abreast of all the changes. Included in Part Two is an hour-long lecture that reviews the scientific literature giving credence for this type of practice. Over 200 peer-reviewed articles, the foundation for Dr. Rouzier’s advanced course, will be provided as a reference for the participant. This is the same lecture Dr. Rouzier gives to medical academies to inform physicians of the health benefits of age management therapies.

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COURSE DEscription:  


Part II: Mastering the Protocols for Optimization of Hormone Replacement Therapy - Advanced Protocols - March 2019

This course has been approved for21 AMA PRA Category 1 Credits, 21 Nursing Contact Hours (21 pharmacologic hours), 21 Hours Pharmacy Credit (knowledge based)


Workshop Schedule:

  • Friday, 8:00 a.m. - 6:00 p.m.
  • Saturday, 8:00 a.m. - 6:00 p.m.
  • Sunday, 8:00 a.m. - 12:00 noon

    Syllabus Information:

    All participants will receive an electronic and printed syllabus with their registration.  The eSyllabus will be available for download at least one week prior to the course.  An email notification will be sent when it is available for download and will include links and instructions.  This early release provides an opportunity to download and review the materials prior to the course.

    PLEASE NOTE: We request you download the material prior to the event as internet access in the meeting room may be limited.  We will also have flash drives available for those that find this easier than downloading.  The syllabus can be saved in Adobe Reader which allows participants to add "sticky  notes" directly on the slide as the speaker is talking. THese notes can be saved permanently to your document.  Other recommended applications include iBooks (for apple mobile devices) and iAnnotate (for mobile devices).  Lastly, put perhaps most important for many of us, a printed syllabus is available with an option for good old fashioned note taking.


    Claiming Credit - Pre/Post Testing and Evaluation

    To help us evaluate changes in knowledge this course has a pre and post test along with a course evaluation.  Please login HERE to take the pre-test prior to the start of the course, You will need to either create an account if this is your first time using the FCM website or login to your already created account.  Once the course if complete the post test and evaluation will be available

    The course code is: BHRT23819P1Y

    Notification will be sent out after the course with links to complete the survey.  Instructions can also be found on the first page of your course syllabus.  The survey must be completed within one-year in order to claim your credit.  Certificates are available to print once all forms are completed.


    Registration:

    • Hilton Salt Lake City Center (255 South West Temple Salt Lake City, UT 84101) 801-238-4889
    • Alpine Ballroom
    • Registration 7:30 am - 8:00 am
    • Meeting start time: 8:00 am


    Buffet Luncheons:

    • Friday - Hilton Salt Lake City Center - Canyon A, B, C

    Guest Speakers: Dr. Michele Neil-Sherwood and Dr. Mark Sherwood

    Talk Title: "Optimizing Cardiovascular Clinical Performance"

    • Saturday - Hilton Salt Lake City Center - Canyon A, B, C

    Guest Speaker: Ammon Millet, PharmD

    Talk Title: "Essential Copies and Compounding: A Summary of the FDA Guidance Document"


    Evening Activites:

    • Friday March 8th, 2019 Dinner Reservation at Squatters Pub (147 Broadway, Salt Lake City, UT 84101) at 6:30 pm.   We have a large table set aside for a group of 25 starting at 6:30 PM.  Neal usually comes to dinner but later around 8:00 pm so come early if you prefer an early evening or workout first (like Neal does) and come closer to 7:45 or 8:00 pm.  Hope to see many of you there.  Its informal with casual conversation.  Everyone is on their own in terms of ordering and paying for their meal, we just provide a table, good atmosphere and an opportunity to spend time with your fellow colleagues
    • For shopping and food near the hotel check out City Creek: https://www.shopcitycreekcenter.com/
    • For food within 2 miles of the hotel check this list: Salt Lake City Dining.jpg


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    COURSE OBJECTIVES:

    Upon completion of this workshop, the healthcare professional will be able to:

    1. Recognize what the practice of nutritional medicine is and be able to identify four distinct but overlapping metabolic/endocrine/immunological disorders that frequently play a role in pathogenesis of a number of chronic conditions.

