2 DAYS COURSE
PRACTICAL
&
CLINICAL
ANTI-AGING
WORKSHOP
PROF. DR. PAUL LING TAI
D.P.M., FACFS, ABPS, ABBARM, DACBN
PARAGUAY
JULY 5 – 6, 2012
Prof. Dr. Paul Ling Tai
D.P.M., FACFS, ABPS. ABAARM, DACBN
Ankle & Foot Surgeon, Orthopedic Podiatric Surgical Reconstructive Team, Surgery Department
Annapolis-Oakwood Hospital, Detroit, Michigan
Professor of Anti Aging Regenerative Medicine, University of Paulista (UNIP), Sao Paulo, Brazil
Coordinator & Professor of Anti-Aging & Endocrinology
Pos Graduaco - Laco Sensu Universidate De Gama FKHO School of medicine Rio De Janero, Brasil
Chief of Surgical Residency - Board of Licensy of Pediatric Medicine & Surgery. State of Michigan
Professor of Integrative Medicine. NYCPM, New York, New York
Professor of Anti Aging Master Degree, Pontifical Univ. Catholic, Belo
Horizonte, Minas Gerais, Brazil
Co-Coordinator Master of Science in Public Health, Anti Aging/Regenerative Medicine. Approved Post
Graduates Studies by the Ministry of Education, Sao Paulo, Brazil
Official Latin American Delegate and Coordinator for the World Anti Aging Academy of Medicine
(WAAAM)
Founder and Coordinator of A4M Brazil Society and Medical Congress.
Personal Representative for Latin America to Dr. Robert Goldman, MD, PhD, DO, FAASP- Chairman of
A4M,
Past Adjunct Professor of Surgery. OCPM, Cleveland, Ohio
Vice Chairman & Chief Examiner of State of Michigan
Faculty member, lecturer, workshop, author
American Academy of Anti Aging Medicine (A4M)
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Dr. Tai doing surgery
at Oakwood Hospital
Medical Board Certification
Fellow – American College of Foot & Ankle Surgeons - FOTO
Diplomate – American Board of Podiatric Surgeons - FOTO
Diplomate - American Academy of Anti Aging Board (ABAARM): Oral Exam
and Written Exam (A4M) - FOTO
The Grand Physician General – The Supreme Council of the Sovereign
Medical Order of Knights Hospitaller
Professor, Dean of Endocrinology Dept. University of Natural Medicine,
Quito, Ecuador.
Member - Royal College of Papal Knights in Americas. Granted by Vatican
H.H. Pope Benedict XVI, signed by Vatican Secretary of State Cardinal
Bertone.
Chairman & President, A4M Brazil (American Academy of Anti Aging
Medicine-Brazil)
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Prof. Dr. Paul Ling Tai
D.P.M., FACFS, ABPS. ABAARM, DACBN
• Prof. Dr. Tai is a Knighted physician
• Helped thousands of patients and consulted
countless doctors on difficult cases all over the
world, earning him the title of the “Doctor’s
doctor” and “Doctor of last resort”.
• Member of the Royal College of Papal Knights in
Americas. Vatican, His Holiness H.H. Pope
BENEDICT XVI.
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Prof. Dr. Paul Ling Tai
D.P.M., FACFS, ABPS. ABAARM, DACBN
Author
Book Publication: Cordyceps Miracles, 2005
Book Publication: 8 Powerful Secrets to Anti Aging, 2007
Newsletter: Healthy Lifestyle, 2008
Medical Journal: The Bariatrician, 2008
Book Publication: Fabulously Beautiful You! 2009
Book Publication: Thin Factor, 2010
Medical Textbook: Non-Invasive Plastic Surgery
and Anti-aging 2010
DVD: Complete Courses, Weight Loss technology for Aging
Advanced Courses of Anti-Aging
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Saliva Hormone Testing
 Evaluate a pooled saliva sample from multiple
collections
 Possible to get reliable assessment
of hormone concentration in
diurnal fluctuations
 Hormone assessment from
saliva allows
 Specific direct determination of
biologically active of “free”
fraction of hormone
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Saliva
 Saliva is NOT an appropriate matrix for
conjugated steroids
 Estrone-sulfate
 DHEA-sulfate
 Affected by flow rate
 Saliva also not appropriate for thyroid
 Presence of T4 in saliva results from blood
contamination
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Physiology of Salivary Glands
More than one mechanism exists for blood
components to pass the membrane barrier into
the salivary ducts
 Passing through the space between the acinar
cells (tight junctions)
 Only molecules with a relatively small molecular
weight (MW<1900) may pass through




MW Hormones ca. 300
MW albumin = 66,000
MW CBG = 46,500
MW SHBG = 115,000
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Saliva Collection
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Saliva Hormone Blood Contaminations
As blood contains about 50 times higher concentrations
of hormones, special attention should be given to avoid
blood contamination
0
0,01
0,019
0,038
0,075
0,156
0,312
0,625
1,25
2,5 %
The rejection point of blood contamination is
when it is visible to the naked eye at 0.156%
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The Saliva Collection Container
 Saliva hormones are small non-polar molecules which tend
to stick to plastic material
 Polyethylene is highly absorptive for Progesterone
 Highly non-polar
 Glass seems to be completely absorption-free
 Stoppers made of polyethylene are highly absorptive
 The best plastic material seems to be Ultra-Pure
Polypropylene, not recycled plastic
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Human
Growth
Hormone
New England Journal of Medicine,
October 1999; 341: 1206-1216.
