A4M MMI | Anti-Aging Medical News - Winter 2021 by Tarsus Medical

Dear Colleagues, Welcome to the 29th Annual World Congress presented by the American Academy of Anti-Aging Medicine (A4M). We could not be more pleased to be back LIVE in Las Vegas, in person, and reinvigorated to build a more resilient model of health care delivery that focuses on science-based, whole-person care. The last two years have been filled with unprecedented challenges as the health care field battled the COVID-19 pandemic alongside the entire world. But we at A4M can see an opportunity within the chaos of this health crisis that exposed the vulnerability of patients, providers, and communities. The title of our assembly this year says it all: “The Next Chapter: Unmasking the Hidden Epidemic.” We will embark on a new chapter of care with keen attention to underserved patient populations, environmental health, and other important topics that were brought sharply into focus by the pandemic. The next four days will deliver exciting insights, strategies, therapeutics, and resources to confidently lead the field into a future we didn’t expect – but one we will meet with a renewed commitment to integrative and innovative approaches to health. Beginning on Thursday with carefully curated preconference workshops, our agenda kicks off by addressing some pertinent topics in anti-aging and complementary medicine. The exploration of these valuable clinical issues is sponsored by leaders in diagnostic and preventative medicine. Then, as the conference kicks off on Friday, keynote speakers who are thought leaders in the fields of nutrition and habit change, brain health and regeneration, gut microbiome, and genomics will present forward-focused sessions to inspire a restructuring of the current health care landscape. Compelling topics covered include hormone balance and modulation, opioid alternatives to managing pain, photobiomodulation and brain health, blood markers in systemic longevity, epigenetic engineering, and psychedelics in neuroplasticity and depression.

Ronald Klatz MD, DO

Co-Founder

Robert Goldman

A4M and its parent company, Tarsus Medical, are determined to provide both new and MD, PhD, DO, FAASP returning participants transformative live clinical experiences with unparalleled attention Co-Founder to the health and safety of all our stakeholders. Physical distancing, increased attention to cleanliness and hygiene, and a new event format informed by local COVID-19 guidelines are just some of the ways we are committed to keeping everyone healthy. On behalf of the entire A4M team we want to thank each of you for bringing vision, expertise and commitment to this event. As the leaders in the field, you have the knowledge, motivation, and experience to wholly transform the modern health care landscape — you are truly our greatest asset. Please enjoy your stay in Las Vegas and accept our sincere thanks for your continued support. In Good Health, Ronald Klatz, MD, DO & Robert M. Goldman, MD, PhD A4M Founders

ANTI-AGING MEDICAL NEWS | WINTER 2021

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ANTI-AGING MEDICAL NEWS | WINTER 2021

ANTI - AGING MEDICAL NEWS | WINTER 2021

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

Exhibitor Index ...........................164

Product Announcements .............80

Exhibit Hall Floormap .................168 Exhibitor Listings ........................169

ARTICLES

26 36 44 52 62 68

76 122 128 134 140 148 158

Fasting with Food: Leveraging Nutrition for Healthy Aging By: Lacy Kuester, MS, MPP, RDN

How Old Are You, Really? It’s All In The Pulse By: Joseph M. Raffaele, MD

Distinctive Detoxification. The Case For Including The Microbiome In Detox Strategy By: Jocelyn Strand, ND - Director of Clinical Education, Biocidin®

Glycomics In Clinical Action: The Endothelial Glycocalyx By: Helen Messier, PhD, MD

The Roles of NAD+ in Healthy Aging and Age-Associated Disorders By: Kendra Whitmire, MS, CNS

CBD and Pain By: Sahar Swidan, PharmD, BCPS, ABAAHP, FAARFM, FACA

Improving Survival Through the Elimination of Circulating Pro-metastatic Clusters By: Mark A Rosenberg, MD

The Future of CIRS By: Andrew Heyman, MD, MHSA

Glutathione Supplementation: What the Clinical Research Shows Reprinted with permission from Emerson Ecologics Element Issue 3 2021

The Intestinal Microbiota and the effect on Food Sensitivities and the Gut-Brain Axis By: Brent L. Dorval, PhD

Elements of Ageless Skin By: Kasey Hutchinson

A Systems Biology Approach to Biological Aging: The Longevity Wheel By: Quicksilver Scientific

Peptide Therapeutics: The Future is Now By: Jim LaValle, RPh, CCN, MT

ANTI-AGING MEDICAL NEWS | WINTER 2021

A4M | MMI

PLANNING COMMITTEE

Andrew Heyman

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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 | WINTER 2021

DECEMBER 12TH � 12:40 PM

Must be Present to Win Winner has the chance to win the car or take $30k in cash. The Lexus on display and the prize that will be won may diﬀ er from the photograph.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Drawing - Exhibit Hall

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Sunday December 12th at 12:40 pm Your entry form can be found in your attendee bag or at the A4M/MMI booth #4055. Winner has the chance to win the car or take $30k in cash .

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PME SESSIONS

(NON-CME)

THURSDAY | DECEMBER 9TH 6:15 pm The Nuts and Bolts Management to Hormonal BioIdentity Presented by:

Ron Rothenberg MD, Barbie Barrett MD, Andrew Jurow MD, Kris Hart, NP

Locati on:

Titian 2302

6:15 pm The Spectrum of Phytochemicals for Whole-Body Wellness

Presented by:

Deanna Minich, MS, PhD, CNS, FACN

Locati on:

Veronese 2402

ANTI-AGING MEDICAL NEWS | WINTER 2021

Sponsored by:

FRIDAY | DECEMBER 10TH 6:30 am - 7:30 am | Breakfast - *RSVP Necessary Strengthening the Clinical Connection: Expert Use of Diagnostic Testing in the Integrative Medicine Practice Presented by:

James LaValle, RPh, CCN & Jaclyn Smeaton, ND

Locati on:

Veronese 2402

6:15 pm Fasting and FMD® - Learn About the Latest Science and Findings Behind This Nutritional Breakthrough Presented by:

James LaValle, RPh, CCN

Locati on:

Veronese 2402

6:15 pm Thyroid and The Adrenals: It Is All About Balance Presented by:

Pamela W. Smith, M.D., MPH, MS

Locati on:

Titian 2302

Sponsored by:

SATURDAY | DECEMBER 11TH 6:30 am - 7:30 am | Breakfast - *RSVP Necessary The Microbiome, Inﬂammation and Leaky Gut Presented by:

Mahmoud Ghannoum, PHD, MSC, MBA, FAAM, FIDSA

Locati on:

Veronese 2402

6:15 pm The Longevity Wheel: Application of Longevity Protocols Presented by:

Christopher Shade, PhD

Locati on:

Titian 2302

6:15 pm

Sponsored by:

The Role of Telomeres and Viral Infections in Immune Senescence Presented by:

Joseph Raﬀaele, MD

Locati on:

Veronese 2402

ANTI-AGING MEDICAL NEWS | WINTER 2021

JOIN US FOR

The Spectrum of Phytochemicals for Whole-Body Wellness The average American eats well below the suggested amount of fruits and vegetables on a daily basis and dietary fiber intake being at about half of the recommended level. In this presentation, Dr. Deanna Minich ‘makes the case’ from a body and mind perspective how important it is to incorporate more plant-based foods of all types into the diet through the principles of color, creativity, and variety.

E V E N I N G

W O R K S H O P

JOIN US: Thursday, December 9th @ 6:15pm Room: Veronese 2402

PRESENTED BY

Dr. Deanna Minich

Dr. Minich iis a nutrition researcher, educator, and functional medicine-trained clinician with a unique approach to nutrition that combines physiology and psychology.

•

N O N - C M E

800.522.4762

•

www.gdx.net

PRODUC T

SHOWC A SE (NON-CME)

Location:

Exhibit Hall FRIDAY | DECEMBER 10TH 11:30 AM

Unlocking Cellular Potential – Key Nutrients To Revitalize Mitochondrial Health

Sponsored by:

Presented by: Abby Klosterbuer, PhD, RDN Medical Affairs Manager, US - Nestlé Health Science Erin Quann, PhD, RDN Global Medical Affairs Lead - Healthy Aging & Cellular Nutrition Nestlé Health Science Sponsored by:

12:00 PM

Senolytics And Mitochondria Treatments: The Best Way To Pair Available Therapies For Longevity

12:30 PM

Postbiotics And Mitochondrial Health: Mitopure, The First And Only Postbiotic To Improve Mitochondrial Health By Activating Mitophagy

Presented by: Blake McLeod, PharmD, C.O.O. Sponsored by:

Presented by: Anurag Singh MD, PhD, Chief Medical Officer, Amazentis Life Science

Sponsored by:

1:00 PM

A Metabolomic Approach to Diet, Exercise, and Gut Health Presented by: Michael Chapman, ND

Sponsored by:

4:30 PM

Make A Difference & A Fortune Sharing Your Message Presented by: Clint Arthur

Sponsored by:

5:00 PM 16

Optimizing Muscle Growth in Women with EMSCULPT NEO and Testosterone Presented by: Melinda Silva, MD, FAARM, ABAARM

ANTI-AGING MEDICAL NEWS | WINTER 2021

SATURDAY | DECEMBER 11TH Sponsored by:

11:30 AM

12:00 PM

How to Use Loyalty and Rewards Programs in 2021 Presented by: Philipp Sitter, CEO, RepeatMD

Why You Will Live 30 Years Longer than You Thought Medical Breakthroughs are Happening Now!

Sponsored by:

Presented by: Daniel Montano

12:30 PM

Cosmetics from Signature Biologics: Transforming MedSpa from Artificial Products to Natural Origin Perinatal Products

Sponsored by:

Presented by: Dan Wagner, VP of Sales & Dr. Ramon Coronado, PhD., VP of Regulatory Affairs & Technology Transfer Sponsored by:

1:00 PM

Setting Your Practice Apart & Growing Revenue with Fotona Presented by: Dr. Raja Nalluri

Sponsored by:

4:30 PM

Treating Cancer with Personalized Dendritic Cells Presented by: Matthew Halpert

Sponsored by:

5:00 PM

Grow Your Business with LeadingResponse Presented by: John McCloskey

SUNDAY | DECEMBER 12TH 1:00 PM

Martial Arts Presentation

Sponsored by:

AntiAging Health Secrets of Hollywood Movie Stars and World Champion Martial Artists An array of famed speakers comprised of World Champion martial arts experts and Hollywood celebrity movie stars will be on the Expo stage to present their personal fitness training secrets and dietary programs on how they stay young, youthful and strong even though many in their 60s and beyond. This has become an annual seminar with these renowned individuals with new ones presenting annually. Robert M. Goldman MD, PhD, DO, FAASP · World Chairman-International Medical Commission · Co-Founder & Chairman of the Board-A4M · Founder & Chairman-International Sports Hall of Fame · Co-Founder & Chairman-World Academy of Anti-Aging Medicine · President Emeritus-National Academy of Sports Medicine (NASM) · Chairman-U.S. Sports Academy’s Board of Visitors

ANTI-AGING MEDICAL NEWS | WINTER 2021

2021GRADUATES

We would like to extend a well-deserved congratulations to our 2021 graduates! These Fellows have completed the necessary clinical coursework for the following: Fellowship in Anti-Aging, Metabolic and Functional Medicine; Fellowship in Integrative Cancer Therapy; Fellowship in Stem Cell Therapy; and the Aesthetic Anti-Aging Fellowship. Best wishes to this year’s graduates!

Safia Anwar Muhammad MBBS

Khaled Dewan

DDS, IFMCP, ABAAHP, FAAMM

Nicole Guidish

PharmD, CPh, FAAMM, ABAAHP

Varsha Arun

Elizabeth Brinson

MBBS, DDVL, DNB

MSN, FNP, FAAMFM, ABAAHP

Laura Donnelly

Florida Escudero

RNBN, MN, NP, ABAAHP, FAAMM

Tammy Harris

MSN, MSHS, APRN, FAAMFM, ABAAHP

MD, FPCP, FSCT

Adriane Hines

DC, DABCI, ABAAHP

Katherine Carlson ARNP-BC, ABAAHP, FAAMM

Melissa Fleszar

DNP, MSN, BSN, ADN, APRN-BC, ABAAHP, FAAMM

Irena Kodz

MD, ABAARM, FAAMFM

ANTI-AGING MEDICAL NEWS | WINTER 2021

Christopher Chappel

MBBS, FRACGP, IFMCP, FAAMM, ABAARM

Gianfranco Giacca

RPh, ABAAHP, FAAMM

Natchalee Kunaporn

MD, ABAARM, FAAMFM

Jeremy Lam

Arturo Lizano

MD, ABAARM, FAAMFM

Amy Oden

Shakkeela Padanilathu Kunjummar

MSN, APRN, FNP-C, FAANP, FAAMM, ABAAHP

Robert Richard

DO, FAAMFM, ABAARM

MBBS, DCH, CCFP, FCFP, FAAMFM, ABAARM

Kimberly Suriano

MD, FACOG, ABAARM, FAAMFM

Sahar Taha

MBBS, MBA

Yoko Masuda

MD, ABAARM, FAAMFM

Joanne Pautz

MTech Hom, ABAAHP, FAAMFM

Mahendra Sanapati

MD, DABA, DABIPP, FSCT

Sze Ling Snowy Tan

ND, ABAAHP, FAAMFM, IFMCP

John Wells

RT (R), (MR), ABAAHP, FAAMFM

Bethany Mello

DNP, MSN, FAAMM, NP-c

Faride Ramos

MD, ABAARM, FAAMFM

Kaitlin Staebler

PA-C, FAAMFM, ABAAHP

Anne Trussell

MD, ABAARM, FAAMFM

MSN, ARNP, FNP-C

Jaime Reid

PharmD, ABAAHP, FAAMM

Christian Stella

PharmD, ABAAHP, FAAMM

Nikolaos Tzenios

MD, ABAARM

Thorntavach Wootthananont

Candice Monteith

Ph.D, FAAMFM, ABAAHP, FRSPH, FRSM

Yixiu Zheng

MD, ABAARM, FAAMM

ANTI-AGING MEDICAL NEWS | WINTER 2021

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Don’t Miss Emerson Ecologics and Wellevate in Action at A4M. Strengthening the Clinical Connection: Expert Use of Diagnostic Testing in the Integrative Medicine Practice Featuring James LaValle, RPh, CCNDr. Jaclyn Smeaton, ND Friday, December 10th | 6:30 am | NON-CME

Membership Includes:

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For More Information Call 561.997.0112

members@a4m.com • www.a4m.com

Join us for a workshop

Friday, December 10th 6:15 PM Room Veronese BR 2402

Fasting and FMD

Learn about the latest science and findings behind this nutritional breakthrough PRESENTED BY

James LaValle

RPh, CCN, MT, ND (trad)

America’s Esteemed Health & Wellness Expert

NON CME

Enjoy an evening learning about the science and clinical application of Fasting Mimicking and meeting other healthcare providers. Hors d’oeuvres and beverages will be served. Antonia Perez | aperez@l-nutra.com | 310.775.3655 L-Nutra | Director of Strategic Partnerships prolonprofessional.com

SCAN TO LEARN MORE

Fasting with Food: Leveraging Nutrition for Healthy Aging

By: Lacy Kuester, MS, MPP, RDN 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 | WINTER 2021

Fasting with Food: Leveraging Nutrition for Healthy Aging

Introduction Fasting has been a part of evolutionary history, religions, and traditions across cultures and time.1 Today it’s gaining popularity not only for its role in spiritual practice but for its potential health-promoting benefits. It’s no surprise that the term “fasting” has topped the charts among Google’s most searched topics this past year as word continues to spread about its ability to support healthy aging. To understand the mode of action behind fasting’s potentially profound and wide-reaching effects on human health, we first need to understand its basic effects at the level of the cell.

activate and carry out autophagy, however, periodic fasting (PF) would be required. PF is fasting for more than two days, usually anywhere from three to seven consecutive days, that is done several times per year. Due to its extended duration, PF goes beyond providing weight loss and metabolic support to promote autophagy and cellular rejuvenation. These cellular cleansing and renewing effects can only be attained through a prolonged fast. Table 2 below can serve as quick reference for the differing effects of fasts based on their duration. Table 2. The Effects of Fasts of Different Durations6-9, 12, 13, 18

Cellular Effects of Fasting Food is not merely fuel. It’s also a source of information for our cells, upregulating or downregulating pathways that influence the cell’s function. For example, the consumption of amino acids, protein, and carbohydrates upregulate the cell’s nutrient-sensing pathways (NSPs), which include mTOR (mechanistic target of rapamycin), IGF-1 (insulinlike growth factor 1), and PKA (protein-kinase A).2-4 In yeast, worm, fly, and mammal models, the upregulation of these NSPs activates the cell’s growth and aging mechanisms. In flies and mammals, NSP upregulation inhibits FOXO, one of a class of forkhead transcription factors that have many functions including activating cellular stress-resistance, antioxidant production, and autophagy, the body’s built-in mechanism for eliminating damaged or worn-out structures in the cell. When in a fasting state, by contrast, NSPs are downregulated and FOXO is upregulated. As a result, the cell enters a stress-resistant state and activates autophagy.2-5 Fasting, therefore, supports the cell’s natural rejuvenation and protective functions and can support healthy aging. Table 1. Cellular Response to Feeding versus Fasting in Mammals

Until relatively recently, water fasts were thought to be the only means to perform a multi-day fast; however, such a restrictive intervention is neither ideal nor necessary. First, the feelings of fatigue, headache, weakness, and hunger that a person can experience may be overwhelming, creating compliance issues. Second, water fasts can contribute to nutrient deficiencies, gallbladder dysfunction, hypoglycemia, hypotension, and the catabolism of lean muscle mass. These risks are not inconsequential and may pose shortand long-term risks to patients’ health. Finally, water fasts, especially multi-day fasts, may simply be unsafe for some people due to underlying health conditions.10,11 So how can practitioners help patients reap the benefits of healthy aging that fasting can provide without doing harm? One method sounds paradoxical but involves supporting the fasting window with food. Supporting Your Patient’s Fast… with Food

Fasting-Mimicking Diet Fasting Duration Determines Effects Establishing the optimum fasting window for each patient must be done on a case-by-case basis to ensure safety and feasibility. The desired outcome of the fast should be a guiding factor as well since fasts of different lengths are associated with different effects. For example, fasts of less than 12-24 hours have been tied to positive weight and metabolic effects. If the goal is to

The fasting-mimicking diet (FMD) is one way for those who want the benefits of prolonged water fast without many of the drawbacks. The diet provides a specific mix of macronutrients (detailed in Table 3 below) that a person can consume without upregulating the NSPs, thereby inducing a cellular fasting state while providing nutrition. The diet consists mostly of plant-based, unsaturated fats and restricts protein, simple carbohydrates, and total energy.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Fasting with Food: Leveraging Nutrition for Healthy Aging

FMD is the result of decades of research and is designed to be a periodic, prolonged fast, meaning it lasts more than two days and is meant to be done more than once per year.3 Table 3. Key Characteristics of FMD

of fasting and 8 hours of feeding). A 12-hour fast is aligned with the body’s circadian rhythm and may be the best way to balance the benefits of fasting with the stress it can induce. However, a 16:8 may more quickly bring about weight loss. • Alternate-day fasting (ADF). In this method of IF, patients freely eat for a day, fast the next day, and repeat.

FMD shows great promise as a safe and effective strategy to support healthy aging. In a clinical trial of 100 healthy individuals, one 5-day cycle of FMD resulted in five pounds of weight loss and a one-inch reduction of waist circumference.12 Three consecutive cycles (one cycle performed each month over three months) resulted in a reduction in trunk fat, weight, waist circumference, and BMI without causing a loss of lean body mass (see full findings in Table 4). These effects were largely maintained three months after the completion of the trial, indicating that although FMD is a short-term intervention, it can have significant, lasting benefits. No major adverse outcomes were reported in the trial, and, in a follow-up survey to the study, a majority of respondents stated that they had an improved relationship with food, improved mental clarity and energy, fewer cravings, and better portion control.13 Ongoing studies are examining the effects of additional FMD cycles.

• 5:2 Diet (5:2). Patients following this IF pattern will consume their usual diet five days a week and fast for the other two. Patients can choose the days that make the most sense for them, and the days do not need to be consecutive. Each type of IF has been studied to determine its unique health benefits (summarized in Table 5). While the fasting window is not long enough to cause the degree of cellular rejuvenation or autophagy that is achieved in FMD, IF still contributes to healthy aging by supporting cardiometabolic health. Clearly, even incorporating shorter fasting windows can have positive implications for individuals’ health and wellbeing. Table 5. Benefits of Different Styles Intermittent Fasting3

Table 4. Summary of Outcomes in Clinical Trial and Post-Trial Survey of FMD

*Based on survey conducted by L-Nutra, June 2019. Data on file. **Benefits seen in a clinical trial when FMD was used once a month for 3 to 4 consecutive months. Data on file.

It is important to note that FMD is not designed to diagnose, treat, cure, or prevent any disease states. Each patient should be assessed by the provider, and medications continued for treatment purposes.

Intermittent Fasting Intermittent fasting (IF), is not one specific dietary pattern. The only unifying characteristic of all types of IF is that the fasting window lasts less than two non-consecutive days, but IF might look like: • Time-restricted eating (TRE). This is a form of IF in which your patient limits their feeding window to specific hours of the day. Popular combinations are 12:12 fasts (12 hours each of fasting and feeding) and 16:8 fasts (16 hours

While the fasting window in IF is relatively short, it can still be difficult for some individuals to adhere to it. This, again, is where fasting with food can be leveraged to help people extend their fasting window without foregoing all nutrition. A 2021 clinical trial of 105 healthy individuals tested whether a bar with a specific combination of plant-based macronutrients could extend ketosis in individuals observing TRE.14 They found that participants who consumed the fastingmimicking bar after a 15-hour overnight fast had similar postprandial glucose and ketone levels compared to individuals who consumed only water after the same fasting period. Providing nourishment without physiologically breaking the fast is likely a safe and effective way to make IF attainable for more individuals. Other Popular Diets Your Patients Might Ask About While other diets purport to have their own unique health benefits, they do not help individuals achieve the cellular fasting state of a PF. They therefore do not impact cellular pathways to support cellular autophagy and rejuvenation. Keto and low-calorie diets are two

ANTI-AGING MEDICAL NEWS | WINTER 2021

Fasting with Food: Leveraging Nutrition for Healthy Aging

popular approaches to nutrition that patients may ask about, so it’s important to be able to discuss their potential benefits and drawbacks.

Ketogenic Diet The ketogenic diet (keto) was developed as a treatment for pediatric epilepsy,15 but it gained popularity with the public due to two possible unintended side effects: weight loss and improved insulin sensitivity.16 As obesity and insulin resistance are implicated in a growing number of health conditions, more patients may start asking about the efficacy of trying keto. The diet, when done correctly, causes the body to switch from glucose to ketones as the primary energy source.15 However, the permissible amount of protein and calories on keto likely upregulates the NSPs. This means that while keto mimics fasting on the physiological level, it is unlikely to do so on a cellular level. Keto is a lot more effort than FMD with far fewer health benefits. It must be adhered to for weeks to months, and it imposes strict, daily limits on what can and cannot be consumed. A key feature of the diet is the restriction of carbohydrates,15,16 which can put patients at risk of becoming micronutrient deficient. It can also make it challenging for individuals to consume adequate fiber. A keto diet tends to include higher amounts of animal-based saturated fats, which in the long run may be harmful to cardiovascular health. Long-term, this diet is less likely than FMD to contribute to healthy aging for most individuals.

A Low-Calorie Diet

number on the scale, must be considered when recommending any diet. Considering that a low-calorie diet is likely unsustainable, does not promote lasting weight loss, and does not downregulate NSPs, it is not the best intervention to support healthy aging. Conclusion Personalized nutrition can and should be a pillar of every patient treatment plan for healthy aging. For those patients seeking strategies to support healthy aging, fasting may be an appropriate intervention. Fasting with food offers a solution to make both short and multi-day fasts safer and more feasible. When combined with a regular, healthy diet, fasting done periodically can support metabolic and cardiovascular health, weight loss, and cellular rejuvenation to support a healthy aging lifestyle.

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.

Citations

A low-calorie diet is the most simplistic way to think about achieving weight loss. It might be the most intuitively appealing approach to patients because choosing to consume smaller portions is more straightforward than, say, planning out the exact balance of macros one can consume. Patients may see other health benefits in addition to weight loss when following a low-calorie diet. For example, excess visceral fat loss is associated with improved cardiometabolic health.17 But undertaking a low-calorie diet for weight loss, as is true for most diets, is not likely to confer long-term results. The body compensates for long-term energy restriction by slowing the metabolism. The metabolism is further slowed as muscle mass is lost along with fat, making weight loss more and more difficult to attain. A low-calorie diet also doesn’t necessarily help an individual learn how to eat in a healthy way. Patients may restrict portions without putting an emphasis on choosing the most nutrient-dense foods. This puts them at risk for nutrient deficiencies and sets them up for failure when they inevitably transition off the diet. With a slowed metabolism, the weight is likely to return, and any other health benefits experienced while on the diet are likely to be lost. Patients’ long-term health, not just an immediate result like a lower

1. Arbesmann R. Fasting and prophesy in pagan and Christian antiquity. Tradition. 1951;7:1-71. 2. Fontana L, Partridge L, Longo VD. Dietary restriction, growth factors and aging: from yeast to humans. Science. 2010;328(5976):321-326. 3. Longo VD, Di Tano M, Mattson MP, Guidi N. Intermittent and periodic fasting, longevity and disease. Nature Aging. 2021;(1):47-59. 4. Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab. 2014;19(2):181-192. 5. Martinez-Lopez N, Tarabra E, Toledo M, et al. System-wide benefits of intermeal fasting by autophagy. Cell Metab. 2017;26(6):856-871.e5. 6. Newman JC, Verdin E. β-hydroxybutyrate: a signaling metabolite. Annu Rev Nutr. 2017;37:51-76. 7. Pan JW, Rothman TL, Behar KL, Stein DT, Hetherington HP. Human brain beta-hydroxybutyrate and lactate increase in fasting-induced ketosis. J Cereb Blood Flow Metab. 2000;20(10):1502-1507. 8. Kerndt PR, Naughton JL, Driscoll CE, Loxterkamp DA. Fasting: the history, pathophysiology and complications. West J Med. 1982;137(5):379-399. 9. Pietrocola F, Demont Y, Castoldi F, et al. Metabolic effects of fasting on human and mouse blood in vivo. Autophagy. 2017;13(3):567-578. 10. Bolondi L, Gaiani S, Testa S, Labo G. Gall bladder sludge formation during prolonged fasting after

ANTI-AGING MEDICAL NEWS | WINTER 2021

Fasting with Food: Leveraging Nutrition for Healthy Aging

gastrointestinal tract surgery. Gut. 1985;26:734-738. 11. Wilhelmi de Toledo F, Grundler F, Bergouignan A, Drinda S, Michalsen A. Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects. PLoS ONE. 2019;14(1):e0209353. 12. Wei M, Brandhorst S, Shelehchi M, et al. Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease. Sci Transl Med. 2017;9(377). 13. Data on file. 14. Huang AW, Wei M, Caputo S, et al. An intermittent fasting mimicking nutrition bar extends ketosis in time restricted eating: a randomized, controlled, parallel-arm study. Nutrients. 2021;13(5):1523. 15. Zarnowska IM. Therapeutic use of the ketogenic diet in refractory epilepsy: what we know and what still needs to be learned. Nutrients. 2020;12(9):2616. 16. O’Neill B. Effect of low-carbohydrate diets on cardiometabolic risk, insulin resistance, and metabolic syndrome. Curr Opin Endocrinol Diabetes Obes. 2020;27(5):301-307. 7. Redman LM, Ravussin E. Caloric restriction in humans: impact on physiological, psychological, and behavioral outcomes. Antioxid Redox Signal. 2011;14(2):275-287. 18. Stephen Anton, Christiaan Leeuwenburgh, Fasting or caloric restriction for Healthy Aging, Experimental Gerontology, Volume 48, Issue 10, 2013, Pages 1003-1005

ANTI-AGING MEDICAL NEWS | WINTER 2021

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HOW OLD ARE YOU, REALLY? IT’S ALL IN THE PULSE

By: Joseph M. Raffaele, MD 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 | WINTER 2021

How Old Are You Really? It’s All in the Pulse

“A man is only as old as his arteries.” -William Osler, M.D., the father of modern medicine

We’ll have to forgive Dr. Osler for his sexist lapse. After all, he was revolutionizing medicine way back in the pre-genderconscious 1890s. But cultural semantics aside, Osler’s observation was right on point and remains so even as medicine is undergoing another revolution fueled by artificial intelligence, genomics, and epigenomics. When it comes to aging, you really can judge a man by his arteries. And a woman by hers. At Raffaele Medical, we are reminded of Osler’s remark with every new patient evaluation because it’s cardiovascular health that many people think about most when they’re concerned about living—and staying younger—longer. As

and have lost your father to a heart attack at forty-five—and

its name suggests, the cardiovascular system (CVS) has two

still not have any of the common cardiovascular diseases.

vital components; most people are preoccupied with only the

But if you’re seventy-five, you can have none of these risk

cardio when it’s the vascular they should be watching. Keep

factors and still have an increased chance of having a heart

the blood vessels healthy, and the heart will follow suit.

attack or stroke. While these diseases are extremely rare in people under twenty-five and still uncommon under forty,

WHAT’S THE NUMBER ONE RISK FOR CARDIOVASCULAR DISEASE? We know that heart disease and stroke—the principal components of cardiovascular disease—are the first and fifth leading causes of death, respectively, in the United States, accounting for more than 40 percent of all deaths.1 (Cancer is second.) What do you suppose is the number one

they comprise the number one cause of death in people older than sixty-five. What’s more, your risk of heart attack is six-fold higher in your eighties than in your forties, and your risk of stroke is ten times higher. For the vast range of people between these ages, the more risk factors you have, the higher your chances of having cardiovascular disease earlier. The risks progressively increase with each passing year.

factor that puts a person at risk of dying of cardiovascular

We will all die of cardiovascular disease—unless something

disease or of facing a serious deterioration in quality of life as

else kills us first. Even if you manage to evade every kind

a result? Answers typically involve the usual suspects such

of cancer and the rarest diseases, if you never get diabetes

as hypertension, hyperlipidemia, family history of ischemic

or kidney disease or any other condition that causes

heart disease, obesity, or smoking. A more finely tuned

natural death, your cardiovascular system will eventually

response may be elevated blood levels of homocysteine,2

do you in. That’s why the medical establishment and the

ApoB,3 or short telomeres,4 all of which have been linked to

pharmaceutical and fitness industries have put so much

a heightened risk of premature coronary artery disease and

time, effort, and money into risk factor reduction by trying

stroke.

to alter people’s diets and lifestyles, and by developing

All these factors are important elements of cardiovascular disease risk, but if you voted for any of them for the title of Leading Risk Factor, you’d be wrong. In fact, the greatest risk factor of all for cardiovascular disease is age. If you’re twenty-

drugs and methods to help them lose weight and reduce cholesterol. But until the last decade or so, what’s been ignored is the bedrock upon which all these common risk factors wreak their havoc, and that is the aging process.

five, you can have high cholesterol, smoke two packs a day,

ANTI-AGING MEDICAL NEWS | WINTER 2021

How Old Are You Really? It’s All in the Pulse

This philosophy is echoed in several review publications that

gets progressively stiffer through degradation of endothelial

discuss the concept of vascular or arterial age, which seeks to

function, collagen crosslinking, and loss of elastin in the large

measure the effect that an individual’s particular constellation

arteries, resulting in a tsunami of heart and kidney failure,

of risk factors has on the actual structure and functioning of

even in patients without significant atherosclerosis.8 Gradual

the vascular system. Biological age is a measure of the effect

loss of this function is what we refer to as hardening of the

of all the risk factors a person’s cardiovascular system (CVS)

arteries, or arteriosclerosis, which is more of an intrinsic

has endured to date.5 A biological age biomarker is one that

arterial aging process. While it can be crudely measured by

describes how far from optimal structure and function a

conventional brachial blood pressure, a more sensitive and

person’s cardiovascular system has diverged.6

predictive measure is central arterial stiffness, which affects

THE LESS APPRECIATED FUNCTION OF THE VASCULAR SYSTEM

both the heart’s structure and function. It is a major cause of high blood pressure in older people and a precursor to atherosclerosis. Stiffer arteries are more prone to accumulate

The best candidates for this biomarker of vascular age can be

deposits of cholesterol, white blood cells, and clotting factors

categorized into two major functions of the vascular system they

that make the interior of the artery wall thick and irregular.

measure: the conduit and the cushioning.

While everyone’s arteries stiffen with age, how much they

When most patients and clinicians think of the aging and

do and how fast can vary widely. So, it stands to reason that

deterioration of the CVS, they think about arterial blockage from

the degree of stiffness is a key factor in determining whether

plaque accumulation called atherosclerosis, which is the leading

it will lead to cardiovascular disease and when. And if we

cause of heart attacks and ischemic stroke. This thickening

can take an accurate measure of that process, we have an

of the arteries increases linearly by 0.005 mm per year in the

invaluable biomarker of aging, one that is routinely monitored

average healthy person, as measured by carotid intima-medial

at Raffaele Medical: arterial pulse pressure. This biomarker is

thickness. Once 1.1 mm is reached, atherosclerosis is diagnosed.

a measure of the speed and the size of the pressure wave as

This damage affects the conduit function of the arterial tree,

it travels from the left ventricle through the aorta, and the

which ensures the delivery of blood to tissues that bring oxygen

role played by what is called the reflected wave, which returns

and nutrients. This type of damage leads to angina, heart

after the initial wave reaches the small arterioles. The speed

attacks, and strokes.

of this reflected wave is determined by the stiffness of the

The less appreciated function of the arterial tree is the cushioning element that dampens the cardiac cycle’s damaging pulsations on the fragile small arteries and capillary beds of the

arteries along which they travel: The stiffer the arteries, the more quickly the wave travels out and the earlier the reflected wave arrives back at the heart.

major organ systems. This cushion is lost as the arterial system

ANTI-AGING MEDICAL NEWS | WINTER 2021

How Old Are You Really? It’s All in the Pulse

THE SPHYGMOMANOMETER REIMAGINED: AORTIC PULSE WAVE ANALYSIS

WHAT’S IN A NUMBER? THE KEY TO BEHAVIOR MODIFICATION

At Raffaele Medical, we accurately and noninvasively measure

Now that we have introduced you to an accurate and highly

infinitesimal changes in arterial stiffness using aortic pulse

validated way to measure vascular age, let’s look at how we

wave analysis (APWA) obtained from sensors in an arm cuff

use it at Raffaele Medical. All patients get a baseline vascular

that only looks like a standard brachial pressure cuff. The

reference age, which we have termed CardioAge because

computer-assisted technique determines the speed of pulse

it’s more intuitive for patients. If a patient is hypertensive at

and size of these waves, yielding a measurement of the

baseline, then their CardioAge will automatically be ninety

stiffness of the aorta and the arterial tree. The accuracy of

because those who meet the blood pressure (BP) criteria

these waveform measurements has been validated against

of hypertension invariably have central arterial stiffness

those gleaned from placing catheters inside the aorta.

(an AP) higher than the average non-hypertensive ninety-

The arterial waveform reveals two components: The first is large artery stiffness measured by pulse wave velocity (PWV), where a 1 m/sec increase is associated with a 15 percent increase in cardiovascular disease (CVD) and all-cause mortality after adjusting for multiple risk factors, including age.9 The second component is peripheral artery

year-old. We find this motivates them to take their antihypertensive more assiduously because it is a less abstract concept than cuff BP. And once they’re on effective therapy, their CardioAge often plummets to that of a much younger person, giving them objective evidence that their compliance has meaningful effects.

tone, which can be directly measured by flow-mediated dilatation (FMD) and is a marker of endothelial function.

ARTERIAL STIFFNESS CHANGE WITH AGE: R=0.7

Tone is increased due to decreasing levels of nitric oxide (NO) known to occur with age and is accelerated by many traditional CVD risk factors as well as increased oxidative stress and inflammation.10 Integrating the change in pulse wave velocity with a measurement of endothelial function tells us how much overall work the reflected wave is causing the left ventricle to do while pumping against this augmentation pressure (AP). A number of studies have established a close correlation between AP and age with a linear increase of 0.25 mm (0-20 Hg per year from twenty to ninety years old) in the absence of brachial cuff-determined hypertension.11 When looked at through the lens of AP, essential hypertension is simply accelerated arterial aging.