    2. Develop clinical assessment skills for individualizing treatment around nutritional interventions and their synergistic treatment effects

    3. Demonstrate an understanding of the basic fundamentals and principles around healthy eating along with clinically relevant information on the effects of specific foods and food groups

    4. Identify the health and metabolic effects of sucrose and high fructose corn syrup so that you as a practitioner can better educate your patients.

    5. Review common food additives and evaluate how they can cause adverse reactions in many patient populations

    6. Explore how certain ways of cooking can alter the structure of proteins, producing toxic compounds that may play a role in the pathogenesis of one or more chronic diseases

    7. Review what is meant by reactive hypoglycemia and understand the symptoms, causes, diagnosis and dietary treatments for this condition

    8. Identify hidden food allergies and how best to treat these conditions

    9. Recognize the rationale for the  use of nutritional supplements and propose mechanisms to explain the observed beneficial effects of nutrients in research studies and in clinical practice. 

    10. Outline key elements in HRT presented in Part One: Mastering the Protocols for Optimization of Hormone Replacement Therapy

    11. Identify important issues in the relationship between hormones and cancer: cause, provocation or protection?

    12. Outline problem-solving techniques for difficult cases presenting with multiple disease processes and the potential benefits of hormones.

    13. Discuss literature citing new indications, risks, benefits and complications of estrogen, progesterone and testosterone therapy.

    14. Determine advanced treatment modalities and dosing strategies for estrogen and progesterone, including new and specific approaches to these therapies. 

    15. Describe important aspects of the WHI findings: identify the experts that refute this study, and other factors not included in the trials that would change the conclusions.

    16. Determine advanced treatment modalities, including new and specific approaches to HGH, thyroid and testosterone in age management and disease prevention. 

    17. Discuss over 40 articles that demonstrate thyroid replacement does not cause osteoporosis, even in TSH suppressive doses.

    18. Identify various new therapies for erectile/sexual dysfunction in men and women.

    19. Evaluate the epidemiology of cardiovascular disease and diabetes and the various treatment strategies as they pertain to medication, diet, exercise, lifestyle change and nutritional supplements.

    20. Explore the role of omega 3 fatty acids, antioxidants and glucose and their influence on insulin, inflammation, disease progression and atherosclerosis.

    21. Describe the strategies for using the new cardiovascular risk markers, inflammation markers, new lipid parameters and how to make sense of all the new lipid fractionation components.

    22. Identify the roles of niacin and EFA in diabetes and atherosclerosis.

    23. Identify rational approaches to vitamins and supplements with a review of the medical literature supporting their use in wellness as well as citing any harmful effects and interactions.

    24. Determine current screening methods and management strategies of the most common pre-menopausal hormone disorder, Polycystic Ovary Syndrome (PCOS).

    25. Implement diagnostic and treatment strategies for PCOS.

    26. Apply diagnostic and treatment strategies for hirsutism and hair loss.

    27. Implement strategies for treating osteoporosis using hormone replacement therapy.

    28. Discuss interesting cases in bio identical hormone replacement therapy.

    29. Identify current indications, risks and benefits of using cortisol for the treatment of chronic fatigue.

    30. Determine rational approaches for the evaluation of fatigue with emphasis on cellular hypofunction as it pertains to thyroid hormone. 

    31. Describe, based on the literature, when to use oral vs. saliva testing.

    32. Utilize the knowledge gained to improve patient outcomes in BHRT.

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    Agenda:   Friday     Saturday      Sunday


    Friday, March 8, 2019

    7:30 AM  -  8:00 AM

    Registration

    8:00 AM  -  9:00 AM

    Section 1

    Making sense out of the many HRT studies, the critiques, and the rebuttals. 

    A commentary as to why estrogen is not harmful in most circumstances.

