A4M MMI | Anti-Aging Medical News - Spring 2022 by Tarsus Medical

Fellowship in Anti-Aging, Metabolic and Functional Medicine (FAAMFM) A REDEFINED APPROACH TO FUNCTIONAL MEDICINE Transform your approach to patient-care, and ultimately the trajectory of your clinical career, through the Fellowship in Anti-Aging, Metabolic and Functional Medicine (FAAMFM). Designed for active practitioners seeking to lead at the very forefront of patient-centered medicine, FAAMFM delivers the most comprehensive and forward-thinking clinical training available through a highly personalized and flexible format. Through an advanced, integrative, systems-biology approach to care, FAAMFM has helped clinicians across the globe move past simply treating symptoms but rather deliver optimized clinical outcomes for patients of all ages and backgrounds. The time to do the same for your patients and clinical career is now.

Module III: Frontiers in Neurology and Brain Health

Module VI: Clinical Strategies to Optimize Metabolic Resiliency, Immunocompetence and Biotransformation (Part A)

Module I: Advanced Endocrinology: The Hormonal Symphony

Module IV: Gastroenterology: The Crossroads of Health

Module VII: Clinical Strategies to Optimize Metabolic Resiliency, Immunocompetence and Biotransformation (Part B)

Module II: Cardiology

Module V: TRIADS: A Systems Biology Approach

Module VIII: Longevity Medicine and Bio-HackingOptimizing Lifespan

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Dear Colleagues, Welcome to the 30th Annual Spring Congress presented by the American Academy of Anti-Aging Medicine (A4M). We are delighted to have you join us in person in Hollywood to celebrate our 30th year of providing best-in-class, innovative medical education. During a time of prevailing health crises, your continued commitment to forward-thinking education and redefining modern medicine is invaluable to us and the industry as a whole. Though the past two years have been profoundly challenging on an institutional level, as well as on a personal level, we at A4M view today’s health care landscape as an imperative opportunity for action. Together, we can address the integral needs of public health and the systems that were designed to care for it. As we work to restore optimal population health, filling voids with the latest comprehensive medical education, we can transform the standard of medicine into one that is rooted in research-based, whole-person care. At the core of our efforts lies the foundational element of optimizing individual patient health, which begins with improving the current state of nutrition. This year’s conference titled “Eat, Fuel, Heal: Nurturing the Second Brain” will delve into this pertinent facet of overall wellness and how it can be leveraged to prevent, treat, and even reverse a variety of chronic diseases. As we explore evidence-based dietary interventions for health restoration, we will reveal how prescribing food as medicine can transform patient health, reducing the burden of cardiovascular disease, diabetes, and many other health conditions. The following three days will deliver the latest clinical insights, strategies, and resources to inspire the practice of wholeperson care from the inside out. Beginning on Thursday with carefully selected pre-conference workshops, this year’s agenda kicks off with detailed investigations of select dietary interventions for longevity and critical tools for practice management. Then, as the conference kicks off on Friday, renowned leaders in the fields of nutrition, gastroenterology, integrative and anti-aging medicine, endocrinology, and psychology will lead cutting-edge sessions to inspire commitment to innovative, integrative approaches to care. Presentation topics include nutrition and hormone health, intermittent fasting and disease prevention, the multi-faceted role of the gut microbiome in general health, and the connection between mental wellness and dietary patterns. As proud leaders of advanced medical education, A4M and its parent company, Tarsus Medical, are determined to deliver innovative live clinical experiences that prioritize the health and safety of all our stakeholders. Physical distancing, increased attention to cleanliness and hygiene, and a modified conference format in adherence to local COVID-19 guidelines are a few of the many ways we are taking care of you. On behalf of the entire A4M team, we want to thank each of you for bringing vision, expertise, and commitment to this event and our ever-expanding community of pioneering medical professionals. As leaders in the field, you have the knowledge, motivation, and experience to shape a new and improved landscape of patient-centered health care. Please enjoy your stay in Hollywood and accept our sincere gratitude for your ongoing support. In Good Health, Ronald Klatz, MD, DO & Robert M. Goldman, MD, PhD A4M Founders

Ronald Klatz MD, DO

Co-Founder

ANTI-AGING MEDICAL NEWS | SPRING 2022

Robert Goldman MD, PhD, DO, FAASP Co-Founder

SHOW REGULATIONS 1. An official picture ID is required to pick up name badge. 2. Name badge must be worn at all times during show hours and official events. 3. No one under the age of 18 will be admitted into the Exhibit Hall. 4. This event is open to healthcare professionals and their invited guests only. 5. Photography is permitted in the Exhibit Hall only by press, with the prior permission of show management, and prior permission from the firm(s) whose booth(s) are being photographed. Videography in the Exhibit Hall (motion video, film, or digital) is permitted only at discretion and with advance permission of show management and the prior permission of individual(s) and/or firm being photographed. 6. Audio and video recording (tape or digital) of this event is expressly prohibited. 7. U nauthorized solicitation is prohibited. In addition, non-A4M and/or commercial literature of any kind may not be distributed near or at the event registration area and all event-related general public areas. 8. N o medical procedures are permitted to take place in Exhibit Hall booths without prior permission of show management. 9. S how management reserves the right to expel any individual and/or company without recourse or refund at its sole discretion. 10. PHOTO RELEASE: Anyone in attendance at any A4M event may be subject to any photography or videography conducted during the event which may be used in any form for future media purposes. Please contact A4M with any concerns.

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ANTI-AGING MEDICAL NEWS | SPRING 2022

TABLE OF CONTENTS General Information ......................4

Exhibitor Index ...........................138

Product Announcements .............91

Exhibit Hall Floormap .................142 Exhibitor Listings ........................143

22 28 34 40 46 58 68 72 76 82 120 128

Leveraging Support from the Mitochondria -

Microbiome Axis for Mitochondrial Health & Lifespan Enhancement Testicular Cancer: An Anti-Aging Approach By: Pamela W. Smith, MD, MPH, MS

Test, Don’t Guess if You are Nitric Oxide Deficienty By: Mitch Ghen, DO, PhD & Nathan S. Bryan, PhD®

Unlocking the Power of Dietary Restriction: A Strategy to Support Healthy Aging at the Cellular Level By: Lacy Kuester, MS, MPP, RDN

The Pathophysiology of Stress By: Andrew Heyman, MD, MHSA

Evaluation Of The Effects Of CBD Hemp Extract On Opioid Use And Quality Of Life Indicators In Chronic Pain Patients: A Prospective Cohort Study By: Capano A, Weaver R, Burkman E.

Does PEA Support a Normal Pain Response? By: Kendra Whitmire, MS, CNS

Prevention and Lifestyle Care Beats Costly Medical Tests and Treatments Every Time By: Erika Schwartz, MD

The Gut Microbiome in Dermatology By: Christine Stubbe, ND

Nurturing the Second Brain By: Nathan S. Bryan, PhD

Problem with Topical Sex-Hormone Delivery and Testing in Serum and Urine By: David T. Zava, PhD

Hyperbaric Oxygen and Regenerative Medicine - Effect of the “Hyperoxia-Hypoxia Paradox” On Stem Cell Mobilization, Cell Signaling, Inflammation, Epigenetics & Cell Regeneration By: Jason Sonners, DC, PhD(c)

ANTI-AGING MEDICAL NEWS | SPRING 2022

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A4M | MMI

PLANNING COMMITTEE

Andrew Heyman

Pamela W. Smith MD, MPH, MS

Sahar Swidan

MD, MHSA, ABFM, ABIHM

PharmD, BCPS, ABAAHP, FAARFM

Director of Academic Affairs

Director of Professional Programming

Mark C. Houston

MD, MS, MSc, FAARM, ABAARM

James LaValle RPh. CCN, MT

Mark Rosenberg

MD, FAARM, ABAARM

A4M FOUNDERS Ronald Klatz

Robert Goldman

MD, DO

MD, PhD, DO, FAASP

Co-Founder

ANTI-AGING MEDICAL NEWS | SPRING 2022

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1] The giveaway is not open to any exhibitors and their staff, suppliers or supplier affiliates to the 30th Annual Spring Congress. 2] Only one entry per person will be accepted. 3] This entry form must be completed fully and correctly, validated by each of the sponsors and their unique stamps in the logo square, signed and including your full name, City & State of residence for verification purposes. 4] You must be present at the time of the giveaway to win. 5] The prize is not transferable or redeemable for cash. 6] Impact duties, federal, state, and local taxes are the responsibility of the winner. 7] A W-9 tax form must be completed prior to prize collection. 8] The actual Rolex watch on display may differ from photograph. 9] Must be 18 years or older to WIN.

PME SESSIONS THURSDAY | APRIL 28TH 6:15 pm

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Leveraging Support from the Mitochondria-

Microbiome Axis for Mitochondrial Health & Lifespan Enhancement

By:

Christine Stubbe ND

The following article is not endorsed and/or supported by The American Academy of Anti-Aging Medicine . The purposes of this publication do not imply endorsement and/or support of any author, company or theme related to this article .

ANTI-AGING MEDICAL NEWS | SPRING 2022

Leveraging Support from the Mitochondria - Microbiome Axis for Mitochondrial Health & Lifespan Enhancement

Abstract: Mitochondria are the cell’s power plants. They’re found in varying numbers within almost all living cells. These tiny organelles float freely through a cell’s cytoplasm, acting as its digestive system. Mitochondria take in nutrients, break them down, and create energy-rich ATP molecules for cells—a process known as cellular respiration (Pizzorno, 2014). Mitochondria, microscopic energy factories that fuel the body, typically number in the trillions. They turn air and food into energy in order to power cellular reactions. That energy is used for everything. Young people have plenty of mitochondria. However, mitochondria decline in number and size over time. The energy that the young take for granted fades away during the aging process. Mitochondrial decline is suggested as one of the main drivers of aging (Chistiakov et al., 2014). When mitochondria work optimally, cells are fueled efficiently and biological pathways run smoothly. But, aging mitochondria can become dysfunctional, disrupting cellular processes and stockpiling damage. Mitochondrial dysfunction due to accumulated damage is a hallmark of aging. But what if the relationship between the mitochondria and the human gut microbiome could shed some light on paving a path to maintaining healthier mitochondria and slowing the aging process?

diversity of the human microbiome substantially outnumbers human genes. Modern clinical science now focuses on the importance of the microbiome for metabolic health and well-being—and rightfully so.The ancestral mitochondria-microbiome axis is at the center of this symbiosis. The microbiome produces influential metabolites critical for mitochondrial function and biogenesis (the process by which cells increase mitochondrial numbers). These essential mitochondrial-supportive metabolites include: • Short-chain fatty acids (SCFAs)—especially butyrate • Urolithins—especially urolithin A • Lactate A self-perpetuating system is at play between the microbiome, the metabolites it produces, and maintaining mitochondrial health. An abundance of SCFAs, urolithins, and lactate supports an increase in microbial diversity. And conversely, an increase in microbial diversity supports the creation of more SCFAs, urolithins, and lactate. This cycle supports healthier mitochondria (Franco-Obregón & Gilbert, 2017).

The Microbiome-Mitochondria Connection The interaction between the microbiome and mitochondria has been mostly ignored. Yet, their relationship is a foundation for health and longevity. Mitochondria arose from a mutualistic relationship between ancient bacteria and single-celled organisms like protozoa. Cell-to-cell communication began between these ancient microbes and protists, allowing for multicellularity. The ability of an organism to be multicellular comes down to initiating a complex host to the bacteria communication that occurs through metabolic and immune processes. In this scenario, the body and its resident mitochondria are the “host,” and the microbiome supplies essential metabolites to the host (Franco-Obregón & Gilbert, 2017).

The Microbiome-Mitochondria Axis

A Breakdown of Mitochondrial Support Provided by Key Microbiome Metabolites BUTYRATE: (Clark & Mach, 2017; Don hoe et al., 2011; Zhang et al., 2010) • SCFAs, especially butyrate, supports AMP kinase expression, which promotes mitochondrial biogenesis • Is the main energy support for colonocyte (intestinal epithelial cell) mitochondria • Supports mitochondrial insulin regulation, promoting glucose homeostasis • Supports fatty acid beta-oxidation, which in turn reduces intracellular lipid accumulation • Supports an increase in ATP output and bioenergetics

Humans have vast and diverse gut microbiomes. The sheer genetic ANTI-AGING MEDICAL NEWS | SPRING 2022

Leveraging Support from the Mitochondria - Microbiome Axis for Mitochondrial Health & Lifespan Enhancement

UROLITHINS: (Al-Harbi et al., 2021; Chen et al., 2020; Di’Amico et al., 2021) • Commensal (friendly) gut flora make urolithins from ellagitannins consumed in the diet. They come from berries, fruits, nuts, and other polyphenol sources • Urolithin A (UA) supports mitophagy, a form of autophagy that selectively degrades damaged mitochondria. Removal of damaged mitochondria and cellular cleanup via mitophagy promotes healthy aging • UA support increases energy output and mitochondrial capacity • In animal studies, UA supports increased cell longevity via increased mitochondrial longevity LACTATE: (Van Hall, 2000) • Beneficial bacteria in the gut produce lactic acid, which supports the growth of more SCFA and urolithin-producing bacteria. • Lactate provides a fuel source for mitochondria in skeletal muscles and cardiac muscles Mechanisms and factors involved in mitochondrial aging constitute a multi-pronged discussion. However, it’s clear that microbes, which through evolution gave rise to the mitochondria themselves, significantly impact mitochondrial aging. Through microbiome diversity and the production of microbial metabolites, the microbiome appears to support healthy mitochondrial aging in various ways. As research continues to look at the microbiomemitochondria axis, perhaps we can outline more mechanisms and factors by which this relationship may support mitochondrial function, delaying mitochondrial aging and expanding longevity.

References 1. Al-Harbi, S. A., Abdulrahman, A. O., Zamzami, M. A., & Khan, M. I. (2021). Urolithins: The Gut Based Polyphenol Metabolites of Ellagitannins in Cancer Prevention, a Review. Frontiers in nutrition, 8, 647582. https://doi.org/10.3389/ fnut.2021.647582 2. Chen, G., Kroemer, G., & Kepp, O. (2020). Mitophagy: An Emerging Role in Aging and Age-Associated Diseases. Frontiers in cell and developmental biology, 8, 200. https://doi.org/10.3389/fcell.2020.00200 3. Chistiakov, D. A., Sobenin, I. A., Revin, V. V., Orekhov, A. N., & Bobryshev, Y. V. (2014).Mitochondrial aging and age-related dysfunction of mitochondria. BioMed research international, 2014, 238463. https://doi. org/10.1155/2014/238463 4. Clark, A., & Mach, N. (2017). The Crosstalk between the Gut Microbiota and Mitochondria during Exercise. Frontiers in physiology, 8, 319. https://doi. org/10.3389/fphys.2017.00319 5. D’Amico, D., Andreux, P. A., Valdés, P., Singh, A., Rinsch, C., & Auwerx, J. (2021). Impact of the Natural Compound Urolithin A on Health, Disease, and Aging. Trends in molecular medicine, 27(7), 687–699. https://doi.org/10.1016/j. molmed.2021.04.009 6. Donohoe, D. R., Garge, N., Zhang, X., Sun, W., O’Connell, T. M., Bunger, M. K., & Bultman, S. J. (2011). The microbiome and butyrate regulate energy metabolism and autophagy in the mammalian colon. Cell metabolism, 13(5), 517–526. https://doi.org/10.1016/j.cmet.2011.02.018 7. Franco-Obregón, A., & Gilbert, J. A. (2017). The Microbiome-Mitochondrion Connection: Common Ancestries, Common Mechanisms, Common Goals. mSystems, 2(3), e00018-17. https://doi.org/10.1128/mSystems.00018-17 8. Pizzorno J. (2014). Mitochondria-Fundamental to Life and Health. Integr Med (Encinitas), 13(2), 8-15. https://www.ncbi.nlm.nih.gov/pmXc/articles/ PMC4684129/ 9. Van Hall, G. (2000). Lactate as a fuel for mitochondrial respiration. Acta physiologica Scandinavica, 168(4), 643–656. https://doi.org/10.1046/j.1365201x.2000.00716.x 10. Zhang, L., Keung, W., Samokhvalov, V., Wang, W., & Lopaschuk, G. D. (2010). Role of fatty acid uptake and fatty acid beta-oxidation in mediating insulin resistance in heart and skeletal muscle. Biochimica et biophysica acta, 1801(1), 1–22. https://doi.org/10.1016/j.bbalip.2009.09.014

ANTI-AGING MEDICAL NEWS | SPRING 2022

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Testicular Cancer:

An Anti-Aging Approach

By:

Pamela W. Smith By:

MD, MPH, MS

Pamela W. Smith MD, MPH, MS

ANTI-AGING MEDICAL NEWS | SPRING 2022

Testicular Cancer: An Anti-Aging Approach

Description Testicular cancer is the most common solid tumor among males 15 to 34 years of age, with an estimated 8,850 new cases and 410 deaths during 2017 in the United States. With effective treatment, the overall five-year survival rate is 97%.1 The signs and symptoms of testicular cancer include scrotal swelling, scrotal heaviness, painless, sold testicular mass, firmness of the testis, dull ache in the scrotum or abdomen, acute pain in the testis or scrotum.2 Epididymitis is an important part of the differential diagnosis of a scrotal mass. If tenderness, swelling, or examination abnormalities persist after antibiotic treatment, further evaluation is necessary to rule out testicular cancer. 3 Etiology and Risk Factors Risk factors for testicular cancer are numerous. 4 In patients with undescended testis (cryptorchidism), the relative risk of developing testicular cancer ranges from 2.9 to 6.3; the risk is increased in both testes, although the risk is much higher in the ipsilateral testis. 5-6 Among these patients, the risk of cancer increases when orchiopexy is delayed until after puberty or never performed compared with early orchiopexy.7-8 Even after early orchiopexy, the risk of testicular cancer remains elevated compared with the general population.9 Patients with a personal history of testicular cancer have a 12-times greater risk of developing a contralateral testicular cancer than the general population. However, the greatest risk is in the first five years after diagnosis, and the 15-year cumulative risk is 1.9%.10 In addition, patients with a father or brother with testicular cancer have a significantly great risk of developing the disease.11-13 Moreover, men with infertility have an increased risk of developing testicular cancer, with a standardized incidence ratio of 1.6 to 2.8, although the underlying mechanism is unclear.14-16 Human immunodeficiency virus infection/AIDS increases the risk of seminoma, but this is negated with the antiretroviral treatment.17 Associations between testicular cancer and marijuana use, inguinal hernia, diet, maternal smoking, and body size are inconclusive. 1820 Testicular microlithiasis, and vasectomy are not risk factors for testicular cancer.21 Infections with human papillomavirus (HPV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B-19, and human immunodeficiency virus (HIV) increase the patient’s risk.22

In addition, trauma to the testicle is a risk factor.23-24 Furthermore, high maternal estrogen levels are a risk factor.25 Conventional Therapies26 If a solid intratesticular mass is discovered, orchiectomy is both diagnostic and therapeutic. Radical inguinal orchiectomy, including removal of the spermatic cord to the internal inguinal ring, is the primary treatment for any malignant tumor found on surgical exploration of a testicular mass. Testis-sparing surgery is generally not recommended but may be performed for a small tumor in one testis or for small bilateral tumors. Orchiectomy may be delayed if life-threatening metastases require more urgent attention.27-28 Treatment after orchiectomy is based on histology, staging, prognosis, and an individualized discussion with the patient on the benefits and harms of treatment options.29 Adjunct therapies may include radiation and/or chemotherapy. The high survival rate and young age of patients with testicular cancer result in long periods of survivorship with multiple sources of potential morbidity and mortality. Complications arise from both the disease process and treatment and vary according to individual course. Secondary malignancy may be a concern in these patients. Testicular cancer survivors treated with radiotherapy or chemotherapy are at increased risk of secondary malignant neoplasms. There is a threefold increased risk of leukemia among testicular cancer survivors treated with radiotherapy to the abdomen and pelvis. Cisplatin and etoposide therapies also increase the risk of secondary leukemia.30 Radiotherapy and chemotherapy increase the risk of solid cancers beginning five years after treatment.31 Sites of secondary malignancy, in order of greatest to least risk, included stomach, pancreas, pleura, bladder, colon, and esophagus.32 Infertility and hypogonadism should be addressed with the patient. Cancer alone may affect fertility. A systematic review found that up to 50% of patients with testicular cancer have semen abnormalities prior to orchiectomy.33 Orchiectomy and the effects of chemotherapy and radiation also carry significant risks of future infertility. RPLND may induce retrograde ejaculation or anejaculation, although advances in surgical techniques have reduced this risk.34 Adjuvant therapy increases the short- and long-term risks of cardiovascular disease in testicular cancer survivors. A recent

ANTI-AGING MEDICAL NEWS | SPRING 2022

Testicular Cancer: An Anti-Aging Approach

population-based study of more than 15,000 testicular cancer survivors found a fivefold increased risk of cardiovascular mortality within the first year after chemotherapy compared with orchiectomy alone. This cardiovascular risk was not significant beyond the first year.35 A retrospective study of testicular cancer survivors compared with age-matched control patients showed that radiotherapy or chemotherapy imposes greater than a twofold increased long-term risk (after 10 years posttreatment) for atherosclerotic disease; combined therapy increased the risk to almost fivefold.36 Mediastinal irradiation, in particular, carries more risk than subphrenic irradiation.37 There are no evidencebased recommendations for heart disease screening in testicular cancer survivors. Physicians and other health care providers should be aware of potential cardiovascular risk in cancer survivors with attention to standard risk factor screening and lifestyle interventions for primary cardiovascular disease prevention. Anti-Aging Medicine Therapies Anti-Aging Medicine therapies include all the conventional approaches discussed previously along with the following treatments. Smoking If the patient smokes, work with the patient on smoking cessation therapies. Stress Stress from any cause is known to modulate the immune response and can partially suppress certain aspects of immune function.38 In addition, prolonged psychological stress appears to be correlated with cellular aging, inducing characteristic senescence features such as increased oxidative stress, reduced telomere length, chronic exposure to glucocorticoids, decreased thymus, changes in cell trafficking, decreased cell-mediated immune response, steroid resistance, and chronic low-grade inflammation.39-41 In fact, immunosenescence (alteration of immune function due to aging) has been widely reported in older individuals, as a result of the chronic antigen stimulation and cellular stress encountered throughout life. 42 However, other factors are also associated with the acquisition of precocious senescent features in immune cells, including tissue damage, oxidative stress, cytotoxic therapies, DNA damage, chronic inflammation, and chronic psychological stress.43 Furthermore, both biological and psychological stress experienced during cancer therapy may be responsible for stimulating molecular processes that induce premature aging and

deterioration of immune system in testicular cancer survivors, leading to an increased susceptibility to infections, cancer, and autoimmune diseases.44-45 The increasing evidence described above, that some cancer treatments may induce cellular senescence and aging of the immune system, may have implications on the development of secondary medical conditions later in life.46 Testicular cancer survivors have an increased risk to suffer of late adverse events, including hypogonadism, infertility, metabolic syndromes, neurotoxicity, lower cognitive functions, reduced renal function, heart disease, and secondary cancers.47 Hypogonadism also increases the risk of developing metabolic syndrome, including cardiovascular complications and diabetes, which appears to be greater after combination therapy (chemo-radiotherapy).48-49 In addition, testicular cancer survivors struggle with high rates of anxiety and PTSD.50-52 Inflammation One study hypothesized a correlation between low testosterone levels and increased secretion of pro-inflammatory cytokines in the genesis and maintenance of chronic diseases.53 Lower the inflammatory component in the body with EPA/DHA,curcumin, and low-dose naltrexone. Low-Dose Naltrexone (LDN) The results of increasing studies indicate that LDN exerts its immunoregulatory activity by binding to opioid receptors in or on immune cells and tumor cells. These new discoveries indicate that LDN may become a promising immunomodulatory agent in the therapy for cancer and many immune-related diseases.54 It has also been reported that LDN is able to reduce tumor growth by interfering with cell signaling as well as by modifying the immune system. This data supports further the idea that LDN possesses anticancer activity, which may be improved by modifying the conventional treatment schedule.55 Testosterone Replacement A recent study is the first to investigate the effect of testosterone substitution in testicular cancer survivors with mild Leydig cell insufficiency.56 Consider HCG or clomiphene citrate to raise testosterone levels in younger men if levels are low. Consider testosterone replacement in males that are in andropause that have a history of testicular cancer. A study revealed that all three treatments were equally effective in restoring testosterone levels.57

ANTI-AGING MEDICAL NEWS | SPRING 2022

Testicular Cancer: An Anti-Aging Approach

Conclusion As you have seen there are both conventional and Anti-Aging Medicine treatments that are successful for testicular cancer. Also

considering possible risk factors for other diseases that need to be mitigated as the patient ages are paramount along with therapies to improve their lifestyle.

References 1. Baird, D., et al., “Testicular Cancer: Diagnosis and Treatment,” Amer Fam Physician 2018; 97(4):261-68. 2. Shaw, J., et al., “Diagnosis and treatment of testicular cancer,” Amer Fam Physician 2008; 77(4):470. 3. McConaghy, J., et al., “Epididymitis: an overview,” Amer Fam Physician 2016; 94(9):723–26. 4. Ibid., Shaw. 5. Lip, S., et al., “A meta-analysis of the risk of boys with isolated cryptorchidism developing testicular cancer in later life,” Arch Dis Child 2013; 98(1):20–6. 6. Akre, O., et al., “Risk of contralateral testicular cancer among men with unilaterally undescended testis: a meta analysis,” Int Jour Cancer 2009; 124(3):687–89. 7. Walsh, T., et al., “Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer,” Jour Urol 2007; 178(4 pt 1):1440–46. 8. Chan, E., et al., “FRCSC for Canadian Association of Pediatric Surgeon Evidence-Based Resource. Ideal timing of orchiopexy: a systematic review,” Pediatr Surg 2014; 30(1):87–97. 9. Pettersson, A., et al., “Age at surgery for undescended testis and risk of testicular cancer,” NEJM 2007; 356(18):1835–41. 10. Fossa, S., et al., “Risk of contralateral testicular cancer,” Jour Nat; Cancer Inst 2005; 97(14):1056–66. 11. Hemminki, K., et al., “Familial risk in testicular cancer as a clue to a heritable and environmental aetiology,” Brit Jour Cancer 2004; 90(9):1765–70. 12. Del Risco Kollerud, R., et al., “Family history of cancer and risk of paediatric and young adult’s testicular cancer: A Norwegian cohort study,” Brit Jour Cancer 2019; 120(10):1007-14. 13. Hemminki, K., et al., “Familial risks in testicular cancer as aetiological clues,” Int Jour Androl 2006; 29(1):205-10. 14. Jacobsen, R., et al., “Risk of testicular cancer in men with abnormal semen characteristics: cohort study,” BMJ 2000; 321(7264):789–92. 15. Walsh, T., et al., “Increased risk of testicular germ cell cancer among infertile men,” Arch Intern Med 2009; 169(4):351–56. 16. Eisenberg, M., et al., “Increased risk of cancer in infertile men,” Jour Urol 2015; 193(5):1596–1601. 17. Goedert, J., et al., “Risk of germ cell tumors among men with HIV/acquired immunodeficiency syndrome,” Cancer Epidemiol Biomarkers Prev 2007; 16(6):1266–69. 18. Gurney, J., et al., “Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis,” BMC Cancer 2015; 15:897. 19. Manecksha, R., et al., “Epidemiology of testicular cancer,” BJU Int 2009; 104(9 part B):1329–33. 20. Lerro, C., et al., “A systematic review and meta-analysis of the relationship between body size and testicular cancer,” Brit Jour Cancer 2010; 103(9):1467–74. 21. Ibid., Hemminki. 22. Garolla, A., et al., “Role of viral infections in testicular cancer etiology: Evidence from a systematic review and meta-analysis,” Front Endocrinol (Lausanne) 2019; 10:355. 23. Coupland, C., et al., “Risk factors for testicular germ cell tumours by histological tumour type. United Kingdom Testicular Cancer Study Group,” Brit Jour Cancer 1999; 80(11):1859-63. 24. Haughey, B., et al., “The epidemiology of testicular cancer in upstate New York,” Amer Jour Epidemiol 1989; 130(1):25-36. 25. Depue, R., et al., “Estrogen exposure during gestation and risk of testicular cancer,” Jour Natl Cancer Inst 1983; 71(6):1151-55. 26. Gaddam, S., et al., Testicle Cancer, StatPearls (Internet). Nov. 7, 2021. 27. European Association of Urology. Guidelines. Testicular cancer. 2015. https:// uroweb.org/guideline/testicular-cancer. Accessed September 30, 2020. 28. American Cancer Society. Can testicular cancer be found early? http://www. cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-detection. Accessed December 4, 2021. 29. Albers, P., et al., “European Association of Urology. Guidelines on testicular cancer: 2015 update,” Eur Urol 2015; 68(6):1054–68. 30. Fung, C., et al., “Long-term morbidity of testicular cancer treatment,” Urol Clin North Amer 2015; 42(3):393–408.

31. Ibid., Fung. 32. Travis, L., et al., “Second cancers among 40,576 testicular cancer patients: focus on long-term survivors,” Jour Nat Cancer Inst 2005; 97(18):1354–65. 33. Djaladat, H., et al., “The association between testis cancer and semen abnormalities before orchiectomy: a systematic review,” Jour Adolesc Young Adults Oncol 2014; 3(4):153–59. 34. Ostrowski, K., et al., “Infertility with testicular cancer,” Urol Clin North Amer 2015; 42(3):409–20. 35. Fung, C., et al., “cardiovascular disease mortality after chemotherapy or surgery for testicular nonseminoma: a population-based study,” Jour Clin Oncol 2015; 33(28):3105–15. 36. Haugnes, H., et al., “Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study,” Jour Clin Oncol 2010; 28(30):4649–57. 37. van den Belt-Dusebout, A., et al., “Long-term risk of cardiovascular disease in 5-year survivors of testicular cancer,” Jour Clin Oncol 2006; 24(3):467–75. 38. Glaser, R., et al., “Stress-induced immune dysfunction: Implications for health,” Nat Rev Immunol 2005; 3:243–51. 39. Bauer, M., “Chronic stress and immunosenescence: a review,” Neuroimmunomodulation 2008; 15:241-50. 40. Reed, R., “Stress and immunological aging,” Curr Opin Behav Sci 2019; 28:38–43. 41. Epel, E., “Psychological and metabolic stress: a recipe for accelerated cellular aging?” Hormones 2009; 8(1):7–22. 42. DePadova, S., et al., “Immunosenescence in testicular cancer survivors: Potential implications of cancer therapies and psychological distress,” Front Oncol 2020; 10:564346. 43. Smith, P., Max Your Immunity. Garden City Park, NY: Square One Publishers, 2021. 44. Ibid., DePadova. 45. Bauer, M., et al., “The role of stress factors during aging of the immune system,” Ann NY Acad Sci 2009; 1153:139–52. 46. Cupit-Link, M., et al., “Biology of premature ageing in survivors of cancer,” ESMO Open 2017; 2:e000250. 47. Lubberts, S., et al., “Early ageing after cytotoxic treatment for testicular cancer and cellular senescence: Time to act,” Crit Rev Oncol Hematol 2020; 151:102963. 48. Haugnes, H., et al., “Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study,” Jour Clin Oncol 2010; 28:4649–57. 49. La Vignera, S., et al., “Hypogonadism and sexual dysfunction in testicular tumor survivors: A systematic review,” Front Endocrinol Lausanne 2019; 10:264. 50. Smith, A., et al., “The prevalence, severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study,” Jour Cancer Surviv 2016; 10(2):223–33. 51. Kreiberg, M., et al., “Psychological stress in long-term testicular cancer survivors: a Danish nationwide cohort study,” Jour Cancer Surv 2020; 14(1):72–9. 52. Dahl, A., et al., “Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings,” Jour Cancer Surviv 2016; 410(5):842–9. 53. Maggio, M., et al., “Correlation between testosterone and the inflammatory marker soluble interleukin-6 receptor in older men,” Jour Clin Endocrinol Metabol 2006; 91(1):345-47. 54. Li, Z., et al., “Low-dose naltrexone (LCN): A promising treatment in immunerelated diseases and cancer therapy,” Int Immunopharmacol 2018; 61: 178-84. 55. Liu, W., et al., “Naltrexone at low doses upregulates a unique gene expression not seen with normal doses: Implications for its use in cancer therapy,” Int Jour Oncol 2016; 4992):793-802. 56. Bandak, M., et al., “A randomized double-blind study of testosterone replacement therapy or placebo in testicular cancer survivors with mild Leydig cell insufficiency (Einstein-intervention),” BMC Cancer 2017; 17:461. 57. Habous, M., et al., “Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short course randomized study,” BJU Int 2018; 122(5):889-97.

ANTI-AGING MEDICAL NEWS | SPRING 2022

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Test, Don’t Guess if You are Nitric Oxide Deficient

Test, Don’t Guess if You are Nitric Oxide Deficient By:

Mitch Ghen DO, PhD &

By:

Nathan S. Bryan Mitch Ghen PhDPhD DO, &

Nathan S. Bryan PhD

ANTI-AGING MEDICAL NEWS | SPRING 2022

Test, Don’t Guess if You are Nitric Oxide Deficient

Despite billions of dollars in annual funding, Americans remain one of the least healthy of any major developed society. Chronic diseases such as cardiovascular disease, diabetes, cancer, Alzheimer’s Disease remain the leading causes of death around the world. The growing list of diagnosed syndromes such as chronic fatigue syndrome further reveal that the medical community has no real understanding of how to prevent, treat or cure most human disease. What has become clear over the past thirty years in science and medicine, at least to the integrative physicians, is that chronic disease is caused by only two things. 1.The body is missing something that it needs (vitamins, minerals, adequate hydration, etc) or 2. The body is exposed to something that is toxic (infections, environmental toxins, chemicals, EMF, etc.) Therefore, in order to address the many chronic conditions affecting most Americans, we must identify through testing what is missing and what toxins/chemicals are in our body. Once you correct both of these underlying issues, the human body can heal itself. That is the way our bodies are designed to work and that is the only way to change the course of patient care. If we start with this premise and then work backwards, we can begin to elucidate clear mechanisms of action of every single human chronic disease. Every major chronic disease is characterized and associated with dysfunctional mitochondria and decreased blood flow to the affected organ. Without functional mitochondria, the cells cannot generate sufficient energy to do their job and they fail. Without sufficient blood flow, the cells and tissues do not get enough oxygen and other nutrients to support mitochondrial function. Therefore, energy production is compromised and waste products build up due to inadequate circulation. Although they are different, mechanistically they are connected. You can’t have one without the other. The connection to adequate circulation and optimal mitochondrial function is nitric oxide or NO. NO is a signaling molecule produced by our endothelial, neuronal and immune cells in the body. NO produced by our endothelial cells signals the surrounding smooth muscle in our blood vessels to relax and dilate allowing for more oxygen and nutrient delivery to downstream tissues and cells [1]. NO is also required for oxygen delivery by hemoglobin during the arterio-venous transit [2]. NO is necessary and sufficient for mitochondrial biogenesis [3] and NO controls and regulates mitochondrial ATP production [4-6]. Without sufficient NO production, there is decreased blood flow and oxygen delivery to cells and their mitochondria cannot generate energy. The net result is that cells fail to do their job, tissues become dysfunctional and organs fail.

There are many things that cause a disruption in nitric oxide production. The older one gets, the less NO produced by the endothelial cells [7-9]. This is referred to as endothelial dysfunction. There are non-invasive devices that can accurately measure endothelial function from flow mediated dilation (FMD) and autonomic nervous system testing. A deficiency in magnesium can cause a disruption in NO production since magnesium is required by the nitric oxide synthase (NOS) enzyme. The oxidation of tetrahydrobiopterin (BH4) is the rate limiting step in NOS production of NO. Therefore, anything that limits BH4 production or causes its oxidation will cause a disruption in NO. Exposure to heavy metals scavenge NO but also prevents its production. Metals such as mercury, aluminum, lead, iron, or cadmium inhibit NO production. Exposure to chemicals such as glyphosate cause the NOS enzyme to become dysfunctional [10]. Certain medications affect NO production. The use of antacids, specifically proton pump inhibitors (PPIs) cause an increase in asymmetric dimethyl L-arginine (ADMA) [11] which inhibits NO production [12]. The use of mouthwash disrupts good commensal oral nitrate reducing bacteria [13-15]. The consequences of all of these is the reduction in our ability to produce nitric oxide which is what allows all cells in the body to get the raw materials they need to do their job but also allows for the elimination of waste products. Without nitric oxide, the body cannot function. That is why we must test for critical nutrients that may be missing and test for chemicals and toxins that disrupt NO production. Table 1: Essential Nutrients that are necessary for Enzymatic NO production Missing Nutrients that Cause Nitric Oxide Deficiency

1. Magnesium 2. Selenium 3. Glutathione 4. NADPH 5. Dietary Nitrate

There are known and recognized clinical and biochemical consequences of insufficient NO production. If a patient is NO deficient, biochemically, there is increased inflammation, oxidative stress and immune dysfunction. These are the hallmarks of

ANTI-AGING MEDICAL NEWS | SPRING 2022

Test, Don’t Guess if You are Nitric Oxide Deficient

every single chronic disease. There are a number of biomarkers that begin to appear as nitric oxide production declines and physiological systems become unregulated. This is extremely important, especially since there are no known validated blood labs that can detect NO directly. NO, once produced is gone in less than a second. Therefore, we must rely on subsequent biomarkers that appear when a patient is nitric oxide deficient. The list of relevant biomarkers is below in Table 2. Table 2: Clinical biomarkers that are reflective of nitric oxide deficiency Blood/Saliva Biomarkers Associated with Nitric Oxide Deficiency

1. Elevated HS CRP 2. Elevated homocysteine 3. Elevated Uric acid 4. Oxidized lipoproteins

is part of the insulin signaling pathway [16]. Therefore, when there is a disruption in nitric oxide production that leads to a condition of nitric oxide deficiency, clinical symptoms begin to appear. The primary clinical symptoms are listed in Table 3. In patient care, it is important to consider all of the above. Clinical presentations should give you a first insight into what may be going on in your patients. Based on patient assessment, you can then begin to contemplate certain labs and tests. It is then, you can begin to determine mechanistically what is happening in your patients, address the fundamental issues and then make clinical decisions on how to best treat your patients. Using this approach, one can get to the root cause of disease by repleting the missing nutrients, remove the offending toxins or sources of infection/inflammation. Once this is accomplished, the clinical symptoms and laboratory findings will begin to normalize. In most cases, pharmaceutical intervention is not required. It is clear and indisputable that loss of nitric oxide causes chronic disease. In order to specifically address nitric oxide deficiency and to promote nitric oxide production, below are a few practical tips to accomplish this. 1. Supplement to replete missing nutrients including nitrate

5. ADMA/SDMA

2. Restore endothelial function by oral and IV therapy 3. Stop smoking

6. Salivary nitrite

4. Stop taking antacids

In addition to biomarkers and laboratory findings, certain and specific clinical presentations are reflective of nitric oxide deficiency. NO controls and regulates normal blood pressure. NO regulates perfusion of specific vascular beds upon demand such as during sexual arousal, upon exercise, upon memory recall, etc. Nitric oxide

5. Start exercising 6. Use an infrared sauna to hep detox and to promote NO and mitochondrial function 7. Use fluoride-free toothpaste 8. Discontinue mouthwash

Table 3: Clinical symptoms and presentations of nitric oxide deficiency Clinical Symptoms of Nitric Oxide Deficiency

1. Hypertension – Systemic and Pulmonary

7. Atherosclerosis

2. Erectile Dysfunction

8. Blood clotting disorders

3. Vascular Dementia – Alzheimer’s Disease

9. Acute respiratory distress syndrome

4. Diabetes

10. Heart failure

5. Peripheral Artery Disease

11. Chronic kidney disease

6. Small vessel disease – Ischemic, non-obstructive Coronary Artery Disease

ANTI-AGING MEDICAL NEWS | SPRING 2022

Test, Don’t Guess if You are Nitric Oxide Deficient

Give the body what it needs, remove from the body what it does not need or what is toxic, and the body heals itself. This is the true essence of human physiology and the future of health care. It is clear the current and old way of medicine and health care is not working. We must think differently, and we must approach health care differently. The science and technology are available, well validated to provide a way forward. The human body cannot and will not heal itself without sufficient nitric oxide production. This should be the priority in managing any patient.