ATCOR Medical 2004: data on file

This makes AP an excellent biomarker of arterial health and of overall aging, providing a way for us to measure the changing stiffness of the arteries to catch subclinical cardiovascular dysfunction well in advance of conventional methods. Additionally, AP is determined by processes that are reversible, making it a very useful biomarker to test if a given treatment strategy is having a positive effect, whether through lifestyle modifications such as increasing aerobic exercise and lowering stress, supplementing diminishing supplies of NO through beetroot extract, hormone therapy, or through targeted pharmaceuticals such as ACE-I, 12 and more. Pharmaceutical companies are actively looking for drugs to both prevent and dissolve the collagen crosslinking that causes the large artery component of arterial stiffness.13

ANTI-AGING MEDICAL NEWS | WINTER 2021

How Old Are You Really? It’s All in the Pulse

At the other end of the spectrum, we can pick up early accelerated vascular aging even when the blood pressure is completely normal. When we tell a healthy, normotensive fifty-

“While it can be crudely measured by

year-old woman that her CardioAge is 60, she sits up and takes

conventional brachial blood pressure, a

notice. This motivates her to engage in more intense dieting

more sensitive and predictive measure

and exercise, and to increase compliance with supplements

is central arterial stiffness, which

and HRT to lower her CardioAge as much as possible. When she sees the reduction in CardioAge after just a couple of months,

affects both the heart’s structure and

she is further motivated to maintain these habits. We regularly

function.”

see patients become competitive with themselves, their spouses, and their friends once they are given their CardioAge, which leads them down the path of lifelong behavioral changes with better health outcomes.

Dr. Joseph Raffaele provides scientifically-based treatment programs targeting biomarkers of healthy aging derived from decades of research and experience in longevity medicine. He is also the co-founder of PhysioAge Health Analytics.

REFERENCES 1.

Heron M. Deaths: Leading Causes for 2018. Natl Vital Stat Rep Cent Dis

cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll

Peng H, Man C, Xu J, Fan Y. Elevated homocysteine levels and prospective studies. J Zhejiang Univ Sci B. 2015 Jan;16(1):78–86. Benderly M, Boyko V, Goldbourt U. Apolipoproteins and longterm prognosis in coronary heart disease patients. Am Heart J. Telomeres Mendelian Randomization Collaboration, Haycock PC, Burgess S, Nounu A, Zheng J, Okoli GN, et al. Association Between Telomere Length and Risk of Cancer and NonNeoplastic Diseases: A Mendelian Randomization Study. JAMA Thijssen DHJ, Carter SE, Green DJ. Arterial structure and function in vascular ageing: are you as old as your arteries? J Physiol. 2016 Apr 15;594(8):2275–84.

al. Age-related reduction of NO availability and oxidative stress in humans. Hypertens Dallas Tex 1979. 2001 Aug;38(2):274–9. 11. McEniery CM, Yasmin, Hall IR, Qasem A, Wilkinson IB, on wave reflection and aortic pulse wave velocity: the AngloCardiff Collaborative Trial (ACCT). J Am Coll Cardiol. 2005 Nov 1;46(9):1753–60. 12. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, et al. Differential impact of blood pressure-lowering drugs on

Oncol. 2017 May 1; 3(5):636–651. 5.

Cardiol. 2010 Mar 30;55(13):1318–27. 10. Taddei S, Virdis A, Ghiadoni L, Salvetti G, Bernini G, Magagna A, et

Cockcroft JR, et al. Normal vascular aging: differential effects

2009 Jan;157(1):103–10. 4.

Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of

May;70(4):1–115. risk of cardiovascular and all-cause mortality: a meta-analysis of 3.

Control Prev Natl Cent Health Stat Natl Vital Stat Syst. 2021

Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a “set up” for vascular disease. Circulation. 2003 Jan

central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006 Mar 7;113(9):1213–25. 13. Song Q, Liu J, Dong L, Wang X, Zhang X. Novel advances in inhibiting advanced glycation end product formation using natural compounds. Biomed Pharmacother. 2021 Aug 1;140:111750.

7;107(1):139–46. 7.

van den Munckhof ICL, Jones H, Hopman MTE, de Graaf J, Nyakayiru J, van Dijk B, et al. Relation between age and carotid artery intima‐medial thickness: a systematic review. Clin Cardiol. 2018 May 12;41(5):698–704.

O’Rourke MF, Hashimoto J. Mechanical factors in arterial aging: a clinical perspective. J Am Coll Cardiol. 2007 Jul 3;50(1):1–13.

ANTI-AGING MEDICAL NEWS | WINTER 2021

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Distinctive Detoxification

The case for including the microbiome in detox strategy

By: Jocelyn Strand, ND - Director of Clinical Educati on, Biocidin® 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 | WINTER 2021

Distinctive Detoxification | The case for including the microbiome in detox strategy

One of the foundational therapeutics in functional medicine is supporting detoxification for our patients. When we think of toxicity, endogenous (internally produced) toxins don’t necessarily spring to mind. But the microbiome is a source of metabolites and inflammatory mediators that can either support health and detoxification or contribute to our toxic load and disease. There is a bidirectional relationship between the gut and the liver governed by the microorganisms populating the GI tract, referred to as the gut-liver axis (GLA). It explains why we see deeper cleansing when detoxification protocols are combined with a microbial balancing cleanse. Additionally, biofilms, produced by microorganisms, can be an ongoing source of toxins. If left unaddressed, they can create a continual source of toxic exposure and an obstacle to lasting therapeutic effect. Environmental Determinants of Chronic Disease There is an ongoing nature vs. nurture (genetics vs. environment) debate. But the field of epigenetics (which describes the effect of environmental factors on the behavior of genes) has proven that the environment carries vastly more weight than the inherited gene under most circumstances. The most influential environmental factors are toxic exposure and total toxic load. According to the World Health Organization, chronic, noncommunicable diseases are rapidly becoming a global epidemic. Neurocognitive, metabolic, autoimmune, and cardiovascular diseases are on the rise. Genetics, lifestyle, and nutrition are not the only underlying causes. Early life, ongoing exposures, and bio-accumulated toxicants also contribute to chronic disease.

MECHANISMS OF TOXICITY IN CHRONIC DISEASE: Oxidative Stress Endocrine Disruptionnces Genotoxicity Enzyme Inhibition Dysbiosis Genetics may predispose individuals to chronic disease, but this cannot account for the rapidly increasing prevalence of chronic illnesses within just a generation or two. There is a compelling case for pervasive environmental factors as an underlying cause of chronic illness. As Judith Stern of the University of California at Davis states, “Genetics loads the gun, but environment pulls the trigger.” 1 One of the most influential environmental factors is the prevalence of toxicity. The microbiome plays a pivotal role in governing the metabolism of exogenous (externally produced) and endogenous toxins. Let’s take a closer look. A Healthy Microbiome Benefits the Host

Toxic Elements

Beneficial bacteria play a variety of important roles in human health, and dysbiosis (microbiota imbalance) plays a significant role in the pathogenesis of intestinal and extraintestinal illnesses.2 The influence of the microbiome affects multiple areas influencing detoxification. These include: • Hydration • Nutrient Synthesis • Protection against pathogens by a barrier effect • Training of the immune system • Immune reserves for systemic defenses • Production of short-chain fatty acids

Naturally Occurring Substances

Short-Chain Fatty Acids

Pesticides

Short-Chain Fatty Acids (SCFAs) are metabolites produced primarily in the colon via enzymatic conversion or fermentation by gut bacteria of indigestible dietary residue. They are key mediators for communication between the host and gut microbes. SCFAs produced by microbes can influence host immunity and metabolism, including promoting T regulatory cell function and reducing risk of inflammatory disease. They also affect gut integrity by decreasing the luminal pH, enhancing absorption

ENVIRONMENTAL CONTRIBUTORS TO CHRONIC DISEASE:

Persistent Organic Pollutants Volatile Organic Compounds Plastics

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270432/ 2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962619/pdf/394_2018_Article_1703.pdf

ANTI-AGING MEDICAL NEWS | WINTER 2021

Distinctive Detoxification | The case for including the microbiome in detox strategy

of some nutrients, exerting beneficial effects against intestinal inflammation, and protecting intestinal epithelial integrity. Finally, SCFAs have a direct impact on gut microbiota composition.3 A healthy microbiome is requisite for the robust production of SCFAs. Lipopolysaccharides Lipopolysaccharides (LPS) are found on the outer shell of gramnegative bacteria and are a potent endotoxin contributing to various diseases. LPS is one of many pathogen-associated molecular patterns (PAMPs) and initiates a potent cytokine response (from macrophages and Kupffer cells in the liver), resulting in inflammation through binding of toll-like receptors (TLRs) and direct binding. Even small amounts of LPS due to bacterial infection are sufficient to elicit an inflammatory response.4 Inflammation resulting from LPS in the lumen of the gastrointestinal (GI) tract creates damage to the mucosa and the tight junctions of the gut, leading to increased intestinal permeability, allowing translocation of bacterial metabolites into the adjacent lymphatics and blood flow where it travels via the portal vein and must be cleared by the cells in the liver.5 LPS and the Liver Removal of intestinal products by the liver is vital in protecting systemic tissues and organs from inflammatory damage. Those products include bacterial endotoxins (LPS), bacterial exotoxins (cytolysin), fungal exotoxins (candidalysin) and other PAMPS from microorganisms - many of which promote hepatocellular injury. Studies show that LPS is cleared within minutes following injection and primarily localized in the liver. The resulting inflammatory cascade causes collateral damage to hepatocytes, and their ability to participate in detoxification.6 The effect of LPS is so significant that it can be considered a cofactor for liver injury. Murine research shows that LPS augments injury by hepatotoxins. In mice with a sterile gut (no LPS), damage due to exposure of hepatotoxins was mitigated. Similarly, in alcoholic liver disease, LPS is also a cofactor. Rats fed ethanol only developed fatty liver. However, when LPS was introduced, it resulted in hepatic necrosis.7 3 4 5 6 7 8 9 10 11 12

Gut-Liver Axis (GLA) The Gut-Liver Axis describes a bidirectional pathway in which the gastrointestinal system, microbiome, and the liver influence and depend upon one another. Disruption of the GLA results in loss of homeostasis, compensation, and eventual disease through elevated toxins and resulting inflammation.8 The liver plays a pivotal role in regulating the microbiome by releasing primary bile acids (BA) into the small intestine. Bile acids are antimicrobial and prevent the overgrowth of microorganisms and resultant proinflammatory bacterial metabolites. Reduction in the formation and release of BA is associated with overgrowth of microorganisms in the small intestine. Alterations of bile acid homeostasis leading to excessive intrahepatic accumulation of potentially toxic BAs and their metabolites are thought to play a pivotal role in mediating the hepatic injury of cholestatic diseases. The vast majority (95%) of primary bile acids are reabsorbed via enterohepatic recirculation. Microbiota modify the remaining 5% into secondary BA.9 Secondary BAs are highly toxic, and excess levels contribute to inflammation, cholestasis, gallstone formation and carcinogenesis. In the presence of a healthy microbiome (which also acts upon xenobiotics and other endogenous toxins), the effects of secondary bile acids are mitigated by the production of SCFAs exerting their anti-inflammatory effect.10 Small Intestinal Bacterial Overgrowth and Liver Disease The destruction of liver tissue resulting from dysbiosis is illustrated by the connection between small intestinal bacterial overgrowth (SIBO) and liver disease. Chronic liver disease (CLD) patients have SIBO significantly more often when compared with controls. The association of SIBO and CLD is not confined to patients with advanced disease, suggesting that SIBO is not a consequence of advanced liver disease but may play a role in the progression of CLD.11 Gram-negative bacteria and the resulting elevation in LPS frequently accompanied by SIBO contributes to intestinal permeability, damaging the protective barrier, and increasing risk of non-alcoholic fatty liver disease.12

Frontiers | Gut Microbiota, Short-Chain Fatty Acids, and Herbal Medicines | Pharmacology (frontiersin.org) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829348/pdf/fimmu-11-594150.pdf https://www.sciencedirect.com/science/article/pii/S0753332221006727 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868813/ Lipopolysaccharides in liver injury: molecular mechanisms of Kupffer cell activation | American Journal of Physiology-Gastrointestinal and Liver Physiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004151/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204491/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429521/pdf/ijms-20-01214.pdf https://pubmed.ncbi.nlm.nih.gov/29272899/ https://pubmed.ncbi.nlm.nih.gov/27308646/

ANTI-AGING MEDICAL NEWS | WINTER 2021

Distinctive Detoxification | The case for including the microbiome in detox strategy

Biofilms Biofilms are involved in the majority of clinical infections. They are communities of microbial cells surrounded by a secreted polymer called the “extracellular polymeric substance.”They are composed of multiple organisms (aerobic and anaerobic bacteria and/or fungal species). More than 80% of all microbial infections have developed biofilms within two weeks from the onset of infection. Biofilm bacteria can resist up to 5000 times the antibiotic concentration that would typically be needed to resolve infections and, once established, are an ongoing source of reinfection. Biofilms in the GI tract often contain bacterial metabolites, as described above. In fact, LPS is part of the structure of biofilms.13 The composition of microbial biofilm depends on the environmental conditions in which the microbes reside. Biofilm is a survival mechanism for microorganisms and provides protection from environmental stress, acid, antimicrobials, UV, desiccation, predation, biocides, solvent, toxic chemicals, and other pollutants.14 Biofilms and Toxicity Biofilms exist in the natural world, including on and in the human body, where they retain environmental toxicity and create toxic byproducts themselves. How sticky are they? They are used for the biochemical conversion of pollutants by sorption (heavy metals, hydrocarbons, industrial waste, and wastewater). The molecules produced by biofilm communities contain glycoconjugates such as glycoproteins, glycopeptides, peptidoglycans, glycolipids, lipopolysaccharides, and glycosides – many of which result in inflammation and contribute to toxicity in the body.15 Failure to address biofilms can result in refractory illness, and an ongoing source of toxicity.15

Many of the microorganisms in the mouth participate in the production of biofilms, which are easily identified by the sensation of “fuzzy teeth.”These biofilms have the same qualities and effects as those elsewhere in the body and, as such, are a source of toxicity and recalcitrant disease.17 Evaluation of the oral microbiome is a powerful tool for reducing circulating endotoxins. Botanicals and the Microbiome Herbal medicines have been utilized by humans to treat infection for thousands of years and provide a safe and effective option for addressing biofilms and dysbiosis. A study with nearly 400 people found that herbal remedies were as effective as Rifaximin (the most studied antibiotic related to SIBO) at treating symptoms. That trial used an array of botanicals and essential oils. 18 Using the anti-pathogenic properties of more than one botanical in a combination or formula provides a broader spectrum and deeper activity against pathogens. The resulting formulations, or “biocidal combinations,’’ are powerful allies that may be used to address infection. Pilot testing at the University of Binghamton has illustrated remarkable broad-spectrum antimicrobial and antibiofilm activity (in vitro) with a combination containing Bilberry extract, Noni, Milk Thistle, Echinacea (Purpurea & Angustifolia), Goldenseal, Shiitake, White Willow, Garlic, Grapeseed extract, Black Walnut (hull and leaf ), Raspberry, Fumitory, Gentian, Tea Tree oil, Galbanum oil, Lavender oil, and Oregano oil.

Oral Health, Dysbiosis, and Biofilms When LPS is produced in the gut, the liver clears it, protecting systemic tissues and organs. However, when gram-negative bacteria such as Porphyromonas gingivalis produce toxic metabolites in the mouth, it results in the direct translocation to adjacent blood flow and lymphatics. Oral dysbiosis and its resultant upregulation of inflammatory pathways is linked to diabetes, cardiovascular disease, Alzheimer’s dementia, respiratory diseases, and more.16

13 14 15 16 17 18

Botanicals are Effective Against Biofilms Botanicals accomplish control of biofilms through several methods. One method is through the inhibition of quorum sensing. Quorum sensing is cell signaling by bacteria and other organisms using autoinducers to determine gene expression,

https://pubmed.ncbi.nlm.nih.gov/28950999/ Microbial glycoconjugates in organic pollutant bioremediation: recent advances and applications (nih.gov) https://pubmed.ncbi.nlm.nih.gov/32858856/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443998/pdf/10.1177_0022034520926126.pdf https://pubmed.ncbi.nlm.nih.gov/32858856/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/

ANTI-AGING MEDICAL NEWS | WINTER 2021

Distinctive Detoxification | The case for including the microbiome in detox strategy

virulence, resistance, and development of biofilms. Botanicals shown to inhibit quorum sensing, such as Garlic and Oregano, are well known for their antimicrobial ability. This understanding of how they can combat biofilms highlights their clinical and historical significance.19 Another method of biofilm control is by the inhibition of efflux pumps within cells, called “multidrug resistance pumps.” Plants containing tannins, berberine, and certain phenolics have effects as efflux pump inhibitors, demonstrating marked synergy when combined with conventional antibiotics against a variety of both gram-positive and gram-negative organisms. Goldenseal, Black Walnut, White Willow, Raspberry Leaf, and Garlic are a few that have been studied.20

Botanicals and LPS Another recent pilot study illustrates the effectiveness of a similar biocidal formula. When administered with a formula containing binding agents (activated charcoal, zeolite clay, silica, apple pectin, humic and fulvic acids, aloe), it reduced immune markers associated with LPS exposure after six weeks of application. The potential therapeutic effect of reducing LPS- associated inflammation is far-reaching.

When applying detoxification strategies in clinical practice, it is common to include nutrient therapy to supplement detox pathways in the liver and gut. Adding botanicals to balance the microbiome in the gastrointestinal tract and oral cavity is a welltolerated and effective way to uplevel the experience and deepen the effects – setting patients up for vitality and health.

19 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119553/ 20 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486105/

ANTI-AGING MEDICAL NEWS | WINTER 2021

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GLYCOMICS IN CLINICAL ACTION: THE ENDOTHELIAL GLYCOCALYX

By: Helen Messier, PhD, MD 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 | WINTER 2021

GLYCOMICS IN CLINICAL ACTION: THE ENDOTHELIAL GLYCOCALYX

The recent explosion of interest in glycomics — the science of sugar molecules (glycans) — is a reminder of how much is still to be learned about the fundamentals of human biology. What we see in this field is an example of an apparently uninteresting phenomenon that turns out to be decisively important. Think glial cells in the brain, or “junk DNA.”

The translation of science to clinical application always takes time, but the findings of glycomic research are already bearing fruit in our understanding of immune functioning, cardiovascular disease, diabetes, kidney disease, cancer metastasis, HIV and influenza. The Endothelial Glycocalyx

Glycans are polymer chains of covalently linked monosaccharides and include both polysaccharides and monosaccharides. Glycans can be covalently bound to proteins or lipids forming glycoproteins or glycolipids respectively. Until quite recently, they were thought to provide mere structural support and were not actively studied. Now it is known that glycans perform essential signaling functions, playing a dynamic role in a multitude of critical physiological activities.1

A clinically important example of the dynamic role played by glycans appears in one structure of the vascular system: the endothelial glycocalyx (EGX).3 This is the microscopically thin gel-like layer that forms the inner lining of every blood vessel in the body, all 60,000 miles of arteries, veins and capillaries. The EGX is a selectively permeable barrier with anti-adhesive, anti-inflammatory, and antioxidative properties. It mediates biochemical and biomechanical signals in the circulating blood for optimal endothelial function.

Glycans do play structural roles in the organism, but they can also be individually recognized by other molecules, primarily glycanbinding proteins known as lectins. Intrinsic glycan-binding proteins recognize glycans from the same organism and typically mediate cell-to-cell interactions. Extrinsic glycan-binding proteins are mostly pathogens, so in this case glycan recognition plays an important role in infectious diseases.2 This wide range of structural and signalling functions along with technical advancements in our ability to isolate and identify glycans has prompted an accelerating growth in glycomic research over the past 20 years:

The EGX is composed of glycoproteins, proteoglycans and glycosaminoglycans.4 Proteoglycans provide the primary binding of the EGX to the endothelial membrane. They consist of a core protein to which glycosaminoglycan chains are linked. There are five types of glycosaminoglycan in the EGX: heparan sulfate, chondroitin sulfate, dermatan sulfate, keratan sulfate, and hyaluronan. The most populous of these is heparan sulfate, making up 50 to 90% of the total amount of proteoglycans. A number of other glycoproteins are contained within the forest of glycans making up the EGX. Cell adhesion molecules along with

Graph showing glycomic research growth

1 Wang W, Özdemir V. Special Issue: Glycomics and Personalized Glycomedicine. OMICS. 2019;23(12):599-600. doi:10.1089/omi.2019.0177 2 Varki, Ajit, and John B. Lowe. “Biological Roles of Glycans.” Essentials of Glycobiology, edited by Ajit Varki et al., 2nd ed., Cold Spring Harbor Laboratory Press, 2009, http://www.ncbi.nlm.nih.gov/ books/NBK1897/. 3 VanTeeffelen JW, Brands J, Stroes ES, Vink H. Endothelial Glycocalyx: Sweet Shield of Blood Vessels. Trends in Cardiovascular Medicine. 2007;17(3):101-105. doi:10.1016/j.tcm.2007.02.002 4 Li Q, Xie Y, Wong M, Barboza M, Lebrilla CB. Comprehensive structural glycomic characterization of the glycocalyxes of cells and tissues. Nature Protocols. 2020;15(8):2668-2704. doi:10.1038/ s41596-020-0350-4

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GLYCOMICS IN CLINICAL ACTION: THE ENDOTHELIAL GLYCOCALYX

coagulation and fibrinolysis factors jut out from the endothelial cell layer.5 Closer to the flowing blood, there are several soluble proteins and proteoglycans that are embedded within the EGX mesh. The total volume of the EGX is significantT — about 2 liters, compared to about 5 liters of total blood volume. Image of EGX structure

At its simplest, the EGX provides essential structural protection of the blood vessel wall.6 Like Teflon, its slippery-smooth surface prevents the adhesion and penetration of unwanted particles in the blood. But the EGX plays a far more active role than this static picture suggests. The EGX is a “smart” barrier that actively mediates what is allowed to pass from the blood into the tissues, and what is not.7 It also facilitates the generation of important molecules, including nitric oxide. And it plays a central role in regulating inflammation, oxidation and coagulation. With all these functions, the EGX is gaining increasing attention as the target for treatment of a range of pathologies, from atherosclerosis to renal disease to diabetic neuropathy.8 In this short overview, we’ll take a brief look at how the EGX was discovered, and the essential functions that have been identified. Then we’ll consider EGX degradation, both its causes and consequences, and the associated pathologies. We’ll give special focus to atherosclerotic plaque, because this is the pathway to the single largest cause of human mortality, cardiovascular disease (CVD). Then we’ll turn our attention to the challenge of restoring the EGX, well-researched ways to achieve this, and the clinical benefits.

The Research Trajectory: An Exemplary Field of Glycomic Science Research into the EGX has grown exponentially, in tandem with the larger field of glycomic science. Observing its history shines a useful light on what this critical structure means for human health. When we grasp how the EGX at first eluded notice, was then misunderstood, and was finally revealed, we see more clearly what an important physiological role it plays. We also understand why even today, so few medical professionals are acquainted with it. The endothelium, a single-cell layer lining the interior of every blood vessel, has long been known to science. Before the EGX was discovered, it was assumed that the flowing blood directly contacted the endothelium. However, with the beginning of advanced microscopy, a puzzling gap was detected between the lumen and the vessel wall. It appeared to be an empty space, so the first explanation was some kind of repulsive electrical field. Improved visualization revealed the presence of a physical barrier, which was named the endothelial glycocalyx. It had never been detected in autopsies because it was so thin and fragile. However, as technologies improved, its full structure and constitution was uncovered. In today’s imaging, the EGX appears as a forest of small hairlike elements protruding, rather like villi, from the vessel wall. Biochemical analysis of the EGX revealed a composition of negatively charged sulfates organized in a carbohydrate-rich mesh of membrane molecules.

Image Credit: Gouverneur, et al., Journal of Internal Medicine (2006), 259: 393-400

5 Reitsma S, Slaaf DW, Vink H, van Zandvoort MA, oude Egbrink MG. The endothelial glycocalyx: composition, functions, and visualization. Pflugers Arch. 2007;454(3):345-359. doi:10.1007/s00424007-0212-8 6 Harding IC, Mitra R, Mensah SA, Nersesyan A, Bal NN, Ebong EE. Endothelial barrier reinforcement relies on flow-regulated glycocalyx, a potential therapeutic target. Biorheology. 2019;56(2-3):131149. doi:10.3233/BIR-180205 7 Alphonsus CS, Rodseth RN. The endothelial glycocalyx: a review of the vascular barrier. Anaesthesia. 2014;69(7):777-784. doi:10.1111/anae.12661 8 Facchini L, Bellin A, Toro EF. Modeling Loss of Microvascular Wall Homeostasis during Glycocalyx Deterioration and Hypertension that Impacts Plasma Filtration and Solute Exchange. Curr Neurovasc Res. 2016;13(2):147-155. doi:10.2174/1567202613666160223121415

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GLYCOMICS IN CLINICAL ACTION: THE ENDOTHELIAL GLYCOCALYX

From a glycomics perspective, what is striking about the EGX is its remarkably dynamic character.9,10 The exact composition, thickness and architecture of the EGX is in constant change, responding to the flow and contents of the blood. It is the dynamic character of the EGX that enables it to perform such a wide range of physiologically important functions. The EGX is universal in the vascular system, including the smallest capillaries where it constitutes a significant percentage of their total volume. The Functions That Matter The primary function of the EGX is to provide a semi-permeable barrier between the lumen and the endothelium. It normally allows only the smallest molecules (<70 kDa) through to the endothelium. This inhibits the passage or adhesion of LDL, Lp(a), platelets and other blood contents.11 We’ve mentioned that glycans can function as signaling molecules, and in the case of the EGX this capability has special importance. The shear stress of flowing blood triggers the EGX to send a signal to the endothelium, prompting the generation of nitric oxide. As a vasodilator, NO plays a vital role in maintaining blood pressure and the overall performance of the microvasculature. Relevant to blood pressure, the EGX also buffers blood sodium. The glycosaminoglycans (GAG) in the EGX are negatively charged due to their high sulfate content. They bind to and inactivate sodium as non-osmotic sodium storage, preventing accumulation into the endothelium and vascular smooth muscle. The EGX mediates inflammation in the vascular system. The relevance of this becomes clearer as CVD is increasingly recognized as an inflammatory disorder. Specifically, the EGX affects the interaction of leukocytes with the endothelial wall. A healthy EGX, with its slippery anti-adhesive surface, supports the “rolling” of leukocytes as they pass through the lumen. Without

this protection, leukocytes are liable to adhere to, and penetrate, the endothelium.12 The EGX has an important antioxidant function because it houses sodium oxide dismutase (SOD) which is critical in the ceaseless combat with corrosive free radicals and cellular oxidation. Again, absent an intact EGX, this function collapses with important implications for vascular aging and overall health. The EGX houses both coagulation and anticoagulation factors. As a result, its presence reduces the likelihood of blood clots forming in the lumen in the event of inflammatory disturbance of the endothelium.13 Degradation of the EGX The EGX is extremely thin and fragile. It degrades easily, and the degradation can be seen both directly through microscopic visualization, and indirectly by identifying EGX components and sheddases floating in the blood .14 The breakdown tends to first occur at bifurcations in the vascular system where there is greatest turbulence in the blood flow. As a structure the EGX is unusually dynamic, capable of both collapsing and rebuilding quickly. In fact, a healthy EGX exhibits a constant turnover, balancing shedding and new synthesis. However, chronic loss of the EGX can pose serious threats to the vascular system, and hence to the health of the entire body. Causes of chronic EGX degradation include the familiar enemies of cardiovascular health: • • • • • •

High sugar diet Lack of exercise Stress and inflammation Infections High blood pressure Aging

Problems arise when these causative factors are sustained over time, preventing the natural rebound of the EGX. Other causes

9 Cosgun ZC, Fels B, Kusche-Vihrog K. Nanomechanics of the Endothelial Glycocalyx: From Structure to Function. The American Journal of Pathology. 2020;190(4):732-741. doi:10.1016/j. ajpath.2019.07.021 10 Curry FE, Adamson RH. ENDOTHELIAL GLYCOCALYX: PERMEABILITY BARRIER AND MECHANOSENSOR. Ann Biomed Eng. 2012;40(4):828-839. doi:10.1007/s10439-0110429-8 11 Liu X, Fan Y, Deng X. Effect of the endothelial glycocalyx layer on arterial LDL transport under normal and high pressure. Journal of Theoretical Biology. 2011;283(1):71-81. doi:10.1016/j. jtbi.2011.05.03 12 Constantinescu Alina A., Vink Hans, Spaan Jos A.E. Endothelial Cell Glycocalyx Modulates Immobilization of Leukocytes at the Endothelial Surface. Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23(9):1541-1547. doi:10.1161/01.ATV.0000085630.24353.3D 13 Buchheim J-I, Enzinger MC, Choukèr A, Bruegel M, Holdt L, Rehm M. The stressed vascular barrier and coagulation - The impact of key glycocalyx components on in vitro clot formation. Thromb Res. 2020;186:93-102. doi:10.1016/j.thromres.2019.12.015 14 Becker BF, Jacob M, Leipert S, Salmon AHJ, Chappell D. Degradation of the endothelial glycocalyx in clinical settings: searching for the sheddases. Br J Clin Pharmacol. 2015;80(3):389-402. doi:10.1111/bcp.12629

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GLYCOMICS IN CLINICAL ACTION: THE ENDOTHELIAL GLYCOCALYX

can include trauma, electrolyte imbalances, surgery and the administration of IV fluids. Consequences of EGX Degradation Once the multiple functions of the EGX are fully understood, the seriousness of its degradation becomes apparent.15 The body suffers loss of an essential barrier function throughout the vascular system. This results in increased leukocyte and platelet adhesion to the endothelium. In addition, an important trigger of NO production is lost, as well as a key antioxidant function. There’s a reduction in coagulation control, leading to increased thrombin generation, and greater exposure to inflammation both systemic and local. These consequences have very real clinical implications. Most obviously, EGX dysfunction is a factor in CVD and stroke. The importance of this factor is increasingly apparent, as the inflammatory character of atherosclerosis is better understood. We address this in more detail below. Because of the vasodilation role of NO, loss of the EGX is almost certainly implicated in hypertension. It’s also likely to be involved in a range of other conditions where the microvasculature plays an essential role. Examples include peripheral artery disease, Raynaud’s, renal disease, diabetic neuropathy, macular degeneration, and erectile dysfunction. In some cases, research has already been conducted on the role of the EGX in the associated pathology. Mostly, we can draw conclusions from what is known about the vascular aspect of these conditions, and the total dependence of the microvasculature on a healthy EGX. For any condition that is exacerbated by compromised blood flow, or by inflammation of the arteries, or by dysfunction of the capillaries, clinical attention should be paid to the condition of the EGX. The Case of Atherosclerosis EGX dysfunction plays an important role in atherogenesis and the specific threat posed by vulnerable plaque. Any insult to the artery wall may prompt an influx of macrophages, and if there’s an opening, these are liable to penetrate the endothelium. Especially in areas of high turbulence, LDL may enter into the

subendothelial space, where it can be oxidized and be ingested by macrophages to form foam cells. These can accumulate to become the most dangerous form of plaque — the unstable, vulnerable type with a lipid-rich necrotic core. If the fragile cap on vulnerable plaque breaks, clots can form and erupt into the lumen. It’s important to note that this mechanism does not require high volumes of circulating LDL,16 which may explain why 50% of myocardial infarctions afflict individuals whose blood lipid levels are “normal”. The importance of the EGX lies at the beginning of the story. Simply put, LDL can only pose a risk if excessive amounts penetrate the endothelium. A healthy EGX will inhibit this from happening, or it will support reverse transport (efflux) if excessive LDL penetration does occur. Restoration of the EGX It should be clear that maintaining a robust EGX is essential for sustained health, and restoring a compromised EGX should be a priority in the treatment of any disorder where vascular dysfunction is an issue. As mentioned the EGX, while fragile, is also resilient. It can be repaired rapidly, though as yet no pharmaceutical solution has been specifically designed to meet this need. Lifestyle factors are always important, of course, and any indication of EGX dysfunction should prompt attention to the core issues of diet, exercise, sleep and stress management. A number of glycocalyx regenerating compounds (GRCs) have shown promise in recent years. These include albumin, NAC, and heparin mimetics (Sulodexide). Beyond these options, an understanding of glycomics can help the practitioner. Knowing that the EGX is comprised primarily of glycans, the question becomes: which natural glycans might be provided to help regenerate a compromised EGX? Over the past twenty years, there have been studies of one restorative agent in particular in relation to cardiovascular health that holds promise for this role, rhamnan sulfate (RS). Like many polysaccharides, RS has a complex structure and not all versions found in nature are equally useful. One particular form, derived from a rare seaweed, Monostroma nitidum, has been researched specifically for its potential as

15 Dogné S, Flamion B. Endothelial Glycocalyx Impairment in Disease: Focus on Hyaluronan Shedding. The American Journal of Pathology. 2020;190(4):768-780. doi:10.1016/j.ajpath.2019.11.01 16 Fernández-Friera Leticia, Fuster Valentín, López-Melgar Beatriz, et al. Normal LDL-Cholesterol Levels Are Associated With Subclinical Atherosclerosis in the Absence of Risk Factors. Journal of the American College of Cardiology. 2017;70(24):2979-2991. doi:10.1016/j.jacc.2017.10.024

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GLYCOMICS IN CLINICAL ACTION: THE ENDOTHELIAL GLYCOCALYX

a GRC.17,18 In one study, a microfluidic chip was developed to examine the impact of various GRCs on a living EGX in laboratory conditions. The study showed that marine-sourced RS was the most effective GRC and quickly rebuilt an EGX compromised by sugar exposure. Conclusion For clinicians, the most important conclusion to be drawn from this overview is the decisive role in human health that is played by a physiological structure that is still widely unknown: the endothelial glycocalyx. Becoming acquainted with the EGX, learning to recognize its dysfunction, and researching ways to restore and protect it, are worthwhile priorities for every practitioner. More broadly, the role of the EGX exemplifies the growing significance of glycomics, and we can expect a wave of new discoveries to open up new therapeutic opportunities in the near future.

Dr. Messier earned a PhD in molecular immunology and an MD in family medicine. She practices and teaches functional medicine. Her passion is bringing scientific understanding into clinical practice so that patients can benefit from research findings sooner.

