American Longevity Center's Guide to Healthy Aging by Kyle Peacy

G U I D E

T O

HORMONE THERAPY

American Longevity Center Healthy Aging and Proactive Medicine

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So much has changed since the first time I went to American Longevity Center. I feel like the man I used to be. I feel younger, my wife says I LOOK younger and that has definitely brought a romantic spark back to our marriage. I never thought it was possible to be this physically fit at my age. - Paul N., West Palm Beach Florida

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TABLE OF CONTENTS I. What Is Hormone Therapy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 What Are Hormones? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Get Back To Feeling Great With Hormone Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Do I Need My Hormones Optimized? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 The First Step – Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 What Exactly Are Symptoms Of A Hormone Deficiency? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Hormone Deficiency Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Hormones Used In Hormone Therapy And What They May Do . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 II. Hormone Therapy For Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Male Menopause: Fact or Fiction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 How Can ALC Help Me? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 III. Hormone Therapy For Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . What Are Bio-identical Hormones? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bio-identical Hormones: Estrogen, Testosterone, and Progesterone . . . . . . . . . . . . . . . . . . . . . . . . . . What is Menopause, Perimenopause, and Postmenopause? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14 16 17 18

IV. An Introduction To HGH Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ask Yourself These Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . What Is HGH? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Coping With Adult Growth Hormone Deficiency (AGHD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Effects Of HGH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19 19 20 20 21

V. An Introduction To Testosterone Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The First Step – Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . What Is Testosterone? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . When Does It Decline? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Benefits Of Testosterone Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Some Facts About Testosterone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23 23 24 24 25 26

VI. ALC FAQs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 VII. What The Experts Are Saying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 VIII. What Our Patients Are Saying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 VIV. Partial List of ALC Advisory Board Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 32

WHAT IS HORMONE THERAPY? Hormone therapy is a medical procedure that focuses on maintaining and regaining good health and wellness. Because of aging, hormones for both men and women naturally decline. A decline in hormones during middle age can affect our mental, physical, and sexual health. Hormone deficiency can cause the following: • Sexual dysfunction and reduced libido • Fatigue and lethargy • Increase in body fat and decrease in muscle mass

Improving metabolic functions and optimizing hormones such as testosterone, estrogen, HGH, and others lead to a more fulfilling and healthier way of life. Hormone therapy, combined with good nutrition and regular exercise, can have a significant impact on your health, physical appearance, and overall well being. To learn more about hormone therapy and its health benefits please read the following information. To find a physician in your area please call us at 1-800-770-7126.

• Irritability, anxiety, and depression • Loss of self-confidence, creativity, and drive These problems can be avoided through hormone therapy, with the proper prescription and care from an ALC physician. ALC is the leading authority in hormone therapy, a medical procedure which is focused on health and wellness for men and women.

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WHAT ARE HORMONES? Hormones play the role of chemical messengers in the processes in our body. The most common hormones are insulin, testosterone, estrogen, cortisol, growth hormone, (HGH), progesterone and thyroid hormones. Hormones function when they are released in the blood stream. Each hormone is released by specific glands and has specific areas in our bodies where they function. The biological processes caused by the hormones affect growth and development, tissue repair and regeneration, metabolism, reproduction, and emotional well-being as well. Each hormone has its specific target cells. There should always be a balance in the production of hormones for the body processes to work efficiently. However, because of aging, hormonal imbalance occurs. A decline in hormones affects our well-being and our overall quality of life.

GET BACK TO FEELING GREAT WITH HORMONE THERAPY It is a fact that millions suffer from hormonal imbalance. This year, almost 80 % of women beyond 50 years old will suffer from hormonal imbalance. By 2025, it is expected that around 40 million women who are beyond 50 years old in the United States will suffer from some kind of hormonal imbalance. They are not alone. Some studies estimate that anywhere from 5-13 million men are also living with the symptoms of a hormone imbalance.

therapy, the doctors at ALC are able to successfully treat andropause, menopause, perimenopause, low testosterone and more.

Experts speculate that declines in hormone levels are happening at a younger age in part due to higher levels of stress placed on young men and women. Stress is a major contributor of hormone imbalances and can cause symptoms associated with aging in men and women as young as thirty or forty. The good news is, thanks to medical advancements practiced at American Longevity Center, no one has to live with a hormone imbalance and its life sapping effects. Through hormone replacement

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DO I NEED MY HORMONES OPTIMIZED? If you are suffering from any of these symptoms, you may need your hormones optimized: • Fatigue • Erectile dysfunction and loss of libido • Lack of enthusiasm, motivation, and drive • Loss of muscle tone and figure • Poor concentration Through the most advanced diagnostic testing available, ALC’s physicians can determine if your symptoms are caused by a decline in hormones. Once diagnosed, we can tailor a treatment program based on your unique body chemistry. A standard blood test will not reveal imbalances in your hormones. If you have been tested for a hormonal imbalance via blood count and lipid panels, you did not receive the proper testing needed to determine the true level of your hormones.

need to suffer any more. You need your vitality to maintain your career, provide for your family, and maintain the lifestyle you enjoy and are accustomed to. When ALC patients begin our physician prescribed and monitored hormone replacement programs, the problems that plagued them are often eliminated and more dramatic improvements in their health are experienced.

