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BHRT Series – Part III


October 26th - 28th, 2018

Hyatt Regency St. Louis at the Arch
315 Chestnut St.
St. Louis, MO, 63102

Course Description:

The educational process for Part III is both didactic and interactive with maximum audience participation. All of the most complex, interesting, and confusing cases experienced by Dr.Rouzier over the last ten years are presented. The participants decide on the corrective management with literature reviews to guide therapy. Be forewarned, as in the past, many concepts taught in other academies are contrary to the medical literature presented in this course. The attendee will decide therapy based on evidence based guidelines rather than public opinion. Although there are no medical boards for this type of practice, Part III is similar to a medical board that digs deeper into the complexities of age management medicine. Clinical cases will be analyzed to formulate appropriate treatments and management to improve the understanding and level of care provided to patients. In Parts I & II the cases and studies are simple and straightforward.

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Course Details     Course Objectives     Agenda     Speakers     Hotel and Travel     Registration Fees     Accreditation    Contact Us     Location

Course Details  


Part III: Mastering the Protocols for Optimization of Hormone Replacement Therapy - Complex Cases - October 2018

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.

Pre-Course Test

In our efforts towards continuous improvement for our course curriculum, the Foundation for Care Management has requested that all attendees take a pre-test.  Visit the FCM website to take the pre-test: FCM Pre-Test

The course code is :  BHRT35418P1Y

Notification will be sent out after the course with links to complete the post-test and survey.  These must be completed to claim your credit.  Your certificate will be available to print online once the survey has been completed.

Breakfast 

We will not be providing breakfast however the hotel serves breakfast at the Urban Star Restaurant and Grab and Go items are available a the Urban Star Market / Starbucks on the lobby level 

Registration 

Friday, Sat. and Sunday

7:00 - 8:00 a.m. (Meeting Start-Time is 8:00 a.m.)

Meeting Room is Regency Ballroom AB (2nd Level)

Buffet Luncheon Friday and Saturday

12:00 - 1:00 pm

Regency Ballroom CD (2nd Level)

Friday Luncheon - Guest Speaker, Mike Clark

Saturday Luncheon - Networking Lunch

Evening Activities

Join us for appetizers and drinks at the Urban Bar on the lobby level directly following the end of lectures on Saturday evening (about 6:30 pm)  On your own for drinks, appetizers courtesy of MedQuest Pharmacy



    Course Objectives


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

    Objectives: Upon completion of this workshop the health care professional will be able to:

    • Become proficient in newer age management protocols not presented in Parts I or II: more recent pertinent literature update and reviews, lab updates, and complex and interesting cases.

    • Discuss the most current literature for bio-identical hormone replacement therapy (BHRT), thyroid, testosterone, DHEA, estrogen and progesterone.

    • Determine the risks and benefits of transdermal estrogen vs. oral estrogen, why one vs. the other one, and review the statistics that claim HRT increases blood clots, or does it?

    • Discuss new research demonstrating estrogen’s protective effects in men, the lack of any harm, and the harm of suppressing estrogen in men.

    • Examine current policy statements for hormone replacement therapy by the North American Menopause Society (NAMS) and American College of Obstetricians and Gynecologists (ACOG), with a critique and review of their recommendations.

    • Describe rational approaches for the use of progesterone in treating PMS and PPD.

    • Discuss new therapies for prostate cancer as well as better diagnostic sensitivity and specificity of MRI-S scan.

    • Determine current management strategies for preventing loss of pregnancy in Polycystic Ovary Syndrome (PCOS) as well as improving pregnancy rates with aromatase inhibitors.

    • Describe the clinical evaluation including laboratory analysis and treatment of Vitamin D deficiency and how much is too much.

    • Examine literature reviews as to what level of Vitamin D protects against cancer, CAD, osteoporosis, dementia, type II DM and AMD.

    • Discuss the pathophysiology of vaginal atrophy and the use of rings, tabs, troches, creams, and DHEA. • Discuss the importance of sex hormone binding globulin (SHBG) in men and women and why it is most predictive of CAD, MS and cancer.