17 Cancel LM, Tarbell JM. Rhamnan sulfate enhances the endothelial glycocalyx and decreases the LDL permeability of human coronary artery endothelial cells in vitro. The FASEB Journal. 2013;27(S1):896.3-896.3. doi:https://doi.org/10.1096/fasebj.27.1_supplement.896.3 18 Okamoto T, Akita N, Terasawa M, Hayashi T, Suzuki K. Rhamnan sulfate extracted from Monostroma nitidum attenuates blood coagulation and inflammation of vascular endothelial cells. J Nat Med. 2019;73(3):614-619. doi:10.1007/s11418-019-01289-5

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The Roles of NAD+ in Healthy Aging and AgeAssociated Disorders

By: Kendra Whitmire, MS, CNS 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 | WINTER 2021

The Roles of NAD+ in Healthy Aging and Age-Associated Disorders

Nicotinamide adenine dinucleotide (NAD+) is an important molecule present in every cell in the body, and it is involved in more than 500 enzymatic reactions. NAD+ and its reduced form as nicotinaminde adenine dinucleotide + hydrogen (NADH) play key roles in energy metabolism, mitochondrial functions, calcium homeostasis, immunological functions, gene expression, cell death, and aging.1 In energy metabolism, NAD+ serves as an electron acceptor and NADH is an electron donor during glycolysis, the tricarboxylic acid cycle, and oxidative phosphorylation for adenosine diphosphate (ATP) synthesis.2 NAD conjugates with phosphate to become nicotinamide adenine dinucleotide phosphate (NADP), which may also be reduced to NADP + hydrogen (NADPH). Among their functions in the body, NADP and NADPH participate in anabolic processes including the synthesis of cholesterol and fatty acids. Additionally, NADPH serves as a coenzyme for reducing reactive oxygen species and maintaining redox balance. The reduction of the antioxidant proteins thioredoxin and glutathione requires NADPH.3 As molecules are consistently accepting and donating electrons, the ratios of the oxidized form to reduced forms of NAD+ and NADP play central roles in redox balance and the function of NAD-associated cellular processes.2 For example, the NADPH:NADP+ ratio increases to enhance the production of fatty acids, amino acids, and other key molecules. Changes to the ratios may also be a marker of dysfunction. Studies have found a diminished NAD+:NADH ratio associated with aging muscle and increased susceptibility to oxidative stress.4 NAD+ Synthesis There are three pathways for NAD+ biosynthesis in mammalian cells: the Preiss-Handler pathway, de novo synthesis, and salvage pathway. The originating sources are nicotinic acid, tryptophan, or nicotinamide mononucleotide (NMN), respectively.3,5,6 The Preiss-Handler pathway begins with nicotinic acid (NA), which undergoes an enzymatic reaction by nicotinic acid phosphoribosyltransferase (NAPRT) to become nicotinic acid mononucleotide (NAMN). This is used in the biosynthesis of nicotinic acid adenine dinucleotide (NAAD+), which is transformed to NAD+ in a reaction by NAD+ synthetase with ammonia and ATP as the byproducts. In de novo synthesis, the amino acid tryptophan undergoes a process of several steps that includes catabolism via the kynurenine pathway to become NAMN, and then it undergoes the same process as the Preiss-Handler pathway to become NAD+.3,7,8

The primary source for NAD+ is the salvage pathway. This pathway involves recycling of the intermediate degradative products of NAD+. The NAD-consuming enzymes degrade NAD into the byproduct NAM. The rate-limiting enzyme nicotinamide phosphoribosyltransferase (NAMPT) converts nicotinamide (NAM) and 5-phosphoribosyl-1-pyrophosphate (PRPP) into NMN, a substrate for NAMT. This is conjugated to ATP to be converted to NAD+ by NMN adenylyltransferase (NMNAT). This pathway can also be fueled by nicotinamide riboside (NR), which can be phosphorylated into NMN.3,9,10 The Multiple Roles of NAD-Consuming Enzymes NAD+ levels significantly impact the activity of NAD-consuming enzymes, such as sirtuins, poly(adenosine diphosphate-ribose) polymerases (PARPS), and CD38, which are involved in the cellular processes that influence important functions, including immune health, blood sugar metabolism, heart health, cognitive function, and healthy aging. When NAD+ levels become insufficient, the activity of these enzymes also decreases, which affects downstream processes. Additionally, the upregulated activity of one or more of these enzymes may deplete NAD+ levels for other NAD-dependent processes, which leads to dysfunction.11 Sirtuins (SIRT), or the silent information regulator 2 (Sir2), are histone deacetylases requiring NAD for enzymatic activity.12 NAD+ acts as a sirtuin activator, and NAD+ substrates, such as NADH and nicotinamide, act as inhibitors. There are seven sirtuins in mammalian cells that play a variety of roles in cellular function, including energy homeostasis, cell cycle, redox balance, and apoptosis.3,13,14 One of the best studied sirtuins is SIRT1, which has been found to be associated with energy production, longevity, DNA repair, glucose metabolism, neuroprotection, and vascular protection.15,16 Studies have also found associations between genetic single-nucleotide polymorphisms (SNPs) in SIRT1 and the risk for obesity, type 2 diabetes, and heart disease,17-19 suggesting a role in SIRT1 and metabolic health. In patients with type 2 diabetes, there was a decrease in NAMPT and SIRT1 expressions.20 PARPS are another family of NAD-consuming enzymes.21 The most well studied is PARP1, which plays a role in DNA repair, gene expression, cell cycle, cell death, inflammation, aging, host-virus interactions, metabolism, and genomic stability.1,22 DNA damage activates PARP1 and mediates key stress signals, with the outcome dependent on the level of activation to result in either repair or initiation of cell death. PARP1 activation can consume significant quantities of NAD+, but it is generally

ANTI-AGING MEDICAL NEWS | WINTER 2021

The Roles of NAD+ in Healthy Aging and Age-Associated Disorders

acute and transient, with NAD+ levels able to quickly recover. However, chronic stress can lead to prolonged activation, which reduces NAD+ levels and its half-life and may impact energy metabolism and other downstream actions. Conversely, inhibition of PARP1 improves mitochondrial function.22,23 Another important class of NAD-consuming enzymes includes the immune-associated ectoenzymes CD38 and CD157. These use NAD+ to produce adenosine diphosphate ribose (ADPR) and hydrolyze cyclic ADPR (cADPR) to mediate intracellular calcium signaling.3 Studies have identified several roles for CD38,24 including mitochondrial dysfunction, inflammation, metabolic disease, diet-induced obesity,25 cancer, oxytocin release, social skills,26 and the immune response.27 CD38 may be a major consumer of NAD+, as 100 molecules are necessary to generate one molecule of cADPR, and CD38-deficient mice have been found to have 10 to 20 times the NAD+ levels in their tissues.28 These enzymes may work collaboratively to support healthy aging or they may inhibit one another. If one of these enzymes becomes overactivated, then it may consume excess NAD+, leaving less for the other enzymes and NAD-required activities in the cell.11,29 This relationship may be dependent on the circumstance. For example, PARP-1 and SIRT1 may work together to promote cell survival under excess stress, or they may interrupt one another’s activity.30 The Connection Between NAD+ and Aging The role NAD+ plays in energy metabolism has long been recognized, but more recent studies demonstrate it may play a role in aging and age-related diseases.11 The mechanisms underlying this association remain under investigation, but this likely has to do with the impact on energy production, mitochondrial function, autophagy, and activity of NAD-consuming enzymes.11 Several animal model studies have found a correlation between NAD+ deficiency and several diseases and disorders, including aging and associated disorders, neurodegenerative disorders, such as Alzheimer’s disease and Parkinson’s disease, and cardiovascular health, diabetes, metabolic syndrome, and obesity.31 One human study looked at plasma samples to determine levels of NAD+ and its associated metabolites. There was an age-related reduction in the plasma levels of NAD+, NADP+, and metabolites, such as nicotinic acid adenine dinucleotide (NAAD) and an increase in NADH and NADPH, NAM, N-methylnicotinamide, and adenosine diphosphate ribose (ADPR). There was also a significant decrease in the ratios of NAD+:NADH, NAD+:ADPR, and NAD+:NAM and a significant increase in the

NADPH:NADP+ ratio, which may indicate excess oxidative stress.4 In a study on samples of human pelvic skin tissue, there was a strong negative association between NAD+ levels and age for both males and females. The male samples also had a negative correlation between NAD+ levels and the activity of NAD-dependent enzyme SIRT1. Males also experienced an increase in PARP activity that had an inverse association with NAD+ levels. These samples also had increased markers for oxidative stress, demonstrating a connection between the accumulation of oxidative damage and increased NAD+ catabolism and depletion.32 Researchers of an in vivo study assessing a novel noninvasive NAD assay on the brain of healthy adults found a gradual but significant decline in the brain’s NAD+:NADH ratio that was associated with reduced NAD+ levels corresponding with age.33 Another study on mice found a reduction of NAMPT and NAD+ in adult neural stem/progenitor cells, which are known to decrease with age and to play a role in cognitive function.34 A human cell and a mouse study found increased expression of CD38 in aging. CD38 levels were higher in the older mice compared to the younger ones and in the mice who were in a pro-inflammatory state due to lipopolysaccharide treatment. During both acute and low-grade chronic inflammation, there was an increase in CD38 activation. The researchers determined the change in NAD+ levels were solely due to this increase in CD38 and that this could be one reason for the reduced NAD+ levels in older age.35 Potential Benefits of Increasing NAD+ Levels with NMN With the associations between dysfunction and reduced NAD+ levels and NAD-consuming enzymes, researchers have begun to look at potential health benefits to increasing NAD+ levels. For example, increasing NAD+ levels have been shown to activate SIRT1 to mitigate some of the age-related and other downstream effects of reduced SIRT1 activity, such as mitochondrial function.36 It may also mediate inflammation and stress responses, support cardiovascular and neurological function, and extend lifespan.37 Supplemental NAD+ precursors (such as NMN) have been found to be beneficial for raising NAD+ levels and associated cellular processes for improved function. Mouse studies have found that NMN supplementation restored healthy glucose metabolism pancreatic islet function and reduced inflammation.38 After NMN supplementation in one study, female mice experienced a complete normalization of glucose and insulin tolerance. The male mice experienced a milder

ANTI-AGING MEDICAL NEWS | WINTER 2021

The Roles of NAD+ in Healthy Aging and Age-Associated Disorders

normalization of glucose tolerance, but not insulin tolerance. The researchers postulated that SIRT1 activation likely played a role in mitigating the effects and improving glucose metabolism.38

activity, insulin sensitivity, and plasma lipid levels. Benefits were also observed in other areas commonly known to be agerelated declines, including bone density and eye function.48

Another study found that administering NMN led to improved glucose tolerance in SIRT1-overexpressing mice. At a young age, the mice experienced improved glucose tolerance and enhanced glucose-stimulated insulin secretion, but this benefit was eliminated as they reached 18 to 24 months of age when they experienced an age-associated reduction of beta-cell activity. NMN supplementation led to a normalization of function.39 In NAMPT-deficit mice who experienced glucose intolerance due to beta-cell dysfunction, administration of NMN led to similar insulin levels as the control group in correcting the dysfunction.40

Human studies on NMN supplementation are ongoing. A small clinical study has found supplementation to be safe, and it leads to a dose-dependent increase of NAD+ metabolites.49 A 6-week randomized, double-blind, placebo-controlled, four-arm clinical trial on amateur runners found that NMN supplementation increased circulatory NAD+ and led to an increase in aerobic capacity, likely due to enhanced oxygen utilization in skeletal muscle.50

Several mouse studies have also demonstrated the potential for NMN to benefit the heart. One study found it protected against ischemia/reperfusion injury in the heart by maintaining NAD+ levels to activate SIRT1.41 Another found it prevented heart failure and helped maintain healthy mitochondrial function in the heart.42

Research demonstrates the potential for improving NAD+ levels with precursors such as NMN to promote healthy aging, redox balance, and a healthy inflammatory response.* The research also indicates potentially improved support for mitochondrial function, heart health, cognitive function, and glucose metabolism.*

NMN may also reverse age-associated arterial dysfunction and oxidative stress through mitigating SIRT1 activity. In a mouse study, NMN supplementation improved vascular function markers and led to 3 times the NAD+ level, in addition to a significant increase in antioxidant markers.43 In a study on human aortic endothelial cells (HAECs), NMN and NR reduced inflammation and reversed dysfunction in the endothelium. The researchers expanded their study and used mice to determine the likelihood that it was due to the effect on CD73, a NAD-dependent enzyme in the same family as CD38.44 Supplementation of NMN may also benefit neurological function. One mouse study evaluating NMN supplementation found it increased SIRT1 and CD38 levels and improved mitochondrial function in the brain, which may improve cognitive function and prevent neurodegeneration.45 Another study found that NMN supplementation in a mouse model of Alzheimer’s disease led to an improvement in cognitive function and improved NAD+ and ATP levels, and that it also improved oxidative stress, protecting against amyloid-beta induced cognitive impairment and neuronal death.46 NMN is also protective against age-related cerebromicrovascular dysfunction that may lead to cognitive impairment.47

Kendra Whitmire, MS, CNS, is a nutritionist and writer. She received her master’s in nutrition and functional medicine from the University of Western States and is a Certified Nutrition Specialist.

NMN may have a wide range of impact by improving several age-related dysfunctions. In one study, a group of mice took NMN for 12 months and experienced suppression of age-associated weight gain, enhanced energy metabolism, and improved physical ANTI-AGING MEDICAL NEWS | WINTER 2021

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CBD & Pain By: Sahar Swidan, PharmD, BCPS, ABAAHP, FAARFM, FACA 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.

CBD and Pain

Chronic pain has proven to be a complex condition to manage, often complicated by reductions in mobility and daily activity, anxiety and depression, and an overall reduction in quality of life. This coupled with the risk of opioid dependence has led to both patients and practitioners searching for treatment alternatives.1 While the use of cannabis-based medicine has been around for hundreds of years to treat different pain conditions, interest in cannabis and its components has recently exploded as more is learned about its mechanisms of action and the body’s own endocannabinoid system.2 Out of more than 100 pharmacologically active cannabinoids discovered in the Cannabis Sativa plant, ∆ 9-tetrahydrocannabinol (THC) and cannabidiol (CBD) and are the two major cannabinoids that are most medically relevant for treating pain as well as a variety of other conditions. THC is the psychoactive component of cannabis and has been studied extensively for its pharmacology, toxicity and therapeutic potential.3 CBD is less studied than THC but could be a promising candidate for pain management and an alternative to opioids due to its nonpsychoactive properties, better safety profile, and its analgesic, anti-inflammatory, antioxidant, and anxiolytic activity.2,4,5 The exact mechanism of CBD is currently not known but it has been shown to interact with various receptors, enzymes, and ion channels and can interact both directly and indirectly with the body’s endocannabinoid system.3 The Endocannabinoid System The endocannabinoid system is a network of receptors, signaling molecules, and synthetic and degrading enzymes that are distributed throughout the peripheral and central nervous systems of the body.4,6 Its main function is to keep the body in a state of homeostasis through communication with other body systems, resulting in the regulation of metabolism and food behavior, mood and anxiety, pain perception, memory, and reward.2,7 Cannabinoids such as THC and CBD can mimic the body’s natural endocannabinoids and activate the endogenous endocannabinoid system. Modulating this system could lead to therapeutic benefits not only for pain but a variety of other diseases, including mental health disorders, neurological and movement disorders, autoimmune disease, spinal cord injury, cancer, cardiovascular disease, stroke, traumatic brain injury, and osteoporosis.7 The endocannabinoid system consists of 3 main components: cannabinoid receptors, endocannabinoids, and metabolic enzymes. Cannabinoid receptors

The effects of endocannabinoids are primarily mediated by the CB1 and CB2 cannabinoid receptors.8 Both CB1 and CB2 are G protein coupled receptors affecting c-AMP. CB1 receptors are predominantly found in the central nervous system (CNS), especially in the nociceptive areas of the brain such as the cortex, basal ganglia, hippocampus, and cerebellum. They can also be found on certain cells of the immune system, adipose tissue, liver, muscle, reproductive cells, kidney, and lungs.2,7,8 CB2 receptors are found to a much lesser extent in the CNS but are more prevalent in the peripheral nervous system and lymphoid and immune tissues.2 CB2 receptors have been shown to increase up to 100 fold following tissue injury or inflammation and play a role in pain modulation and the inflammatory process.2,9 Endocannabinoids and Metabolic Enzymes The body’s endocannabinoid system creates endogenous cannabinoid signaling molecules when needed. Endocannabinoids differ from conventional neurotransmitters in that they are typically synthesized in postganglionic neurons and released in one or two rapid enzymatic steps, as opposed to being synthesized priori and stored in vesicles in preganglionic neurons, ready for release into the extracellular space.7,8 Endocannabinoids also diffuse in a reverse direction and exert their effects through receptors on preganglionic neurons. Conventional neurotransmitters diffuse from preganglionic to postganglionic neurons.7 The body’s two major endocannabinoids are anandamide (AEA) and 2-arachidonoylglycerol (2-AG). 2-AG and AEA serve as ligands to CB1 and CB2 receptors and can be created from arachidonic acid when needed.10 Endocannabinoids have both a short range of effects and short half life prior to their degradation.11 In addition to interacting with cannabinoid receptors, endocannabinoids can also fine-tune cell homeostasis through coordinating interactions with more than one target at once.12 Two major enzymes responsible for degrading endocannabinoids are fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL). MAGL is the primary enzyme for metabolizing 2-AG and FAAH is the primary enzyme responsible for the degradation of AEA.13,14 CBD and the Endocannabinoid System CBD is both hydrophobic and lipophilic, allowing it to easily cross the blood-brain barrier.15 Despite a low affinity for CB1 and CB2 receptors, CBD has a wide range of therapeutic effects due to its multiple mechanisms of action. CBD has been shown to inhibit endocannabinoid reuptake, transient receptor potential vaniliod 1 and G protein-

CBD and Pain

coupled receptor 55 activation, and can increase the activity of 5HT1A receptors.16 CBD is also known to decrease microglial and macrophage migration, which may explain its ability to decrease inflammation and provide neuroprotective effects.17 Proof of efficacy of CBD is currently limited to use of Epidiolex as an anti-epileptic. Epidiolex is a pure CBD product that is FDA approved for the treatment of seizures associated with Lennnox-Gastraut syndrome, Dravet syndrome, or tuberous sclerosis complex in patients ≥ 1 year of age.3 Three other FDA approved cannabinoid products are nabiximols (Sativex), dronabinol and nabilone. Nabiximols is a product that contains a nonsynthetic 1:1 ratio of THC and CBD in an oromucosal spray and is approved for the treatment of neuropathic pain and MS-related ailments. Dronabinol and nabilone are synthetic THC products approved for the treatment of weight loss in AIDS patients and chemotherapy-induced nausea.18

0.5 mg THC, 0.3 mg cannabidivarin (CBDV), 0.9 mg cannabidiolic acid (CBDA), 0.8 mg canabichrome (CBC), and > 1% botanical terpene were used in this study. Almost all participants (91) used two soft gels daily during the study period. Over half of the patients (53%) reduced or eliminated their opioids within the 8 weeks study period and almost all (94%) reported quality of life improvements, with a significant improvement in pain and sleep. The study authors concluded that CBD-rich extract could significantly reduce opioid use and improve chronic pain and sleep quality in patients with chronic pain who are currently using opioids. More studies are needed to confirm and expand upon these findings.19 No clinical studies have been conducted to date on the use of CBD for complex regional pain syndrome, however, anecdotal evidence suggests its potential effectiveness for this condition.20 Recent Studies of CBD use in Fibromyalgia

CBD Use in Chronic Pain The beneficial effects of cannabinoids, including CBD, have been demonstrated in many preclinical animal models of acute pain, chronic pain, and neuropathic pain.7 Nabiximols (1:1 ratio of TCH/CBD) are the most clinically studied and currently used cannabinoid pharmaceutical product in the treatment of chronic pain.18 Currently, clinical data for CBD-induced analgesia are limited.7 Xu et al recently conducted a randomized, placebo-controlled pilot study using topical CBD oil in 29 patients with symptomatic peripheral neuropathy of the lower extremities. This is the first known study to analyze the effects of CBD oil in this patient population. Patients randomized to the CBD group applied CBD topically (250 mg CBD/3 fl. oz) to symptomatic areas up to four times per day or placebo for 4 weeks. After 4 weeks, the placebo group was allowed to crossover into the treatment group. Study results demonstrated significant reductions in neuropathic pain scale (NPS) domains compared to placebo for intense pain, sharp pain, and cold and itchy sensations, with a larger reduction in ratings of intense pain, sharp pain and itchy sensations. Although not statistically significant, there was a greater overall reduction in ratings for deep pain. There was also a significant time effect observed in the CBD group in reduction of sharp, unpleasant, and surface pain over the 4 week study period. No adverse events were reported in the study. Study authors concluded that CBD oil can be effective for this patient population for improving pain and other types of sensations common in peripheral neuropathy and may be an effective alternative therapy.5 Capano el al conducted an 8 week, prospective, single-arm cohort study in 97 patients with chronic pain to assess the impact of full hemp extract on opioid use and quality of life measures. CBD -rich soft gels containing 15.7 mg CBD,

Clinical data for cannabinoid use in fibromyalgia is currently limited. Early clinical studies used nabilone with limited success, however most evidence is based on retrospective trials.21 Despite very limited research, there is some evidence to support the use of CBD in fibromyalgia and, given its known immunomodulatory and pain perception effects, many patients are trying CBD products as a substitute for conventional pain medications. A recent national online survey by Boehnke et al found that CBD product use is common among individuals with fibromyalgia. Many of the individuals using CBD in this study reported improvements across numerous FM-related symptoms.22 A secondary analysis of participants > 18 year of age and currently using CBD products (N=878) found that CBD products were used as a substitute for pain medications. Overall, 72% of participants in the secondary analysis indicated that they had substituted CBD products for pain medications. CBD products were most commonly substituted for NSAIDS (59.0%), opioids (53.3%), gabapentanoids (35.0%), and benzodiazepines (23.1%). When individuals were subdivided by most commonly used CBD product (ie, CBD isolate, hemp (CBD products with <0.3% THC), and CB-cannabis (CBD products with >0.3% THC), the CBD-cannabis subgroup had the highest proportion of participants (79.4%) reporting CBD product substitution for other pain medications, followed by the hemp subgroup (74.7%), and isolate (64.3%). The most common reasons for substituting CBD products for pain medications were fewer adverse side effects and better symptom management. Overall, those who substituted CBD products reported greater symptom improvements that those who did not, with the greatest symptom improvements reported in the CBD-cannabis subgroup.23 Van de Donk et al conducted a double-blind, randomized, placebo-controlled 4-way crossover study to examine the effects

CBD and Pain

of cannabis in 20 chronic pain patients with fibromyalgia. Every patient received each of the 4 possible pharmaceutical grade treatments (high THC/ low CBD; high CBD/low THC; combined high THC/high CBD; and a cannabis placebo containing no TCH or CBD but full terpene profile). Each product was delivered as a single inhalation in random order with at least 2 weeks in between visits. Pain thresholds, spontaneous pain scores, and drug high were assessed at multiple time points for 3 hours post dose. None of the treatments had an effect greater than placebo on spontaneous pain scores. Compared to placebo responder rates, significantly more patients responded to high dose THC/high dose CBD, with a 30% reduction in spontaneous pain. The other 2 active treatments were similar to placebo. Pain reduction score correlated with magnitude of drug high. Pressure pain threshold increased significantly during exposure to high THC content cannabis products. Interestingly, exposure to high CBD content cannabis did not demonstrate analgesic activity in any of the spontaneous or evoked pain models. Study authors proposed that a single CBD dose may be insufficient to demonstrate an analgesic response, the dose may have been too low in the study, or perhaps the benefits of CBD in chronic pain may be related more to improvements in insomnia, anxiety, cognition, and/or mood. THC and CBD appeared to have synergistic pharmacokinetic actions but antagonistic pharmacodynamic interactions when inhaled together. The most commonly reported adverse events not related to inhalation were drug high, dizziness, and nausea.24 CBD Safety Considerations CBD has been shown to be safe and well tolerated in both animal pain models and clinical studies.3 Clinical data indicate that isolated CBD used chronically at doses as high as 1,500 mg/day are safe and well tolerated without significant adverse effects.17 The most commonly reported adverse effects are tiredness, diarrhea, dry mouth, and changes in appetite and weight.25,26 Use of CBD can cause elevated liver function tests and caution should be used in patients with known hepatic dysfunction.16 Length of treatment, variability in CBD formulation, dose, and route of administration (eg, smoking, oral, mucosal, rectal, transcutaneous, intravenous) also affect safety. CBD is metabolized in the liver and intestine by cytochrome P450 (CYP) CYP2C19 and CYP3A4, and 5’ diphosphoglucuronosyltransferase (UGT).27 Monitoring for drug interactions is important since patients with chronic pain conditions typically take multiple medications, including anti-epileptics and antidepressants. Other potential safety concerns are cytotoxicity, decreased receptor activity, and diminished effects over time.17,24 The terminal half-life is between 18 and 32 hours.18

Hemp-derived cannabis extracts with TCH <0.3% have been deemed federally legal and are widely available as overthe-counter products. It is important to note that most are unregulated without rigorous standardization of CBD potency, content of other constituents, or clinical information.28 When it comes to choosing a high-quality product, health care providers can be a key resource for patients. The Mayo Clinic published a checklist for assessing quality of CBD and hemp oil products based on requirements that they use for collaboration with dietary supplement manufacturers. This checklist can be a useful tool to aid healthcare providers in their research of high-quality products from reputable companies.16

References 1. Dahlhamer J, Lucas J, Zelaya, C, et al. Prevalence of chronic pain and high-impact chronic pain among adults — United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001–1006. DOI: http://dx.doi.org/10.15585/mmwr.mm6736a2 2. Boyaji S, Merkow J, Elman RNM, Kaye AD, Yong RJ, Urman RD. The role of cannabidiol (CBD) in chronic pain management: an assessment of current evidence. Curr Pain Headache Rep. 2020;24(2):4. Published 2020 Jan 24. doi:10.1007/s11916-020-0835-4 3. Mlost J, Bryk M, Starowicz K. Cannabidiol for pain treatment: focus on pharmacology and mechanism of action. Int J Mol Sci. 2020;21(22):8870. Published 2020 Nov 23. doi:10.3390/ijms21228870 4. Brandly D. CBD and chronic pain. Published March 4, 2018. Accessed October 30, 2021. https:// drdavidbrady.com/cbd-chronic-pain/ 5. Xu DH, Cullen BD, Tang M, Fang Y. The effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities. Curr Pharm Biotechnol. 2020;21(5):390-402. doi:10.2174/1389201020666191202111534 6. Ebbert JO, Scharf EL, Hurt RT. Medical cannabis. Mayo Clin Proc. 2018;93(12):1842-1847. doi:10.1016/j.mayocp.2018.09.005 7. Corroon J, Felice JF. The endocannabinoid system and its modulation by cannabidiol (CBD). Altern Ther Health Med. 2019;25(S2):6-14. 8. Lu HC, Mackie K. An introduction to the endogenous cannabinoid system. Biol Psychiatry. 2016;79(7):516525. doi:10.1016/j.biopsych.2015.07.028 9. Maresz K, Carrier EJ, Ponomarev ED, Hillard CJ, Dittel BN. Modulation of the cannabinoid CB2 receptor in microglial cells in response to inflammatory stimuli. J Neurochem. 2005;95(2):437-445. doi:10.1111/j.1471-4159.2005.03380.x 10. Mouslech Z, Valla V. Endocannabinoid system: An overview of its potential in current medical practice. Neuro Endocrinol Lett. 2009;30(2):153-179. 11. Carter W. What is the endocannabinoid system? An introduction to the ECS. Published June 30, 2020. Accessed October 30, 2021. https://www.cbdmd.com/blog/post/ an-introduction-to-the-endocannabinoid-system

CBD and Pain

12. Di Marzo V, De Petrocellis L. Why do cannabinoid receptors have more than one endogenous ligand?. Philos Trans R Soc Lond B Biol Sci. 2012;367(1607):32163228. doi:10.1098/rstb.2011.0382 13. Gil-Ordóñez A, Martín-Fontecha M, Ortega-Gutiérrez S, López-Rodríguez ML. Monoacylglycerol lipase (MAGL) as a promising therapeutic target. Biochem Pharmacol. 2018;157:18-32. doi:10.1016/j.bcp.2018.07.036 14. Ahn K, Johnson DS, Cravatt BF. Fatty acid amide hydrolase as a potential therapeutic target for the treatment of pain and CNS disorders. Expert Opin Drug Discov. 2009;4(7):763-784. doi:10.1517/17460440903018857 15. Lutz J. The empowered patient’s guide to CBD. Published June 22, 2021. Accessed October 20, 2021. https://www. practicalpainmanagement.com/patient/treatments/ marijuana-cannabis/empowered-pain-patient-guide-cbd 16. VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ guide to cannabidiol and hemp oils. Mayo Clin Proc. 2019;94(9):1840-1851. doi:10.1016/j.mayocp.2019.01.003 17. Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JA. Safety and side effects of cannabidiol, a cannabis sativa constituent. Curr Drug Saf. 2011;6(4):237-249. doi:10.2174/157488611798280924 18. Urits I, Gress K, Charipova K, et al. Use of cannabidiol (CBD) for the treatment of chronic pain. Best Pract Res Clin Anaesthesiol. 2020;34(3):463-477. doi:10.1016/j.bpa.2020.06.004 19. Capano A, Weaver R, Burkman E. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgrad Med. 2020;132(1):56-61. doi:10.1080/00325481.2019.1685298 20. Potts S. CBD for CRPS. Published November 28, 2018. Accessed October 29, 2021. https://cbdinstead.com/ blogs/cbd-and-pain-management/cbd-for-crps

21. Berger AA, Keefe J, Winnick A, et al. Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia. Best Pract Res Clin Anaesthesiol. 2020;34(3):617-631. doi:10.1016/j.bpa.2020.08.010 22. Boehnke KF, Gagnier JJ, Matallana L, Williams DA. Cannabidiol use for fibromyalgia: prevalence of use and perceptions of effectiveness in a large online survey. J Pain. 2021;22(5):556-566. doi:10.1016/j.jpain.2020.12.001 23. Boehnke KF, Gagnier JJ, Matallana L, Williams DA. Substituting cannabidiol for opioids and pain medications among individuals with fibromyalgia: a large online survey [published online ahead of print, 2021 May 13]. J Pain. 2021;S1526-5900(21)00220-0. doi:10.1016/j.jpain.2021.04.011 24. van de Donk T, Niesters M, Kowal MA, Olofsen E, Dahan A, van Velzen M. An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain. 2019;160(4):860-869. doi:10.1097/j.pain.0000000000001464 25. 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(1):139154. Published 2017 Jun 1. doi:10.1089/can.2016.0034 26. Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res. 2018;3(1):152-161. Published 2018 Jul 1. doi:10.1089/can.2018.0006 27. Epidiolex. Package insert. Greenwich Biosciences. 2021. 28. Pauli CS, Conroy M, Vanden Heuvel BD, Park SH. Cannabidiol drugs clinical trial outcomes and adverse effects. Front Pharmacol. 2020;11:63. Published 2020 Feb 25. doi:10.3389/fphar.2020.00063

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Improving Survival Through the Elimination of Circulating Pro-metastatic Clusters By: Mark A Rosenberg, MD 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 | WINTER 2021

Improving Survival Through the Elimination of Circulating Pro-metastatic Clusters

Improvement in survival for most advanced stage solid tumors, unfortunately, can be measured in months and not years. The ancients recognized that there was no curative treatment once the cancer had spread and that intervention might be more harmful than no treatment at all. Galen, the Greek physician and philosopher, did write about surgical cures for breast cancer but only if the tumor could be completely removed at an early stage. In modern times, if we resect the tumor before it has spread, the patient is cured. On the other hand, if spreading has already occurred, the result would be no different than during the times of Galen; the patient will succumb to their disease. The difference between ancient and modern times, is that we now have different modalities to “buy some time,” and somewhat extend survival. The primary weapons used to treat cancer are surgical resection, chemotherapy, radiation therapy, drugs that target specific receptors or genes, and finally, immunotherapy. Chemotherapy has been used for many years and unfortunately the contribution to survival has been disappointing. There was a landmark article published in the journal, “Clinical Oncology” in December 2004, entitled, “The Contribution of Cytotoxic Chemotherapy to Five-Year Survival in Adult Malignancies.”The investigators analyzed results of all randomized clinical trials performed in Australia and the U.S. that reported a statistically significant increase in five-year survival due to the use of chemotherapy in adult malignancies (between 1990 in 2004). The study conclusions were the following: the contribution to five-year survival in Australia was 2.3%; the contribution to five-year survival in the U.S. was 2.1%; median survival in lung cancer has increased by two months in the past 20 years; overall survival benefit of less than 5% has been achieved in the adjuvant treatment of breast, colon, and head and neck cancers. Most individuals do not succumb to their primary tumors, rather they succumb to metastatic disease. The gateway to metastatic disease involves detachment of cells from the primary tumor, intravasation of the cells into blood vessels, at which time they are termed circulating tumor cells (CTCs), followed by the eventual extravasation from blood vessels. These CTCs are destined, or primed, at an early stage, to extravasate and then infiltrate a specific organ/milieu, such as bone, long, liver, etc. Multiple studies have revealed that the number of CTCs found, correlate with patient survival. In fact, quantifying CTCs has been shown to be a more accurate prognostic factor with regards to survival then either the trends in imaging studies (progression or regression) or tumor markers. For example, in one study, 177 newly diagnosed patients with metastatic breast cancer were in rolled; 83

were receiving initial therapy for metastatic breast cancer. CTCs were measured at initiation of therapy and monthly thereafter for up to six months. The median overall survival for individuals with greater than or equal to five CTCs at baseline was 10.9 months, whereas individuals with less than five CTCs at baseline, had an overall median survival of 21.9 months. Similar studies were performed with metastatic colorectal cancer and prostate cancer; again, the most important predictor with regards to survival were the number of CTCs. A plethora of data reveals that tumor cells may be shed into circulation with early stage disease, in contrary to the old but prevailing theory, which posits that metastasis is a late event. A recent study, published in nature genetics revealed that up to 80% of metastatic colorectal cancers are likely to have spread to distant locations in the body before the original tumor has exceeded the size of a poppyseed. CTCs have even been detected in the bloodstream in the absence of detectable solid tumor. Because seeding or spreading of the cancer often occurs before we are aware of it, we have to question the efficacy of our staging and screening modalities. A 1 mm lesion that can be seen on an imaging study is comprised of approximately 1 million cancer cells. So, it is quite possible to have metastatic disease, comprised of multiple lesions, that will be missed on imaging studies, because of their small sizes. Improved staging and screening will require blood testing for circulating tumor cells and circulating tumor DNA, and/or evaluation of DNA methylation patterns. Evaluation of cancer that is circulating in the bloodstream will allow us to detect evidence of cancer proliferation even when nothing is seen on a scan. When evaluation of CTCs and circulating tumor DNA becomes standard of care, it will greatly change our practice guidelines. As an integrative oncologist, I have witnessed numerous patients receive adjuvant chemotherapy with curative intent for stage II breast and colorectal cancer, only to be told after completion of therapy, that their disease has spread to other organs. The truth is that the disease did not suddenly spread. It was a process that was occurring much earlier, likely at diagnosis, but we were simply unaware of the ongoing process. The CTCs represent a process through which a local disease becomes a systemic disease. Although rare in the circulation compared with single CTCs, CTC-clusters have 23-50-fold increased metastatic potential. Studies have also revealed the involvement of CTC clusters very early on upon breast cancer diagnosis, highlighting a previously unappreciated feature of CTC and metastasis biology. Studies have also demonstrated that CTC clusters, despite their rarity, are responsible for seeding ∼50–97% of metastatic tumors in

ANTI-AGING MEDICAL NEWS | WINTER 2021

Improving Survival Through the Elimination of Circulating Pro-metastatic Clusters

mouse models. Experiments also revealed that the detection of only one CTC cluster in blood at any given time point correlated with significantly lower survival rates in the patients with prostate, colorectal, breast and small-cell lung cancers. Another type of cell that is instrumental in the metastatic process are the cancer associated macrophage-like cells (CAML). CAMLs are a recently identified cancer specific circulating stromal cell common in a variety of solid cancers regardless of disease stage. In several studies, the presence of any large or “giant” CAML was a significant prognosticator for worse outcome. Another entity that is frequently isolated with metastatic disease is the CTC-neutrophil cluster; neutrophils escort circulating tumor cells to enable cell cycle progression. Patients in whom at least one CTC–neutrophil cluster was detected in 7.5 ml of peripheral blood were characterized by a significantly worse progression-free survival compared to patients with five or more CTCs per 7.5 ml of peripheral blood (previously defined as a threshold for adverse outcome), as well as when compared to all patients with no CTC– neutrophil clusters, patients with at least one CTC per 7.5 ml of blood or patients in whom either single CTCs or CTC clusters were found. Mice injected with CTCs from CTC–neutrophil clusters developed overt metastasis much faster than those injected with CTCs alone and, accordingly, survived for a shorter time. Thus, CTC–neutrophil clusters represent the most efficient metastasisforming cell subpopulation among breast CTCs, and their presence in the bloodstream of patients is associated with a poor prognosis.

anoikis, and physical shielding against the attacks of the immune cells. If a technique were to be developed that allowed for the elimination of circulating cells that promote metastatic seeding, could cancer then become a local disease, which can be more adequately managed? In 2018, a mouse study was published entitled, “Selective killing of circulating tumor cells prevents metastasis and extends survival.” In this mouse study, a technique called photodynamic therapy was used to kill CTCs in mice with metastatic large cell lung cancer. The study showed that the elimination of CTCs decreased metastasis and extended survival. After reviewing the above presentation, it should be clear that the conduit that converts a focal cancer into a systemic disease, is the circulation. As long as we allow pro-metastatic clusters to leave the circulation and find their new homes, it is extremely unlikely that we will ever truly “cure” cancer, once it has spread. I, Mark A Rosenberg, M.D., have recently filed a provisional patent for an external blood filtration device, that will attempt render these circulating clusters harmless.