 HGH




Restores normal body composition
Improves muscle tone
Normalizes serum lipid concentrations
Improves quality of life
 Energy level, mood & emotions
 After six months of treatment
 Metabolism increased by six percent to 11%
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Growth Hormone Benefits
 Better muscle tone
 Loss of excess fat
 Improved skin
elasticity & thickness
 Stronger bones
 Improved immune
system
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Growth Hormone Benefits
 Improved energy & anti-fatigue, vitality
 Increased creativity, positive outlook
 Improved memory,
thinking, mental clarity
 Greater social friendliness
 Positive & self confident
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Psychic











Excessive emotions (72.9%)
Sharp verbal retorts (64.6%)
Permanent fatigue (72.9%)
Easily exhausted after physical activity (89.6%)
Low resistance to staying up after midnight (83.3%)
Anxiety (70.8%)
Insufficient aggressiveness (54.2%)
Sense of powerlessness (75%)
Depression (60.4%)
Low self-esteem (50%)
Low sociability (tendency for social isolation) (45%)
 As reported by 48 adults (aged 27 – 82 years) with low plasma IGF-1
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Abdominal Scan
 GH deficiency
 Excess abdominal visceral
fat
 GH treatment
 Marked fat reduction
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Frequency of Psychic Complaints Before &
After GH Treatment in Adult Patients
Before Treatment
100
90
80
70
60
50
40
30
20
10
0
89
After GH Treatment
83
73
60
10
Permanent
Fatigue
12
Easily
Exhausted
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54
11
Low
Depression
Resistance to
Stying Up
After Midnight
50
14
Insufficient
Agressiveness
10
Low SelfEsteem
25
Supplementation of Strontium
 n = 1489
 Strontium ranelate 2 g/d
 Reduced risk
Vertebral fracture – 31%
Non-vertebral fracture – 27%
Major non-vertebral fractures – 33%
Hip fracture – 24%
Seeman E, et al. Five years treatment with strontium ranelate reduces
vertebral and non-vertebral fractures and increases the number and
quality of life-years remaining in women over 80 years of age. Bone.
2010 Apr, 46(4): 1038-42. Epub 2009 Dec 21. PMID: 20026265
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Glucose Supplementation
Cynannon MHCP 5%, Fulvic/Humate, Quercetin, Alpha Lipoic
Acid, Corosolic Acid, Pancreatic Ext., Chromium Polynicotinate
One capsule three times a day with meals, or more, as needed
 Corosolic acid & MHCP
 Improve the insulin sensitivity at the receptor site
 Dr. Yamazaki, Hiroshima U. Sch. Medicine
 Improve modulation of blood sugar levels by 31.9%
 Dr. William Judy, SW. Inst. Bio Res. Florida
 Chromium
 Improve the glucose tolerance of Type I & Type II Diabetes
 Anderson RA Chromium and glucose intolerance in Diabetes. J.
Am. Col. Nutr. 1998.
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Arthritis
Clematis Chinensis, Trichosanthes Kirilowii, Prunella Vulgaris
Park, et al 1995; Ahn, et al 1996; Kim, et al1996. Seoul, Korea
96 patients osteo-arthritis of the knee – 5 weeks
95.8% improvement from fair to very good
Gingerol
Bliddal, et al 2000.
75 patients arthritis hip & knee
Ginger vs. Ibuprofen
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Growth Hormone
Treatment of Deficiencies
Standard
Injection 0.2 mg – 0.5 mg per day
Best
Injection 2 units – 8 units per week in divided daily dosages
Caution:
 Side effects of excess are more frequent
 Not Physiologic – HGH output highest 10 p.m. – 2 a.m.
 Best when given in small dosages/frequent shots
Signs of excess:
 Swollen feet, neuropathy, carpal tunnel, excessive muscle
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Growth Hormone
Secretagogue
Human Growth Matrix
Oral spray sublingual Nanolyposome
Fulvic Ext., Humate Ext., Deer Antler Ext., IGF-1, IGF-2, EGF (Epidermal), NGF(Neuro),
TGF(Transfer), VGF(Vascular), Cocoa, Stevia, Shugr™, Pituitary ext., Eurycoma Ext.
Directions: (Adjust dosage to individual needs)
 Maintenance: Take sublingual 2 pumps a.m. & p.m. – Hold for 1
minute before swallowing
 Treatment: Take sublingual 3 – 4 pumps a.m. & p.m. for specific
deficiency & for arthritis inflammation
 For Super Athletes: take 4 – 6 pumps a.m. & p.m.
Signs of excess:
 Swollen feet, neuropathy, carpal tunnel, excessive muscle
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DHEA
DHEA Clinical Applications
 Aging (hormone marker)
 Depression
 Immunodeficiency Syndrome
 Lupus Erythematosus
 Obesity
 Cancer Prevention
 Bellino FL, Ann NY Acad Sci
1995; Belancer A, et al.
 Regelson W, et al. Ann NY Acad
Sci 1994; Khorram D, et al.
 Jakubowicz DJ, et al. J Clin Endoc
Met 1005; Porter J, et al. Ann NY
Acad Sci 1995.
 Memory Loss
 Majewska M. Ann NY Acad Sci
1995; Melanoir CL, et al.
Neuroscience Abs. 1002.
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 Wolkowitz O. Ann NY Acad Sci
1995.
 V. Vollenhoven, et al. Arthri
Rheum 1994.
 Boone CW, et al. Cancer Res.
1990.
 Osteoporosis
 Spector TD, et al. Clin Endoc
1991.
32
DHEA Clinical Applications
al. J Biol Chem 1989.
 Chronic Fatigue Syndrome
 Galabrese VP, et al. Lancet
1989; Lebihuber FE, et al. Am  Distribution of body fat
 Williams DP, et al. J Clin
J Psych 1992.