References: 1. Arnold, W.P., et al., Nitric oxide activates guanylate cyclase and increases guanosine 3’:5’-cyclic monophosphate levels in various tissue preparations. Proc Natl Acad Sci U S A, 1977. 74(8): p. 3203-7. 2. Zhang, R., et al., Hemoglobin betaCys93 is essential for cardiovascular function and integrated response to hypoxia. Proc Natl Acad Sci U S A, 2015. 112(20): p. 6425-30. 3. Nisoli, E., et al., Mitochondrial biogenesis in mammals: the role of endogenous nitric oxide. Science, 2003. 299(5608): p. 896-9. 4. Brown, G.C., Nitric oxide regulates mitochondrial respiration and cell functions by inhibiting cytochrome oxidase. FEBS Lett, 1995. 369: p. 136-139. 5. Shiva, S., et al., Nitrite augments tolerance to ischemia/reperfusion injury via the modulation of mitochondrial electron transfer. Journal of Experimental Medicine, 2007. 204(9): p. 2089-2102. 6. Basu, S., et al., Nitrite reductase activity of cytochrome c. J Biol Chem, 2008. 283(47): p. 32590-7. 7. Egashira, K., et al., Effects of age on endothelium-dependent vasodilation of resistance coronary artery by acetylcholine in humans. Circulation, 1993. 88(1): p. 77-81. 8. Taddei, S., et al., Age-related reduction of NO availability and oxidative stress in humans. Hypertension, 2001. 38(2): p. 274-9. 9. Gerhard, M., et al., Aging progressively impairs endothelium-dependent vasodilation in forearm resistance vessels of humans. Hypertension, 1996. 27(4): p. 849-53. 10. Gaur, H. and A. Bhargava, Glyphosate induces toxicity and modulates calcium and NO signaling in zebrafish embryos. Biochem Biophys Res Commun, 2019. 513(4): p. 1070-1075. 11. Ghebremariam, Y.T., et al., Proton pump inhibitors and vascular function: A prospective cross-over pilot study. Vasc Med, 2015. 20(4): p. 309-16. 12. Cooke, J.P. and Y.T. Ghebremariam, DDAH says NO to ADMA. Arterioscler Thromb Vasc Biol, 2011. 31(7): p. 1462-4. 13. Kapil, V., et al., Physiological role for nitrate-reducing oral bacteria in blood pressure control. Free Radic Biol Med, 2013. 55: p. 93-100. 14. Doel, J.J., et al., Evaluation of bacterial nitrate reduction in the human oral cavity. Eur J Oral Sci, 2005. 113(1): p. 14-9. 15. Duncan, C., et al., Chemical generation of nitric oxide in the mouth from the enterosalivary circulation of dietary nitrate. Nat Med, 1995. 1(6): p. 546-51. 16. Jiang, H., et al., Dietary nitrite improves insulin signaling through GLUT4 translocation. Free Radic Biol Med, 2014. 67: p. 51-7.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Unlocking the Power of Dietary Restriction:

A Strategy to Support Healthy Aging at the Cellular Level

A Strategy to Support Healthy Aging at the Cellular Level By:

By: Lacy Kuester Lacy Kuester MS, MPP, RDN

MS, MPP, RDN

ANTI-AGING MEDICAL NEWS | SPRING 2022

Unlocking the Power of Dietary Restriction: A Strategy to Support Healthy Aging at the Cellular Level

Introduction It’s no secret that patients are always looking for the most effective way to take charge of their health and support their journey towards healthy aging. But there are some common myths to bust and misleading simplifications to overcome before diving into the power of dietary restriction as a practical tool for healthy aging. Supporting healthy aging is not just about extending lifespan. In fact, it’s also about preserving health span. Lifespan is simply the number of years a person lives whereas health span refers to the number of years a person lives in good health. Decades of research have proven that modifying what we eat, how much we eat, and when we eat can influence health span and, among non-human species, life span.1-4 This article will provide an overview of several forms of dietary restriction that modulate cellular mechanisms associated with healthy aging. Dietary Restriction: Origins and Definitions Dietary restriction (DR) is a general term that may include caloric restriction, the restriction of specific nutrients, or different methods of fasting.1,3,4 Its effect on lifespan and health span has been an active area of study for over a century. The origin of this research — which gave rise to the Biology of Aging field — dates back to 1917 when researchers noted that caloric restriction extended the lifespan of rats.1,4 Since the publication of that study, several forms of DR have been tested as strategies to extend health span and lifespan among various species.1-4 Forms of Dietary Restriction Associated with Extended Health Span and/or Lifespan Among Various Species

Molecular Mechanisms of Dietary Restriction Understanding the molecular mechanisms of dietary restriction provides a rigorous scientific foundation to identify a dietary

approach to support healthy aging at the deepest,cellular level.Since the link between DR and extended lifespan was first established, scientists have sought to uncover the mechanisms through which it influences cellular pathways that are implicated in the aging process. The answer is due in part to the fact that food interacts with nutrient-sensing pathways (NSPs) within the cell. These pathways include mTOR (mechanistic target of rapamycin), IGF1 (insulin-like growth factor-1), and PKA (protein-kinase A).1-5 NSPs are upregulated when the body has adequate energy, glucose, protein, and amino acids. In this state, the cell’s mechanisms for growth, replication, and aging are activated. The opposite is true in the absence of adequate nutrients: NSPs are inhibited and instead FOXO, one of a class of forkhead transcription factors, is upregulated. FOXO has many functions including activating cellular stress-resistance, antioxidant production, and autophagy, the body’s built-in mechanism for recycling worn-out intracellular structures. Nutrients therefore activate pro-aging functions of the cell while DR upregulates the cell’s protective functions.1-3,5,6 Dietary Restriction Extends Non-Human Lifespan As an important first step to demonstrate whether dietary restriction extends non-human lifespan, a more in-depth look into the comprehensive scientific evidence is required. The effect of DR on human lifespan has yet to be determined; however, the fact that humans share similar cellular mechanisms with organisms whose lifespans are extended with DR is promising.1,3,4 Studies of yeast, worms, flies, rodents, and non-human primates have confirmed that caloric restriction — while providing adequate nutrients to prevent malnutrition — extends lifespan.1-4 In these same species, the restriction of total protein, branched chain amino acids (BCAAs), and other amino acids (AAs) such as methionine exerted similar effects.The pro-longevity effect of protein restriction is maintained even in the absence of caloric restriction, indicating that it may be possible to support longer lifespan through the manipulation of macronutrients while meeting an individual’s total energy needs.1,4 Adhering to periods of fasting – both intermittent fasting (IF) and periodic fasting (PF) – has also been associated with longer lifespan in various animal models.1,3 (See table below for descriptions of various forms of fasting that have been trialed.) Studies of IF and PF among rodents are promising; however, more research is needed. The effect of IF on lifespan appears to differ for rodents based on their species and age,

ANTI-AGING MEDICAL NEWS | SPRING 2022

Unlocking the Power of Dietary Restriction: A Strategy to Support Healthy Aging at the Cellular Level

among other factors.1 Rodent PF trials, though evincing a pro-longevity effect, have been conducted with only one species.1,3 Additional studies among diverse rodent populations are warranted to elucidate whether the effects PF can be reliably replicated. Dietary Restriction Extends Human Health Span

Conclusion

In recent years, the positive impact of DR on health span, including among humans, has been well-documented. Caloric restriction, protein and AA restriction, and fasting have been associated with a reduction of risk factors for diabetes, cardiovascular disease, and other chronic health conditions.The reduction of risk factors, in turn, delay or prevent disease onset.3,4 Humans routinely experienced DR throughout history, both inadvertently due to food scarcity and by choice as part of various cultural and religious practices. Given the abundance of food that is readily available today, individuals are less likely to practice any form of DR, which may interfere with their goals for healthy aging.

Unlocking the power of evidence-based fasting will serve as a valuable tool in patients’ quest for healthy aging. Nutrition is a powerful pillar of lifestyle medicine that can support healthy aging. Dietary restriction -- which includes caloric restriction, the restriction of protein and specific amino acids, intermittent fasting, and periodic fasting – is one strategy to support the body’s natural mechanisms to support healthy aging. Though it’s too soon to know if DR can contribute to a longer lifespan among humans, it has been established as a means to lengthen life among numerous non-human species. DR achieves this by flipping the switch on the body’s NSPs, taking them out of growth mode and instead activating repair mode. Through these mechanisms, among others, DR may extend both health span and lifespan.

Disease States and Disorders in which Dietary Restriction Confers a Protective Effect Among Humans(1,3,4)

Despite the beneficial effects of protein restriction, a current trend in nutrition is to encourage a higher intake of protein. Residents of Western countries like the United States tend to eat more protein and AAs than the recommended amount, and they often choose animal-based proteins like meat and dairy, which are associated with poor health outcomes when overconsumed. This recent trend bears negative implications; human studies link high intake of protein and AAs with blood sugar imbalance, insulin resistance, obesity, diabetes, and reduced cognitive function.1 Thus, patients may benefit from reducing their total protein intake (while meeting physiological needs) and by choosing plant-based protein options more often. Fasting has entered the zeitgeist and healthcare practitioners are increasingly more considering IF and PF as part of their nutrition recommendations for patients. Research in the safety and efficacy of various forms of fasting continues to emerge and both currently appear to be promising and safe approaches to positively impact human health span by reducing the risk and incidence of chronic illness.

Bio Lacy Kuester, MS, MPP, RDN

Lacy is a Registered Dietitian Nutritionist with a Master of Science in Nutrition, Healthspan & Longevity from the University of Southern California. This article is sponsored by L-Nutra, with whom Lacy is currently affiliated.

References 1. Green CL, Lamming DW, Fontana L. Molecular mechanisms of dietary restriction promoting health and longevity. Nat Rev Mol Cell Biol. 2021;23(1):56-7.

2. Fontana L, Partridge L, Longo VD. Extending healthy life span — from yeast to humans. Science. 2010;328(5976):321-326. 3. Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab. 2014;19(2):181-192.

4. López-Lluch G, Navas P. Calorie restriction as an intervention in ageing. J Physiol.

ANTI-AGING MEDICAL NEWS | SPRING 2022

2016;594(8):2043-2060. JP270543

doi:10.1113/

5. Longo VD, Di Tano M, Mattson MP, Guidi N. Intermittent and periodic fasting, longevity and disease. Nature Aging. 2021;(1):47-59. 6. Martinez-Lopez N,Tarabra E,Toledo M, et al. System-wide benefits of intermeal fasting by autophagy. Cell Metab. 2017;26(6):856871.e5.

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The Pathophysiology of Stress

By:

Andrew Heyman MD,Heyman MHSA Andrew By:

MD, MHSA

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Pathophysiology of Stress

Introduction The importance of the hypothalamic-pituitary-adrenal axis (HPA) in mediating the stress response and maintaining physiologic homeostasis has long been described. It is well established that chronic stress propagates a systemic cascade of dysfunctional metabolic events initially intended to be adaptive. Dysfunction of the HPA axis appears to be a major initiating and contributing factor to this process, ultimately giving rise to disruption of the normal diurnal cortisol release pattern. Maladaptive cortisol release patterns can be characterized as hypercortisol, which is an overly exaggerated response to stress, or hypocortisol,which is an underproduction of cortisol under stressful circumstances. While the latter has been often characterized as ‘Adrenal Fatigue,’ this notion does not fully appreciate the complex, multi-step process that results in low cortisol states, or the body of literature that characterizes hypocortisolism as an adaptive response to stress.

pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), central nervous system (CNS) and periphery, in addition to the cardiopulmonary, endocrine, immune and gastrointestinal tract.1-4 When these systems remain resilient and produce a positively coordinated reaction to stress, resiliency and metabolic reserve is maintained and the health of the individual protected. Allostatic Load: Overwhelming the Stress Response Chronic activation of the stress system contributes to the “Allostatic load” as coined by McEwen and Stellar, which reflects the total strain on the stress response.1 Contributors to allostatic load include major life events, trauma, abuse, work, home, community, as well as day-to-day lifestyle behaviors including sufficient rest, diet, nutrition, exercise, toxins, and substance abuse.1-8 If allostatic load overwhelms the body’s ability to compensate, thus degrading allostasis, a number of emotional and physiological manifestations can arise including: 1-9

This paper reviews the components of the stress response, mechanisms of alterations in cortisol production, and common botanical therapies utilized in mitigating the stress response and protecting the health of the individual.

Mood

Depression, Anxiety and Sleep Disorders; Altered perception, behavior and social interactions

Physiologic Adaptation to Stress

Cognition

Memory loss, word finding difficulties, decreased executive function

Endocrine

Obesity, Insulin resistance, Diabetes, decreased leptin, increased grehlin,

Cardiovascular

Abnormal heart rate, hypertension, hyperlipidemia, elevated fibrinogen, myocardial infarction, stroke

Immune

Poor immune defense, Increased pro-inflammatory cytokines, cancers, auto-immune diseases, Atopic illnesses

Neurologic

Headaches, decreased heart rate variability (HRV), increased SNS activity (12hour urinary norepinephrine and epinephrine)

Reproductive

Infertility, hormone imbalances

Gastrointestinal

GERD, peptic ulcers, Irritable Bowel Syndrome, Ulcerative Colitis

Skin

Rashes, hives, atopic dermatitis

Physiologic stress is a “state of disharmony or threatened homeostasis” that occurs in the central nervous system (CNS) and surrounding tissues and organs.1 It triggers an intricate series of metabolic responses collectively called the “adaptive stress response” that is intrinsically designed to help the body reestablish equilibrium to counteract a perceived extrinsic or intrinsic “stressor.”1-4 Lifestyle behaviors along with stress duration, intensity, and frequency can add to dysregulation of the stress system and result in a myriad of health problems and ultimately, disease, thus affecting an individual’s ongoing resiliency or “successful adaption to change.”1-6The brain’s ability, in particular, to resist the effects of a stressor plays a central role in determining the integrity of the stress response itself, and whether it remains intact or develops abnormal patterns of reaction over time.1,2,5 Allostasis: Balance in the Stress Response The ability to achieve stability through change or “Allostasis” within the stress response is reliant upon a system of healthy interactions across the neuroendocrine, cellular, and molecular components of the stress system, including the hypothalamic-

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The Pathophysiology of Stress

McEwen categorizes these into primary, secondary and tertiary markers of allostatic load. Primary mediators that have a direct response from stress and predictive validity in the context of longitudinal behavioral assessments include cortisol, adrenaline, sympathetic and parasympathetic activity, proand anti-inflammatory cytokines, metabolic hormones and neurotransmitters and neuromodulators.10 Secondary markers are indirect measures of immune system efficacy and a result of the aggregate impact of primary mediators including WHR, BP, cholesterol/HDL ratio, HDL cholesterol, glycosylated hemoglobin, inflammatory markers mentioned above (IL-6, C-reactive protein, and fibrinogen), and telomere length and telomerase activity.1-10 Individuals who experience early life adversity are likely to experience higher levels of oxidative and inflammatory stress (primary mediators) resulting in telomere shortening (secondary outcome) or obesity (secondary outcome), and are at increased risk for depression, diabetes, CVD or substance abuse.1-10 Tertiary mediators or outcomes such as CVD, decreased physical activity, severe cognitive decline, Alzheimer’s disease, vascular dementia, or cancer are the diseases or disorders that result from the extreme values of secondary outcomes due to increased allostatic load.10 The Stress Response: It All Begins in the Brain The stress response begins in the paraventricular nucleus (PVN) of the hypothalamus, the anterior lobe of the pituitary gland, and the adrenal gland, otherwise known as the hypothalamic-pituitaryadrenal (HPA) axis.1-9 Neurons in the medial parvocelluar subdivision of the PVN synthesize and secrete corticotropinreleasing factor (CRF), the principle regulator of the HPA axis and automonic nervous system (learning, memory, feeding, reproduction), and vasopressin (AVP).9 In response to stress, CRF is released and binds to the CRF type 1 receptor (CRFR1) on pituitary corticotropes which activate the cyclic adenosine monophosphate (cAMP) pathway and release of adrenocoriticotrophic hormone (ACTH) into systemic circulation.1,3,4,9 Circulating ACTH binds to the melanocortin type 2 receptors (MC2-R) in the adreno-cortical zona fasciculata, causing steroidogenesis and glucocorticoid, mineralocorticoid (MR), and androgenic steroid synthesis and secretion.1,3,4,9 Stress-receptive neurons in the brain stem,relay sensory information

from cranial nerves to the PVN that excite large areas of thoracic and abdominal viscera.9 Projections from the prefrontal cortex and amygdala limbic structures regulate the behavioral responses to stress by releasing catecholamines.9 The anterior cingulate and prelimbic cortex increase ACTH and glucocorticoid responses to stress.1,2,9 Medial (MeA) nuclei of the amygdala are activated following exposure to “emotional” stressors while central (CeA) nuclei are activated by “physiological” stressors and regulate the HPA axis through intermediary brain stem neurons.1,9,10 The amygdala is a target for circulating glucocorticoids and the CeA and MeA express both GR and mineralocorticoid receptors (MR). In contrast to the effects on hippocampal and cortical neurons, glucocorticoids increase expression of CRF in the CeA and potentiate autonomic responses to chronic stress.1-10 Activation of brain stem noradrenergic neurons and sympathetic and renomedullary circuits further contribute to the body’s response to stressful stimuli including emotion, vigilance, memory, and resiliency.1,3,9,10 Stressful stimuli alter neuronal electrophysiological activity and induce release of norepinephrine, ACTH release, anxiogenic-like activity, and immune suppresion.1-10 Metabolic Response to Stress The extra-CNS metabolic response to acute stress includes rapid and strong elevation of plasma concentrations of glucose, insulin, glycerol, and ketone bodies, stimulation of adipose tissue lipase by circulating catecholamines, activation of the autonomic nervous system via glucagon secretion, and decrease in triacylglycerol levels.1,4,9 Several neuropeptide systems in the brain are substantially affected by stress including norepinephrine, epinephrine, serotonin, dopamine, glutamate, taurine, GABA, glycine, phenylethylamine (PEA),and histamine.1-10 Ongoing disruption of neurotransmission can potentially lead to neuropsychiatric symptom manifestation and acceleration of neurotransmitter depletion, with the mesoprefrontal pathway being particularly at-risk, thus impacting reward-mediating neurotransmitters possibly leading to addictive behaviors.1,9,10 Activation of cerebral cholinergic transmission impacts arousal, motivation, and cognition.1,4,9,10Extracellular levels of glutamate, the major excitatory amino acid transmitter, increases in numerous regions of the brain, while changes in GABA receptor properties can also impact the stress response.4,9,10

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Pathophysiology of Stress

However, several aspects of GABA-ergic neurotransmission may be obscured by endogenous steroid hormone derivatives whose synthesis is increased following stress.4,9,10These compounds influence several aspects of the behavioral and neuroendocrine response to stress.9-10 Alterations in the endogenous opioid neurotransmission are implicated in stress-related endocrine and autonomic responses.9,10 Alterations in the Stress Response Stress can induce changes in CRH and AVP expression in the PVN, and increased concentrations of ACTH in the systemic circulation, result in desensitization of pituitary CRH receptors and blunted ACTH release.1-10 This dissociation between CRH hyperactivity and refractory corticotrophin responsiveness is a pathognomonic feature of stress-associated neuroendocrine dysregulation.10 Beyond this, stress drastically affects growth hormone secretion, thyroid axis function, and reproductive function via decreased gonadotropin levels, suppressed gonadal steroids, increased circulating prolactin, disruption of the ovarian cycle, and decreased libido.1-10 Hypocortisolism: A Protective Mechanism? While elevated cortisol patterns are well recognized and understood, the process through which hypocortisolism evolves remains ill defined. Although reduced availability of cortisol may be due to primary dysfunction of the adrenal glands, controversially labeled as “adrenal fatigue”, reductions in biosynthesis of hormones at different levels of the HPA axis likely play a greater role. Since integrity of HPA axis function and predictable patterns of diurnal cortisol release are essential for maintaining homeostasis during periods of chronic stress, much of the available research on hypocortisolism and stress induced disease has focused on disturbances in these latter mechanisms. Hellhammer and Wade postulated a developmental model whereby hypocortisolism may develop via hypoactivity of the HPA axis after prolonged periods of chronic stress. After an initial period of HPA axis hyperactivity and hypercortisolism, hypocortisolism may ultimately develop as a type of maladaptive “over compensation” of the self preservation mechanisms designed to protect metabolic machinery, and particular the brain, from the deleterious effects of persistent cortisol elevation.112 An increase in hypothalamic release of CRF with subsequent adaptive down-regulation of CRF receptors at the level of the pituitary gland has also been proposed. Although this has been demonstrated

in animal studies, replication of such a process in human subjects has been difficult but may be indirectly implied. Yehuda et al. and others have postulated that an increase in the sensitivity of the HPA axis to hypercortisolism induces negative feedback control on further release of stimulating hormones thereby causing hypocortisolism.213 McEwen identifies a central mechanism for low cortisol states via alterations in the CA1 and CA3 regions of the hippocampus. Known as the ‘Neurodegenerative Model of Hypocortisolism,’ in which the hippocampus plays a central role in the regulating the entirety of the stress response. While a primary purpose of this critical brain structure is to consolidate memories, and assign importance to those memories, it also maintains the highest concentration of cortisol receptors in the brain.314 The hippocampus is therefore exquisitely vulnerable to high stress states, with cortisol potentially playing a catabolic or damaging role that can lead to alterations in both function and structure of this brain center. It should be noted that the hippocampus serves a regulatory role to the HPA axis, and once injured, can lead to low cortisol states. The neuroinflammation and neurodegeneration associated with the damaging effects of cortisol in the brain argues for therapeutic strategies that limit injury of cortisol to key brain areas, reduce inflammation and induce neurogenesis. Intrinsic dysfunction of the adrenal gland has also been proposed as well, but overall limited data exists in comparison to other mechanisms that lead to hypocortisolism. Heim and colleagues have reviewed studies on the effects of chronic stress on the adrenal glands and have concluded, “There is a considerable body of evidence of reduced adrenal gland activity and reactivity in human subjects living under conditions of chronic stress.”415 Scott and colleagues found patients with CFS and abnormal endocrine parameters to have a significant reduction in adrenal gland volume compared to control subjects.516 Another study by Cleare et al. found CFS patients to have impaired adrenal cortical function as evidenced by not only decreased basal cortisol levels but also blunted cortisol responses to stimulation testing.617 Regardless of the underlying process, some believe the maladaptive physiological changes induced by hypocortisolism may actually be protective to ensure survival. As postulated by Fries et al, “Hypocortisolism is a protective response dampening chronic HPA axis activity and thereby reducing the damaging effects of the glucocorticoid response to daily hassles at the expense of symptoms such as high stress sensitivity, pain, and fatigue”.18

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Pathophysiology of Stress

In further support of this theory, Fries and colleagues have observed comparable groups of pregnant women and found those with lower morning cortisol levels had higher daily stress compared to their counterparts experiencing normal or low daily stress loads. The authors speculate that the hypocortisolism may be a counterregulatory protective mechanism designed to protect placental CRF from maternal cortisol.718 Raison and Miller suggest that hypocortisolism enhanced stimulation of the immune system may be protective as well. In individuals suffering from recurrent or ongoing infectious assaults, reduced glucocorticoid signaling impairs the normally adaptive inhibitory mechanisms thereby promoting the body’s ability to mount adequate retaliatory defenses. Other authors have coined the term “sickness response” to describe the anorexia, fatigue, anhedonia, hyperesthesia, and concentration difficulties often accompanying the body’s response to infection via elevated immune activity.819 In his 1988 paper, Hart wrote that the sickness response results from the body’s adaptive attempts to ration and prioritize its defenses to better eliminate the pathogen.920 Many symptoms of the sickness response mimic those of stress related bodily disorders, and an association between hypocortisolism induced FMS and the sickness response has been observed. The notion that hypocortisolism is actually protective is intriguing. Hypocortisolism, has been linked to fibromyalgia (FMS), posttraumatic stress disorder (PTSD), irritable bowel syndrome (IBS), low back pain (LBP), burn-out, atypical depression, chronic pelvic pain (CPP), chronic fatigue syndrome (CFS), insomnia, and degenerative neurological diseases.2-7 Damaging effects on the immune system occur due to increased levels of pro-inflammatory cytokines and natural killer cells (NK) and T-lymphocytes which lower resistance to inflammatory and infectious disease.1-7 Breast cancer patients demonstrate significant post-treatment exhaustion and have been shown to have significantly altered HPA axis activity in combination with elevated IL-6 levels, flattened cortisol curves, increased mortality, and metastases. Furthermore, the more flattened the cortisol curve the worse the prognosis and the earlier the mortality. Additional studies have found elevations in interleukin-1 , natural killer cells, antinuclear autoantibodies, thyroid antibodies, and prostaglandins in patients with PTSD, in patients with intrusive traumatic memories, in sexually abused girls, and in patients with CFS, FMS, and chronic pelvic pain respectively.

The hypocortisol state also permissively allows an increase in sympathetic nervous system and catecholamine activity since normal cortisol-mediated suppression is lacking. Increased levels of catecholamines have been observed in patients with both PTSD and FMS. Furthermore, exaggerations in sympathetic tone, in conjunction with underlying hypocortisolism, further fuels the production of pro-inflammatory cytokines. Associations between insulin resistance, obesity, diabetes, osteoporosis, mood disorders, and chronic pain have been described in patients with elevated levels of cytokines, particularly interleukin-6. Alterations in rhythmicity of cortisol release have been associated with various negative outcomes, including tumor growth, early mortality in cancer, obesity and disrupted glucose metabolism. Increased coronary artery calcification and metabolic syndrome have also been linked to circadian abnormalities in cortisol, particularly flattened cortisol curves. Measuring the Stress Response Emerging metabolic measures of stress or “biomarkers” assist in evaluating the complex multi-system brain-body biological interactions that occur and predict the risk of disease and response to proposed interventions that can impact mental and thereby physical wellness for a lifetime.10 One of the key features of the HPA axis is its circadian rhythm that results in a predictable diurnal cortisol secretion pattern, whereby cortisol levels are naturally highest just before awakening, and decline over the course of the day.2 The preferred method for measuring the stress response is a singleday, four-point cortisol test, with the most important measurements being the first morning cortisol or cortisol awakening response (CAR) measured 30-40 minutes after awakening, and last sample prior to bedtime.2 Clinicians may ask patients to refrain from exercise on day of testing to avoid mis-diagnosis of hypercortisolism or diurnal dysrhythmia.2 CAR is used significantly more than the overall diurnal salivary cortisol to define stress-induced HPA axis abnormality as a mini “stress test”as it is influenced by overall HPA reactivity and a person’s anticipation of stress.2 A blunted cortisol response upon wakening is a sign of burnout or chronic fatigue, while higher CAR is can be indicative of depression.2 Testing should be done on a “normal” day of anticipated stress, but if an abnormal stressor is encountered, they

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Pathophysiology of Stress

can rinse out the collection tubes and repeat the test on a “normal” day.2 Additionally, common abnormal diurnal patterns include persistently elevated cortisol throughout the day, ‘hypercortisolism,’ and conversely abnormally low cortisol, or ‘hypocortisolism.’ Each has been associated with a variety of symptomatic and clinical states, but hypocortisolism is thought to represent a more ‘injured’ stress response and higher risk for morbidity and mortality overall, likely due to releasing of the immune response yielding higher baseline levels of inflammation.

stimulating, relaxing, helping to improve focus or immune function, or normalizing unbalanced physiological processes. They have been shown to clinically reduce self-reported stress, improve mood and energy, and strengthen the immune system. They are often particularly helpful in stress-related conditions due to their shielding effects on the brain, immune and cardiopulmonary systems. Some, such as ginseng, ashwagandha, and rhodiola, are specifically neuroprotective by blunting the impact of cortisol within the CNS by reducing neuroinflammation and even encouraging repair..

Botanicals for Stress ‘Adaptogens’ are a diverse group of herbs that restore overall balance and functioning of the body as a whole through Name

Uses

Dosage

Astragaluls (Astragalus membranaceus)

Enhances mental and physical performance, learning ability, stress, fatigue, resistance to cancer and diabetes, immune function, chemoprotective, increase oxygen to tissues

250-500mg, 3-4 times daily of a standardized extract (at least 0.4% 4’-hydroxy-3’methoxyisoflavone 7-sug.); 3 weeks on, 2 weeks off cycle

Ashwagandha (Indian ginseng, Poison gooseberry, Winter cherry)

Strengthen immunity to colds and infections, improve physical and athletic ability, increase vitality, male fertility and libido, regulate blood sugar, antioxidant, antibiotic, anti-inflammatory, rejuvenating, astringent, anti-anxiety, anti-tumor, diuretic, insomnia, reduce cholesterol, arthritis, tuberculosis, asthma, leukoderma, bronchitis, backache, fibromyalgia,menstrual problems, hiccups, chronic liver disease, balances cortisol, supports HPA axis, boosts thyroid hormones

400-900 mg daily of a standardized extract (at least 2.5% withanolides); 3 weeks on, 2 weeks off cycle

Bacopa (Bacopa monniera)

50-100g, 1-4 times a day Cognitive function, concentration, fatigue, antioxidant, anxiety, epilepsy of a standardized extract (20% bacosides A&B)

Chaga mushroom

Strongest anti-cancer mushroom with an epochal effect in breast, liver, uterine and gastric cancer, hypertension, diabetes, tuberculosis (TB) of the bones, strengthen immune system, antiinflammatory, anti-ulcer, anti-tumor, DNA Repair, anti-mutagenic

Cordyceps (Cordyceps sinensis)

Immunosuppresive, anti-aging, antioxidant, decreases proinflammatory monoamine oxidase and lipid peroxidation activity, liver and lung protection (increase oxygenation), asthma, bronchitis, chemoprotective, anti-cancer, chronic renal failure, atherosclerosis, antiarrhythmic effects

Eleuthero root or Siberian ginseng (Eleutherococcus senticosus)

Invigorate qi (chi or energy) or endurance, strengthen immune system, memory, chemoprotective, DNA repair, antiinflammatory, normalize body function, particularly kidney, spleen and heart meridians, radiological protection, anticholesterolemic, anti-oxidant, angina, headache, insomnia, poor appetite, stress, fatigue, HPA-axis dysfunction

ANTI-AGING MEDICAL NEWS | SPRING 2022

1050mg, 2-3 times per day of a standardized extract (0.14% adenosine and 5% mannitol)

The Pathophysiology of Stress

Adrenal stress, expectorant, phytoestrogen effects, food sweetener, reduces cholesterol manufacturing, antiviral

250-500mg, 3 times daily standardized to contain 20% glycyrrhizinic acid or 15-30 drops of liquid extract, 3 times daily in juice or beverage

Holy basil (Tulsi, Ocimum tenuiflorum or Ocimum sanctum)

Enhance body’s natural response to physical and emotional stress, reduce bloating and gas, antioxidant, support healthy adrenal function, cortisol release and immunity, radiation protection, lipid balance, blood sugar regulation, anti-inflammatory (COX-2 inhibitor), cancer prevention, slow age-related memory impairment, lower cholesterol

400-800mg daily of a standardized extract (1.0 - 2.5% ursolic acid; supercritical extracts 7-11% eugenol & 4% caryophyllene; hydroethanolic extracts 0.7-4.0% triterpenoic acids, ursolic and oleanolic acids; steam distilled extracts 40% eugenol & 15% caryophyllene

L-theanine

Found in green tea, induces relaxation through increased dopamine and serotonin, and improves sleep quality

100 mg-200mg, 1-3 times daily

Mastic (Pistacia lentiscus)

Adrenal stress, expectorant, food sweetener, H.pylori infections, oral health/cancer, phytoestrogen effects,

Oleoresin: 500mg, 2-4 times daily

Mucuna pruriens (Cowhage, Velvet bean)

Lower stress as a source of L-DOPA the precursor for dopamine, neuroprotective, Parkinson’s disease, antioxidant, blood sugar, weight loss, metabolic syndrome, male infertility

100-200 mg of a standardized extract (20-95% L-Dopa) once daily in the morning, 30 minutes before breakfast

Muira puama (Ptychopetalum olacoides)

Neuroprotective, stress, libido, depression, mood

500mg up to 3 times daily

Panax ginseng

Mood, cognition, immunity, antifatigue, protection against mental, physical and environmental stress

Glycyrrhiza Glabra (Licorice)

Phenyl-GABA

200mg BID

Phosphatidylserine (PS)

Decrease symptoms of mild depression in mood disorders

Relora Plus

Proprietary blend of plant extracts from Magnolia officianalis, Phellodendron amurense, and B-vitamins that normalizes cortisol levels, stress-related eating, decreases weight gain, and anxiety

Rosa Majalis

Anti-cancer, anti-oxidant, source for Vitamins A,C,E

Reishi or Lingzhi (Ganoderma lucidum)

Adaptogen (mental, physical performance, learning, decrease stress and fatigue), blood pressure stabilizer, antioxidant, analgesic, kidney and nerve tonic, strengthen immune system, anti-inflammatory, anti-viral, anti-tumor, anti-parisitic, liver protectant, blood glucose regulation, chemoprotective

Rhaponticum

Strength or endurance or reduce fatigue, impotence or aphrodisiac

ANTI-AGING MEDICAL NEWS | SPRING 2022

250mg, 3 times daily

150-300mg, 3-4 times daily of standardized extract (4% triterpenes and 10% polysaccharides (β-1, 3-glucans))

The Pathophysiology of Stress

Rhodiola rosea (Golden root, Roseroot, Western roseroot, Aaron’s rod, Arctic root, King’s crown, Lignum Rhodium, Orpin Rose)

Adaptogen, strength or endurance, reduce fatigue, mental and physical performance, decrease recovery time, antioxidant, learning, adrenal stress, depression, improve immunity, sleep patterns, mood stability, and motivation, resistance to cancer, type 2 diabetes, cardio-protective

150-300mg, 1-3 times daily, standardized (3-5% rosavins and less than 1% salidrosides)

Schisandra or Magnolia vine

Antioxidant, infection-resistant, increase skin health, liver protectant, stress/fatigue, enhance mental and physical performance, learning, adaptogen, improve resistance to cancer and diabetes, improve immune function, chemoprotective

100-200mg, twice daily with food standardized (9% schisandrans), taken 3 weeks on, 2 weeks off

Shiitake (Lentinus edodes)

Enhances mental and physical performance, increases learning ability, and decreases stress and fatigue, may improve resistance to cancer and diabetes, immune function, antiviral, chemoprotective

100-400mg 3 times daily of a standardized extract

Stress and cortisol balance, energy/fatigue, weight loss, erectile dysfunction, testosterone balance, infertility, athletic performance, antioxidant, anti-inflammatory

200-400mg daily of a standardized water extract of the root (50:1 to 200:1 water extraction; 200:1 standardized to 1% eurycomanone, 22% protein, 30% polysaccharides, 35% glycosaponins; LJ100 = 100:1 water extraction; contains 40% glycosaponins and 22% eurypeptides)

Insomnia, anxiety, sedation, stress/sleep disorders

200-500mg of standardized extract (0.4-1% valerenic acids), or 30-60 drops of liquid extract (1:4 w/v) in water 1-2 hours before bedtime or as needed

Tongkat Ali (Eurycoma longifolia)

Valerian (Valeriana officianalis)

Nervines Tonics Nervines are a class of botanicals that reduce sympathetic overdrive, anxiety, and irritability by sedating the autonomic nervous system

and inducing a sense of calm or relaxation. They can be used during the day to blunt a hyperaroused state, or in the evening for sleep induction.

Avena sativa (Oats)

Antidepressant, anxiolytic, nervous system tonic & trophorestorative, nutritional, hypolipidemic (as food), cardiotonic, demulcent, emollient, vulnerary, antispasmodic

Infusion: 1 heaped Tbsp (approx. 3 g) to 1 cup Water; steep until at room temperature. Drink throughout the day. Tincture: (1:5, 25%), 1-5 ml TID. Bath: Add 1 heaping cup to bath water, enjoy!

Bacopa monniera (Brahmi)

Cognition & memory enhancer, nerve and brain tonic, mild anti-convulsant, antioxidant, antiinflammatory, cardiotonic, vasocontrictor, bitter, emetic, laxative & diuretic (leaf ), aphrodisiac

Powdered herb: 5-10g, QD. Extract: 300mg, QD. Capsule: 3000mg BID. Skin rub: skin mixed with oil applied prn. Tincture: (1:2, 25%), 5-13ml QD

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Pathophysiology of Stress

Borago officinalis (Borage)

Leaf: Diuretic, demulcent, emollient, refrigerant, adrenal restorative, galactagogue, expectorant. Oil: inflammatory modulating, anti-atheroslcerotic, anti-platelet, hypolipidemic, atopic dermatitis, dysmenorrhea, PMS, cyclic mastalgia, hypertension and diabetic neuropathy.

2 tsp dried herb/cup; 1 cup BID. Tincture: (1:5, 60%), 1-10 ml BID. Juice pulp from fresh leaves, 10 ml BID. Seed oil: 500 mg capsule: 1-4 capsules daily.

Centella asiatica (Gotu kola)

Strengthens nervous system, function, memory, relaxant, detoxifer, diuretic, topical antibiotic, peripheral vasodilator, anti-rheumatic, vulnerary, venotonic, keratolytic, anti-mycobacerial, bitter, digestive, antiinflammatory, laxative, dermatological builder, connective tissue builder, cellulite, cirrhosis of the liver, keloids and hypertrophic scars, leprosy, scleroderma, varicose veins and venous insufficiency, and wound repair.

Tincture: (1:2, 45%), 3-6ml QD. Dried leaves: 0.6g TID. Infusion: 1 tbsp/cup, infuse 10 min, TID. Poultice. Extract: standardized to contain asiaticoside (40%), 60-120mg QD.