ALC conducts comprehensive lab tests, including the hormone panel test, that result in an accurate diagnosis. If you are suffering from a hormone imbalance you may be facing a number of uncomfortable symptoms, and possibly even premature aging. You may have noticed a marked decline in your physique, loss of muscle mass and unusual weight gain. If you have a lack of energy, stamina, motivation and have trouble sleeping, there is no

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THE FIRST STEP ď&#x161;ş DETECTION Hormones reach their peak levels when we are young, usually during our teens and twenties. But as we grow older, hormone levels in the bloodstream gradually decline. Signs of hormonal decline include lack of vitality, weight gain, loss of libido and lethargy. Hormones decline at different rates. Some decline quickly, like estrogen and progesterone, during menopause. Other, including HGH, testosterone, thyroid hormones, DHEA, and melatonin, decline much slower. A general health intake and lab test at ALC are the first steps in detecting low hormone levels. For more information about hormone testing, please call ALC at 1-800-770-7126.

WHAT EXACTLY ARE SYMPTOMS OF A HORMONE DEFICIENCY? The physical, mental, and sexual health of an individual are usually negatively affected by a hormone deficiency. This happens because individuals often experience a deficiency in multiple hormones, not just one. The following is a questionnaire that will help you determine if you have a hormone deficiency and may be a good candidate for hormone replacement therapy.

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HORMONE DEFICIENCY QUESTIONNAIRE The following questionnaires are designed to assess your hormonal health. You can finish each questionnaire TESTOSTERONE

within 30 minutes to 1 hour. Don't rush and take your time to accurately answer each question. Cirle the number that best answers each question. SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

My face became slack & wrinkles started to show up

I've lost muscle tone

Fat started to accumulate in my belly

I don't feel like making love anymore

I’ve developed fatty tissue in my chest area

I feel more hesitant and less self-confident

My sexual performance has diminished

I have hot flashes and I always sweat

I tire easily after physical activity

(Men & Women)

(Men Only)

Add up your overall score _______

HGH

5 or less: Satisfactory level Between 6 and 10: Possible testosterone deficiency 11 or More: Probable testosterone deficiency

SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

I'm losing more hair

My cheeks became saggy

My gums are receding

My abdomen is flabby (I’ve got a “spare tire”)

My muscles are slack

My hair is more dry than usual

I have difficulty recovering from physical activities

I feel exhausted

I tend to isolate myself from others

I feel worried & anxious

(Men & Women)

Add up your overall score _______ 10 or less: Satisfactory level Between 11 and 20: Possible HGH deficiency 21 or More: Probable HGH deficiency

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DHEA

SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

I have dry hair

I have dry skin and eyes My belly is getting fatter

0 0 0

1 1 1

2 2 2

3 3 3

4 4 4

I don't have much hair in my pubic area (0=plenty, 4=hairless)

I don't have much fatty tissue in my pubic area (flat “mound of Venus” in women, 0=padded, 4=fat)

I don't have much of the special scent during sexual arousal

Loud noises seem to irritate me

I have low libido

I have flabby muscles

Add up your overall score _______

THYROID

10 or less: Satisfactory level Between11 and 20: Possible DHEA deficiency 21 or More: Probable DHEA deficiency

SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

I am sensitive to cold temperatures

My hands and feet are always cold

My face is puffy and my eyelids are swollen in the morning

I easily gain weight

I have dry skin

I have a hard time getting up in the morning

I feel more tired at rest as compared to when I am active

I am constipated often

I have stiff joints in the morning

I feel like I'm living in a slow motion manner

Add up your overall score _______ 10 or less: Satisfactory level Between11 and 20: Possible Thyroid deficiency 21 or More: Probable Thyroid deficiency

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MELATONIN

SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

I look old for my age

I have trouble sleeping at night

I wake up during the night

I can't get back to sleep once I wake up

I think of anxious thoughts when trying to fall asleep

My feet get too hot at night

I don't feel rested when I wake up

I feel like I'm out of synch with the rest of the world because I go to bed late and wake up late

I can't tolerate jet lag

I drink, smoke, and/or use a beta-blocker or a sleep aid

Add up your overall score _______

ESTROGEN

10 or less: Satisfactory level Between11 and 20: Possible Melatonin deficiency 21 or More: Probable Melatonin deficiency

SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

I am losing hair

I'm getting thinner, and vertical wrinkles have appeared on the top of my lips

My face is puffy and my eyelids are swollen in the morning

My breasts are droopy

I have more facial hair

0 0 0

1 1 1

2 2 2

3 3 3

4 4 4

0 0

1 1

2 2

3 3

4 4

My menstrual flow is light (0=moderate, 1-3=low,4=none)

(For women with periods) I have an irregular cycle (<27 days) or too long of a cycle (>31 days)

(For women without periods) I don't feel like

Women Only

I have dry and easily irritated eyes I have hot flashes I always feel tired I feel depressed

making love

Add up your overall score _______ 10 or less: Satisfactory level Between 11 and 20: Possible Estrogen deficiency 21 or More: Probable Estrogen deficiency

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PROGESTERONE

SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

My breasts are larger

My friends complain that I'm nervous and agitated

0 0

1 1

2 2

3 3

4 4

I can't get back to sleep once I wake up

I have swollen, tender, or painful breasts before my period

0 0

1 1

2 2

3 3

4 4

I have periods of time when I feel down

0 0

1 1

2 2

3 3

4 4

I have continuously painful periods

Women Only

I am anxious I sleep restlessly and lightly The following questions are for women who are not in menopause yet, and for women who are in menopause but are undergoing hormone replacement therapy (estrogen or estrogen and progesterone).