    A critique of the WHI trial and a meta-analysis demonstrating opposite conclusions of the WHI.  Putting the pieces together will make you an expert on all ifs, ands, or buts.  It is the knowledge and command of this scientific literature (that your colleagues will never know) that makes you the expert.  Estrogen replacement is so very complex and a full understanding of all the studies and data is necessary to prescribe and defend HRT.  Having a command of the literature will enable you to explain when estrogen is indicated, which one, and why, the safety of estradiol and potential harm of CEE, the harm of not utilizing estrogen and estrogen depravation, and the harm of assuming and extrapolating the harm of CEE to E2.

    Speaker: Dr. Neal Rouzier 

    9:00 AM  -  10:00 AM

    Section 2

    Bio-identical HRT:  A review of all the evidence both for and against BHRT with the positives and negatives (E2 vs. E3).  And which natural estrogen is worthless and which one is very protective as per EBM.  Let the literature and science guide us as to which one to use, and how much, and which one should be avoided.  We will disprove the concept that estriol is the safe estrogen.  E3 does not protect against breast cancer or any other estrogen related deficiency. We’ll prove that E2 is the safe and most beneficial estrogen.  Do not make unsubstantiated claims about E3.

     

    Speaker: Dr. Neal Rouzier

    10:00 AM  -  10:15 AM

    BREAK

    10:15 AM  -  12:15 PM

    Section 3

    Review the hormone paradox and the myths and controversies of the oncogenic effects of hormones as to whether they are causative or protective against cancer.  A literature review of HGH & testosterone in men will show benefits of protecting against cancer as opposed to the incorrect common opinion of testosterone causing cancer.  As for women, estrogen and progesterone are also accused of causing cancer in spite of the literature support for the contrary.  Studies will be reviewed that evaluate whether they cause cancer or protect against cancer and how optimization protects against cancer. Well review all the literature that proves MPA ≠ OMP. Finally, testosterone is second to progesterone in protecting against breast cancer.  Can estrogen be safely used in cancer survivors?   Over 40 studies prove it can and should be used.  Not replacing hormones increases morbidity and mortality which proves the oncologic world doesn’t know their own literature. What level of progesterone is best for breast cancer protection and what level of testosterone is most appropriate?  All hormones have been demonstrated to protect against cancer and it is the loss of hormones that increases that risk.  Only one hormone increases cancer risk and that is a drug and not a hormone.  It is amazing what medical experts do not know or understand about hormones and will make incorrect assumptions to avoid HRT whereas doing so increases morbidity and mortality.  They cause harm by not utilizing HRT but they don’t understand that they don’t know.

     

    Speaker: Dr. Neal Rouzier

    12:15 PM  -  1:15 PM

    LUNCH

    1:15 PM  -  2:15 PM

    Copy of Section 3

    Review the hormone paradox and the myths and controversies of the oncogenic effects of hormones as to whether they are causative or protective against cancer.  A literature review of HGH & testosterone in men will show benefits of protecting against cancer as opposed to the incorrect common opinion of testosterone causing cancer.  As for women, estrogen and progesterone are also accused of causing cancer in spite of the literature support for the contrary.  Studies will be reviewed that evaluate whether they cause cancer or protect against cancer and how optimization protects against cancer. Well review all the literature that proves MPA ≠ OMP. Finally, testosterone is second to progesterone in protecting against breast cancer.  Can estrogen be safely used in cancer survivors?   Over 40 studies prove it can and should be used.  Not replacing hormones increases morbidity and mortality which proves the oncologic world doesn’t know their own literature. What level of progesterone is best for breast cancer protection and what level of testosterone is most appropriate?  All hormones have been demonstrated to protect against cancer and it is the loss of hormones that increases that risk.  Only one hormone increases cancer risk and that is a drug and not a hormone.  It is amazing what medical experts do not know or understand about hormones and will make incorrect assumptions to avoid HRT whereas doing so increases morbidity and mortality.  They cause harm by not utilizing HRT but they don’t understand that they don’t know.