Hypericum perforatum (St. John’s wort)

Anti-depressant, anti-inflammatory, antimicrobial, astringent, nervine tonic, topical wound healing (burns)

Infusion: 2-4 g / cup QD to TID Tincture (1:5, 40%), 1-4 ml TID Standardized extract: 500 to 1000 mg divided daily of extract standardized to 0.3% hypericin for mildmoderate depression.

Verbena officinalis (Blue vervain)

Digestive tonic that increases intestinal motility, parasympathomimetic, anti-spasmodic, mild analgesic, nervous system tonic, hepatic stimulant, depression, melancholy

Infusion: 1 tsp/cup water, 1 cup QD – TID (fresh 3x dried). Tincture: (1:5, 25%), 2-5 ml TID. Fluid extract: (1:1, 25%), 1-3 ml TID.

Vinca major/minor (Periwinkle)

Astringent, cerebral circulatory stimulant, cytotoxic (anti-cancer), diabetes, glaucoma, stroke, brain trauma, poor memory, disordered thinking

Tincture: (1:5, 60%), 1-5 ml TID. 100 ml weekly max.

Nervines Tonics

Lavendula off. (Lavender)

Carminative, nervous system relaxant, sedative, antispasmodic, anti-depressant, anti-septic, aromatic, uterine stimulant, emmenagogue, diuretic, hypotensive, anti-rheumatic

ANTI-AGING MEDICAL NEWS | SPRING 2022

Tincture: (1:2, 60%), 2-5ml QD. Dried flowers: 1-2g, TID. Capsules: 500mg, BID. Infusion: 1 tsp/cup, infuse 15 min, TID. Essential oil: 1-4ggt inhalations, chest rub, massage oil, pillow, douche. Bath: 100g infused and strained, added to bath.

The Pathophysiology of Stress

Humulus lupulus (Hops)

Sedative, hypnotic, diuretic, analgesic, topical antibacterial, astringent, antispasmodic, premature ejaculation, 100 mg 2 times a day of restlessness, nervous tension, headache, indigestion, standardized product (5.2% restless leg syndrome, anxiety, phytoestrogen (PMS bitter acids & 4% flavonoids) or menopause-related hormonal imbalances)

Melissa off. (Lemon Balm)

Nervous system tonic and relaxant, carminative, sedative, diaphoretic, antidepressant, anti-viral, antimicrobial, hyperthyroidism choleretic, antispasmodic, anti-histamine, mild analgesic, cardiotonic, hepatic, gout, herpes, rheumatism, neuralgias

Capsules: 2-4 g QD. Infusion: 2 tsp/ cup, BID. Tincture: (1:2, 45%), 3-6 ml TID (maximum of 100 ml per week). Topically: poultice, compress, Herpelieve: apply 2 – 4 times daily.

Matricaria recutita (Chamomile)

Nervous system sedative, antispasmodic, analgesic, anti-inflammatory, antiseptic, carminative, antimicrobial, anti-allergic, anti-uler, wound healing, neuralgia, rheumatic and muscular pains

Infusion: 1-2 tsp/cup water; steep 3-5 min. covered; 1 cup TID. Tincture (1:5, 45%), 1-4 ml TID; max. weely dose 100 ml. Baths, Steams, Enemas. Note: Matricaria is best dosed on the low end of its dosage range over a long period of time.

Stachys offincialis (Betony)

Sedative, mild diuretic, carminative, aromatic, skeletal muscle relaxant, astringent, alterative, circulatory tonic

Infusion: 1 tsp/cup TID. Tincture: (1:5, 45%), 2-6ml TID. Dried herb: 2-4g, TID. Poultice, mouth wash/gargle.

Scutellaria laterifolia (Skullcap)

Sedative, nervous system relaxant, antispasmodic, anticonvulsant, hypotensive

Powdered herb: 1-2 g QD. Infusion: 1 tbsp/cup, TID. Tincture: (1:2, 45%), 2-4 ml TID (weekly max. = 100 ml).

Passiflora incarnata (Passionflower)

Antispasmodic, sedative, hypnotic, vasodilator, cardiotonic, analgesic, anxiolytic, relaxant, diuretic, anti-depressant, insomnia

Anxiety: 100-250mg, 2 times daily standardized (3.5-4% isovitexin); Insomnia/sedation: 200-500mg at bedtime standardized ((3.5-4% isovitexin)

Tilia europa (Lime flower, Linden tree)

Anxiolytic, hypotensive, sedative, diaphoretic, antispasmodic, diuretic, emollient, immunomodulator, anti-inflammatory, expectorant, anti-coagulant, mild astringent, peripheral vasodilator

Infusion: 1tsp/cup, 3-5 times QD. Tincture: (1:5, 40%), 3-5ml TID. Dried flowers: 2-4g, TID.

Lactuca virosa (Wild Lettuce)

Nervous system relaxant, sedative, analgesic, hypnotic, narcotic, antispasmodic, whooping cough, rheumatism, aphrodisiac

Dried leaves: 0.5-3g TID. Infusion: 1 tsp/cup, infuse 15 min, TID. Tincture: (1:1, 25%), 0.5-3ml TID.

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Pathophysiology of Stress

Piper methysticum (Kava-kava)

Sedative, nervous system, anticonvulsant, local anesthetic, analgesic, anti-fungal, anti-spasmodic, stimulant, anti-depressant, muscle relaxant, euphoric, anti-inflammatory, diaphroretic, carminative, diuretic, interstitial cystitis, restless leg syndrome, anxiety, cognition

100-300mg, 1-3 times daily (for no more than 3 months) standardized to contain 30-70% kavalactones

References 1. 2. 3.

4. 5. 6. 7. 8. 9.

McEwen, B.S. (2006). Protective and damaging effects of stress mediators: a central role of the brain. Dialogues in Clinical Neuroscience 8(4), pp. 367-381.

12. Fries E, Hesse J, Hellhammer J, Hellhammer DH. “A new view on hypocortisolism”. Psychoneuroendocrinology. 2005; 10:1010-6.

Tsigos C, Kyrou I, Kassi E, et al. Stress, Endocrine Physiology and Pathophysiology. Updated 2016 Mar 10. In: De Groot LJ, Chrousos, Dungan K, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK278995/?report=reader.

14.

Guilliams T. The Role of Chronic Stress and the HPA Axis in Chronic Disease Management. 2015. Point Institute.

Schneiderman N, Ironson G, Siegel S. Stress and Health: Psychological, Behavioral, and Biological Determinants. Annu Rev Clin Psychol. 2005;1: 607–628. doi:10.1146/ annurev.clinpsy.1.102803.144141 Guilliams and Edwards (2010). Chronic Stress and the HPA Axis: Clinical Assessment and Therapeutic Considerations. Point Institute.

Fries, E. et al. A new view on hypocortisolism. Psychoneuroendocrinology. 2005;30(10), pp. 1010-1016. Sterling, P. (2012). Allostasis: A model of predictive regulation. Psychology & Behavior 106 (1), pp. 5-15.

Edwards L, Heyman A, Swidan S, Hypocortisolism: An Evidence-based Review. Integrative Medicine. Sep-Oct 2011;10 (4): 26-33. Smith S, Vale W. The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues in Clinical Neuroscience. 2006; 8 (4): 383-395.

10. McEwen BS, Gray JD, Nasca C. Recognizing resilience: Learning from the effects of stress on the brain. Neurobiology of Stress. 2015;1:1-11. doi:10.1016/j. ynstr.2014.09.001.

13. Yehuda R. “Sensitization of the hypothalamic-pituitary-adrenal axis in posttraumatic stress disorder.” Ann NY Acad Sci. 1997; 821: 57-75.

15.

McEwen BS. “Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators”. Euro J Pharmacol. 2008; 583:174-185. Heim C, Ehlert U, Hanker JP, Hellhammer DH. “Abuse –related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain”. Psychosom Med. 1998; 60:309-318.

16. Scott LV, Teh J, Reznek R, Martin A, et al. “Small adrenal glands in chronic fatigue syndrome: a preliminary computer tomography study”. Psychoneuroendocrinology. 1999; 24:759-768. 17. Cleare AJ, Miell J, Heap E, Sookdeo S, et al. “Hypothalamic-pituitary-adrenal axis dysfunction in chronic fatigue syndrome, and the effects of low-dose hydrocortisone therapy”. J Clin Endocrinol Metab. 2001; 86(8):3545-3554.

18. Fries E, Hesse J, Hellhammer J, Hellhammer DH. “A new view on hypocortisolism”. Psychoneuroendocrinology. 2005; 10:1010-6. 19. Raison CL, Miller AH. “When not enough is too much: The role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders”. Am J Psychiatry. 2003; 160(9):1554-1565.

20. Hart BL. “Biological basis of the behavior of sick animals”. Neurosci Behavior Rev. 1988; 60:309-18.

11. Heyman A, Edwards l, Lavalle J, Swidan S. Cardiometabolic disease in men: an integrative approach to managing hormonal risk factors. JMH. March 2010; 7(1): 92-101.

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JOIN THE LEADERS In Advanced Anti-aging Medicine

CHRONIC INFLAMMATORY RESPONSE SYNDROME PART A | ONLINE PART B | MAY 2 | ONLINE This is the first comprehensive course ever offered by two of the world’s experts on Chronic Inflammatory Response Syndrome. Drs. Heyman and Shoemaker have created an intensive, 4-week online educational experience designed for the health professional seeking proficiency and certification in treating Biotoxin Illness, including comprehensive management of the Mold and Lyme patient. Up to 20% of the US population is vulnerable to biotoxin exposures, leading to chronic fatigue, fibromyalgia, neuroinflammatory related disorders, cardiopulmonary problems, gastrointestinal dysfunction, and immune impairment. Every Anti-aging, Functional and Integrative practitioner must know how to treat this condition since it is so common, and often underlies hormonal imbalances, ‘leaky gut,’ mood and memory problems, weight gain and so many other complaints treated by our specialty.

OBJECTIVES At the end of this symposium, the attendee will be able to: PART I To review the epidemiology and case definition of CIRS To perform a comprehensive evaluation of the CIRS patient To understand ancillary testing and its contribution towards proper diagnosis To synthesize and apply validated treatments for the CIRS patient, including those affected by Mold and Lyme disease To apply a Functional and Integrative medicine therapeutic approach to the CIRS patient. To understand how to manage special populations within CIRS PART II To review diagnosis and treatment of Lyme disease To understand ancillary testing and its contribution towards proper diagnosis To examine and apply proper CIRS treatment to special populations To apply transcriptomic analysis to CIRS patients. To manage CIRS cases including plateaus and re-exposures.

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Evaluation Of The Effects Of CBD Hemp Extract On Opioid Use And Quality Of Life Indicators In Chronic Pain Patients:

A Prospective Cohort Study

A Prospective Cohort Study By:

By: Capano A, Weaver R, Burkman E. Evaluation Capano of the effects of hemp extract opioid use and quality A,CBD Weaver R,onBurkman E. of life indicators in

chronic pain patients: prospective cohort study. Postgrad Med.on 2020 Jan;132(1):56-61. doi:of life indicators in Evaluati ona of the effects of CBD hemp extract opioid use and quality 10.1080/00325481.2019.1685298. 2019 Nov 12. PMID: 31711352. chronic pain patients: aEpub prospecti ve cohort study. Postgrad Med. 2020 Jan;132(1):56-61. doi:

10.1080/00325481.2019.1685298. Epub 2019 Nov 12. PMID: 31711352.

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Evaluation Of The Effects Of CBD Hemp Extract On Opioid Use And Quality Of Life Indicators In Chronic Pain Patients: A Prospective Cohort Study

mitigate the escalation of opioid doses in patients with chronic pain with a substantial reduction in opioid intake [14].

Introduction Chronic pain is a major cause of disability worldwide with a prevalence rate of 15% to 30% in the general adult population, and more than 500 billion dollars annual costs in the United States. Unfortunately, multiple reports are showing a lack of satisfactory results with available pharmacotherapy with less than 70% of patients having pain relief [1]. Currently, opioids are the mainstay for pain control for most cases including, neuropathic and cancer pain. Nonetheless, the inherent adverse events of opioids are representing major concerns [2]. All too often, these patients become dependent on opioid medications, which carry a risk of tolerance and subsequent physical dependence and multiple adverse effects such as somnolence and constipation, and the potential of death from an overdose [3,4]. Therefore, enormous efforts are exerted to find additional approaches and to provide alternative options with a better safety profile and comparable efficacy. Cannabis, the plant source of cannabinoids (CB), have been used for millennia for different purposes such as pain control and stress relief. Recently, the delineation of the endocannabinoid system and CB receptors in humans has paved the road for broader applications [5]. Their natural source and the widespread use besides its lower risk of addiction or dependency and relative safety have flagged them for in-depth investigation for potential therapeutic roles. Two molecules have bee nof high-interest: cannabidiol (CBD) and tetrahydrocannabidiol(THC). Recent evidence highlights cannabinoids’ efficacy and safety for pain control. Whiting et al. analyzed 28 clinical trials evaluating cannabinoids in pain control, concluding that there is a moderatequality evidence that cannabinoids may result in marked pain reduction [7]. This was consistent with its effect on neuropathic pain where cannabinoids were effective in pain relief [8,9]. National Academies of Science, Engineering, and Medicine conducted an extensive systematic review to evaluate cannabinoids, stating that there is ‘extensive evidence’ of cannabinoids’ efficacy in pain relief with good tolerability [10]. Besides its potential direct effects on pain, cannabinoids are suggested to have a role in reducing opioid intake [11,12]. A recent report has highlighted the lower mortality from opioids’ overdose in states with medical cannabis legalization. Similarly, Medicare prescriptions’ reports revealed reduced opioids’ use and their consequent adverse events in the United States (U.S.) with legalized cannabis access [13]. In addition, cannabinoids use may

The above studies reference the effects of both THC and CBD, the two most abundant and frequently used cannabinoids. THC is a psychogenic molecule responsible for eliciting a ‘high’ sought out in recreational marijuana use. CBD is not intoxicating and therefore possesses an arguably better safety profile than THC [15–17]. Because of these differences in intoxication and abuse potential, the THC and CBD experience varying regulatory paths. Despite increasing state-level legalization, cannabis plants with higher levels (>0.3%) of THC are considered ‘marijuana’ and are federally illegal in the U.S [18]. Low THC (<0.3%) cannabis plants, known as hemp, and its extracts have been recently deemed federally legal in the U.S. via pilot programs in Section 7606 of the 2014 Farm Bill, subsequently made permanent via the 2018 Farm Bill [19–21]. Therefore, hemp-derived cannabis extracts, low in THC and high in CBD, have become increasingly available as over-the counter products and subject to widespread consumer use across diverse populations [22]. Aiming to control the opioid epidemic, CBD has been investigated for its potential to reduce the addiction risk and physiological dependence features of opioid use while subsequently managing pain [23]. Preclinical models demonstrate CBD’s ability to decrease relapse risk by reducing opioid seeking behavior [24]. Early human trials confirm CBD’s potential in reducing opioid withdrawal symptoms [25]. A recent survey study concluded that 44% of hemp CBD users reported it helped reduce the use of their opioid pain medication [25]. CBD was found to reduce the craving, anxiety and psychological manifestations significantly in drugabstinent individuals with previous opioid dependency [26,27]. Emerging literature supports evidence for CBD in pain relief and opioid reduction, but no studies to date have evaluated the effects of readily available hemp CBD in chronic pain and opioid use in a single cohort. In the present study, we aim at investigating the impact of hemp CBD use on opioid use in chronic pain, disability, physical and psychosocial symptoms, sleep, and motivation to taper opioids. We believe that such a study will fill the existing gap and highlight potentially applicable roles for CBD therapeutic indications. Methods Study design and ethical considerations Our study is a prospective, single-arm cohort study that was

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Evaluation Of The Effects Of CBD Hemp Extract On Opioid Use And Quality Of Life Indicators In Chronic Pain Patients: A Prospective Cohort Study

carried out at Murphy Pain Center, U.S. The study was granted an Institutional Review Board approval from Advarra. All study procedures were conducted in accordance with the declaration of Helsinki. In addition, all enrolled participants had to sign an IRB approved informed consent form at a standard of care visit. For confidentiality, all participants’ data have been coded and stored separately from participants’ identifiers and contact information. The crosswalk between the study ID and participant identifiers has been stored separately from participant data in a passwordprotected file within a password-protected folder on a secure server system.

soft gels. One participant declined CBD and expressed his concern in that he could not afford to pay out of pocket for the product after the end of the study if it was successful. One participant reported that CBD ‘made her heart race’ and combined twice-daily dosing into one dose to manage the side effect. One participant reported nausea from CBD but continued using the product.One participant reported ‘heart burn and dry mouth’ after initiating CBD. One participant reported CBD increased her nighttime anxiety and disturbed sleep. No significant adverse events were reported.

Participants’ recruitment

The primary outcome of the study was the effectiveness of the CBDrich extract to reduce the dependence on opioids for pain control measured via the opioids’ dose. Secondary outcomes included the pain-related quality of life (QoL) changes which were assessed by Pain Disability Index (PDI), 4-item Patient Health Questionnaire (PHQ-4), Pittsburgh Sleep Quality Index (PSQI), 3-item scale assessing Pain Intensity and Interference (PEG). The willingness of the patients to taper their opioid medications by administering the readiness to Taper Visual Analog scale was also included. Three data collection points were assigned for each participant: baseline, week 4, and week 8 with corresponding levels of CBD-rich extract use at each interval. The outcomes’ assessment at each of the three timepoints was conducted via phone or in-person interviews on the web or paper-based questionnaires and/or scales according to the patient’s preference. In addition, open-ended comments were allowed and documented for qualitative analysis.

Between September and December 2018, patients were informed about the study aims and procedures at their standard care visits at Murphy Pain Center. Patients were enrolled if they met the following eligibility criteria: (1) age between 30 and 65 years old, (2) has moderate to severe chronic pain for at least 3 years, and (3) has been stable on opioids for at least 1 year (defined as less than 10% change in its severity). The Morphine Equivalent Daily Dose (MEDD) of the administered opioid had to be at least 50 to be enrolled in the study. Participants were excluded if they had (1) any history of substance use disorder, (2) any psychotic disorder, (3) abnormal drug screen over the last 12 months, (4) history of nonfatal overdose, (5) any epileptic activity in the last 12 months, (6) incapacitating systemic disorder (cardiac, renal or hepatic), or (7) any known allergy to cannabis-based products. CBD-rich hemp-extract use Participants were offered a free sixty-count bottle of hempderived (15 mg), CBD-rich soft gels at baseline, and weeks 4, and 8, which were provided for free by Ananda Professional. Each soft gel contained 15.7 mg CBD, 0.5 mg THC, 0.3 mg cannabidivarin (CBDV), 0.9 mg cannabidiolic acid (CBDA), 0.8 mg cannabichrome (CBC), and >1% botanical terpene blend. Participants were educated on safe CBD use, and ultimately elected whether or not to use CBD and self-titrated their dose of CBD. Of the 97 participants who completed the study, 94 chose to use the CBD soft gels. Almost all participants (91) used two soft gels (~30 mg) daily. One participant supplemented his free bottle of CBD soft gels and consumed four soft gels (~60 mg) daily. Two participants reported using only one soft gel (~15 mg) daily. Three participants chose not to use CBD. Two initiated the CBD but reported the adverse effect of drowsiness and stopped using the

Outcomes’ assessment and follow-up points

Patient-reported side effects were collected at each clinic visit and at the time of follow-up questionnaire completion. Side effects were considered serious if they were life threatening, resulting in hospitalization or emergency department visits, or required medical intervention for resolution. No serious side effects were reported. Data analysis Data analysis was conducted using SPSS v.24 software (SPSS Inc., Chicago, IL). Continuous variables are presented as mean ± SD. Cronbach’s alpha was calculated for each of the included scales to assess the reliability of indices. Normal distribution of the data was checked by the Kolmogorov–Smirnov test. If normally distributed, ANOVA test was used to compare the means of the outcomes between the three levels of CBD-rich extract use. For categorical variables, chi-Square test was used. Otherwise, the corresponding non-parametric tests were used. P value <0.05 was considered statistically significant in all these tests.

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Evaluation Of The Effects Of CBD Hemp Extract On Opioid Use And Quality Of Life Indicators In Chronic Pain Patients: A Prospective Cohort Study

Results The study recruited 131 participants, 97 of whom completed the 8-week follow-up period. All of the 97 participants, 31 males & 66 females, had a documented diagnosis of chronic pain and were on a stable on opioid dose for at least 2 years. The mean age of the study population was 56.1 years (range from 39 to 70 years). Ninetyfour (96.9%) out of the 97 participants who completed the 8-week follow-up period used CBD hemp extract. Primary outcomes Fifty of the 94 (53.2%) participants using the CBD hemp extract were able to reduce opioid medications at week 8. Additional reductions in polypharmacy on the medication receipt were noted; six participants reported reducing or eliminating their anxiety medications, and four participants reported reducing or eliminating their sleep medication. None of the three participants who declined to use CBD hemp extract reduced their opioid medication at any interval. Secondary outcomes Eighty-nine (94%) of the hemp CBD users reported improved quality of life outcomes on subjective, open-ended questions. Quality of life was further evaluated by the four indices and/or questionnaires PDI, PHQ-4, PSQI, and PEG. For each of these indices, the reliability was measured through the Cronbach’s alpha which was relatively high for all of them, indicating good reliability. Cronbach’s alpha was 0.88, 0.77, 0.63, and 0.89 for the PDI, PHQ-4, PSQI, and PEG, respectively The first index, PDI, was assessed with its seven components and showed no significant changes over the study duration, starting from 38.02 (95% CI 35.38–40.66) at baseline, declining to 36.4 (95% CI 34.15–38.73) and 34.1 (95% CI 31.61–36.58) at weeks 4 and 8, respectively (p = 0.09). In addition, the change in the PHQ-4 for the CBD-rich extract showed no statistically significant difference over the follow-up period (4.8 [95% CI 4.18–5.41] at baseline and 4.5 at week 4 [95% CI 3.95–5.12] and week 8 [95% CI 3.79–5.14], p = 0.7). Sleep quality was assessed via the PSQI. The mean score value significantly changed from 12.09 (95% CI 11.37–12.80) at baseline to 10.7 (95% CI 9.99–11.44) and 10.3 (95% CI 9.48–11.20) at week 4 and week 8, respectively (p = 0.03). Similarly, the PEG scale showed significant difference among the follow-up points (6.5 [95% CI 6.16–6.81], 5.9 [95% CI 5.55–6.25]and 5.7 [95% CI 5.31–6.12]

at baseline, week 4 and week 8, respectively, p = 0.006). Table 1 and Figure 1 show the change in the quality of life indices. The willingness to reduce the opioid dose was evaluated through the readiness to taper the visual analog scale. The average score was 4.6 (95% CI 4.1–5.3) at baseline, and 4.4 at weeks 4 (95% CI 3.7–5.1) and 8 (95% CI 3.6–5.2) (p = 0.8) with no significant change. To assess the impact of gender, all parameters were compared between males and females in our study population. No statistically significant differences between both genders were detected for all time points, except for PHQ-4 score which showed a significant decline in males compared with females at week 8 (indicating better effectiveness in males). However, this significant difference was not present at baseline or week 4. Discussion The results of this study suggest that using CBD-rich hemp extract oil may help reduce opioid use and improve quality of life, specifically in regards to pain and sleep, among chronic pain patients. This is consistent with emerging literature on the topic, which has concluded that CBD is an effective analgesic, and one that helps reduce barriers to opioid reduction, such as physiological withdrawal symptoms [22–31]. Recently, Wiese et al. summarized the evidence for different used of the cannabinoids with opioids [13]. Haroutounian et al. evaluated the pain in 308 patients using S-TOPS pain score.The score was significantly improved from 83.8 to 75, with 65.9% of patients reported pain improvement. In addition, sleep quality showed significant improvement [28]. Additional studies showed significant improvement in pain symptoms using CBD as augmentation for opioids [9,25–31]. Limitations At the beginning of the study, the investigator hypothesized that participants may report reduced opioid use in order to appear agreeable to the interviewers, but this concern changed with experience. In reality, many participants disclosed that they were hesitant to report any reduction in opioid use due to the potential consequences of changes in prescriptions. If CBD-rich hemp extract helped their pain and resulted in decreased opioid use, this would result in limited prescription opioids.They often questioned what would happen at the conclusion of the study if the patient could not access affordable CBDrich hemp extract and their pain returned to baseline. Opioids are likely covered by insurance, but CBD-rich hemp extract is not.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Evaluation Of The Effects Of CBD Hemp Extract On Opioid Use And Quality Of Life Indicators In Chronic Pain Patients: A Prospective Cohort Study

Additionally, there is a small amount (<0.3%) of delta9-THC, the intoxicating compound abundant in marijuana plants, in CBDrich hemp extract.This poses a risk that participants could fail a drug test at work or in other pain management settings, compromising their employment, livelihood, and medical care. They could not risk this consequence. It is important to consider that while the study population did not include participants with dual diagnoses or a history of substance use disorders, but nevertheless several participants described themselves as ‘addicted to’ their opioid pain medications. According to the World Health Organization, the public health risk of CBD is considered limited, but cannabis use is not absent of abuse risk or addiction potential [32,33]. Cannabis derived from hemp, including the product used in this study, is high in CBD and low in THC and is considered less harmful than the alternative [34]. Still, cannabis use disorder is real and some studies show cannabis may perpetuate the cycle of addiction or lead to other substance abuse [35,36]. Additionally, even with cannabis products with low THC concentration, the aroma of cannabis itself could present the risk of cue-induced drug-seeking behavior in those with previous substance use disorder. Our study limitations include a lack of a randomized, placebocontrolled design. The short length of the study, lack of control group, and relatively small sample size limit conclusions. The attrition rate was moderate and was influenced by external factors such as changes in or loss of patient insurance plans and alteration in insurance policies at the primary clinic over the course of the study. Several participants’ phone service was canceled over the course of the study which contributed to the attrition rate. As with all voluntary participation studies, the potential differences in those who agreed to participate versus those who declined to participate may influence the study conclusion. Pain diagnoses, comorbidities, type of opioid, opioid dose and CBD dose also varied among the participants.Several patients used fentanyl patches and therefore could not self-titrate to reduce opioid intake, as was possible with short-acting oral medications, such as oxycodone/acetaminophen and oxycodone controlled release. Variables such as changes in weather may contribute to pain, as the study began in warm months and concluded in colder months, a factor many participants reported as influencing their pain. Several participants noted significant life events that likely influenced pain and medication use, such as a car accident or surgery, during the study period. A final average change in MEQ over time would have been a valuable data point, but it was not available as many

prescriptions did not officially change due to short study duration. Two participants reported completely eliminating opioid use over the 8-week period, while others reported deliberately skipping or forgetting doses of opioid medication. Some reported skipping or missing doses every day, whereas others did so irregularly. Still, more detailed data on average MEQ change over time would have improved clarity of study outcomes. Finally, due to their subjective natures, the variables of pain, sleep, and mood are difficult variables to assess, even with validated instruments. The risk of confirmation and response biases during interviews cannot be ignored. Future research should expand on these findings and include larger, randomized, placebo-controlled trials. These results also signal a need for improved clinical education on the topic, particularly in the pain management specialty, and potential adjustments to drugtest policies within clinics and across employers. Conclusion This study concludes that using CBD for chronic pain in patients using opioids has a significant effect on reducing opioid intake, reducing pain and improving QoL. Over half of the participants who added CBD hemp extract reduced or eliminated opioids over the course of 8 weeks, and almost all CBD users reported improvements in QoL.

Acknowledgments James Murphy granted access to his patient population for this study and allowed enrollment and data collection in his clinic, Murphy Pain Center. He has agreed to be acknowledged in this study. Data analysis and editorial assistance were provided by Omar Aboshady a medical writer and freelancer at Upwork. Data Sharing The data that support the findings of this study are available from the corresponding author, AC, upon reasonable request. Reviewer Disclosure One of the reviewers is a Consultant/Speaker and Researcher for US World Meds, BDSI, Salix, Enalare, Scilex, and Neumentum. They have no relationship with this specific research.

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Evaluation Of The Effects Of CBD Hemp Extract On Opioid Use And Quality Of Life Indicators In Chronic Pain Patients: A Prospective Cohort Study

Funding The study was funded by Ananda Professional.The funders had no role in study design, data collection, and analysis, or preparation of the manuscript. Alex Capano is employed by Ecofibre Ltd, which wholly owns the sponsor company, Ananda Professional.

Declaration of Interest No potential conflict of interest was reported by the authors.

References 1. Gatchel RJ, McGeary DD, McGeary CA, et al. Interdisciplinary chronic pain management: past, present, and future. Am Psychologist. 2014;69:119. 2. Pergolizzi J, Böger RH, Budd K, et al. Opioids and the management of chronic severe pain in the elderly: consensus statement of an international expert panel with focus on the six clinically most often used World Health Organization step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract. 2008;8:287–313. 3. Smith HS, Kirsh KL, Passik SD. Chronic opioid therapy issues associated with opioid abuse potential. J Opioid Manag. 2009;5 (5):287–300. 4. Kalso E, Edwards JE, Moore RA, et al. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain. 2004 Dec 1;112 (3):372–380 5. Whittle BA, Guy GW, Robson P. Prospects for new cannabis-based prescription medicines. J Cannabis Ther. 2001;1:183–205. 6. Pertwee RG. Pharmacology of cannabinoid CB1 and CB2 receptors. Pharmacol Ther. 1997;74(2):129–180. 7. Burstein S. Cannabidiol (CBD) and its analogs: a review of their effects on inflammation. Bioorg Med Chem. 2015;23:1377–1385. 8. Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: a systematic review and meta-analysis. Jama. 2015;313:2456–2473 9. Serpell M, Ratcliffe S, Hovorka J, et al. A double-blind, randomized, placebocontrolled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment. Eur J Pain. 2014;18:999–1012. 10. Meng H, Johnston B, Englesakis M, et al. Selective cannabinoids for chronic neuropathic pain: a systematic review and meta-analysis. Anesthesia Analg. 2017;125:1638–1652. 11. Abrams DI. The therapeutic effects of cannabis and cannabinoids: an update from the national academies of sciences, engineering and medicine report. Eur J Intern Med. 2018;49:7–11. 12. Johnson JR, Burnell-Nugent M, Lossignol D, et al. Multicenter, doubleblind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manage. 2010;39:167–179 13. Wiese B, Wilson-Poe AR. Emerging evidence for cannabis’ role in opioid use disorder. Cannabis Cannabinoid Res. 2018;3:179–189. 14. Bradford AC, Bradford WD, Abraham A, et al. Association between US state medical cannabis laws and opioid prescribing in the medicare part D population. JAMA Intern Med. 2018;178:667–672. 15. Birnbaum A. How high can patients get on CBD? Epilepsy Curr. 2019 Sep 16:1535759719874408. 16. Dill JL, Kurkowski A. CBD: considerations for use within the health system. Hosp Pharm. 2019. doi:10.1177/0018578719873870. 17. Crippa JA, Guimarães FS, Campos AC, et al. Translational investigation of the therapeutic potential of cannabidiol (CBD): toward a new age. Front Immunol. 2018;9:2009. doi:10.3389/fimmu.2018.02009. 18. Dragone D, Prarolo G, Vanin P, et al. Crime and the legalization of recreational marijuana. J Econ Behav Organiz. 2019 Mar;1 (159):488–501. 19. Mead A. The legal status of cannabis (marijuana) and cannabidiol (CBD)

under US law. Epilepsy Behav. 2017 May;1 (70):288–291. 20. Malone T, Gomez K. Hemp in the United States: a case study of regulatory path dependence. Appl Econ Perspect Policy. 2019 Mar 8;41(2):199–214. 21. Mead A. Legal and regulatory issues governing cannabis and cannabisderived products in the United States. Front Plant Sci. 2019;10. doi:10.3389/ fpls.2019.00697. 22. Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res. 2018 Jul 1;3(1):152–161. 23. Khan SP, Pickens TA, Berlau DJ. Perspectives on cannabis as a substitute for opioid analgesics. Pain Manag. 2019 Jan 25;9(2):191–203. 24. Ren Y, Whittard J, Higuera-Matas A, et al. Cannabidiol, a nonpsychotropic component of cannabis, inhibits cue-induced heroin seeking and normalizes discrete mesolimbic neuronal disturbances. J Neurosci. 2009 Nov 25;29(47):14764–14769. 25. Moeller-Bertram T, Schilling J, Hughes C, et al. (360) can CBD reduce the use of pain medication? Lessons from a survey in a pain clinic environment. J Pain. 2019 Apr 1;20(4):S64. 26. Hurd YL, Yoon M, Manini AF, et al. Early phase in the development of cannabidiol as a treatment for addiction: opioid relapse takes initial center stage. Neurotherapeutics. 2015 Oct 1;12(4):807–815. 27. Hurd YL, Spriggs S, Alishayev J, et al. Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder: a double-blind randomized placebo-controlled trial. Am J Psychiatry. 2019 May 21. doi:10.1176/appi.ajp.2019.18101191 28. Haroutounian S, Ratz Y, Ginosar Y, et al. The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain. Clin J Pain. 2016 Dec 1;32(12):1036–1043. 29. Knopf A. CBD may help prevent relapse in abstinent heroin addicts. Alcohol Drug Abuse Weekly. 2019 Jun 3;31(22):3–4. 30. Johnson JR, Lossignol D, Burnell-Nugent M, et al. An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancerrelated pain refractory to strong opioid analgesics. J Pain Symptom Manage. 2013;46:207–218. 31. Iffland K, Grotenhermen F. An update on safety and side effects of cannabidiol: a review of clinical data and relevant animal studies. Cannabis Cannabinoid Res. 2017;2:139–154. 32. World Health Organization. Cannabidiol (CBD) pre-review report agenda item 5.2. Expert Committee on Drug Dependence Thirtyninth Meeting; Geneva; 2017. 33. Lau N, Sales P, Averill S, et al. A safer alternative: cannabis substitution as harm reduction. Drug Alcohol Rev. 2015;34(6):654–659. 34. Curran HV, Freeman TP, Mokrysz C, et al. Keep off the grass? Cannabis, cognition and addiction. Nat Rev Neurosci. 2016;17(5):293. 35. Zehra A, Burns J, Liu CK, et al. Cannabis addiction and the brain: a review. FOCUS J Am Psychiatr Assoc. 2019;17(2):169–182. 36. Simpson AK, Magid V. Cannabis use disorder in adolescence. Child Adolesc Psychiatr Clin N Am. 2016;25(3):431–443.

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Does PEA Support a Normal Pain Response?

By:

Kendra Whitmire MS, CNS By:

Kendra Whitmire MS, CNS

ANTI-AGING MEDICAL NEWS | SPRING 2022

Does PEA Support a Normal Pain Response?

Palmitoylethanolamide (PEA) is an endogenous endocannabinoid receptor agonist and naturally occurring fatty acid amide in the N-acylethanolamines family.1 As an autocoid local injury antagonist amide, it plays a role in lipid metabolism, nociceptor inhibition, and downregulation of inflammation. These actions have led to researchers looking into its potential for supporting a normal pain response.2 Studies have found that PEA downmodulates mast cells and associated proinflammatory modulators by modulating the immune system and inflammatory response.3 It also inhibits glial cells.3 PEA stimulates the endocannabinoid system (ECS), which is involved in pain and other disorders.4 PEA works directly or indirectly by activating key ECS receptors including proliferator-activated receptor alpha (PPAR-alpha), cannabinoid receptor type 1 and 2 (CB1 and CB2), transient receptor potential cation channel subfamily V member. 1/vanilloid receptor 1 (TrpV1), and the orphan G-coupled protein receptor 55 (GPR55).5 By enhancing the levels of two endocannabinoid agonists (arachidonoylethanolamine/anandamide (AEA) and 2-arachidonoylglycerol) it supports the activation of CB2, CB1, and TRPV1 to create an entourage effect that stimulates endogenous endocannabinoid activity.6

Two meta-analyses also support the potential for PEA to contribute to a significant reduction in pain.8,9 The findings showed that PEA treatment led to a fivefold more rapid reduction of pain intensity over time compared to the control group. 8,9 The PEA-treated group also experienced a reduction in the pain scale of 1.04 points every 2 weeks (with a 35% variability) compared to 0.20 points (1% variability) in the control group. 8,9 PEA treatment for 60 days also led to a pain score ≤3 in 81% of the patient compared to 40.9% in the control. 8,9 The researchers also confirmed the safety of PEA, including that it does not interfere with poly-drug therapies.8,9 As these clinical studies and more demonstrate, the properties of PEA, particularly its actions on the ECS, show potential for supporting a variety of chronic pain conditions alone or as adjunct therapy. PEA can be found in food sources such as peanuts, soybeans, eggs, milk, tomatoes, and black-eyed peas. Some people may find it beneficial to supplement with higher levels to promote a natural pain response.*

Clinical studies have found that these actions may support chronic pain in a variety of conditions. In one study, supplementing with 600 mg PEA twice daily either alone or as adjunct therapy for 3 weeks and then downgrading to once daily for 4 additional weeks led to a significant decrease in the mean score pain of all patients in the study.7 This was independent of the pathological condition associated with chronic pain.7

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Prevention and Lifestyle Care Beats Costly Medical Tests and Treatments Every Time

By:

Erika Schwartz MD

By:

Erika Schwartz MD

ANTI-AGING MEDICAL NEWS | SPRING 2022

Prevention and Lifestyle Care Beats Costly Medical Tests and Treatments Every Time

For decades we have been told our medical system is broken. We might have known this long before the COVID-19 pandemic started, but unfortunately, now we see its gaping holes so much more clearly. COVID deaths were sadly multiplied by the inept medical care provided to too many hospitalized patients. For example, it took one year to realize that placing patients on their bellies saved lives by allowing more oxygen to move into their lungs. What kind of craziness is this? Has common sense been eradicated from medical education and the practice of medicine? Didn’t we all know lungs expand better if you’re on your belly? And what about blowing people’s lungs out with respirators that didn’t help? I’ve listened to horror story after story from my patients and peers about the fearmongering that rules the healthcare system and about how many unnecessary tests and procedures we are subjected to on an ongoing basis. Recently, I heard a commercial on the radio from a cancer center telling listeners in no uncertain terms that “cancer rates have gone up”since the beginning of COVID because patients no longer show up for routine screenings like they did before. Where is the data to back up that statement? Why is this ad even allowed to be broadcast? Is it because freedom of speech now means freedom to bully and scare the living daylights out of patients and open the door for the healthcare system to make up for all the money it lost during the pandemic? How horrific is this? We spend money like water and never get to the root cause of the problems we are so glibly treating with drugs and procedures and testing. We don’t really help patients; we only make more money for the broken system. The fact that we have the most expensive healthcare globally, but our outcomes are not so great makes one wonder where we have gone wrong? The US spends at least 18% of its GDP ($3.35 trillion) on health expenditures. If costs continue to rise, by 2050, Medicare and Medicaid alone will account for 20% of the GDP. And still all projections point to continued rises in chronic disease. Every patient I speak to tells me how afraid they are to go to the hospital. There is no such thing as physical examinations or history-taking anymore. Decades have proven these diagnostic tools to work, yet now we have replaced them with an obligatory CT scan and 20 test tubes of blood. Why wouldn’t people be afraid to go to hospitals?