Cancer-associated fibroblasts (CAFs) present in clusters can further enhance the survival of CTCs in circulation. CAFs can help cancer cells to survive in circulation by conferring resistance to the fluid shear forces, the main cause of CTC death in the circulation. Furthermore, they may contribute to create a suitable environment for CTCs to survive and proliferate at distant sites, probably protected from immune attack due to CAFs-mediated immune evasion. It is also important to keep in mind that CTC clusters are often not simply a collection of tumor cells.CTC clusters often include some other non-tumor cells such as endothelial cells, erythrocytes, stromal cells, leukocytes, platelets, and cancer-associated fibroblasts. These non-malignant counterparts were believed to provide advantages for CTC clusters survival. Higher metastatic potential of CTC clusters has been reported to be related to several factors. These factors include the cooperation of heterogeneous cell phenotypes within the clusters, strong cell–cell adhesions, which protect the tumor cells against

ANTI-AGING MEDICAL NEWS | WINTER 2021

Stay in * Control NEW UNIQUE FORMULA!

Supports healthy immune response to normal biological stress* Respiratory and joint health* Ache ActionTM is a clean botanical blend of standardized Willow bark, Ginger, and Boswellia extracts that helps maintain the normal balance of key immune mediators to promote joint comfort and mobility.* With 60,000 units of activity, serrapeptase supports healthy immune system function and promotes the body’s normal healing processes.* It may also support respiratory health by helping to maintain normal mucus function.* facebook.com/ProtocolForLifeBalance linkedin.com/company/protocol-for-life-balance instagram.com/protocolforlife

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Product Announcements

Global Direct by Access

Libido Pro Female A Botanical Boost*

Booth #7013 Access Medical Labs Ph: 866-720-8386 | www.accessmedlab.com Access Medical Laboratories is introducing Global Direct by Access, offering next day test results from anywhere in the country. Global Direct by Access encompasses a complete menu of test capabilities through blood, saliva, urine & swab samples. Receive your patients’ results the day after collection using our unique lab kits and simple collection process. Empower your patients as they take control of their health with fast, accurate, convenient testing.

Allergy Research Group Ph: 800-545-9960 | www.allergyresearchgroup.com Addressing low libido requires a multi-faceted approach. Allergy Research Group® is pleased to announce new Libido Pro Female liquid nutritional supplement. We selected botanicals with long histories of traditional use, uniquely blended to support optimal blood flow, but also to support healthy responses to stress which can hinder sexual desire and pleasure.* Libido Pro Female is made with organic cane sugar-derived ethanol and the highest quality ingredients available. *This statement has not been evaluated by the U.S. Food and Drug administration. The product is not intended to diagnose, treat, cure, or prevent any disease.

Libido Pro Male

Tannic [CF] Serum

Booth #4060

Booth #5063

Allergy Research Group

Alphascience Clinical Skincare

Ph: 800-545-9960 | www.allergyresearchgroup.com

Ph: 760-822-4833 | www.alphascience.com

Addressing low libido requires a multi-faceted approach. Allergy Research Group® is pleased to announce new Libido Pro Male liquid nutritional supplement. We selected botanicals with long histories of traditional use, uniquely blended to support optimal blood flow, but also to support healthy responses to stress which can hinder sexual desire and pleasure.* Libido Pro Male is made with organic cane sugar-derived ethanol and the highest quality ingredients available.

Improves wrinkles, roughness, redness and the general appearance of photo aging. This serum will support the skin’s ecosystem for health with ingredients of natural origin and allowing the skin to retain all of its vital force. 10% stabilized L-Ascorbic Acid: antioxidant, prevents spots and enhances skin radiance, stimulates collagen. 2% Tannic Acid: regulates pigmentation, anti glycation, strengthens blood vessels. 0.5% Ferulic Acid: antioxidant, repairs damages from environmental aggressions. Ginkgo Biloba concentrate: antioxidant, improves skin irrigation.

A Botanical Boost*

Booth #4060

Product Announcements

HA Booster

ASAP Health Max 35

Booth #5063

Booth #5043

Alphascience Clinical Skincare

American Biotech Labs

Ph: 760-822-4833 | www.alphascience.com

Ph: 801-756-1000 |

Plumping moisture concentrate. Organic Silicium fills in and restructure the skin with Hyaluronic Acid. 5% Complex of Organic silicium + Hyaluronic Acid: Penetration of hyaluronic acid and restructures the skin. 1.5% Vegetal Taurine: Boosts cellular energy, provides antioxidant and anti-pollution. 0.5% Pure Hyaluronic Acids: High and low molecular weights for both superficial and deep action. Biomimetic hydration polymer: Optimal and adaptive moisturization. Reinforces the natural barrier function of the skin and protects against environmental damages.

Now a higher concentration nano-silver technology for all your patients’ needs

ASAP Health Max 14

Bliss Clinical Endo Relief Cream

Booth #5043

Booth #4071

American Biotech Labs

Ananda Professional

Ph: 801-756-1000 |

Ph: 618-696-2203 | www.anandaprofessional.com

A stronger daily-dose

Ananda Professional was founded on the passionate belief that the hemp plant and its powerful cannabinoids have a unique ability to balance the mind and body and help you find bliss in everyday moments. The Endo Relief Cream features clinician-selected botanicals and a high concentration of full spectrum cannabinoids to support your body’s natural system and help reduce chronic and monthly vaginal and pelvic discomfort. This waterless formulation delivers relief without disrupting your natural balance.

Product Announcements

Bliss Clinical Flora Balancing Gel

Super Turmero™

Booth #4071

Booth #9009

Ananda Professional

Apex Energetics

Ph: 618-696-2203 | www.anandaprofessional.com

Ph: 1-800-736-4381 | www.apexenergetics.com

Discover a natural way to feel refreshed without fragrances or harsh chemicals. Ananda Professional’s Flora Balancing Gel contains vegan lactic acid and previous from chicory root to restore vaginal flora to a healthy, balanced and blissful state. Moisturizing seaweed and full spectrum hemp extracts soothe vaginal dryness and discomfort while argon and ginseng heighten sensations in intimate moments.

Super Turmero™, new from Apex Energetics, combines the highly effective BCM-95®† turmeric with gingerols, in a proprietary micellized solution. This innovative formula is designed to maximize the absorption and utilization of curcuminoids, which have naturally low oral bioavailability. · Patented blend of curcuminoids with absorption-potentiating turmerones · Ginger extract standardized to 20% gingerols · Black pepper extract (piperine) · Delivery with advanced micellization technology · Great taste | apexenergetics. com/super-turmero | 1-800-736-4381 †BCM-95® is registered exclusive trademark to Arjuna Natural Pvt. Ltd.

Sovereign Copper

AVACEN R2 PRO

Booth #6042

Booth #5079

Argentyn 23 by Natural-Immunogenics

AVACEN Medical

Ph: 888-328-8840 | www.SovereignCopper.com

Ph: 888-428-2236 | www.avacen.com

Sovereign Silver®, recently launched Sovereign Copper® Bio-Active Copper Hydrosol. Sovereign Copper’s dual action blend offers several multi-functional benefits behind its 4 IN 1 formulation, which helps relieve achy joints & bones, while supporting cardiovascular function, healthy hair, skin, & nails, and improved energy & metabolism.* Sovereign Copper is available in multiple sizes and is Gluten Free, GMO Free, and Allergen Free. SovereignCopper.com

The AVACEN R2 PRO is a Heat System for Relaxation. With 14 patents, the AVACEN R2 PRO is the professional model of the AVACEN R2; this model is for commercial applications (Hyperbaric oxygen therapy, spas, physical therapist, chiropractors, and practitioners). Relaxation can help lower heart rates, blood pressure, and oxygen consumption and alleviate the symptoms associated with many conditions, including hypertension, arthritis, insomnia, depression, infertility, cancer, anxiety, and even aging.

Product Announcements

At Home SARS-CoV2 Saliva Test

At Home Covid-19 Antibody Bloodspot Test

Booth #7044

AYUMETRIX

Ph: 503-344-1389 | www.ayumetrix.com

The AYUMETRIX SARS-CoV2 Microchip RT-PCR COVID-19 test that uses a pre-loaded microchip kit with the CDC recommended primers & probes lyophilized in the microchip for testing of the SARS-CoV-2 in saliva collected from the individuals suspected with signs and symptoms of COVID19 infection by their healthcare provider. The test can be used for at-home self saliva collection.

The AYUMETRIX SARS-CoV2 IgG ELISA system is intended for the qualitative and semi-quantitative detection of IgG antibodies in serum and plasma collected from the individuals suspected with signs and symptoms of COVID19 infection by their healthcare provider. This test can be used for at home finger stick bloodspot self sample collection.

Berkeley Life Professional Nitric Oxide Capsules

Megacidin®

Booth #7043 Berkeley Life Professional Nitric Oxide

Biocidin

Ph: 773-750-7745 | www.berkeleylife.com

Ph: 831-786-9711 | www.biocidin.com

Berkeley Life Professional’s proprietary dietary nitrate blend provides the plant-based bioequivalents of a leafy green diet helping patients maintain their nitric oxide levels as they age. Each two capsule dose has the nitrate equivalent of 5oz of spinach and 7oz of beets.

Megacidin®, Biocidin’s newest product, is a convenient, easy-touse throat spray. It combines the 17 herbs and essential oils in Biocidin®TS with a proprietary blend of spore-based probiotics from Microbiome Labs, a pioneer in all-spore probiotics. A human clinical trial (the gold standard in science) shows a 66% increase in sIgA in only 60 minutes following use of Biocidin®TS.1 Also, research shows the probiotics in Megacidin®, Bacillus subtilis® HU58 and Bacillus coagulans® SC-208, have the ability to support immune defenses.2 3. The result is a robust formulation in a convenient oral spray that empowers patients with a science-backed strategy for supporting immune health in daily life or while traveling.

Product Announcements

Biocanic

Biocanic Lite

Booth #7073

Biocanic

Ph: 619-867-2318 | www.biocanic.com

Biocanic is the first of its kind health program intelligence system specifically designed to streamline personalized health programs for integrative physicians. Biocanic helps physicians more effectively design, build and implement personalized health programs by automatically process and centralizing the key lab and assessment data into a single, easy-to-use dashboard. Biocanic currently supports automatic processing of over 80 different lab reports ranging from standard blood chemistry through microbiome, organic acids or advanced hormone tests.

Biocanic Lite is available to practitioners looking for a cost-effective and delightful solution to engage with their clients in their coaching programs. Biocanic Lite takes the best of the Biocanic features and benefits but with no complex usage tiers or limitations. Biocanic products are designed around a long-term engagement model between practitioners and their clients. One flat fee per month, so you can grow your business without worrying about your software prices increasing. Visit www.biocanic.com for a free demo.

Telomere Superior Formula

Astaxanthin Formula

Booth #9049

Biogena

Ph: 213-444-7902 | www.biogena-usa.com

The new way of healthy aging** - Potent combination to support healthy aging and maintain youthful energy** - With niacin, which is required for the activity of sirtuins, improves energy yield in the mitochondria, and thus is involved in normal energy metabolism** - With resveratrol and pterostilbene to maintain youthful gene expression and cellular energy production** - With a combination of potent plant extracts that protect mitochondria from free radicals, which contribute to cellular aging**. ** These statements have not been evaluated by the Food and Drug Administration.

The effective solution for the ultimate antioxidant boost** To enhance the antioxidant capacity and to protect the cell membranes from oxidative damage** - To support the skin’s natural antioxidant defences, increase its elasticity and moisture and decrease hyperpigmentation and wrinkle formation** - To protect eyes from sun damage, help tired eyes caused by an overexposure to computer screens** - To improve muscle endurance of athletes and to support the cardiovascular system** - Contains the carotenoid astaxanthin in highest quality and purity from Austrian algae cultivation. **These statements have not been evaluated by the Food and Drug Administration.

First of its kind health program intelligence system.

Product Announcements

BioPro+ CortiSleep PM

Receptor Detox

Booth #5086

Booth #6013

BioProtein Technology

Biotics Research Corporation

Ph: 800-280-2456 | www.bioproteintech.com

Ph: 800-231-5777 | www.bioticsresearch.com

Want to FIX your patients’ WEIGHT, STRESS, and LIBIDO? The answer is simple: BETTER SLEEP. Inadequate and poor quality sleep increases our stress hormone, Cortisol. Elevated cortisol is linked to weight gain, hormone imbalances, fatigue and more. The solution: BioPro+ CortiSleepPM. CortiSleepPM promotes deeper restorative sleep patterns immediately. It works FASTER, is EASIER to use, and is 100% SAFE. CortiSleepPM supports metabolism, hormones, libido and more! It’s non-habit forming and non-synthetic so there aren’t any side effects like common sleep drugs.

Receptor Daily Detox, formulated by Dr. Devaki Lindsey Berkson, contains carefully selected nutrients shown to gently, effectively and safely optimize hormone receptor function, ensuring healthy hormone signaling. This product is recommended daily for optimal receptor functioning for both females and males, and highly recommended for mature people on hormone replacement.

Hormone Balance & Protect

Weight Loss in a Box™

Booth #6013

Booth #5046

Biotics Research Corporation

ADigital Health

Ph: 800-231-5777 | www.bioticsresearch.com

Ph: 561-247-3839 | www.adigitalhealth.com

Hormone Balance & Protect is a nutritional and herbal formula critical to supporting healthy and safe metabolism of endogenous hormones as well as hormonal therapies. Formulated by Dr. Devaki Lindsey Berkson, this formula provides key nutrients and botanicals to help stabilize hormone levels and enhance their binding, restoring balance to hormonal signaling pathways.

Effortlessly add a new revenue stream to your practice by adding a turnkey weight loss program in your practice. We created Weight Loss in a Box™ so that you and your staff have everything you need to succeed in implementing a weight loss program in your practice - right “out of the box. Weight Loss in a Box™ includes a bluetooth body composition scale, protein shaker, water bottle, stretch exercise band and measuring tape, in a beautifully packaged box, that you can sell as a complete offering to your patients in conjunction with the ADigital Health remote care platform and Weight Loss Roadmap digital program. At a time when seeing patients in person is difficult or impossible, a remote care solution like Weight Loss in a Box™ is the solution you need to help patients and keep revenue flowing.

Product Announcements

Freedom 20R Emerald Package

Discovery 24 Series Emerald Package

Booth #3064

BrainMaster Technologies

Ph: 440-232-6000 | www.brainmaster.com

The Freedom 20R is the latest in mobile EEG technology, offering an unmatched level of usability and signal quality for research and practitioner applications. With the Freedom 20R, you can obtain EEG signals on most subjects in just under two minutes. The headset, which supports the full 10-20 System, adapts to adult and most older child head sizes and is easy to apply with a minimum of adjustment.

This system features 24 channels of EEG Biofeedback recording including: 22 channels connected to a standard electrode cap, plus 2 channels of differential inputs with separate references, useful for monitoring any of a wide range of EEG or related potentials. It offers 1024 samples per second on all channels, with 24-bit resolution, and an amplifier bandwidth from DC (0.000 Hz) to 80 Hz. A lightweight, portable device, it is ideal for use with laptop computers for remote or home training, as well as in clinical or laboratory use. The unit is entirely powered by the USB interface, eliminating the need for batteries, while maintaining client safety.

Emsculpt Neo

Arterosil

Booth #9015

Booth #4026

BTL Industries, Inc.

Calroy Health Sciences

Ph: 866-285-1656 | www.emsculptneo.com

Ph: 1-800-609-6409 | www.arterosil.com

EMSCULPT NEO builds off the legacy of its predecessor, EMSCULPT, by simultaneously emitting both radio frequency and high intensity electromagnetic energies. The end result is more fat reduction (30% on average) and muscle growth (25% on average), than any single gold standard product, for less time and less money. Best of all, EMSCULPT NEO has broad appeal as it can treat patients up to BMI 35!

Arterosil is clinically proven to protect and restore the endothelial glycocalyx - the slippery gel lining of every artery, vein and micro-capillary. Backed by $20 million and 15 years of research, Arterosil has been shown to help reduce plaque, maintain blood pressure in the normal range, reduce neuropathic pain, and improve sexual performance.

Product Announcements

Mirror iPad App

IntelliStand

Booth #6048

Canfield Scientific Inc.

Ph: 1-973-434-1200 | www.canfieldsci.com

The all new Mirror iPad App enables impactful image-based consultations and now features whiteboarding capabilities and simulation tools. Easily annotate your client’s images within the app and simulate outcomes of several procedures and treatments including fillers, botox, resurfacing, peels, plastic surgery procedures, and more. In addition, simulate first impressions with FaceReality, an AI-based simulation that recognizes facial appearance and scores the face on multiple consumer-oriented characteristics relating to first impressions based on groundbreaking research.

IntelliStand is an integrated imaging solution for standardizing face and body image capture. The ergonomic, lightweight design facilitates efficient, repeatable, and easy image capture that users of all photography skill levels can use. Camera height is easily adjusted for total body imaging with repeatable camera positions and lighting and locking mechanisms to keep image capture consistent. Plus, projected laser line ensures standardized distance for optimal imaging every time.

Roll On Applicator

24 Day Supply Trial Bottle

Booth #8070

Carbon-60, Greska’s

Ph: 720-600-6040 | www.C-60.com

Carbon-60 for your Pet in a convenient pump / squirt bottle. For a healthier pet.

Greska’s Carbon-60 is the worlds 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 as an orally as a dietary supplement. It supports a higher quality of live for healthy aging. Stop by Booth 8070 for a FREE SAMPLE. You’ll be glad you did.

Greska’s Carbon-60 now comes in a convenient pump / squirt 24 day trial size bottle. Greska’s Carbon-60 is the worlds 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 as an orally as a dietary supplement. It supports a higher quality of live for healthy aging. Stop by Booth 8070 for a FREE SAMPLE. You’ll be glad you did.

Product Announcements

Celluma RESTORE

60 Day Growth Kit

Booth #5060

Booth #2046

Celluma Light Therapy

Cellustrious® Hair Restoration

Ph: 714-978-0080 | www.celluma.com

Ph: 213-536-9339 | www.cellustrious.com

The all-in-one Celluma RESTORE is the first device to be FDAcleared to treat three common concerns of the mature individual. Addressing hair regrowth, aging skin and general pain conditions, the Celluma RESTORE is versatile, convenient and easy-to-use in a clinical setting or at home. Celluma’s patented, shape-taking design permits customized placement over the head to effectively deliver light energy and promote hair regrowth. Additionally, the Celluma RESTORE can be placed anywhere on the body to reduce pain and improve skin health.

The 60 Day Advanced Growth Kit was designed to improve scalp health and maximize your hair quality, density, and strength. Includes the Cellustrious® Hair Growth Serum, Cellustrious® Scalp Replenisher, Cellustrious® Scalp Stamp, and the Cellustrious® Leave-in Conditioner.

Glutaryl and Glutaryl+

CD Smart Devices

Booth #2027

Central Drugs

Ph: 562-691-6754 | www.centraldrugsrx.com

Glutaryl and Glutaryl+ use patented technology to stabilize Glutathione and elevates blood levels when administered topically. Utilizing groundbreaking sub-nanotechnology, Glutaryl/Glutaryl+ is the fastest way for consumers to raise serum Glutathione levels in their body.

Our selection of CD Smart Devices is versatile to accommodate your various medication needs. The CD Smartpen and CD Smartpump can be used for multiple transdermal medications such as hormones, aesthetics/cosmetics, dermatological, pain management, and veterinary. An easy transition from syringe or clicker device, the CD Smartpen is the premier choice for your medication delivery on the go.

Product Announcements

Pro Cream Formula

BBOIL

Booth #9014

Booth #9029

Clinicians Supplement Consultants

CS Health LLC

Ph: 855-272-7220 | www.cscprivatelabel.com

Ph: 502-583-4402 | www.cs-health.com

50 milligrams micronized progesterone. 30 convenient unit dose pillow pack applicators. Dr. Erika’s progesterone cream, Pro-cream, is conveniently dispensed in unit dose mini- packs to insure you get the same exact dose of progesterone every time you use it. Pro-cream is a low dose bioidentical progesterone preparation in cream form. It may ease common PMS and early menopause symptoms such as hot flashes, night sweats, bloating, sleep disorders, mood swings Procream is an effective alternative to prescription hormone replacement therapy for women with mild to moderate symptoms. Pro-cream Formula comes in unit dose mini-packs for ease of application and ‘no-guess’ dosing.

4 oz bottle of 100 % Broccoli Seed Oil produced from a CO2 Critical Extraction process.

Potenza

The Lymphocyte MAP

Booth #6072

Booth #3032

Cynosure

Cyrex Laboratories

www.cynosure.com/product/potenza

Ph: 657-303-3898 | www.LymphocyteMap.com

The world’s first RF microneedling system that combines monopolar and bipolar RF at 1 or 2MHz frequencies in a single device. Potenza takes RF microneedling to new levels. The versatility this system provides allows you to customize treatments based on your patients’ specific needs – all skin types, anywhere on the body, any time of the year. - 4 different RF modes for shallow and deep treatments in one system Monopolar, Bipolar, 1 & 2 MHz - One of a kind Fusion Tip used for enhance topical penetration to maximize results - Unique Tiger Tip™ technology semi-insulated needles to treat more tissue at multiple depths - 10 different tips: Multi-needle arrays in various densities.

Based on a culmination of 10 years of research and development, The Lymphocyte MAP measures the integrity of the immune system at the cellular level. This unique panel helps identify a patient’s immune status based on 29 key biomarkers and determinants. It utilizes an advanced proprietary flow cytometry method, which combines cutting-edge laser technology with monoclonal antibodies, to precisely measure the properties of living cells such as size, shape, density and granularity which results in a precise count of various lymphocyte subpopulations. This helps identify patterns of imbalance of T cells, B cells and Natural Killer cells. It then organizes these patterns into specific immunotypes to provide an invaluable picture of the immune system.

Product Announcements

Men’s & Women’s Conceiva

Kyosenex

Booth #1050

Daily Wellness Company

Ph: 1-800-988-4869 | www.dailywellness.com

The gold standard for natural fertility health, Men’s & Women’s Conceiva are the only formulas validated by a major medical University study. Men’s Conceiva supports sperm motility and quality while Women’s Conceiva optimizes reproductive hormone balance. Trusted safe and effective for over 20 years!

Sourced from organic bovine thymus gland, Kyosenex is an adaptive dietary supplement that supports a normal immune system response. Kyosenex also supports normal inflammatory response and alleviates itching caused by environmental and occasional allergies. Kyosenex uses patented technologies to purify key components such as thymosin Fraction V from organic thymus glands. These purified components are essential for a well-balanced immune system, the key to a longer, healthier life.

EVENING PRIMROSE OIL

LIPOSOMAL ADK

Booth #6097

DaVinci Laboratories

Ph: 802-878-5508 | www.davincilabs.com

Evening primrose oil is rich in beneficial forms of omega-6 essential fatty acids (EFAs). The body cant make EFAs, so you need to obtain them from the diet. EFAs are critical for the skin, nerves, joints, immune system, and womens health.* Evening primrose oil contains an important EFA known as gamma linolenic acid (GLA). Normally, we make GLA from its “mother” essential fatty acid, linoleic acid (LA). However, eating overly processed foods and saturated fats, drinking a moderate to high amount of alcohol, aging, and a deficiency of zinc, magnesium, and vitamin B6 can stop the body from making enough GLA. DaVinci® Laboratories is now offering a liquid evening primrose oil supplement that can support healthy levels of both LA and GLA.*

Liposomal ADK contains the vitamin heavy-hitters that work in combination to build healthier, stronger, more resilient bones throughout life.* Vitamin A supports growth and repair of bones.* Vitamin D regulates absorption of calcium in the gut.* Vitamin K2 activates a critical protein, osteocalcin, which incorporates calcium into bones.* With these vitamins on your side, you’ll have strong, dense, durable bones that will last a lifetime.*

Product Announcements

MyoStim™

Supreme Hybrid

Booth #2021

Booth #7085

Designs for Health

Daiwa Massage Chairs by U.S. JACLEAN, INC.

Ph: (860) 623-6314 | www.designsforhealth.com

Ph: 310-538-2298 | www.daiwamassage.com

Complete suite of muscle-supportive nutrients formulated to promote muscle tissue preservation and healthy aging in a delicious orange-flavored, easy-to-mix powder* MyoStim™ combines 15 g of collagen peptides (as BodyBalance®), 3 g of L-leucine, 2 g of HMB (as MyHMB®), 2.5 g of creatine (as Creatine MagnaPower®), 150 mg of GG (as GG-Gold™), and 25 mcg (1,000 IU) of vitamin D3 per 27 gram serving that work synergistically to help mitigate the effects of age-related muscle loss and support lean body composition.* * 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.

The ultimate massage experience for an active life. Daiwa introduces a new category of massage chair. The Supreme Hybrid is the most luxurious massage chair in the world. This massage chair is equipped with the first 6D massage roller system (2 upper and 4 lower), a Hybrid design that combines an inversion stretch with an L-shaped massage track, and 50-layered Japanese Shiatsu airbags. The Supreme Hybrid looks as exceptional as its features are.

OMX™ Organic Metabolomics

DEFEND PRO

Booth #2020

Booth #5035

Diagnostic Solutions Laboratory

DNA Health

Ph: 877-485-5336 | www.diagnosticsolutionslab.com

Ph: 800-235-9602 | www.trydnahealth.com

The new OMX™ Organic Metabolomics Test from Diagnostic Solutions Laboratory uses a systems-biology approach to evaluate organic acids and amino acids, providing critical insight into metabolic health. By evaluating functional biomarkers from six key areas of health, OMX empowers practitioners to personalize interventions that can optimize health and manage chronic disease.

Defend Pro provides a synergistic combination of fat-soluble vitamins featuring 300mcg of a double microencapsulated bioactive all-trans K2 VITAL MK-7, 250 mcg (10,000 IU) of vitamin D3, along with efficacious amounts of vitamin A, and vitamin E. Defend Pro also features AstraGin (astragus membranceus and panax notogingseng) to promote maximum nutrient absorption and delivery in the body. This exclusive formula is designed to support the balance of fat-soluble vitamins in the body and optimize calcium transport. Help defend your bones, heart, and immune health with Defend Pro.

Product Announcements

BPC-157 PRO

DP4

Booth #5035

Booth #3081

DNA Health

Dp Derm

Ph: 800-235-9602 | www.trydnahealth.com

Ph: 305-552-0550 | www.Dpderm.com

BPC-157 has been one of the most popular products in the market for repair and recovery for several years now. BPC-157 PRO with added salcaprozate sodium(SNAC) provides superior absorption of BPC in the body. DNA Health now offers 6 different oral variations, as well as a topical cosmetic cream. With 7 total different BPC options, personalizing based on your patients needs has never been easier. BPC-157 PRO is available in tablets, rapid and delayed release capsules, all in 250mcg and 500mcg doses.

DP4™ delivers the ultimate in advanced microneedling and can create an astounding 1,920 puncture channels per second, up to 104% faster than other microneedling devices. All functionality, like speed and depth, can be controlled with the touch of a button for reliable results. Larger areas can be treated faster, with exceptional outcomes and almost no pain or downtime.

Host Your Own Summit!

EB-V1 Delayed Release

Booth #2088

Booth #3075

DrSummits.com

EBM Medical, LLC

Ph: 619-436-7750 | www.DrSummits.com

Ph: 985-966-3670 | www.EBMmedial.com

Host your own consumer or patient summit. For example the recent Mycotoxin summit, Reverse Alzheimer’s Summit, Advanced AntiAging Technology Summit and more. Check out www.Drsummits. com/Calendar for a full list of summit examples.

EB-V1 delayed release capsules are designed to optimize and maximize immune system response.

Product Announcements

Doctor Recommended Meals

MicroPen EVO

Booth #2062

Booth #8033

EchefMD

Eclipse

Ph: 727-648-2791 | www.Echefmd.net

Ph: 800-759-6876 | www.eclipsemed.com/evo

eChefMD prepares healthy meals to compliment diet programs prescribed by physicians and dietitians. Our meals have been carefully prepared to give you the best tasting “healthy” meal options.

With the FDA cleared Eclipse MicroPen EVO, your practice can be a part of the future. EVO is microneedling evolved. This evolution is made possible by the physician-designed pen with its ergonomic form, simple to operate functionality, and convenience of wireless charging. The EVO offers a true solution to patients with facial acne scars looking to improve their skin’s tone, texture, and color with each visit. Key features include: - Powerful cordless operation - No dragging or tearing of skin - Quiet operation - Minimal to no vibration - Safe and innovative cartridge design - High ROI procedure with low patient downtime

Wellevate® Labs This latest innovation on the Wellevate® Connected Care platform radically simplifies the process of ordering, reviewing and sharing lab results. It’s a single, secure virtual hub for over 1000 conventional and specialty labs, featuring tests from some of the most trusted names in diagnostics. Wellevate Labs even offers Mobile Phlebotomy Service for better adherence and a Physician Support Network for expanded provider access. This is another leap forwards in Wellevate’s mission to streamline your process and amplifying your practice. Login to your Wellevate account to sign up today at go.wellevate.me/labs or call 800.798.0708.

gammaCore Sapphire

WELLEVATE® LABS

Booth #8074

Booth #5013

electroCore, Inc.

Emerson Ecologics

Ph: | www.gammaCore.com

Ph: 800.654.4432 | www.go.wellevate.me/labs

gammaCore Sapphire™ (nVNS) is the first FDA-cleared non-invasive, hand-held device to treat migraine and cluster headache. gammaCore is self-administered by patients without the potential side effects associated with commonly prescribed drugs. When placed on a patient’s neck over the vagus nerve, gammaCore stimulates the nerve’s afferent fibers. You can provide gammaCore at point-of-care with gConcierge™. Our patient training and support will ensure maximized treatment outcomes. Visit Exhibit #8074 or gammaCore. com to learn about NEW indications.

This latest innovation on the Wellevate® Connected Care platform radically simplifies the process of ordering, reviewing and sharing lab results. It’s a single, secure virtual hub for over 1,000 conventional and specialty labs, featuring tests from some of the most trusted names in diagnostics. Wellevate Labs even offers Mobile Phlebotomy Service for better adherence and a Physician Support Network for expanded provider access. This is another leap forwards in Wellevate’s mission to streamline your process and amplify your practice.

(non-invasive vagus nerve stimulator)

Product Announcements ®

COLD BUSTER

NO W W

Immune Health Liquid

When you feel a cold coming on, you need to act fast. COLD BUSTER contains a powerful combination of cold processed phytonutrients in addition to vitamins, minerals and antioxidants to support immune health.* Already battling sniffles or just feeling under the weather? Fight back naturally. COLD BUSTER is a fast acting liquid – no messy powders or hard to swallow pills. •

Liquid Fast

•

Non Drowsy

•

ITH

Elderberr

Zero Sugar

Great Tasting Formula Packed with Elderberry, Aronia, Black Currant, plus: Echinacea, Elderberry, Chamomile and Oregano: Plants that provide powerful immune benefits* Fruits and Vegetables: Orange, chamomile, lemon, broccoli, apple, blueberry, chokeberry, black currant & cranberry provide immune boosting antioxidants* Green Tea: Contains bioactive polyphenols that function as helpful antioxidants, impacting the formation of free radicals* Vitamin C: A powerful antioxidant, supporting white blood cell function and overall antibody responses.* Vitamin D: An important factor in immune system health.*

ID# 29509 Cold Buster (16 ounce bottle) ID# 29507 Cold Buster (box of 20 –1 oz single serve packets)

Supplement Facts Serving Size: 1 Ounce (30mL) Servings Per Container: 16

Zinc: Essential for maintaining normal cell-mediated immune function and critical to other enzymes that support healthy free radical balance in the body.* Calcium: One of the most vital minerals for optimal functioning of your entire body, it supports a healthy pH level in the body, necessary for immune resilience* Magnesium: An essential nutrient needed for maintaining proper levels of immune-related cells.*

! ) ' ) ' " %)$ &"# ) &# ' Total Carbohydrate* )%))))))) $ Sugars )%)))))))))) Vitamin C (ascorbic acid) (()!%)))))) (($ Vitamin D (cholecalciferol) (() )))))) (($ Calcium (calcium citrate/malate) ()!%))))))))) $ Magnesium (magnesium citrate/malate) (()!%)))))))) $ Zinc (zinc sulfate and/or-chloride) )!%)))))))) $ Copper (copper sulfate and/or- gluconate) ( )!%)))))))) ($ COLD BUSTER* BLEND

Black Currant: Contains four times the amount of vitamin C as oranges, and double the amount of antioxidants as blueberries.* Chokeberry (Aronia): Berries are packed with essential phytonutrients, vitamins, and antioxidants.*

www.eniva.com

gluten FREE

vegetarian

(()!% )))))))))

Organic Honey, Apple, Cranberry, Green Tea leaf, Broccoli, Chamomile flower, Echinacea flower, Aronia (Chokeberry), Blueberry, Elderberry, Black Currant, Oregano leaf, Orange, Lemon

Copper: A vital component of the human enzyme copper-zinc superoxide dismutase, a potent antioxidant.*

cold

BLENDED

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Purified water, malic acid, citric acid, natural flavors, xanthan and/or guar gum, organic stevia leaf extract, sodium benzoate, potassium sorbate to protect freshness.

USA

* This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

0802.08.19.REV.02

Cold Buster

VanChroZin

Booth #9039

Eniva Health Corporation

Ph: 260-615-8057 | www.eniva.com

Liquid immune booster to enhance the body’ s resistance to all forms of infection. Features elderberry, Vitamin C, D3, zinc, echinacea, oregano, green tea and other botainicals.

A liquid blend of the 3 blood sugar mineral elements in a submicron delivery for maximum impact at the cellular level. This product will effectively lower a blood sugar number 30-60 points within 45 mins. Dynamic and fast and time tested to help stabilize blood sugar levels.

MyDNAge Biological Age Test

MyDNAge Biological Age Test Version 2

Booth #7097

Epimorphy LLC

Ph: 1-833-693-6243 | www.mydnage.com

The myDNAge® test is a DNA age test using epigenetics. The myDNAge® test is based on Dr. Horvath’s epigenetic aging clock and utilizes our proprietary SWARM® (Simplified Whole-panel Amplification Reaction Method) technology to analyze DNA methylation patterns of over 2,000 loci on the human genome and generate epigenetic age predictions in a high throughput manner.

The myDNAge® test is a biological age assessment based on epigenetics. The new report is still based on Dr. Horvath’s epigenetic aging clock and utilizes SWARM® technology to analyze methylation patterns of over 2,000 loci in the human genome. Our R&D team has updated the report to incorporate an additional index to highlight genetic variations that advance a customer’s understanding of their biological age and well-being. This updated version, 2.0 , will present a more comprehensive analysis in 20 plus pages in order to help our customers understand their specific results.

Liquid immune booster

Product Announcements

Intensive Nourishing Cream

EXOVEX

Booth #3066

Booth #4043

Epionce

ExocelBio

Ph: 866-374-6623 | www.epionce.com

Ph: 858-255-4499 | www.exocelbio.com

Newly enhanced Epionce Intensive Nourishing Cream is an ultrarich, multitasking moisturizer proven to reduce the appearance of fine lines and wrinkles on the face and neck. Barrier-boosting ceramides combine with rejuvenating botanicals like Acacia Seed, Maca Root and Green Algae Extracts to give skin maximum hydration and superior anti-aging results. Clinical studies show 96.3% reduction in fine lines and wrinkles and 92.6% improvement in radiance on the neck by week 8.

EXOVEX is a line of aesthetic serums that support the body’s natural ability to turn back time. For professional use only, EXOVEX is designed as a companion product for skin and hair rejuvenation, used in post-microneedling or energy-based aesthetic applications. The secretomes with growth factors and RNA in EXOVEX assists in accelerating post-procedure downtime and improving the skin appearance of tone, texture, and fine lines, and the hair appearance of healthy aging and regrowth

Viral Immunity Platform(tm)

Depression & Anxiety Platform

Booth #2054

GATC Health Corp

Ph: 833-333-4282 | www.gatchealth.com

DNA test kit to determine an individual’s genetic response to viral infection, i.e. COVID-19 and others. Details susceptibility, severity of infection and potential long-term health effects.