The lower part of my belly is swollen I'm aggressive and irritable I lose my temper

Add up your overall score _______

PREGNENOLONE

Post-menopausal women not treated with hormone replacement therapy (Estrogen or Estrogen and Progesterone): 4 or less: Satisfactory level Between 5 and 8: Possible Progesterone deficiency 9 or More: Probable Progesterone deficiency Menstrual women and menopausal women taking hormone replacement therapy (Estrogen or Estrogen and Progesterone): 10 or less: Satisfactory level Between 11 and 20: Possible Progesterone deficiency 21 or More: Probable Progesterone deficiency

SIGNS & SYMPTOMS

NEVER

SOMETIMES

REGULARLY

OFTEN

CONSTANTLY

I suffer from memory loss

I have joint aches (wrists, elbows, feet, ankles, knees, fingers)

I cannot handle stress and I feel drained

I don't perceive colors as brightly as before

I don't like art as I did before

I don't have much hair on my underarms and pubic area (0=plenty, 4=hairless)

I have flabby muscles

I have a lot of light-colored urine during the day

My blood pressure is low

I crave salty foods

Add up your overall score _______ 10 or less: Satisfactory level Between11 and 20: Possible Pregnenolone deficiency 21 or More: Probable Pregnenolone deficiency

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A lot of people are surprised that the problems they have been dealing with for several years are actually symptoms of a hormone imbalance. The questionnaires are for educational purposes and are not basis for an objective analysis of hormone therapy symptoms. However, low scores in these questionnaires can be an indication that you may have a hormone deficiency. If your score was low, you should call ALC and schedule an initial screening or blood test for your hormone levels to be accurately evaluated. Give us a call at 1-800-770-7126 so that we can help guide you through the process. You can change and improve your symptoms by getting more exercise and following a healthy, balanced diet. However, if you are already leading a healthy lifestyle and still suffer from symptoms, it's time for you to explore hormone medications.

HORMONES USED IN HORMONE THERAPY AND WHAT THEY MAY DO HGH • Cell rejuvenation • Aids muscle gain and fat loss • Makes healing faster • Boosts energy to youthful levels • Overall improvement in quality of life and longevity TESTOSTERONE • Libido booster for both males and females • Improves heart health • Prevents osteoporosis • Improves muscle tone and strength • Reduces fat DHEA • Promotes heart health • Lowers blood cholesterol • Slows down progressive diabetes • Heals arthritis • Prevents mental acuity THYROID HORMONE • Regulates cell growth and metabolism • Helps maintain weight • Improves vascular health • Boosts energy • Increases concentration • Controls body temperature

MELATONIN • Improves sleep • Treats jet lag • Boosts the immune system ESTROGEN • Treats symptoms of menopause • Prevents coronary heart disease • Improves brain processes • Anti-osteoporosis • Prevents Alzheimer's disease • Improves skin and muscle tone PROGESTERONE • Acts as an antidepressant and tranquilizer • Increases female libido • Prevents cancer • Improves thyroid activities • Helps burn fat • Prevents osteoporosis PRENEGNELONE • Precursor of other hormones • Anti-stress and fatigue • Prevents arthritis • Aids in a healthier heart • Boosts immune system • Prevents coronary heart disease • Boosts memory • Maximizes brain function • Prevents Alzheimer's disease

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HORMONE THERAPY FOR MEN Men are living a better and more vigorous life thanks to medical advancements. During the last 20 years, medicine underwent great developments. Improvements in surgical procedures, diagnostic tools, and advancements in research techniques changed the medical industry. Cancers, such as colon and prostate, are more treatable now. The chances of survival also improved. Patients of open heart surgery quickly recover and can be outpatients just days after operation. You can fill a lot of textbooks with these advancements. American Longevity Center is thrilled that hormone therapy programs that are monitored by progressive physicians are also getting more attention and are taking their rightful place in the medical profession.

MALE MENOPAUSE FACT OR FICTION? This issue has not been generally accepted in the medical industry. In the past many doctors ignored the condition commonly referred to as male menopause and even today, some still do not accept that low hormone levels is a serious condition that requires medical attention. PROBLEMS ASSOCIATED WITH LOW HORMONE LEVELS:

• Irritability • Sleep problems • Diminished libido • Erectile dysfunction • Muscle loss • Weight gain • Loss of memory • Hair loss • Decrease in bone density • Depression

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When our hormones dip, we reach the point where we cannot enjoy our daily activities because our bodies cannot keep up. We lose enthusiasm and energy, and we feel more tired. Sexual stamina and performance is at its lowest. Additionally, our physical appearance suffers as well. We lose our hair, become more wrinkled and experience weight gain. Some doctors will tell you that “it's all just a part of aging” and “get used to it”. You may have also been told to “eat better and exercise regularly.” Another common diagnosis- “You show signs of depression; you need antidepressants” or “take an ED pill”. The truth of the matter is, symptoms associated with a decline in hormones are not ‘just a part of getting older’. Symptoms and conditions that result in a hormonal decline are completely treatable, preventable and reversible.

HOW CAN ALC HELP ME?