     

    Speaker: Dr. Neal Rouzier

    2:15 PM  -  3:15 PM

    Section 4

    Interesting articles and facts on HRT:  A literature review of what the experts don’t tell you about risks and benefits of HRT.  Don’t ignore the world’s literature-the WHI does not negate all prior studies.  Become conversant in all the other studies in opposition to WHI.  Don’t assume or extrapolate the harm of CEE/MPA to E2/P4. It is amazing what medical experts do not know or understand about hormones and will make incorrect assumptions to avoid HRT whereas doing so increases morbidity and mortality.  They cause harm by not utilizing HRT but they don’t realize that they truly don’t know or understand hormones.

    Speaker: Dr. Neal Rouzier

    3:15 PM  -  3:30 PM

    BREAK

    3:30 PM  -  4:30 PM

    Section 5

    Progesterone optimization: Oral vs. transdermal vs. SL.  Multiple studies prove that transdermal cream is worthless and can be harmful in suboptimal levels yet it is still the most often (incorrectly) prescribed form of progesterone.  We’ll review the harm of relying just on saliva testing for monitoring which is fraught with error.  The BHRT industry makes claim that they use hormones that protect against cancer whereas they are actually increasing the risk and incidence of uterine cancer. 

    Scientific studies prove where your levels should be for maximum protection cancer and where they should not be due to risks.  Case studies with labs show which levels are protective and which are not and we’ll see what happens with sub-optimal levels.  Further literature review demonstrates all the benefits of progesterone but only if physiologic levels are maintained.

    Speaker: Dr. Neal Rouzier 

    4:30 PM  -  5:30 PM

    Section 6

    Testosterone’s risks and benefits from JCEM and NEJM meta-analysis, new guidelines, and alternative methods of prescribing testosterone for men and women.  Learn all the alternative methods of raising testosterone levels besides transdermal creams. When to avoid transdermal, when to avoid IM, when to use HCG vs. clomiphene, and when to use oral testosterone?  Which are the cheapest, which are the best, and which ones should be avoided.  Basically everything you could possibly ever need to know about optimizing testosterone.  A literature review (EBM) will support the many alternative methods to raising testosterone.

     

    Speaker: Dr. Neal Rouzier

    Saturday, March 9, 2019

    7:30 AM  -  8:00 AM

    Registration

    8:00 AM  -  9:00 AM

    Copy of Section 6

    Testosterone’s risks and benefits from JCEM and NEJM meta-analysis, new guidelines, and alternative methods of prescribing testosterone for men and women.  Learn all the alternative methods of raising testosterone levels besides transdermal creams. When to avoid transdermal, when to avoid IM, when to use HCG vs. clomiphene, and when to use oral testosterone?  Which are the cheapest, which are the best, and which ones should be avoided.  Basically everything you could possibly ever need to know about optimizing testosterone.  A literature review (EBM) will support the many alternative methods to raising testosterone.

     

    Speaker: Dr. Neal Rouzier 

    9:00 AM  -  10:00 AM

    Section 7

    A literature review of the battle and controversy over oral vs. transdermal estrogen, which type, how, when, why, and how the ESTHER study guides us.  Knowledge is power when it comes to estrogen administration, the risks and benefits of both.  Review of HRT and clotting and how to evaluate the risk and decrease the risk.  And just what is that relative risk anyway that everyone always alludes to?  Please don’t tell me the risk of clotting-rather give me the numbers. The importance of SHBG in prescribing E2 as it pertains to CA and CAD.  Thrombophilia work-up, test panels with case examples of + labs and how patients should be treated.  Develop a treatment plan that encompasses the foregoing but that requires in-depth knowledge of the vast literature and relative risks.  Finally, OK, what to do when someone develops a clot while on HRT and has a negative work-up, or that has had a prior clot, even if provoked.  Review the harm of transdermal estradiol and the null set.

    Speaker: Dr. Neal Rouzier 

    10:00 AM  -  10:15 AM

    BREAK

    10:15 AM  -  11:15 AM

    Section 8

    Thyroid update and cardiovascular review articles of the importance of T3 optimization for cardiac disease prevention and lipid improvements.  Thyroid replacement does not cause osteoporosis- an extensive literature review.  So you think you know thyroid?  More cases, labs, and articles.  More literature support for optimizing T3 in spite of AACE recommendations to the contrary.  U.S. Pharmacopia report on desiccated thyroid. Stock up now because desiccated thyroid is going away thanks to big Pharma.