These tests, medications, and even surgeries are the last things you need unless you get run over by a bus, have an internal catastrophe, or are in some kind of other accident. We don’t talk about the root cause of our health problems because we will eliminate trillions of dollars overnight from healthcare expenditures if we start there. We say we talk about prevention, but we don’t. Many doctors advertise that they specialize in prevention, yet it’s often lip service. There is no training in medical school on lifestyle and prevention. It’s only still considered voodoo by conventional medical training. Most medical students and physicians do not receive adequate training in even the basics of lifestyle medicine, such as nutrition, sleep, stress management and physical activity. But the truth is simple. We can easily help make our patients’ lives better. Here’s how our patients are doing damage to their health: • Patients frequently drink alcohol. • Patients don’t hydrate with water and wait until dehydration sends them to the emergency room. • Patients eat junk food and don’t realize that’s why they are full of inflammation and become chronically ill. • Patients are often sedentary and spend a great deal of time watching the small, medium, and large blue screens that destroy their vision and cognitive functions with impunity. • Patients don’t sleep even though we all know the importance of sleep in rejuvenation and healing. • Patients don’t understand the importance of meditating or breathing or just managing their stress, even though we know the less they react to stress, the less they will get sick and the better their immune system will work. • Our patients don’t ever stop. They just keep running themselves into the ground. And having more tests and procedures and taking more medication is only another way to destroy their lives and avoid preventing disease. What is preventative and lifestyle care, and why does it matter? Preventative and lifestyle care is healthcare that prevents disease, injury, or illness, rather than treating a condition that has already become catastrophic or chronic. The goal of preventative care is to help people stay healthy, to improve their healthspan. Often, evidence-based lifestyle therapeutic interventions, including a whole-food plant-dominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection, are primary modalities

ANTI-AGING MEDICAL NEWS | SPRING 2022

Prevention and Lifestyle Care Beats Costly Medical Tests and Treatments Every Time

delivered by clinicians trained and certified. Preventive care helps lower healthcare costs in America by preventing or treating diseases before they require medical care. Lifestyle medicine intervention could help reverse chronic disease, leading to significant health care cost savings, according to a study conducted by the American College of Lifestyle Medicine published on 10/29/21 in the International Journal of Environmental Research and Public Health. Why seek additional education?

Academy offers graduate level education designed to produce the “complete practitioner” in all aspects of whole-person care. A4M has spent three decades equipping thousands of clinicians from across the globe with multifunctional tools to combat the growing burden of chronic disease and improve the human health span. Use the COVID crisis to stop and look at your patient care. Don’t think you know enough and do seek additional education and training in the areas that will help your patient prevent disease, change lifestyle habits, and reach healthy longevity and lead productive lives.

As the established global leader for continuing medical education, the American Academy of Anti-Aging Medicine (A4M) is rooted in a forward-focused mission to redefine modern medicine through prevention, lifestyle, and whole-person care. Founded in 1992, the

Ericka Schwartz, MD is a leading expert in prevention, bioidentical hormone therapy, peptides and longevity medicine. Founder and CEO of Evolved Science and the Better Health Initiative, a 501c3 foundation committed to education in prevention and the optimization of the Doctor Patient relationship. Dr. Erika is the author of 8 bestselling books, TEDx speaker and sees patients in NYC from all around the globe.

ANTI-AGING MEDICAL NEWS | SPRING 2022

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The Gut Microbiome in Dermatology

By:

Christine Stubbe Christine Stubbe ND

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Gut Microbiome in Dermatology

Abstract: The human body is home to ecosystems of bacteria, yeast, and other organisms that inhabit different regions of the body. The Human Microbiome Project utilized advanced technologies such as 16S rRNA sequencing and metagenomic whole genome shotgun sequencing to characterize species and strains and gain insights into their functional roles.1 The skin has a microbiome that is distinct from the gut microbiome. The gut microbiome is abundant and diverse and has far reaching systemic effects through both direct and indirect mechanisms. Gut dysbiosis can adversely affect the skin. The gut-skin axis is a bidirectional relationship associated with a number of dermatological conditions including rosacea, acne, psoriasis, atopic dermatitis, and others.2 Additionally, the gut microbiome impacts inflammation, skin-barrier function, and features of skin aging.3 A search in the PubMed database using terms ‘gastrointestinal and skin’ or ‘gut and skin’ or any variation of those terms yields thousands of articles with a steep rise in recent years. However, the connection between the gut and skin has long been recognized with publications dating back to the early 1900’s. These earlier studies noted connections with hypochlorhydria, small intestinal bacterial overgrowth (SIBO), increased intestinal permeability and skin conditions such as acne vulgaris.4 The gut-skin axis is an area of highly active research, however specific mechanisms are still being elucidated. Major mechanisms of how the gut may impact the skin involves intestinal permeability, dysbiosis, and inflammation. Increased intestinal permeability,also referred to as “leaky gut”,is the breakdown of gut barrier function resulting in increased passage of antigenic food proteins and bacteria or bacterial components including toxic lipopolysaccharides (LPS). These antigenic substances enter the circulation, eliciting an immune or inflammatory response that affects many organs, including the skin.5 The gut microbiome is an important immune mediator in the gut and systemically. While a healthy gut microbiome can reduce inflammation, a dysbiotic gut may perpetuate inflammation by producing inflammatory mediators that travel systemically or signal inflammatory cascades at distant sites such as the skin.6-8

Next, we will focus on a few specific skin conditions, particularly as they relate to adults in the anti-aging clinical practice. There are numerous studies on atopic dermatitis and children showing benefit of probiotics as an intervention. Evidence is accumulating on the importance of addressing the gut in other dermatological conditions as well. Gut health is important at all stages of life for healthy skin. Adult Acne Vulgaris One of the several contributors to acne development involves skin bacteria Cutibacterium acnes (formerly Propionibacterium acnes) and others, and both topical as well as oral antibiotics are effective treatments. Another factor in acne development involves increased release of inflammatory mediators. Antibiotics also have anti-inflammatory effects independent of their antimicrobial effects. However, long term use of antibiotics can detrimentally impact the gut microbiome as well as have other side effects. Studies show that gut microbiome dysbiosis is a factor in acne development, which begs the question of whether oral antibiotics are perhaps correcting a gut dysbiosis that could have been contributing to acne, in addition to treating the skin bacteria. However, it is well known that antibiotics can also create a dysbiotic gut microbiome, which could theoretically perpetuate acne and other issues. More research is needed for understanding the mechanisms of the gut-skin axis in acne.4 Studies suggest that increased intestinal permeability can result in increased circulating gut-derived bacterial endotoxin levels which has been observed in acne vulgaris patients. Endotoxins such as LPS are proinflammatory, and inflammation is a key factor in many skin diseases.4 Studies show that adding probiotics as adjuvants to antibiotic treatment for acne results in improved clinical outcomes and fewer antibiotic-induced side effects. Oral probiotics reduce systemic oxidative stress, regulate inflammatory cytokines, and reduce inflammatory markers, all mechanisms that contribute to acne pathogenicity.4 A small pilot, randomized, doubleblinded, placebo-controlled study on adults with acne studied the probiotic Lactobacillus rhamnosus for 12 weeks. Genes involved in insulin signaling were studied as insulin resistance is thought to be a contributor to acne. Results showed that the intervention normalized skin expression of genes involved in insulin signaling and improved the appearance of adult acne.9 Rosacea Rosacea is a chronic inflammatory skin disease characterized by

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Gut Microbiome in Dermatology

facial flushing, erythema, pustules, and telangiectasia on the central face. The exact pathophysiology is debated and likely multifactorial, however there are numerous studies connecting rosacea with gastrointestinal (GI) tract disorders.10 A large population-based study of 50,000 patients with rosacea showed that the prevalence of celiac disease, inflammatory bowel disease (IBD), small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS) were all significantly higher among patients with rosacea as compared with controls.11

It is important to note that in the first study above, rifaximin did not help rosacea in patients who did not have SIBO.7 Rifaximin is a non-absorbable antibiotic, so likely does not affect cutaneous organisms. Therefore, it is a very specific treatment for SIBO. It is also not known to possess anti-inflammatory properties like other antibiotics, so it is truly resulting in symptom resolution solely through bacterial eradication.12 Therefore, the importance of testing for, and treating the cause is crucial, as the etiology may differ among patients.

Rosacea management often involves symptom management rather than targeting the underlying cause. Treatment plans encourage avoiding triggers such as alcohol, spicy foods, or excessive sunlight exposure, but often without complete resolution. However, both topical and systemic microbiome-based treatments have proven successful.10

Psoriasis

SIBO may play a pathogenic role in triggering rosacea by increasing circulating cytokines, especially tumor necrosis factor-alpha; eradication may decrease inflammation, and thus the cutaneous manifestations of rosacea. A randomized, placebocontrolled study on 113 rosacea patients and 60 healthy controls showed that eradication of SIBO with rifaximin resulted in an almost complete resolution of skin lesions in 78% of patients that was maintained for at least 3 years.7,12 Similarly, a doubleblind, controlled study showed that after SIBO eradication with rifaximin, 46% of patients had complete clearance or marked improvement (including 4 patients with ocular rosacea), 25% reported moderately improved rosacea, and 11% mildly improved rosacea.13 Both studies showed that placebo patients had no change in rosacea or GI symptoms, but when crossed over to rifaximin, there was almost complete resolution.

Psoriasis is an inflammatory, autoimmune skin disease characterized by raised erythematous plaques with silvery scales. While the pathogenesis is not clear, it does appear that there are many associated mechanisms involving the gut. Studies on psoriasis patients’ microbiome and microbiome metabolites have shown that gut microbiota dysbiosis, lower beneficial short chain fatty acid (SCFA) production, increased trimethylamine-N-oxide (TMAO), LPS and other endotoxins, gut immune dysregulation, and increased intestinal permeability all play a role.14,15 One study showed that malabsorption was more prevalent among psoriatic patients than among controls. When the researchers investigated possible causes of malabsorption, they found that 21% of patients had SIBO, 6% had celiac disease, 3% had parasitic infections and 1 patient had eosinophilic gastroenteritis.16 Similar to rosacea discussed previously,treating SIBO with rifaximin results in improved cutaneous manifestations of psoriasis.17 Psoriasis is also associated with inflammatory bowel disease (IBD) and celiac disease. Treating the underlying cause can improve psoriasis.18,19 Skin Aging Skin is impacted by degenerative molecular processes such as oxidation, inflammation, and glycation that promote aging. While these processes are largely affected by diet, UV radiation, environment, and other factors, the microbiome can also play a role, especially in inflammation. Fiber-rich foods that support healthy bacteria and fermented and cultured foods may be beneficial for decreasing inflammation that can ultimately impact skin aging.3 Probiotics may be able to regulate protective mechanisms in the skin. A randomized, double blind, placebo-controlled study on 110 people with dry skin showed that oral supplementation with the probiotic Lactobacillus plantarum resulted in improvement in skin hydration, elasticity and gloss, and a reduction in wrinkle depth.20 Another study on 139 healthy women showed that

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Gut Microbiome in Dermatology

Interrelationship of gut dysbiosis, intestinal permeability, and aging skin. SASP=senescence associated secretory phenotype; F/B=Firmicutes/Bacteroidetes (Boyajian JL, et al. Nutrients. 2021 Dec;13(12):4550)

the combination of oral Lactobacillus johnsonii with carotenoids resulted in reduced UV-induced skin damage.21 In addition to aging skin, neoplastic changes also have an association with the microbiome. Changes in the microbiota and mycobiota correlate with histological features in patients with early-stage melanoma, and to the clinical course and response to immune therapies of advanced-stage melanoma. Just like many of the other conditions previously discussed, it is speculated that inflammation in the gut linked to altered microbial profiles could contribute to a systemic proinflammatory and pro-oncogenic status.6 Gastrointestinal Analysis Gastrointestinal (GI) assessment is helpful not only for GI complaints but also for systemic health. Stool microbiome testing techniques are continuously evolving from culture, to 16s rRNA, to a recent interest in metagenomic or whole genome sequencing. Metagenomics and metabolomics studies are important in assessing GI production of substances such as LPS, TMAO, and SCFA that circulate systemically and affect distant organs such as skin. There are already many functional laboratory tools at our disposal for

assessing many of the GI diseases mentioned in this article including SIBO, IBD, IBS, celiac disease, eosinophilic gastroenteritis, parasitic infections, and intestinal permeability. Comprehensive stool testing may help evaluate dysbiosis and factors that perpetuate a dysbiotic gut.22 A common thread among many skin diseases involves an inflammatory component, and it is well known that the gut – mainly the gut microbiome – is a crucial regulator of GI and systemic inflammation. While there is not a specific GI marker that is known to directly cause skin issues, test abnormalities may reveal an unhealthy gut that may be indirectly impacting skin and other organ health. Markers such as LPS and TMAO which in stool, can be assessed with metagenomic analysis, may help elucidate whether the gut is contributing to the skin condition. Additionally, SIBO breath testing may reveal a specific type of dysbiosis in the small intestine that can perpetuate intestinal permeability and inflammation. The lactulose mannitol intestinal permeability urine test can determine if leaky gut is a factor in skin diseases. All these tests can reveal actionable results for implementing treatment plans for patients. The functional medicine treatment arsenal for correcting GI test abnormalities and diseases is vast and offers patients hope far beyond the standard of care.

ANTI-AGING MEDICAL NEWS | SPRING 2022

The Gut Microbiome in Dermatology

Conclusion The age-old tenet by Hippocrates that “all disease begins in the gut” is proving to be true. Inflammation appears to be at the root of most diseases, with gut permeability and dysbiosis as triggering factors. The evidence connecting the gut-skin axis is compelling and as it continues to expand, we can expect that targeted gastrointestinal therapeutics will become recognized as standard treatments for dermatological conditions. Laboratory GI assessments can help clinicians examine whether their patient’s skin condition is GI-related.The future of stool testing is very promising and moves us closer to bridging the information gap between the gut-skin axis.

References 1. 2. 3. 4. 5. 6. 7. 8. 9.

NIH. NIH Human Microbiome Project. 2022; https://hmpdacc.org/hmp/, 2022.

De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021;9(2).

Katta R, Sanchez A, Tantry E. An Anti-Wrinkle Diet: Nutritional Strategies to Combat Oxidation, Inflammation and Glycation. Skin Ther Lett. 2020;25(2):3-7. Clark AK, Haas KN, Sivamani RK. Edible Plants and Their Influence on the Gut Microbiome and Acne. Int J Mol Sci. 2017;18(5).

HY7714 on Skin Aging: A Randomized, Double Blind, Placebo-Controlled Study. J Microbiol Biotechnol. 2015;25(12):2160-2168.

21. Bouilly-Gauthier D, Jeannes C, Maubert Y, et al. Clinical evidence of benefits of a dietary supplement containing probiotic and carotenoids on ultraviolet-induced skin damage. Br J Dermatol. 2010;163(3):536-543. 22. Goepp J, Fowler E, McBride T, Landis D. Frequency of abnormal fecal biomarkers in irritable bowel syndrome. Global Adv Health Med. 2014;3(3):9-15.

Maguire M, Maguire G. The role of microbiota, and probiotics and prebiotics in skin health. Arch Derm Res. 2017;309(6):411-421.

Vitali F, Colucci R, Di Paola M, et al. Early melanoma invasivity correlates with gut fungal and bacterial profiles. Br J Derm. 2022;186(1):106-116. Parodi A, Paolino S, Greco A, et al. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clin Gastroenterol Hepatol. 2008;6(7):759-764.

Boyajian JL, Ghebretatios M, Schaly S, Islam P, Prakash S. Microbiome and Human Aging: Probiotic and Prebiotic Potentials in Longevity, Skin Health and Cellular Senescence. Nutrients. 2021;13(12).

Fabbrocini G, Bertona M, Picazo Ó, Pareja-Galeano H, Monfrecola G, Emanuele E. Supplementation with Lactobacillus rhamnosus SP1 normalises skin expression of genes implicated in insulin signalling and improves adult acne. Benef Microb. 2016;7(5):625-630.

10. Daou H, Paradiso M, Hennessy K, Seminario-Vidal L. Rosacea and the Microbiome: A Systematic Review. Dermatol Ther. 2021;11(1):1-12. 11. Egeberg A, Weinstock LB, Thyssen EP, Gislason GH, Thyssen JP. Rosacea and gastrointestinal disorders: a population-based cohort study.Br J Dermatol. 2017;176(1):100106. 12. Drago F, De Col E, Agnoletti AF, et al. The role of small intestinal bacterial overgrowth in rosacea: A 3-year follow-up. J Am Acad Dermatol. 2016;75(3):e113-e115.

13. Weinstock LB, Steinhoff M. Rosacea and small intestinal bacterial overgrowth: prevalence and response to rifaximin. J Am Acad Dermatol. 2013;68(5):875-876.

14. Ely PH. Is psoriasis a bowel disease? Successful treatment with bile acids and bioflavonoids suggests it is. Clin Dermatol. 2018;36(3):376-389. 15. Polak K, Bergler-Czop B, Szczepanek M, Wojciechowska K, Frątczak A, Kiss N. Psoriasis and Gut Microbiome-Current State of Art. Int J Mol Sci. 2021;22(9).

16. Ojetti V, De Simone C, Aguilar Sanchez J, et al. Malabsorption in psoriatic patients: cause or consequence? Scan J Gastroenterol. 2006;41(11):1267-1271.

17. Drago F, Ciccarese G, Indemini E, Savarino V, Parodi A. Psoriasis and small intestine bacterial overgrowth. Int J Dermatol. 2018;57(1):112-113.

18. Kim M, Choi KH, Hwang SW, Lee YB, Park HJ, Bae JM. Inflammatory bowel disease is associated with an increased risk of inflammatory skin diseases: A population-based crosssectional study. J Am Acad Dermatol. 2017;76(1):40-48.

19. De Bastiani R, Gabrielli M, Lora L, et al. Association between coeliac disease and psoriasis: Italian primary care multicentre study. Dermatology. 2015;230(2):156-160. 20. Lee DE, Huh CS, Ra J, et al. Clinical Evidence of Effects of Lactobacillus plantarum

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Christine Stubbe, ND is a

Medical Education specialist, GI product line specialist, and content writer for Genova Diagnostics. She participates in many teaching and speaking events, and has written for peer-reviewed journals and other publications. cstubbe@gdx.net 800.522.4762

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Nurturing the Second Brain

By:

Nathan S. Bryan PhD S. Bryan Nathan By:

PhD

ANTI-AGING MEDICAL NEWS | SPRING 2022

Nurturing the Second Brain

For centuries now, people have taken intentional measures to eradicate bacteria and other microbes from our environment and our surroundings, including in and on the human body. Science started revealing several decades ago that this may not be the best approach for human health. Today the pervasive use of antibacterial soaps and hand lotions, the over use of antibiotics, the use of antiseptic mouthwash, fluoride-based toothpaste and the consumption of foods that contain herbicides are wreaking havoc on the human microbiome. The clinical consequences of such are devastating. The number of bacteria that live in and on the human body outnumber human cells by more than a factor of ten. The vast majority of these bacteria occupy our gastrointestinal system that starts in the mouth and ends at the anus. Although this long tube goes inside and throughout our head, neck, abdomen and pelvis, it is still considered the outside world. We have learned remarkable information about this outside world that affects our internal function over the past 30 years. In fact, the human microbiome is now considered its own organ. Just like any other organ, when its structure and function is disturbed, it becomes dysfunctional and that is when symptoms and disease start to manifest. This organ is so diverse and so important to human health and disease, it is often now called the second brain. It is appropriately named because it controls our mood, our senses, our thought processes, our immune system, our blood pressure and even pain. The old saying “gut feeling” now has true scientific meaning. The human genome codes for about 23,000 gene products. The microbiome codes for more than 3 million gene products. These gene products produced from normal bacterial metabolism and respiration control and regulate many human physiological functions. The bacteria that live inside us are there to do things that we, as humans, cannot do or have not yet evolved to do. When their structure, function, diversity and metabolism is altered, the human host is altered [1]. The clinical consequences are apparent and obvious. Recent studies showing a role for microbiota in blood pressure regulation might provide promising new therapeutic approaches. Increasing evidence indicates that dysregulation of commensal microbiota is linked to a variety of chronic disorders, some of which (including diabetes mellitus, obesity, chronic kidney disease [CKD], heart failure, etc) have an impact on blood pressure regulation and are risk factors for hypertension [2, 3]. Thus, it is reasonable to infer that microbiota could be a major participant in regulation of blood pressure. Although the majority of the work on the human microbiome has focused on gut bacteria, we and others have more recently focused on the oral microbiome. There are a number of clinical studies showing that alterations in the oral microbiome can cause an increase in blood pressure [4-

7]. Alterations in the oral microbiome inhibit the cardiovascular protective effects of exercise [8]. The mechanism of action of both physical exercise and a vegetarian diet is activation and promotion of nitric oxide [9-11]. Remarkable progress has been made to advance our understanding of the complex bacterial communities in human oral cavities, their classification, and implications in human health and diseases [12-14]. The oral microbiome comprises ≈700 species. Recent advances in metagenomic and metabolomic technologies, coupled with successful cultivation of oral bacterial species, have all contributed to an explosion of oral microbiome research and understanding. Because the oral cavity is the first to experience environmental, nutritional, and other external influences, a delicate balance in its microbial communities can have a major impact on human health and diseases. The significance of oral microbiome is continuously emerging, implicating oral dysbiosis in many periodontal diseases and other chronic diseases, such as cardiovascular disease (CVD) and hypertension [7, 15]. For example, a direct relationship between the levels of subgingival periodontal bacteria and high blood pressure has recently been reported [15]. It is known that NO can be modulated by microbial communities in the oral cavity to effectively reduce dietary nitrates to nitrite and NO, independent of its enzymatic synthesis from L-arginine [7]. Dietary nitrate from vegetable matter or from the oxidation of endogenous NO production is absorbed from the upper digestive tract into the bloodstream and concentrated in the salivary glands by active transport. About 20% of salivary nitrate is reduced to nitrite in the mouth by facultative anaerobic bacteria that are found on the surface of the tongue [16]. This pathway in humans seems to serve as an alternative mechanism that can provide an endothelium-independent source of bioactive NO compensating for insufficient host NO production. This pathway is dependent on commensal oral bacteria to perform the first step (2-electron reduction) because mammals lack a functional nitrate reductase. The presence of nitrate-reducing bacteria in the oral cavity, concentrated on the tongue, has been well documented [5, 17]. Meta-analysis has shown that increasing the dietary intake of nitrate-rich food products is effective in reducing blood pressure [18]. Therapeutically, this information can offer an effective strategy to promote NO production and treat hypertension by modulating the specific oral nitrate- and nitrite-reducing bacterial communities. Understanding and harnessing this redundant compensatory pathway may prove to be a viable and cost-effective strategy. Furthermore, this pathway may explain the biochemical and physiological link between oral health and CVD through maintenance of NO production.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Nurturing the Second Brain This is paradigm changing science. Hypertension, the number one risk factor for development of cardiovascular disease (CVD) is poorly managed. In the United States, about 78 million (1 out of every 3) people have high blood pressure or hypertension. Another 1 out of 3 have pre-hypertension (CDC fact sheet). That puts over 200 million Americans at an increased risk for developing CVD. Despite major advances in understanding the pathophysiology of hypertension and availability of antihypertensive drugs, management of blood pressure is still not achieved, even with multiple drugs. According to the AHA 2015 Statistics Fact Sheet, 75% of Americans are aware of their hypertension and take medication to treat it. However, only about half of those are adequately managed. Loss of nitric oxide production and signaling is the cause of hypertension [19, 20]. Since blood pressure remains elevated in approximately half of all treated hypertensive patients [21, 22], this reveals another mechanism at play rather than the known targets of drug therapy. Science points to the presence of oral nitrate reducing bacteria as a mechanism for management of systemic blood pressure and other conditions. Disruptions in the oral microbiome leads to decreased NO production. Better management of blood pressure reduces all-cause mortality [23]. This approach is supported by biochemical, physiological and epidemiological evidence. Loss of the protective effects of exercise and an increase in blood pressure puts one at enormous risk of CVD. The fact that mouthwash and any anti-septic treatment including fluoride toothpaste disrupts the oral microbiome and causes an increase in blood pressure leading to increased risk of CVD should be the top headline throughout the world. It appears that high blood pressure may be a symptom of oral dysbiosis. It is imperative we stop disrupting the microbiome and start doing what is proven to restore and support the oral microbiome which will lead to better systemic NO production. Things that disrupt the oral microbiome and nitric oxide production: 1. ANTISEPTIC MOUTHWASH. If you are using mouthwash, please stop. There is clear and indisputable evidence that mouthwash kills commensal good bacteria in your mouth that are there to generate nitrite and nitric oxide. 2. FLUORIDE. You must stop using fluoride toothpaste. Not only is fluoride a neurotoxin that causes neurological damage, it destroys your thyroid function and acts as an antiseptic that kills good oral bacteria and leads to nitric

oxide deficiency. Fluoride is also in municipal water. Invest in a water purification system that removes fluoride from your water that you drink, cook in and bathe in. If not, you are constantly poisoning yourself. It is no wonder we have an epidemic thyroid disease and heart disease. 3. ANTACIDS. If you are using antacids, you must stop. Antacids, particularly proton pump inhibitors have been shown to inhibit nitric oxide production. Furthermore, those on PPIs for more than 3 years have a more than 30% higher incidence of heart attack and stroke. The evidence is clear. Antacids lead to increased heart attacks and strokes. Things that stimulate, activate and replete nitric oxide. 1. PHYSICAL ACTIVITY. When we start to exercise, it tells our blood vessels we need to deliver more oxygen to the working skeletal and heart muscle to keep up with the metabolic demand. This signals our blood vessels to make nitric oxide. This explains why exercise is medicine. However, this does not happen if mouthwash is used. 2. CONSUMPTION OF GREEN LEAFY VEGETABLES. Green leafy vegetables are on average highest in inorganic nitrate. Nitrate is converted to nitrite and nitric oxide by oral and gut bacteria. The standard American diet (SAD) is deficient in nitrate. Add more vegetables to your diet. Unfortunately, organically grown vegetables are low in nitrate due to restrictions of nitrogenbased fertilizers. 3. SAFE AND EFFECTIVE NITRIC . . . . OXIDE SUPPLEMENT. If your body cannot make nitric oxide, consider taking a product that delivers nitric oxide. This can be done through standardized nitrate products that provide the body with a natural substrate that is missing in many of our foods. Nitrate is a nutrient that most Americans are missing. Similar to other nutrients like magnesium, iodine, selenium and zinc, nitrate is deficient in our diet. Organically grown vegetables contain about ten times less nitrate than conventionally grown vegetables [24]. Furthermore, there are wide variations in the amount of nitrate across different vegetables and from different geographical regions [24]. Interestingly, nitrate acts as a prebiotic for the oral nitrate reducing bacteria. Therefore, if you’re deficient in nitrate, then there is no substrate to feed the oral nitrate reducing bacteria. We have demonstrated that giving supplemental nitrate fortifies and increases the number and

ANTI-AGING MEDICAL NEWS | SPRING 2022

Nurturing the Second Brain

species of nitrate reducing bacteria in the oral cavity [25]. This will lead to better conversion of nitrate to nitrite and nitric oxide. If you

follow these very simple steps above you are taking steps to reduce your risk of becoming a statistic to cardiovascular disease.

References 1. Lynch, S.V. and O. Pedersen, The Human Intestinal Microbiome in Health and Disease. N Engl J Med, 2016. 375(24): p. 2369-2379.

2. Aron-Wisnewsky, J. and K. Clement, The gut microbiome, diet, and links to cardiometabolic and chronic disorders. Nat Rev Nephrol, 2016. 12(3): p. 169-81. 3. Zhao, L., The gut microbiota and obesity: from correlation to causality. Nat Rev Microbiol, 2013. 11(9): p. 639-47.

4. Kapil, V., et al., Physiological role for nitrate-reducing oral bacteria in blood pressure control. Free Radic Biol Med, 2013. 55: p. 93-100.

intima-media thickness: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Circulation, 2005. 111(5): p. 576-82.

16. Lundberg, J.O., et al., Nitrate, bacteria and human health. Nat Rev Microbiol, 2004. 2(7): p. 593-602.

17. Doel, J.J., et al., Evaluation of bacterial nitrate reduction in the human oral cavity. Eur J Oral Sci, 2005. 113(1): p. 14-9. 18. Siervo, M., et al., Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr, 2013. 143(6): p. 818-26.

5. Hyde, E.R., et al., Metagenomic analysis of nitrate-reducing bacteria in the oral cavity: implications for nitric oxide homeostasis. PLoS One, 2014. 9(3): p. e88645.

19. Arnold, W.P., et al., Nitric oxide activates guanylate cyclase and increases guanosine 3’:5’-cyclic monophosphate levels in various tissue preparations. Proc Natl Acad Sci U S A, 1977. 74(8): p. 3203-7.

7. Bryan, N.S., G. Tribble, and N. Angelov, Oral Microbiome and Nitric Oxide: the Missing Link in the Management of Blood Pressure. Curr Hypertens Rep, 2017. 19(4): p. 33.

21. Wang, Y.R., G.C. Alexander, and R.S. Stafford, Outpatient hypertension treatment, treatment intensification, and control in Western Europe and the United States. Arch Intern Med, 2007. 167(2): p. 141-7.

6. Tribble, G.D., et al., Frequency of Tongue Cleaning Impacts the Human Tongue Microbiome Composition and Enterosalivary Circulation of Nitrate. Front Cell Infect Microbiol, 2019. 9: p. 39.

8. Cutler, C., et al., Post-exercise hypotension and skeletal muscle oxygenation is regulated by nitrate-reducing activity of oral bacteria. Free Radic Biol Med, 2019. 143: p. 252-259. 9. Rassaf, T., et al., Nitric oxide synthase-derived plasma nitrite predicts exercise capacity. Br J Sports Med, 2007. 41(10): p. 669-73; discussion 673.

10. Green, D.J., et al., Control of skeletal muscle blood flow during dynamic exercise: contribution of endothelium-derived nitric oxide. Sports Med, 1996. 21(2): p. 119-46. 11. Bryan, N.S. and J.L. Ivy, Inorganic nitrite and nitrate: evidence to support consideration as dietary nutrients. Nutr Res, 2015. 35(8): p. 643-54.

12. Dewhirst, F.E., et al., The human oral microbiome. J Bacteriol, 2010. 192(19): p. 5002-17.

20. Bryan, N.S., K. Bian, and F. Murad, Discovery of the nitric oxide signaling pathway and targets for drug development. Front Biosci, 2009. 14: p. 1-18.

22. Cutler, J.A., et al., Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988-1994 and 1999-2004. Hypertension, 2008. 52(5): p. 81827. 23. Wright, J.T., Jr., et al., A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med, 2015. 373(22): p. 2103-16.

24. Nunez de Gonzalez, M.T., et al., A survey of nitrate and nitrite concentrations in conventional and organic-labeled raw vegetables at retail. J Food Sci, 2015. 80(5): p. C942-9.

25. Hyde, E.R., et al., Characterization of the rat oral microbiome and the effects of dietary nitrate. Free Radic Biol Med, 2014.

13. Mark Welch, J.L., et al., Biogeography of a human oral microbiome at the micron scale. Proc Natl Acad Sci U S A, 2016. 113(6): p. E791-800.

14. Baker, J.L., et al., Ecology of the Oral Microbiome: Beyond Bacteria. Trends Microbiol, 2017. 25(5): p. 362-374. 15. Desvarieux, M., et al., Periodontal microbiota and carotid

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NMR Metabolomics Testing

StressCalm

Metabolomics Panels--Serum & Urine

Booth #819

Booth #121

Boiron Inc.

Boston Heart Diagnostics

Ph: 888-264-7668 | boironusa .com

Ph: 877-425-1252 | bostonheartdiagnostics .com

StressCalm™ is powered by plants to relieve occasional nervous tension, irritability, hypersensitivity, and fatigue due to everyday stress.* This homeopathic medicine works without causing drowsiness, dependence, or drug interactions. Convenient and discreet, the meltaway tablets are easy to take at the onset of symptoms — no food or water required. StressCalm is made by Boiron, world leader in homeopathic medicines, and recommended for adults and children ages 12 and older.

Take your lab testing to the next level with the newest technology available from Boston Heart! We utilize NMR for our new Metabolomics panels, providing broader insights to complex metabolic pathways. Serum Metabolomics will allow you to optimize a wide range of lipids, lipoproteins, and serum metabolites from a single tube of blood. Urine Metabolomics will provide in-depth analysis at a lower cost than organic acid testing. Launching Spring/Summer 2022.

Dried Blood Testing

Advanced Cardiometabolic, Nutritional, and Hormone Testing Using Dried Bloodspots

Arterosil

Booth #121

Booth #807

Boston Heart Diagnostics

Calroy Health Sciences

Ph: 877-425-1252 | bostonheartdiagnostics .com

Ph: 800-609-6409 | arterosil .com

Boston Heart is proud to launch Advanced Cardiometabolic, Nutritional, and Hormone Testing Using Dried Bloodspots. Measure changes in advanced lipids, inflammation, glucose/A1c, insulin resistance, beta cell function, omega-3 fatty acids, vitamins, sex hormones, thyroid function, and kidney function resulting from your treatment and lifestyle recommendations. Include genetic markers on DBS to provide additional precision guidance. Includes lab reports, patient reports, and optional 20-page patient Life Plan with ultrapersonalized dietary and lifestyle recommendations. Launching Spring/Summer 2022

Arterosil® is the world’s first glycocalyx-regenerating supplement. It is also the only product patented to stabilize and regress vulnerable plaque. Your blood vessels have a micro-thin gel lining called the endothelial glycocalyx. The glycocalyx protects and regulates the entire endothelium and is therefore the foundation of vascular health. It inhibits cholesterol and other harmful particles from adhering to or penetrating the endothelial wall. By promoting the health of the glycocalyx, Arterosil supports normal endothelial function, promotes a healthy heart, improves blood flow, and helps maintain blood pressure in the normal range.* Arterosil also helps support normal erectile function in men.* In addition, Arterosil is the only dietary supplement of any type with a US patent targeting vulnerable plaque.

G- Antioxidant Revitalization Serum

Booth #419

Booth #901

Carbon-60, Greska’s

Central Drugs Pharmacy

Ph: 303-901-9050 | c-60 .com

Ph: 562- 352- 9630 | Auroskincare .com

Greska’s Carbon-60 targets Oxidative Stress... the main cause for most any health issue and the main cause for aging. The new 15-Day Supply bottle gives you a price point opportunity to experience this remarkable 2012 breakthrough product. Greska’s Carbon-60 is the only certified Food-Grade/topical ointment C60. This 15-Day Supply contains the same Carbon-60 concentration formula as our 45-Day Supply. It’s highly bio-available Carbon, exactly what your body needs for a boost in overall health and athletic performance. Carbon is a known detoxifier, and Greska’s Carbon-60 provides a Whole-Body Detox of all toxins at the cellular level. Feel the difference within a week! Try it today for “A Better you at Any Age.”

A groundbreaking high-potency antioxidant serum to transform and strengthen skin. Powered by Glutathione, the Master Antioxidant, is the first of its kind to promote Skin Wellness as it works from the inside out to balance oxidative stress. The Auro GSH™ Antioxidant Delivery System, a patented, first-of-its-kind technology, optimizes Glutathione absorption and efficacy.

Citrine - Vitamin C Radiance Complex

BPC 157

Booth #901

Booth #815

Central Drugs Pharmacy

Clinicians Supplement Consultants

Ph: 562- 352- 9630 | Auroskincare .com

Ph: 855-272-7220 | cscprivatelabel .com

A powerhouse Vitamin C serum with an unprecedented 25% concentration of Ascorbic Acid Vitamin C to help dramatically brighten the look of skin and defend against environmental stress. The Auro GSH™ Antioxidant Delivery System, a patented, first-of-itskind technology, optimizes Vitamin C absorption and efficacy.

Clinicians BPC 157 in the Arginate salt form. 500mcg in a single capsule. Available wholesale to health care professionals only, not sold discounted online, and it is available direct to patients as part of our Supplement Concierge Dispensary Program.

PRODUCT ANNOUNCEMENTS

15-Day Supply

PRODUCT ANNOUNCEMENTS 98

Ultimate Immuno-Max

ezGel

Booth #815

Booth #322

Clinicians Supplement Consultants

CosmoFrance

Ph: 855-272-7220 | cscprivatelabel .com

Ph: 305-538-0110 | ezgel .net

Ultimate Immuno-Max is aimed at providing the most potent immune supportive nutrients both on a daily basis as well as during acute immune stress.* Because these ingredients support the immune system’s ability to adapt and not simply up-regulate immune function, those with hyperactive immune responses may also incorporate this formula, under a physician’s supervision, into their daily regimen. Wellmune® Beta Glucan - Monolaurin - Colostrum (yielding Immunoglobulin G)

EZGEL is an all-natural, autologous regenerative therapy obtained through centrifugation of a whole blood sample to isolate beneficial cells, then subjected to a cooling and heating process. By mixing the albumin of plasma and the growth factors of PRF, this organic gel concentrate delivers instant volumizing and beautiful skin rejuvenation

Lymphocyte MAP

Collagen Bright™

Booth #416

Booth #522

Cyrex Laboratories

DaVinci Laboratories

Ph: 657 .303 .3898 | lymphocytemap .com | JoinCyrex .com

Ph: 800-325-1776 | davincilabs .com

The Lymphocyte MAP measures the integrity of the immune system at the cellular level, enabling practitioners to classify their patients’ immunotype or their immune identity. It uses an advanced flow cytometry method that combines laser technology with monoclonal antibodies to measure theproperties of living cells based on size, shape, density and granularity, resulting in a high-precision count of various lymphocyte subpopulations. The Lymphocyte MAP identifies the patterns of balance or imbalance of T cells, B cells and natural killer cells detected in the blood of a patient, and organizes them into specific immunotypes to facilitate interpretation of test results.

Collagen Bright™ contains an exceptional form of collagen, hyaluronic acid, vitamin C, Cordyceps, and biotin, which support collagen rebuilding and anti-aging properties of the skin.* Working in combination, these ingredients promote healthy skin, support skin hydration, and minimize wrinkles and fine lines.*

OMX™ Organic Metabolomics

Booth #707

Booth #913

Designs for Health

Diagnostic Solutions Laboratory

Ph: 860-623-6314 | designsforhealth .com

Ph: 877-485-5336 | diagnosticsolutionslab .com

Cannab-PEA 300™ combines 300 mg of palmitoylethanolamide (PEA) with 10 mg of standardized full-spectrum phytocannabinoids per capsule for a synergistic effect to support endocannabinoid signaling and a normal pain response.* It utilizes the innovative ComboCap® delivery to combine powder and liquid into one capsule. Learn more at designsforhealth.com.