    • Describe the data demonstrating that androgen suppression therapy, as well as estrogen deprivation, is associated with poor survival in men in comparison with placebo.

    • Outline advanced treatment protocols for over 100 clinical cases based on clinical presentation, laboratory analysis, treatment, and complications in the Q & A sections.

    • Discuss the inverse relationship of estrogen and prostate cancer. • Develop an understanding and treatment rationale for prostate cancer survivors through case presentations and literature review.

    • Appreciate the lack of efficacy of estriol in spite of purported benefits.

    • Describe the difference in clotting between Premarin®, Provera®, esterified estradiol, and micronized progesterone as per JAMA.

    • Examine data proving that oral progesterone decreases clotting risk and inflammation as opposed to MPA that increases these risks as per the ESTHER trial.

    • Appreciate the data demonstrating that only certain types of estrogen increase the production of fatty acid esters that result in protection against atherosclerosis and plaque deposition at the blood vessel wall.

    • Demonstrate an understanding of the importance of maintaining low levels of aldosterone in patients with PCOS.

    • Demonstrate an understanding of the importance of body weight in determining which type of HRT to prescribe. • Critique the data demonstrating that testosterone can both increase and decrease CVD in women and learn to decipher the correct approach.

    • Identify the two mechanisms by which estrogen treats and protects against prostate cancer.

    • Review treatment of endometrial proliferation with serial ultrasound results and laboratory monitoring.

    • Illustrate a historical perspective on progesterone presenting no risk of breast cancer or VTE.

    • Present over 200 complex case studies to compare, contrast and analyze treatment protocols.

    • Demonstrate skills in case studies with interactive discussion to ensure interpretation and treatment protocols are as demonstrated in our evidenced based scientific literature.

    • Examine the medical literature to understand how hormones affect cardiovascular disease for both men and women.

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    Agenda - Friday     Saturday      Sunday


    Friday, October 26th, 2018


    • 7:30 AM  -  8:00 AM

      Registration

      8:00 AM  -  9:00 AM

      Section A

      • Vitamin D: Recent relevant literature review of a most important hormone. Everything that you could possibly want to know about vitamin D.

      • Vitamin D3: Diagnosing, prescribing, monitoring, adjusting, and optimizing.

      • How much is too much or not enough? Experts disagree on what is optimal.

      • How much is toxic per the literature, and what are the symptoms of toxicity?

      • Dosing based on serum levels, NTX, and DEXA results.

      • Lab review of baseline levels and treatment endpoints.

      Speakers:

      9:00 AM  -  10:00 AM

      Section B

      • Diagnosis of PCOS vs. adrenal hyperplasia (21-hydroxylase deficiency) and use of 17α-hydroxyprogesterone to make the diagnosis.

      • What the books don’t tell you about complex cases of PCOS.

      • PCOS- adverse outcomes and prevention of CAD and cancer.

      • Weight loss in PCOS through administration of metformin and thyroid per the literature.

      • NAFLD, endothelial dysfunction, aldosterone, & aromatase inhibitors in treating PCOS.

      • Focus on the vagina and the various methods to treat and protect against urogenital atrophy.

      • Systemic vs. non-systemic absorption of vaginal estrogen.

      • Perimenopause = No Man’s Land! Treatment options.

      • Doctor, I’m bleeding!!! What to do? Simply follow the protocol.

      • A lab review with treatment guidelines for perimenopause.

      • Functional hypothyroidism and receptor site resistance.

      • Thyroid does not cause osteoporosis

      • Thyroid in the treatment of heart disease and dyslipidemia.

      Speakers:

      10:00 AM  -  10:15 AM

      BREAK

      10:15 AM  -  12:15 PM

      Section 1
      50 Case Studies with Question and Answer
      Speakers:

      12:15 PM  -  1:15 PM

      LUNCH

      1:15 PM  -  2:15 PM

      Section C

      • The unifying hypothesis of estrogen’s effects on atherosclerosis progression, complications, and plaque vulnerability.