Endoc Met 1993.
 Inhibition of Atherosclerosis
 Eich DM. Circulation 1993.  Anti-glucocorticoids
 Wright BE, et al. Int J Obesity
 Myocardial Risk
1992; Brown E. Am J Med Res
1992.
 Hantgnena, et al. Athero Sci
1994; J. Shihara F. Cardiology
 Health & Longevity
1992.
 Shealy N. Book: DHEA: The
 Thyroid Hormone
Youth & Health Hormone
 McIntosh MK, et al. J Nutr
Biochem 1992; Song MK, et
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DHEA & Health Benefits
 Improves mild to moderate lupus, skin, joint, headache, fatigue
 Stanford Univ. 1994
 50% reduction of Atherosclerosis plaque in rabbits
 John Hopkins Univ. 1998
 1029 men & 942 women 25% less CVD on higher levels of DHEA
 Univ. of San Diego
 Double-blind DHEA 50 mg for adrenal exhaustion decrease anxiety &
depression
 NEJM 1999
 Higher DHEA better mental function in Alzheimer’s disease
 McGill Univ. 1999
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DHEA
Treatment of Deficiencies
DO NOT USE ORAL
First Pass Technology & Principle
 Cause overstress to liver
 Over-stimulate the production of SHBG creates
binding of overall hormones
 Net decrease & deficiencies of free hormone
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DHEA
Treatment of Deficiencies
DHEA
 Maintenance:
 DHEA: 12 – 20 mg a.m. transdermal
 Treatment:
 Use double or triple doses
“DHEA oral route has only 10 – 15% of the
active compound of transdermal.”
Labrie C, et al. J Endocrinol, 1996 Sep; 150 Suppl: 5107-18
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Studies on DHEA & Cancer
 Dr. McCormick & Dr. Rao (doctors/authors)
 1999 – Dr. McCormick & Dr. Rao found that rats
supplemented with DHEA & exposed to cancer seemed to
be resistant to further developing other forms of cancer
“DHEA inhibits prostate cancer induction both when
chronic administration is begun prior to carcinogen
exposure, and when administration is delayed until preneoplastic prostate lesions are present.”
McCormick DL and Rao KVN, et al. “Chemoprevention of hormone
dependent prostate cancer in wistar unilever rats.” The Journal of
European Urology, 1999; 35: 464-467.
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DHEA & Breast Cancer
 No association found
between
 DHEA-S levels
 Breast cancer risk
Barret-Connor E, et al. Dehydroepiandrosterone sulfate and breast
cancer risk. Cancer Res 1999 Oct 15; 50(20): 6571-4.
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University of California
School of Medicine, 1995
What’s interesting about all these reported increases in mood &
energy is that they were not what the tests were conducted to prove
 13 men & 17 women were administered
50 mg of DHEA for 6 months
 Among other benefits, the men & women also reported
a “physical & psychological well-being”
 Men – 67%
 Women – 84%
 Attributed boost of activity & frame of mind to the
DHEA-influenced rise of serum IGF-1 levels & its
increased bioavailability to target tissues
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UCSD School of Medicine,
La Jolla, California
Study by Dr.’s Samuel Yen, Khorram & Vu
 Immunological effects measured in 65-year-old
men supplemented with 50 mg per day of DHEA
 Yen observed an IGF-1 rise of 18%
 Natural killer cells (the cells that fight cancer) rose by
1/3
 Ability to ward off cancerous cells increased by 30 – 75%
 T-cells & B-cells (combat bacteria)
 Responded more quickly to foreign attackers
 IL-2 (cytokine imperative to immune cell
communication)
 Rose significantly
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Labrie C, Flamand M, Belanger A, Labrie F. J Endocrinol. 1996
Sep; 150 Suppl: S107-18. Laboratory of Molecular
Endocrinology CHUL Research Center, Quebec, Canada.
High bioavailability of
dehydroepiandrosterone
administered cutaneous in rats
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Pregnenolone
Pregnenolone
Pregnenolone provides
the materials for other
hormones to grow &
multiply in number
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J.F. Flood, et al. “Memory-enhancing effects in
male mice of pregnenolone and steroids
metabolically derived from it.” Proceedings from
the National Academy of Science of the United
States of America, 1992; 89: 1567-71.
 Memory enhancing effects Neurons communicate
in male mice using
with each other through
pregnenolone
electrochemicals
 Pregnenolone helps the  Higher levels of
neurotransmission of the
pregnenolone able to
nerves
think clearer by recalling
information with less
delay
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Functions of Pregnenolone
 Pregnenolone
 Increases levels of acetylcholine in the
hippocampus & other memory regions in the
brain
 Modulates the neurotransmitter GABA
 Helps to repair nerve damage
 Promotes mood elevation
 Improves sleep
 Some women report lessening of hot flashes or
premenstrual symptoms
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Pregnenolone
The optimum level of pregnenolone is
at 35 years of age
By the age of 75, you will have lost
65% of your pregnenolone
Roberts E. Pregnenolone from Selye to Alzheimer’s.
Biochemical Pharma 1995. Vol. 49, No. 1, Pg. 1-16.