DNA test kit to determine an individual’s genetic propensity to Major Depressive Disorder and Generalized Anxiety Disorder, and recommends treatment options.

Product Announcements

GeneSavvy Starter Kit

GeneSavvy Starter Kit with Anti-Aging Report

Booth #8097

GeneSavvy

Ph: 425-686-0000 | www.GeneSavvy.com

The GeneSavvy Starter Kit uses next-generation sequencing technology to explore millions of whole exome and whole mitochondrial genome markers. Discover thousands of truly unique genetic variants that can help you design the ultimate patientcentered, personalized, and effective treatment plans to achieve vibrant longevity.

Mitochondrial Function? Nutrient Metabolism? Methylation? Neurotransmitters? The gene networks included in the GeneSavvy Anti-Aging Report can help design the ultimate patient-centered, personalized, and effective treatment plans to achieve vibrant longevity.

Cardio Check

TrichoTest™

Booth #5021

Booth #3060

Genova Diagnostics

GX Sciences

Ph: 800-522-4762 | www.gdx.net

Ph: 844-258-5564 | www.gxsciences.com

The Cardio Check Profile is an advanced blood assessment of lipids and cardiometabolic analytes providing insight regarding independent risk. Combining the best of conventional and functional laboratory biomarkers, the profile evaluates cholesterol and triglyceride levels, as well as targeted apolipoproteins, important ratios, high sensitivity CRP, and homocysteine. Clinicians can take a broader look at a patient’s cardiac health to develop targeted therapeutic strategies.

Personalize alopecia (hair loss) treatments to patients through genomic testing with TrichoTest™; supporting practitioners, prescribers, and other licensed healthcare professionals. 3 polymorphisms within 16 SNPs, resulting in 48 (3_16) genetic variations related to alopecia, are analyzed using state-of-the-art technology. The resulting report is delivered to the provider fast and is comprehensive, easy to understand, and provides invaluable, scientifically validated information to assist in creating a personalized treatment plan for each patient.

Product Announcements 9021

NutriGen™

Formula 82D

Booth #3060

Booth #9021

GX Sciences

Hair Science Corporation

Ph: 844-258-5564 | www.gxsciences.com

Ph: 866-558-1744 | www.hairsciencecorp.com

An innovative, comprehensive genetic test for weight loss, responseto-exercise, intolerances, and nutritional needs, among others: NutriGen™ is the most complete in the market with 363 (3_121) genetic variations (SNPs) analyzed using state-of-the-art technology. The report is delivered to the provider fast, is easy to understand, and proposes a dietary plan considering several foods with a 3-phase supplementation program. NutriGen™ can be especially helpful for patients who have tried other regiments with little to no success.

Non-sticky, Propylene Glycol-free base. Formula 82D contains Minoxidil and Dutasteride along with a topical steroid to improve efficacy and reduce irritation, complimented by other proprietary ingredients that improve the formula’s overall effectiveness, stability and usability.

Liposomal Cinnamon, Clove & Oregano

Autoimmune Viral Trio Panel

Booth #6095

Booth #1035

Hopkinton Drug Compounding Pharmacy

Immunosciences Lab, Inc.

Ph: 855-585-0005 | www.doctorinspiredformulations.com

Ph: 310-657-1077 | www.Immunoscienceslab.com

Cinnamon, Clove and Oregano has been used individually for a variety of restorative opportunities. By combining them, their shared attributes, may support a wider therapeutic spectrum. Cinnamon, Clove and Oregano may support those suffering from tick-borne infections, viruses, bacteria, fungi and yeast. These ingredients may also help to support inflammation, oxidative stress and immune health.

The Autoimmune Viral Trio Panel tests for three viruses in particular that have been identified as the major players and contributors towards inflammation and autoimmune disorders: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV-6). By measuring levels of antibodies in the blood you can determine likelihood of these viral contributions to various autoimmune disorders.

Product Announcements

Innovation Vitamin Blend

Sermorelin Peptide

Booth #5047

Innovation Compounding, Inc.

Ph: 800-547-1399 | www.innovationcompounding.com

The various B vitamins in the Innovation Vitamin Blend act as coenzymes or precursors for amino acid formation and activate key metabolic pathways involved in supporting optimal metabolism and energy levels. Additionally, vitamin C, in the form of ascorbic acid, provides strong antioxidant support. Sterile injectable solution. Suitable for IV drip infusion and IV slow push.

Innovation Compounding offers sermorelin peptide preparations as a sterile injectable solution or nasal spray. The pharmacy also formulates five different sermorelin-containing blends depending on the dosing your patient needs.

Mind and Mood Boost

Immune Support Essentials

Booth #1043

Innovations Group Inc.

Ph: 800-461-4170 | www.nutrascriptives.com

MedQuest Pharmacy is excited to announce Mind and Mood Boost by Nutrascriptives, a highly recommended and reliable protocol trusted by Behavioral Health experts. This effective combination of Vitamin D3, Daily Multiple, Magnesium Glycinate, Melatonin SR, B Complex, and Folate B-12 supports and enhances healthy mood and emotional functioning. As with all of our products, Mind and Body Boost supplements are third-party tested for potency and free of common allergens and unnecessary fillers.

MedQuest Pharmacy is pleased to introduce Immune Support Essentials, by Nutrascriptives. This complete and research-based regimen includes clinical-grade supplements recognized for their ability to aid with a healthy immune system. Benefit from the power of our proprietary Immune blend containing Echinacea, Astragalus, Elderberry, Goldenseal Root, Epicor®, Immunolin®, ResistAid™, BetaGlucans and combination of mushrooms, along with quality sources of Zinc, Vitamin C, D3, Magnesium, Glutathione and Melatonin. All products are third-party tested for potency and free of common allergens and unnecessary fillers.

(Behavioral Health)

Product Announcements

CerebroPep

IQ Skyline Massage Chairs

Booth #3097

Booth #2091

Integrative Peptides

IQ Technologies Inc. & Irest

Text Us: +1.443.732.5272 | www.integrativepeptides.com

Ph: 702-260-8829 | www.iqskyline.com

• Neuroprotective properties • Neurotrophic repair properties • Supports cognitive health and well-being • Supports treatment of dementia, traumatic brain injury (TBI), and stroke • Helps to prevent cognitive decline after brain injury. Similar to other porcine neuro peptides such as cerebrolysin, CerebroPep is a special formulation of porcine derived peptide blend which supports cognitive health and wellbeing. CerebroPep is a nootropic drug that consists of low-molecular peptides which possesses neuroprotective and neurotrophic repair properties. This means they can penetrate the blood-brain (or bloodSCF) barrier and reach neurons directly, making the drug able to show organo-specific combined effects towards the brain.

IQ Technologies Inc. has been the top distribution company in the health and wellness industry for over ten years. Within that time the company has mastered the capability of bringing forth the very best products time and time again to satisfied customers worldwide. With this in mind, IQ Technologies would like to introduce to you the most innovative and technically advanced massage chair product in the Health and Wellness market, the IQ Skyline Massage Chairs.

FIT 176

Kyani Origin

Booth #3027

Booth #7062

KBMO Diagnostics

Kyani

Ph: 617-933-8130 | www.KBMODiagnostics.com

Ph: 801-717-7962 | www.eastbaywellness.kyani.com

KBMO Diagnostics is excited to launch the FIT 176. We had feedback from over 150 providers on what new food items to add to our test. We are the only company measuring CBD. We measure the main ingredients of Omega 3. You receive a personalized Meal plan and a individual Patient App. The FIT 176 can come as a finger stick or blood draw kit.

Kyani Origin features a perfect balance of nature-based macronutrients, including plant-based proteins, healthy fats, and carbohydrates, to help you maintain a healthy weight, recover from workouts, and live the active life you love! Even more, Origin provides the vital nutrients your body needs to produce nitric oxide, a key signaling molecule that supports circulation and promotes nutrient absorption. This Nitro Effect helps your body make the most of Origin’s clean, plant-based macronutrients. It comes in chocolate or vanilla.

Nitro-Powered Plant-Based Protein Shake

Product Announcements

100

Black Oxygen Fulvic Acid

IV Infusion Packets

Booth #9022

Booth #3063

LAA Home Services LLC

Liquivida

Ph: 602.931.9526 | www.Boxygen.life

Ph: 954-398-3889 | www.liquividalounge.com

Worlds Best Fulvic Acid & Humic Acid Powder available in powder and capsules. Naturally sourced organic, vegetarian and gluten free, may be used as oral supplement or topical application. This product will help replenish over 70 essential minerals, amino acids and vitamins

5 new IV nutrient infusion packets. (single dose vials) Changing that way to make IV’s easier

Fast Bar Intermittent Fasting Bar

spermidineLIFE® Immunity+

Booth #4007

Booth #6060

L-Nutra

Longevity Labs+

www.fastbar.com

Ph: 800-876-9183 | www.spermidinelife.us

Newly published study shows that Fast Bar allows to extend the fast without signaling a postprandial response. Come and request a copy of the newly published study and taste the new flavors.

Healthy cells, exercise and a balanced diet are all vital to maintaining a strong immune system. As we age, the functionality and effectiveness of the immune system decreases gradually, making us more prone to illness and disease. Cells play an important role in immune response. To support cell function and cell renewal, it is essential that our bodies receive enough micronutrients. spermidineLIFE® Immunity+ combines the active micronutrients vitamin C, zinc, wheat germ extract with a high spermidine content, vitamin B1, and shiitake powder to help support a strong immune system.

Product Announcements

spermidineLIFE® Memory+

ASCOR®

Booth #6060

Booth #1056

Longevity Labs+

McGuff Company Inc.

Ph: 800-876-9183 | www.spermidinelife.us

Ph: 800-854-7220 | www.ascoriv.com

The essential ingredients contained in spermidineLIFE® Memory+ make it an ideal supplement to support our normal cognitive function and overall brain health. The nutrients thiamine, iron, brahmi powder and saffron extract contribute to reducing mental fatigue and decline.

ASCOR® is the first and only FDA-approved ascorbic acid (Vitamin C) injection product. FDA approval means that the strength, safety, effectiveness and quality of ASCOR® are assured. ASCOR® is made in a manufacturing facility that is FDA-inspected and operates under federal current good manufacturing practices.Other ascorbic acid (Vitamin C) injections are compounded drugs. Compounded ascorbic acid injection drugs have not undergone FDA pre-market review for safety, effectiveness, and quality. Additionally, the facilities where compounded drugs are made have not undergone an FDA pre-approval inspection to ensure the compounding facility is in compliance with FDA rules and regulations and meets all regulatory requirements for sterility, potency, pH and purity.

INFRARED THERMOGRAPHY

Bellanova Nano Mist Therapy

Booth #7086

Booth #7049

MEDICORE CO. LTD.

Meditime Co. Ltd.

Ph: 82-31-8027-7070 | www.medi-core.com

Ph: 909-274-7700 | www.amameditime.com

IRIS-XP can measure the pain and inflammation on the skin by using an Infrared thermal camera. It has no pain, no radiation and noncontact, but it is detecting the trigger point for better treatment.

Bellanova is a multi all-in-one system based on the concurrent use of fine mist, low-level laser (660nm), microcurrent, and anion. Using a nano gun spray, nanoparticles of bioactive substances and effective ingredients with sizes smaller than pores are sprayed onto the epidermis for deep penetration into skin. Delivering the regenerative effects of these mixed technologies in a single treatment allows Bellanova to effectively treat for anti-aging, skin brightening, and complexion enhancement, including instant skin improvement.

(Ascorbic Acid Injection)

101

Product Announcements

Advanced Sterilization

Viola Threads

Master Drug Formulary

Booth #7049

Booth #4096

Meditime Co. Ltd.

MediZap

Ph: 909-274-7700 | www.amameditime.com

Ph: 775-386-6677 | www.medizap.co

VIOLA Threads provide medical aesthetic practitioners with various types of fully biodegradable threads that come in different shapes and sizes for a variety of applications. Our PDO threads are US FDA 510k Approved (#K190264) for barbed suture, which consists of dyed polydioxanone (PDO) and is indicated for use in soft tissue approximation, where the use of absorbable suture is appropriate. All VIOLA Threads products are manufactured, sterilized, and prepared from South Korea.

MediZap, the first and only E-beam provider built for compounding is consistently staying ahead of the curve with new upcoming USP 797 regulations, offering terminal sterilization that delivers an SAL of 10-6. We now feature a new Master Drug Formulary approach that will make validating multiple drug products at once possible with a more cost-effective investment.

Element Exclusive Partnership

102

IV Set

15 Micron Filter, 85”, Flow Regulator, Y-Site, Non-DEHP, Latex-Free, Vented Spike MeriSet 007 IV Administration Set # M007

Booth #4096

Booth #4037

MediZap

Merit Pharmaceutical

Ph: 775-386-6677 | www.medizap.co

Ph: 323-227-4831 | www.meritpharm.com

MediZap is proud to announce a new exclusive partnership with Element; a leading global contract research organization that specializes an upfront R&D to commercialization testing of life science drug products. MediZap has chosen Element for its top-notch biopharmaceutical testing, rapid sterility scans, and environmental monitoring to better serve our customers. Element inline integration with MediZap reduces testing timelines and increases BUD’s.

IV Set, 15 Micron Filter, 85”, Flow Regulator, Y-Site, Non-DEHP, Latex-Free, Vented Spike MeriSet 007 IV Administration Set # M007

Product Announcements

PEA Relief™

SereneSkin™

Booth #6032

Booth #3007

Metagenics

Microbiome Labs

Ph: 800-692-9400 | www.metagenics.com

Ph: | www.microbiomelabs.com

An estimated 126 million (55.7 percent) American adults reported some type of bodily discomfort in the previous three months.1 minor pain can have a noticeable negative impact on those afflicted, with effects including sleeplessness, decreased activity, and mood changes, thus affecting their wellbeing and quality of life. Approaches to mild pain relief remain limited, and more holistic approaches remain a point of public interest.* Now there’s a way to relieve mild pain with a more holistic approach.* *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. 1. Nahin RL. J Pain. 2015;16(8):769-780.

SereneSkin™ is a probiotic-powered skincare supplement that supports a radiant, youthful complexion as well as supporting total body health. SereneSkin™ is a unique blend of four spore-forming Bacillus probiotic strains with added vitamin K2 for overall skin microbiome and gut-skin axis support. The skin is the body’s first line of defense, so it’s essential to know how to keep it healthy. The skin, like the gut, has a unique bacterial community — its own microbiome.

MINT™ PETIT

MINT™ FIX

Booth #3079

MINT™ (HansBiomed USA Inc.)

Ph: 562-777-7043 | www.mintpdo.com

Material: Polydioxanone (PDO) Thread Length: 14cm USP Size: 2-0 Barb Design: 3D type, 360 degrees of helical and bi-directional. Cannula: 19G W-Type

Material: Polydioxanone (PDO) Thread Length: 15cm USP Size: 2-0 Barb Design: 3D type, 360 degrees of helical and mutli-directional Cannula: 18G W-Type

103

Product Announcements

104

Website Design, Development, and Marketing campaigns specifically for Doctors

Pro GAD Enhancer

Booth #1030

Booth #6070

Modern Doc Media

Neurobiologix Nutrition

Ph: 1-866-509-5054 | www.ModernDocMedia.com

Ph: 866-500-5388 | www.DrNeurobiologix.com

Modern Doc specializes in Website Design, Development, and Marketing campaigns specifically for Doctors. Our team is staffed with the industry’s best designers, developers, and SEO experts. With an average of 15+ years of working on national and local marketing campaigns, this allows us to analyze, design, develop and implement a winning marketing strategy for your practice. #itstimeforachange Custom websites, UX/UI design, SEO strategies, and Google core vitals. Is SEO dead?... No, it’s just that most don’t keep up with google trends at a deep level. Talk to us and learn what is needed to be successful in today’s online world.

Pro GAD Enhancer, created by a leading neuro-immune specialist was created to assist patients who have difficulty producing adequate amounts of GABA, an important brain neurotransmitter. GABA plays the principal role of reducing excitability throughout the nervous system, as well as, regulation of musde relaxation. Many patients possess a genetic mutation of GAD (Glutamic Acid Decarboxylase), the primary enzyme that creates GABA. A weakness in the GAD enzyme creates an increased amount of Glutamate, the primary excitatory neurotransmitter of the nervous system, and a relative deficiency of GABA. This imbalance creates an overly stimulated nervous system and traditional GABA should not be used.

PEA Soothe Support

NOVA Complete

Booth #6070

Booth #7032

Neurobiologix Nutrition

NuMedica

Ph: 866.500.5388 | www.DrNeurobiologix.com

Ph: 800.869.8100 | www.numedica.com

Palmitoylethanolamide (PEA) is a bio-identical fatty acid amide that is normally synthesized by healthy tissue In the human body in response to inflammation. PEA is made by various plants and animals and is present throughout the animal kingdom. PEA can be found in many different tissues including glia, neurons, retina, white blood cells, mast cells and adipocytes. Supplementing with PEA has been scientifically shown to naturally assist in the reduction of inflammation and to have neuro-protective and possibly pain control effects. This natural anti-inflammatory supports the nervous system and abnormal immune responses and consists of 2 other cofactors to support delivery of PEA.*

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.*

Product Announcements

Growth Activator Hair Serum

Weight Management Kit

Booth #1049

Booth #7033

Nutrafol

Olympia Pharmacy

Ph: 888-908-3858 | www.nutrafol.com/professionals

Ph: 407-250-4000 | www.olympiapharmacy.com

A ground-breaking advancement in scalp support, Nutrafol’s Growth Activator is the first of its kind: an extremely lightweight and fastabsorbing hair serum formulated with Ashwagandha Exosomes to boost cell-renewal and naturally activate thicker-looking, strongerfeeling hair in as little as 90 days.

“Get Skinny” on Olympia’s new Weight Management Kits! This great alternative to HCG is physician-supervised and designed to help any individual safely and effectively reach his or her specific weight-loss goals. The Olympia weight-management protocol uses a combination of Naltrexone, Sermorelin, Lipo-Trim SL and low-calorie intake to achieve optimum weight loss results. The protocol may also boost metabolism and help patients lose large amounts of fat, all without feeling hungry.

Fortius420 - EXP

Re3 Advanced Pellet Delivery System for Men and Women

Booth #3021

Booth #8060

OxyHealth

Pellecome LLC

Ph: 562-906-8888 | www.oxyhealth.com

Ph: 1-888-773-9969 | www.pellecome.com

Our second largest and most versatile hyperbaric chamber Fortius420 - EXP is a market favorite. It comes with the capability of treating patients up to 3.0 ATA (29 psi) operating pressure. This chamber boasts a considerable 42” diametric interior and is 62 inches in length. However, despite its large size, the Fortius420 EXP has been designed to fit in most offices and clinics.

Pellecome introduced the Patented 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 insertion device places pellets in a perfect line every time, providing consistent hormone absorption and minimizing patient discomfort and risk of pellet extrusion.

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Product Announcements

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NMN RX Complete

Brain-Mag Rx

Booth #2037

Physicians Longevity

Ph: 805-679-6989 | www.PhysiciansLongevity.com

NMN Rx Complete is the first and only perfectly balanced combination of NMN, Trans-Resveratrol and TMG on the market. Instead of having to take three separate supplements each day, you can now get the ideal balance of all three in one convenient serving. A single scoop of NMN will provide you with 1,000 mg of NMN, 1,000 mg of trans-resveratrol, and 500 mg of TMG – the daily dosage most often recommended by the world’s leading longevity experts.

Magtein® (Magnesium L-threonate) is a patented compound that effectively crosses the blood brain barrier.* Magtein® is the most bioavailable magnesium for the brain.* Clinical research shows it provides significant improvement in executive function, working memory, attention and episodic memory. The cognitive improvement is equivalent to a nine-year reduction in “brain age”.

MaxPulse

TMFLOW

Booth #3061

PreCheck Health Services Inc.

Ph: 305-203-4711 | www.precheckhealth.com

Heart Rate Variability & Accelerated Photoplethysmograph Analyzer - The Max Pulse is a simple, user-friendly, non-invasive, FDA Class II medical device. It provides measurements using Heart Rate Variability & Accelerated Plethysmography to access overall Cardiovascular and Autonomic Nervous System function.

Vascular function and autonomic nervous system assessments Including 3 technologies TBL-ABI, SWEATC and OXI_W. TM Flow analysis focuses on early detection and follow-up of complications (autonomic nervous system & vascular system) of chronic metabolic diseases such as Diabetes.

Product Announcements

HART CVE

HART CADhs

Booth #1047

Prevencio, Inc.

Ph: 619-889-8539 | www.prevenciomed.com

HART CVE is a multi-protein blood test to determine 1 year risk for heart attack, stroke or cardiovascular death. No fasting required by patient. The test is more accurate (86%) than other available assessment tests. Accurate in patients with diabetes and kidney disease. A HART risk score is reported ranging from 0-10 with low risk (0-3), Moderate Risk is (4-6) and Higher Risk is (7-10). Results for individual biomarkers are also reported.

HART CADhs is a multi-protein blood panel test to determine significant (≥70%) obstruction of a coronary artery. No fasting required by patient. The test is more accurate (86%) than other available tests, including treadmill stress tests (52%). Accurate in patients with diabetes and kidney disease. A risk score is reported ranging from 0-5 with lower risk (0-2), Moderate Risk is (3) and Higher Risk is (4-5). Results for individual biomarkers are also reported.

ProCBD Softgels

ImmuNootropic

Booth #7075

Booth #7070

ProCBD by CV Sciences

Professional Health Products

Ph: 855-758-7223 Ext. 2 | www.pluscbdoil.com

Ph: 1-800-245-1313 | www.professional-health-products.com

ProCBD clinical strength CBD products are designed to fit a variety of patient needs, including yours. Working with your healthcare practitioner, you can create a unique CBD plan personalized with ProCBD Softgels. Because they provide exact levels of CBD, softgels are common choice for their consistency and ease of use. Clinical strength formula - 100 mg CBD per softgel - 30 ct and 60 ct - NonGMO | Gluten-Free | Vegan

ImmuNootropic is a blend of energy-promoting exogenous ketones (beta-hydroxybutyrate from GoBHB®) and the powerful immune boosting nutrients Olive Leaf Extract, Grapeseed Extract and Pau d’ Arco delivered in a delicious and easy-to-dose powdered drink mix. Ketones are a source both fast-acting and sustained energy for all cells of the body, especially the brain, heart and muscle cells. Our bodies naturally produce ketones during times of fasting & carbohydrate restriction; they have many positive health benefits including support for cognition, healthy weight and metabolism, production of NADPH (the “battery of our cells”)as well as appetite suppression.

100 mg - 30 ct or 60 ct

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Product Announcements

Carb Block

V Zone

Booth #7070

Booth #7094

Professional Health Products

Promoitalia LLC

Ph: 1-800-245-1313 | www.professional-health-products.com

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Carb Block provides a synergistic proprietary blend of unique ingredients shown to: *Naturally block the absorption of carbohydrates (Phase 2® Carb Controller™) *Decrease (carb) cravings & promote healthy weight control (Relora®, SunFiber®) *Provide complete nutritional support for the gut (Organic *Aloe vera, SunFiber®, glutamine, ginger, licorice root, fennel) *Provide nutrients shown to enhance thermogenesis (fat burning) in the body (Medium Chain Triglycerides (MCTs))

The advanced cosmetic system for the beauty and well-being of the eyes, eyebrows and eyelashes. - A unique treatment. - Specific ingredients designed to improve the well-being of the periocular tissues, formulated to give an immediate feeling of well-being by illuminating the eyes from the first application.

Civance

Lipo-S

Booth #2060

Prosoma Corp, LLC

Ph: 727-648-2791 | www.civance.com

Supports Healthy Cognitive Function. Citicoline is the natural precursor of the major cell membrane phospholipid phosphatidylcholine. Given orally, citicoline is non-toxic and very well tolerated.

Lipo-S Oral MIC Solution. Lipo-S is a unique “high” dose blend of MIC, MCB, and LCAR in an oral solution. Methionine 125mg/4ml - Inositol 250mg/4ml - Choline 250mg/4ml - Methylcobalamin 2.5mg/4ml - L-Carnitine 500mg/4ml

Product Announcements

Ache Action™

Serrapeptase

Booth #8043

Protocol for Life Balance

Ph: 877-776-8610 | www.protocolforlife.com

For Occasional Minor Aches & Pains of Overexertion* Advanced Formula with AprèsFlex® How it Works - Ache Action™ is a blend of complementary herbs that may help to support a healthy response to normal physiological stress.* Maintenance of a normal balance of key immune mediators has been shown to play a key role in healthy cardiovascular function, as well as in joint health.* By helping to support a balanced response to these signals, the herbal components of Ache Action™ may assist in the maintenance of healthy joints and may help to relieve occasional minor pain resulting from overexertion or stress.* * These statements have not been evaluated by the Food and Drug

Healthy Immune Function* Promotes Respiratory Health* How it Works - Serrapeptase (serratiopeptidase) is a protein-digesting enzyme isolated from the friendly bacterium Serratia marcescens. * Studies indicate that serrapeptase is absorbed intact from the digestive tract and that it acts systemically to support healthy immune system functions and promote the body’s normal healing processes. * Some evidence suggests that serrapeptase may support respiratory health by helping to maintain normal mucus secretions.*

NEW UNIQUE FORMULA

* 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.

Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Longevity Elite™

Rejuvapen NXT

Booth #4021

Booth #6061

Quicksilver Scientific

Refine USA

Ph: 303-531-0861 | www.quicksilverscientific.com

Ph: 866-590-5533 | www.rejuvapennxt.com

Our master adaptogen and hormone tonic is designed to provide ongoing age optimization support targeting sex and stress hormone balance while targeting AMPK, sirtuins, and telomeres – our foundational longevity mechanisms in the body. Longevity Elite’s advanced nanoemulsion formula blends premium sourced adaptogenic herb extracts and isolates and the key hormone precursor pregnenolone.

The Rejuvapen NXT® is an FDA-cleared medical microneedling device from Refine USA. Its advanced technology has raised the bar for microneedling devices with 9-speed settings, a precise Infinite Depth Dial, a patented ISO seal, and a digital motor. The Rejuvapen NXT is made in the U.S. and offers the flexibility to customize each patient’s treatment to produce consistent clinical results.

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Product Announcements

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faceLITE

ProText (Q4246)

Booth #6061

Booth #6033

Refine USA

Regenative Labs

Ph: 866-590-5533 | www.rejuvapennxt.com

Ph: 800-891-3452 | regenativelabs.com

The faceLITE phototherapy face mask uses optimized red and infra-red skin boosting technology that penetrates deep into the skin, stimulates collagen, elastin production and improves blood flow. faceLITE is clinically proven to improve skin hydration, firming and signs of aging with instant visible results. Our LED Facial Mask is an easy to use, portable, non-invasive treatment that requires no downtime.

ProText(Q4246) is the first and only connective tissue supplement derived from umbilical tissue that has been recognized as a 361 by any government body. It is applied locally, directly to the site of a structural defect in soft tissue or cartilage and is intended for homologous use to supplement damaged tissues by providing cushioning and structural support. ProText provides the scaffolding necessary to replace missing or damaged tissue, containing a variety of structural proteins, cytokines, and growth factors.

A2M

Vitamin D3-K2-MK7 Mega

Booth #5064

Booth #4039

Regenerative Kits

Rejuvenation Science

Ph: 1-888-789-8855 | www.regenerativekits.com

Ph: 310-798-2830 | www.rejuvenation-science.com

Alpha-2-macroglobulin (A2M) is a plasma protein and is found in significant quantities in the blood. A2M has been described as a broad spectrum multi-purpose protease inhibitor. This means that it is able to inactivate a variety of proteinases that are known to degrade cartilage. 1–2 Osteoarthritis (OA) is in part due to the diseased joint overproducing several chemicals that slowly erode cartilage. By inhibiting these chemicals (proteases), alpha-2- macroglobulin can stop the progression of OA by preventing the cartilage from breaking down and avoiding cartilage loss, which improves joint function and decreases pain.

Vitamin D3-K2-MK-7 Mega combines 5,000 IU vitamin D-3 and 180mcg K-2, two nutrients extensively researched for their roles in the health of bones, teeth, the immune and cardiovascular systems.* Unknown until recently, the vascular system within bones transports new stem cells and new immune cells from marrow out of the bones and into the normal blood system for transport to the site of an immune invasion.* MenaQ7® MK-7 is a patented soy-free, bioavailable form of vitamin K-2.

Product Announcements

RepeatMD

Rupa Health Lab Portal

Booth #7091

Booth #4032

RepeatMD

Rupa Health

Ph: 713-496-0261 | www.repeatmd.com

Ph: | www.rupahealth.com

RepeatMD grows high-margin services by building your aesthetic practice its own private-label mobile-rewards program. Average client results: - 76% increase in patient visitation - 44% increase in referrals - 21% increase in patient spending. We don’t think it’s fair to spend more time and money marketing and get fewer results. We understand you don’t have time to do it all; that’s why we created a solution that’s helped hundreds of practices grow their cash-based, high-margin services automatically.

Find, compare, order and track functional medicine lab tests from 20+ labs in a single portal.

mJoule featuring Moxi and BBL HERO

BARE HR

Booth #2071

Sciton

Ph: 650-493-9155 | www.sciton.com

The new mJOULE™ platform redefines standards for affordable quality and versatility. Because results matter at every budget. • BBL(R) HERO™ helps turn back the visible signs of aging anywhere on the body • BBL HERO with 4x the speed, 3x the peak power, and 2x the cooling will forever change how you treat skin from head to toe • MOXI™ , a 1927nm fractionated thulium laser, opens the door to a younger prejuvenation patient • Versatile and synergistic treatments • Single targeted treatments to regular skin care regimens • Affordable and expandable; choose both or one, add second modality in the future. Transform your practice and your patients with the latest innovation by Sciton.

BARE HR is the fastest laser hair removal device on the market with the versatility to safely and effectively treat patients of all skin types, anytime of year, anywhere on the body. Offering extra-large spot sizes and the ability to choose between an independent 810 nm diode or the unique “Blend Technology” with 810, 940, and 1060 nm wavelengths you can deliver the ultimate personalized hair reduction experience.

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Product Announcements

My Weight

My Sleep

Booth #4064

SeeBeyond™ Medicine

Ph: 914-722-9440 | seebeyondmedicine.com

Ph: 914-722-9440 | www.seebeyondmedicine.com

My Weight is a uniquely special weight loss supplement we have formulated after successfully treating thousands of patients suffering from obesity in my practice for over a decade. 42% of American adults, nearly 80 million people, live with obesity. One of the biggest misconceptions of obesity is that this is a lifestyle choice but it’s not. It is a disease, just like diabetes and cancer. My Weight was formulated to tackle multi-faceted barriers to weight loss. Weight loss resistance comes from uncontrolled appetite, slow metabolism, stress, poor sleep, as well as, anxious or depressed mood. We carefully crafted key ingredients that help decrease appetite, boost metabolism and support a healthier mindset.

My Sleep is a special and proprietary blend that supports healthy sleep and relaxation. Lemon balm has long been used as an essential oil, promoting restful sleep and healthy digestion. Valerian root, passion root, chamomile and hops extracts calm the body while Melatonin, GABA and L-theanine calm the mind. Realize the power of ancient herbs combined with new age compounds like GABA to get your sleep back on track today.

U C D E R M

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Selphyl PRP/PRFM

Signature UCDerm

Booth #8062

Booth #6007

Selphyl

Signature Biologics

Ph: 480-664-9490 | www.selphyl.com

Ph: 972-507-5916 | www.signaturebiologics.com

PLATELET-RICH FIBRIN MATRIX (PRFM) NEXT GENERATION PRP The SELPHYL® System is designed for the safe and rapid preparation of Platelet-rich Fibrin Matrix (PRFM) from a small sample of blood at the patient point of care. Many PRP systems require operator skill, have varying results and have extensive contamination with red blood cells and white blood cells. SELPHYL® removes virtually all contaminating cells and is independent of operator technique. PRP is converted to PRFM through a controlled process, creating a scaffold that serves to protect and preserve platelets. Think of SELPHYL® PRFM as the next generation PRP.

Signature UCDerm is a human umbilical cord tissue product for aesthetic application. Utilizing a dense tissue content for viscosity, Signature UCDerm allows for easy topical application to provide extracellular proteins to trouble spots and natural hyaluronic acid hydration.

Product Announcements

Blue Cannatine

Just Blue

Booth #8044

Smarter Not Harder, Inc.

www.troscriptions.com

Blue Cannatine is our signature nootropic formula that contains low dose and pharmaceutical grade methylene blue, nicotine, caffeine, and cbd. Launch into limitless mode with increased flow, enhanced verbal fluidity, upgraded memory, focus, productivity and a not-sosubtle energy boost for 3 to 5 hours.

Just Blue is our 16mg pharmaceutical grade purity/potency tested methylene blue troche. It is a fantastic mitochondrial optimizer, redox cycler, and has neuroprotective potential as well. Enjoy high definition and wide focus, enjoy high levels of endurance, and feel it activating when combined with sunlight. In short, Just Blue it!

Regenacol™ Skin Inside® Skin and Whole Body Nutrition

GI Stability™

Booth #9046

Booth #8021

Sovereign Laboratories

Standard Process Inc.

Ph: 928-421-2241 | colostrumtherapy.com

Ph: 800-558-8740 | www.standardprocess.com

Regenacol™ Skin Inside® Skin and Whole Body Nutrition is a oncedaily powdered drink mix with Colostrum-LD® (bovine colostrum) as its base ingredient. Research shows that bovine colostrum helps maintain tight junction integrity, thereby providing restorative power for excessive intestinal permeability (“leaky gut”) when incorporated into a healthy lifestyle. It also features essential vitamins and minerals, peptides, botanicals, and specialty nutrients that not only nourish whole body health but also play a critical role in key biochemical pathways which promote and maintain healthy-looking skin.

GI Stability supports the GI tract by delivering targeted prebiotic action, supporting a healthy gut microbiome, and feeding the growth of beneficial bacteria.

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Product Announcements

E-Z Mg™

Semaglutide + Cyanocobalamin

Booth #8021

Booth #5027

Standard Process Inc.

Tailor Made Compounding

Ph: 800-558-8740 | www.standardprocess.com

Ph: 859-887-0013 | www.tailormadecompounding.com

E-Z Mg is a plant-based, multiform organic magnesium (Mg) supplement developed to support patients with inadequate dietary magnesium intake.*

Uses: Semaglutide + Cyanocobalamin is a once-weekly subcutaneous injection GLP-1 agonist for weight loss. GLP-1 agonists were initially developed to improve glycemic control with type 2 diabetics as an adjunct to diet and exercise. More recently, Semaglutide gained an FDA-approved indication for non-diabetic weight loss. Trial Findings: The New England Journal of Medicine’s publication of the STEP trial revealed more than 50% of trial participants lost 15% of their body weight. How It Works: Semaglutide works to enhance the growth of beta cells in the pancreas, which are sites of insulin production. Semaglutide will also delay gastric emptying by reducing glucagon secretion in a glucose-dependent manner. The delay in gastric emptying can reduce appetite, improve control of eating, and reduce food cravings.

Liposomal -

Atraumatic Trocar for BHRT insertion

Booth #5027

Booth #7047

Tailor Made Compounding

TherapellET

Ph: 859-887-0013 | www.tailormadecompounding.com

Ph: 775-224-0000 | www.atrocars.com

Liposomes are nano-sized bubbles with an outer shell composed of healthy lipids that act as delivery vehicles for transporting substances into the body effectively via facilitating absorption directly in the mouth or by preventing breakdown by stomach acid. Liposomal Technology works by engulfing and protecting vitamins, nutrients and botanical extracts, making more of the active compound available in the intestines and reducing potential gastrointestinal discomfort. Liposomal delivery technology has been demonstrated to significantly increase the absorption of nutrients and provide superior bioavailability.

The atraumatic blunt-tip trocar preserves delicate adipose tissue and microvasculature necessary for proper absorption of hormones. It requires a single insertion for both male and female treatment. The trocar eliminates pellet extrusions and minimizes hematoma commonly associated with the sharp tip trocar insertion technique. Providers can save $50-80 on pellet cost for a male procedure by utilizing patent pending 300mg dosing system.