I decided to undergo one of their hormone replacement programs after a comprehensive evaluation showed that I was suffering from Low Testosterone. I’ve never felt better. I feel much younger and revitalized. ALC’s physicians are extraordinary. Their staff is really caring. - Mike G., Miami, Florida

Male menopause, which can occur in a man as young as 35, is referred to as andropause. Andropause is caused by a reduction in the body’s production of testosterone and other hormones. It’s a normal part of aging - scientists say that by a time a man has reached his mid-twenties, his testosterone production will drop an average of 1-2% per year. For some men, it happens at a much quicker rate. Andropause can leave you feeling tired and out of energy. You also may lose interest in things you used to enjoy, find yourself unexplainably anxious, angry, or depressed, and notice a diminished sex drive. Other common problems include: • Problems with mood – irritability, anxiety and depression • Sexual dysfunction - erectile dysfunction may develop • Decrease in muscle mass, and increase in breast tissue and waistline muscles • Loss of focus, concentration and lesser optimal brain function • Fat accumulation and difficulty in getting rid of it • Poor results after extra effort is given at the gym The focus of hormone replacement therapy for men is to overcome these problems in a safe and effective way. This is done by creating a special, all-inclusive, individualized treatment program for each patient that involves hormone replacement therapy, nutrition, a fitness regimen, and dietary or herbal supplements.

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The physicians at American Longevity Center are nationally recognized experts in the field of hormone replacement therapy. WELL DOCUMENTED The benefits of hormone replacement therapy appear in many peer-reviewed journals which include Aging, American Journal of Cardiology, Journal of Clinical Endocrinology and Metabolism, Lancet, and many more. SYNERGISTIC Great results are experienced from hormone replacement treatments that are combined with good diet, nutritional supplements and regular exercise, as compared to therapies alone. EVIDENCE-BASED Hormone therapies conducted by ALC are based on accurate and unique processes that only result in objective assessments and recommendations. HOLISTIC At ALC, hormone treatments are founded on an organized framework for the diagnostic assessment and for the succeeding treatment regimen design. The overall personalized treatment plan is not just based on the physician's tests, your goals and needs are also incorporated. “Our findings suggest that endogenous testosterone, estrogen and free IGF-1 levels may play a protective role in the development of atherosclerosis (coronary heart disease) in aging men.” - Dept. of Internal Medicine, Erasmus University Medical Center – Published 2003

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HORMONE THERAPY FOR WOMEN Nowadays, most women balance their career with being a mother and a wife. That's why it can be easy for women to forget about maintaining their personal health and well-being. Women and men really do differ in a lot of ways. Some of a woman’s hormones protect her from diseases while at the same time, they can also harm her. Moreover, she is vulnerable to diseases like osteoporosis and cancer of the ovary and breast. When women consider their health, they often consider their weight. It is important to note that having good health is not limited to maintaining a healthy weight. Because of the risks that are associated with aging, you should be informed of the health practices that can benefit your health and your overall wellbeing in general.

As women progress through middle age, they begin to undergo what’s known as, “the change of life,” or menopause. Menopause is the natural process during which the female body ends menstruation, loses fertility, and ceases to be capable of reproduction. The word itself literally means, “end of monthly cycles.” Menopause typically happens between ages 45 to 55, though it may onset earlier or later in some cases (perimenopause). Though it’s a normal part of the aging process, for some women menopause may be a very uncomfortable time, accompanied by a number of unpleasant symptoms.

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SYMPTOMS OF PERIMENOPAUSE INCLUDE: • Irregular menstrual cycle length • Increased breast tenderness • Irritability, mood swings and anxiety • Water retention • Weight gain • Inability to cope • Poor concentration • Loss of appetite for sex SYMPTOMS OF MENOPAUSE INCLUDE: • Exercise & diet resistance • Weight gain • Breast tenderness & headaches • Tearfulness & Anxiety • Hot flashes & insomnia • Loss of appetite for sex • Fatigue, mood swings, & depression • Foggy thinking & confusion For some physicians, the usual practice is to prescribe contraceptive pills to regulate your period, antidepressants to lift your mood, or benzodiazepines to calm you down. However, these are just temporary solutions; the root cause of these problems remains. Women who suffer from these symptoms can expect and experience better health results when they prescribe to a simple hormone therapy program which is combined with exercise, proper diet, and nutritional and hormone medications. Hormone Replacement Therapy at American Longevity Center restores balance to the body, raising hormone levels to where they were pre-menopause. This leads to a complete revitalization: raised energy levels, elimination of menopausal side-effects, and an overall feeling of health. Add in the total lifestyle treatments available at ALC, and you’ll be feeling better than ever. Losing years to menopause isn’t the norm anymore. At American Longevity Center, you can reclaim your life and live it on your terms.