The OMX_™ Organic Metabolomics test from Diagnostic Solutions Laboratory evaluates urine and plasma metabolites—including organic acids, amino acids, and other key compounds—to assist practitioners in unraveling their patient’s metabolic pathways, revealing their unique Metabolic Signature. Using a systems-biology approach, OMX assesses biomarkers that go beyond the traditional lists of metabolites. It enables practitioners to see a patient’s larger health picture by deciphering and connecting perturbations of key metabolic pathways and analytes.

IgG Food Explorer

HuMap™

Booth #913

Booth #206

Diagnostic Solutions Laboratory

Doctor’s Data, Inc.

Ph: 877-485-5336 | diagnosticsolutionslab .com

Ph: 630-377-8139 | doctorsdata .com

The IgG Food Explorer by Diagnostic Solutions Laboratory is an Elisabased multiplex food sensitivity test measuring total IgG antibodies to a plethora of foods. IgG Food Explorer evaluates over 250 food antigens using a simple at-home collection. Results help practitioners personalize diet and lifestyle guidance for their patients to reduce and eliminate symptoms related to adverse food reactions. IgE Allergy Explorer which tests over 150 allergens at the extract and component level is also available.

The Hormone and Urine Metabolite Assessment Profile (HuMap™) by Doctor’s Data_provides_a complete_overview_of steroid hormones, their metabolites, and the_efficiency of the enzymes that metabolize these hormones. Because the breakdown of hormones relies so heavily on processes within the liver, this test can also_elucidate areas of interest as it pertains to conjugation of each metabolite. Additionally, testing urinary hormone metabolites can_contribute to further_understanding of supplemental hormone utilization, conversion, and potential risk for the development of pathology.

PRODUCT ANNOUNCEMENTS

Cannab-PEA 300™

PRODUCT ANNOUNCEMENTS 100

Host Your Own Online Summit

intraMAX 2.0

Booth #220

Booth #1016

DrSummits.com

Drucker Labs

Ph: 619-436-7750 | Drsummits .com

Ph: 888-881-2344 | store .druckerlabs .com

Build your profitable email list quickly by hosting your own online summit with drsummits.com. We are a done-for-you online summit production company who can grow your traffic leads and sales fast.

In just one ounce daily, intraMAX 2.0 provides over 415 Organicallybound nutrients in a complete formula that is highly bioavailable, easy to take, great-tasting, and naturally preserved with intraFRESH technology!

intraMAX 2.0

gammaCore Sapphire™

Naturally Unsweetened

(non-invasive vagus nerve stimulator)

Booth #1016

Booth #212

Drucker Labs

electroCore, Inc.

Ph: 888-881-2344 | store .druckerlabs .com

Ph: 888-903 2673 | gammacore .com

With an all-natural flavor and no added sugar, intraMAX 2.0 Naturally Unsweetened provides over 415 Organically-bound nutrients in a complete formula that is highly bioavailable and the perfect nutritional complement for MCS/EI patients and for patients with diets that are restrictive to added sweeteners. intraMAX 2.0 Naturally Unsweetened is 100% naturally preserved with our proprietary intraFRESH technology!

gammaCore Sapphire™ (nVNS) is the first and only FDA cleared noninvasive device to treat and prevent multiple types of headache pain via the vagus nerve. It’s small, handheld and portable for quick and easy treatments whenever and wherever needed. Available by Rx for acute and preventive treatment.

Enzyme Science Digest Gold™

Booth #401

Booth #813

Emerson Ecologics

Enzyme Science

Ph: 800-654-4432 | emersonecologics .com

Ph: 941-441-3725 | enzyscience .com

We’re excited to share that Emerson Ecologics® is now part of Fullscript. For over 40 years, Emerson has supported the practice of healthy living as the leading distributor of vitamins, supplements, and natural health products. Now as one, Emerson and Fullscript are working together to enable the future of integrative care delivery. A4M has been a fantastic partner to Emerson Ecologics and we are excited about the possibilities this acquisition could create for our shared organizations and the industry itself.

High potency, probiotic-free formula to help break down all the components of a meal.*This award-winning formula provides superior protein and fat digestion as well as a combination of carbohydrase enzymes for digesting a wide range of sugars and fibers commonly consumed in an average meal.*This digestive enzyme formula is ideal for someone who may be sensitive to probiotics because Digest Gold is 100% vegan, probiotic-free, and comprised of high-quality ingredients void of fillers and excipients.

Serrapeptase Pro™

Triamcinolone Pellets

Booth #813

Booth #200

Enzyme Science

EVEXIAS Health Solutions

Ph: 941-441-3725 | enzyscience .com

Ph: 817-203-8216 | fko-outsourcing .com

Potent proteolytic enzymes to promote joint mobility, improve circulation, cardiovascular and immune health.* Taken on an empty stomach, Serrapeptase is absorbed through the intestine and transported directly into the bloodstream.* The proteolytic nature of this enzyme allows for the ability to dissolve dead and damaged tissue that is a by-product of the healing response.* In addition to its proteolytic activity, Serrapeptase possesses both fibrinolytic and caseinolytic properties making it vital for circulatory and cardiovascular health.*

Testosterone pellets with triamcinolone have been shown to reduce pain with insertion, improve post-procedure comfort and support better patient outcomes. Triamcinolone is a key ingredient in testosterone pellets produced by FarmaKeio Outsourcing. The addition of triamcinolone has been researched to show that this ingredient may help reduce inflammation associated with insertion and help improve overall patient outcomes.

PRODUCT ANNOUNCEMENTS

Emerson Ecologics: a Fullscript company

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Flosom

FemiWave

Booth #1219

Booth #812

Flosom

GAINSWave/FemiWave

Ph: 888-435-6766 | htflosom .com

Ph: 855-383-5779 | femiwave .com

Flosom is a novel Men’s Urinary Health supplement that contains a proprietary blend of natural plant oil extracts. It is a clinically tested formulation that supports Prostate health, improved rest, and overall vitality.

FemiWave is a procedure that uses pulse waves to repair blood vessels, which improves blood flow to the vagina. Women can expect to experience increased sensitivity and lubrication, as well as strengthening, tightening and improved physical appearance. Overall, FemiWave helps enhance sexual fulfillment and function. The procedure is non-invasive, comfortable, and performed on the outer and inner labia right in the provider’s office. There is no downtime, drugs, or laser and the results are long-lasting. FemiWave uses shockwave therapy which has been around for years and is based on numerous clinical studies proven to increase blood flow and restore healthy tissue.

XPulser DEEP SLEEP

PulsedBox M3

Booth #219

Health Energy Partners LLC

Ph: 518-461-8963 | drpawluk .com

Battery run device for those who have trouble sleeping. Portable and easy to use, this product helps with sleep related issues.

Medium to high intensity pemf device to help with chronic pain and other common ailments

Affordable And Portable Sleep Issue Device

Can’t Weight

Booth #123

Booth #317

Healy World

Integrative Peptides

Ph: 407-920-2507 | biohackingwithfrequencies .com

integrativepeptides .com/product/cant-weight

We would love to introduce The Healy! The diversity of applications of the Healy devices are evident in the amount of individual, personalized microcurrent therapies offered. People have been using it to enhance energy, focus, sleep, physical fitness, stress, depression, aches and pains and much more. Healy is small, lightweight and easy to use. It doesn’t need it’s own screen, data storage or input device. Microcurrent therapy has never been easier or more focused! The Healy system offers bioenergetic support exactly where you need it.

Can’t Weight is a protein hydrolysate peptide blend which acts on food intake modulators at the hypothalamic and digestive levels. This blend has been shown to help lower caloric intake and reduce body fat mass.

intracellular NAD good spot test

AgingSOS™ + IC-NAD

Booth #422

Jinfiniti: The Longevity Biomarker Company

Ph: 214-679-0059 | jinfiniti .com/products/intracellular-nad

The only commercially available NAD test on the market. Ideal for NAD optimization by measuring NAD level before and after NAD management via supplementation or IV infusion.

AgingSOS™ test. AgingSOS™ is a first-of-its-kind biomarker panel, a comprehensive tool to maximize healthy longevity. AgingSOS™ analyzes innovative longevity biomarkers including intracellular NAD, circulating NAD, cellular senescence (SA-_-galactosidase), reactive oxygen metabolites, total antioxidant capacity and 15 other health tests

PRODUCT ANNOUNCEMENTS

Healy Micro-Current Frequency Device

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PRODUCT ANNOUNCEMENTS 104

KBMO FIT 176 plus Zonulin KBMO FIT 132 plus Zonulin

ProLon Reset

Booth #100

Booth #301

KBMO Diagnostics

L-Nutra

Ph: 617-933-8130 | kbmodiagnostics .com/zonulin-test

Ph: 310-7753655 | prolonfast .com

Dr Brent Dorval and Dr Alessio Fasano have partnered to create the only Zonulin assay which does not cross react with haptoglobin, properdin or any complement fragments. They have achieved this by creating a unique recombinant zonulin protein. By measuring the Zonulin antibody It makes the assay also uniquely stable to avoid the fluctuations reported in Zonulin protein assays. The assay also has similar positivity rates as seen in Fasano’s letter to the Lancet, Zonulin is available on the KBMO FIT 176 and FIT 132 panels in serum and blood spot

ProLon ReSet makes it easier to fast for a full day by giving you nourishment, fuel and curbing hunger while keeping your body fasting!. Use as a full-day fasting break for your body whenever you need a reset from unhealthy eating.Take a break from mindless eating, high-calorie diets, sugar and carbs. Amp up your Intermittent Fasting with a nutrition program that gives you many of the benefits of a full day fast.

NEW Flavors for Fast Bars

Essentials 5 in 1 DR

Booth #301

Booth #1112

L-Nutra

MD Prescriptives

Ph: 310-7753655 | prolonfast .com

Ph: 877-963-7737 | mdprescriptives .com

L-Nutra is introducing two new flavors of its popular Fast Bar. These two new flavors capitalize the trend of berrys as part of a healthy nutrition. The two flavors are: Blueberry Acai - Lemon Strawberry. For more information please visit fastbar.com

Essentials 5 in 1 DR (Delayed Release) our premier, multi-vitaminmineral rich product, incorporates the latest scientific research on nutrition and metabolic functions. Individual nutrients are formulated for maximum bioavailability, synergy, hormonal/metabolic activation, and antioxidant capacity. Delayed release capsules minimize or eliminate the gastric side effects some individuals experience taking a multivitamin. It is a complete multinutrient in one bottle, virtually eliminating the need for additional supplemental Vitamin B, Vitamin E, Vitamin A, Vitamin K, and extra minerals.

Complete multinutrient for maximum hormonal/metabolic activation.

MedEcho Physical Rehab Recovery Kit

Booth #1112

Booth #1116

MD Prescriptives

MedEcho Products

Ph: 877-963-7737 | mdprescriptives .com

Ph: 727-699-1114 MedEchoRecovery .com | MedEchoSports .com

Magnesium MD is a novel, highly absorbable and bio-available magnesium chelate for sensitive individuals, with ATA-Mg™ (Magnesium Acetyl-taurinate). It has both Magnesium glycinate and ATA-Mg™ (magnesium acetyl-taurinate) making it a more bio-available source of both magnesium and taurine. By incorporating the ATA form of magnesium, it is more lipophilic and therefore has enhanced cellular, neuronal, and blood-brain barrier penetration. This form has been studied for use in severe headaches and seizures. The glycine form of magnesium allows it to be actively taken up by the intestinal mucosa, due to the active transport for amino acids, as opposed to the usual passive transport for most minerals.

The first program kit designed as a safe, non-addictive alternative to opioids and other pain medications, lessening known side effects. A simple and auto-training program for patients to manage pain with professional grade results. Our Physical Rehab Kit Kit is a dual-action delivery system that allows this topical and oral combination to be instantly felt with enduring relief. Inflamed joint, muscle, and tissue discomfort are soothed without the systemic effects of NSAIDs. Kits include a simple-to-follow program guide with print and video application/dosage instructions, expert support if needed, and all necessary MedEcho products for topical and oral applications in one professional kit.

MedEcho Sports Recovery Kit

Smart Pulse

Booth #1116

Booth #825

MedEcho Products

Medicore, Co. Ltd.

Ph: 727-699-1114 MedEchoRecovery .com | MedEchoSports .com

Ph: 82-318-027-7070 | medi-core .com

Our Sport Recovery Kit is a dual-action delivery system that allows this topical and oral combination to be instantly felt with enduring relief. Inflamed joint, muscle, and tissue discomfort are soothed without the systemic effects of NSAIDs. Kits include a simpleto-follow program guide with print and video application/dosage instructions, expert support if needed, and all necessary MedEcho products for topical and oral applications in one professional kit.

PRODUCT ANNOUNCEMENTS

Magnesium MD

Smart Pulse is a measuring the overall health in a minute for the cardiovascular disease and autonomic nerve system function. It can be used for personal monitoring the health and provide the recommendation of nutritional supplements.

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Merchant Preferred Zero

D3 Algae

Booth #919

Booth #413

Merchant Preferred Zero

Metagenics

Ph: 540-484-3429 | mpzero .net

Ph: 800-692-9400 | metagenics .com

With Merchant Preferred Zero the business owner begins keeping all the fees to process credit cards. Your patient/customer pays a flat percentage on transactions paid by credit card.

Introducing a vegetarian offering of vitamin D3, made entirely with non-animal-derived ingredients. D3 Algae delivers 2,500 IU (62.5 mcg) of vegetarian vitamin D3 sourced from algae; with only 3 ingredients, this small tablet can be either swallowed or chewed, as it has a neutral, slightly sweet taste.

D3 Spray

PyloGuard™

Booth #413

Booth #313

Metagenics

Microbiome Labs

Ph: 800-692-9400 | metagenics .com

Ph: 904-940-2208 | microbiomelabs .com

Introducing a vegetarian offering of vitamin D3, made entirely with non-animal-derived ingredients. D3 Spray delivers 1,000 IU (25 mcg) of vegetarian vitamin D3 sourced from lichen in an easy-to-use spray; unflavored, neutral taste.

Burning stomach, painful ulcers? Make H. pylori a thing of the past with PyloGuard™! Harnessing the power of nature, inactivated Lactobacillus reuteri DSM17648 gently binds to H. pylori to escort it out the digestive tract. PyloGuard™ is useful as a monotherapy — with no side effects! It also makes triple therapy more effective. This formulation has extensive research to back it up, ask us for more details! Try microbiome-friendly PyloGuard™ on your H. pylori patients today!

NOVA Complete

Booth #612

NuMedica

Ph: 800-869-8100 | numedica .com

Cognitein™ is a unique combination of Magtein® (magnesium L-threonate), L-taurine and L-theanine designed to help support healthy cognitive function. Magtein®, magnesium L-threonate, has been shown to support healthy levels of magnesium in the brain and functional neuronal terminals.* Magtein® is a patented and clinically studied ingredient shown to support cognitive function and healthy brain aging.* L-taurine is an abundant amino acid in the human body but taurine levels typically decrease with age. New studies show that taurine may play a major role in supporting the brain when exposed to toxic chemicals from water supplies and other environmental sources.* *These statements have not been evaluated by the Food

NOVA Complete™ is designed to increase nitric oxide production in the body.* Instead of relying on L-arginine like most formulas, it features a superior combination of L-citrulline, select botanicals, and key vitamins and minerals to boost nitric oxide, relax blood vessels, and enhance circulation in men and women over 40.* *These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

Dynamic GI Defend

LivComplete

Booth #113

Booth #1009

NutriDyn

Nutritional Frontiers

Ph: 800-444-9998 | nutridyn .com

Ph: 412-922-2566 | nutritionalfrontiers .com

Dynamic GI Defend contains the highest concentration of naturally sourced immunoglobulins from ImmunoLin®, a serum-derived bovine immunoglobulin/protein isolate that helps support healthy gut barrier function. Dynamic GI Defend works by binding, neutralizing, and removing toxins in the gut to promote restored gut homeostasis and healthy immune system function. Toxins naturally occur in the gut during the breakdown and turnover of food in the GI tract. Here, they can activate an intestinal immune response if they encounter a weakened gut barrier wall. ImmunoLin® binds these toxins together, making them too large to pass through the gut barrier and allowing them to be safely removed through regular bodily processes.

LivComplete was formulated to provide complete support for liver function and detoxification. Along with herbs and nutrients to enhance the liver’s ability to perform detoxification,* LivComplete contains an array of nutrients to support the body’s ability to repair oxidative stress. Our bodies may become overwhelmed by overexposure to the toxins found in air and water sources, chemicals and hormones added to food, as well as chemicals in household goods, fabrics, plastics, and personal care products. Symptoms of fatigue, frequent headaches, lack of mental clarity, allergies, food intolerance, mood imbalances, hormonal problems, and more, may be the result of toxic burden and could induce someone to decide to embark on a detoxification program.

PRODUCT ANNOUNCEMENTS

Cognitein

and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

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Z-Binder

OutcomeMD Tracking, Management, and Marketing Platform

Booth #601

Booth #407

OrthoMolecular

OutcomeMD

Ph: 800-332-2351 | orthomolecularproducts .com

Ph: 1 -878–OUTCOME | outcomemd .com/a4mconference

For a more thorough detox, try Z-Binder. Z-Binder contains natural binding ingredients from the purest sources to support enhanced clearance of heavy metals, unwanted organisms, and organic compounds like glyphosate. The ingredients in Z-Binder have an ideal microscopic shape to ensure excellent binding ability and remove stubborn toxins from the body—helping your patients feel better, faster.

More Bookings. Better Outcomes. Happier Patients. Goodbye assumptions, hello data. Leverage your outcomes to increase your online presence and see up to 50% more bookings and referrals with OutcomeMD’s Outcome Tracking, Management, and Marketing Platform.

OutsetHealth.com

(866) 634-8560

Why Outset Health? Is your medical practice interested in: • Increasing patient retention? • Improving overall patient well-being? • Reducing patient non-compliance? • Non-insurance, all cash-based programs? • Increasing profitability? Outset Health has identified and created proven methods to help your medical practice achieve all these goals! With over 40 years of experience in the Health & Wellness industry, we have gathered insight from providers, patients and office staff to create solutions that deliver real results to optimize your practice’s efficiency.

What Sets Us Apart? We have conducted extensive research and development in the Health & Wellness industry to identify why implementing new solutions into an already busy medical practice often falls short of reaching its full potential. Those reasons include: • • • • • • • • •

Overworked staff focused on current business Inconsistent messaging to patients Difficult to transition to cash-based patient sales Lack of ongoing support for frequently asked questions Minimal support for advanced case studies Billing inefficiencies Insufficient technical support Missing other key elements that would enhance outcomes Upfront Costs Our solutions are specifically designed to address all these needs on your behalf to ensure your practice achieves optimal results!

Outset Hormones Personalized - Outset Pellet Therapy - Outset Lifestyle

PELLECOME FIT®

Booth #1123

Booth #316

Outset Health

Pellecome LLC

Ph: 866-461-3405 | outsethealth .com/learn-more

Ph: 888-773-9969 | pellecome .com

WHY OUTSET HEALTH? Optimizing the efficiency of your practice Outset Health has identified and created proven methods to help your medical practice achieve all these goals! With over 40 years of experience in the Health & Wellness industry, we have gathered insight from providers, patients, and office staff to create solutions that deliver real results to optimize efficiency for your practice. Our health aging programs are designed to minimize impact to your practice and maximize health outcomes for their patients.

PELLECOME FIT® is a customized medical treatment program based upon an individual’s metabolic and hormonal needs to support optimal health, recovery, and maximize the The Power to Perform.® The goal is to optimize the health and performance of each individual based upon their specific needs in either recovery or enhancement. We achieve this by BHRT, The Power of Peptides, Weight loss Pellets & Supplementation.

Customized dosage calculator for medical providers

Triple Combination Compounded Hair Loss Formulas

Booth #1212

Pharmacy Solutions

Ph: 817-274-0050 | pstransform .com

Customized, patient specific dosage calculator for medical weight loss formulas. Addressing the root causes of unhelathy weight, including sleep, stress, behavior and more

A new triple formula to treat men with alopecia and initiate hair growth.

Meta

Beauty Focus Collagen+

Booth #106

Pharmanex

Ph: 404-538-5608 |

It took us seven year of research to arrive at this anthocyanin blend (rich in Cyanidin and Delphinidin) to accomplish 215mg of daily, powerful metabolic support. It supports core metabolism, vital organs including liver and heart, healthy inflammatory balance/immune activity for healthy cellular function, healthy microbiome for better gut , healthy blood glucose and improves the antioxidant defense system for reducing oxidative stress.

Clinically proven to reduce fine lines and winkles, support hydration and boost collagen and elastin production in the skin. Its Bioactive Collagen Peptides have a special peptide “fingerprint” that allows them to more effectively bind to collagen receptors and enhance beauty. It has the highest stimulatory effect of all collagens tested in vitro. It includes Lutein for radiance and antioxidant protection for oxidative stressors like “blue light”. Its Phytoceramides help skin stay hydrated and moisturized.

PRODUCT ANNOUNCEMENTS

Transform Medical Weight Loss

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Multifunction Cardiogram™

Prism Light Pod

Booth #822

Booth #222

Premier Heart

Prism Light Pod

Ph: 904-907-4542 | premierheart .com

Ph: 720-902-9996 | prismlightpod .com

The Multifunction Cardiogram™ is a unique tool available to detect Coronary Artery Disease and other cardiac conditions. The MCG is extremely accurate and reliable, surpassing many established clinical techniques. It works equally as well for men and women. It takes under 10 minutes, is mobile, noninvasive, and cost effective. The Multifunction Cardiogram Technology can save time, money, and help save precious lives.

Founded in 2017, Prism Light Pod is the industry’s most-advanced & award-winning whole-body red light therapy system. Prism Light Pod uses red and near-infrared light waves to speed the body’s natural recovery process 4-10 times faster. Prism Light Pod is an FDA registered Class II medical device. Sessions are private, safe, noninvasive and optimized for performance recovery, pain management, weight-loss, anti-aging and more. Prism Light Pod has been awarded the prestigious Global Excellence Award as the Most-Powerful FullBody Red Light Therapy System of 2020 and the Best Red Light Therapy Device of 2021.

Civance

Canifen

Booth #914

Prosoma LLC

Ph: 727-648-2791 | civance .com

For the support of healthy connitive function. Civance provides 1000MG per 4ml oral liquid dose. Taken daily each bottle has 30 servings.

1000 mg of Full Spectrum CBD per serving. Sourced from premium, domestically grown hemp, manufactured in a stateof-the-art facility, and independently 3rd party tested. Accurate dosing with oral dose syringe.

VEMI Meditation Bed

Booth #124

Booth #1201

PUR-C / VCICI

PureWave Technologies

Ph: 888-724-1953 | PUR-C .com | VCICI .com

purewavenow .com

PUR-C’s products are physician developed; ultra-pure, professional grade products that have become the leading brand of Sodium Ascorbate Vitamin C chosen by Integrative Physicians worldwide. The Company is committed to providing superior quality, outstanding service, best value, and extensive training to its growing global network of healthcare professionals, physicians, biological dentists, and holistic veterinarians. PUR-C products, ULTRA-C and ESSEN-C, are based on the original protocols, and time-honored methods of Dr. Frederick Klenner, and Dr. Robert Cathcart’s.

Through a dynamic combination of Vibroacoustics, ElectroMagnetic, and far Infrared light, the VEMI Meditation Bed, takes relaxation to an unparalleled level of wellness. Millions of gentle frequencies of sound and electromagnetic fields immerse and harmonize the body on a deep cellular level benefiting emotional and physical wellness. Feel the difference with PureWave’s VEMI. Our luxury wellness products are for commercial and household use. We manufacture and distribute advanced frequency products for effortless self-care experiences.

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Problem with Topical Sex-Hormone Delivery and Testing in Serum and Urine

By:

Problem with Topical SexHormone Delivery and Testing in Serum and Urine

DavidBy:T. Zava PhD David T. Zava PhD

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ANTI-AGING MEDICAL NEWS | SPRING 2022

Problem with Topical Sex-Hormone Delivery and Testing in Serum and Urine

Abstract: Measurement of sex-steroids estrogens (estradiol, estriol), progesterone, and testosterone in various body fluids (serum, urine, saliva, finger-stick capillary blood - dried blood spot [aka DBS]) has been a useful tool to determine if adverse symptoms/conditions reported by the patient might be related to an imbalance in their sexhormone levels. Knowledge of the sex-hormone level in relation to levels seen in healthy individuals provides guidance for determining strategies for either lowering an excess of a sex-hormone or adding back a hormone that is low with sex-hormone therapy. All four body fluids listed above have been successfully used to determine hormone excess and deficiency in both premenopausal and postmenopausal women, and in men throughout their reproductive life cycles and beyond (1). Measurement of the sex-steroids following sex-steroid therapies has been a convenient way to determine if desired hormone levels have been achieved to help thwart annoying symptoms (e.g., hot flashes, night sweats) that diminish quality of life as one transitions into and through menopause and andropause.With exogenous sexhormone therapies all four body fluids can be used to successfully monitor most of the different types of hormone delivery systems. For the most part these include oral, transdermal patch, topicalpercutaneous, intramuscular-subcutaneous injections, pellets, vaginal, troche/sublingual (2, 3). However, only two of the four body fluids, saliva and finger-prick capillary blood (DBS), accurately measure tissue uptake (bioavailable) of sex-steroids delivered as a topical cream or gel (1, 2). To be clear, endogenous hormones and other hormone delivery systems can usually be used successfully to monitor the sex-hormones. That topical sex-hormone therapy is inaccurate for serum and urine is well recognized by most practitioners who are befuddled as to why sex-steroid therapy does not increase significantly in serum or urine with physiological topical sex-hormone dosing, yet saliva and DBS increase in a dosedependent manner to physiological ranges. In this brief review I will explain with simple examples what happens when topical sexhormones are used and why serum and urine should not be used to monitor topically delivered sex-hormones. Topical Sex-Hormone Therapy at Physiological Dosing Increases Serum and Urine Levels of the Sex Hormones Very Little Topical therapy with the sex-hormones estradiol, progesterone, and testosterone at physiological dosing has little impact on baseline serum and urine levels of these hormones in men and postmenopausal women (3). This has been interpreted to mean

that very little (only about 10%) of these hormones enter the body through the skin and therefore about 10-fold higher dosing is required to achieve near physiological levels, which in some cases (e.g., progesterone) is never achieved regardless of dose. While pharmacological dosing with estradiol and testosterone in postmenopausal women and hypogonadal men does raise serum and urine levels of these hormones slightly and closer in some individuals to physiological levels seen in premenopausal women and younger men, respectively, dosing with luteal physiological (10-30 mg) or pharmacological (100-300 mg) amounts of topical progesterone have almost no impact on serum or urine progesterone levels (1, 4). This has been the rationale for using pharmacological dosing of estradiol and progesterone in women and testosterone in men that far exceed by at least an order of magnitude the levels produced daily by the ovaries, testes, and adrenal glands (1, 2). Physiological Dosing with Topical Sex-Steroids Increases Salivary and Capillary Blood Sex-Steroid to Physiological Levels In striking contrast to what is seen in serum and urine with topical hormone therapy, physiological dosing of the sex-steroids raises salivary and capillary blood levels of these hormones from low baseline levels expected in postmenopausal women and hypogonadal men to high physiological levels seen in healthy young women and men. Moreover, increasing the dosing to pharmacological ranges raises the levels to high pharmacological levels, suggesting that the hormone has been overdosed. With topical sex-hormone therapy venipuncture serum/plasma and urine show a poor dose-response relationship whereas saliva and capillary blood rise in a linear dose-dependent relationship to physiological levels with physiological dosing. The discrepant results in serum/urine versus saliva/DBS has raised the interesting question of what is the most appropriate dose to use for topical sex-steroid therapy-physiological or pharmacological dosing? Two camps exist, practitioners using physiological dosing and following saliva and capillary blood levels of the sex-hormones, and those using pharmacological dosing and following serum and urine levels of sex-hormones. Below I will briefly review what we know about these two camps, and their rationale for dosing. Clinical Studies Support the Evidence that Saliva and DBS more Accurately Reflect Delivery of Topical Sex-Hormone Therapy to Tissues and Tissue Response to the Therapy In recent years research results from studies looking at the

ANTI-AGING MEDICAL NEWS | SPRING 2022

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Problem with Topical Sex-Hormone Delivery and Testing in Serum and Urine

relationship of sex-hormone levels in serum, urine, saliva, and finger-stick capillary blood of women and men using topically (percutaneous) delivered estrogens (estradiol, estriol), progesterone, and testosterone, have raised the question of what topical dose (physiological or pharmacological) is more effective and appropriate for achieving physiological levels of hormones in tissues and correcting many of the symptoms and conditions associated with sex-hormone imbalances. Very few studies in humans have addressed the issue of the relationship of hormone levels in different body fluids and tissue levels of the hormones following different routes of hormone delivery. Unquestionably, the greatest controversy and confusion concerning this issue is with body fluid distribution of the sexsteroids following topical hormone delivery. Below I will provide some evidence that may help shed light on this controversial issue. The issue of serum levels, tissue uptake, and biological response to topical progesterone and estradiol has been addressed in several studies (5, 6, 7). In the Leonetti study, topical progesterone used at physiological dosing was able to counter the growth-promoting actions of estrogens on the uterine lining.The dose used raises saliva and DBS levels of progesterone, but has no impact on serum or urine levels, as shown by others (6). Another seminal clinical research study by a French-Taiwanese group (7) provides strong evidence to show that topically delivered hormones enter tissues and have biological effects despite showing no increase in serum levels of the estradiol and progesterone used topically. What these clinical scientists demonstrated is that topical progesterone applied to women’s breasts at physiological dosing (25 mg) did not raise serum levels of progesterone, but increased breast tissue levels 100- to 200-fold! Moreover, the topical progesterone inhibited topical estrogen-stimulated cell proliferation of the breast epithelial cells. While it is unfortunate that saliva, capillary blood (DBS), and urine were not tested in this study, the results showed clearly that the levels of serum progesterone and estradiol did not increase and based on this limited information the authors were hard-pressed to explain how these hormones had such a pronounced effect on breast epithelial cell proliferation, or why the tissue levels of progesterone and estradiol were much higher than serum levels. Estradiol and progesterone did not increase in serum of these women who applied topical estradiol and progesterone at physiological dosing (1 mg of estradiol and 25 mg of progesterone). It is reasonably argued by some that the tissue response to estradiol

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and progesterone in the Chang study is from local absorption into the breast tissue without delivery to the bloodstream (serum) or other tissues. While the serum results are consistent (very little increase in serum estradiol and progesterone at this dosing) with what we and others have reported with topical sex-hormone delivery, we have observed that this dosing applied anywhere on the body significantly increases both saliva and capillary blood levels of estradiol and progesterone to physiological levels seen in premenopausal women, which is why the Leonetti group found that physiological topical dosing with topical progesterone inhibited estrogen-stimulated proliferation of the endometrial lining based on endometrial biopsies. An important point is that both studies looked at tissue response to topical hormone delivery. Serum and urine results for progesterone would not have predicted these results; saliva and DBS would. WADA Results Support the Notion that Serum and Urine do NOT Detect Doping with Topical Testosterone Other groups such as the World Anti-Doping Agency (WADA) that monitor the testosterone levels of professional athletes to prevent unfair anabolic hormone performance enhancement have recently stumbled on the realization that athletes could potentially use topical testosterone and not be caught because the conventional methods for testing have traditionally used serum and urine. They now recognize that topical testosterone can be used illegally and will show little increase beyond physiological levels with pharmacological, anabolic-enhancing, testosterone dosing. Research studies investigating differences in levels of testosterone in saliva, capillary DBS, serum, and urine following topical testosterone doping clearly show that the doping is only detected with measurement of testosterone in saliva or capillary blood, but not venipuncture serum or urine (8, 9, 10). Consistent with literature described above, the WADA studies confirm that saliva and capillary DBS levels of topically delivered hormones more accurately reflect how much hormone is being delivered to tissues. If topically delivered anabolic steroid (i.e., testosterone) doping didn’t enhance the athlete’s performance this therapy would have been quickly abandoned. It wasn’t. What’s It All Mean? While the scientific literature shows that salivary, capillary blood, and tissue levels of sex-hormones increase with sex-hormone therapy, but very little or no increase is seen in serum or urine levels. How this occurs physiologically remains controversial, but has been addressed (11). From the pharmacokinetics of steroid hormone delivery to tissues with topically applied steroid hormones the most

ANTI-AGING MEDICAL NEWS | SPRING 2022

Problem with Topical Sex-Hormone Delivery and Testing in Serum and Urine

logical explanation is that when applied to the skin the hormones are transported slowly to tissues via the lymphatics. The fingertips and salivary glands from which capillary blood and saliva are taken for hormone testing have an abundance of lymphatics that are intertwined with the capillary beds that feed oxygenated blood to the tissues. Entry of topically delivered hormones into the brain is also likely to occur through the newly discovered brain lymphatics, referred to as glymphatics (12), and would explain the sleepinducing effects of low-dose topical progesterone as it is delivered into the brain via the glymphatics and metabolized to the anxiolytic metabolite allopregnanolone. Allopregnanolone freely diffuses across the blood-brain-barrier and can be detected in saliva and DBS by more sophisticated liquid chromatography tandem mass spectrometry methods. We have shown that allopregnanolone rises with both topical and oral progesterone therapy, and is very high in these body fluids in most pregnant women (13) From a clinical perspective, scientific evidence is mounting that when steroid hormones are delivered topically, they should only be monitored with body fluids such as saliva or capillary blood. These body fluids more closely portray the bioavailable or tissue levels of the supplemented hormone than do conventional serum or urine. While serum and urine, like capillary blood and saliva, are useful for monitoring endogenously synthesized hormones, and some forms of exogenous therapies, the use of venipuncture serum/plasma or urine to monitor topically delivered sex-hormones will result in a gross underestimation of the true bioavailable (tissue) level of the hormones. As I have seen over the years of testing hormones this often results in escalating pharmacological overdosing in a futile attempt to raise the hormones to a physiological level. At the tissue/ receptor level excessive dosing with any steroid will eventually result in a negative feedback to down-regulate the steroid’s cellular receptor (tachyphylaxis), rendering the cells insensitive to further hormonemediated actions. It is important to understand that what I have described for topical delivery of the sex-steroid hormones also applies to all other low molecular weight (< 500 Mr) relatively non-polar steroids (androgen precursors such as DHEA, cortisol, synthetic steroids) and other small non-polar non-steroidal molecules (sunscreen products) that are applied to the skin.

References 1. Zava DT. Topical therapy with estradiol, progesterone, and testosterone and their distribution in saliva, capillary blood, serum, and urine. Townsend Letter. 2021:31-34. 2. Zava DT. Topical delivery of sex steroid hormones and distribution in different body fluids. Anti-Aging Medical News. American Academy of Anti-Aging Medicine. Spring 2019:20-23. 3. Zava DT. Testing with different body fluids and the results of the hormone delivery rate. Anti-Aging Medical News. American Academy of Anti-Aging Medicine. 2013:47-51. 4. Du JY, Sanchez P, Kim L, et al. Percutaneous progesterone delivery via cream or gel application in postmenopausal women: a randomized cross-over study of progesterone levels in serum, whole blood, saliva, and capillary blood. Menopause. 2013;20(11):1169-1175. 5. Leonetti HB, Wilson KJ, Anasti JN. Topical progesterone cream has an antiproliferative effect on estrogen-stimulated endometrium. Fertil Steril. 2003;79(1):221-222. 6. O’Leary P, Feddema P, Chan K, et al. Salivary, but not serum or urinary levels of progesterone are elevated after topical application of progesterone cream to pre-and postmenopausal women. Clin Endocrinol (Oxf ). 2000;53(5):615-620. 7. Chang KJ, Lee TT, Linares-Cruz G, et al. Influences of percutaneous administration of estradiol and progesterone on human breast epithelial cell cycle in vivo. Fertil Steril. 1995; 63(4):785-791. 8.Thieme D,Rautenberg C,Grosse J,et al.Significant increase of salivary testosterone levels after single therapeutic transdermal administration of testosterone: suitability as a potential screening parameter in doping control. Drug Test Anal. 2013;5(11-12): 819-825. 9. Schönfelder M, Hofmann H, Schulz T, et al. Potential detection of low-dose transdermal testosterone administration in blood, urine, and saliva. Drug Test Anal. 2016;8(11-12):1186-1196. 10. Salamin O, Nicoli R, Xu C, et al. Steroid profiling by UHPLC-MS/MS in dried blood spots collected from healthy women with and without testosterone gel administration. J Pharm Biomed Anal. 2021;204:114280. 11. Zava DT, Groves MN, Stanczyk F. Percutaneous absorption of progesterone. Maturitas. 2014;77(2):91-92. 12. Jessen NA, Finmann Munk AS, Lundgaard I, et al. The glymphatic system: a beginner’s guide. Neurochem Res. 2015;40(12):2583-2599. 13. Young SM, Gryder LK, Cross C, et al. Effects of placentophagy on maternal salivary hormones: a pilot trial, part 1. Women Birth. 2018;31(4):e245-e257.

Bio: David T. Zava, PhD, has devoted his career to breast cancer research and the development of non-invasive methods for testing hormones in saliva, blood spot, and dried urine.