      • MMP, clotting factors, inflammatory proteins, and estradiol fatty acid esters in CAD.

      • Loss of estrogen associated with increased mortality and dementia.

      • The difference in early, mid, and late estrogen replacement.

      • The pharmaceutical-company push to block estrogen and the resultant harm of estrogen deprivation- “A Time For Reflection of Aromatase Inhibitors” from Menopause.

      • Going against the ACOG guidelines in order to save lives-the literature proves them wrong. All hormones are not the same, so don’t ignore this information.

      • The documented benefits of estrogen and the morbidity of loss of estrogen that is ignored.

      • A literature review to make sense of the misunderstanding for HRT. Mastering the literature will make you the expert amongst your peers that don’t understand HRT.

      Speakers:

      2:15 PM  -  4:00 PM

      Section 2
      50 Case Studies with Question and Answer
      Speakers:

      4:00 PM  -  4:15 PM

      BREAK

      4:15 PM  -  5:00 PM

      Section D

      • A historical perspective to determine why everyone preaches only transdermal estrogen.

      • A literature review proving transdermal estrogen is the safest estrogen.

      • A literature review proving oral estrogen is the best for saving lives.

      • Natural progesterone confers no risk of breast cancer or VTE.

      • What about JAMA, EPAT, CORA, WEST, KEEPS, & DANISH trials of oral E2? Why the NIH uses oral E2 and not transdermal.

      • Understanding relative risks as your guide for HRT replacement.

      • The anti-proliferative, oncostatic, immune stimulatory, and thrombopoetic effects of HRT.

      • What you should know about the literature before you speak out!

      Speakers:

      5:00 PM  -  6:45 PM

      Section 3
      50 Case Studies with Question and Answer
      Speakers:

    Saturday, October 27th, 2018 - back to agenda


    • 7:30 AM  -  8:00 AM

      Registration

      8:00 AM  -  9:00 AM

      Section E

      • Importance of optimizing androgens in women for health and well-being.

      • Measurement of FAI and implications.

      • Does testosterone causes diabetes and breast cancer in women as per the literature?

      • SHBG drives the benefit of HRT and is the most important biological marker to predict CAD, MS, and cancer.

      • A literature review showing it’s not the testosterone but rather insulin resistance that is the culprit.

      • Association does not prove causation.

      • SHBG: The most important biological marker to predict DM, CAD, and breast cancer in both men and women.

      • It’s not testosterone’s fault but rather the SHBG, or lack thereof that is to blame.

      • How and why to safely and successfully raise SHBG?

      Speakers:

      9:00 AM  -  11:00 AM

      Section 4
      50 Case Studies with Question and Answer
      Speakers:

      11:00 AM  -  11:15 AM

      BREAK

      11:15 AM  -  12:15 PM

      Section F

      • Testosterone, SHBG, and diabetes in men.

      • Testosterone protects against IR→DM→CAD→MS→Cancer

      • Low SHBG predicts all-cause mortality, CAD, osteoporosis, and cancer in men. • Prostate cancer prevention by SHBG and testosterone?

      • The harm of ADT and how to reverse the complications of ADT.

      • Testosterone deprivation without estrogen deprivation. • Lab review of testosterone.

      • Sex hormones in men. A literature review demonstrating optimal levels of estrogen and testosterone are necessary for men’s health.

      • The harm of blocking estrogen with aromatase inhibitors.

      • The benefit of prescribing estrogen in men.

      Speakers:

      12:00 PM  -  1:00 PM

      LUNCH

      1:00 PM  -  3:00 PM

      Section 5
      50 Case Studies with Question and Answer
      Speakers:

      3:00 PM  -  3:15 PM

      BREAK

      3:15 PM  -  4:15 PM

      Section G

      • Safety and efficacy of testosterone in prostate cancer survivors.

      • Incidence of prostate cancer and whether we should be treating men with testosterone.

      • Why testosterone has become incorrectly and inappropriately associated with prostate cancer.