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Pregnenolone
 Forgetful
Signs of Deficiency
 Can’t think well
 Memory loss
 Hair loss
 Tired & irritated
 Life & color seem dim
 No interest in beauty &
nature
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Pregnenolone
Signs of Deficiency
 Incurrent body aches & pains
 Lack of muscle tone
 Pessimistic
 Crave salt
 Frequent urination
 Don’t concentrate well
 Depression
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Pregnenolone
Treatment of Deficiencies
DO NOT USE ORAL
First Pass Technology & Principle
 Cause overstress to liver
 Over-stimulate the production of SHBG creates
binding of overall hormones
 Net decrease & deficiencies of free hormone
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Pregnenolone
Treatment of Deficiencies
Pregnenolone
 Maintenance:
 Pregnenolone: 18 mg – 30 a.m. transdermal
 Treatment:
 Use double or triple doses
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Testosterone
Testosterone Production
 2% of testosterone is free
 98% is bound
 38% bound to albumin
 60% bound to SHBG
Bagatell CJ, et al. N Engl J Med. 1996 Mar 14; 334(11):
707-14.
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Relative Potency of Androgens
T – 100
DHT – 300
DHEA – 5
DHEA-S – 5
Androstenedione - 10
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Aromatase Testosterone
 Aromatase
 Inducer (men)
 Insulin resistance & diabetes II
 Inhibitors
 Chinese herbal formula




Aralia dasyphylla
Curcuma zedoria
Cyperus rotundus
Smilax glabra
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Aromatase Testosterone
 Aromatase
 Chrysin
 A bioflavonoid component
 Herb passiflora
 Melatonin
 Quercetin
 Grape seed extract
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Aromatase
Men & Women Over 45 Years
Aromatase is an enzyme
Neutralize Aromatase
I3C
DIM
Soy
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Sinha-Hikim I, et al. Clin Endocrinol
Metab. 2006 Aug; 91(8): 3024-33.
“Effects of testosterone
supplementation on skeletal
muscle fiber hypertrophy &
satellite cells in communitydwelling older men.”
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Women Libido Sexual Function
 Lower testosterone & free
testosterone
 Lower libido
 Desire
 Arousal
 Lubrication
 Orgasm
Int. J. Impot. Res. 2004.
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Testosterone &
Metabolic Syndrome
 Low levels of testosterone have several common
features with metabolic syndrome





T levels inversely associated with central obesity
T inversely associated with systolic BP
Men with diabetes had lower T levels
Inverse association between T & HgA1C
T may have a protective role in the development of
metabolic syndrome & subsequent diabetes mellitus &
cardiovascular disease in aging men
Svartberg J. Epidemiology: Testosteorne & the Metabolic Syndrome
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Endogenous Sex Hormones & Progression
of Carotid Atherosclerosis in Elderly Men
Higher Testosterone =
Less Atherosclerosis
Higher Estrone =
More Atherosclerosis
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TRT & PC
 Review of 16 studies, some placebo controlled
 Various T formulations
 Up to 15 year studies
 No increased risk over the background prevalence
Gould DC, Kirby RS. Testosteorne replacement therapy for late
onset hypogonadism: What is the risk of inducing prostate
cancer? Prostate Cancer Prostatic Dis. 2006; 9(1): 1408.
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Testosterone & BPH
“Multiple studies have failed to
demonstrate exacerbation of voiding
symptoms attributable to benign
prostatic hyperplasia during
testosterone supplementation.”
Rhoden NEJM 2004.
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Treatment of Elevated Testosterone
Saw palmetto
Metformin
Spironolactone
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Causes of High Levels of
5 Alpha-Reductase
 Insulin resistance
 Obesity
 High-protein diets
 Sodium restriction
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 Licorice
 Hyperthyroidism
 DHEA
supplementation
64
Testosterone
Treatment of Deficiencies
DO NOT USE ORAL
First Pass Technology & Principle
 Cause overstress to liver
 Over-stimulate the production of SHBG creates
binding of overall hormones
 Net decrease & deficiencies of free hormone
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65
Progesterone
Progesterone
 Hormone that supports conception & sustain
pregnancy
 Fast increase after 14 days of menses after
ovulation
 Highest level at 21 days – drops at 28 days
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Functions of Progesterone
 Pro-gestation
 Uses fat for energy
 Decreases TBG
 Natural anti-depressant
& anxiolytic
 May increase libido
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Functions of Progesterone
 Promotes cell differentiation
 Promotes normal cell death
 Decreases estrogen receptor synthesis
 Improves estrogen receptor sensitivity
 Decreases estrogen induced mitosis
 Natural diuretic – blocks aldosterone
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Progesterone
 Transdermal showed significant decreases of
uterine lining hyperplasia
 Anasti, et al. 2001.
 Laboratory study shows 20 times progesterone
in brain cells than in blood serum
 Lee, et al. 1996.
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Progesterone
 Transdermal progesterone decreased breast cell groth
by 400%
 Chang, et al. 1995.
 Progesterone lowers vascular endothelia growth factor
(JEGF) potent angiogenic factor
 Heer, et al. 1998.
 Incidence of breast cancer is 540% greater in women
with low progesterone than normal levels
 Corovan, et al. 1981.
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Progesterone Lyposome
20 mg progesterone dose
 PMS
 One dose per day at night
 Start on 12th day of menses to 28th day or bleeding
 Perimenopause
 One dose per day or one dose a.m. & night
 Start on 8th day of menses to 28th day or bleeding
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Progesterone Lyposome
20 mg progesterone dose
 Endometriosis
 Use one dose a.m. & 2 doses p.m.
 Start on 6th day of menses to 28th day – wait 5 days
 Severe bleeding may persist or worsen the first few days,
then improve
 Birth control pills – synthetic
 Use the dose in the p.m. while on the bill
 Start on 6th day of menses to 28th day – wait 5 days
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Progesterone Lyposome
20 mg progesterone dose
 Osteoporosis
 One dose daily a.m. & p.m.