Liposomal Vitamin C 1000mg 150mL - Liposomal Glutathione 500mg 120mL - Liposomal Curcumin with Resveratrol 200mg/75mg 180mL - Liposomal Zinc 15mg 120mL Liposomal Vitamin D3/K2 2500iu/200mcg 120mL - Liposomal Quercetin 200mg 180mL

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Product Announcements

Giant Laser Cluster

3.5mm & 4.5mm SS Diamond Tip Trocar Trays

Booth #6043

Booth #9037

THOR Photomedicine

Trocar Supplies

Ph: 1-877-355-3151 | www.thorlaser.com

Ph: 740-314-9959 | www.trocarsupplies.com

The Giant Laser Cluster features 80 lasers and is designed to treat the back and neck. The FDA intended use includes the relief of muscle and joint pain. Come try it at booth #6043

A new diamond tip design has the original shaft length of 5cms. 1 - Tray. 1 - Fenestrated Drape with Adhesive Patch. 3 - Non-Woven Dressings. 1 - Transparent Dressing with Instruction Sheet. 6 - Tape Strips. 1 - Forceps. 1 - Scalpel. 1 - 10cc Luer Lock Syringe. 1 - 21 Gauge X 1 1/2” Needle. 1 - 18 Gauge X 1 1/2” Needle. 1 - 30 Gauge X 1/2” Needle. 1 - SS 3.5mm or 4.5mm Sharp Obturator with Diamond Tip Protector and Cannula. 1 - SS 3.5mm or 4.5mm Trocar #3 Blunt Obturator. 1 - Pellet Holding Cup 1. 1 - 1.6ML Prevantics Swabstick with Insert. 1 - Pair of Walleted Large Gloves

TruAge Complete Collection

Amelior

Booth #5033

TruDiagnostic

Ph: 833-963-1700 | www.trudiagnostic.com/truage

DNA Methylation is the best biomarker for accurately measuring biological age and predicting age-related health outcomes. TruAge analyzes methylation to create a broad spectrum of biological age reports and health insights. Track how new treatments affect your patient’s biological age, immune system age, telomere length disease risks, and more. The TruAge Complete Collection now includes DunedinPACE: a Pace of Aging metric sensitive to short-term changes, making it an excellent tool for personalized medicine.

Target aging at its source. Amelior is an evidence-based, all-inone natural supplement to support optimal epigenetic aging. The ingredients chosen for Amelior regulate crucial mechanisms that controls how your DNA is replicated, read and understood. Many ingredients have also been shown in clinical trials to offer assistance to your body’s fight against chronic diseases by boosting immune system recovery and metabolism regulation.

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Product Announcements

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FDA Approved Somatropin

44 IgE Food Panel

Booth #6021

Booth #6037

University Compounding Pharmacy

US BioTek Laboratories

Ph: 800-985-8065 | www.ucprx.com

Ph: 206-365-1256 | www.usbiotek.com

FDA approved HGH for $100

Food allergies are recognized to trigger adverse reactions such as skin conditions, GI problems, anaphylaxis, and more. With proper identification and elimination of the offending foods many experiences symptom relief and reaction evasion. Our IgE antibody panels serve as a useful tool in the identification of triggering foods in individuals. The 44 IgE Food Panel assesses IgE responses to 44 foods. This assessment can be completed via serum or dried blood spot card making is simple to complete in any location. It can also be done as a stand-alone test or in conjunction with a food sensitivity IgG, IgA, or IgG4 panel.

36 Inhalant IgE Panel

IV GLUTATHIONE PUSH V-KIT

Booth #6037

Booth #4045

US BioTek Laboratories

Vertisis Custom Pharmacy

Ph: 206-365-1256 | www.usbiotek.com

www.vertisis.com

Aeroallergens from trees, grasses, mold, dust, and others can produce symptoms that range from minor to severe in affected individuals. Our 36 Inhalant IgE Panel assesses antibody response to 36 airborne allergens, providing helpful information for effective allergy management. We run our IgE panels on a sophisticated FDAapproved immunoassay analyzer that utilizes enzyme-amplified chemiluminescence technology and can be run utilizing either serum or dried blood spot card samples.

Glutathione 200mg/ml 5ml - Hydroxocobalamin 5000mcg/ml 5ml Glutathione/0.9% Sodium Chloride Mixture - Osmolarity 773mOsm

Product Announcements

V-30

DermaFuse

Booth #4080

Viora, Inc.

Ph: 888-415-1192 | www.vioramed.com

Viora’s V30 Multi-Technology platform (part of the V-Series ) is specifically designed to meet these challenges and more! You can have it all! • Multi Proprietary Technology Platform • All high-end technologies • Clinically proven and validated by the market • Multiple applications from a single HP • Multiple applications in one system • Wide array of treatment protocols and applications to grow your business • Total Face & Body solution • Expandable, customized solution that grows with your business and maximizes ROI • Future technologies will fit the platform – upgrades! Viora specializes in providing you with the most advanced technologies within one platform, so you can expand your practice as you need and on your time.By combining multiple technologies, the V30Multi-technology platform enables you to offer multiple applications to your patients. Each technology is accessible via a different handpiece and can be acquired separately, so you control your treatment menu.

A FIRST-OF-ITS-KIND, AFFORDABLE & EFFECTIVE NEEDLE-FREE DEVICE DermaFuse®, Viora’s energy-based device, provides a needle-free method for superior enhancement of delivery of all-natural, high-quality topicals. Customizable to a multitude of aesthetic concerns, your patients will enjoy the benefits of immediately visible results without pain or downtime. DermaFuse® is a compact and affordable device with attractive pricing on consumables, giving you the ability to provide patients with a beautiful outcome at every session. DermaFuse® can be offered to patients as a high-frequency, repeatable treatment to maximize your ROI. One device treats a multitude of skin concerns, including: - Anti-Aging and wrinkle correction - Collagen regeneration - Skin rehydration - Skin firming and toning - Skin lightening and pigmentation - Skin texture and tone - Acne clearance and oil control.

Cortilief

Histalief

Booth #8042

Vita Aid Professional Therapeutics

Ph: 1-800-490-1738 | www.vitaaid.com

Cortisol Modulating Formula • High dose Phosphatidylserine (150 mg/capsule) from sunflower seeds + potent Magnolia (90% honokiol) & Phellodendron (85% berberine) Extracts - synergistic action to reduce high cortisol state • Ashwagandha - improve stress-coping response • Wild Jujube Seed Extract (a natural GABA agonist) + L-Theanine to promote relaxation & sleep

Featuring synergistic herbal extracts - Tinospora, Perilla, Urtica - with vitamin C & Quercetin to help support Normal Histamine Levels and Mast Cell Stability

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Product Announcements

118

VivoScore

Empower Sleep Partnership

Booth #3037

Vivos

Ph: 816-853-8667 | www.vivoslife.com

VivoScore is a comprehensive home sleep apnea test (“HSAT”) that utilizes proprietary cardiopulmonary coupling technology developed by MyCardio LLC (“SleepImage”). VivoScore consists of a singlesensor ring recorder that works with a mobile phone application and proprietary cloud-based algorithms to evaluate sleep quality and clinically diagnose sleep apnea. For more information, see https:// vivoslife.com/vivoscore-press-announcement/

Vivos has partnered with Empower Sleep, founded and led by Dr. Sahil Chopra, to improve health through the lens of sleep. Sahil Chopra, MD completed his residency at UCLA in internal medicine. He then completed two sleep fellowships--at Harvard Medical School and Beth Israel Deaconess Medical Center. Through a treatment protocol that includes VivoScore, sleep coaches, insomnia therapists, and physicians, Empower Sleep is committed to restoring patients’ sleep. For more information, please visit empowersleep.com

ReadiSorb GO

PulseWave ESWT

Booth #4036

Booth #6085

ReadiSorb

Zizion Group Inc.

Ph: 877-303-3238 | www.readisorb.com

Ph: 561-221-1000 | www.MedGeneRx.com

Our Brand new product, ReadiSorb GO, is liposomal glutathione in great tasting powder. Simply mix with water and drink. Each packet contains 500mg glutathione and there are 30 packets per box. If you would like a few sample packets sent to you let us know. The flavors are a natural botanical blend that is allergen free.

Acoustic Wave Therapy is a radial Shockwave device that uses the body’s intrinsic repair mechanisms to regenerate its tissue. The system comes complete with two channels, a powered and selfcooling handpiece, heavy-duty power supply, foot pedal, and 5 distinct applicator heads (36 mm, 25 mm, 15 mm focused, 15 mm unfocused, and 6 mm) that are able to treat many conditions. These include erectile dysfunction, over two dozen orthopedic indications, and body shaping. The device comes with 10 specially designed hybrid silicon caps that are placed on the applicator heads and a sturdy custom metal carrying case. Visit www.shockwavehealing.com for more information and available studies showing its efficacy.

Product Announcements

MedGeneRx 30cc High-Performance PRP Kit

The Wellness Suite

Booth #6085

Booth #4079

Zizion Group Inc.

ZRT Laboratory

Ph: 561-221-1000 | www.MedGeneRx.com

Ph: 503-466-2445 | www.zrtlab.com

FDA cleared Class II PRP kits indicated for the rapid preparation of autologous Platelet Rich Plasma (PRP) from a small sample of blood at the patient’s point of care. Each kit is capable of multiple spin protocols, to enhance Platelet Concentration. All preparation protocols have been validated by an independent lab.

ZRT’s Wellness suite of profiles includes the Wellness Metrics Profile for an overall hormonal and metabolic health screening, the Fitness Metrics Profile for those wanting to monitor fitness or weight loss goals, and the Elite Athlete Metrics Profile for athletes who train at a higher level. Wherever you are on your wellness journey, there is a profile to help you maximize your potential!

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The Future of

CIRS By: Andrew Heyman, MD, MHSA

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.

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The Future of CIRS

It is difficult, if not dangerous, to predict the future. But, trends and good data can point the way towards possibilities and probabilities. There is a momentum building in our understanding of Chronic Inflammatory Response Syndrome (CIRS), and the science has grown exponentially in the past 18 months thanks to transcriptomics. This new knowledge is sweeping our efforts forward in a more defined direction while we hone our understanding of the disease. The future is coming into focus. There are also larger moving parts within the general CIRS practitioner community, and even external social and market forces that seem to be creating a set of likely outcomes that are both exciting and important. If we return to the fundamentals of CIRS, beginning with the seemingly innocuous Sarcin Ricin loop present in all living creatures that create the nexus and permanent vulnerability to biotoxins, it is obvious that this disease will never be fully eliminated. In fact, from an evolutionary perspective, CIRS can be seen as an adaptation to cellular threats, albeit a debilitating one for a large minority of the population. I think back to my Family Medicine training at the University of Michigan, a stellar formal education already built on 20 years of professional work in Integrative Medicine. I thought I had the intellectual and diagnostic capabilities at my disposal to understand most patients who walked into my academic clinic. I could bring to bear the full power of scientific medicine through the resources of a major research center, but also slip into the other ‘medical languages’ of Traditional Chinese Medicine, Manual Therapies, Botanical Medicine, and the newer ‘Functional, Anti-Aging and Integrative approaches’ that would allow me to understand complex illnesses through different lenses. With that broad foundation, still, patients presenting with fatigue, pain, mood issues, functional bowel disorders, weight gain, and much more would too often slip through my carefully erected expertise with ease. Yet, aren’t these complaints the hallmark of any primary care office? Our bread and butter? How was it that neither the healing wisdom of the ages nor the most advanced science of the day could not fully and completely understand and resolve these common complaints? If we are honest with ourselves as professionals, scientists and healers, it felt as if I had reached a kind of cognitive

and scientific frontier. What lay beyond? Were there answers out there already known, or would new ones need to be generated for these common complaints that have plagued humans for millenia and appeared resistant to just about every form of therapy across time and culture. 2014. I meet Dr. Ritchie Shoemaker in the countryside of Virginia. Sometimes you can feel your life changing in the moment, and other significant events need distance and reflection to appreciate their enormity. In this case, I knew immediately I was in the presence of a genius but also did not fully comprehend the upheaval his work would bring to bear on my own. He spoke the language of science, but used a dialect I had never heard before. He was riffing off emerging ideas called proteomics and genomics, applying unfamiliar measurement tools, and as a result, was generating clinical outcomes that appeared impossible. A master of his art, one that he created in the backwaters of Pocomoke, all on his own. Reminds me of the story of Robert Johnson. A relative unknown in the 1930s, who emerged from the obscurity of the delta to define a generation of blues and rock and roll. He recorded only 29 songs, having developed a unique playing technique that seemed to be inspired by something supernatural (some argue he met the devil at the crossroads, because no human could have figured out his brilliant style by himself ). He created an approach to music that would forever influence many famous musicians after him. Every once in a while, we come across these almost mythic figures who blend creative insight, technique, and skill into something completely novel and transformative. In my humble opinion, CIRS represents that breakthrough. Dr. Shoemaker embodies that formidable genius whose medium is human suffering and makes music with molecules and cells. There is a permanence to CIRS because humans have always lived with it. There is a brilliance to the diagnosis, since it is ubiquitous, but like quick silver has escaped recognition to all those that came before us except one. A Robert Johnson like figure who sat on the banks of the Chesapeake Bay and saw what no one else could see. Look around your practice. CIRS is everywhere. Look inside yourself. It may be in you too. Did you miss it? We all did.

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The Future of CIRS

So where do we go from here? First, we must recognize this is a disease squarely in the domain of primary care. It is my firm belief all PCPs should have command of this topic. Additionally, the health of our indoor spaces must be included as a vital sign for every patient. There is just no way around these ideas. Furthermore, the science that underpins CIRS has matured to the point where, I believe, it is almost malpractice to offer ‘medication management’ to these many broken humans in lieu of proper treatment that is actually curative. Of course, there is still more to learn and understand about the subject. But as I started walking the research path with Dr. Shoemaker, and participated in carefully constructing a scientific framework for CIRS, one thing became clear. Every piece of new data would reinforce, expand or refine our understanding of CIRS. New findings would never fundamentally undermine the science that came before it. Even with the incredible power of transcriptomics, gene expression revealed the inner workings of the disease, yet did not alter our basic conceptions or knowledge base.

Science Transcriptomics appears to be the true breakthrough in diagnosing CIRS. Gene expression has revealed the hallmarks of the disease – molecular hypometabolism, altered immune efficiency, defective apoptosis, aerobic glycolysis – and linked these molecular abnormalities to risk for vascular dementia, diabetes, thrombotic events, and pulmonary hypertension, to name a few. We will continue to identify patterns of aberrant gene expression, and conduct the difficult work to make meaning of these findings. Who knew your home could make you fat, depressed and demented? Who knew that water damage leads to amplified microbial growth of bacteria more commonly than fungal elements? Who knew that this is as much a proliferative disorder as inflammatory? Now we know. Additionally, applying new metabolomics techniques to measure mitochondrial production of downstream small molecule patterns may also help identify subsets of CIRS patients and unlock issues around those resistant to standard therapy, chemically sensitive individuals, and elucidate the impact of the exposome on cellular health. Better diagnostics in general, and the ‘Omics revolution in particular, will allow us to diagnose CIRS patients more quickly and may generate more targeted therapeutic countermeasures.

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Where we lag behind is a broad array of treatments that reliably cure the illness. Currently, we are blessed with Vasoactive Intestinal Peptide. A miraculous but single arrow in our therapeutic quiver, that restores the individual back to health, heals the brain and corrects gene response. We know certain molecular and genomic features of CIRS respond to earlier interventions before VIP is administered. We follow the steps of therapy, conclude with VIP and hope for cure. But can we develop treatment strategies that rapidly and precisely induce cure while bypassing the intermediary steps of treatment? Is there an alternative to VIP? I believe this is the next important stage in CIRS – reliable, powerful, and precise treatments – validated through restored transcriptomics. Maybe new treatments will be discovered in the family of emerging regenerative techniques such as peptides, exosomes, stem cells, phage therapy, CRISPR, nutrients, or even high extract natural compounds. Or maybe, as was the case with cholestyramine, an old drug will be identified that demonstrates unique characteristics well suited for CIRS. As we dive deeper into the pathophysiology of the condition, a key finding is the profound orchestration the mitochondria have on cell behavior, and the shift towards a pathologic but permanent altered state of gene expression. While downstream consequences of this molecular activity are measurable changes in levels of signaling molecules, nutrients, amino acids, lipids, inflammatory markers, the microbiome and more, these are merely the leaves on the tree. Without casting aspersions, ‘Functional Medicine’ has been overly focused on assessing and treating these abnormal small molecule findings, while ignoring the key insight transcriptomics offers – to cure these patients, we have to find therapies that shift genomic expression of the mitochondria back to a healthy state of oxidative phosphorylation and normal cellular energetics. Merely treating the leaves on the tree will not achieve this end. We have to fix the roots of this disease instead. Overall, the clinical imperative should be to heal patients more quickly, build resiliency and resistance to future exposures, and ensure complete resolution in all tissues and organs. Unfortunately, there is currently little (read: no) extramural funding for CIRS. How do we get to these conclusions? Will there be a Robert Johnson who emerges from the mist, or can we leverage another trend?

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The Future of CIRS

Professionals

to medicine overall by engaging in the research effort as well.

I am an educator by nature. I enjoy watching students grow in their careers. It is especially satisfying in clinical medicine since every practitioner I train will go on to help thousands of patients during their lifetime. Over a 30year career in academia and education, I would selfishly like to think I have reached well over a million patients through my students. While I have broad education responsibilities now, my main concentration is in CIRS.

An organized network of trained and certified providers, unified by their education and connected within a technological ecosystem, will allow for an acceleration of discoveries in CIRS. While we can wait for another ‘Robert Johnson,’ instead we have the tools at our disposal to test new diagnostics and therapeutics in an organized fashion.

Dr. Shoemaker and I are committed to offering a graduate level learning experience on the subject. We are able to leverage the assets of online learning capabilities to reach dozens of willing practitioners, and this year alone, we will have formally trained over 100 practitioners in the Science of CIRS. Wow. What an honor and privilege. This community of excellent providers will grow and they will treat hundreds of thousands of CIRS patients over the coming years. The ‘music’ of Dr. Shoemaker will continue to change lives. With that said, this expanding network of trained professionals offers a larger opportunity to conduct patient centered outcomes research. There is power in numbers. If we cannot obtain funding for formal investigations, we can draw upon the collective contributions of many providers to aggregate properly sized data sets to assess outcomes. Technology, especially cloud based, has been a game changer in this regard. New ‘point of care’ platforms, wearables, apps and iOT devices can act as the glue between practitioner and patient, while funneling data across large populations to centralized research hubs.

This is not an easy choice for some, since it requires a participatory spirit, adoption of unified technology platforms, and a commitment to expand the practitioner identity to include researcher as well. The time is now, though. I hope we can usher in a shared spirit of collaborative research in the coming years to accelerate our understanding of CIRS.

Policy Everyone deserves health. It is a social good that should not be reserved for only those who can afford it. A person cannot reach his or her potential, compete in the marketplace, or participate effectively in society if they are sickened by their living environment. It does not take much thought to see the financial, social and cultural implications of CIRS. This may be the largest, and most expensive, unrecognized public health crisis of the modern era. It has particular implications for the underserved who lack access to medical care, proper nutrition and social opportunities. But in all my years of working in inner city Philadelphia, Washington DC and Detroit, I never considered the contribution a sick building may play in the overall disease burden of this particular population.

Family Medicine, in the 1990s, was the first medical specialty to assemble practice based research networks (PBRN) to achieve just this goal. Although at the time, EMRs were still new, if not uncommon, and accessing data at the clinic level required super human efforts to mine paper charts. Now, the efficiencies of technology have reduced these barriers to entry on large-scale research.

We already struggled with managing their obesity, diabetes and heart disease, mental health disorders and substance abuse, violence and neglect. I have often been impressed by the number of CIRS patients that report anger, and even rage, generated by the illness. Add poverty, poor coping skills and a gun to this mix. A scary thought indeed. I think this is a particularly vulnerable population for CIRS, and one that has little recourse for proper diagnosis and treatment, let alone remediation.

CIRS providers must make a commitment to participate in the PBRN model to accelerate research findings. While the early, and ongoing work of Drs. Shoemaker and Ryan have been singular and heroic, it is time for the current generation of CIRS providers to give back to them, to their patients, and

Additionally, we do not have nearly enough properly trained practitioners, PCPs in particular, to manage the millions of CIRS patients currently living in the US. The amount of resources required to match health services to this particular population is under funded and grossly under recognized

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The Future of CIRS

by medical institutions. Health advocacy that leads to meaningful policy changes will need to occur on the state and federal level to support formal education, inclusion in clinical guidelines and recognition as a distinct disease category that has particular impact on vulnerable populations. Large-scale clinical outcomes data will likely lead the way as the basis for policy related changes. I see this public health advocacy work occurring in the near future, but it is not imminent. In the meantime, patient groups can act as a vehicle for meaningful dialogue as a start point, beyond the chat rooms inhabited by individuals only seeking medical advice for themselves.

It is time for the next generation of providers, in partnership with the public, to raise awareness of CIRS, conduct high quality outcomes research, establish reliable clinical guidelines, and assure people have access to clean interior environments. My hope is that the rush of satisfaction and relief practitioners feel when they cure a CIRS patient can be focused into these other activities to inspire meaningful change in medical, public health, policy and legal domains. No one is coming to save us. We have to build on the current momentum to create a better future for ourselves, our patients, and the general population.

Awareness raising activities, recognition of healthy environments as a form of social justice, and lobbying for protections against landlords, building owners, construction companies and employers will need to be energized by effective advocates for change. This is an uphill battle at best, but pressure from the public on politicians, the medical community and social institutions have a track record of success in other movements for change. At some point, public awareness will reach a critical mass. But we are only a few voices in the wilderness right now. Practitioners need to take their role as cultural leader as seriously as their role as researcher. I suggest beginning by giving local talks on CIRS. Raise awareness, advocate for change, encourage community based groups to take the issue seriously as a public health problem, while continuing to treat patients and help collect data to change medicine. A lot to do….. But we have approached the point of no return. CIRS is real. CIRS is common. It has enormous socioeconomic and health services implications that deserve its own social movement for change. Otherwise practitioners remain vulnerable to state medical boards. Patients remain under diagnosed and untreated. Those responsible for assuring clean interior environments are not held to account. And the crisis continues on a grand scale.

Final Thoughts We have a roadmap for the clinical aspects of CIRS. The scientific foundation is now relatively firm and offers a framework to expand our data sets overall, seek additional effective therapies, and apply new research methods to a very old disease. Medicine, and society, needs to catch up. Dr. Shoemaker gave us a gift through his insights and almost 30 years of work on the subject.

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ANTI-AGING MEDICAL NEWS | WINTER 2021

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Glutathione Supplementation: What the Clinical Research Shows

Reprinted with permission from Emerson Ecologics Element Issue 3 2021 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.

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Glutathione Supplementation: What the Clinical Research Shows

At the center of the body’s multifaceted antioxidant defense system lies glutathione—the “master antioxidant”. Synthesized in the cytoplasm of every human cell, glutathione is a powerful force against toxins and damaging free radicals. The ability to mount a response to free radicals and oxidative stress is a fundamental biological process required to maintain health. Increasing evidence, including a study published in 2020 in ACS Infectious Diseases, suggests that a decline in antioxidant defenses underlies the susceptibility to acute illness— as well as many chronic diseases and of course, aging itself. During aging, glutathione levels appear to decline in many tissues, thereby putting cells at increased risk of succumbing to stress. The evidence for such a decline is strongest in the brain where glutathione loss is implicated in both Parkinson’s disease and in neuronal injury following stroke. Depletion of glutathione—or a disruption in its synthesis or metabolism—has been implicated in diseases that affect the heart, lungs, liver, brain, muscular and immune systems. Glutathione can become depleted by exposure to medications, environmental toxins, heavy metals, and pesticides. The demand for glutathione also increases in the face of stress, weight gain, alcohol consumption, and normal aging. Taking supplements to support glutathione levels is a sensible approach for anybody who wants to optimize their foundational cellular antioxidant defense. However, the best way to do this has been controversial. For decades, precursor supplementation has been the most accepted way to boost glutathione levels, and it works. But we now have evidence suggesting that preformed glutathione supplements may also be a viable option. Still, questions abound. Here’s a look at the clinical research for the various forms of glutathione supplements. HOW GLUTATHIONE WORKS Understanding glutathione’s mechanisms of action is important when choosing supplements to support healthy glutathione metabolism. Glutathione is a tripeptide molecule that’s synthesized from glutamate, cysteine, and glycine. It’s found inside every cell of the human body, and also in extracellular fluids. Much of the body’s glutathione is concentrated in liver cells, but there are also high levels

in the kidneys and the mucosal secretions of the intestines and lungs. Even though we use the term glutathione as if it were a single entity, it actually exists in multiple forms. Glutathione is continually transitioning between a reduced form, an oxidized form, a disulfide cysteine-containing form, and a protein-bound form. The most biologically active and beneficial form is reduced glutathione. Abbreviated as GSH, the reduced form contains a thiol group of sulfur and a hydrogen (—SH). The thiol group makes reduced glutathione extremely efficient at neutralizing harmful reactive oxygen species, such as hydrogen peroxide and lipid peroxides. This neutralization process is catalyzed by the enzyme glutathione transferase. While that’s good for combating free radicals, it also means that GSH transforms into its oxidized glutathione disulfide form (GSSH). This GSSH must then be recycled back to GSH in order to continue to protect the cells. The enzyme glutathione reductase catalyzes the recycling of GSSH back to GSH. It does this in the presence of electrons donated from the reduced form of nicotinamide adenine dinucleotide phosphate (NADPH). It’s also important to note that along with its direct antioxidant action, glutathione contributes to antioxidant defenses in many other ways. Glutathione has the ability to regenerate other antioxidants, including vitamins C and E. It also can bind to drugs, alcohol, pesticides, and carcinogens as part of detoxification pathways in the liver and intestinal tract. GLUTATHIONE PRECURSORS For many years, there was a widespread belief that glutathione couldn’t be absorbed when taken orally. It was thought that glutathione’s molecular size was too large to cross the intestinal barrier, and that intestinal γ–glutamyl transpeptidase would enzymatically split glutathione into its amino acid constituents before it could be absorbed. Even though recent research has changed that thinking, using precursors and synergistic agents to support the endogenous production of glutathione is still a valid approach—beginning with n-acetyl cysteine (NAC). NAC is just one of the three amino acids required for glutathione synthesis, but it’s the rate-limiting one. NAC has long been accepted as a way to support glutathione

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Glutathione Supplementation: What the Clinical Research Shows

production, and is the standard of care to restore hepatic glutathione levels in acetaminophen toxicity. But NAC isn’t the only variable at play in the pathway of glutathione synthesis. Glutathione production takes place in two steps. First is the bonding of l-glutamate with l-cysteine, and second is the addition of l-glycine. The first step requires either magnesium or manganese as an enzymatic cofactor. Both steps are also dependent on a steady source of energy in the form of ATP. NAC doesn’t necessarily need to be taken as a supplement to feed into the pathway of glutathione synthesis. The body can produce cysteine from methionine as long as the transsulfuration and methylation pathways are intact. The following supplements also feed into pathways related to glutathione and can support its endogenous metabolism: Whey protein (as a source of amino acid precursors) Selenium (as a cofactor for glutathione peroxidase) B vitamins (to support methylation and transsulfuration pathways) Sulforaphane glucosinolate (as a source of sulfur) Alpha-lipoic acid (to support mitochondrial health and energy production) Nicotinamide mononucleotide (to support NADH metabolism) Diet can also support the maintenance of healthy glutathione levels. Protein-rich foods provide NAC and other amino-acid precursors. Good sources of sulfur include cruciferous vegetables, eggs, and garlic. Minimizing consumption of pesticides, alcohol, and other toxins can reduce the burden on glutathione and other antioxidant defenses. Even though precursor and synergistic compounds remain a viable way to support glutathione levels, there’s no guarantee this approach will be effective. Genetics, chronic illness, and aging can all interfere with the pathways involved in glutathione metabolism and may limit the efficacy of this approach. To bypass potential metabolic errors in glutathione production, we look to the possibility of supplementing preformed glutathione. Here are four of the best-studied options. REDUCED GLUTATHIONE (SETRIA) The earliest evidence that glutathione might be absorbed across the intestinal wall came from animal and mechanistic studies in the late 1980s and early 1990s. Researchers found that oral intake of GSH was more effective than its precursors at increasing plasma glutathione levels in mice.

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Next, researchers found that glutathione could be transported across the buccal mucosa in humans. Then in 1997, researchers at the University of Firenze, Italy, discovered GSH-specific transporter molecules in human intestinal epithelial cells. This was a huge boost to the theory that glutathione could indeed be absorbed across the intestinal tract intact. The first placebo-controlled trial of oral glutathione supplementation was published in the European Journal of Nutrition in 2015. Dr. John Richie and his colleagues at Penn State University gave 54 healthy adults either a placebo or 250 mg or 1,000 mg a day of oral GSH for six months. The results? Impressive. Glutathione levels increased significantly from baseline in whole blood and red blood cells after three months and six months—regardless of which dosage was taken. After six months, the group taking 1,000 mg per day had a 31 percent increase in glutathione levels in whole blood, a 35 percent increase in red blood cells, and a 250 percent increase in buccal cells. The study also showed that oral consumption of reduced glutathione supported natural killer cell function. The study was conducted using Setria, a branded form of reduced glutathione that’s manufactured using a patented fermentation process. S-ACETYL-GLUTATHIONE (EMOTHIAN) In an ongoing attempt to optimize oral glutathione supplementation, a company in France developed a form called s-acetyl-glutathione. It has an acetyl group (CH3CO) bound to the sulfur atom on glutathione, which makes the compound more stable than GSH in plasma. The acetyl group is also thought to facilitate absorption through the intestinal wall. Once in circulation, s-acetyl-glutathione can be taken up by body cells and converted into GSH. A study published in 2018 in Clinical Nutrition & Dietetics compared the bioavailability of s-acetyl-glutathione to Setria. Eighteen participants were given a single dose of each compound in a randomized, crossover study. The results showed that, on average, plasma concentrations of glutathione reached a higher maximum concentration and area under the curve for s-acetyl-glutathione than Setria. But the results for red blood cell concentrations were the opposite, with a higher maximum concentration and area under the curve for Setria. Plasma concentrations of cysteine and glycine didn’t differ between the two groups.

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Glutathione Supplementation: What the Clinical Research Shows

It appears that all four forms of glutathione we’ve reviewed offer some benefit.

LIPOSOMAL GLUTATHIONE Liposomes are commonly used to protect drugs and nutrients from degradation and enhance their delivery, so it makes sense that liposomal glutathione is now available. A 2015 study demonstrated that oral liposomal glutathione supported immune function in a select population of individuals. But we didn’t know much about liposomal glutathione’s bioavailability or its ability to enhance the body’s GSH stores until 2018. That’s when the same researchers at Penn State who had previously looked at supplementation with reduced glutathione in published a study of liposomal glutathione in the European Journal of Clinical Nutrition. Their one-month trial involved 12 healthy adults given either 500 mg or 1,000 mg of oral liposomal GSH per day.. Results showed a trend of increased levels of glutathione in whole blood for both supplementation groups, with the largest increase (40 percent) in the 500 mg group at two weeks. There was also a trend of increased glutathione in red blood cells for both groups, with the largest increase (28 percent) in both groups at two weeks. In addition, the study showed that oral consumption of liposomal GSH reduced biomarkers of oxidative stress and supported healthy immune function, including natural killer cell and white blood cell activity.

Setria (reduced glutathione) has been shown to support glutathione levels in both the whole blood and the red blood cells when taken for as long as six months and at a dosage as high as 1,000 mg per day. It’s the standard against which other forms of preformed glutathione are often tested. Emothian (s-acetyl glutathione) has only been evaluated in a single-dose bioavailability trial, but the results suggest it may be even more effective than Setria at increasing plasma levels of GSH—but not quite as effective at increasing red blood cell levels. Liposomal glutathione has only been evaluated for as long as one month, but the results suggest that its ability to support endogenous glutathione levels is similar to Setria. Sublingual administration of liposomal glutathione may offer a slight advantage over oral administration. Based on the current level of evidence, you’ll most likely be doing your patients a service no matter which form of glutathione you recommend. Glutathione is at the center of our antioxidant defense system and a key player in supporting healthy aging.

SUBLINGUAL GLUTATHIONE Liposomal glutathione is also available in a sublingual form. This route of administration is thought to be superior to the oral form because it avoids the risk of intestinal enzymatic degradation. To evaluate whether this is true, researchers in France compared a sublingual liposomal glutathione to oral GSH in a three-week trial. Twenty participants were given either sublingual liposomal glutathione (450 mg per day in three divided doses) or oral reduced GSH (in the same dosage). Results showed a significantly greater increase in total and reduced GSH levels in the plasma of the study participants taking the sublingual form, compared with those taking the oral form. The sublingual liposomal GSH was also found to increase plasma levels of vitamin E.

SELECTED REFERENCES Ballatori N, et al. Biol Chem. (2009);390(3):191-214. Fanelli S, et al. Clinical Nutrition & Dietetics (2018). Gould RL and Pazdro R. Nutrients 11, no. 5 (2019). Guloyan V, et al. Antioxidants (Basel) 9, no. 10 (2020). Ly J, et al. J Interferon Cytokine Res 35, no. 11 (2015): 875–87. Polonikov A. ACS Infect Dis 6, no. 7 (2020): 1558–62. Richie JP, et al. Eur J Nutr 54, no. 2 (2015): 251–63. Schmitt B, et al. Redox Biol 6 (2015): 198–205. Sinha R, et al. Eur J Clin Nutr 72, no. 1 (2018): 105–11.

CHOOSING A GLUTATHIONE SUPPLEMENT Supplementation with glutathione precursors and synergistic agents has long been an accepted strategy to boost antioxidant defenses. This is still a valid approach, but we now also have evidence to support a role for preformed glutathione. One of the most challenging questions to answer is which form of glutathione is the best? ANTI-AGING MEDICAL NEWS | WINTER 2021

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0.6

ß-Hydroxybutyrate (mM)

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2 Hours

100 50 0

Water Fast

FMD Bar

Breakfast

(e)

(d)

After 15 h of overnight fast, study foods were consumed at hour 0 for the breakfast and FMD groups. (a) Ketone and (d) glucose levels were measured at time 0 and hourly for 4 h. (b) Blood ketone levels 3 h after the experimental groups consumed the study foods. (e) Blood glucose levels 1 h after the experimental groups consuming the study foods. Data represent mean and standard error. *** p < 0.001, **** p < 0.0001, FMD or breakfast group compared to the water fast group, one-way ANOVA, with Tukey’s multiple comparisons test.

Fast Bar allows your patients to curb their hunger without breaking their fast*

MLR2021-0921 / v1.0 / 14Oct2021

The Intestinal Microbiota and the effect on Food Sensitivities and the Gut-Brain Axis

By: Brent L. Dorval, PhD 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.