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WHAT ARE BIOIDENTICAL HORMONES? Bio-identical hormones are offered as an alternative form of HRT. Unlike synthetic hormones, bio-identical hormones or natural hormones are replicas of the body's own natural hormones. Bio-identical hormones are biologically identical to the same hormones your body makes. Synthetic hormones are derived from plant progesterone and animal estrogens, but are not identical to the hormones your body uses. Adult Onset Growth Hormone Deficiency Syndrome, Pre-menopause, and Menopause are just some of the conditions that bio-identical hormone therapy can treat. Other than alleviating the symptoms that are associated with conditions mentioned above, hormone therapy can also: • Improve the immune system • Enhance cognitive function and improve memory • Improve sexual performance • Give you more radiant skin • Increase muscle mass and reduce body fat • Make you feel more energetic • Make you feel and look younger

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BIOIDENTICAL HORMONES: ESTROGEN, TESTOSTERONE AND PROGESTERONE Suzanne Somers, in her book The Sexy Years, describes the transdermal administration of 'bio-identical' estrogen, testosterone and progesterone through a daily cream. This is a state-of -the art, very safe and effective form of treatment. Bio-identical hormones are often designated as the best form of treatment because they are scientifically designed to interact with your own hormones. As we age, our bodies make less of the vital hormones we still need. This leads to andropause, low testosterone, thyroid disorders, menopause and a host of other uncomfortable conditions commonly associated with aging. Bio-identical hormones are made in a compound pharmacy to be 100% identical to your own hormones. Many people, even doctors, can sometimes confuse Bio-identical hormones with synthetic hormones. Synthetic hormones are also made in a lab and referred to as natural, but may contain hormones that wouldn’t normally be found in the human body. Synthetic hormones may be derived from plant compounds as well as the urine of a pregnant mare. While the estrogen derived from the pregnant mare is natural, it is only found in horses, not humans. The physicians at American Longevity Center conduct a comprehensive health analysis of each patient to determine the reason for the decline in their hormones and can then recommend the best method of treatment. Often times, Bio-identical hormones can eliminate many of the symptoms men and women experience due to a lack of adequate hormone levels.

I always felt weak and fatigued. I was gaining weight and having a lot of joint aches. The worse part, I was feeling very depressed. I consulted some doctors but to no avail, my problem persisted. Then I heard about ALC’s hormone therapy. After the lab tests, I decided to undergo their program. From then on, my life has changed. ALC helped bring back my health and enthusiasm for life. -Monica H., Los Angeles, CA

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WHAT ARE MENOPAUSE, PREď&#x161;şMENOPAUSE, PERIMENOPAUSE AND POSTMENOPAUSE? After 12 months without having a period, a woman is said to be in menopause. Premenopause, which is characterized by several symptoms, occurs in the 5 to 10 years prior to the menopause period. Because of sharp changes in estrogen levels, a woman will experience symptoms that can include hot flashes, weight gain, irritability, difficulty concentrating, troubles with memory, dry skin, and others. Additionally, the rate at which women lose bone mass in the first five years after menopause is faster than in any period of a woman's life.

Post menopause can bring an increased risk of cardiovascular diseases, more vulnerability to osteoporosis and increases in bone fractures. The chance of developing diabetes and Alzheimer's is also higher. Hormone therapy can intervene during the critical premenopause stage. Taking a proactive approach to your health can help prevent the onset of these conditions and enable you to live a more enjoyable, active lifestyle.

I thought it was just normal for someone my age to experience troubles like depression. I heard of hormone therapy and called ALC. Upon consultation, I became aware that I was suffering from a hormonal imbalance. ALC diagnosed me and designed the program based on the results of my lab tests. After months of hormone treatment, I became more enthusiastic and I feel so much better. -Brenda N., Chicago, IL

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AN INTRODUCTION TO HGH THERAPY The damaging effects of low Human Growth Hormone (HGH) levels in adults have been widely unknown until recently. The physiological and psychological consequences of this already recognized clinical syndrome adversely affect the following: • Body mass • Obesity and accumulation of fat • Blood lipids • Muscle strength • Composition of bones • Energy and capacity to perform exercise • Cardiovascular health • Psychological health “All the evidence shows that HGH is one of the safest drugs we have. Thousands of patients have been followed for the last 16 years.” -Dr. Pinchas Cohen UCLA – Published 2003

ASK THESE QUESTIONS TO YOURSELF: Do you have a flabby abdomen? Do you feel muscle weakness? Do you experience sleep-related problems? Do you gain weight? Do you lose hair? Do you always feel exhausted? Do you have a hard time recovering after exercise? Low HGH also causes psychological problems like anxiety or nervousness, depression, and withdrawal from the rest of the society. If you have experienced the symptoms mentioned above, you should have your HGH levels tested to see if you are a candidate for HGH therapy.

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WHAT IS HGH? HGH is a hormone produced by the pituitary gland that aids in adolescent development. As the body ages past 30 and beyond, it naturally cuts production of HGH and other hormones even though it’s not necessarily medically beneficial. In some people, the cuts are drastic, and an HGH deficiency can result. In that case, people may undergo premature aging and suffer a noticeable decline in health and their physical appearance. Without hormones, bodily functions such as digestion and growth will never be possible. HGH plays a crucial part in muscle growth, brain function, physical and mental health, healing and tissue repair, and metabolism. As we age, the production of HGH together with IGF-1 decreases by 2-4 % yearly (on average). At the age of 20, our body produces 800 micrograms of HGH. When we reach 80, it decreases to 60 (or less) micrograms. A person with 200 ng/dl or lower is already considered to be HGH deficient.

COPING WITH ADULT GROWTH HORMONE DEFICIENCY AGHD AGHD refers to the condition wherein adults have low levels of HGH.