ANTI-AGING MEDICAL NEWS | SPRING 2022

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Hyperbaric Oxygen and Regenerative Medicine

Effect of the “Hyperoxia-Hypoxia Paradox” On Stem Cell Mobilization, Cell Signaling, Inflammation, Epigenetics & Cell Regeneration

By:

Sonners JasonJason Sonners DC, PhD(c) DC, PhD(c)

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Hyperbaric Oxygen and Regenerative Medicine Effect of the “Hyperoxia-Hypoxia Paradox” On Stem Cell Mobilization, Cell Signaling, Inflammation, Epigenetics & Cell Regeneration

Abstract: In the United States, hyperbaric oxygen therapies (HBOT) is approved and used effectively for a short list of severe, life and limb threatening conditions. These range from osteomyelitis, osteonecrosis and gangrene to non-healing wounds, diabetic neuropathy, crush injuries, radiation burns and more. This therapy has been proven to be noninvasive, safe and effective for improving patient’s recovery, healing times and tissue regeneration when applied to these acute and severe conditions. On the other hand, chronic inflammatory illnesses are affecting a much larger range of people, cost our medical system many billions of dollars every year, destroy our quality of life and reduce our ability to be contributing members of society. Some of these conditions include autoimmunity, neurodegenerative and musculoskeletal degenerative diseases, cardiovascular disease, cancer and many others. Common denominators for many of these illnesses include chronic inflammation, metabolic and mitochondrial dysfunction and immune dysregulation. The majority of hyperbaric studies point to very specific mechanisms of action at work when used for the more traditionally treated hyperbaric cases. There is mounting evidence which suggests that the mechanisms for these “on label” acute and severe cases would be similar or even identical to the mechanisms required by other chronic illnesses to also improve their cases, outcomes and recovery times. Hyperbaric can be delivered a number of ways, from mild pressure to high pressure and from 21% oxygen through 100% oxygen. Current hyperbaric research also shows that intermittent and relative hyperoxia-hypoxia is a strong stimulator of many cell signaling and epigenetic signaling cascades used for the promotion of and adaptation to improved cellular healing and regenerative responses. The research on these concepts are currently in its infancy but recent studies have shown us that hyperbaric oxygen therapy, through Hif-1A, Reactive oxygen species (ROS) signaling and Sirtuin stimulation can help to promote hormonal balance, nervous system balance, improve mitochondrial performance, reduce inflammation and stimulate cell and tissue repair and regeneration for many different health concerns. Another study published in 2019 also showed us that using hyperbaric oxygen can also stimulate telomere growth putting HBOT well within the modalities to be considered for a well-rounded antiaging and regenerative medicine approach to improved health and quality of life. Background Content The pathology of chronic illness parallels the pathophysiology of aging. In many ways chronic illness creates a pathway towards accelerated cellular aging. Marked by chronic inflammation, mitochon-

drial dysfunction, cellular senescence, genetic damage and changes to epigenetic and genetic expression, aging is the number one risk factor for developing chronic illness [1,2,3] Improved ATP production and mitochondrial efficiency, improved DNA replication and protein translation, increases in stem cells, increased telomere length and improved cellular signaling capacity are associated with improved cellular physiology and repair. Hyperbaric therapy has been implicated in assisting with all of these processes in a variety of studies. [4,9,13] Hyperbaric Oxygen Therapy (HBOT) involves exposing a person to an increase in atmospheric pressure and percentage of oxygen leading to an increase in pressure of oxygen (PO2) greater than what they are typically being exposed to in their environment. This change in oxygen pressure is sensed throughout the entire body primarily through hypoxic inducible factors leading to stimulation of sirtuins and ROS. The overall effects and benefits of hyperbaric oxygen are based on 3 variables. Pressure, Percentage of Oxygen and Time. [5,8,13,14] Hyperbaric Mechanisms Within the 14 insurance-based indications there are 10 well established mechanisms of actions or effects of hyperbaric oxygen therapy. Understanding the mechanisms by which these conditions improve using hyperbaric therapy, would lead one to believe that the same mechanisms that promote healing in these devastating and acutely severe conditions are the same mechanisms that can help improve the healing, recovery, performance and function in these other more chronic illnesses or as a whole helping to preserve quality of life as we age. 1. Increased oxygen perfusion [4,5,13,14,15] (Immediate increase in free-floating oxygen available for tissue use, hyperoxygenation) Due to the increase in pressure and percentage of oxygen, increased amounts of oxygen can be dissolved into the plasma of the blood. The plasma then act as a reservoir of “extra” oxygen that can be used by cells for aerobic respiration among other functions requiring oxygen consumption. Especially in areas of trauma (capillary damage) or inflammation blocking “normal” blood flow and oxygenation, this free-floating amount of oxygen can play a critical role in improving tissue oxygenation levels.

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2. Neovascularization - Angiogenesis [4,5,14,15] (vegF, Hif-1A, FGF, PDGF) Mainly through the cycling of hyperbaric sessions and through the hyperoxia/hypoxia paradox and cell signaling cascade hyperbaric therapy has become a well-documented stimulator of Hif-1A and vegF, promoting new capillary growth and restructuring of capillary beds and micro circulation.

6. Stem cell activation & release [5,10,14,15] Promotes up to an 8-fold increase in mesenchymal and CNS stem cells.

3. Increased white blood cell function [13,14,15] (Improved neutrophil and macrophage activity increased ROS and NOS)

7. Vasoconstriction [4,7,8,9,13] This helps to decrease edema and swelling resulting from damaged tissues.

WBC’s specifically neutrophils and macrophages use ROS as part of their immune protective strategies fighting infection and other invaders. Hyperbaric Therapy stimulates an increase in ROS which appears to help feed the immune system some of the raw materials required for appropriate immune responses.

8. Mitogenesis [4,7,11,12] Promotes an increase in size, shape, efficiency, and number of mitochondria.

4. Nerve healing factors [4,9,13,14] (increases in VegF, BDNF, Hif1A, hyperoxygenation) Brain and nervous tissue are very metabolically active tissue and consume a large percentage of oxygen, even under normal circumstances. The brain for instance makes up about 2-3% of body mass but can utilize upwards of 20+% of the oxygen we bring in. As a result of their metabolic requirements even under normal circumstances, delivering higher amount of oxygen for healing from damage is not easily managed through the body’s distribution mechanisms. Using hyperbaric as a tool to deliver increased oxygen carrying capacity allows for an easier redistribution of oxygen to areas more in need of increased perfusion. Oxygen also has an anabolic effect on tissue helping to stimulate growth factors sch as BDNF, PDGF, vegF and others improving the rate of healing and recover of tissue from injury. Studies looking at brain function and healing post TBI/ Concussion and ischemic stroke show strong promise for hyperbaric playing a role in brain injury recovery. 5. Wound healing – anabolic (growth factors) [7,8,13,15,20] (PDGF, VegF, stem cells and collagen production circulatory healing) This is probably one of the most studied mechanisms of action for hyperbaric. The combination of increased capillary oxygen tension, increased angiogenesis, increased stem cell

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release, growth factor release, immune system stimulation and antimicrobial properties of hyperbaric oxygen make hyperbaric therapy an effective treatment for improved wound care healing and recovery.

9. Reduced Cytokines [6,8,9,10,11] TNF-Alpha, Hif-1A, reduction of inflammatory cytokines, increase in anti-inflammatory cytokines. 10.Anti-microbial/microbiome balancing [12,13,14] Reduction in anaerobic pathogens and increase in aerobic probiotics. Ultimately these mechanisms of action are the most commonly described and most well understood mechanisms of healing from the majority of potential injuries and illness we encounter, and oxygen, specifically increased PO2, plays a critical role in promoting all of them. In addition to these above stated mechanisms, hyperbaric has also been shown to improve insulin sensitivity [16,17], increase telomere length [11,18,19], reduce cellular senescence [11,20,21], improve mitochondrial oxygenation [11,20,21], improve respiratory and cardiovascular efficiency [22,23] and improve physical and mental performance [24,25,26]. Current hyperbaric research also shows that intermittent and relative hyperoxia-hypoxia is a strong stimulator of many cell signaling cascades used for the promotion of and adaptation to improved healing and regenerative responses. Due to the increased pressure of oxygen, the patient’s blood plasma becomes hyperoxic. Blood plasma typically carries very little free floating O2 (.3 ml O2/ 100 ml of blood), under pressure, plasma becomes a reservoir capable of holding many times the normal amount. When the session is over and the patient exits the pressurized environment,

ANTI-AGING MEDICAL NEWS | SPRING 2022

Hyperbaric Oxygen and Regenerative Medicine Effect of the “Hyperoxia-Hypoxia Paradox” On Stem Cell Mobilization, Cell Signaling, Inflammation, Epigenetics & Cell Regeneration

that excess oxygen begins to dissipate out of circulation and is ultimately consumed by the surrounding cells. The person at that moment in time is becoming relatively hypoxic (oxygen is rapidly leaving the circulatory system) and this process seems to stimulate the hypoxic pathways, such as angiogenesis, stem cell release and HIF-1 alpha without the typical consequences of hypoxia including loss of mitogenesis and decreased sirtuin activation.This is process is referred to as the hyperoxic-hypoxic paradox. Therefore, there are 2 distinct cellular interaction of pressurized oxygen. 1. Oxygen as a component of a fuel source used in the process of oxidative phosphorylation and ATP production. Oxygen is one of the rate limiting steps to ATP production, as the body is exposed to higher oxygen levels for a period of time mitochondrial size and density increase to make more use of the available oxygen. This will improve mitochondrial performance and efficiency while also increase ATP production. [4,10,11,20,21] 2. Oxygen as a signaling molecule used in the hyperoxiahypoxia cell signaling pathways stimulating certain cascades including but not limited to Hif-1A, Cytokines, sirtuins, RONS promoting cell adaptation, healing, recovery responses, regenerative pathways, growth factor release, stem cell release and reversal of membrane, genetic and epigenetic damage. [9,10,11,14,15] Hyperbaric Oxygen Therapy (HBOT): Hyperbaric oxygen therapy has been used for several severe acute conditions for its ability to reduce inflammation and swelling while also promote healing, recovery and regeneration of tissue. HBOT has an anabolic stimulating property and studies show that it promotes stem cell release, growth factors including PDNF, BDNF, IGF VegF. It also promotes autophagy, immune balance, mitochondrial performance, sirtuin activation and DNA/Epigenetic repair. Some of these cellular adaptations occur from the actual exposure to the increased free floating oxygen levels supplied by the increased pressure of oxygen being inhaled, while other of these benefits occur due to the cycling of higher and lower pressures of oxygen causing a relative hyperoxia-hypoxia condition within the body. These oxygen pressure changes appear to have a massive cell signaling effect within the body promoting healing and regeneration of cells and tissues systemically throughout the body. [11,12,13,14]

Conclusion: Humans have long been fascinated by the aging process and compelled to find the fountain of youth. While we have not fully defined exact mechanisms of aging nor have we found the fountain of youth, we have made enormous strides in understanding the aging process and the role of elevated inflammation, reduced mitochondrial function and epigenetic damage plays in accelerating the aging process, cellular degeneration and leads to many of the chronic illnesses that remain so common. Through more recent research and clinical investigation hyperbaric therapy is proving to be a foundational tool in the quest for improved quality of life. HBOT’s ability to stimulate healing and regeneration, reduce inflammation and promote cellular longevity make it a viable therapy in the regenerative medicine clinic.

References: Aging: 1. Boss GR, Seegmiller JE. Age-related physiological changes and their clinical significance. West J Med. 1981;135(6):434-440. 2. Son’kin, Valentin & Tambovtseva, Ritta. (2012). Energy Metabolism in Children and Adolescents. 10.5772/31457. 3. Bratic A, Larsson NG. The role of mitochondria in aging. J Clin Invest. 2013;123(3):951-957. doi:10.1172/JCI64125 Hyperbaric Indications: 4. Moon, R.E, 2019, Hyperbaric Oxygen Therapy Indications, 14th Edition, Best Publishing Company 631 U.S. Highway 1, Suite 307 North Palm Beach, Florida 33408 5. Jain KK. History of Hyperbaric Medicine, Chapter 1. In: Textbook of Hyperbaric Medicine, ed. K.K. Jain. Hogrefe and Huber Publishers,Toronto, Canada, 1996. Pps. 2-9 6. Freiberger J, et al. Superoxide dismutase responds to hyperoxia in rat hippocampus. Undersea Hyperb Med. 2004;31(2):227-32. 7. Ishii Y, et al. Effects of hyperbaric oxygen on procollagen messenger RNA levels and collagen synthesis in the healing of rat tendon laceration. Tissue Eng. 1999;5(3):279-86. 8. Oh S, et al. Comparison of the effects of 40% oxygen and two atmospheric absolute air pressure conditions on stress-induced premature senescence of normal human diploid fibroblasts. Cell Stress and Chaperones. 2008;13(4):447-458. 9. Yin W, et al. Down regulation of COX-2 is involved in hyperbaric oxygen treatment in a rat transient focal cerebral ischemia model. Brain Res. 2002;926(1-2):165-71. 10. Li Y, et al. Multiple effects of hyperbaric oxygen on the expression of HIF-1 alpha and apoptotic genes in a global ischemia-hypotension rat model. Exp Neurol. 2005;191(1):198-210. Hyperoxia/Hypoxia Paradox 11. Gu GJ, Li YP, Peng ZY, et al. Mechanism of ischemic tolerance induced by hyperbaric oxygen preconditioning involves upregulation of hypoxia-inducible factor-1alpha and erythropoietin in rats. J 12. A Thomson AJ, Drummond GB, Waring WS, Webb DJ, Maxwell SR. Effects of short-term isocapnic hyperoxia and hypoxia on cardiovascular function. J Appl Physiol. 2006;101:809-816.ppl Physiol. 2008;104(4):1185-91.

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Hyperbaric Mechanisms: 13. Thom SR. Oxidative stress is fundamental to hyperbaric oxygen therapy. J Appl Physiol. 2009 Mar;106(3):988–95 14. Camporesi EM, Bosco G. Mechanisms of action of hyperbaric oxygen therapy. Undersea Hyperb Med. 2014;41(3):247–52 15. Thom SR. Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg. 2011 Jan;127:131S–141S. Insulin: 16. Wilkinson, D., Chapman, I.M. and Heilbronn, L.K. (2012), Hyperbaric oxygen therapy improves peripheral insulin sensitivity in humans. Diabetic Medicine, 29: 986-989. https://doi.org/10.1111/j.14645491.2012.03587.x 17. Liu Y, Zhang D, Yuan J, et al. Hyperbaric Oxygen Ameliorates Insulin Sensitivity by Increasing GLUT4 Expression in Skeletal Muscle and Stimulating UCP1 in Brown Adipose Tissue in T2DM Mice. Front Endocrinol (Lausanne). 2020;11:32. Published 2020 Jan 31. doi:10.3389/ fendo.2020.00032 Telomere elongation: 18. Hachmo Y, Hadanny A, Abu Hamed R, et al. Hyperbaric oxygen therapy increases telomere length and decreases immunosenescence in isolated blood cells: a prospective trial. Aging (Albany NY). 2020;12(22):2244522456. doi:10.18632/aging.202188 19. Liran I. Shlush, Karl L. Skorecki, Shalev Itzkovitz, Shiran Yehezkel, Yardena Segev, Hofit Shachar, Ron Berkovitz, Yochai Adir, Irma Vulto, Peter M. Lansdorp, Sara Selig, Telomere elongation followed by telomere length reduction, in leukocytes from divers exposed to intense oxidative stress – Implications for tissue and organismal aging, Mechanisms of Ageing and Development, Volume 132, Issue 3, 2011, Pages 123-130

Mitochondrial oxygenation and function: 20. Eilam Palzur, Menashe Zaaroor, Eugene Vlodavsky, Felix Milman, Jean F. Soustiel, Neuroprotective effect of hyperbaric oxygen therapy in brain injury is mediated by preservation of mitochondrial membrane properties, Brain Research, Volume 1221, 2008, Pages 126-133 21. Sarah B. Rockswold, Gaylan L. Rockswold & Archie Defillo (2007) Hyperbaric oxygen in traumatic brain injury, Neurological Research, 29:2, 162172, DOI: 10.1179/016164107X181798 Respiration Efficiency : 22. Adamiec L. Effect of hyperbaric oxygen therapy on some basic vital functions. Acta Physiol Pol. 1977 May-Jun;28(3):215-24. PMID: 899812. 23. Aylin‐Burns, N., Krager, K.J., Zhou, D. and Hauer‐Jensen, M. (2017), Investigating the effects of hyperbaric oxygen on mitochondrial function of endothelial progenitor cells.. The FASEB Journal, 31: 711.7 711.7. Brain/body performance 24. Vadas D, Kalichman L, Hadanny A, Efrati S. Hyperbaric Oxygen Environment Can Enhance Brain Activity and Multitasking Performance. Front Integr Neurosci. 2017;11:25. Published 2017 Sep 27. doi:10.3389/ fnint.2017.00025 25. Hadanny, A. et al. ‘Hyperbaric Oxygen Can Induce Neuroplasticity and Improve Cognitive Functions of Patients Suffering from Anoxic Brain Damage’. 1 Jan. 2015 : 471 – 486. 26. Shandley S, Wolf EG, Schubert-Kappan CM, et al. Increased circulating stem cells and better cognitive performance in traumatic brain injury subjects following hyperbaric oxygen therapy. Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc. 2017 May-Jun;44(3):257-269. DOI: 10.22462/5.6.2017.6.

Dr. Jason Sonners has always been fascinated by the machinery of the human frame and always working to integrate new knowledge and practical experience. In addition to his Doctor of Chiropractic, he earned his Diplomate of the Chiropractic Board of Clinical Nutrition (DCBCN) and his Diplomate of the International Board of Applied Kinesiology (DIBAK). He is currently enrolled at the University of Miami School of Medicine earning his PhD in molecular biology with a concentration in regenerative medicine. Dr. Sonners utilizes his combined training in various modalities to create comprehensive programs and help patients achieve their health goals. His patients are dealing with, among other conditions, a variety of autoimmune and neurological conditions, allergies, autism and cancer. He combines Chiropractic, Hyperbaric Oxygen Therapy, Nutrition, Exercise, Detoxification programs and more to naturally support patients and guide them through their health challenges. Dr. Sonners and his wife, Dr. Melissa Sonners, are co-owners of Core Therapies Family Wellness Center in Northern New Jersey, a holistic center with eight chiropractors whose specialties include functional neurology, functional medicine, hyperbaric oxygen, pre/post-partum, pediatric and sports injuries. Core Therapies also offers acupuncture, massage, infrared, sauna, spinal decompression, yoga and laser therapies. They are also the owners of NJ HBOT & HBOT USA. While serving on the faculty of the International Hyperbaric Association, Dr. Sonners is also a faculty member of MedMAPS, a group of professionals offering comprehensive education and fellowship to medical professionals for the care of children with autism spectrum disorders and related chronic complex conditions.

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BHI Therapeutic Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1118

Emerson Ecologics: a Fullscript company . . . . . . . . . . . . . . . . 401

Biocidin Botanicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 622

Enbiosis Biotechnology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 920

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Energist Medical Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 925

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BioProtein Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1213

Enzyme Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 813

Biosound Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 816

EVEXIAS Health Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200

Bio-Tech Pharmacal, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1013

Ezra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 523

Biotics Research Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . 900

Flore by Sun Genomics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1014

BodyHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1007

Flosom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1219

Boiron Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 819

Fortress Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1018

Boston Heart Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Forum Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 618

Brite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 922

Fotona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319

Calmoseptine, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1003

GAINSWave/FemiWave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 812

Calroy Health Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 807

Genova Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201

Carbon-60, Greska's . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419

Global Life Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213

Cell Science Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1114

Great Plains Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 906

Central Drugs Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 901

Hallandale Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 617

ChromaDex, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1225

Hawaiian Moon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1006

Clinicians Supplement Consultants . . . . . . . . . . . . . . . . . . . . . 815

Healing Breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1221

College Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1113

Health Experts Alliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

ANTI-AGING MEDICAL NEWS | SPRING 2022

Healthcare Risk Advisors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520 Healy World . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Hormone Therapy Centers of America, LLC . . . . . . . . . . . . . 1015 ImmunoStim Therapeutics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1220 ImprimisRx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 916 InBody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1017 Integrative Peptides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317 Jinfiniti: The Longevity Biomarker Company . . . . . . . . . . . . . 422 KBMO Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Kimera Labs, Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Lake Nona Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 623 LeadingResponse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 518 L-Nutra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301 MD Prescriptives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1112 MedEcho, CBD Derived for Healthcare . . . . . . . . . . . . . . . . 1116 Medical Wave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 909 Medicore, Co. Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 825 Merchant Preferred Zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 919 Metagenics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413 Microbiome Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Modern Doc Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421 My Practice Connect™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 821 New Life Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 823 NewLife Advanced Stem Cells . . . . . . . . . . . . . . . . . . . . . . . . . 824 NuMedica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612 Nutrafol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 921 NutriDyn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Nutritional Frontiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1009 OrthoMolecular . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 601 OutcomeMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407 Outset Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1123 OxyHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 PatientNow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Pellecome LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 Pharmacy Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1212 Pharmanex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Phoenix Thera Lase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325 Podcasting & Videos Made Easy . . . . . . . . . . . . . . . . . . . . . . . .924 Power2Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 616 Precheck Health Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Precision Compounding Pharmacy and Wellness . . . . . . . . . 817 Precision Point Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 324 Premier Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 822

Prism Light Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222 Prosoma LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 914 Protocol For Life Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417 PUR-C / VCICI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 PureWave Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1201 Qualgen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1025 Quartermaster Tax Management, LLC . . . . . . . . . . . . . . . . . . 1023 Quest Diagnostics - Cleveland HeartLab . . . . . . . . . . . . . . . 1224 Quicksilver Scientific . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513 Rapid Release Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 712 Red Light - Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1020 Refine USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Regenative Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 723 Rupa Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412 Seca . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425 Self Care Catalysts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1218 Skin Science Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1107 Sofwave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320 Specialist Training by The Institute . . . . . . . . . . . . . . . . . . . . . . 917 Stellar Biomolecular Research . . . . . . . . . . . . . . . . . . . . . . . . . 1012 Synergy Med Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1022 TA Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501 Tailor Made Compounding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801 The Center For Regenerative Medicine . . . . . . . . . . . . . . . . . . 525 The DNA Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1024 The JOI Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 620 Top Doctor Magazine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1121 Triple Hair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1214 TruDiagnostic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 512 Überlube . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1125 Unified Office . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 623 University Compounding Pharmacy . . . . . . . . . . . . . . . . . . . . .607 Vasolabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 820 Venus Concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1106 Vertisis Custom Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423 Vitalounge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 623 Viviscal PRO & XFusion by Toppik . . . . . . . . . . . . . . . . . . . . . . 318 Weave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915 Wellness Clinic Marketing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 717 Wellness Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321 Zizion Group Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 ZRT Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 701

Prestige Products Direct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 908

ANTI-AGING MEDICAL NEWS | SPRING 2022

139

BECOME BOARD CERTIFIED TODAY

• Treat patients more effectively than traditional medical practitioners

• Run a successful medical practice as a leading Board Certified professional in your region

• Demonstrate your committment to disease prevention

ABAARM - The American Board of Anti-Aging /Regenerative Medicine (ABAARM) is a certification program for individuals with MD, DO, DPM and MBBS degrees.

ABAAHP - The American Board of Anti-Aging Health Practitioners (ABAAHP) is a certification program for individuals with DC, PharmD, DDS, ND, RN, LPN, PA, MA, RPh, NP, PhD, and Acupuncturist degrees.

For More Information Contact Us at 561.997.0112 or boards@a4m.com www.a4m.com

TA-65® HELPS SUPPORT A HEALTHY IMMUNE SYSTEM Double-Blind, Placebo-Controlled, Randomized Clinical Trial Demonstrates Telomerase Activator TA-65® Decreases Immunosenescent

TA-65®

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CD8+CD28- T Cells in Humans

21% Reduction in Senescent T-Cells with TA-65® See Our 500 Patient Study Details: www.tasciences.com/tcells

For more information visit us at booth #501 or go to www.tasciences.com/a4m

ANTI-AGING MEDICAL NEWS | SPRING 2022

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Dimension 10'x10' 10'x15' 10'x20' 19'x20' 20'x20'

0% - 0 SqFt Rented 100% - 28,230 SqFt Available

Cashier

Food Entrance

194 0 28,230 194 Totals:

WITHOUT EXPRESS WRITTEN CONSENT OF GLOBAL EXPERIENCE SPECIALISTS.

COPYRIGHT c BY GLOBAL EXPERIENCE SPECIALISTS, ALL RIGHTS RESERVED. NO PART OF THIS PUBLICATION MAY BE REPRODUCED, STORED IN ANY RETRIEVAL SYSTEM, OR TRANSMITTED IN ANY FORM OR BY ANY MEANS ELECTRONIC, MECHANICAL, PHOTOCOPYING, RECORDING, OR OTHERWISE -

TO VERIFY ALL DIMENSIONS AND LOCATIONS.

RESPONSIBILITY OF THE EXHIBITOR TO PHYSICALLY INSPECT THE FACILITY

ARCHITECTURAL COMPONENTS OF THE FACILITY IS A CONSIDERATION IN THE CONSTRUCTION OR USAGE OF AN EXHIBIT, IT IS THE SOLE

PLAN. IF THE LOCATION OF BUILDING COLUMNS, UTILITIES, OR OTHER

EVERY EFFORT HAS BEEN MADE TO INSURE THE ACCURACY OF ALL INFORMATION CONTAINED ON THIS FLOOR PLAN. HOWEVER, NO WARRANTIES, EITHER EXPRESSED OR IMPLIED, ARE MADE WITH RESPECT TO THIS FLOOR

Available 133 1 46 1 13 Rented 0 0 0 0 0 SqFt 13,300 150 9,200 380 5,200 Qty 133 1 46 1 13

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By: MCDERD

Plotted: Jan 20, 2020

File: acaaab-2104-dipres-Great Hall.dwg

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EXHIBITOR LISTINGS ANTI-AGING MEDICAL NEWS | SPRING 2022

143

EXHIBITOR LISTINGS 144

AC Grace

Access Medical Labs

ADigital Health

Booth #613

Booth #507

Booth #1108

PO Box 570, Big Sandy, Texas, 75755 | United States

5151 Corporate Way, Jupiter, Florida, 33458 | United States

Ph: 800-833-4368

Ph: 866-720-8386 ext. 120

840 US-1 N, Ste 435M North Palm Beach, Florida, 33408 | United States

Email: info@acgrace.com

Email: info@accessmedlab.com

www.acgrace.com

www.accessmedlab.com

Providing The Highest quality Products since 1962.

Access is the nation’s premier specialty diagnostic lab. We offer a broad menu of testing from blood, saliva, urine & swab samples. We perform all of your tests in our 25,000 sq. ft. ultra-automated facility in Jupiter, Florida & provide results within 24hrs. Since 2003, we continuously strive to innovate, inspire and improve solutions for physicians by providing an exceptional personalized experience with the most accurate testing.

Aerodiagnostics

Aesthetic Management Partners

AlgaeCal

Booth #1124

Booth #1119

Booth #418

561 Virginia Road, Ste 100 Concord, Massachusetts, 1742 | United States

9109 Macon Road , Cordova, Tennessee, 38016 | United States

Ph: 617-608-3832

Ph: 877-267-2670

1286 Homer Street, #200 Vancouver, British Columbia, V6B 2Y5 | Canada

Email: kgrimard@aerodiagnostics.com

Email: info@amplifimd.com

www.aerodiagnostics.com

www.aestheticmanagementpartners.com

Aerodiagnostics was founded on the principles of customer service and convenience. We offer convenient non-invasive hydrogen and methane breath collection kits that can be used in the comfort of your patients home or place of employment. Our goal is to provide you with highly accurate tests in a collection environment that is convenient.

At AMP we believe that patients come first. Delivering on the experience and result for the patient is the key to building a thriving practice. We do that by getting the patient a phenomenal result, which in turn will get the physician an excellent financial result. If it’s good for the patient, good for the physician, and good for AMP, and it’s right course of action. This is what guides us in everything we do.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Ph: 561-247-3839 Email: info@adigitalhealth.com www.adigitalhealth.com ADigital Health is a remote patient care and monitoring platform that helps doctor automate care instructions and manage patients between encounters to improve patient outcomes and increase practice revenue. Easily enroll patients into care plans including turnkey weight management, heart-healthy and gut health programs so patients receive your guidance everyday, digitally. Patients can track progress including body metrics, calories, activity, steps, sleep and more. Provide better care and support in a fraction of the time.

Ph: 844-618-1700 ext 2 Email: clinicalsupport@algaecal.com www.algaecal.com/hcp AlgaeCal formulas are supported by clinical studies to increase bone density beyond baseline -- a claim no other calcium supplement can make. Formulated from our exclusive red algae (Lithothamnion superpositum), AlgaeCal Plus provides over a dozen bone-essential minerals. Our companion product Strontium Boost speeds results while also strengthening bones. Stop by our booth for a free gift (while supplies last) revealing the latest bone-health research and a roadmap to offer your patients better bone-health outcomes.

Alletess Medical

Booth #118

Booth #1001

2300 S. Main Street, South Salt Lake, Utah, 84115 | United States

14 Howard Street, Rockland, Massachusetts, 2370 | United States

1801 N Military Trail Ste, 200 Boca Raton, Florida, 33431 | United States

Ph: 800-545-9960

Ph: 800-225-5404 ext. 312

Ph: 561-997-0112

Email: customerservice@allergyresearchgroup. com

Email: ksaccone@foodallergy

Email: info@a4m.com

www.foodallergy.com

www.a4m.com

Alletess Medical Laboratory has provided allergy and immunology testing services to healthcare practitioners worldwide for 4 decades. Our test offerings include IgG and IgA food sensitivity testing, panels for autoimmune disorders, allergy testing for molds, inhalants and foods. We have registered dietitians on staff to help guide your patients through their journey to better health. Our transparent pricing, unrivaled customer service, and quick turnaround time make us the best choice for your practice.

Rooted in a forward-focused mission to redefine modern medicine, The American Academy of Anti-Aging Medicine (A4M) is the global leader for continuing medical education in longevity medicine, metabolic resilience, and whole-person care. A4M provides an advanced network of educational and networking opportunities including traditional CME events, intensive curriculum-based courses, certification programs, in-depth workshops, and more. A4M has acquired membership of over 26,000 members, which includes physicians, nurses, and researchers, that represent over 120 nations.

American Cell Technology

Ananda Professional

AnazaoHealth

Booth #323

Booth #312

Booth #517

13794 NW 4th Street, Ste 212 Sunrise, Florida, 33325 | United States

190 Corporate Blvd., Georgetown, Kentucky, 40324 | United States

5710 Hoover Blvd, Tampa, Florida, 33634 | United States

Ph: 844-443-2355

Ph: 502-792-0008

Ph: 800-995-4363

Email: info@americancelltechnology.com

Email: andrea.deweese@anandaprofessional. com

Email: emarketing@anazaohealth.com

www.allergyresearchgroup.com Since 1979, Allergy Research Group® has been providing healthcare practitioners with the highest quality, cutting-edge nutritional supplements. We maintain strict quality control procedures and source ingredients with the lowest possible allergy potential, to meet the health needs of your most sensitive patients. Allergy Research Group’s mission is to provide products to improve quality of life through scientifically based innovation, purity of ingredients, education, and outstanding service.

www.americancelltechnology.com American Cell Technology provides leading edge personal stem cell banking services to collect, process, grow and store adult and newborn autologous Mesenchymal Stem Cells (your own MSCs) for potential future medical or regenerative use as determined by you and your personal physician.

www.anandaprofessional.com Ananda Professional is the #1 CBD brand supported by clinical research. With a mission to champion the knowledge, safety and efficacy of CBD products, we’ve invested over $40 million in research to advance the clinical evidence of hemp extract. Our goal is to improve patient outcomes and increase your profitability with lucrative referral programs. From unique product formulations to HCP-specific trainings and tools, everything is geared to make you the CBD experts in your community.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Booth #25

EXHIBITOR LISTINGS

American Academy of Anti-Aging Medicine

Allergy Research Group

www.anazaohealth.com AnazaoHealth is a national specialty compounding pharmacy. With a 30,000-square-foot 503B FDARegistered Outsourcing Facility in Las Vegas and a 46,000-square-foot traditional 503A compounding pharmacy in Tampa. Both facilities have the appropriate licensure to conduct business in all 50 states, District of Columbia, and selected U.S. territories. AnazaoHealth compounds preparations for Aesthetics, Age Management, Weight Management, IV & Injection Therapy Solutions, Sexual Wellness Solutions, Hormone Replacement, Personalized Hair Care Solutions, Mental Clarity & Acuity &and more.

145

EXHIBITOR LISTINGS

since 2001

146

Anti Aging Bed

Argentyn 23

AVACEN Medical

Booth #117

Booth #907

Booth #216, 1101

995 W. Kennedy Blvd., Ste.32, Orlando, Florida, 32810 | United States

7504 Pennsylvania Ave, Sarasota, Florida, 34243 | United States

2365 Camino Vida Roble, Unit C Carlsbad, California, 92011 | United States

Ph: 800-385-4243

Ph: 941-702-6100 ext. 303

Ph: 888-428-2230

Email: info@antiagingbed.com

Email: tescobar@n-icorp.com

Email: djforsgren@avacen.com

www.antiagingbed.com

www.argentyn23.com

www.avacen.com

Anti Aging Bed is a brand new category of sleep and revolutionary product utilizing proven technologies for advanced recovery & regeneration. Designed by industry veterans and doctors for the modern society. With multi US approved patented sleep system, Anti Aging Bed is disrupting the outdated mattress industry. Our proven tecnologies help to reduce oxidative stress combined with NanoBionic component to enhance faster recovery while sleeping. We are - Transforming The Way The World Sleeps.

Since its launch in 2001, thousands of clinics worldwide have chosen Argentyn 23 Bio-Active Silver Hydrosol™ and First Aid Gel. Argentyn 23’s proprietary manufacturing process results in the smallest particles achievable with greater than 98% positively charged bio-active silver ions and silver nanoclusters. Sovereign Copper was launched in Q4 of 2021. This is a proprietary blend of Copper I and Copper II species, formulated for superior bio-availability for Daily Wellness. Visit our Booth # 907.

AVACEN Medical’s FDA-cleared, Class ll, CE Marked medical devices use the AVACEN Treatment Method – a patented noninvasive pain management platform. AVACEN uses a microprocessor-controlled chamber to surround the hand with slight negative pressure while adding heat to the palm, gently expanding the volume of blood in the palm’s unique vascular networks. Heat is simultaneously transferred from the computer managed heat transfer pad into these vascular networks, essentially warming the body from the inside out.

Ballancer®Pro USA

Bankers Healthcare Group

BENEV Company Inc

Booth #112

Booth #1115

Booth #1120

3033 Chimney Rock Rd., Ste 580-G Houston, Texas, 77056 | United States

10234 W. State Road 84, Davie, Florida, 33324 | United States

23263 Madero Suite A, Mission Viejo, California, 92691 | United States

Ph: 424-362-7228

Ph: 954-660-7985

Ph: 949-457-2222

Email: info@ballancerpro.com

Email: rudy@bhg-inc.com

Email: susan@benev.com

www.ballancerpro.com

www.bankershealthcaregroup.com

www.benev.com

The Ballancer®_Pro is the most state-of-the-art and safest Lymphatic Massage system. Backed by 20 years of clinical studies this FDA-cleared technology is “light years” ahead of any compression therapy system. Trusted by the Best Doctors in the world this relaxing treatment safely delivers a myriad of benefits from pain relief, lymphatic drainage, detox, enhanced circulation, optimal health to beauty, and weight loss. The Ballancer®_Pro has been coined “The Rolls-Royce of Lymphatic Massage”.

Bankers Healthcare Group provides innovative, hassle-free financial solutions to licensed healthcare practitioners and other highly skilled professionals. Since 2001, BHG has provided more than $8 billion in financial solutions to thousands of satisfied customers nationwide. BHG is proud to maintain partnerships with leading healthcare industry associations, and is recognized regionally and nationally for innovation, continued growth, and being a best place to work. BHG is partially owned by Pinnacle Financial Partners.

At BENEV our mission is to inspire a more vibrant life and create a more beautiful world by providing innovative and effective professional solutions and medical devices that revive, restore, and renew in all facets of the health and beauty market. As an FDAregistered manufacturer based in California, we are expanding our global network with integrity, creativity, and passion in a relentless pursuit to BENefit EVeryone.

ANTI-AGING MEDICAL NEWS | SPRING 2022

BHI Therapeutic Sciences

Biocidin Botanicals

Booth #103

Booth #1118

Booth #622

1449 S. Michigan Ave , Unit 449 Chicago, Illinois, 60605 | United States

214 State Street, Ste 101 Hackensack, New Jersey, 7601 | United States

PO Box 2499, Aptos, California, 95001 | United States

Ph: 773-750-7745

Ph: 212-206-7073

Ph: 800-775-4140

Email: info@berkeleylife.com

Email: bmehling@bluehorizoninternational. com

Email: questions@biocidin.com

www.berkeleylife.com Berkeley Life Professional nitric oxide products are used successfully by top practitioners around the country. Our proprietary supplement formulation and test strip provides a system for practitioners to assess nitric oxide levels, facilitate patient conversations, and improve patient protocols. Transparent practitioner relationships continue to inspire product improvements and innovation. Now with the partnership of Dr. Nathan S. Bryan, Berkeley Life Professional is positioned to be the leading name in practitionerrecommended nitric oxide support products.

www.bhirejuve.com BHI Therapeutic Sciences is pioneering ethical, effective, safe and affordable stem cell treatment therapies utilizing cord blood stem cells. The organization is also home to BHI Rejuve, a hormone optimization program designed to help clients reach their full potential. Our program helps restore natural hormone balance. We know that one hormone optimization therapy does not fit all, which is why our bioidentical hormone replacement therapy is personalized for each person’s specific hormone deficiency.

www.biocidin.com Biocidin® is a synergistic combination of botanicals, which targets the entire GI tract and oral cavity, and supports microbiome balance for healthy digestion and elimination. These broad-spectrum botanicals offer systemic support and have been utilized by practitioners for more than 30 years.

Bioclinic Naturals

Bionox, Inc.

BioProtein Technology

Booth #104

Booth #1216

Booth #1213

#104-3686 Bonneville Place, Burnaby, British Columbia, V3N 4T6 | Canada

3620 Pelham Rd, Greenville, South Carolina, 29615 | United States

5706 Benjamin Center Dr., Ste 114 Tampa, Florida, 33634 | United States

Ph: 888-826-9625 Email: customerservice@bioclinicnaturals.com www.bioclinicnaturals.com Bioclinic Naturals® is a Canadian nutraceutical manufacturer of a professional product line comprised of fertility kits and supplements, Essential Fatty Acids, mitochondrial support, detox support, PCOS support, and natural stress and sleep aids. Our goal is to provide the best quality, tested, raw materials. Whenever possible we grow our own plant-based ingredients and any raw material we do not produce ourselves is subjected to the highest level of scrutiny to ensure the quality and purity.

Ph: 877-278-9070 Email: customercare@bionoxusa.com www.bionoxusa.com Bionox is motivating all to live life fully. Unlock your body’s innate power to realize optimum health with trusted, scientifically tested, doctor-formulated nitric oxide solutions. In 2005, Dr. Jay Wilkins discovered the clinically proven effectiveness of nitric oxide to maximize health. After researching the numerous benefits of nitric oxide, he founded Bionox to develop and promote a diverse line of easy to digest supplements that motivate wellness across all lifestyles.

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

Berkeley Life Professional

Ph: 800-280-2456 Email: info@bioproteintech.com www.bioproteintech.com BioProtein Technology is the home of BioPro+, the first of its kind Bioidentical alternative to synthetic HGH - Growth Hormone treatments. Since 2009 BioProtein Technology has been providing physicians and their patients cutting edge alternatives to the industry’s most common pharmaceutical anti-aging and regenerative drugs. Whether its hormones, weight loss, libido, or sleep & stress, BioProtein Technology has a non-synthetic alternative that works faster, is easier to use, and 100% safe.

147

EXHIBITOR LISTINGS

Biosound Technologies

Bio-Tech Pharmacal, Inc.

Biotics Research Corporation

Booth #816

Booth #1013

Booth #900

21955 US Hwy 19, Clearwater, Florida, 33765 | United States

3481 N Highway 112, Fayetteville, Arkansas, 72704 | United States

6801 Biotics Research Drive, Rosenberg, Texas, 77471 | United States

Ph: 888-495-1946

Ph: 888-906-4304

Ph: 800-231-5777

Email: chris@biosoundhealing.com

Email: lee@bio-tech-pharm.com

Email: biotics@bioticsresearch.com

www.biosoundhealing.com

www.biotechpharmacal.com

www.bioticsresearch.com

Biosound Technologies has been creating vibroacoustic therapy systems for the last 11 years. The Biosound Therapy system is a unique therapy system that incorporates full-body vibrations with therapeutic music and meditations. It also has a biofeedback program. A Biosound massage interrupts patterns of stress, trauma, and pain. It’s holistic and non-invasive, stimulating a heightened sense of relaxation through vibrations and sound waves. Provides client with great sleep, energy, circulation, productivity, and mood, while lowering anxiety.