     

    Speaker: Dr. Neal Rouzier

    11:15 AM  -  12:15 PM

    Section 9
    Preventive cardiology or how to avoid CABG, stents, and MI when statins don’t work:  A literature review of hormones, toxic blood markers, prediction of CVD, and treatment without using drugs. Preferential use of hormones, niacin, RYR, EFA, supplements, life style changes, and diet to prevent CVD and how to monitor effects via the NMR panel.  The expert recommendations are to no longer monitory cholesterol levels as LDL may not predict CAD.  Then what should we monitor and what is predictive?  LDL particle number and small LDL particle numbers.  We’ll look at the cases and outcomes

    12:15 PM  -  1:15 PM

    LUNCH

    1:15 PM  -  2:15 PM

    Section 10

    Cardiology cases:  How to stop progression of the disease.  Management when statins don’t lower LDL-P and small LDL-P.  That which the cardiologists should use but don’t.  Putting all the pieces together using the best preventive strategies to avoid succumbing to that which kills 90% of us.  Use of NMR panel, LDL-P’s, apo-B, non-HDL cholesterol, cardiac markers, eicosinoids, insulin, and inflammatory cytokines.  Does lowering cholesterol by means other than statins provide the same benefits?

    Speaker: Dr. Neal Rouzier 

    2:15 PM  -  5:30 PM

    Section 11-13

    11

    Complex cases, labs, adjustments, fun and interesting cases, and lots of WWND (What Would Neal Do) cases. Lab updates that utilize the new reagents with comparisons with the old labs and reagents.  Conversion to the new reference ranges. 

     

    12

    Literature review of HRT, new and most recent that was not covered in Part I.  Everyday there is something new and this is the venue that keeps us up to date.

    13

    Case Study Questions and Answers

     

    Speaker: Dr. Neal Rouzier

    3:15 PM  -  3:30 PM

    BREAK

    5:30 PM  -  6:00 PM

    Question and Answer
    Speaker: Dr. Neal Rouzier 

    Sunday, March 10, 2019

    7:30 AM  -  8:08 AM

    Registration

    8:00 AM  -  9:00 AM

    Section 14

    Polycystic Ovary Syndrome:  Diagnosis and treatment of the most common pre-menopausal endocrinopathy that everyone fails to diagnosis.  Never miss it again because if you don’t specifically look for it, then you won’t find it.  PCOS increases risk of CAD, DM, breast cancer, & uterine cancer which further emphasizes the need for early detection and treatment.  Assume that everyone has PCOS until you prove that they don’t.  Unfortunately the most common treatments for PCOS don’t work. There is only one treatment that will work and that is the one that no one knows or appreciates.   We’ll review the before and after labs demonstrating improvement.  Quality of life and fertility relies on this one treatment.

    Speaker: Dr. Neal Rouzier 

    9:00 AM  -  10:00 AM

    Section 15

    Osteoporosis:  Diagnosis and treatment using DEXA scan and NTX urine metabolites to monitor bone loss.  Treatment of osteoporosis beyond bisphosphonates: HRT, Vitamin D, Vitamin K, strontium, ipraflavone.  Measuring and monitoring improvements in NTX- a lab review. 

    Estrogen metabolites- do they or do they not predict breast cancer and should we waste money on testing.  Lab review of 2 OH-E1 vs. 16α OH-E1.  DIM? Do you really need it and does it really work?  I didn’t know that estradiol caused cancer?  A look at EBM and studies from JNCI that refute confabulation.
    Speaker: Dr. Neal Rouzier 

    10:00 AM  -  10:15 AM

    BREAK

    10:15 AM  -  11:15 AM

    Section 16

    Estrogen and Progesterone in men:  What the literature supports in so far as harmful effects of low vs. high levels.  Use of aromatase inhibitors in men or how to increase the risk of CAD, CVD, dementia, osteoporosis, and ED by blocking estrogen.  The harm of prescribing progesterone in men unless you want to increase the risk of MI or ED and inflammation.  Use EBM to guide your therapy, not what someone theorizes.