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These are some of the most common symptoms associated with AGHD. All of these however are not experienced by people with AGHD, it varies from case to case. If you are experiencing any of these symptoms then we have the proper and effective HGH therapies available for you. PHYSICAL SYMPTOMS • Loss of appetite for sex • Weight gain • Fatigue and signs of weakness • Muscle weakness • Problems with sleep PSYCHOLOGICAL PROBLEMS • Depression • Anxiety and nervousness • Withdrawal from others • Shyness • Feeling of losing hope

EFFECTS OF HGH A study, which was conducted by Dr. Daniel Rudman, published in the New England Journal of Medicine (Rudman: 323:1- 6, 1990) shows the promise of HGH therapy. It was the first major study about the effects of HGH therapy. The study involved 21 men (ages between 60 and 80) who had IGF-1 levels that were less than 350 IU per liter. They were divided into two groups – 12 test subjects and 9 control subjects. There was a six-month period allotted for data collection. Then, another 6 months for the clinical tests wherein the 12 test subjects received HGH injections while the 9 control subjects did not. The results were amazing. In the 12 test subjects there was an increase in vertebral bone height, decrease in adipose fat tissue, and increase in lean muscle mass. There was considerable increase in the HGH levels of these test subjects. This study became a milestone in all the other HGH therapy protocols.

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POTENTIAL EFFECTS OF HGH THERAPY Skin Energy Bone Sexual Power Muscle Fat Memory Heart Kidney Immune System Hair Cholesterol

Increased skin elasticity, texture, and tightness More energy and emotional stability Stronger bones Increased potency and frequency Increased muscle strength and mass Reduced body fat Enhanced brain functions Enhanced vascular endurance and lower blood pressure Improved kidney function Enhanced immune system and faster healing Reduction in hair loss Lower LDL and higher HDL

“HGH therapy imparts great psychological, psychosocial and cardiovascular health benefits. The treatment adds greatly to the quality of life and to maintaining a healthy lifestyle.” Dr. Carol Ann Ryser – Health Centers of America - Published 2002

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AN INTRODUCTION TO TESTOSTERONE THERAPY Every man gets to a point as he ages where he feels as if the years are beginning to catch up to him. It’s like the spring goes out of your step – you’re tired all the time, have trouble focusing at work, find yourself depressed or irritable. Lately, it’s hard to even get excited about quality time with your wife. For some men, this point in time can come as early as his early thirties, for others it may not come until their forties or fifties. Data from the U.S. Food and Drug Administration (FDA) suggests that 4-5 million American men have low testosterone levels. Take note, only 5% are treated. Do you belong to the 95% who suffer from this drop in hormone levels?

THE FIRST STEP DETECTION The most important step in treatment of low testosterone is detection. Take this ten-point quiz to see if you may be suffering from low testosterone: 1. Are you over 30 years old? 2. Do you have poor muscle tone? 3. Do you always gain weight, especially in your mid-section? 4. Do you always feel weak and tired? 5. After exercise, do you have a hard time recovering? 6. Do you have very low appetite for sex or symptoms of sexual dysfunction? 7. Do you feel irritable, unmotivated, and at times depressed? 8. Are you having a hard time in coping up with stress? 9. Do you have sleeping problems? 10. Do you drink alcohol, smoke cigarettes, or take prescription meds? If your answer is “yes” to most of the questions then there is a high possibility that you are suffering from low testosterone levels and a common condition called andropause. Andropause is the physical and psychological changes that men undergo gradually. Andropause is characterized by a decline in testosterone. For some men, this decline may be more drastic, leading to certain conditions that may be uncomfortable to live with. Testosterone therapy is your best option in treating andropause. It can also reduce age-related diseases that cause disability and death, and thus can increase lifespan.

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WHAT IS TESTOSTERONE? Testosterone, a hormone produced in a man's testes, is responsible for the development of male characteristics, muscle growth, and development of a deep voice. It also influences the production of sperm and sex drive. Testosterone is usually thought to be found only in men but women also produce the hormone in their ovaries and adrenal glands. “Testosterone replacement therapy enhances muscle strength and lean body mass, decreases leptin, and may enhance cognitive function, bone mineral density, and has positive effects on the cardiovascular system.” -Dr. Anton Dotson – Cenegenics Medical Institute

WHEN DOES IT DECLINE? For some men, by the time they reach the age of 25, testosterone levels begin to decline. Although low testosterone is a common condition, it’s only recently that the media and even medical field has started to give it the attention it rightfully deserves.

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So how do you know if you suffer from low testosterone? The following list of warning signs has a number of likely indicators: • Lack of Sex Drive • Erectile Dysfunction (ED) • Hair Loss • Fatigue • Decline in Stamina • Loss of Energy • Muscle Loss • Fat Retention • Loss of Bone Mass • Depression • Anxiety • Forgetfulness • Irritability • Inability to Concentrate • Insomnia or Sleep Apnea • Heat Flashes • Unexplained Sweatiness • Male Breasts (Gynecomastia) If you find that several of these symptoms apply to you, you might have low testosterone. Luckily, the solution is readily available at American Longevity Center.