 Start on 6th day of menses to 28th day – wait 5
days
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PCOS
 Three criteria set up by the National
Institutions of Health
 Irregular or absence of menstruation
 Excess androgen production
 Lack of other reasons for irregular or absence of
cycles & excess androgens
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PCOS
 Having ovarian cysts is
not one of the three
criteria for the
diagnosis of PCOS
 Ovaries with many
cysts does not
necessarily mean that
the patient has PCOS
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Progesterone
Treatment of Deficiencies
Progesterone
 Pre-menopause
 20 – 60 mg Transdermal – 14th – 28th Day
 Post-menopause
 20 – 100 mg Transdermal – 14th – 28th Day
 Post-partum Depression
 50 – 300 mg Transdermal – Daily
 Infertility
 50 – 150 mg Transdermal – 14th – 28th Day
 Birth Control
 100 – 200 mg Transdermal - Daily
Copyrights:OIBConsultants, Inc.
77
Progesterone
Treatment of Deficiencies
Progesterone Specialist
(5 mg Progesterone per pump)
Fulvic Ext. EPL, Evening Primrose Oil, Shea Butter, Glycerin, Progesterone, USP, Chastetree,
Dong Quai, Rhodiola, Panax Ginseng, Aloe Vera, Lavender Oil, Almond Oil, Hemp Oil,
Alpha Lipoic Acid, Vitamin E, Vitamin A, Allantoin, NaPca, Dimethicone
Directions: (Adjust dosage to individual needs)
 Apply 2 pumps to soft skin area – rub vigorously – for 25
days – Discontinue for 5 days or if bleeding – Repeat
cycle.
Signs of excess:
 Sleepiness, dizziness, droopy breasts, low libido, sleeping
too much, short menstruation
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78
Sitruk-Ware, et al. Treatment of Benign Breast Diseases by
Progesterone Applied Topically. International Symposium on
Percutaneous Absorption of Steroids, Academic Press, 1980,
pp 219-229.
Telethermographic modifications after 3 months
of percutaneous progesterone treatment in
diverse benign breast diseases:
+++ good results, + partial improvement, 0 failures
(Lafaye & Aubert, 1978)
Number
+++
+
0
Mastodynia
250
78
19
3
Increased Nodulatiry
80
80
10
10
Fibroadenomas
30
0
20
80
Cysts
30
0
40
60
Fibrocystic Disease
80
75
18
7
Copyrights:OIBConsultants, Inc.
79
Estrogen
Estrogen Contributes
 Development of secondary sex characteristics
 Defining difference between men & women
 In women characteristics include:
 Breasts
 Widened pelvis
 Increased amounts of body fat in the buttock, thigh & hip
region
 Less facial hair
 Smoother skin than men
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81
Estrogen Sources
 Ovaries
 Fat
 Estradiol E2 –
Productive years
 Aromatized from DHEA  Estriol E3 – Pregnancy
& Testosterone
 SHBG liver protein
binder
 Estrone E1 –
Menopausal
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82
Estrone (E1)
 Predominant estrogen post-menopausally
 Aromatized from androstenedione in peripheral
tissues; also derived from E2
 Reproduction, sexual development, bone health
 Positive correlations with insulin & BMI
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83
Estradiol (E2)
 Most potent estrogen
 Predominant estrogen pre-menopausally
 Derived from both Estrone & testosterone
 Assists in female reproduction, sexual
development, bone health, arterial blood flow,
neuroprotection
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84
Estriol (E3)
 Least potent estrogen
 Derived from E1 & E2
 Competes with E2 binding at estrogen
receptor, therefore considered safer than E1 &
E2
2006 HRT study: E3 was not associated with breast cancer –
Lyytinen H, 2006.
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85
Enzyme-Inducing & Inhibitors
 Estrogens increase
 2-OH Estrone: 16α Estrone
 “Brassica” family vegetables
 Exercise
 Linseed
 Indole 3-carbinol (I3C)
 Diindolylmethane (DIM)
 Soy
 Progesterone
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86
Functions of Estradiol
 Helps
 Maintain potassium
 Absorb calcium,
magnesium & zinc
 Maintain bones
 Maintain memory
 Improve sleep
 Increases




HDL
Growth hormone
Serotonin
Endorphins
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 Decreases





LDL
Total cholesterol
Triglycerides
Platelet stickiness
Fatigue
 Works as an antioxidant
Vliet E, Women Weight & Hormones. New
York: M. Evans & Company, 2001; pg 85.
87
Estrogen In Men
 Active in every tissue
studied
 Pre-optic sexuality
centers
 Brain
 Hypothalamus
 High concentrations of
Erα & Erβ
 Pro-optic
 High in Ers & Ars
 Controls sexuality
 Libido
 Erectile function
 eNOS
 Pelvic & penile arteries
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 Estradiol needed
 Vascular system through
eNOS activation
 Pro-inflammatory
activity of vascular
plaque
 iNOS, MMPs, IL-6,
COX2
88
2-OH Estrone: 16α-OH Estrone
 Data provides support
 2:16 ratio
 Associated with
 Reduced breast cancer risk
 Prostate cancer
 Ideal ratio range
 Between 2 - 4
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89
2-OH Estrone/Methylation
 Good estrogen
 Does not stimulate cell growth
 Blocks action of stronger estrogen products that may be
carcinogenic
 2-OH Estrone
 Protective against cancer when methylated by catecholO-methyltransferase (COMT) into 2-methoxy-estrone
 Ratio of 2-methoxyestrone to 2-hydroxyestrone can be
measured in urine
 Good gauge of the body’s ability to methlate
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90
Diurnal Changes of Estradiol in Plasma
in 2 Females During Luteal Phase
Estradiol in Plasma, Diurnal Fine Profile
Concentration in pg/ml
300
250
200
150
100
50
0
8:00
AM
12:00
PM
4:00
PM
8:00
PM
12:00
AM
4:00
AM
8:00
AM
Plasma sampling every 20 minutes: C.V.: ~20%
Single values between 90 pg/ml (minimum) – 265 pg/ml (maximum)
Copyrights:OIBConsultants, Inc.