Since 1984, Bio-Tech Pharmacal, Inc. has operated as a dietary supplement manufacturer. Producing 87+ products, all manufactured in Fayetteville, Arkansas, among the hills of the Natural State. Bio-Tech partners with leading international pharmaceutical companies, scientific research agencies, advocacy, and non-profit organizations, as well as individual clients around the world.

Biotics Research is a professional nutritional supplement manufacturer founded on innovative ideas, carefully researched concepts and superior quality products. Family-owned and operated for 40+ years, Biotics Research continues to revolutionize the nutritional supplement industry by utilizing “The Best of Science and Nature”. They were the first to produce and market CoQ10 as a dietary supplement in the US. Biotics Research continues its role as a leader in the industry providing bioavailable, safe and effective supplements.

BodyHealth

Boiron Inc.

Boston Heart Diagnostics

Booth #1007

Booth #819

Booth #121

745 Main St., Dunedin, Florida, 34698 | United States

4 Campus Blvd., Newtown Sq., Pennsylvania, 19073 | United States

200 Crossing Blvd., Framingham, Massachusetts, 1702 | United States

Ph: 888-264-7668

Ph: 877-425-1252

Email: medicaldev@boiron.com

Email: customercare@bostonheartdx.com

www.boironusa.com

www.bostonheartdiagnostics.com

Boiron, world leader in homeopathic medicines, is best known for Oscillococcinum® and Arnicare® . Since 1932, Boiron has been funding scientific research and educating the public and health care professionals on homeopathic medicines. Boiron maintains the highest standards in manufacturing, complying with the FDA, HPUS, and drug GMP.

Boston Heart Diagnostics is transforming the treatment of cardiovascular disease and related diseases with novel diagnostics, reports, and a personalized, scientifically designed nutrition and lifestyle program that have the power to change the way healthcare providers and patients communicate about heart health.

Ph: 877-804-3258 www.bodyhealth.com

Founded by Dr. David Minkoff, MD in 2000. In his practice, he concentrates on alternative and complementary approaches, with a focus on detoxification and dietary/nutrition changes. He believes that in order to achieve optimum health, patients must firstly, reduce the number of toxins and pollutants entering the body; secondly, increase the number of toxins and pollutants leaving the body and thirdly, improve the quality of nutrition so the body can rebuild and heal.

148

ANTI-AGING MEDICAL NEWS | SPRING 2022

Calmoseptine, Inc.

Calroy Health Sciences

Booth #922

Booth #1003

Booth #807

1058 N. Tamiami Trail, Ste 108 Sarasota, Florida, 34236 | United States

16602 Burke Lane, Huntington Beach, California, 92647 | United States

14362 N Frank Lloyd Wright, Suite 1000, Scottsdale, Arizona, 85260 | United States

Ph: 941-284-5579 Email: support@menopausemethod.com www.brite.live Designed for Physicians and Nurse Practitioners in active practice: Implementable training. Office tools. Menopause questionnaires. An app for patients. Application and titration videos and treatment program charting documents for your patients. Vendor list of labs and pharmacies. Everything is built with this in mind: “Do doctors need it? Will they use it? Have we clearly and simply communicated it? Will it radically improve their practice?”

Ph: 714-840-3405 Email: Info@Calmoseptine.com www.calmoseptine.com Calmoseptine Inc. markets Calmoseptine Ointment in all 50 states, Canada, United Arab Emirates, Jordan, Cuba, Peru, and Chili. Calmoseptine Ointment is an effective, multi-purpose moisture barrier that protects and helps heal skin irritations. Calmoseptine Ointment is available in 2.5-oz jars or tubes, 4-oz tubes, 1/8-oz packets, and 20g tubes through most wholesalers, distributors and pharmacies. For more information, please call us at 800-800-3405, e-mail us at info@ calmoseptine.com, or visit www.calmoseptine.com.

Ph: 800-609-6409 Email: support@arterosil.com www.arterosil.com Calroy Health Sciences leads in creating innovative solutions for vascular health. Calroy is the maker of Arterosil ®, which supports the endothelial glycocalyx in all 60,000 miles of blood vessels in the body. Arterosil is clinically proven to protect and restore the endothelial glycocalyx, for improved vascular health and blood flow. As a company dedicated to sciencebased innovations that transform human health with natural solutions, Calroy supports a robust research agenda.

Carbon-60, Greska’s

Cell Science Systems

Central Drugs Pharmacy

Booth #419

Booth #1114

Booth #901

8156 S. Wadsworth Blvd., Littleton, Colorado, 80128 | United States

852 S. Military Trail, Deerfield Beach, Florida, 33442 | United States

520 W. La Habra Blvd., La Habra, California, 90631 | United States

Ph: 303-521-4001 Email: bob@c-60.com www.c-60.com Greska’s Carbon-60 is the world’s largest supplier of the ONLY proven Food-Grade carbon 60 product. It is a nano sized pure carbon-based cellular detoxifier, free radical stabilizer and more. It supports a vast number of health issues either applied topically or taken orally as a dietary supplement. It supports a higher quality of live for healthy aging. Stop by Booth 419 for a FREE SAMPLE. You’ll be glad you did.

Ph: 800-872-5228 Email: rweldon@cellsciencesystems.com www.cellsciencesystems.com Cell Science Systems Corp. is a specialty clinical laboratory that develops and performs laboratory testing in immunology and cell biology supporting the personalized treatment and prevention of chronic disease. Cell Science Systems, Corp. operates a CLIA certified laboratory and is a FDA inspected and registered cGMP medical device manufacturer meeting ISO EN13485 standards.

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

Brite

Ph: 562-691-6754 Email: nayan@centraldrugsrx.com www.centraldrugsrx.com Central Drugs is an industry leader in the art and science of custom compounding and individualized health-care solutions with a team of expert pharmacists at our state-of-the-art 503A compounding pharmacy. Central Drugs is your pharmacy partner, working with clinics to provide resources, education, and services to improve the overall health of your patients. Central Drugs specializes in compounding, seeking the most innovative, effective and trending formulations to meet the needs of clinics across 30 states.

149

ChromaDex, Inc.

Clinicians Supplement Consultants

College Pharmacy

Booth #815

Booth #1113

10900 Wilshire Blvd., Suite 600, Los Angeles, California, 90024 | United States

180 Froehlich Farm Blvd., Woodbury, New York, 11797 | United States

Ph: 908-625-4793

Ph: 855-272-7220

3505 Austin Bluffs Pkwy, Ste 101 Colorado Springs, Colorado, 80918 | United States

Email: greg.arabatzis@chromadex.com

Email: dlc@cscprivatelabel.com

www.truniagen.com

www.cliniciansconcierge.com

Your NAD+ supply declines with age as well as in response to stressors on your body including alcohol consumption, intense exercise, and lack of sleep. While nicotinamide riboside can be found naturally in certain foods, you cannot get anywhere near the amount you need through a normal diet to effectively increase NAD+. That is why we created Tru Niagen®, the only patented, broadly studied, and safety-reviewed nicotinamide riboside in the world.

Clinicians Supplement Consultants allows practitioners to provide concierge service and sales of professional supplements brands and practitioners own private label supplements to their patients. With professionals only brands, concierge supplement fulfillment service and private label development and management company CSC allows practitioners focus on the patient while CSC handles all aspects of inventory, dispensing, fulfillment, and patient compliance . We focus on the the bottom line so our practitioners can focus on patient success.

EXHIBITOR LISTINGS

Booth #1225

150

Ph: 800-888-9358 ext. 137 Email: customerservice@collegepharmacy.com www.collegepharmacy.com THE COLLEGE PHARMACY DIFFERENCE: QUALITY. INNOVATION. EXPERIENCE. SINCE 1974. For over 40 years, College Pharmacy has provided healthcare practitioners and patients with high-quality compounded preparations and outstanding customer service. Our experienced pharmacists collaborate with patients and healthcare practitioners to provide innovative solutions for health and wellness success. It is our compounding process, attention to detail, and quality of the compounding components that continues to make our formulations exceptional.

PHARMACY CosmoFrance

CRE8 Pharmacy

Cyrex Laboratories

Booth #322

Booth #215

Booth #416

1444 Biscayne Blvd., Ste 218 Miami, Florida, 33132 | United States

3700 NW 126th Avenue, Coral Springs, Florida, 33065 | United States

2602 S. 24th Street, Phoenix, Arizona, 85034 | United States

Ph: 786-475-5512

Ph: 888-224-5181

Ph: 602-759-1245

Email: conference@cosmofrance.net

Email: david@cre8rx.com

Email: michelle.c@cyrexlabs.com

www.cosmofrance.net

www.cre8pharmacy.com

www.joincyrex.com

__CosmoFrance Inc. - established in 1997 in Miami, FL - specializes in the import & distribution of medical devices for non-invasive aesthetic procedures. CosmoFrance manufactures & distributes the following products in the US: • ezPRF® Platelet-Rich Fibrin, the ultimate blood concentrate. • ezGel® The autologous biostimulating solution. • The DermaSculpt® blunttipped microcannula. • The CosmoPen® microneedling pen. • NovaThreads, absorbable PDO threads. Visit cosmofrance.net__

CRE8 Pharmacy offers compounding services for personalized medicine and patient-specific prescriptions. We are a team, working at creating perfect formulations, dispensing orders reliably and resolving any issues promptly. Specializing in Peptides, Hormone Replacement Therapy, Sexual Wellness, Weight Loss & Energy, Cognitive & Mental Health formulas. Sterile & Non-Sterile compounds, Generic & Brand medications. Welcome to the future of compounding pharmacy.

Cyrex Laboratories®, a unique clinical immunology laboratory specializes in environmentally-induced autoimmunity. Cyrex delivers next generation assessments for intestinal and blood-brain barrier permeability – environmental trigger screening including dietary antigens, pathogens, xenobiotics; and multi-tissue antibody testing for predictive biomarkers. The Lymphocyte MAP™ test panel establishes a new industry standard in screening the immune system. Through continuous collaboration with leading experts Cyrex develops innovative arrays that assess the cross-connections between the body’s immune, gastrointestinal and neurological systems.

ANTI-AGING MEDICAL NEWS | SPRING 2022

DaVinci Laboratories

Booth #107

Booth #522

John Eccles House, Robert Robinson Ave., Oxford Science Prk. Oxford, England, OX44GP | United Kingdom

1816 W. 135th St., Gardena, California, 90249 | United States

929 Harvest Lane, Williston, Vermont, 5495 | United States

Ph: 800-650-4234

Ph: 310-538-2298

Ph: 802-872-1924

Email: sales@usjaclean.com

Email: bkanya@foodsciencecorp.com

www.daiwamassage.com

www.davincilabs.com

Established in 1982 & Headquartered in Gardena, CA. We offer an assortment of high-quality health & wellness products. We pride ourselves with great costumer service.

Since 1973, DaVinci® Laboratories has been a leader in nutritional research, product development and innovation. Our dedication to higher integrity, and insistence on superior quality are reflections of our core values. Our team of experts is always willing to assist you in matters relating to nutrition. Today, DaVinci® continues to set new standards for quality and product innovation to keep you as healthy and informed as possible.

Designer Drugs Pharmacy

Designs for Health

DEXA+

Booth #1021

Booth #707

Booth #721

7304 Jarnigan Rd., Chattanooga, Tennessee, 37421 | United States

980 South St., Suffield, Connecticut, 6078 | United States

141 Peyerk Ct. Unit D, Romeo, Michigan, 48065 | United States

Ph: 860-752-7474

Ph: 586-532-1150

Email: info@designsforhealth.com

Email: torlando@dexaplus.com

www.designsforhealth.com

www.dexaplus.com

Our Mission: Designing a Well World. We are driven by a higher purpose. We are activists for health - rooted in and united by science. Transforming boundaries, breaking barriers, setting new standards, disrupting the status quo. We believe in science-based nutrition and natural medicine, developing health products without compromise, and advancing the way education and technology support wellness for all. We design a new paradigm. We design a well world.

DEXA+ is a provider DEXA Scanners and an educator of the benefits of DEXA and the 3 Critical Health Markers (Bone Health, Body Composition and Visceral Fat, the number predictor of heart disease and Type 2 Diabetes.) Our Scanners and Programs provide State of the Art equipment and leading technology for clinics. If you would like to include DEXA in your clinic DEXA+ is the leader in the industry. Contact us to learn more.

Booth #918

Email: alzheimers@vanguardpharma.com www.cytoxgroup.com Cytox provides non-invasive, risk assessment and patient stratification tools for Alzheimer’s disease and dementia. The Alzheimer’s Risk Test is a genetic test that can predict one’s risk of developing Alzheimer’s disease. The test offers insights into potential cognitive decline in patients of any age, all via a simple saliva sample. Cytox’s mission is to transform how new treatments are developed, people are screened, and how patients are managed within the Alzheimer’s disease care pathway.

Ph: 423-954-2585 Email: brandyt@compound-rx.com www.designerdrugs.us For more than 20 years, Designer Drugs has been working with patients and physicians to provide custom solutions for their pharmaceutical needs. Our technicians are certified to compound sterile and nonsterile medications. Our pharmacy proudly compounds ophthalmics, injections, dermatologic preparations, hormone replacement options, and many more products. These preparations are designed specifically to meet individual needs with the highest level of safety and accuracy. Designer Drugs is licensed to ship prescriptions to all fifty states.

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

Daiwa Massage chair by US Jaclean, Inc.

Cytox Ltd.

151

EXHIBITOR LISTINGS 152

Diagnostic Solutions Laboratory

Doctor Multimedia

Doctor’s Data, Inc.

Booth #913

Booth #1008

Booth #206

31 Lupi Ct., Ste 250 Palm Coast, Florida, 32137 | United States

8070 La Jolla Shores Dr., La Jolla, California, 92037 | United States

3755 Illinois Ave., St. Charles, Illinois, 60174 | United States

Ph: 877-485-5336

Ph: 800-679-3309

Ph: 630-377-8139

Email: cs@diagnosticsolutionslab.com

Email: info@doctormultimedia.com

Email: info@doctorsdata.com

www.diagnosticsolutionslab.com

www.doctormultimedia.com

www.doctorsdata.com

Diagnostic Solutions Laboratory bridges the gap between healthcare providers and the clinical laboratory by offering cutting-edge laboratory tests such as GI-MAP, OMX (Organic Metabolomics), CytoDX, and GenomicInsight. Designed to identify underlying root causes of symptoms and disease, our test results give practitioners the tools needed to formulate personalized treatment protocols for optimized patient outcomes. Our commitment to education and service ensures both practitioners and their patients will benefit from the latest research.

We are experts in website design and marketing for the medical industry. We provide doctors with internet solutions and marketing techniques that turn the web into an advantage for their practices. We focus our website design and marketing efforts solely on the medical industry, and as a result we have developed proven campaigns that improve your patient’s experience, enhance your online presence, and increase your practice’s bottom line.

Doctor’s Data, Inc. has provided innovative specialty testing to healthcare practitioners around the world from our advanced, CLIA-licensed clinical laboratory since 1972. A specialist and pioneer in essential and toxic elemental testing, the laboratory provides a wide array of functional testing to aid in decision making and better patient outcomes. Choose DDI to help you assess and treat heavy metal burden, nutritional deficiencies, gastrointestinal function, hormone status, cardiovascular risk, liver and metabolic abnormalities, and more.

Dr.Fuji / ACIGI

DrPawluk.com

DrSummits.com

Booth #912

Booth #219

Booth #220

4399 Ingot Street, Fremont, California, 94538 | United States

1001 Cromwell Bridge Rd., Towson, Maryland, 21286 | United States

7040 Avenida Encinas, Ste. 104-284, Carlsbad, California, 92011 | United States

Ph: 510-651-9088

Ph: 518-461-8963

Ph: 619-436-7750

Email: marketing@drfuji.com

Email: alex@drpawluk.com

Email: bret@drsummits.com

www.fujichair.com

www.drpawluk.com

www.drsummits.com

Dr. Fuji aims to foster they physical well-being of our customers, also strives to help our elite professionals in all industries, such as health care, sports and technology, so that they may elevate their patient/ employee care and practices to a higher level.

At drpawluk.com, we’re dedicated to bringing you unbiased, research-based information on Pulsed Electromagnetic Field (PEMF) therapy for home and clinical use. If you’re looking for a pemf machine or pemf device for a specific health condition, we can help help you find information about how PEMF can work for your needs.

DrSummits produces large online consumer summits for Doctors producing over 500,000 patient leads for doctors annually. The fastest way to get famous online, and build a highly profitable list of prospective patients and clients is to host your own summit with us.

DR. FUJI

ANTI-AGING MEDICAL NEWS | SPRING 2022

DUTCH Test

Eclipse

Booth #1016

by Precision Analytical Booth #713

1600 Capital Ave. , Ste #100 Plano, Texas, 75074 | United States

3138 NE Rivergate, Ste.301C, #301c McMinnville, Oregon, 97128 | United States

5916 Stone Creek Dr., Ste 120 The Colony, TX, 75056 | United States

Ph: 888-881-2344

Ph: 503-687-2050

Ph: 214-728-1637

Email: info@druckerlabs.com

Email: sales@dutchtest.com

Email: dhensley@eclipsemed.com

www.druckerlabs.com

www.dutchtest.com

www.eclipsemed.com

Drucker Labs has dedicated the last 20 years to innovating, developing and manufacturing a complete line of superior liquid dietary supplements for Optimal Immune Function. Our proprietary intraLINE 2.0 products are a key foundation for immunological support and resistance. intraMAX® 2.0, intraKID® 2.0 and intraMIN® are the highest quality, 100% Organically-bound trace mineral-based nutritional supplements on the market - created from the finest and purest ingredients obtainable.

The DUTCH Test® (Dried Urine Test for Comprehensive Hormones) helps practitioners answer complex clinical questions by providing the most comprehensive hormone monitoring results with simple patient collection. Our rigorous pursuit for the truth in hormone testing has produced multiple peer-reviewed studies proving the effectiveness of dried urine testing as an alternative to serum (blood) or saliva for monitoring a variety of hormone therapy applications.

Eclipse is the trusted leader in Platelet-Rich Plasma technology with over 800,000 patient cases worldwide. In addition to Eclipse PRP, additional product offerings include: the FDA-cleared Eclipse MicroPen EVO microneedling device, Votesse hair health products, eVive pulse wave therapy technology, Theradome laser hair helmet, and the DermaFlex line of microcannulas. Eclipse leads the market in high-efficacy, affordable products that generate profitability for physicians while producing high satisfaction for patients.

electroCore, Inc.

Emerson Ecologics:

Booth #521

Enbiosis Biotechnology

Booth #212

a Fullscript company Booth #401

200 Forge Way, Ste 205 Rockaway, New Jersey, 14-Jul-21 | United States

9185 E. Pima Center Pkwy, Suite 200, Scottsdale, Arizona, 85258 | United States

Maslak Mh. 1453 sitesi Blok: Daire:91 Sariyer, Istanbul, Istanbul, 34398 | Turkey

Ph: 613-707-2861

Ph: 00905056328282

Email: marketing@fullscript.com

Email: byagmur@enbiosis.com

www.gammacore.com

go.emersonecologics.com/fullscriptpartnership

www.enbiosis.com

gammaCore Sapphire™ (non-invasive vagus nerve stimulator) is a handheld device that directly stimulates the vagus nerve at the neck. This stimulation results in increased parasympathetic innervation, helping to treat several disorders resulting from vagus insufficiency. The device is FDA-cleared to prevent and treat migraine and cluster headache. It is available only by prescription. Designed as a portable, easy-to-use technology, gammaCore can be self-administered by patients without potential side effects associated with commonly prescribed drugs.

Emerson Ecologics® is now part of Fullscript. As one, we’re working together to enable the future of integrative care. Emerson Ecologics offers more than 300 professional brands, the broadest selection of wellness products, educational resources, and technology, like Wellevate, that supports your practice success. We are proud to have earned the trust of over 30,000 practitioners and look forward to serving you and supporting the practice of healthy living. For more information, visit emersonecologics. com/fullscript-partnership

Ph: 1-888-903-2673 Email: CustomerService@electroCore.com

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

Drucker Labs

Booth #920

ENBIOSIS produces AI-driven next-generation bioengineering / biotechnology solutions aimed to improve human health and quality of life by using microbial organisms forming a symbiotic life with the human body. Upon rigorous wet & dry lab procedures, we present our customers with a detailed microbiome report. Our AI technology then scores food items (to help dietitians create personalized nutritional plans) and suggests personalized prebiotics.

153

Energist Medical Group

EnviroKlenz

Enzyme Science

Booth #925

Booth #1222

Booth #813

2 Park Pavillions, Clos Llyn Cwm, Wales, SA68QY | United Kingdom

24301 Walden Center Dr. Ste 101, Bonita Springs, Florida, 34134 | United States

771 Commerce Dr., Venice, Florida, 34292 | United States

Ph: 239-330-9650

Ph: 941-441-3781

Email: pvanhorn@timilon.com

Email: orders@enzyscience.com

www.enviroklenz.com

www.enzyscience.com

EnviroKlenz Air Systems were designed by Timilon Corporation to create safer environments, crafting one simple technology as the foundation for endless applications. Dedicated to eliminating chemicals, biological contaminants, and toxins of any kind, our technology’s unique history begins with chemical decontamination to aid in U.S. military operations. We took this same powerful technology and utilized it in everyday applications as a trusted solution for destroying airborne toxins in medical centers, office buildings, schools and homes.

Enzyme Science is the practitioner division of Enzymedica, the #1 selling enzyme brand in the United States. For over 10 years, we have partnered with thousands of health professionals to provide patients with quality care through innovative supplements. Enzyme Science is committed to producing formulas with cutting-edge science via sustainable practices to support total health and wellness. We maintain exceptional quality standards and create vegetarian, vegan, and kosher-certified products whenever possible.

EVEXIAS Health Solutions

Ezra

Flore by Sun Genomics

Booth #200

Booth #523

Booth #1014

920 S. Kimball Avenue, Ste 100 Southlake, Texas, 76092 | United States

419 Park Avenue South, New York, New York, 10016 | United States

5151 Shoreham Place, Ste. 105, San Diego, California, 92122 | United States

Ph: 833-839-4735

Ph: 888-402-3972

Ph: 661-888-4799

Email: info@evexias.com

Email: hello@ezra.com

Email: Customerservice@sungenomics.com

www.evexias.com

www.ezra.com

www.flore.com

EVEXIAS Health Solutions (EHS) has helped thousands of practitioners enhance patient care through advanced medical education and training from industry-leading experts and cutting-edge therapies and technologies that support disease prevention and improve quality of life. Every EHS program is backed by strategic business plans exclusively developed to drive growth for private medical practices.

Ezra believes cancer screening should be the easiest part of your healthcare routine. Developed with the nation’s top medical experts, Ezra leverages the power of MRI to get an accurate look inside your body while safely screening for more than 22 possible cancers. You’ll experience concierge-level support from start to finish, thoughtful care packages for ultimate comfort during your screening, and an easy-to-interpret report crafted by our team of US-certified radiologists and medical providers.

Floré is the only custom probiotic with the secret ingredient. That secret ingredient is you! We create custom gut probiotics tailored and formulated to your unique microflora to improve your digestion, increase your energy, and reduce bloating; helping you perform at your best.

Ph: +44 0 1792 798768 Email: sales@energist.com www.energist.com

EXHIBITOR LISTINGS

Energist is the founding and leading global provider of nitrogen plasma solutions for the medical aesthetic marketplace; NeoGen Plasma Skin Regeneration is unique, it is not a Plasma Pen, PRP, Light or Laser. Equivalent results to a CO2 ablative without the complications and downtime. Manufactured in the UK, patented, FDA cleared (K132754) for 7 indications since 2013, clinically proven by +30 IRB clinical studies and hundreds of 100,000’s of treatments without any reported adverse incidents.

PH A RM AC EUTI CA LS

Flosom

Fortress Pharmaceuticals

Forum Health

Booth #1219

Booth #1018

Booth #618

9985 W. Tree Tops Ct., Davie, Florida, 33328 | United States

14897 edgemere Dr, spring hill, Florida, 78232 | United States

601 S. Saginaw St. 5th floor, Flint, Michigan, 48502 | United States

Ph: 954-559-9638

Ph: 918-520-4245

Ph: 855-976-5578

Email: steve@flosom.com

Email: medicadirector62@gmail.com

Email: info@forumhealth.com

www.flosom.com

www.fortresspharmacyrx.com

www.forumhealth.com

Flosom is a novel Men’s Urinary/Prostate Health supplement. Flosom is pharmacist formulated and created specifically for men facing urinary health challenges that occur as we age.Flosom uses pharmaceutical grade extract of the Saw Palmetto Plant and combines it with high quality hemp CBD extract that creates the best synergistic results for men experiencing issues from a growing prostate. It is clinically tested by board certified urologists and manufacturered at the highest level of integrity.

We are a national compounding pharmacy specializing in the hormone replacement, weight loss, biodentical hormones, anti-aging niche. We are the most affordable choice for doctors wanting to utilize a 503A pharmacy. We are centered around technology leading to fast shipping and excellent customer service. Our proprietary software allows easy prescribing and tracking information for clinics who both serve local and national patient populations.

Forum Health is a growing network of healthcare providers & practices who serve patients around the world. Our providers have decades of experience practicing functional and integrative medicine drawn from areas in clinical nutrition, anti-aging, environmental science, chronic disease, lifestyle medicine and more. Through practice acquisition and employing talented healthcare providers, we connect the best like-minded practitioners with business experts and a network of collaborative peers. Become part of our network today!

Fotona

GAINSWave/FemiWave

Genova Diagnostics

Booth #319

Booth #812

Booth #201

2307 Springlake Road, Ste 518 Dallas, Texas, 75234 | United States

2920 NE 207th St., Aventura, Florida, 33180 | United States

Ph: 972-598-9000

Ph: 855-383-5779

63 Zillicoa St., Asheville, North Carolina, 28801 | United States

Email: info@fotona.org

Email: divyea@gainswave.com

www.fotona.com

www.joingainswave.com

With over 50 years of laser expertise and industry leadership, Fotona has sold over 30,000 lasers worldwide with distribution in over 60 countries. Fotona produces award-winning lasers in dentistry, aesthetics, dermatology, gynecology, and surgery. Having a strong history of dedication to R&D, Fotona has a reputation for unparalleled quality, reliability, ease-of-use and durability.

GAINSWave® and FemiWave® are high-demand procedures that enable any medical practice to quickly add $200k or more to their bottom line. GAINSWave® and FemiWave® membership provides medical practices a simple, turn-key solution to enter the highly profitable field of male and female sexual wellness. We’ve helped hundreds of doctors and health care professionals from all types of backgrounds, provide much-needed business solutions that are proven, increase practice cash revenues and assist in scalable business growth.

Ph: 800-522-4762 Email: info@gdx.net www.gdx.net Genova Diagnostics is a leading clinical laboratory applying systems-based testing approaches to the diagnosis, treatment and prevention of complex chronic disease. Genova specializes in clinical laboratory services with actionable information.

EXHIBITOR LISTINGS

FORTRESS

EXHIBITOR LISTINGS 156

Global Life Rejuvenation

Great Plains Laboratory

Hallandale Pharmacy

Booth #213

Booth #906

Booth #617

168 East Main Street, Denville, New Jersey, 7834 | United States

11813 West 77th Street, Lenexa, Kansas, 66214 | United States

2666 Sw 36th St, Lauderdale, Florida, 33312 | United States

Ph: 973-627-1750

Ph: 913-341-8949

Ph: 954-455-3822

Email: demetriaglaab@denvillemedical.com

Email: sales@gpl4u.com

Email: jmaman@hallandalerx.com

www.globalliferejuvenation.com

www.greatplainslaboratory.com

www.hallandalerx.com

Global Life Rejuvenation A Leader in Anti-Aging Medicine and Hormone Replacement Therapy for Men and Women. Global Life Rejuvenation has Network Providers nationwide. Global Life educates and connects patients with our highly trained network physicians specializing in Anti -Aging Medicine.

Great Plains Laboratory is a leader in providing testing for nutritional factors in chronic illnesses such as fibromyalgia, autism, AD(H)D, gastrointestinal and neuropsychiatric disorders. We offer a variety of metabolic tests including those for immune deficiency, amino acids, essential fatty acids, inflammation, metal toxicity, toxic chemicals, and food allergies.

Hallandale Pharmacy’s is a 503a designated and PCAB accredited compounding pharmacy, that is committed to provide quality and affordable custom prescription formulations nationwide. The cGMP guidelines that Hallandale Pharmacy has adopted is led by our Quality Assurance team and supporting staff. While quality is the foundation of our practice, our service to our patients and providers drives our mission. We regard our relationships with our trusted practitioners as a partnership.

Hawaiian Moon

Healing Breaths

Health Experts Alliance

Booth #1006

Booth #1221

Booth #122

1226 Turner St., Clearwater, Florida, 33756 | United States

PO BOX 2010, Cupertino, California, 95015 | United States

159 Horizon Hill, Alpharetta, Georgia, 30004 | United States

Ph: 888-256-3276

Ph: 628-280-6527

Ph: 810-875-7346

Email: customerservice@hmaloe.com

Email: hello@healingbreaths.org

Email: taylor@healthexpertsalliance.com

www.aloecream.biz

www.healingbreaths.org

www.healthexpertsalliance.com

Say Goodbye to Dry Skin with Hawaiian Moon Organic Aloe Cream! It is free of dyes, fragrance, parabens, sulfates, mineral oil_, and any other harsh chemicals, including petroleum. Our cream penetrates the skin up to 7 layers deep, and absorbs into the skin instantly.

Healing Breaths offers evidence-based self-care and resilience programs that allow healthcare professionals and leaders to rejuvenate, reconnect with their purpose, and discover a deeper shared sense of oneness with others. Our evidence-based techniques reduce clinical anxiety and cortisol levels while increasing mental health and life satisfaction. To learn more visit healingbreaths.org.

Creating Your Dream Virtual Practice and Liberating the Doctors of the Future.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Hormone Therapy Centers of America, LLC

Healy World

Booth #520

Booth #123

7 South Main Street, Ste 200 West Hartford, Connecticut, 6107 | United States

1009 sw 21st street, Fort lauderdale, Florida, 33315 | United States

5 Cowboys Way, Ste 300 Frisco, Texas, 75034 | United States

Ph: 407-920-2507

Ph: 469-214-0786

Email: info@biohackingwithfrequencies.com

Email: rhettrichardson@ht-ca.com

www.biohackingwithfrequencies.com

www.ht-ca.com

Healy World creates revolutionary products and opportunities to empower you to thrive and live a life of freedom, passion and joy. The Healy is a small but very powerful device (controlled by your Apple or Android smartphone) that uses Individualized Microcurrent Frequency (IMF) programs to harmonize your Bioenergetic Field for many important areas of life.

HTCA partners with practices to provide a full turnkey solution to implementing Bioidentical Hormone Replacement Therapy into your Practice, Clinic, or Med Spa. Our program consists of five key components: training, dosing, materials, marketing, and support.

Ph: 860-422-4250 Email: rtrenchard@hcradv.com www.hcradv.com Healthcare Risk Advisors is a risk management and consulting company designed to deliver innovative risk placement and risk transfer solutions focusing on the health care practices industry.

Booth #1015

EXHIBITOR LISTINGS

Healthcare Risk Advisors

ImmunoStim Therapeutics

ImprimisRx

InBody

Booth #1220

Booth #916

Booth #1017

3422 Business Center Dr. Ste. 1123, Pearland, Texas, 77584 | United States

1000 Aviara Parkway, 220 Carlsbad, California, 92011 | United States

13850 Cerritos Corporate Dr., Unit C Cerritos, California, 90703 | United States

Ph: 949-241-9715

Ph: 844-446-6979

Ph: 562-306-5960

Email: care@immunostim.io

Email: kharrskog@imprimisrx.com

Email: convention@inbody.com

www.immunostim.io

www.imprimisrx.com

www.inbodyusa.com

Based in Cancun, Mexico - ImmunoStim Therapeutics provides an all-inclusive, revolutionary cancer immunotherapy for most solid tumor situations. Utilizing a one-of-a-kind technique in educating a patient’s dendritic cells, our therapy is unique in creating a full, robust, and specific immune response along with immunological memory. ImmunoStim’s therapy has resulted in successful human treatment and is currently being evaluated in multiple FDA clinical trials. Offering a personalized premium cancer immunotherapy treatment for premium people.

At ImprimisRx we work hard every day to earn your trust by providing quality products and exceptional service! Please let us know how we can continue to improve via the Chat feature on imprimisrx.com. Thank you for allowing us to serve you and your patients!

For 25 years, InBody has revolutionized body composition. Trusted by specialists in the anti-aging, functional, and regenerative medicine fields, InBody DSM BIA devices deliver detailed biometrics to help holistically treat and prevent diseases. In seconds, the InBody Test yields vital metrics like body fat percentage, visceral fat analysis, and BMR, allowing physicians to tailor treatments, predict patient outcomes, and monitor long-term progress for sustained health and wellness.

ANTI-AGING MEDICAL NEWS | SPRING 2022

157

I N T E G R AT I V E P E P T I D E S Orally Bioavailable Peptide Supplements

Jinfiniti: The Longevity Biomarker Company

KBMO Diagnostics

Booth #422

Booth #100

103 W. Main St., Hudson, Michigan, 49247 | United States

1235 Walton Way, Augusta, Georgia, 30901 | United States

Ph: 310-955-6278

Ph: 214-679-0059

4 Business Way, Hopedale, Massachusetts, 2332 | United States

Email: lori@integrativepeptides.com

Email: +1 (706)-831-8882

www.integrativepeptides.com

www.jinfiniti.com

Founded in 2018, Integrative Peptides provides innovative best-in-class peptide supplements that meet the highest standards for safety and purity at a fraction of the cost. Integrative Peptides was born out of the idea that there had to be a better way for patients and their healthcare providers to gain access to safe peptide supplements without a needle.

Jinfiniti provides analysis of actionable longevity biomarkers including NAD and cellular senesce.

Kimera Labs, Inc

Lake Nona Diagnostics

LeadingResponse

Booth #223

Booth #623

Booth #518

2810 N. Commerce Parkway, Miramar, Florida, 33025 | United States

6555 Sanger Rd., , Ste 223 Orlando, Florida, 32827 | United States

4805 Independence Parkway, Ste 250 Tampa, Florida, 33634 | United States

Ph: 305-454-7836

Ph: 954-614-1692

Ph: 813-885-8270

Email: info@KimeraLabs.com

Email: jess.romeo@lakenonadx.com

Email: johnm@leadingresponse.com

www.kimeralabs.com

www.lakenonadx.com

www.leadingresponse.com

A leading exosome biotechnology laboratory specializing in the production of perinatal mesenchymal stem cell-derived (MSC) exosome products for cosmetic use and scientific and clinical research.

We are a CLIA/COLA accredited laboratory in Lake Nona, Florida and Deerfield Beach, Florida. We specialize in a wide array of testing including, HRT & Wellness - Respiratory/COVID-19/ Flu A & B & RSV Molecular UTI - Wound Care - Toxicology- Chemistry analyzer screen/ LCMS full confirm panel. We use “state of the art” instruments including full automation for COVID-19 testing. Our staff is specialized in high complexity testing and motivated to get results to our customers, fast.

With more than 25 years of experience driving new business opportunities for clients in healthcare, LeadingResponse leverages multichannel marketing solutions to connect companies with highly qualified, motivated prospects. As part of its solutions offerings, LeadingResponse develops dynamic digital ads, direct mail campaigns, webinars, in-person events, one-onone appointments, combined with tailored marketing strategies to help every client achieve its unique goals.

Integrative Peptides

EXHIBITOR LISTINGS

Booth #317

158

ANTI-AGING MEDICAL NEWS | SPRING 2022

Ph: 617-933-8130 Email: info@kbmodiagnostics.com www.kbmodiagnostics.com The FIT Test is the most sensitive food test available using patented technology. The multiple pathway approach allows us to look at food sensitivities but also inflammation and gut permeability all from one test. We also provide best in class compliance tools including a personalized meal plan and a patient app. We have an FDA Registered and ISO 13485 compliant manufacturing facility as well as a CLIA High Complexity Laboratory based near Boston, Massachusetts.

MD Prescriptives

Booth #301

Booth #1112

5905 Legacy Drive, 5th Floor Plano, Texas, 75024 | United States

3025 Silver Star Rd., Ste 117 Orlando, Florida, 32808 | United States

1936 Bruce B Downs Blvd., Ste.514, 514 Wesley Chapel, Florida, 33543 | United States

Ph: 310-775-3655

Ph: 877-963-7737 or 407-418-0700

Ph: 727-699-1114

Email: aperez@l-nutra.com

Email: info@MDPrescriptives.com

Email: info@medechocbd.com

www.l-nutra.com

www.mdprescriptives.com

www.medechocbd.com

At L-Nutra, we’re spearheading a global movement to turn sick care into health care. We believe food – one of the few things you consume continually – is a key to health, longevity and preventing and curing disease. We’re using groundbreaking science and natural, plantbased solutions to prove it. In short, we’re here to change the world and usher in an entirely new kind of proactive health care. This is the nutritech revolution.

MD Prescriptives is a clean, professionalgrade line, based on the latest science, clinical experience in thousands of patients spanning decades, and utilizing the most bioavailable forms at therapeutic doses. Our products are based on the 5-point model which aims to optimize functions in the mind, body, hormones, nutrition, and detoxification. By optimizing these key functions, we activate our innate self-repair mechanisms that regenerate our health on a cellular level.

MedEcho is a developed scientific approach to help patients manage pain, sleep, and stress that combines healthcare professional oversight, education, and a simple step-by-step protocol with condition-specific formulas intended to maximize results.

Booth #1116

EXHIBITOR LISTINGS

MedEcho, CBD Derived for Healthcare

L-Nutra

Mp Z

ERO

MERCHANT PREFERRED ZERO

Medical Wave

Medicore, Co. Ltd.

Merchant Preferred Zero

Booth #909

Booth #825

Booth #919

6224 SE Portofino Circle, Hobe Sound , Florida, 33455 | United States

#827~828, Tower D, Hangang Misa 2, Hyundai Knowledge Industry Center, 520 HANAM-SI, Kyonggi-do, 12925 | Republic of Korea

170 Chestnut Ridge Road, Queensbury, New York, 12804 | United States

Ph: 800-595-0577 Email: info@medicalwaveus.com www.medicalwaveus.com Medical Wave is the leader in EPAT technology. We specialize in providing preventative and anti-aging medical professionals the world’s most effective and advanced EPAT technology reporting a 91 % success rate according to clinical studies. Practices across the country utilize our technology to optimize their patient’s quality of life. We are committed to helping physicians in the fields of integrative, preventative, functional and regenerative medicine improve their patient outcomes while creating new revenue streams.