BENEFITS OF TESTOSTERONE THERAPY Men who get testosterone supplements see a noticeable improvement in the physical well-being. They experience a big boost to their physique and body composition, gaining muscle mass and losing body fat. Boosting testosterone levels frequently leads to weight loss and improved mobility over a longer time period, especially when combined with regular exercise. Testosterone helps prevent broken bones by improving bone density, and plays an important part in cardiovascular health. Testosterone treatments also raise a man’s energy and stamina levels, often to where they were in his younger years. It improves a man’s mood and mental outlook, eliminating much of the mental stress associated with aging that’s caused by low testosterone.Men who addressed their andropause condition and sought hormone replacement therapy saw dramatic health benefits across the board. And if you need any more convincing on the importance of treating andropause, the condition of low testosterone itself has been linked to increased risk of death. In our present generation, it is normal to undergo different types of procedures to improve our appearance, well-being, and health. One more option that we need to seriously consider is testosterone therapy for men.

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EXPECTED RESULTS FROM TESTOSTERONE THERAPY Muscle Sexual Power Energy Memory

Increase in muscle mass and strength Enhanced sexual potency Enhanced energy, endurance, and stamina Improved mental ability

Mood

Improved mood and feeling of well-being

Heart

Protection against heart diseases

Concentration

Better focus and concentration

I had trouble with my sex drive. Often times, I feel depressed. I took some medications as advised by my doctor but none solved my problems. Upon hearing of ALC, I immediately scheduled a consultation. ALC’s testosterone program solved my problems. The results were great. - Justin R., Miami, FL

SOME FACTS ABOUT TESTOSTERONE • After the age of 50, it is estimated that 20% of men will reach their lowest testosterone levels • For men over 40, the drop in testosterone levels aﬀects their cognitive, physical, and sexual function • Low levels of testosterone should not be viewed as “normal for your age” • If you are having symptoms associated with andropause, you should be treated • A 25 year-old man has twice the amount of testosterone compared to a 40-year old man Some individuals have medical conditions that will not allow them to undergo testosterone therapy. To ensure that you are healthy enough to receive testosterone therapy, all patients undergo a comprehensive medical evaluation by ALC doctors before beginning any treatment program.

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ALC FAQS WHAT DOES ALC DO? American Longevity Center offers hormone replacement therapy and advanced healthy aging medicine for men and women who want to look and feel their best as they age. Offering the latest medical breakthroughs in proactive medicine, the expert physicians at ALC are able to effectively diagnose and treat conditions such as menopause, andropause, low testosterone, hyperthyroidism, hypothyroidism, nutritional deficiencies and other conditions that occur as a result of hormonal imbalances. WHERE ARE YOU LOCATED? We are headquartered in Aventura, Florida however we have offices throughout the U.S. To check if there is an affiliate doctor near you, please call 1-800-770-7126. AM I REQUIRED TO SEE ONE OF YOUR DOCTORS? Yes. All our patients are required to have a physical exam and consultation with an ALC affiliated doctor prior to any treatment program. HOW DO I GET STARTED? Call ALC at 1-800-770-7126. IF I GO TO ONE OF YOUR PHYSICIANS, WILL I AUTOMATICALLY QUALIFY FOR TREATMENT? No. You will need to undergo a physical examination first and have your lab tests reviewed. ALC doctors will only treat those who are diagnosed to be deficient in hormones and are experiencing Adult Growth Hormone Deficiency, Hypogonadism/Andropause, and Menopause or Hypothyroidism. If you have normal hormone levels or it appears that you do not need the therapy – treatment will not be prescribed. HOW ARE THE HORMONES OPTIMIZED? We administer testosterone either through injections or transdermal topical cream. For HGH, we only use injections. Estrogen and progesterone are taken through a specially formulated cream. Oxytocin, DHEA, melatonin, and thyroid hormones are taken in pill form. DO YOU ACCEPT INSURANCE? No. We do not accept any third party payments – insurance, Medicare, or Medicaid. We will neither respond to any inquiry nor fill out paperwork related to insurance.

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WHAT ARE YOUR PRICES? Here at ALC, we treat you as unique individuals with different needs as compared to others. We do not subscribe to the saying “one size fits all” in our programs. We design your therapy based on the results of your physical exam, lab tests, and other important factors. Pricing will be determined based on your evaluation and diagnosis. We can however offer estimates of our treatment programs. For more information, give us a call at 1-800-770-7126. IS HORMONE THERAPY SAFE? Yes. Numerous published studies show that natural hormone replacement is safe. No medical treatment or procedure is risk free. ALC therapy programs are supervised by leading physicians. Our specialists only prescribe dosages that are fit for your needs. ARE THERE SIDE EFFECTS? You may experience some side-effects. Our physicians will go over possible side effects with you. To minimize the side effects, our doctors prescribe dosages that are appropriate by your body. Less than 5% of our patients experience side effects. We address the side effects by adjusting the dosage as we go along the medication process. One more important step in ensuring our patients' safety is continued lab testing during your treatment program. WHEN SHOULD I THINK ABOUT HORMONE THERAPY? Hormones start to decline during your mid to late twenties. Upon reaching 30, there are drastic drops in your hormone levels and symptoms start to arise. If you are experiencing symptoms that are making it difficult to live a healthy, happy and active life, you should consider supplementing your hormones. HOW DO I KNOW IF THE PROGRAM IS WORKING? You will notice an improvement in the way you look and feel within four to six weeks. We also analyze the results by conducting additional lab tests, body composition tests, and bone density test to keep track of your progress while in the program. As we go along, we may make adjustments or fine tune your program to maximize your results.