91
Archives of Dermatology,
December 1997; 133: 339-342.
 Estrogen therapy decreases skin wrinkling &
dryness
 Estrogen increases dermal thickness as it
preserves skin texture
 Collagen decreases by 30% after menopause
 Skin changes are reversible with estrogen
replacement therapy
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Phyto-Estrogen
 Increases bone mass
 Lowers LDL & triglycerides
 St. Germain, et al. 2001.
 Friendly estrogen – Estriol-like from Genistein,
Daidzen, Glycetein
 Setchell, et al. 2001.
 Genistein & Daidzen shown to protect against breast &
uterine cancer & CVD
 Hawrylewicz, et al. 1995; Goodman, et al. 1997; Anthony,
et al. 1998; Olive, et al. 1998.
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93
Estrogen
Treatment of Deficiencies
 Bi-Estro
 0.6 mg E2
 1.5 mg E3
 An optimum physiologic ratio of 20% E2 & 80% E3
Copyrights:OIBConsultants, Inc.
94
Estrogen
Treatment of Deficiencies
Max Estro E
(1 pump phyto Estrogen is 0.3 mg E2 & 1.5 mg E3)
Fulvic Extract, Essential Phospholipids, Evening Primrose Oil, Shea Butter, Glycerin, Aloe Vera,
Black Cohosh, Genistein, Daidzen, Pueraria Mirifica, Gynostema, Rhodiola, Lavender oil, Almond
oil, Hemp oil, Alpha Lipoic, Vitamin E, Vitamin A, Allantoin, NaPca
Directions: (Adjust dosage to individual needs)
 Apply to soft parts of skin 3 pump per day a.m. or in
divided doses. May repeat 3 pump in p.m.
Signs of excess:
 Tender breast, swollen abdomen, heavy periods, anxiety,
irritable, emotional, moody, short temper
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95
Dr. Tai’s Health Pearl
Too much Estrogen
Need more Estrogen
Estrogen level OK – Progesterone OK
Need more Progesterone
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96
Estrogen
Treatment of Deficiencies
Estrogen Defense
Idole-3-Carbinol (I-3-C), Diindolymethane (DIM), Evodia, Resveratrol,
Fermented Grape Skin & Seed, Chrysin, Piperine Extract
Lower dosages of Estrogen supplements
Indol-3-Carbinol & Diindolylmethane proven to
lower circulating Estrogen
Directions: (Adjust dosage to individual needs)
 Take one capsule twice daily or more as needed
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97
Thyroid
Importance of
Optimal Thyroid Function
 Effects on cellular
metabolism
 Activates brain &
neurological function
 Cardiac contractile
support
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 Osteoblastic support of
bone
 Menstrual cycle
regulation
 Activates all other
hormone receptors
 Hormone restoration
must start with thyroid
99
Thyroid Gland Function
 Control metabolic rate
 Control body temperature
 Skin & mental health
 Mitochondria
 Control infections
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100
Thyroid
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101
Metabolism of Thyroid Hormone
 Requires about 50 mg of iodine per year
 About 70% of the T4 secreted daily is
deiodinated to yield T3+rT3 in equal parts
 80% of circulating T3 comes from peripheral
monodeionization of T4 at the thyrosyl ring
 Occurs in the liver, kidney & other tissues
 Circulating rT3 is made the same way
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102
Thyroid & Muscle
 No thyroid – No increase in muscle
 Thyroid hormones influence muscle metabolism
 Low thyroid does not build muscle
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103
Interesting Facts About Thyroid
 Low thyroid directly causes low pregnenolone
 Tagawa, N., Clinc Chem 2000; 46: 523-5828.
 Thyroid dysfunction is associated with heart disease
 Rouzier, N., Longevity and Preventive Medicine Symposium, 2002.
 Decreased T3 hormone causes increase of cholesterol up to 50% &
LDL
 Brownstein, D. Overcoming Thyroid Disorders. Medical Alt. Press,
2002. p. 8.
 Low thyroid hormone is associated with chronic fibromyalgia
 Brownstein, D. Overcoming Thyroid Disorders. Medical Alt. Press,
2002. p. 8.
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104
Thyroid
 Affects all organs





Metabolism
Body composition
Energy levels
Mood
Hair & skin
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105
rT3/T3 Ratio
 rT3/T3 ratio may increase with







Pregnancy
Estrogen therapy
Fasting
Liver disease
Renal disease
Drugs (PTU, some beta blockers, amiodarone)
Stress
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Tissues & Organs Most Readily
Affected by Cellular Energy Declines
(In order of Impact)




Central nervous system
Hearty & skeletal muscle
Kidneys
Hormone-producing tissues
 Wallace D. Mitochondrial DNA is aging and
disease. Scientific American, August 1997.