     

    Speaker: Dr. Neal Rouzier 

    11:15 AM  -  12:15 PM

    Section 17
    Speaker: Dr. Neal Rouzier 

    12:15 PM  -  12:15 PM

    ADJOURN

    SPEAKERS:

    download (1).png

    Neal Rouzier

    Dr. Neal Rouzier is a pioneer in the bio identical hormone replacement field, practicing almost since its inception in the early 1990’s. He has dedicated his life’s work to uncovering the medical literature that supports safe and effective protocols for unique and personalized patient care. He is the Director of the Preventive Medicine Clinics of the Desert, specializing in the medical management of aging and preventive care for men and women. He has treated more than 2,000 patients with natural hormone replacement therapy and is recognized as a renowned leader and expert in the field. Additionally, Dr. Rouzier is the author of Natural Hormone Replacement for Men and Women: How to Achieve Healthy Aging. He has over 16 years of experience as an educator and practicing physician, and 29 years of Emergency Medicine experience at Queen of the Valley Hospital in West Covina, CA.

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    REGISTRATION:


          EARLY BIRD PRICE    

     VALID NOW THRU:  FEBRUARY 8, 2019  

       REGULAR PRICE   

     EFFECTIVE:  FEBRUARY 8, 2019 

    Medical Providers and Pharmacists

    $1,195.00 

    $1,295.00




    Support Staff and Part II Graduates

    $675.00 

    $675.00

    (MA, RN, Office Manager)




    *Cancellation Policy

    If cancellation is received more than 3 weeks in advance a full credit can be applied to your account for future use. If less than 3 weeks a $350.00 cancellation fee applies and the balance will be applied as a credit to a future event.

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    ACCREDITATION:


    AMA PRA Category 1 Statement

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Foundation for Care Management (FCM) and Worldlink Medical. The Foundation for Care Management is accredited by the ACCME to provide continuing medical education for physicians.

    FCM designates this educational activity for a maximum of 20 AMA PRA Category 1 CreditsTM. 

    Physicians should only claim credit commensurate with the extent of their participation in this activity.

    The ACCME defines a “Commercial Interest” as any entity producing, marketing, re-selling, or distributing health care goods or services  consumed by, or used on, patients.

     Nursing Statement

    The Foundation for Care Management is an approved provider of continuing nursing education by the Western Multi-State Division (WMSD), Approver of Continuing Nursing Education an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.  20 Nursing contact hour(s).

     Pharmacy Statement

    The Foundation for Care Management is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Program # 0347-9999-18-003-L01-P Objectives appropriate for pharmacists. This activity is 20 Contact Hours Pharmacy Credit.  *This CME is Knowledge Based (K). Initial release May 4, 2018

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    HOTEL AND TRAVEL:




    Hilton Salt Lake City Center

    255 South West Temple
    Salt Lake City, UT 84101

    801-238-4889

    Block Room Rate is $179.00 and the block expires on Thursday, February 14, 2019 or when the block is sold out whichever comes first

    Click Here to make your hotel room reservation 


    NOTE:  The room block is now full.  Due to a city wide event availability on Thursday night is very tight at many downtown hotels.  We recommend staying at the airport on Thursday night and then booking at the Hilton for Friday and Saturday.


    Airport recommendation:

    Hilton Garden Inn Salt Lake City Airport

    The Hilton Garden Inn does provide shuttle service from the airport

    Click Here to make a reservation at the Hilton Garden Inn


    Book direct for Hilton Salt Lake City Center, room block is sold out

    Book Direct Salt Lake City Center (Hilton)


    For additional help with your room reservations please contact Sage Holman at 801-294-1486 or sholman@worldlinkmedical.com

    Nearest Airport - Salt Lake International (SLC)

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    LOCATION:

    Hilton Salt Lake City Center
    255 South West Temple
    Salt Lake City, UT 84101

    801-238-4889

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