Ph: 82-318-027-7070 Email: bkyoo@medi-core.com www.medi-core.com Medicore established in 1999 as a medical device manufacturer of measuring the autonomic nerve system and plethysmography. By using Heart Rate Variability and Plethysmography technology, it can measure the symptoms of cardiovascular disease and cardiac status accurately and reliably as we have lot of clinical researches and also preventing them at early time as keeping monitor on the overall health condition. We can manufacture the customizing device for the clients by OEM or API integration.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Ph: 540-484-3429 Email: dgalbraith@merchantpreferred.com www.mpzero.net Merchant Preferred Zero allows the business owner stop paying merchant services fees. Growing their monthly profit year after year. This is ideal for any business and simple to integrate. Credit card fees should not be a cost of doing business. MPZero provides the hardware at no cost. No long-term contract.

159

EXHIBITOR LISTINGS 160

Metagenics

Microbiome Labs

Modern Doc Media

Booth #413

Booth #313

Booth #421

25 Enterprise, Ste 200 Aliso Viejo, California, 92656 | United States

1332 Waukegan Rd. 101 E. Town Pl, Ste 210 Glenview, Illinois, 60025 | United States

7455 Caminito Rialto, La Jolla, California, 92037 | United States

Ph: 800-692-9400

Ph: 904-940-2208

Ph: 866-509-5054

Email: Info.customerservice@metagenics.com

Email: info@microbiomelabs.com

Email: info@moderndocmedia.com

www.metagenics.com/

www.microbiomelabs.com

www.moderndocmedia.com

Metagenics was founded on a revolutionary idea: Our genes do not predetermine our health potential, and through nutrition, we can impact how our genes express themselves. Embodied by our company motto—genetic potential through nutrition—this groundbreaking principle drives us to deliver highquality, science-based nutritional supplements, medical foods, and lifestyle programs to support healthcare practitioners in their efforts to help patients achieve their health and wellness goals.

Microbiome Labs is a company focused on improving health outcomes through the modulation of the gut microbiome. The company was built upon three major pillars: clinical research, education, and product innovation. This unorthodox approach is far and away what continues to set Microbiome Labs apart from the rest of the supplement industry. We strive to create unique and effective solutions that help practitioners change lives all over the world.

Modern Doc specializes in Website Design, Development, and Marketing campaigns specifically for Doctors. Our team is staffed with a team with some of the best designers, developers, and SEO experts in the industry. With 15+ years of working on national and local marketing campaigns, this allows us to implement a winning marketing strategy for your practice.

My Practice Connect™

New Life Medical

NewLife Advanced Stem Cells

Booth #821

Booth #823

Booth #824

2744 Summerdale Drive, Clearwater, Florida, 33761 | United States

244 Crystal Grove Blvd., Lutz, Florida, 33558 | United States

Carrera 44 #10 sur 4, Medellin, Antioquia, 50022 | Colombia

Ph: 866-801-8411

Ph: 727-831-8300

Ph: 786-856-0717

Email: info@mypracticeconnect.com

Email: AudreW@newliferegen.com

Email: jeff@gaiastemcells.com

mypracticeconnect.com

www.newliferegen.com/

www.newlifeadvancedstemcells.com

Our web-based Rx Ordering Platform connects you to multiple compounding pharmacies, regenerative medicine companies and more so you can electronically order, track, and manage all of your wellness, lifestyle, and derm meds, plus regen products from multiple sources in one main portal; available with or without 20+ IV Recipes, Protocols, Patient and Provider Resources. We also offer private virtual or in-person training on Biohacking Therapies including IV Therapy, Peptides, NAD+, Sexual Rejuvenation, and much more!

New Life Biologics products are cutting edge technology that can be used in almost every specialty of medicine.

NewLife Advanced Stem Cells provides access to the most modern, safe and effective stem cell medicine, not presently available in the U.S. Laboratories in Latin America culture cells to greatly increase quantity for enhanced results. Intravenous delivery for internal organs and general anti-aging. Topical, spinal, intrathecal, cerebral and joint injections also provided. NewLife partners with U.S. doctors to offer this cutting-edge medicine. Our concierge service guarantees a safe and comfortable patient experience.

ANTI-AGING MEDICAL NEWS | SPRING 2022

NutriDyn

A Partner in Health

Nutrafol

NutriDyn

Booth #612

Booth #921

Booth #113

9503 E. 55th Place, Tulsa, Oklahoma, 74145 | United States

136 Madison Ave., Floor 10, New York, New York, 10016 | United States

5414 Hwy.12, POBox 219, Maple Plain, Minnesota, 55359 | United States

Ph: 800-869-8100

Ph: 888-454-3320

Ph: 800-444-9998

Email: nicole.gemper@numedica.com

Email: partners@nutrafol.com

Email: info@nutridyn.com

www.numedica.com

www.nutrafol.com

www.nutridyn.com

NuMedica® is an NSF® GMP Certified, FDA registered company implementing the latest quality control standards in manufacturing and testing of our formulas. Our formulas are designed with active ingredients for higher performance along with advanced nutrient delivery methods and Enhanced Absorption Technologies™ offering value through increased bioavailability.

Nutrafol is the category creator of hair wellness, providing a science-backed approach to hair health. Its hair growth nutraceuticals target the underlying causes of thinning hair -like stress, hormones, environment and nutrition- and use a patented blend of medical-grade botanicals and standardized ingredients to support the whole body from within. Nutrafol has shown to improve hair growth and reduce shedding in clinical studies, and are recommended by healthcare providers and hair professionals for trusted results.

NutriDyn is proud to be a 3rd generation familyowned business that continues to focus on providing healthcare professionals with premium-quality nutritional supplements and educational services to optimize the health of their patients. We pride ourselves on continually providing cutting-edge research and products to our partners in health by hosting conferences, workshops, and seminars. The purity of ingredients, reliability of claims, and product effectiveness is why many practitioners worldwide trust NutriDyn as their partner in health.

Nutritional Frontiers

OrthoMolecular

OutcomeMD

Booth #1009

Booth #601

Booth #407

3191 Washington Pike, Bridgeville, Pennsylvania, 15017 | United States

28160 W. Northwest Hwy, Ste. 100, Barrington, Illinois, 60010 | United States

145 S Fairfax Ave, Ste 200 Los Angeles, California, 90036 | United States

Ph: 800-332-2351

Ph: 878-OUT-COME

Email: contactus@ompimail.com

Email: sales@outcomemd.com

www.orthomolecularproducts.com

www.outcomemd.com/a4mconference

For over 30 years, Ortho Molecular Products has partnered exclusively with health care providers to deliver nutritional solutions of the highest efficacy. The most trusted voices in health care put their trust in our products to help patients get better, faster. Our commitment to science, careful raw ingredient selection, and strict quality standards goes into every supplement we formulate. To learn more, visit www. orthomolecularproducts.com or call 1-800-332-2351.

OutcomeMD, Inc., based in Los Angeles, CA, is a digital outcome tracking platform that helps healthcare professionals elevate care and allows patients to celebrate their medical outcomes. Patients are empowered with coordinated care, timely symptom management and medical goal transparency. Providers receive data that informs treatment decisions and drives new business. OutcomeMD is delivering the future of healthcare today!

Ph: 412-922-2566 Email: jamiedorley@nutritionalfrontiers.com www.nutritionalfrontiers.com Nutritional Frontiers- where we are breaking through nutritional boundaries! Our mission is to make the world healthy again by providing natural solutions and educational programs for healthcare professionals and their patients worldwide with excellent quality, integrity, research, and service. The Nutritional Frontiers team brings a combined 150+ years of experience in the wellness industry. We provide professional and patient education, wellness events, customized marketing, inventory management, private labeling, and custom formulations.

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

NuMedica

161

Outset Health Booth #1123

Booth #307

6830 Spencer St, Ste 102 Las Vegas, Nevada, 89119 | United States

10719 Norwalk Blvd., Santa Fe Springs, California, 90670 | United States

Ph: 866-461-3293 Email: Hello@OutsetHealth.com

EXHIBITOR LISTINGS

www.outsethealth.com

162

OxyHealth

Ph: 562-906-8888 Email: information@oxyhealth.com www.oxyhealth.com

PatientNow Booth #207 115 INVERNESS DR E, Ste 100 Orlando, Florida, 32819 | United States Ph: 407-793-9254 Email: aneff@patientnow.com www.patientnow.com

Outset Health offers a turn key concierge medicine business model and training for private practitioners. With over 40 years of experience in the Health & Wellness industry, we have gathered insight from providers, patients, and office staff to create clinical programs that deliver real results and optimize efficiency for your practice. For more information on Outset Health visit OutsetHealth.com or contact us at 866-461-3293.

OxyHealth is the world’s leading provider of hyperbaric chambers. Presently, OxyHealth is the pioneer of the industry with over 15,000 chambers in use, more than all other providers combined. OxyHealth continues to remain at the forefront of superior performance, quality and cutting-edge design concepts that far exceed industry safety standards.

Pellecome LLC

Pharmacy Solutions

Pharmanex

Booth #316

Booth #1212

Booth #106

111 Canfield Ave, Ste. A-7, Randolph, New Jersey, 7869 | United States

1921 W. Pioneer Pkwy., Arlington, Texas, 76013 | United States

5023 Oak Trail Drive, Dunwoody, Georgia, 30338 | United States

Ph: 973-714-9136

Ph: 817-274-0050

Ph: 404-538-5608

Email: melissa@pellecome.com

Email: Info@Rxcompound.com

Email: jim.hcalliance@gmail.com

www.pellecome.com

www.rxcompound.com

www.nuskin.com

Pellecome is a medical company that introduced the Re3 Advanced Pellet Delivery System for Men and Women, a medical device kit that enables clinicians of any specialty to insert pellets easily and safely, every time. The kit includes an insertion tool with needle guide, precision scalpel and convenient needle filler. The Pellecome insertion device places pellets in a perfect line every time, providing consistent hormone absorption and minimizing patient discomfort and risk of pellet extrusion.

Pharmacy Solutions is a specialty compounding pharmacy that has been providing positive patient outcomes for over 30 years. Licensed in over 45 states and specializing in: • Formulas for Hair growth • Medical weight loss • Women’s health and wellness • Men’s Health and Wellness • Hormone Pellets • Ophthalmology • Clinical Studies. Pharmacy Solutions provides resources and solutions for providers to offer safe and effective outcomes for patients anywhere in the country.

Pharmanex provides patented nutritional testing equipment and high-quality nutritional products that support systemic health. Our Biophotonic scanner measures antioxidant levels with a 30 second, noninvasive test. Our program creates an additional revenue source for your practice while it supports you in lifting your patients’ health. Published clinical studies substantiate the direct relationship between increased antioxidants and improved oral health. Please stop by our booth for a FREE SCAN.

ANTI-AGING MEDICAL NEWS | SPRING 2022

PatientNow provides leading EMR, practice management, CRM, digital marketing & photo management solutions to help launch, grow, and scale the modern anti-aging practice.

Podcasting & Videos Made Easy

Power2Practice

Booth #325

Booth #924

Booth #616

5454 La Sierra, 203 Dallas, Texas, 75231 | United States

16118 Caldera Ln, Naples, Florida, 34110 | United States

2907 Butterfield Rd., Ste 100 Oak Brook, Illinois, 60523 | United States

Ph: 469-567-3959

Ph: 218-705-7893

Ph: 800-590-7459

Email: debra@phoenixthera-lase.com

Email: shawnsmith@themobilepro.net

Email: sales@power2practice.com

www.phoenixthera-lase.com

www.podcastingandvideosmadeeasy.com

www.power2practice.com

Non-Invasive Laser Therapy for treatment of acute and chronic pain, reduces inflammation related to soft tissue injuries

Podcasting and Videos Made Easy exists to help you scale your time, and grow your business, by training you and your staff how to create & launch a professional quality YouTube promo video AND podcast in ONE weekend of training - even if you’re a non-techie. Through our in-person workshops, follow-up support, and access to our network of trusted partners, we equip providers to harness the power of video and podcast marketing.

Power2Practice is specifically designed for functional and integrative medicine. With features such as customized note templates, cash-based billing module/superbills, specialty lab integrations, Fullscript interface, Power2Practice gives you all the EMR capabilities you expect, plus the specialized features you need. Our intuitive patient portal facilitates patient communication, online scheduling, appointment reminders and much more. Plus, with the addition of our newly released Televisit module, Power2Practice streamlines the efficiencies of the charting, front office and patient experience.

EXHIBITOR LISTINGS

Phoenix Thera Lase

Compounding Pharmacy and Wellness

Precision Compounding Pharmacy and Wellness

Precision Point Diagnostics

Booth #817

Booth #324

100 Biscayne Blvd. Ste 1212, Miami, Florida, 33132 | United States

2657 Merrick Rd., Bellmore, New York, 11710 | United States

9 Dunwoody Park Ste # 121, Dunwoody, Georgia, 30338 | United States

Ph: 305-203-4711

Ph: 516-833-6262

Ph: 678-736-6374

Email: Support@precheckhealth.com

Email: christianstella@precisionpharmacy.net

Email: info@precisionpointdiagnostics.com

www.precheckhealth.com

precisioncompoundingpharmacy.net

www.precisionpointdiagnostics.com

PreCheck Health Services is a strong proponent of early detection and prevention of diseases.

With capabilities of customizing individual formulations, Precision Compounding Pharmacy makes it easy to individualize patient care. We pride ourselves on our high levels of communication, affordable compounded formulations, clinical consultations, and quick door to door deliveries.

Precision Point Diagnostics is an innovator of testing solutions that assist in the diagnosis and management of conditions commonly addressed by Functional Medicine. Our unique profiles address comprehensive approaches to Patient care.

Precheck Health Services Booth #120

ANTI-AGING MEDICAL NEWS | SPRING 2022

163

EXHIBITOR LISTINGS 164

Premier Heart

Prestige Products Direct

Prism Light Pod

Booth #822

Booth #908

Booth #222

731 Duval Station Rd., Suite 107-26, Jacksonville, Florida, 32218 | United States

12440 SW 117 Ct., Miami, Florida, 33186 | United States

13303 E. Adams Aircraft Circle, Englewood, Colorado, 80112 | United States

Ph: 904-907-4542

Ph: 305-234-8081

Ph: 720-231-5384

Email: support@realhearthealth.com

Email: triaddirect@gmail.com

Email: infoprismlightpod@gmail.com,

www.premierheart.com

www.triadaer.com

www.prismlightpod.com

Our goal is to redefine heart health in the 21st Century through Early Detection, Lifestyle Optimization, Reversal and Prevention. Multifunction Cardiogram™ Technology provides testing that is noninvasive, stress and radiation free, cost effective, and 100% evidence based. The system delivers a unique Ischemic Burden Score as well as indicators for 25 other pathological findings. The device is portable and the test takes less than 10 minutes with real-time results using AI technology.

Triad Aer. Professional Air Purification system

Prism Light Pod is the leading provider of whole-body red light therapy systems for the natural health and wellness industry and winner of the 2020 and 2021 LuxLife Award for the Best and Most Powerful WholeBody Red Light Therapy Systems. Developed by a team of passionate health professionals and industrial engineers, Prism Light Pod, headquartered in Denver, CO, is the most powerful and innovative design of fullbody, photobiomodulation systems and distributes its products world wide.

Prosoma LLC

Protocol For Life Balance

PUR-C / VCICI

Booth #914

Booth #417

Booth #124

1212 Court St., Ste D Clearwater, Florida, 33756 | United States

244 Knollwood Drive, Bloomingdale, Illinois, 60108 | United States

Ph: 727-648-2791

Ph: 877-776-8610

650 Cleveland , Ste 952 Clearwater Beach, Florida, 33757 | United States

Email: jrios@prosomacorp.com

Email: sales@protocolforlife.com

www.prosomacorp.net

www.protocolforlife.com

Prosoma is a privately held pharmaceutical and nutraceutical company headquartered in Clearwater, FL. Prosoma is focused on the development, production, marketing and distribution of pharmaceutical and supplement products. Physicians choose Prosoma for their patients’ treatments because of our commitment to providing the world’s highest quality, leading-edge nutraceuticals, delivered with a commitment to the highest cGMP safety and quality standards and exclusively distributed through medical professionals.

Protocol For Life Balance is a well-researched, potent, and efficacious brand of high-quality dietary supplements and natural products sold exclusively through licensed healthcare practitioners. Protocol For Life Balance offers many unique formulas and products, that come with a money -back guarantee if any patient is less than 100% satisfied. Our mission is simply to provide quality products that lead to healthy patients and satisfied physicians. Family Owned and Operated. www.protocolforlife.com 877-776-8610

ANTI-AGING MEDICAL NEWS | SPRING 2022

Ph: 888-724-1953 Email: info@PUR-C.com www.pur-c.com PUR-C is a leading brand of Vitamin C products, (ULTRA-C™ and ESSEN-C™) made of ultra-pure Sodium Ascorbate. Vitamin C is a nutrient your body needs to form blood vessels, cartilage, and collagen. Vitamin C is vital to the healing process. PUR-C is physician developed, and exclusively sold to healthcare providers. PUR-C optimizes the immune system of patients with excessive oxidative stress including acute/chronic infections, injuries, periodontal disease, environmental toxicity, sleep disorders, ocular health and more.

Qualgen

Booth #1201

Booth #1025

1014 Gateway Blvd., Boynton Beach, Florida, 33426 | United States

301 Enterprise Dr., Edmond, Oklahoma, 73013 | United States

Ph: 561-965-7777

Ph: 405-551-8216

Email: info@purewavenow.com

Email: jpeverley@qualgen.us

www.purewavenow.com

www.qualgen.us

PureWave is a Technology Company that focuses on Bioenergetics; the science of how energy is transferred into the cells, tissues, organs and the whole body!. Energy has a fundamental influence on our health. At PureWave we do research, product development & distribution of energy based wellness devices for consumer and professional applications that also do not emit harmful EMF’s.

Qualgen is an FDA registered 503B outsourcing facility with state-of-the-art sterile labs that meet cGMP requirements. Qualgen has a wide range of compounded bio-identical estradiol and testosterone hormone pellets, testosterone cypionate, BLT Cream and more coming soon! Qualgen offers same-day shipping, easy account set up and superior customer service.

Quest Diagnostics Cleveland HeartLab

Quicksilver Scientific

Rapid Release Therapy

Booth #1224

Booth #513

Booth #712

6701 Carnegie Ave, Ste 500 Cleveland, Ohio, 44103 | United States

1960 Cherry St, LOUISVILLE, Colorado, 80027 | United States

3303 Harbor Blvd.,, Ste D-10 Costa Mesa, California, 92626 | United States

Ph: 216-213-3656

Ph: 303-531-0861

Ph: 949-415-4778

Email: caroelise.f.belmont@questdiagnostics. com

Email: support@quicksilverscientific.com

Email: info@rapidreleasetech.com

www.quicksilverscientific.com

www.rapidreleasetech.com

Quicksilver Scientific® is a leading manufacturer of advanced nutritional systems with a focus on detoxification. We specialize in superior liposomal delivery systems and heavy metal testing to support optimal health. Our advanced liposomal supplements are highly absorbable and support the body in the elimination of the broad range of toxins we’re exposed to. We are passionate about health and well-being and are committed to improving the lives of everyone we touch.

Innovative high speed vibration therapy device uses dual motion and 5 built in treatment heads to allow precise targeting of the tiniest to largest muscles, gently releasing restrictions in the fascia and connective tissue, and increasing flexibility. Stop by for a quick session to release your pain and tension, leaving you refreshed, relaxed and pain free.

www.questdiagnostics.com Quest Diagnostics empowers people to take action to improve health outcomes. Derived from the world’s largest database of clinical lab results, our diagnostic insights reveal new avenues to identify and treat disease, inspire healthy behaviors and improve health care management. Quest annually serves one in three adult Americans and half the physicians and hospitals in the United States, and our 47,000 employees understand that, our diagnostic insights can inspire actions that transform lives.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Booth #1023

805 Trade St. NW, Suite 101-A, Ste 101-A Concord, North Carolina, 28027 | United States Ph: 704-490-4111 Email: info@quartermastertax.com www.quartermastertax.com Quartermaster Tax Management is a proactive tax planning firm that specializes in creating taxfree income for our clients through Research & Development tax credits in the Medical and Healthcare space.

EXHIBITOR LISTINGS

Quartermaster Tax Management, LLC

PureWave Technologies

165

EXHIBITOR LISTINGS

Red Light - Wellness

Refine USA

Regenative Labs

Booth #1020

Booth #101

Booth #723

4515 Miami Street, Saint Louis, Missouri, 63116 | United States

340 3rd Ave South, Ste C Jax Beach, Florida, 32250 | United States

1700 West Main St., Ste 3 Pensacola, Florida, 32502 | United States

Ph: 314-760-5604

Ph: 904-240-4269

Ph: 800-891-3452

Email: redlightbeds@gmail.com

Email: support@refineusa.com

Email: tristessa@regenativelabs.com

www.redlight-wellness.com

www.refineusa.com

www.regenativelabs.com

Family-owned with 42 years experience, Red Light Wellness manufactures and distributes red/nearinfrared(NIR) beds and equipment from our 75,000sq ft facility in St. Louis, MO. Our patented design delivers results your clients can see through weight loss, pain reduction and more. Our bed produces so many results Logan University is using our bed for research and education. Our wellness collection boosts sales, converts existing clients into photobiomodulation clients and attracts new clients to increase your ROI.

Refine USA, LLC located in Jacksonville, FL has been a market leader in the manufacturing and distribution of premier aesthetic technologies for more than 18 years. We pride ourselves on designing and developing medical devices that meet the clinical and financial needs of aesthetic health care providers. The FDA Cleared Rejuvapen NXT® Microneedling System, the PureSpin® PRP System and the Facelite USA LED Series are just a few examples of our “market-changing” technologies.

Regenative Labs is a human tissue allograft manufacturer, specializing in birth tissue (amniotic membrane, umbilical cord).

Rupa Health

Seca

Self Care Catalysts

Booth #412

Booth #425

Booth #1218

177 Townsend St., #528 San Francisco, California, 94107 | United States

13601 Benson Avenue, Chino, California, 91710 | United States

477 Richmond Street W, Ste.306, Toronto, Ontario, M5V3E7 | Canada

Ph: 800-542-7322

Ph: 727-249-8241

Email: info.us@seca.com

Email: leigh.mack@alirahealth.com

www.seca.com/554

www.selfcarecatalysts.com

As a global leader in healthcare medical technology, seca provides over 180 years of expertise in measuring systems, scales, body composition analysis, vital monitors, software, and service support with scientifically validated precision. With the diagnostic aid of seca medical Body Composition Analyzer, a patient’s health baseline is determined using key components (fat mass, visceral adipose tissue, skeletal muscle mass, body water), providing a comprehensive overview of one’s health status to tailor therapy and optimize treatment.

Self Care Catalysts is a patient-centered digital health company that puts patients at the center and intersection of human networks, technology and science. We enable patients to become active and informed participants of their journey, while helping healthcare stakeholders optimize time to meet patient needs.

Ph: 208-422-4536 Email: hello@rupahealth.com www.rupahealth.com Rupa Health is a platform for ordering functional medicine lab tests. Order, track, and get results from 20+ lab companies in one place. We also take patient support off your plate.

166

ANTI-AGING MEDICAL NEWS | SPRING 2022

Science Solutions ™

Skin Science Solutions

Sofwave

Specialist Training by The Institute

Booth #1107

Booth #320

Booth #917

180 Rt. 117 bypass, Bedford Hills, New York, 10507 | United States

1211 Puerta Del Sol, 200 San Clemente, California, 92673 | United States

200 Glades Rd, Ste 1 Boca Raton, Florida, 33432 | United States

Ph: 914-907-1850 Email: info@skinsciencesolutions.com www.skinsciencesolutions.com Skin Science Solutions is the exclusive US distributor for Pagani and i-Tech lines of non-invasive body contouring / wellness devices. Among the products we distribute include: Icoone Roboderm; The Pagani Cryo and STAR T Shock; STAR Face and STAR Lymphactive. We support each product with training, marketing, technical and aesthetic support.

Ph: 855-763-9283 Email: info@sofwave.com www.sofwave.com Sofwave™ breakthrough, non-invasive Synchronous Ultrasound Parallel Beam Technology SUPERB™ FDA-cleared to lift the eyebrow, lift submental tissue, improve facial lines and wrinkles.

Ph: 954-993-4567 Email: info@stcell.com specialist.training Specialist Training by The Institute offers Regenerative Medicine training packages that take place in either a modern clinic setting or your own clinic, as well as procedure supply kits designed specifically for these protocols. Trainees are taught by industry pioneer, Joseph R. Purita, MD and his expert staff of specialists. Learn hands-on how to do EBO2, the most advanced ozone therapy on the market, as well as autologous cell therapy and other biologic modalities.

Stellar Biomolecular Research

Synergy Med Sales

TA Sciences

Booth #1012

Booth #1022

Booth #501

Klostertrabe 205, Edenkoben Edenkoben, Rheinland-Pfalz, 67480 | Germany

1000 Jupiter Rd., Ste.700, Plano, Texas, 75074 | United States

420 Lexington Ave., #2900 New York, New York, 10170 | United States

Ph: 608-844-8989

Ph: 214-545-4206

Ph: 212-588-8805

Email: info@sbi-europe.com

Email: doug@ajmpmedical.com

Email: eric@tasciences.com

www.sbi-europe.com

www.synergymedsales.com

www.tasciences.com

SBR engages manufacturing consultants, biochemist and biomolecular research therapists to innovate a diverse array of healthcare and aesthetic products and services for consumers who seek alternative regenerative solutions against premature aging and debilitating chronic diseases through their brand MF Plus and LAB RMS.

AJMP MEDICAL is a family of companies and brands; Synergy MedSales, Medex Trade and CatchMD, serving new and certified pre-owned distribution points from an array of best in-class technologies and energy based devices with head-quarters in Dallas- Fort Worth. Our company’s vision derives from the modernization and development of aesthetic medicine therapies with exclusive attention towards supplying efficacious technologies and optimizing return-on-investment for our valued clients.

T.A. Sciences® was founded in New York City by Noel Thomas Patton in 2002. T.A. Sciences® is dedicated to creating research-based, clinically tested products that help address telomere shortening through Telomerase Activation. T.A. Sciences® is widely recognized as the leader in the field of Telomere Biology. T.A. Sciences® spends over $1 million each year on leading edge scientific research, including double-blind, placebocontrolled studies proving the safety and effectiveness of its premiere product TA-65®.

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

REDEFINING BEAUTY

167

The Center For Regenerative Medicine

The DNA Company

Booth #525

Booth #1024

200 Moore Drive, Nicholasville, Kentucky, 40356 | United States

1001 NE 125th St., Miami, Florida, 33161 | United States

3425 Laird Road Unit 2, Mississauga, Ontario, L5L5R8 | Canada

Ph: 859-887-0013

Ph: 305-891-4686

Ph: 416-919-9509

Email: ataylor@tailormadehealth.com

Email: wilson@genorthix.com

Email: kashif@thednacompany.com

www.tailormadecompounding.com

www.neuroregenesis.com

www.thednacompany.com

The Tailor Made Difference. A Higher Standard of Care. As experts in compounded medications, we provide custom wellness solutions to satisfy the unique needs of all types of patients. Our individualized treatments not only yield better health results - but maintain them for years to come. Visit us at www. tailormadecompounding.com to learn more about our integrative care treatments!

The Center for Regenerative Medicine in Miami, Florida concentrates on helping Patients to get back to a functional level of life and their activities using Regenerative medicine. The center’s expertise is in treatment of conditions of Neurological, Ophtomological and Orthopedics. We have developed and teach therapies focused on treatment and management of patients in need of Regenerative medicine. Our team includes health professionals organized around a central theme.

The DNA Company has developed the most comprehensive DNA test ever. Trusted by leading biohackers such as Dave Asprey, what sets The DNA Company apart is the suite of 38 reports covering six core systems for human optimization. The DNA Company partners with world class leaders such as Dr. BJ Fogg, to deliver not just data but easily actionable insights. We help you unlock your genome to prevent diseases, slow aging and optimize performance.

The JOI Group

Top Doctor Magazine

Triple Hair

Booth #620

Booth #1121

Booth #1214

45 Technology Pky. S, Ste.225, Peachtree Corners, Georgia, 30092 | United States

1441 Brickell Ave. Ste 301, Miami, Florida, 33131 | United States

855 Dieppe Blvd., Dieppe, New Brunswick, E1A7R8 | Canada

Ph: 434-215-9002

Ph: 514-824-7223

Email: lillian@topdoctormagazine.com

Email: jlachapelle@triplehair.ca

www.topdoctormagazine.com

www.triplehair.ca

Top Doctor Magazine is on a mission to be the influencing voice among the medical community, inspiring people to proactive health.

Triple Hair is a biotechnology company specializing in developing innovative treatments for alopecia. Founded by Dr. Houfar Sekhavat, a former hair loss sufferer, the company has developed hair growth formulas showing significant regrowth in clinical studies. Therapy-07 is a patented triple combination of minoxidil, finasteride and latanoprost working synergistically to stop hair loss and induce hair regrowth. Therapy-16 (RIZN) and Therapy-17 (PLENTY NATURAL) are effective patented drug-free solution combining natural active ingredients.

Tailor Made Compounding

EXHIBITOR LISTINGS

Booth #801

Ph: 770-838-3570 Email: info@thejoigroup.com www.thejoigroup.com JOI is a company focused on supporting independently owned medical practices. We help navigate the frustrations of owning and operating a medical practice. We do so by quickly and easy implementing monthly recurring revenue streams into your practice. We also serve as a group purchasing organization, helping you save money on the high quality products and services you use everyday. Our goal is simple - we help you optimize every aspect of money and medicine.

168

ANTI-AGING MEDICAL NEWS | SPRING 2022

Überlube

Unified Office

Booth #512

Booth #1125

Booth #623

881 Corporate Drive, Lexington, Kentucky, 40503 | United States

7316 Ridgeway, Skokie, Illinois, 60076 | United States

20 Trafalgar Square, Ste.302, Nashua, New Hampshire, 3063 | United States

Ph: 937-570-0471

Ph: 773-454-5188

Ph: 603-842-9977

Email: hannah@trudiagnostic.com

Email: cheryl@uberlube.com

Email: ken.stess@unifiedoffice.com

www.trudiagnostic.com

www.uberlube.com

www.unifiedoffice.com

TruDiagnostic is a leading health data company with a focus on multi-omics and insights gained from the fluid epigenome. Established in early 2020, after development and build out of its 10,000 square ft state of the art laboratory with Illumina equipment and consultation it launched its first physician and patient test “TruAge”. Today, TruDiagnostic has built a premiere epigenetic database of DNA Methylation markers and covariates which is one of the largest in the world.

Überlube is a luxury silicone lubricant designed to enhance intimacy. Physician recommended, überlube is not harmful to healthy bacteria or pH levels. Überlube is cruelty free with no animal products, vegan friendly and contains no alcohol, gluten, glycerin, parabens, scents or flavors. Überlube is latex safe. Not recommended for use with silicone products. Uberlube for: Sex: transfer sensation while reducing friction. Sport: long lasting anti-chafe. Style: finish hair with a perfect understated sheen

Unified Office is the only reliable platform that goes to work for you and your patients. Unified Office Telemedicine Patient-Provider eXchange is a powerful ‘Business Class’ communications managed service and analytics software that assists Doctors, their practice and their office managers drive revenue capture, increasing operational effectiveness, and creating a better patient-user experience in the newly developing era of Telehealth. Unified Office delivers the most fully featured, cost effective and easy to use telemedicine solution.

University Compounding Pharmacy

Vasolabs

Venus Concept

Booth #607

Booth #820

Booth #1106

1875 3rd Ave., San Diego, California, 92101 | United States

1414 South 600 West, Wood Cross, Utah, 84087 | United States

235 Yorkland BLVD, Ste 900 Toronto, Ontario, M2J 4Y8 | Canada

Ph: 800-985-8065 ext. 5700

Ph: 801-797-2297

Ph: 877-226-0510

Email: dave@ucprx.com

Email: practice@vasolabs.com

Email: info@venusconcept.com

www.ucprx.com

www.vasolabs.com

www.venusconcept.com

UNIVERSITY COMPOUNDING PHARMACY (UCP) a nationally recognized leader in drug and device therapies. For 27 years our expert Pharmacists and experienced Physician Liaison team have been dedicated to support an unbiased product line, devising the management of BHRT conditions for your patients. We meet FDA & BOP prescription requirements and dispense in nearly 50 states. COMPOUNDED: THYROIDS, ESTROGENS, PDE-5 INHIBITORSBIOIDENTICAL HORMONES.

Vasolabs offers preventive heart screenings at affordable prices to help save lives. Partnering with physicians and provide the most accurate, complete cardiovascular diagnostic testing to help them in their primary goal of preventing and eliminating the need for treatment. The more your patients know, the more they can take control of their situation and improve their heart health for the better. We provide the tools you need for quick and accurate diagnosis for your patients.

Venus Concept Inc. is a global leader in the medical aesthetic industry, pairing best-in-class technology with our industry-unique comprehensive business solutions. We offer a broad product portfolio of minimallyinvasive and non-invasive aesthetic and hair restoration device platforms that address today’s most in-demand aesthetic needs.

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

TruDiagnostic

169

EXHIBITOR LISTINGS 170

Vertisis Custom Pharmacy

Vitalounge

Viviscal PRO & XFusion by Toppik

Booth #423

Booth #623

Booth #318

9343 E. Bahia Drive, Ste 200 Scottsdale, Arizona, 85260 | United States

8081 Turkey Lake Rd., #620, Orlando, Florida, 32819 | United States

500 Charles Ewing Blvd, Ewing, New Jersey, 8628 | United States

Ph: 303-476-3447

Ph: 941-932-5866

Ph: 786-568-6393

Email: matthewb@vertisis.com

Email: hello@vitalounge.com

Email: taryn.weinstock2@churchdwight.com

www.vertisis.com

www.vitalounge.com

www.vxprohair.com

Vertisis is one of the most unique sterile-injectable compounding pharmacies in the United States. Our focus is on going “above and beyond” traditional compounding pharmacies by raising the standards of 503A compounding pharmacies to include exceptional products, unique delivery, advanced education, and an amazing relationship with health care providers with a seamless delivery of care. We are Vertisis Custom Pharmacy, your custom compounding pharmacy for integrative and naturopathic IV therapies and compounds.

VitaLounge is a premier nutrient IV therapy wellness clinic

Science meets aesthetics to give your patients a complete system that targets thinning hair inside and out. While clinically proven Viviscal PRO Supplements promote existing hair growth in 6-months, XFusion by Toppik Keratin Hair Fibers conceal thinning hair instantly. Together, they offer the perfect complement to your hair loss treatments and procedures, giving patients the short-term and long-term solutions that they need to fight the effects of hair loss and boost their confidence.

Weave

Wellness Clinic Marketing

Wellness Pharmacy

Booth #915

Booth #717

Booth #321

1331 W. Powell Way, Lehi, Utah, 84043 | United States

1470 Biscayne Blvd, Miami, Florida, 33132 | United States

3401 Independence Dr.,, Ste 231 Birmingham, Alabama, 35209 | United States

Ph: 888-545-8880

Ph: 305-900-5505

Ph: 800-227-2627

Email: SDRS@GETWEAVE.COM

Email: alex@wellnessclinicmarketing.com

Email: info@wellnesspharmacy.com

www.getweave.com

www.wellnessclinicmarketing.com

www.wellnesspharmacy.com

Weave is the all-in-one customer communication and engagement platform for small business. From the first phone call to the final invoice and every touchpoint in between, Weave connects the entire customer journey. Weave’s software solutions transform how local businesses attract, communicate with, and engage customers to grow their business.

Helping Medical Wellness Clinics and Men’s Health centers get patients for hormone therapy, sexual health, cosmetic, and other regenerative & anti-aging procedures. We do this by implementing a proven Patient Acquisition System that includes advanced marketing strategies to position medical practices in front of people looking for better healthcare. So in the big picture, by helping medical practices service more patients, we indirectly assist many people in getting better health and longer, more productive lives.

With over 50 years of compounding experience, Wellness Pharmacy is considered the industry leader in quality and customer service. Our specialties include chelation, bioidentical hormones, autism support, and preservative-free injectables. Wellness Pharmacy is also the only pharmacy to successfully patent the preparation of injectable glutathione. PCAB-accredited.

ANTI-AGING MEDICAL NEWS | SPRING 2022

Zizion ZRT Laboratory

Booth #225

Booth #701

141 NW 20th Street Suite G1, Boca Raton, Florida, 33431 | United States

8605 SW Creekside Place, Beaverton, Oregon, 97008 | United States

Ph: 561-221-1000

Ph: 866-600-1636

Email: Bruce@Zizion.com

Email: info@zrt.com

www.zizion.com

www.zrtlab.com

Zizion Group is a medical distribution company with a focus on natural integrative therapies. We bring technologically advanced products, targeted training, and innovative marketing expertise, to empower physicians to expand their practice. We are an endto-end provider, identifying appropriate solutions and deployment methodologies while working with your team to ensure success. You are never considered a customer; you are a valued physician partner.

ZRT laboratory, a CLIA-certified commercial and research laboratory, is the recognized leader in innovative and meaningful hormone and wellness testing. ZRT has pioneered testing methods for hormones, neurotransmitters, heavy metals and more, offering health care professionals convenient testing options in different body fluids including saliva, dried blood spot, dried urine, and serum. ZRT provides comprehensive test results that allow providers to create personalized treatments for optimal outcomes, with the help of our knowledgeable clinical consultants.

ANTI-AGING MEDICAL NEWS | SPRING 2022

EXHIBITOR LISTINGS

Zizion Group Inc.

171

Dairy-Free IgG

SBI Protect Serum-derived bovine immunoglobulins Helps maintain a healthy intestinal immune system by binding a broad range of microbes and toxins within the gut lumen

43 human clinical studies IMMUNE HEALTH

Highest IgG concentration available

Maintains gut barrier function

VISIT BOOTH 601 TO RECEIVE A

FREE BOTTLE OF SBI PROTECT* *Promotion open to licensed medical practitioners. Available while supplies last.

Evidence-Based Formulations. Uncompromising Raw Materials. Patients Get Better Faster. For more than 30 years, Ortho Molecular Products has partnered with health care providers to provide the very best supplements with an unwavering commitment to efficacy.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. LT-TS-003

The DUTCH Test® is more than a comprehensive hormone test with actionable results.

Our team helps

providers become hormone experts through industry-leading research and education.

We want to profoundly change lives by guiding providers through complex endocrine questions they face every day with: · Clinical support · Monthly webinars · Peer-reviewed research · Instructional videos

Visit DUTCHTest.com to Become a Provider Today.

Celebrating 30 years of Innovation in Medical Education DECEMBER 9-11 LAS VEGAS, NV

A4M MMI | Anti-Aging Medical News - Spring 2022

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Exhibitor Listings