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107
Most Common Signs &
Symptoms of Hypothyroidism
 Fatigue & loss of energy  Decreasing memory &
mental slowing
 Increased susceptibility to
infection
 Dry, rough, pale, cold
skin
 Weakness
 Thinning hair &
 Weight gain or increased eyebrows (outer 1/3)
difficulty losing weight
 Cold intolerance to hands
& feet
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108
Most Common Signs &
Symptoms of Hypothyroidism
 Muscle cramps &
frequent muscle aches
 Decreased libido &
sexual performance
 Depression
 High cholesterol
 Irritability, emotional
instability
 Voice change (deepening
& hoarseness)
 Dry, coarse skin & brittle
nails
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109
Dr. Broda Barnes’ Recommendations
 Thyroid must be taken on an empty stomach at least 20 – 30
minutes before meals
 Add ½ grain each month & continue to increase each month
as needed
 Our bodies usually require at least one month to respond to
the increase in dosage
 Stop when patients feel well, experience any side effects, or
reach the dosage of 4 grains (occasionally 5 grains were
used)
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110
Thyroid Intolerance
 Number one sign of intolerance is an increased
heart rate
 More than 10 – 15 beats per minute above baseline
 Worsening of hypothyroid symptoms is a red flag
for
 Mild adrenal fatigue
 Iodine deficiency
 Environmental toxicity
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111
Compounded T4/T3
1 “grain”
T3 – 9 mcg
T4 – 38 mcg
½ “grain”
T3 – 4.5 mcg
T4 – 19 mcg
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112
Optimal Thyroid Replacement
TSH
-0.3 – 5.5 (N)
Below 2.0 (Optimal)
Below 1.0 (Personal)
FT3
-2.3 – 4.3 (N)
-3.5 – 4.3 (Optimal)
rT3
-90 – 350 pg/ml (N)
-50 – 150 (Optimal)
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113
Metabolism Supplementation
Homeopathic Thyroidinum 3C with rare minerals & amino acids
 Selenium – 30 Selenol enzymes conversion T4 to
T3
 Manganese, Zinc, Fulvic/Humate
 L-Thyrosine
 Homeopathic Thyroidinum 3C, Ashwangandha,
Rhodiola
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114
Selenium
 Study looked at critically ill patients
supplemented with 200 mcgs selenium
 Normalization of T3 & T4 with improvement
of T3/rT3 ratio with selenium supplementation
 Berger N, et al. Influence of selenium
supplementation on post-traumatic alterations of
the thyroid axis: a placebo-controlled trial.
Intensive Car Med 2001; 27(1): 91-100.
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115
Iodine Deficiency
 Up to 72% of the world’s
population is affected by an
iodine deficiency disorder
 WHO Nov 12, 1998.
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116
Hypothyroidism
& Breast Cancer
 Areas of the world with high iodine intake
(Japan)
 Low rate of breast cancer
 Estimates are that the breasts need
approximately 5 mg of iodine per day
 50 kg woman
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117
Iodine/Iodide
 The reduced form of iodine is iodide with an
extra electron
 Both forms are needed for optimal function of
every organ & cell in the human body
 Abraham GE, Flechas JD, Hakala JC.
Orthoiodosupplementation: Iodine sufficiency of
the whole human body. The Original Internist, 9:
30-41, 2002.
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118
RDA of Iodine
 The recommended daily amount of iodine for
supplementation by clinicians
 12.5 – 37.5 mg
 Turns out to be the exact range for sufficiency of the
whole human body
 Based on a recently developed loading test
 Abraham GE, Brownstein D, Flechos J. The Saliva/serum
iodine ratio as an index of sodium iodine symporter
efficiency. The Original Internist. Vol 12: 4: 152-6.
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119
Iodine & Fibrocystic Breasts
Iodine has been shown to be
extremely effective in treating &
preventing fibrocystic breasts
 Ghent W, et al. Iodine Replacement in Fibrocystic
Disease of the Breast. Can J Surg. 36: 453-460,
1993.
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120
Thyroid & Weight
T3/T4 falls during acute &
chronic calorie restriction
Is this a factor why lost
weight is usually regained?
 Weinsier RL, et al. Do adaptive changes in metabolic rate favor
weight regain in weight-reduced individuals? An examination
of the self-point theory. Am J Clin Nutr 2000 Nov, 75(5):
1088-94.
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121
Hans Selye’s Mode of Stress
 Adrenal fatigue
 Stress reactions affect mainly the adrenal
cortex (not the medulla)
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122
Stress Response
 Three phases of
response
1. Alarm phase
2. Stage of
resistance
3. Stage of
exhaustion
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123
Alarm Phase
Initial Reaction Phase
 Adrenal congestion & hypertrophy with deletion
of vitamin C in cortex
 Increased secretion of cortisol
followed by a decrease in
secretion
 Thymic atrophy
 Lymphoid tissue atrophy
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124
Stage of Resistance
 Accumulation of secreting granules in cortex
 Blood diluted – receptor resistance
 Increased ability to withstand stress
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125
Stage of Exhaustion
 Decreased ability to withstand stress
 Decreased cortisol levels
 Severe fatigue
 Premature aging
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126
Adrenal Fatigue
&
Chronic Fatigue
Adrenal Fatigue
Daily Energy Patterns
 Morning fatigue – Low cortisol a.m.
 Difficulty waking up early in the morning
(doesn’t really wake up until approx. 10 a.m.)
 Usually feels much better & fully awake after
noon meal
 Afternoon low 2 – 4 p.m.
 Usually feels best after 6 p.m.