      • All studies refute the prevailing wisdom that testosterone causes prostate cancer.

      • The lower the testosterone, the greater the risk of cancer = a paradigm shift.

      • Does or will testosterone protect against prostate cancer?

      • Dispelling the myths that testosterone and DHT cause prostate cancer. Proving Huggins wrong.

      • Peer literature review providing assurance and safety for prescribing testosterone in prostate cancer survivors. • Surgery vs. radiation vs. HIFU vs. cryotherapy vs. laser ablation for prostate cancer.

      Speakers:

      4:15 PM  -  6:15 PM

      Section 6
      50 Case Studies with Q and A
      Speakers:

    Sunday, October 28th, 2018 - back to agenda

    •  

      7:30 AM  -  8:00 AM

      Registration

      8:00 AM  -  9:00 AM

      Section H

      • Proof, or lack thereof, that estrogen causes prostate cancer, or at least it does in rats.

      • Epidemiologic review of sex hormones and cancer.

      • The higher the estradiol, the lower the risk of cancer.

      • Collaborative analysis of 18 prospective studies of hormones and cancer.

      • ADT increases mortality in men with prostate cancer.

      • How to prevent the increased morbidity & mortality, CAD, and side effects of ADT.

      • Estrogen’s vasculoprotective effects in men.

      • It’s low estrogen that causes osteoporosis, not low testosterone.

      • Treatment and prevention of prostate cancer with estrogen.

      • Treatment of prevention of cardiovascular disease with estrogen.

      • Reversal of ADT side effects with estrogen.

      • Estrogen possesses both anti-angiogenic and pro-apoptotic effects not seen with LHRH- agonists.

      • The harm of estrogen blockers in men = same harmful effects as estrogen deprivation in women but these are in men.

      Speakers:

      9:00 AM  -  10:00 AM

      Section 7
      Speakers:

      10:00 AM  -  10:15 AM

      BREAK

      10:15 AM  -  11:00 AM

      Sections I and J

      • Postmenopausal HRT in clinical perspective with other standard treatments- a complex literature review of risk vs. benefit in comparison with other standard, commonly used medications.

      • The harm of statins and ASA versus the benefit of HRT: What are we thinking?

      • Use the scientific literature to guide our therapy.

       • Oral P4 reduces serum levels of estradiol whereas transmucosal does not.

      • Oral P4 reduces weight, transmucosal does not.

       

      • Functional hypothyroidism and receptor site resistance vs. resistance from mainstream medicine.

      • Thyroid update, thyroid resistance, osteoporosis and cardiovascular disease.

      • Progesterone in treatment of PMS, perimenopause, and post-partum depression.

      • Treating and monitoring of endometrial proliferation.

      • 5α-reductase inhibitors, depression, and sexual dysfunction.

      • Progesterone’s role in inflammation, cytokines, and promoting prostate cancer development = the opposite of what you have been misled to believe.

      Speakers:

      11:15 AM  -  12:15 PM

      Sections 8,9,10 and Section K: HRT pearls, tricks, important points to know about HT
      Complex Cases with Q and A Section K: Complex Lab Review. Strange and unusual cases and labs that make no sense
      Speakers:

      12:00 PM  -  12:00 PM

      ADJOURN



































































    Speakers


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    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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    Hotel and Travel




    Hyatt Regency St. Louis at the Arch

    Hyatt Regency St. Louis at the Arch

    315 Chestnut St.

    St. Louis, MO  63102

    Phone 314-655-1234 Group is under Worldlink Medical

    Room Block Rate $169.00  Room Block Rate expires October 5, 2018.

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    Nearest Airport is Lambert St. Louis International Airport.

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    Registration Fees


    Initial Enrollment - $1,295.00

    Discounted Price - $1,195.00 
    *If Registered By Friday, September 28, 2018

    Part II Graduate - $675.00

    Staff Member (MA, RN, Office Mgr) - $675.00

    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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    Contact Us




    Location


    Hyatt Regency St. Louis at the Arch

    315 Chestnut St.
    St. Louis, MO,  63102

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