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The Intestinal Microbiota and the effect on Food Sensitivities and the Gut-Brain Axis

Bacteria in the gut have a positive impact on the ability of the immune system to prevent loss of tolerance, injury to the gut mucosa and the ability to metabolize various compounds which has a direct effect on brain function in the Gut-Brain Axis. Evidence exists which demonstrates that probiotics help reduce damage, or even restore the integrity of a damaged gut mucosa which limits food sensitivities and promotes chemical signaling of the gut with the brain. In other cases, bacteria in the gut some 100 trillion organisms, degrade certain proteins such as gluten and prevent toxicity which ultimately reduces inflammation. There is mounting evidence that intestinal infections, toxins, or foods themselves affect the gut mucosa leading to an immune reaction and the generation of proinflammatory cells and mediators which ultimately lead to a food sensitivity and aberrant brain function. A recent monograph by the Autoimmune Institute points to several key factors which are involved in food sensitivities, but the gut microbiota is clearly very important.1 Work at the Mayo Clinic also stresses the importance of the microbiome.2 Key factors involved in Food Sensitivity include1,2: • Mechanisms of food sensitivities are unclear but gut microbiota and host predisposing factors (genetics) dictate the development of these conditions • Gut microorganisms can degrade/modify food antigens or allergens, increasing or reducing their immunogenicity. • Dietary food components that are insufficiently digested by host enzymes become bacterial substrates, leading to the production of metabolites such as short-chain fatty acids, which are involved in gut homeostasis. • Intestinal barrier dysfunction, which can be influenced by gut microorganisms and pathogens through different pathways. • Mucosal dendritic cells present dietary antigens to naive T helper cells, promoting their differentiation into peripheral T regulatory cells; virus–host interactions abrogate this response, inducing a pathogenic response to antigens. • Enteric bacteria induce T helper 2 cell immunity and protect against food sensitivity by inducing IL-10, which blocks type 2 immunity. What has emerged is that altered gut microbiota contributes to increased intestinal permeability or leaky gut which in turn contributes to an increase in food sensitivities and

altered brain function. From an immunological perspective, altered gut bacteria contributes to leaky gut which results in partially digested food antigens crossing the gut mucosa and entering the lymph nodes (Peyer’s patches, M Cells or GALT-Gut-Associated Lymphoid System) and generating antibodies which then form immune complexes and activate complement causing inflammation. The net result is that food allergens are treated by GALT as either innocuous antigens that induce tolerance or as pathogenic antigens which generate harmful reactions.2,3,4 In addition, alteration in gut bacteria results in a change in chemical signaling from bacterial metabolites such as tryptophan, acetylcholine, catecholamines, Gamma amino butyric acid and other molecules which travel to the brain and modify brain function. The Biodiversity Hypothesis Connection to Food Sensitivities and the Gut-Brain Axis The concept of Biodiversity consolidates the importance of the microbiome and the link to immune regulation and brain function. The Biodiversity Hypothesis5 states “that contact with natural environments enriches the human microbiome, promotes immune balance and protects from allergy and inflammatory disorders”. The following explanation by Tari Haahtela posits that “we are protected by two nested layers of biodiversity: 1) microbiota comprises the outer layer (soil, natural waters, plants, animals) and 2) an inner layer (gut, skin, airways).5 The latter inhabits our body and is colonized from the outer layer. Explosion of human populations along with cultural evolution is profoundly changing our environment and lifestyle. Adaptive immunoregulatory circuits and dynamic homeostasis are at stake in the newly emerged urban surroundings. In general, allergy and chronic inflammatory disorders center around the determinants of immunotolerance which is the key to prevention and more effective treatment. Loss of immunoprotective factors that are derived from nature, is a new kind of health risk poorly acknowledged until recently. This paradigm change has been implemented in the Finnish allergy programme (2008‐2018), which emphasized tolerance (to microorganisms in the environment) rather than avoidance. The first results from this study are promising, showing that the occurrence of allergy in the population overall has started to decrease. The rapidly urbanizing world is facing serious biodiversity loss as global warming increases which demonstrates the interconnected nature of the planet as a whole. The biodiversity hypothesis of health and disease connects societal impact on factors such as city planning, food and energy production and nature conservation. This hypothesis also has a message for individuals’ health and

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well‐being and recommends that one should get closer to nature to experience and enjoy. Haahtela proposes that biodiverse natural environments are dependent on planetary health, which should be a priority among health professionals (Figures 1 and 2). In the context of food sensitivity, the net result is that the loss of biodiversity will affect the gut microbiome and may result in an increase in gut-associated problems. Recently Jake M. Robinson6 has expanded on the concept of biodiversity being connected to the human microbiome and overall health which is an interesting perspective coming out of his background in urban planning. He argues that an increase in biodiversity must be taken into account when designing urban spaces so as to increase overall health of the residents. This is especially important because “by 2050, 70% of the world’s population is expected to live in towns and cities.”

Figure 1

Figure 2

The Gut-Brain Axis and the Microbiome in the Gastrointestinal Tract The gut–brain axis is a bidirectional signaling pathway which takes place between the gastrointestinal tract (GI tract),

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the central nervous system (CNS) and enteric nervous system (ENS).7 The GI tract is connected to the brain (CNS) through ENS vagal and spinal afferent fibers. The brain sends efferent sympathetic and parasympathetic fibers to the GI tract in a constant feedback loop. The microbiota which inhabits the GI tract is composed in many different types of bacteria which have the ability to metabolize a wide variety of compounds which directly affect the CNS. Based on this, the gut microbiota of the ENS is absolutely required to ensure proper brain function and many symptoms and some diseases are associated with altered gut bacteria such as: Anxiety and Mood disorders, Autism, IBS, Multiple Sclerosis, Alzheimer’s, and Parkinson’s Disease. The control exerted by the gut microbiota on the brain include: 1) Production, expression, and turnover of neurotransmitters such as GABA and BDNF, 2) protection of tight junctions in the GI tract, 3) enteric sensory function and 4) bacterial metabolites which alter brain function. The brain in turn controls: 1) mucus and biofilm production, 2) GI tract motility, 3) intestinal permeability and 4) immune function. The ENS is composed of afferent and efferent neurons that not only communicate with the CNS but is also carry on autonomic reflexes without external input from the CNS. These neurons regulate the intestinal muscles which control peristalsis and churning of intestinal contents and the secretion of enzymes (pepsin) and HCl which breaks down food. The ENS and CNS communicate by using dozens of neurotransmitters many of which are identical such as acetylcholine, dopamine and serotonin. The GI tract/ENS contains about 90% of the total serotonin and 50% of the dopamine in the body which provides a direct connection to the CNS.8 It is interesting to note that the consumption of probiotics such as Bifidobacterium and Lactobacillus offer some hope to replace organisms in the gut after various disease processes destroyed the normal flora. The net effect was that using probiotics improved certain CNS-related disorders such as mood changes and anxiety.9 Stress and sleep disturbances can lead to greater gut mucosal permeability in turn causes immune inflammatory responses that contribute to the development of illnesses that cause depression and anxiety. The exact biochemical mechanism for these disorders was not clear but the production of neurotransmitters by certain bacteria is thought to be involved and that probiotics may alter the amount or types of neurotransmitters produced. Gut microflora has also been implicated in Autism and Parkinson’s Disease (PD). Most individuals with Autism and PD also have altered gut flora which may contribute to GI problems or clinically more severe disease, but a direct link was inconclusive.10,11

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The Intestinal Microbiota and the effect on Food Sensitivities and the Gut-Brain Axis

An important concept which parallels the breakdown of tight junctions and release of zonulin in the gut is that the Blood Brain Barrier (BBB) can also become leaky. The BBB or the choroid plexus is comprised of a thin layer of endothelial cells that are held together by tight junctions which controls the movement of molecules from the blood into the CNS. Generalized inflammation from toxins, food molecules or drugs will also cause release of zonulin and cause the choroid plexus to become leaky and allow toxins into the CNS and cause inflammation and altered immune reactions. Based on this it is easy to see that symptoms such as brain fog, headaches and migraines are associated with food sensitivity. A direct link has been established between the importance of the food we consume and overall health.12,13 In addition, the food we consume changes the structure of the gut microbiota and the subsequent effects on the Gut-Brain Axis. The generation of food sensitivities and the generation of leaky gut causes alteration of immune regulation and brain function. Gut health is connected with a healthy microbiome which emerges as a central factor in preventing dysregulation and illness. One must consider gut function in the context of many diseases especially food sensitivities. It is becoming increasingly clear that zonulin controls the opening of tight junctions and is released when inflammation occurs and is indicative of leaky gut. Since tight junctions also occur in the Blood Brain Barrier (choroid plexus), the presence of high amounts of zonulin in blood probably indicates a leaky brain. Zonulin will become an increasingly important marker used in detecting inflammation associated with food sensitivities and altered brain function.

(4)Caminero A et al. Mechanisms by which gut microorganisms influence food sensitivities. Nature Reviews Gastroenterology & Hepatology. 2019; 16(1): 7–18, https://doi:10.1038/s41575-018-0064-z. Accessed: July 7, 2021. (5)Haahtela T. A biodiversity hypothesis. Eur J Allergy and Clin Immunol. 2019; 74(8): 1445-1456. https://doi.org/10.1111/all.13763. Accessed: August 19, 2021. (6)Robinson J. Biodiversity loss could be making us sick – here’s why. Publisher: The Conversation; August 4, 2020. https://theconversation.com/biodiversityloss-could-be-making-us-sick-heres-why-143627. Accessed: August 21, 2021. (7)Wang Y, Kasper L. The role of microbiome in central nervous system disorders. Brain and Behav Immun. 2014; 38: 1-12. doi:10.1113/jphysiol.2004.063388. Accessed: August 19, 2021. (8) Martinucci I et al. Genetics and pharmacogenetics of aminergic transmitter pathways in functional gastrointestinal disorders. Pharmacogenomics. 2015; 16(5): 523-339. doi:10.2217/pgs.15.12. https://pubmed.ncbi.nlm.nih. gov/25916523/. Accessed: July 16, 2021. (9) Wang H, Lee IS, Braun C, Enck P. Effect of probiotics on central nervous system functions in animals and humans - a systematic review. J Neurogastroenterol Motil. 2016; 22(4): 589-605. doi:10.5056/jnm16018. https://pubmed.ncbi.nlm.nih.gov/27413138/. Accessed: August 24, 2021. (10)Dinan T, Cryan J. The impact of gut microbiota on brain and behavior: implications for psychiatry. Curr Opin Clin Nutr Metab Care. 2015:18(6):552558. doi:10.1097/MCO.0000000000000221. https://pubmed.ncbi.nlm.nih.gov/26372511/. Accessed: August 14, 2021. (11)Buie T. Potential Etiologic Factors of Microbiome Disruption in Autism. Clin Ther. 2015: 37(5): 976–83. doi:10.1016/j.clinthera.2015.04.001. https://pubmed.ncbi.nlm.nih.gov/26046240/. Accessed: August 14, 2021. (12) Quigley E. Gut bacteria in health and disease. Gastroenterol Hepatol (N Y). 2013; 9(9): 560–569. PMID 24729765. https:// pubmed.ncbi.nlm.nih.gov/24729765/. Accessed August 4, 2021 (13) Shen S, Wong C. Bugging inflammation: role of the gut microbiota. Clin Transl Immunol. 2016: 5(4): e72. doi:10.1038/ cti.2016.12. PMC 4855262. PMID 27195115.

References (1)Thieme-Burdette M. Food Sensitivity, Intolerance, or Allergy: What’s the difference? . . . . . . . . . . . . . . . . . . . . . . . . . Publisher: Global Autoimmune Institute; July 3, 2020. In: Global Autoimmune Institute, https://www.autoimmuneinstitute.org/food-sensitivity-intolerance-or-allergy/. Accessed: July 12, 2021. (2)Mayo Clinic News. Food Sensitivities may affect gut barrier. In: Mayo Clinic Digestive Diseases. November 12, 2016. https://www.mayoclinic.org/medicalprofessionals/digestive-diseases/news/food-sensitivities-may-affect-gut-barrierfunction/mac-20429973. Accessed: July 7, 2021. (3)Gocki J, Bartuzi Z. Role of immunoglobulin G antibodies in diagnosis of food allergy. Adv in Dermatol Alergol. 2016; 33(4): 253–256, doi:10.5114/ ada.2016.61600, https://pubmed.ncbi.nlm.nih.gov/27605894/. Accessed: August 19, 2021

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The test measures the sensitivity to 176 foods, colorings and additives spanning all major food groups

Elements of Ageless Skin

By: Kasey Hutchinson 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.

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Elements of Ageless Skin

Youthful, radiant skin is a natural consequence of total body wellness. Emotional wellbeing, nourishing foods, restful sleep and good genes all contribute to youthful skin. But what most people don’t know is that the human microbiome can also help stave off wrinkles and collagen loss. Microbes inhabiting the skin and gut can stem inflammation, support skin renewal processes, influence sebum secretions and skin hydration, and support the skin’s basic structural components. The relationship between skin aging and the human microbiome is complex and has only been partially understood, until recently. Innovative scientific discoveries have pinpointed strategies for curbing skin aging by harnessing the power of microbes. ELEMENTS OF AGELESS SKIN

comprised of skin cells known as corneocytes that are held together by skin lipids forming a brick and mortar type of structure.4 Skin barrier lipids include ceramides, fatty acids and cholesterol. Skin lipids are distinct from sebum, which is made of triglycerides, wax esters, squalene and fatty acids that are secreted from the sebaceous gland. The skin barrier also functions as a first-line defense against microbial pathogens and is thus highly involved in inflammatory and immune processes.4 Skin hydration is essential for enzymatic functions, such as keratinization and desquamination (i.e. the production and shedding of skin cells). A weak skin barrier can lead to transepithelial water loss (TEWL), resulting in the appearance of fine lines, wrinkles and loss of skin radiance.5 Pigmentation

Collagen and Elastin Collagen is a protein responsible for keeping skin strong and tight, while elastin helps the skin snap back to its original shape after being stretched. Together, these proteins give skin a firm-yet-supple quality. Collagen and elastin exist within the dermal layer, which is the middle layer of skin located between the superficial epidermis and the fatty subcutaneous layer.1 The dermis comprises 90% of skin’s thickness, so as components of this layer deteriorate, skin appears loose and dimpled.1 Research shows that humans generally stop producing elastin after puberty.2 Collagen is produced throughout life, in areas such as bones and joints. However, collagen production in the skin takes a dive after age 20. After this point, collagen stores decline by about 10% every decade, giving way to the appearance of fine lines, wrinkles, skin thinning and sagging skin.3 Skin Hydration Hydrated skin retains its turgor, pliability and ability to reflect light – i.e. skin radiance.4 Skin hydration is affected by hyaluronic acid content and skin barrier integrity.5 Hyaluronic acid is a water-retaining molecule found primarily in the dermal layer. Along with collagen and elastin, hyaluronic acid is a chief component of the extracellular matrix (ECM). The ECM is the physical scaffolding of skin.6 It not only provides structure, but also initiates biologic cues required for tissue production and homeostasis.6 The skin barrier regulates water losses and is integral for skin hydration. The skin barrier refers to the stratum corneum, which is the outermost layer of the epidermis. This layer is

Melanin is a natural pigment that adds color to hair and skin. Melanin is produced by melanocytes that are found in the epidermis and within hair follicles. It is photoprotective and can prevent sunlight from penetrating deeper tissues of the body. When UV light hits the skin, melanin production is stimulated, which is why skin appears darker after spending time in the sun.7 Youthful skin contains evenly distributed melanocytes, but as a person ages, melanin production drops by about 1-2% per year.7 This doesn’t occur uniformly, however. Certain melanocytes stop producing melanin, while other continue. This gives the appearance of blotchy, photoaged skin and sun-spots. What causes skin aging? Skin aging is caused by both intrinsic and extrinsic factors. Extrinsic aging primarily related to sun exposure. In fact, 80-90% of extrinsic skin aging is caused by UV radiation.8 Other factors involved in extrinsic aging include air pollution, smoking, alcohol, and inadequate nutrition.8 Extrinsic aging shows up on the skin in the form of photo damage, wrinkles, dry scaly patches, and pigmented lesions. Biochemical mechanisms affecting extrinsic aging include free radical damage, DNA damage, glycation and inflammation.9 Intrinsic aging is related to genetics and is time-dependent. Thin skin and exaggerated expression lines are commonly attributed to intrinsic aging. Factors that influence intrinsic aging include decreased function of keratinocytes and fibroblasts, mitochondrial damage, and telomere shortening.9 Inflammation and free radical damage are the underlying mechanisms involved in extrinsic skin aging, and can

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exacerbate intrinsic factors as well. For example, UV sun exposure damages the skin is because it leads to the production of reactive oxygen species.10 Reactive oxygen species stimulate the NF-κB pathway and consequently increase inflammatory cytokine production. The NF-kB pathway also promotes the expression of matrix metalloproteins (MMPs), which are responsible for degrading the ECM resulting in the loss of collagen, elastin and hyaluronic acid from the dermal layer. In fact, the phenomenon known as inflammaging defines the relationship between chronic inflammation and aging. Inflammaging is characterized by increased levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6 and C-reactive protein (CRP).11 Inflammation can also disrupt the process of skin renewal, resulting in poor skin barrier function and contributing to fine lines, wrinkles and dull, flakey skin.12 Inflammation can also break down components of the ECM. The Microbiome in Skin Aging The skin is traditionally thought to have 3 layers: subcutaneous, dermal and epidermal. However, there is also a microbial layer that lays on top of the stratum corneum.13 Skin microbes can penetrate the deeper layers of skin tissue as well. These skin microbes are collectively known as the skin microbiome. The relationship between the skin microbiome and skin aging is still in its infancy, however some studies suggest that the skin microbiome composition can accurately predict someone’s age.14 Older skin is associated with increased microbial diversity, which may boost microbial metabolism of skin components. For example, animal research revealed that transferring microbiota from older fish to younger fish increased hyaluronic acid degradation.15 Alternatively, other microbes may help preserve skin components. For example, the common skin microbe Streptococcus thermophiles can boost ceramide production and thereby strengthen the skin barrier.15 There is also a strong connection between the microbiomes of the skin and gut. This relationship is known as the gutskin axis. The gut microbiome communicates with the skin through by using inflammatory cytokines, short-chain fatty acids, and immune-related molecules.13 Inflammation, barrier dysfunction and dysbiosis are commonly seen in both the skin and gut, leading researchers to believe that modifying the gut microbiome may improve skin health.

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The gut microbiome is the largest immune site and can manage the inflammatory tone of the entire body. Probiotics, such as, B. coagulans produce antioxidant polysaccharides that may protect skin from free radicals.16 Similarly, many species of Lactobacillus can produce super oxide dismutase, an enzyme that neutralizes peroxide free radicals. Probiotics and Antioxidant Protection Recent clinical and preclinical trials suggest that probiotics can increase antioxidant activity in the skin to alleviate UV-induced skin barrier damage and accelerate recovery of immune homeostasis following exposure to UV radiation.16 Probiotics also affect the skin’s redox state by producing highly bioavailable antioxidant nutrients. For example, Bacillis indicus HU36TM produces carotenoids directly at the site of absorption – the gut.17 Carotenoids are the golden children of the cosmetic supplement industry due to their long history of use in combating inflammation and quenching free radicals. Research shows that consuming carotenoids can stave off inflammation and preserve collagen, elastin, and the extracellular matrix. Furthermore, human studies show that carotenoid status within skin can serve as a marker for the overall antioxidative status within the body.18 Unfortunately, food-based carotenoids have poor absorption due to their high molecular weight and low viability through the digestive process. Furthermore, carotenoids in food are bound up in the food matrix which makes them difficult to absorb. Research shows that HU36TM carotenoids are more bioavailable than carotenoids found in foods because they are smaller, easier for the body to absorb and, since they are produced in the gut, they are not subject to gastric acids.17 Bacillus Spore-Based Probiotics Influence Skin Barrier Function In fact, this strain was used in 2 recent clinical trials involving skin health. Results showed that consuming a multi-strain Bacillus probiotic supplement, which included high levels of HU36TM, supported skin barrier integrity and improved transepithelial water loss. This resulted in a clearer, more radiant complexion. This probiotic treatment also increased abundance of Ruminococcus gnavus, a short-chain fatty acidproducing bacteria that may promote a healthy inflammatory process. This supplement didn’t just contain probiotics however. It also included vitamin K2-7, a highly bioavailable, bioactive form of K2. K2 is required for the activation of

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Elements of Ageless Skin

the matrix GLA protein, a specialized protein that binds calcium and is involved with bone mineralization.18 Vitamin K2 Preserves Collagen and Elastin Without adequate K2, calcium can end up in in the ECM where it calcifies collagen and elastin, leading to wrinkles and sagging skin. In fact, some studies show that the severity of facial wrinkles a predicter of osteoporosis in post-menopausal women, since it indicates dysfunction of calcium metabolism.19 Vitamin K2 is produced exclusively through microbial fermentation. Therefore, the main sources of dietary K2 come from fermented foods. However, the gut microbiome also contributes a significant amount of this nutrient, which is another facet of the gut-skin axis that influences skin aging. Probiotics for Modulating Systemic Inflammation In addition to producing important vitamins, probiotics can also help alleviate the most ubiquitous source of systemic inflammation, leaky gut syndrome. This can help protect elements of the ECM and preserve skin’s youthfulness. For example, a recent human study, researchers discovered that a specific blend of Bacillus probiotics significantly reduced serum levels of LPS and lowered production of inflammatory cytokines IL-1β, IL-16 and IL-8.20 These exact inflammatory cytokines are implicated in inflammaging and contribute to collagen and elastin degradation. The gut-skin axis is a commonly overlooked element of skin aging. The gut and skin microbiomes can curtail immune and inflammatory mechanisms that are responsible for collagen and elastin degradation and skin barrier dysfunction. Furthermore, the gut is a major site of vitamin and nutrient production, which can safeguard the skin’s scaffolding and help quench free radicals. Probiotics and targeted skinnourishing nutrients are effective cosmetic supplements that should be considered in skin aging protocols.

Author Bio: Kasey Hutchinson is a Registered Dietitian Nutritionist and Product Development Manager at Microbiome Labs, where she helped develop the dietary recommendations for the BiomeFxTM stool test analysis. Kasey produces evidence-based content to help educate consumers and practitioners on the benefits of spore-based probiotics and use of cutting edge gut-healing protocols.

1. Yousef H, Alhajj M, Sharma S. Anatomy, Skin (Integument), Epidermis. [Updated 2020 Jul 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470464/ 2. Moore J, Thibeault S. Insights into the role of elastin in vocal fold health and disease. J Voice. 2012;26(3):269-275. 3. Reiley, et al. Skin collagen through the lifestages: importance for skin health and beauty. Plastic and Aesthetic Research. 2021; 8(2). 4. Papakonstantinou E, et al. Hyaluronic acid: A key molecule in skin aging. Dermatoendocrinol. 2012;4(3):253-258. 5. Verdier-Sévrain S, Bonté F. Skin hydration: a review on its molecular mechanisms. J Cosmet Dermatol. 2007;6(2):75-82. 6. Frantz C, et al. The extracellular matrix at a glance. J Cell Sci. 2010;123(Pt 24):4195-4200. 7. Brenner M, Hearing VJ. The protective role of melanin against UV damage in human skin. Photochem Photobiol. 2008;84(3):539-549. 8. Puizina-Ivić N. Skin aging. Acta Dermatovenerol Alp Pannonica Adriat. 2008;17(2):47-54. 9. Baumann L. How to Use Oral and Topical Cosmeceuticals to Prevent and Treat Skin Aging. Facial Plast Surg Clin North Am. 2018 Nov;26(4):407-413. 10. Wang, et al. NF-κB signaling in skin aging. Mechanisms of Ageing and Development. 2019; 184: 111160 11. Kelly JR, et al. Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders. Front Cell Neurosci. 2015;9:392. 12. Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets. 2014;13(3):177-190 13. Nakatsuji T, et al. The microbiome extends to subepidermal compartments of normal skin. Nat Commun. 2013;4:1431. 14. Huang, et al. Human Skin, Oral, and Gut Microbiomes Predict Chronological Age. ASM Journals. 2020; 5(1). 15. Abadías-Granado, et al. The microbiome and aging. Plast Aesthet Res. 2021;8:27 16. Kober MM, Bowe WP. The effect of probiotics on immune regulation, acne, and photoaging. Int J Womens Dermatol. 2015;1(2):85-89. 17. Sy, et al. Glycosyl carotenoids from marine spore-forming Bacillus sp. strains are readily bioaccessible and bioavailable. Food Research International. 2013; 51(2): 914-923. 18. Darvin ME, et al. The Role of Carotenoids in Human Skin. Molecules. 2011;16(12):10491-10506. 19. Shuster S. Osteoporosis, a unitary hypothesis of collagen loss in skin and bone. Med Hypotheses. 2005;65(3):426-32. 20. McFarlin BK, et al. Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers. WorldJ Gastrointest Pathophysiol. 2017;8(3):117-126.

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A Systems Biology Approach to Biological Aging: The Longevity Wheel

By: Quicksilver Scientiﬁc 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.

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Elements of ageless skin

For decades, the scientific and medical communities have explained the aging process in an overly simplistic way. Once viewed modestly as a manifestation of accumulated oxidative stress and DNA damage, we now understand that aging is a far more complex process best explained through a systems biology lens that integrates a multitude of underlying mechanisms of aging. Biological aging occurs as an organism gradually accumulates damage to cells and tissues over its lifespan. This sophisticated process is orchestrated by an elegant array of cellular mechanisms and molecules that interact with one another through a complex network of signaling systems. A growing body of research indicates that the modulation of these cellular mechanisms and molecules may slow biological aging, attenuating age-related physiological declines and promoting health across the lifespan. Furthermore, these cellular mechanisms and molecules are amenable to lifestyle and nutraceutical interventions. Thus, contrary to the commonly held belief that age-related physiological declines are inevitable, it appears that we have significant control over the biological aging process. The healthcare field currently lacks a comprehensive and systematic strategy for addressing biological aging and improving healthspan. Quicksilver Scientific’s Dr. Christopher Shade Ph.D, a well-known leader in nutraceutical formulations who has perfected liposomal delivery chemistry in the supplement industry, has developed a revolutionary interlocking model that provides a framework for targeting biological aging and optimizing longevity called the Longevity Wheel.

aspects to changing the way we age (Image 1). For the purpose of this article, we will break down the wheel by systems biology into two overarching processes: The Protection and Repair Triad and The Power Triad. The Protection and Repair Triad A strong physiological foundation is the basis for healthy aging. The Protection and Repair Triad potentiates cellular processes to create a resilient foundation by focusing on chronic inflammation reduction, protection against oxidative stress, repairing damaged cellular components, and alleviating the body’s toxic burden. Biological aging is characterized by an incremental ramping up of chronic inflammation. Age-associated chronic inflammation is caused by a buildup of endogenously-produced toxins, including byproducts of cellular metabolism, exogenouslyacquired toxins from environmental exposures, and chronic cellular senescence. The cumulative effects of these toxic influences damage genomic material, cells, tissues, and organs, leading to physiological degradation and the diseases of aging. The Protection and Repair Triad of the Longevity Wheel optimizes processes involved in cellular and genomic protection and repair, including Nrf2 and AMPK activation, senolytic activity, and telomere protection.

Image 1 Quicksilver Scientific’s Longevity Wheel

Nrf2

With six spokes to its structure, the Longevity Wheel encompasses the most well studied and powerful biological

Nuclear factor erythroid 2-related factor (Nrf2) is a transcription factor protein that turns genes “on” or “off ” by binding to sections of DNA. It regulates the expression of antioxidant proteins, such as the “antioxidant response element” (ARE), that protect the body against oxidative stress - an imbalance between levels of damaging reactive oxygen species, and the body’s ability to detoxify them or repair the resulting damage. Nrf2 activity thus

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protects the body against environmental toxins, many of which exert their detrimental effects by upregulating oxidative stress.

and Power Triads for a truly optimized aging process.

Nrf2 also repairs DNA damage triggered by stressors such as environmental toxins and UV light, and facilitates the synthesis of glutathione, a crucial detoxification molecule. Without sufficient repair mechanisms, excessive DNA damage and depletion of intracellular glutathione may contribute to biological aging.1

Cellular senescence is the process by which cells cease to divide and instead secrete an array of inflammatory mediators. Cellular senescence can exert beneficial or detrimental effects depending on where and when it occurs in the body. There are two main types of senescence: Acute senescence and chronic senescence.

As we age, the body’s ability to induce Nrf2 activity declines, rendering it susceptible to oxidative stress.2 Nrf2 activators, such as silymarin from lipoic acid, milk thistle, curcumin, and DIM, help optimize Nrf2 activity for healthy aging.3,4,5 AMPK AMPK is a master regulator of longevity that acts as an intracellular sensor, detecting when cellular energy levels, in the form of ATP, are low. Upon detecting low ATP levels, AMPK upregulates cellular processes that make energy, including the breakdown of sugars and stored fats. AMPK activation also unlocks the critical pathway of autophagy, the body’s cellular housekeeping system that clears out dysfunctional cellular components, ensuring that the cellular and organelle function continues to run in a smooth, clean fashion. Equally important, AMPK activation stimulates mitochondrial biogenesis, the production of new, healthy mitochondria. Research indicates that a robust pool of healthy mitochondria is crucial for longevity.6 A variety of small molecules also function as AMPK activators, including resveratrol and berberine.7,8,9 Notably, AMPK can only reach its full activation potential in the presence of a system replete with NAD+. The components of the Power Triad thus influence the Protection and Repair Triad, demonstrating a complex web of connections that the scientific community is only just beginning to understand. However, based on what we know thus far, we must optimize all components of the Protection and Repair

Senolytics

• Acute cellular senescence plays indispensable positive roles inside the body, inhibiting the growth of malignant cells, regulating development, and supporting wound healing.10 • Chronic senescence has a net detrimental effect and appears to promote biological aging.11 Senolytics are compounds that selectively induce the death of senescent cells. By regulating the body’s senescent cell burden, senolytics promote healthier cells and tissues supporting longevity. Several natural compounds demonstrate senolytic properties. For example, quercetin, previously mentioned for its sirtuin-activating properties, also regulates the body’s senescent cell burden, attenuating chronic inflammation.12,13 Curcumin and Panax notoginseng also demonstrate senolytic effects, creating a tissue microenvironment that is more conducive to healthy aging.14,15 Telomeres Telomeres are the tiny caps of genetic material at the tips of chromosomes that buffer them against shortening, protecting the vital genetic material in the chromosomal interior. Telomere shortening plays a central role in biological aging, compromising the protective “buffer” at the ends of chromosomes, leaving the internal chromosomal regions vulnerable to damage. The rate at which telomeres shorten essentially serves as an aging “clock,” ticking away one’s age in biological, as opposed to chronological, years.16

1 Maynard S et al. DNA damage, DNA repair, aging, and neurodegeneration. Cold Spring Harb Perspect Med. 2015; 5(10): a025130. 2 Zhou L et al. Aging-related decline in the induction of Nrf2-regulated antioxidant genes in human bronchial epithelial cells. Redox Biol. 2018; 14: 35-40. 3 Vargas-Mendoza N et al. Flavolignans from silymarin as Nrf2 bioactivators and their therapeutic applications. Biomedicines. 2020; 8(5): 122. 4 Receno CN et al. Prolonged dietary curcumin supplementation augments Nrf2 nuclear translocation and attenuates oxidative stress in skeletal muscle of aging rats. FASEB J. 2018; 32(S1): 856.14856.14. 5 Lay-Lay S et al. Pharmacodynamics of dietary phytochemical indoles I3C and DIM: Induction of Nrf2-mediated Phase II drug metabolizing and antioxidant genes and synergism with isothiocyanates. Biopharm Drug Dispos. 2011; 32(5): 289-300. 6 Sun N et al. The mitochondrial basis of aging. Mol Cell. 2016; 61(5): 654-666. 7 Dasgupta B and Millbrandt J. Resveratrol stimulates AMP kinase activity in neurons. Proc Natl Acad Sci USA. 2007; 104(17): 7217-7222. 8 Lee YS et al. Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes. 2006; 55(8): 2256-2264. 9 Gomes AP et al. Berberine protects against high fat diet-induced dysfunction in muscle mitochondria by inducing SIRT1-dependent mitochondrial biogenesis. Biochim Biophys Acta. 2012; 1822(2): 185-195. 10 Campisi J and Rodier F. Four faces of cellular senescence. J Cell Biol. 2011; 192(4): 547-556. 11 Pavic I et al. Hallmarks of senescence and aging. Biochem Med (Zagreb). 2019; 29(3): 030501. 12 Lewinska A et al. AMPK-mediated senolytic and senostatic activity of quercetin surface-functionalized Fe3O4 nanoparticles during oxidant-induced senescence in human fibroblasts. Redox Biol. 2020; 28: 101337. 13 Geng L et al. Low-dose quercetin positively regulates mouse healthspan. Protein & Cell. 2019; 10: 770-775. 14 Bielak-Zmijewska A et al. The role of curcumin in the modulation of ageing. Int J Mol Sci. 2019; 20(5): 1239. 15 Hou J et al. Ginsenoside Rg3 prevents oxidative stress-induced astrocytic senescence and ameliorates senescence paracrine effects on glioblastoma. Molecules. 2017; 22(9): 1516. 16 Vaiserman A and Krasnienkov D. Telomere length as a marker of biological age: State-of-the-art, open issues, and future perspectives. Front Genet. 2021.

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What, exactly, shortens telomeres? Excess glucocorticoid activity, for one, will shorten telomeres.17 This finding makes a strong argument for balancing the neuroendocrine system while simultaneously working on protecting telomeres. A few human cells produce telomerase, an enzyme that elongates telomeres by tacking a short, repetitive DNA sequence onto existing chromosomes. These cells can regenerate shortened telomeres. However, most telomeres are incapable of being repaired once shortened. Proactively protecting telomeres against shortening and bolstering their repair capacities are crucial for slowing biological aging. A growing body of preclinical research indicates that several natural compounds can protect telomeres from premature shortening and support telomerase activity, thereby ensuring that these crucial chromosomal “buffers” remain intact. These natural compounds include the two phytochemicals of Astragalus membranaceous astragaloside IV and cycloastragenol, Terminalia chebula (Haritaki), silymarin, and resveratrol.18,19,20

THE POWER TRIAD Once we have built a strong foundation upregulating antioxidant protection and repairing and clearing damaged cellular components, it’s time to take healthy aging to the next level by optimizing key biochemical pathways involved in metabolism, immune function, and hormone balance. Biological aging is characterized by significant declines in immune function, compromised glycemic regulation, and diminishing levels of the sex steroid hormones that impart vitality and resilience to the human body. As these physiological systems are increasingly compromised with age, the body becomes more susceptible to infectious threats, metabolic diseases such as type 2 diabetes, and hormonal derangements that compromise resilience and vitality. Therefore, to support longevity, we need to power the biochemical pathways and molecules that supply energy for appropriate immune function, metabolic regulation, and hormone synthesis. The Power Triad of the Quicksilver Scientific Longevity Wheel includes three components: NAD+ synthesis, sirtuin activation, and neuroendocrine balance. We will briefly review each of these components in turn.

NAD+ NAD+ (nicotinamide adenine dinucleotide) is a signaling molecule naturally present in every cell and is critical for DNA repair, cellular energy production, and gene expression.21,22 NAD+ levels naturally decline with age, causing a variety of NAD+-dependent processes to falter. Insufficient levels of NAD+ during the aging process can adversely impact the following functions: Cellular energy production: Inside the mitochondria, NAD+ carries high-energy electrons in the biochemical processes that create cellular energy (ATP), including glycolysis, the tricarboxylic acid cycle, and mitochondrial oxidative phosphorylation. Insufficient NAD+ thus lowers the ability of cells to produce energy, impairing cellular function in tissues and organs throughout the body, ranging from the retina of the eye to skeletal muscle.23,24 Sirtuin cofactor: NAD+ is a coenzyme for sirtuins, a crucial family of longevity-promoting proteins.25 Without sufficient NAD+, sirtuins cannot function properly. PARP cofactor: NAD+ is a cofactor for PARPs (poly ADP-ribose polymerase), a family of enzymes that act as “genomic caretakers,” facilitating DNA repair, maintaining genomic integrity, and programming cell death. The human body requires a delicate balance of PARP activity for healthy aging.26 CD38 cofactor: NAD+ is also a cofactor for CD38, also known as “cyclic ADP ribose hydrolase.” CD38 is a glycoprotein found on the surface of many immune cells, including white blood cells.27 An optimal bodily level of NAD+ reduces age-associated chronic inflammation, preserves bone and muscle mass, and regulates circadian rhythms, leading to a healthier aging process.28,29,30,31 Mammalian cells must synthesize NAD+ either de novo from tryptophan through the kynurenine pathway or from vitamin B3 in the form of nicotinamide (NAM) and nicotinic acid (NA). Besides de novo synthesis, the other major NAD+ generation

17 Lee RS et al. Cross-species association between telomere length and glucocorticoid exposure. J Clin Endocrinol Metab. 2021;, dgab519. 18 Na MK et al. Cytoprotective effect on oxidative stress and inhibitory effect on cellular aging of Terminalia chebula fruit. Phytother Res. 2004; 18(9): 737-741. 19 Parzonko A and Naruszewicz M. Silymarin inhibits endothelial progenitor cells' senescence and protects against the antiproliferative activity of rapamycin: preliminary study. J Cardiovasc Pharmacol. 2010; 56(6): 610-618. 20 Xia L et al. Resveratrol reduces endothelial progenitor cells senescence through augmentation of telomerase activity by Akt-dependent mechanisms. Br J Pharmacol. 2008; 155(3): 387-394. 21 Longo VD et al. Interventions to slow aging in humans: Are we ready? Aging Cell. 2015; 14(4): 497-510. 22 Fang EF et al. NAD + in aging: Molecular mechanisms and translational implications. Trends Mol Med. 2017; 23(10): 899-916. 23 Jadeja RN et al. Implications of NAD+ metabolism in the aging retina and retinal degeneration. Oxid Med Cell Longev. 2020; 2020: 2692794. 24 Frederick DW et al. Loss of NAD homeostasis leads to progressive and reversible degeneration of skeletal muscle. Cell Metab. 2016; 24(9): 269-282. 25 Jesko H et al. Sirtuins and their roles in brain aging and neurodegenerative disorders. Neurochem Res. 2017; 42(3): 876-890. 26 Mangerich A and Burkle A. Pleiotropic Cellular Functions of PARP1 in Longevity and Aging: Genome Maintenance Meets Inflammation. Oxid Med Cell Longev. 2012; 2012: 321653. 27 Camacho-Pereira J et al. CD38 dictates age-related NAD decline and mitochondrial dysfunction through a SIRT3-dependent mechanism. Cell Metab. 2016; 23(6): 1127-1139. 28 Kim HN et al. A decrease in NAD+ contributes to the loss of osteoprogenitors and bone mass with aging. NPJ Aging Mech Dis. 2021; 7: 8. 29 Minhas PS et al. Macrophage de novo NAD+ synthesis specifies immune function in aging and inflammation. Nat Immunol. 2019; 20(1): 50-63. 30 Levine DC et al. NAD+ controls circadian reprogramming through PER2 nuclear translocation to counter aging. Mol Cell. 2020; 78(5): 835-849. 31 Schibler U. Senescence of timing reverted: NAD + rejuvenates the circadian clock. Mol Cell. 2020; 78(5): 805-807.