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I'VE SEEN OTHER CLINICS ADVERTISED. WHY IS ALC HEALTH THE BEST PLACE TO GO? At ALC, we require all patients to be examined by a doctor before starting any of our programs. Some clinics do not require their patients to undergo initial tests before starting a program. This is unsafe and very unethical. Here at ALC, our programs include all lab work and tests necessary to begin the program and the follow up consultations. Many clinics charge extra for this. DO YOU RECOMMEND REPLACING TESTOSTERONE, HGH AND OTHER HORMONES AT THE SAME TIME? It depends on your needs and on the results of your tests. If you are growth hormone deficient, and testosterone deficient (or any other hormones), the doctor will recommend a combination treatment. But if you are deficient in only one hormone, then your program will focus on replacing that hormone only. HGH HAS A BAD REPUTATION IN THE MEDIA. WHY IS THAT? Unfortunately, because of the very high dosages taken by some athletes, HGH was given a bad reputation. These athletes take more than ten times the doctor-recommended amounts and too much HGH can be harmful for yoru health. ALC only prescribes HGH if there is a need and we base this off your IGF-1 levels and the symptoms that you experience. Your HGH levels are monitored during treatment to ensure your HGH levels remain at a healthy, optimum level. WILL HORMONE THERAPY HELP SEXUAL DYSFUNCTION? For over 90% of our patients who have sexual dysfunction, hormone replacement for testosterone showed great results. IS HORMONE THERAPY THE SAME THING AS STEROID ABUSE? No. The individuals that we treat are only those who have a medical need for hormone therapy. Also, only bio-identical hormones are used which are easier for the body to absorb. We only optimize your hormones to within acceptable levels. Steroid abuse is usually done by athletes who want to increase their muscle mass in order to have the edge in competitions. They also start with normal dosages but usually they take dosages more than 5 times the recommended therapeutic levels. Blends or “stacks” of designer anabolic steroids, which are non-bio-identical, are also being taken by these athletes. This is really dangerous and can cause serious medical conditions. TO ARRANGE A FREE CONSULTATION, CALL AMERICAN LONGEVITY CENTER AT 1-800-770-7126.

American Longevity Center Healthy Aging and Proactive Medicine

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WHAT THE EXPERTS ARE SAYING “The results of our study show that the use of short-term treatment with growth hormone during a standardized program of low calorie diet and physical exercise is effective in reducing the loss of muscle mass and increasing the loss of fat mass.” Dr. Silvia Savastano, PhD University of Naples – Published 2009 “Supplemental testosterone produced significant gains in total and appendicular lean mass, muscle strength, aerobic endurance with significant reductions in whole-body and truck fat. Outcomes appeared to be further enhanced with HGH supplementation.” Journal of Clinical Endocrinology & Metabolism - Published 2009 “In older adults, increased HGH has resulted in significant improvement in muscle mass and endurance.” Dr. George R. Merrimam University of Washington – Published 2006 “Side effects of HGH therapy for adult deficiency are minor, dose-related, and totally reversible.” New England Journal of Medicine – Published 1999 “Studies have demonstrated that adults with HGH deficiency are both physically and psychologically less healthy that their age-matched peers, and that HGH therapy results in substantial and sustained benefits.” Growth Hormone Research Society Scientific Committee – Published 2001

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WHAT OUR PATIENTS ARE SAYING “The programs that they have at ALC are amazing. I experienced great results and my life changed a lot. It was remarkable!” Robert T., Austin, TX “For the past 2 to 3 years, I was under ALC’s hormone therapy program. I am still experiencing great results, and I do more outdoor activities now.” John H., Fort Lauderdale, FL “ALC changed my life. Thank you for restoring my health. Now that I have optimal hormone levels, I can do so much and enjoy life again.” - Eunice M., Los Angeles, Ca “Upon signing up with one of the programs at ALC, I experienced dramatic results. I am still having hormone therapy treatment until now. I am still amazed by the improvement of my health and well being.” - Grace J., Boston, MA “My health was declining and I thought that it was just part of old age. I was surprised to know that my suffering was caused by low levels of testosterone. I started the testosterone treatments at ALC and I never felt so healthy like this in the past 20 years.” Michael B., Dallas, TX “I feel so much better now. I was living a very active life until I slowed down because of fatigue and depression. ALC’s diagnosis showed that I was having testosterone imbalance. I decided to start their program and I did not regret it. I was able to perform the activities that I really love doing.” Kevin F., Dallas, TX “ALC is the best hormone therapy clinic. Their doctors really explain the procedures and they know what they are doing. I am happy with the results of their testosterone therapy.” Louis S., Boca Raton, FL “My hormone deficiency affected my work and my social life, in general. The results that I experienced in ALC's program are remarkable and will forever change my life.” Tyra C., Austin, TX

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ALC MEDICAL ADVISORY BOARD Our advisory board is comprised of leading experts in the field of anti-aging medicine and age management. It is our commitment to provide our patients with quality health care and topmost laboratory services. The members of ALC advisory board are highly qualified and respected in their fields of specialization. We strive to maintain the highest standards in treatment protocols. ALC advisory board members provide our affiliate doctors with the proper principles of hormone therapy. They play a very vital role in patient care and support and in training our affiliate doctors.

PARTIAL LIST OF ALC HEALTH MEDICAL BOARD MEMBERS SCOTT BECKER, M.D. DAVID BLYWEISS, M.D. FEDRICO J. MARTINEZ, M.D.

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American Longevity Center Healthy Aging and Proactive Medicine

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