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128
Functions of Cortisol
 Balances blood sugar  Bone turnover rate
 Weight control
 Stress reaction
 Immune system
response
 Sleep
 Protein synthesis
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129
Diurnal Rhythm of Salivary Cortisol
Different Wake-Up Times
16
14
Salivary Cortisol [ng/ml]
12
10
8
6
4
2
0
4
6
8
10
12
14
16
18
Tim e of day [h]
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130
Cortisol
Treatment of Excess
 Max Glucose Specialist
 Directions: Take one capsule three times a day with meals or
more as needed by your specific condition or recommended by
your physician
 Max Performance Specialist (Adaptogen)
 Directions: Take 1 tablet 3 times daily
 Max Sea Extract
 Directions: Take 6 drops in a drink once daily
 Max Metabolism
 Directions: Take 1 capsule a.m. & 1 capsule at noon with large
glass of water. May increase the dosage to 3 capsules per day
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131
Cortisol
Treatment of Deficiencies
 Max Performance (Adaptogen)
 Directions: Take 1 tablet 3 times daily
 Max Adrenal Specialist
 Directions: Take 1 capsule daily as needed
 DHEA PleoLyposome
 Directions: Apply to soft skin area. Female: 3
pumps daily a.m.; Male: 5 pumps daily a.m.
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132
Melatonin
Light at Night Chronodisruption,
Melatonin Suppression & Cancer Risk
 Crit Rev Oncog. 2007 Dec; 13(4): 303-28.
 Reiter RJ, Tan DX, Korkmaz A, Erren TC,
Piekarski C, Tamura H, Manchester LC
 Department of Cellular and Structural
Biology, The University of Texas Health
Science Center at San Antonio, San Antonio,
TX 78229-3900, USA.
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134
(Blue-Green Wavelengths) 460 – 480 nm
Most Inhibitory to Melatonin Synthesis & Regulating SCN
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135
Genetic
Defines the
Amplitude
of the
Nocturnal
Melatonin
Peak
Copyrights:OIBConsultants, Inc.
136
Plasma Melatonin (pg/ml)
Duration of
Darkness
70
60
50
40
L:d 16:8
30
20
10
0
Plasma Melatonin (pg/ml)
0000
0800
70
60
50
L:d 10:14
40
30
20
Direct
Proportion to
the
Production
of Melatonin
10
0
1800
0800
)
Copyrights:OIBConsultants, Inc.
70
137
The Brightness of
Light at Night
120
100
80
60
40
20
0
120
250 lux
pg melatonin / ml serum
100
80
Proportionally
suppresses
melatonin
levels
60
40
20
0
120
500 lux
100
80
60
40
20
0
120
1500 lux
100
80
60
40
20
0
12
20
22
24 01
03
Time of date (h)
Copyrights:OIBConsultants, Inc.
08
10
138
Melatonin
Inhibits
Growth of
MCF-7
(Human Breast
Cancer Cells)
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139
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140
Melatonin
Inhibits
Tumor
Growth &
Tumor
Metastases
 J Pineal Res, 2003.
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141
Melatonin Levels Decrease
With Increasing Age
(Cancer is an age-related disease)
Copyrights:OIBConsultants, Inc.
142
Symptoms of
Melatonin Deficiency
 Mental






Light, anxious, agitated sleep
Easily woken
Difficult to fall asleep
Poor dreaming
Hypersensitive
Irritable
Copyrights:OIBConsultants, Inc.
143
Melatonin Excess
 Very deep sleep during 3 – 5 hours
 + too early waking up
 + “heavy” head in the morning
 Sometimes
 Deep & prolonged sleep(iness) the whole night
through until late in the morning
 Too vivid dreams
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144
Combination of
L-Citrulline & L-Arginine
Increases Nitric Oxide
Production
Cardiovascular, Immune Boosting,
Sexual Health Benefits
How are Citrulline
& Arginine Related?
 Citrulline converted into arginine as
soon as it enters
 Kidney
 Vascular endothelium
 Other tissues
 Plasma & tissue levels of arginine
 Necessary for production of nitric oxide & relaxation of blood
vessels
 Romero MJ, Platt DH, Caldwell RB, Caldwell RW. Therapeutic
Use of Citrulline in Cardiovascular Disease. Cardiovasc Drug
Rev. 2006 Fall-Winter; 24(3-4): 275-90.
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146
Citrulline & Arginine
Help Improve Sex Life
 Arginine has been well studied for its ability to
enhance sexual satisfaction
 Both men & women report longer & more
intense orgasms when their intake of arginine
increases
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147
Citrulline & Arginine
Help Improve Sex Life
 Arginine is often used by men to achieve long
lasting & harder erections
 Citrulline & arginine can be combined for
enhanced sexual pleasure & vascular health
 Citrulline is a precursor for arginine
 Arginine is a precursor for nitric oxide
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148
Importance of Nitric-Oxide
to Healthy Blood Flow
 Helps prevent blood
aggregation or platelets from
becoming sticky
 When platelets are not sticky,
they can move single file
through capillaries
 When vascular system is
working efficiently – less
chance blood clot will form
 Less chance of having a heart
attack or stroke
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149
References
• Dessy C, Ferron O. (2004). “Pathophysiological Roles of Nitric Oxide: In
the Heart and the Coronary Vasculature.” Current Medical Chemistry –
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry.
3(3):207-216.
• Osanai T, Fujiwara N, Saitoh M, Sasaki S, Tomita H, Nakamura M, Osawa
H, Yamabe H et al. (2002). “Relationship Between Salt Intake, Nitric Oxide
and Asymmetric Dimethylarginine and Its Relavance to Patients With
End-Stage Renal Disease.” Blood Purification 20(5):466-8. doi:
10.1159/000063555. PMID 12207094.
• Kang L, Reyes RA, Delp JM. “Aging Impairs Flow-Induced Dilation in
Coronary Arterioles: Role of NO and H2O2.” Am J Physiol Heart Circ
Physiol. 2009 September; 297(3):H1087-H1095. Published online 2009
July 17.
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150
Case Studies
Case Study #1
Case Study #2
Case Study #3
Case Study #4
Case Study #5
Case Study #6
Case Study #7
Case Study #8