Part III in the BHRT Workshop Series
SOLVE TROUBLING SYMPTOMS
Mastering The Protocols for Optimization of Hormone Therapy
Details
Course Description
Prerequisites:
The educational process for BHRT education workshop in Part III is both didactic and interactive, with workshop sections devoted to Q and A. Some of the exciting topics to be discussed include:
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- Vitamin D – Its function as a prohormone, best form and ideal levels, how to prescribe, monitor, and adjust.
- Part “B” – PCOS “atypical” presentations of PCOS and how to diagnose. Alternative insulin sensitizers for PCOS patients. PCOS and thyroid (T3 deficiency) dysfunction connection. PCOS and Nonalcoholic fatty liver disease connection.
- Treating Vaginal atrophy
- Perimenopausal transition & early menopause
- Prophylaxis of postpartum depression with progesterone
- Aromatase inhibitors and cognitive decline
- Male insulin resistance issues (corresponds to PCOS) – effects on SHBG, prostate cancer risk; diagnosis and treatment.
- Deep dive into prostate cancer (Understanding PSA and free PSA, harm of ADT, and new research on alternatives to treating prostate cancer.
Only the most interesting, complex, and convoluted cases that Dr. Neal Rouzier has experienced over the last ten years will be presented. Many concepts taught in other academies are contrary to the medical literature presented in this workshop, but this is only because the attendee will decide therapy based on evidence-based guidelines rather than public opinion or popularity.
Clinical cases will be analyzed to decide upon the appropriate treatments and level of care provided to patients. In BHRT Parts I & II, the cases and studies are simple and straightforward. However, a thorough understanding of BHRT Parts I and II are necessary to understand many of the more complex cases presented in the BHRT Part III.
Extensive literature summaries that provide credence and support are presented so that providers have all the available data to defend their practice if necessary. There are many examples of studies that justify BHRT. For example, one study showed that standard statin treatments for cholesterol caused more cancer occurrence than PremPro®. Progesterone causes decreased absorption of estrogen, yet it can be anticipated and prevented. Each of these controversial topics and more will be thoroughly addressed.
Access: This workshop is offered in-person and/or virtually. You can choose if you would like to be shipped printed educational materials. We will also post a recording for each day that same evening. The recording will be available until Thursday of the week after the event to re-watch or catch up on anything you may have missed, but it will not be available after this time.
Accreditation: 20 AMA PRA Category 1 Credits | 20 Nursing Contact Hours (20 pharmacologic hours) | 20 Hours Pharmacy Credit (knowledge based)
Course Objectives
Upon completion of this workshop the health care professional will be able to:
- Identify CFS/Fibromyalgia in addition to, diagnosing, testing, and treating it to improve patient outcomes.
- Describe the data demonstrating that androgen suppression therapy, as well as estrogen deprivation, is associated with poor survival in men in comparison with placebo.
- Identify the inverse relationship between estrogen and prostate cancer and the two mechanisms by which estrogen treats and protects against prostate cancer.
- Examine literature reviews as to what level of Vitamin D helps protect against cancer, CAD, osteoporosis, dementia, type II DM and AMD as well as how to treat Vitamin D deficiency and how much is too much
- Determine current management strategies for preventing loss of pregnancy in Polycystic Ovary Syndrome (PCOS) as well as improving pregnancy rates with aromatase inhibitors and the importance of maintaining low levels of aldosterone with PCOS.
- Discuss the pathophysiology of vaginal atrophy and the use of rings, tabs, troches, creams, and DHEA.
- 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?
- Describe how thyroid replacement therapy does not cause osteoporosis and how it can be protective against heart disease and dyslipidemia.
- Recognize 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.
- 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.
- Discuss the most current literature for bio-identical hormone replacement therapy (BHRT), thyroid, testosterone, DHEA, estrogen, and progesterone.
- Describe the difference in clotting between Premarin®, Provera®, esterified estradiol, and micronized progesterone as per JAMA.
- Discuss the importance of sex hormone binding globulin (SHBG) in men and women and why it is predictive of CAD, MS and cancer.
- Examine the medical literature to understand how hormones affect cardiovascular disease for both men and women and how Testosterone can both increase and decrease CVD in women by interpreting the correct approach.
- Discuss new therapies for prostate cancer as well as better diagnostic sensitivity and specificity of MRI-S scan in addition to treatment rationale for prostate cancer survivors through case presentations and literature review.
- Recall how estrogen therapy can be beneficial in the treatment of prostate cancer and reversing the side effects of ADT.
- Demonstrate skills in multiple case studies with interactive discussion to ensure interpretation and treatment protocols are as demonstrated in our evidenced based scientific literature.
- Describe rational approaches for the use of progesterone in treating PMS and PPD.
- In addition to the clinical skills learned in this course group discussions contribute to the collaborative nature of pharmacists working with physicians and nurse practitioners and their patients to determine a personalized approach to prescribing HT. This collaborative provides a continuum of care for patients in ensuring improved patient outcomes and consistency in care.
Speakers
Neal Rouzier, MD
Faculty Chairman
Neal Rouzier, MD
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.
Agenda
Friday
7:00 – 8:00 AM – Registration
7:30 Live Stream opens
8:00 AM – 12:00 PM
5-10 minute break at the top of every hour
Section A – Chronic Fatigue Syndrome / Fibromyalgia
- Review of the chronic fatigue syndrome: Treatment by optimizing T3.
- The use of cortisol for symptomatic relief of CFS:
- A literature review. Cortisol: Prescribing, monitoring, adjusting, and use of ACTH stimulation test.
- Addison’s disease vs. adrenal insufficiency vs. adrenal suppression and the use of ACTH stimulation test for diagnosis and tapering.
- Just what is adrenal fatigue and how to diagnosis via saliva testing even when the serum cortisol level is normal?
Section B – Progesterone in Men
- 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.
Section C – Vitamin D
- 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
12:00 PM – 1:00 PM Lunch Break
1:00 PM – 6:00 PM
Section D – Advanced PCOS and Vaginal Atrophy
- 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
Section E – Understanding Estrogen Complexity
- 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
Section F – The harm of oral E2, the harm of not using oral E2 – Understanding the relative risk numbers and complexity of estrogen/estradiol/CEE
- 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
6:00 PM – Adjourn
Saturday
8:00 AM – 12:00 PM
Section G – Harm and Benefit of Testosterone and SHBG in Women
- 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
Section H – Treatment and Prevention of Insulin Resistance in Men: Insulin Resistance and Prostate CAncer
- 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
12:00 PM – 1:00 PM – Lunch Break
1:00 PM – 6:00 PM
Section I – The Saturation Theory – Testosterone Treatment of Prostate Cancer Survivors
- 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
Section J – Estrogen and Prostate Cancer
- 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
6:00 PM – Adjourn
Sunday
8:00 AM – 12:00 PM
Section K – Relative Risk of BHRT in Contrast to SHRT
- 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
Section L – A Potpourri for Review
- 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
Section M: – Complex Lab Review. Strange and unusual cases and labs that make no sense
12:00 pm – Adjourn
ACCREDITATION STATEMENTS
In support of improving patient care, this activity has been planned and implemented by The Foundation for Care Management (FCM) and Worldlink Medical. FCM is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team
20 AMA PRA Category 1 for CME
20 Nursing Contact Hours
20 Contact hours Pharmacy Credit. Program # XXXX-XXXX-XXX-XXX-X
This activity was planned by and for the healthcare team, and learners will receive (20 hours) Interprofessional Continuing Education (IPCE) credit for learning and change.
Location & Travel Details
Travel Details
Airport
Salt Lake City International Airport (SLC)
Address
Le Méridien Salt Lake City Downtown
131 South 300 West
Salt Lake City, Utah, USA, 84101
Info
Refund / Cancellations / Bulk Discounts / Course Credit
Early bird discount ($100.00 savings) is available up until 3 weeks prior to the event. This discount does not need a code but is applied automatically.
Up to 3 weeks prior to the course start date the cancellation fee is $100.00. If a cancellation is requested less than 3 weeks in advance the cancellation fee is $350.00. If a cancellation is received one week prior there are no refunds allowed.
To cancel a registration, a credit can be held on file without penalty so long as the cancellation is received more than 2 weeks in advance of the start date. This credit will be applied automatically to your next registration before a credit card is charged.
If two or more prescribers register as a group under one registration ticket there will be a 10% discount applied to each registration after the first one.