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route is through the salvage pathway, making NAD+ from precursor molecules. These processes are not entirely efficient; furthermore, critical enzymes involved in NAD+ metabolism, such as NAMPT, decline with age. Supplementation with NAD+ precursors, such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), thus represents the best strategy for bolstering NAD+ levels with age. Unlike NR, NMN is a direct precursor to NAD+ that has its own dedicated cellular transporter within cell membranes, the Slc12a8 transporter.32 Sirtuins Sirtuins are a family of seven proteins that regulate numerous cellular functions involved in aging, including inflammation, circadian rhythms, energy metabolism, and neuronal function.33 The Power Triad of the Longevity Wheel emphasizes activating sirtuins to support vital, healthy aging. The primary mechanism through which sirtuins regulate cellular metabolism is through their impact on histone deacetylation. In histone deacetylation, sirtuins remove small chemical groups called “acetyl” groups from histone proteins - proteins around which DNA is wrapped inside cellular nuclei. Thus, histone deacetylation by sirtuins promotes genome stability, ensuring that genes are expressed correctly. Sirtuins also deacetylate NF-κB, a protein complex involved in pro-inflammatory cytokine production, and PGC-1α, a protein involved in insulin sensitivity and mitochondrial biogenesis, thereby regulating inflammation, blood glucose metabolism, and mitochondrial function.34 Sirtuin activation thus facilitates metabolic clarity, a coherent state where metabolic pathways work efficiently to regulate blood sugar, burn stored body fat, and create cellular energy. NAD+ is an essential cofactor for sirtuins; NAD+ activation is thus a natural prerequisite to sirtuin activation.35 Emerging research indicates that several small molecules of natural origin function as sirtuin activators. These sirtuin-activating compounds, or STACs, include resveratrol, the famous phytochemical found in grapes and red wine, and quercetin, found in red onions, apples, capers, and green tea.36 (Image 2)

32 33 34 35 36 37 38 39

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Image 2. NAD+ and STACs to activate sirtuins

Neuroendocrine System The neuroendocrine system encompasses the hypothalamic-pituitaryadrenal (HPA), hypothalamic-pituitary-thyroid (HPT), and the hypothalamic-pituitary-gonadal (HPG) axes. The hypothalamus, a small gland nestled in the brain, is the central regulator of the neuroendocrine system and a homeostatic director of hormone synthesis, metabolism, and age-related physiological changes. The HPA axis is perhaps the most famous of the three neuroendocrine system axes. It consists of the hypothalamus, pituitary gland, and adrenal glands and is a primary regulator of the body’s stress response. As such, it significantly impacts cortisol production. In addition, graceful aging necessitates a delicate balance of cortisol; excess cortisol predisposes to declines in immune function and cognition, whereas insufficient cortisol precipitates chronic inflammation.37,38 The HPT axis comprises the hypothalamus, pituitary, and thyroid glands and regulates thyroid function. The hypothalamus senses circulating levels of thyroid hormone; when it detects low thyroid hormone levels, it secretes thyrotropin-releasing hormone (TRH). TRH, in turn, stimulates the anterior pituitary gland to produce thyroid-stimulating hormone (TSH), which commands the thyroid to produce thyroid hormones (T4 and T3) until blood levels return to normal. Improper thyroid function may contribute to fatigue and cognitive decline with age. Finally, the HPG axis consists of the hypothalamus, pituitary gland, and gonadal glands, including the ovaries in females and testes in males. The HPG axis regulates sexual maturation and development in adolescence and reproduction in early adulthood. As we age, the activity of the HPG axis declines.39 The hormones regulated by the HPG, including pregnenolone, estrogen, progesterone, testosterone, and DHEA, influence

Grozio A et al. Slc12a8 is a nicotinamide mononucleotide transporter. Nat Metab. 2019; 1(1): 47-57. Vachharajani VT et al. Sirtuins link inflammation and metabolism. J Immunol Res. 2016: 8167273. Duan W. Sirtuins: from metabolic regulation to brain aging. Front Aging Neurosci. 2013. Anderson KA et al. Metabolic control by sirtuins and other enzymes that sense NAD+, NADH, or their ratio. Biochim Biophys Acta. 2017; 1858(12): 991-998. Iside C et al. SIRT1 activation by natural phytochemicals: An overview. Front Pharmacol. 2020. Ouanes S and Popp J. High cortisol and the risk of dementia and Alzheimer’s disease: A review of the literature. Front Aging Neurosci. 2019. Morey JN et al. Current directions in stress and human immune function. Curr Opin Psychol. 2015; 5: 13-17. Kim JH et al. The hypothalamic-pituitary-gonadal axis controls muscle stem cell senescence through autophagosome clearance. J Cachexia Sarcopenia Muscle. 2021; 12(1): 177-191.

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a broad array of physiological functions involved in aging, including cognition and skeletal muscle maintenance.40,41 The HPA, HPT, and HPG axes work in concert to regulate the body’s stress response and hormonal milieu. Compromised control of the body’s stress response and suboptimal thyroid and steroid hormone levels may accelerate biological aging.42,43 Management of the neuroendocrine system is thus essential for promoting healthy aging and longevity.

Conclusion The longevity-promotion space is undergoing a coming-of-age in both the scientific and medical communities. As our mechanistic understanding of aging biology grows, the need for a systems approach to managing the aging process and optimizing healthspan is paramount. The Longevity Wheel provides a systems-based, comprehensive framework for addressing aging biology that informs the implementation of health protocols designed to help bodies age with vitality and grace.

Mitochondria are important sites of steroid hormone synthesis.44 NAD+ is essential for mitochondrial energy production in the hypothalamic neurons, initiating the entire cascade of events involved in neuroendocrine axis function. Bolstering NAD+ levels, a central component of the Power Triad, is thus necessary for neuroendocrine homeostasis.45 Through their ability to maintain healthy mitochondrial energy production and redox homeostasis, sirtuins also indirectly support a healthy functioning neuroendocrine system.46 Pregnenolone and Adaptogens Provide Vital Neuroendocrine Support Pregnenolone and adaptogens, botanicals that modulate the stress response and enhance resilience, provide powerful support for the neuroendocrine system. Supplemental pregnenolone enhances the precursor pool for steroid hormone synthesis and may facilitate the balanced production of all steroid hormones. Adaptogens, such as Korean Panax Ginseng, increase the expression of hormone receptors at the cellular level, improving hormone signaling without increasing levels of the hormones themselves.47 (Image 3) Other adaptogens, such as Ashwagandha, regulate cortisol levels, while ginsenosides from Panax Notoginseng modulate cellular senescence, the process by which somatic cells cease dividing and instead become stagnant secretors of pro-inflammatory compounds that damage neighboring cells and accelerate biological aging.48

Image 3. Ginseng root has the same base molecular structure as steroidal-backed hormones.

40 41 42 43 44 45 46 47 48

Blair JA et al. Hypothalamic–pituitary-gonadal axis involvement in learning and memory and Alzheimer’s disease: More than “just” estrogen. Schaap LA et al. The association of sex hormone levels with poor mobility, low muscle strength, and incidence of falls among older men and women. Clin Endocrinol (Oxf ). 2005; 63(2): 152-160. Gaffey AE et al. Aging and the HPA axis: Stress and resilience in older adults. Neurosci Biobehav Rev. 2016; 68: 928-945. Van den Beld AW et al. The physiology of endocrine systems with ageing. Lancet Diabetes Endocrinol. 2018; 6(8): 647-658. Miller WL. Steroid hormone synthesis in mitochondria. Mol Cell Endocrinol. 2013; 379(1-2): 62-73. Tokizane K and Imai SI. NAD+ oscillation and hypothalamic neuronal functions. Fac Rev. 2021; 10: 42. Wang CH and Wei YH. Roles of mitochondrial sirtuins in mitochondrial function, redox homeostasis, insulin resistance, and type 2 diabetes. Int J Mol Sci. 2020; 21(15): 5266. Park J et al. Effects of ginseng on two main sex steroid hormone receptors: estrogen and androgen receptors. J Ginseng Res. 2017; 41(2): 215-221. Zhao P, et al. Therapeutic potential and cellular mechanisms of Panax Notoginseng on prevention of aging and cell senescence-associated diseases. Aging Dis. 2017; 8(6): 721-739.

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Peptide Therapeutics: The Future is Now

By: Jim LaValle, RPh, CCN, MT 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.

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Peptide Therapeutics: The Future is Now

From sports medicine to novel treatments for Metabolic Syndrome and all its co-morbid conditions, the use of bioactive peptides in medicine is a subject to which clinicians and their patients, should be exposed. Sleep and cognitive problems, improved performance and recovery, tendon and ligament repair, sexual dysfunction and weight issues are just some of the applications for patients seeking healing and rejuvenation.

The BIOPEP (bioactive peptide) database currently stores about 4000 bioactive peptides, encompassing approximately 992 Angiotensin-I-Converting Enzyme (ACE) inhibitory peptides, 652 antioxidant peptides, 500 antibacterial peptides, 488 dipeptidyl peptidase (DPP) inhibitory peptides, 113 neuropeptides, 20 antiviral peptides, 47 calmodulin-dependent protein kinase II (CaMKII), and many other functional peptides. Sales of novel peptides globally have grown from US $14.1 billion in 2011 to almost US $28.5 billion in 2020. Currently, the United States market is 40% of global peptide sales. Although mass-produced in China also, peptides manufactured by compounding pharmacies in the United States with a 99% or greater purity are recommended.

Peptides are short chains of 2 to 40-50 amino acids that are linked by peptide (amide) bonds. More than 7,000 naturally occurring peptides that have crucial roles in human physiology and performance have been identified. They function as hormones, neurotransmitters, growth factors, ion channel ligands or anti-infectives. In the body, peptides cause a cell-signaling response that can have regulatory and rejuvenative actions on neuro-endocrine-immune function. Peptides can help the body recover from injury or illness faster, lose weight more efficiently, decrease inflammation and pain and improve results in the gym. As a clinical tool, peptides can be specific and efficacious, while for the most part also being relatively safe and well tolerated. The history of peptides in clinical therapeutics began with insulin in the 1920s. There are approximately 60 US FDA approved peptide medications on the market, with continued increased interest by pharmaceutical company research and development, which by 2014 had led to approximately 140 peptide therapeutics being evaluated in clinical trials in the US and 500-600 in pre-clinical trials. Examples of approved pharmaceutical peptides include Lantus insulin, Lupron (prostate cancer treatment), and Byetta or Victoza (GLP-1, glucagon-like peptides for type 2 diabetes). New FDA approved products on the horizon include a melanocortin 4 receptor (MC4R) agonist for metabolic syndrome and weight loss and intranasal PT-141 (bremelanotide) for Female Sexual Dysfunction (and to support men’s sexual health).

Advances in peptide therapies for “off-label” uses offer additional therapeutic options for a plethora of health conditions, including: · Anti-aging · Epigenetic modulation · Stem cell proliferation · Blood glucose and insulin regulation · Weight management/ appetite control · Cardiovascular support – lipids, blood pressure, vascular function · Metaflammation · Improved lean muscular growth · Increased hGH (human growth hormone) levels · Reduced body fat – increased lipolysis · Improved energy, stamina and decreased fatigue

· Improved inflammatory responses · Improve injury recovery · Improved sleep patterns · Improved memory and concentration · Regulation of other hormones, i.e sex, thyroid, blood sugar, stress · Improved sexual desire (libido) · Improved bone mineralization and density · Improved workouts, recovery · Pain control · GI support

· Improved immune responses

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Peptide Therapeutics: The Future is Now

In the U.S. market, unless specified as a drug, peptides are most manufactured in compounding pharmacies with a 503B designation. This is critical for product quality, as some peptides are commonly available on the internet and sold as “research only“ use. Most were made in China, which unfortunately cannot always be relied on for adequate product quality control and in some cases even are adulterated. A 503 B compounding pharmacy must submit products they manufacture for lab analysis to prove content and stability of the product. Many problems have been reported from the use of internet peptides sales, including local reactions and even more severe reactions leading to hospitalization. This is why peptides should be purchased from a qualified pharmacy that follows FDA approved GMPs in their manufacturing facilities. There have been continued innovative technological advances in peptide manufacturing and drug delivery with the fields of

genomics, metabolomics and proteomics all contributing to this innovation. Recombinant technology and genetic engineering have allowed researchers to tweak formulas ever so slightly, improving bioavailability (including CNS availability), efficacy and safety. Progressive compounding pharmacies and labs that have gene sequencing lab equipment and FDA approved Q/A testing (HPLC, mass spectrophotometry, etc.) can tailor-make therapies at a practitioner’s request. Nanotization for improved bioavailability is also an option now. Oral and intranasal peptide formulations are also becoming a reality, with improvements in GI permeability a focus of much research. Peptides are relatively unstable making manufacturing a challenge and delivery is most commonly via injection. Since injections are somewhat objectionable to consumers, oral delivery of peptides is a major area of research and development as well due to the easier delivery method of oral administration. On the horizon also is the use of plant peptides to produce effective human peptide therapies. Some barriers of getting

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more plant peptides to market have been cost of production and modification of structures to increase their bioavailability and assure their absorption. Some of the plant peptides uses include: ·

Antiaging, antioxidant

Antimicrobial

Antidiabetic – IR and MetS (hypertension, hypercholesterolemia, obesity/overweight, blood glucose regulation issues)

Other cardiovascular issues

Anticancer

Pain issues

From peptides as antimicrobial agents to use for cognitive and neurological support to plant peptides for metabolic syndrome, peptides in different delivery forms certainly hold great promise for practitioners. Peptide therapies of different types are an area with a tremendous number of resources being devoted to continued research and development, and with genomics the potential combination of different sequencing for peptides is endless. We certainly can expect the number of peptides, from both animal and plant sources, available as therapeutic agents to increase dramatically over the next few decades. There are several compounding pharmacies in the U.S. offering safe, Q/A verified, pharmacist-synthesized, and/or compounded peptides made for various delivery methods, and as long as FDA regulations continue to allow for them, the environment is unfolding for peptides to be a mainstay therapeutic option for many chronic conditions, acute illnesses or injuries, as well as antiaging and health optimization uses. In summary, keep in mind that improved nutrition, management of hormone relationships, exercise and many other factors all plays a role in creating “whole person” health, which is the emerging term at NIH. Peptides are another tool in the kit that you can explore to revitalize and extend the health span of your patients.

1. Fosgerau K, Hoffman T. Peptide therapeutics: current status and future directions. Drug Discov Today. 2015;20(1):122-8. 2. Banting FG, Best CH, Collip JB, Campbell WR, Fletcher AA. Pancreatic extracts in the treatment of diabetes mellitus. Can Med Assoc J. 1922;12:141–146. 3. Lax R. The future of peptide development in the pharmaceutical industry.

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Peptide Therapeutics: The Future is Now PharManufacturing: Int Peptide Rev 2013:10–5. 4. Kingsberg SA, Cayton AH, Pfaus JG. The Female Sexual Response: Current Models, Neurobiological Underpinnings and Agents Currently Approved or Under Investigation for the Treatment of Hypoactive Sexual Desire Disorder. CNS Drugs. 2015;29(11):915–33. 5. Minkiewicz, Pet al. BIOPEP-UWM database of bioactive peptides: Current opportunities. Int. J Mol Sci. 2019;20(23):5978. 6. Fosgerau K, Hoffman T. Peptide therapeutics: current status and future directions. Drug Discov Today. 2015;20(1):122-8. 7. Kaspar AA, et al. Future directions for peptide therapeutics. Drug Discov Today 2013;18(17/18):807–17. 8. Lalatsa A, Schatzlein AG, Uchegbu IF. Strategies to deliver peptide drugs to the brain. Mol Pharm. 2014;11:1081–1093. 9. Brayden DJ, Alonso MJ. Oral delivery of peptides: opportunities and issues for translation. Adv Drug Deliv Rev. 2016;106:193–195. 10. Bruno BJ, Miller GD, Lim CS. Basics and recent advances in peptide and protein drug delivery. Ther Deliv. 2013;4(!1):1443-1467. 11. Lico C, et al. The use of plants for the production of therapeutic human peptides. Plant Cell Reports. 2012;31:439-51. 12. Chai TT, et al. Plant bioactive peptides: current status and prospects towards use in human health. Protein Peptide Lett. 2021;28:623-42.

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Canada RNA Biochemical Inc . . . . . . . . . . . . . . . . . . . . . . . . . 4048

AC Grace Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2033

Candela . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2048

Access Medical Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7013

Canfield Scientific Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6048

Acella Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7095

Carbon-60, Greska's . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8070

ADigital Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5046

CAREstream America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7090

ADIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5085

Carie Boyd’s Pharmaceutical Compounding . . . . . . . . . . . . 4087

Aesthetic Management Partners . . . . . . . . . . . . . . . . . . . . . . 3038

Celebrity Entrepreneur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5087

Allergy Research Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4060

Cell Science Systems Corp. . . . . . . . . . . . . . . . . . . . . . . . . . . . 9033

Alletess Medical Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . 2014

Celluma Light Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5060

Alphascience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5063

Cellustrious Hair Restoration . . . . . . . . . . . . . . . . . . . . . . . . . 2046

Amazentis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4049 American Biotech Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5043 American Cell Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9027 Ananda Professional . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4071 AnazaoHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3055 AnteAge MD by Cellese . . . . . . . . . . . . . . . . . . . . . . . 7036, 7037 Apex Energetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9009 APYX Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3094 Argentyn 23 by Natural-Immunogenics . . . . . . . . . . . . . . . . 6042 ATCOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4033 AVACEN Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5079 AYUMETRIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7044 Bankers Healthcare Group . . . . . . . . . . . . . . . . . . . . . . . . . . . 6047 BeamaLife Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3047 BENEV Company Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6064 Berkeley Life Professional Nitric Oxide . . . . . . . . . . . . . . . . 7043 Biocanic, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7073 Biogena USA Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9049 BioProtein Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5086 Bio-Tech Pharmacal, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6027 Biotics Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6013 BodyLogic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2032 BrainMaster Technologies Inc. . . . . . . . . . . . . . . . . . . . . . . . . 3064 BTL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9015 Calmoseptine, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4066 Calroy Health Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4026

164

Central Drugs Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2027 Cerbo EHR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7074 Chi's Enterprise Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5042 Clinicians Supplement Consultants . . . . . . . . . . . . . . . . . . . . 9014 CNS Vital Signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4086 College Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6038 Compound Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8066 CosmoFrance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4090 CRE8 Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7046 CS Health LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9029 CuraMedix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1052 Cynosure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6072 Cyrex Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3032 Cytox Ltd . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9036 Daily Wellness Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1050 Daiwa by U.S Jaclean, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7085 DaVinci Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6097 Deca Aloe Arborescens US . . . . . . . . . . . . . . . . . . . . . . . . . . . 4084 Designs for Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2021 DEXA Plus, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4065 DHA Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1040 Diagnostic Solutions Laboratory . . . . . . . . . . . . . . . . . . . . . . 2020 DNA Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5035 DNALife . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7042 Doctor Multimedia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3042, 8047 Doctor's Data, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8037

ANTI-AGING MEDICAL NEWS | WINTER 2021

Doctors Supplement Store . . . . . . . . . . . . . . . . . . . . . . . . . . . 7066 Dp Derm LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3081 Dr.Fuji / ACIGI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3067 DrSummits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2088 EBM Medical, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3075 eChef MD LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2062 Eclipse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8033 electroCore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8074 Endothelix Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1044 EndyMed Medical Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5071 Emerson Ecologics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5013 Eniva Health Corp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9039 EPI / Alpha-Stim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3043

LeadingResponse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6086 LightStim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3046 Liquivida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3063 LivOn Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6067 LK Trust . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8055 L-Nutra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4007 Longevity Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6060 McGuff Company Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1056 Med Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8048 Medical Wave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4067 Medicore, Co. Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7086 Meditime Co. Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7049 Medizap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4096

Epimorphy, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7097

Merchant Preferred Zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4046

Episciences Inc., DBA Epionce . . . . . . . . . . . . . . . . . . . . . . . . 3066

Merit Pharmaceutical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4037

EVOSKIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4047

Metagenics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6032

Excite Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5032

Microbiome Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3007

ExocelBio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4043

MINT™ (HansBiomed USA Inc.) . . . . . . . . . . . . . . . . . . . . . . . 3079

Forum Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7026

Mito Q Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5061

Fotona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1027

Modern Doc Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1030

Franz Skincare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6074

Mushroom Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2065

GATC Health Corp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2054

Neurobiologix Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6070

GeneSavvy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8097

Nu Xtrax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9026

Genova Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5021

NuMedica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7032

Global Life Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5039

NuSkin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2055

Great Plains Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5038

Nutrafol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1049

GX Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3060

Officite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2035

Hair Science Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9021

Olympia Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7033

Hallandale Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6055

Omega Diagnostics Ltd . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8032

Hawaiian Moon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2061, 7071

Ortho Molecular Products . . . . . . . . . . . . . . . . . . . . . . . . . . . 4027

Hopkinton Drug Compounding Pharmacy . . . . . . . . . . . . . 6095

OxyHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3021

Hormone Therapy Centers of America . . . . . . . . . . . . . . . . . 6071

PatientNow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7021

Ideal Protein of America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9025

PedsPal Group Purchasing . . . . . . . . . . . . . . . . . . . . . . . . . . . 3091

Immunosciences Lab, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1035

Pellecome LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8060

ImmunoStim Therapeutics . . . . . . . . . . . . . . . . . . . . . . . . . . . 9020

Pharmacy Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7084

ImprimisRx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8064

Physician Compounding Alliance . . . . . . . . . . . . . . . . . . . . . . 8038

InBody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9032

Physicians Longevity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2037

Innovation Compounding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5047

Podcasting & Videos Made Easy . . . . . . . . . . . . . . . . . . . . . . 2042

Innovations Group Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1043

Power2Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7028

Integrative Peptides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3097

Precheck Health Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3061

IntegrativePRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9023

Precision Analytical Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7027

IQ Technologies Inc. & Irest . . . . . . . . . . . . . . . . . . . . . . . . . . 2091

Precision Compounding Pharmacy . . . . . . . . . . . . . . . . . . . . 9016

Jigsaw Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2044

Precision Point Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . 3049

KBMO Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3027

Predictive Health Diagnostics Co. . . . . . . . . . . . . . . . . . . . . . 4042

Kimera Labs, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6091

Prestige Products Direct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9051

Kyani . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7062

Prevencio, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1047

Las Vegas HEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2094

ProCBD by CV Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7075

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INDEX

Prodome Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4078

TouchMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1055

Professional Health Products . . . . . . . . . . . . . . . . . . . . . . . . . 7070

Trocar Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9037

Progressive Medical Solutions . . . . . . . . . . . . . . . . . . . . . . . . 5037

Tru Niagen / Chromadex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6046

PromoItalia LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7094

TruDiagnostic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5033

Prosoma LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2060

TruGen3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7060

Protocol For Life Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8043

U.SK Under Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5065

Purium Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7061

Ulta Lab Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4061

Qest, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6039

UnCraveRx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2043

Qualgen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9059

University Compounding Pharmacy . . . . . . . . . . . . . . . . . . . 6021

Quest Diagnostics - Cleveland HeartLab . . . . . . . . . . . . . . . 9038

US Biotek Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6037

Quicksilver Scientific . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4021

Vertisis Custom Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . 4045

Rapid Release Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9043

Vibrant America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2047

RealTime Laboratories, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8086

Viora . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4080

Refine USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6061

Vita Aid Professional Therapeutics . . . . . . . . . . . . . . . . . . . . 8042

Regenative Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6033

Vivos Therapeutics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3037

Regenerative Kits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5064

Ward Photonics LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8091

RegenLab USA LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4072

WAVi Co. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1066

Rejuvenation Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4039

Well Cell Global . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3071

Relax Saunas of Momentum 98 INC. . . . . . . . . . . . . . . . . . . 8084

Wellness Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1024

RepeatMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7091

Wells Pharmacy Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2015

Researched Nutritionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6073

Young Goose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2056

ReviveMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5084

Your Energy Systems, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4036

Rhein Consulting Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5044

Zhittya Genesis Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5073

Rupa Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4032

Zingit Technology Services LLC . . . . . . . . . . . . . . . . . . . . . . . 3045

SandsRx Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3044

Zizion Group Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6085

Sciton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2071

ZRT Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4079

SeeBeyond™ Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4064

ZYTO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1033

Selphyl PRP/PRFm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8062 Signature Biologics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6007 Smarter Not Harder, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8044 SottoPelle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3096 Sovereign Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9046 Specialist Training by The Institute . . . . . . . . . . . . . . . . . . . . 5066 Standard Process Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8021 Sun Genomics, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1026 TA Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5007 Tailor Made Compounding . . . . . . . . . . . . . . . . . . . . . . . . . . . 5027 The Mold Pros . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8090 TherapellET dba Atrocars.com . . . . . . . . . . . . . . . . . . . . . . . . 7047 THOR Photomedicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6043 Toolbox Genomics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2038

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ANTI-AGING MEDICAL NEWS | WINTER 2021

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

TA-65®

Placebo

-28

Change in Senescent (CD8+CD28-) T Cells (cells/μl)

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 #5007 or go to www.tasciences.com/a4m-vegas

2021

DECEMBER 10-12, 2021

6097 6095 7094

4094

6091 7090

2087

CONCESSION STAND

EXHIBIT HALL

F LO OR P LA N

The Sands Convention Center - Hall B

3087 4086

4087 5086

5087 6086

3085 4084

4085 5084

5085 6084

6081 7080

4080

7078

5079

7081

8090 8078

2077 6074

3075 3073

1063 2062

4072

5073 6072

4070

5071 6070

3062

5063

2060

2056

5 905

2054

4055

2048

4049

5055

1054

5048

8048

9044

5038

5039

5035

7028

9022 1022 2020

9016 2014

9014

3007

ENTRANCE

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ANTI-AGING MEDICAL NEWS | WINTER 2021

169

American Academy of Anti-Aging Medicine Booth #4055

AC Grace Company

Access Medical Labs

Booth #2033

Booth #7013

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

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

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

Ph: (561) 997-0112

Ph: (800) 833-4368

Ph: (866) 720-8386

Email: info@a4m.com

Email: jflint@acgrace.com

Email: info@accessmedlab.com

www.a4m.com

www.acgrace.com

www.accessmedlab.com

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.

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.

Acella Pharmaceuticals

ADigital Health

ADIT

Booth #7095

Booth #5046

Booth #5085

1880 McFarland Pkwy, Ste. 100 Alpharetta, Georgia, 30005 | United States

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

1325 Pacific Highway, San Diego, California, 92101 | United States

Ph: (678) 325-5189

Ph: (561) 247-3839

Ph: (619) 320-7468

Email: info@acellapharma.com

Email: info@adigitalhealth.com

Email: steven@adit.com

www.acellapharma.com

www.adigitalhealth.com

www.adit.com

Acella Pharmaceuticals, LLC is a specialty pharmaceutical company committed to innovating the healthcare field by bringing quality and affordable products to our customers and patients.

ADigital Health is a remote patient care and monitoring platform that helps doctors automate care instructions and manage patients between encounters to improve patient outcomes and increase practice revenue. Easily enroll patients into care programs so patients receive your guidance and instructions everyday. Patients can track progress including body metrics, calories, steps, activity, water, sleep and more. Provide better care and support in a fraction of the time, right from the palm of your hand.

A practice growth platform that maximizes your patient’s experience, streamlines your front-desk, leverages the most robust marketing strategies, and quantifies everything.

170

ANTI-AGING MEDICAL NEWS | WINTER 2021

The first step... Alletess

Aesthetic Management Partners

Allergy Research Group

Alletess Medical Laboratory

Booth #3038

Booth #4060

Booth #2014

9109 Macon Road, Ste. 120 Cordova, Texas, 38016 | United States

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

Ph: (877) 267-2670

Ph: (800) 545-9960

14 Howard Street, Rockland, Massachusetts, *02370 | United States

Email: info@amplifimd.com

Email: customerservice@allergyresearchgroup. com

www.aestheticmanagementpartners.com

Ph: (800) 255-5404 Ext 312 Email: ksaccone@foodallergy.com

www.allergyresearchgroup.com

www.foodallergy.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.

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.

Alphascience

Amazentis

American Biotech Labs

Booth #5063

Booth #4049

Booth #5043

91 rue Faubourg, St Honore, Ile-de-France, 75008 | France

1160 Batter Street East, Ste. 100 San Francisco, California, 94111 | United States

705 E 50 South, American Fork, Utah, 84003 | United States

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, then it’s the right course of action. This is what guides us in everything we do.

ALPHASCIENCE I N N O V A T I V E

•

S K I N

•

S C I E N C E

Ph: (760) 822-4833 Email: caprice@alphascience.com www.Alphascience.com Supporting the skin’s own ecosystem for health with ingredients of natural origin and allowing the skin to retain all of its vital force. To achieve this, we are committed to pushing the limits of cosmeceuticals by integrating exclusive ingredients, superior technology and innovation into each of our skin treatments. Formulations by Alfred Marchal, PhD Organic Chemistry.

Ph: (888) 631-3359 Email: care@timelinenutrition.com www.timelinenutrition.com Timeline Nutrition is the novel nutrition brand behind Mitopure™, a highly pure form of Urolithin A. Developed with the belief that uncompromising research can unlock a new class of nutrition that is backed by cutting edge science, Mitopure™ is a breakthrough in cellular health. As scientists, we know that physical decline from aging can’t be stopped, however, Timeline is committed to developing products designed to help reduce the impact of time on health.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (801) 756-1000 Email: Kory@ablsilver.com www.silverbiotics.com ABL utilizes a unique silver-based technology to assist with all types of Practitioner needs, from wound dressing gels (great for procedures like laser therapies, wound care, spa treatments, etc), to incredibly moisturizing healing lotions to immune supplements. 3rd party university tests show ABL’s silver technology is 2-4 times more effective than other silvers.

171

American Cell Technology

Ananda Professional

Booth #9027

Booth #4071

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

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

Ph: (844) 443-2355

Ph: (888) 388-1119

Email: info@americancelltechnology.com

Email: hello@anandaprofessional.com

www.americancelltechnology.com

www.anandaprofessional.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.

Ananda Professional is the #1 CBD brand recommended by pharmacists. With $40 million invested in research to advanced the clinical evidence of hemp extract, Ananda’s goal is to champion the knowledge, safety, and efficacy of CBD products. Partnering with leading healthcare institutions, Ananda’s products are used in ongoing studies and phase II clinical trials. With this data, the team of practitioners and scientists meticulously created worldclass health solutions that are driven by science, not fads.

AnazaoHealth

AnteAge MD by Cellese

Apex Energetics

Booth #3055

Booth #7036, 7037

Booth #9009

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

17252 Armstrong Ave., Ste. E Irvine, California, 92614 | United States

16592 Hale Ave., Irvine, California, 92606 | United States

Ph: (800) 995-4363

Ph: (949) 872-1189

Ph: (800) 736-4381

Email: emarketing@anazaohealth.com

Email: bryan@cellese.com

Email: Inez@apexenergetics.com

www.anazaohealth.com

www.anteage.com

www.apexenergetics.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.

AnteAGE® is the next generation of growth factor skin care and treatments. A specific population of cells directs natural skin repair: bone marrow mesenchymal stem cells. The scientists at AnteAGE have decoded the anti-inflammatory biosignal language of these stem cells, culturing them in the lab for use in powerful, targeted anti-aging skin treatments. For microneedling, hair regrowth, vaginal rejuvenation, skin brightening, and anti-aging – AnteAGE delivers the exact natural biosignals needed for healing and rejuvenation.

Our motto—Patient Health First™—reflects our mission. It is also our guiding principle that dictates all decisions, from raw material acquisition to manufacturing to our strong practitioner relationships. Over the past 30+ years, we have built a reputation of integrity by infusing everything we do with this principle, and we remain at the forefront of Functional Medicine discoveries and advances with formulations spearheaded by Datis Kharrazian PhD, DHSc, DC, MS, MMSc, FACN.

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ANTI-AGING MEDICAL NEWS | WINTER 2021

since 2001

APYX Medical

Argentyn 23 by Natural-

ATCOR

Booth #3094

Booth #6042

Booth #4033

5115 Ulmerton Road, Clearwater, Florida, 33760 | United States

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

515 Shuman Blvd., Ste. 515 Naperville, Illinois, 60563 | United States

Ph: (800) 537-2790

Ph: (941) 702-6100

Ph: (630) 228-8871

Email: customerservice@apyxmedical.com

Email: Team@Argentyn23.com

Email: c.targos@atcormedical.com

www.renuvion.com

www.Argentyn23.com

www.atcormedical.com

Apyx Medical is an advanced energy technology company with a passion for elevating people’s lives through innovative products in the cosmetic market. Known for our Renuvion® cosmetic technology we are focused on one thing: bringing transformative solutions to the customers we serve.

Since its launch in 2001, thousands of clinics worldwide have chosen Argentyn 23 Bio-Active Silver Hydrosol™ and First Aid Gel. Argentyn 23 is produced through a proprietary manufacturing technique that results in the smallest particles achievable with greater than 98% positively charged bio-active silver ions and silver nanoclusters. Particle size and charge are confirmed by third-party laboratories/universities. Find out more about how Argentyn 23 can help you harness the power of silver in your practice.

ATCOR develops and markets medical technologies that measure patient risk for hypertension, cardiovascular disease (CVD), and other related vascular disorders. We help clinicians with early detection of target organ damage and management of cardiovascular and renal disease. Our SphygmoCor® technology enables clinicians to measure noninvasive central blood pressure (NcBP), which provides clinicians with better prognostic and diagnostic information to target interventions—effects which cannot be detected with standard brachial blood pressure measurement alone.

AVACEN Medical

AYUMETRIX

Bankers Healthcare Group

Booth #5079

Booth #7044

Booth #6047

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

17387 63rd Ave., Lake Oswego, Oregon, 97035 | United States

3700 Lakeside Drive, Ste. 100 Miramar, Florida, 33027 | United States

Ph: (619) 417-8319

Ph: (503) 819-6676

Ph: (954) 660-7985

Email: djforsgren@avacen.com

Email: skapur@ayumetrix.com

Email: rudy@bhg-inc.com

www.AVACEN.com

WWW.AYUMETRIX.COM

www.bankershealthcaregroup.com

AVACEN 100 uses the AVACEN Treatment Method (ATM) – a noninvasive pain management technology platform for people at normal body temperature. AVACEN uses a microprocessor controlled chamber to surround the hand with a slight negative pressure, while adding heat to the palm, gently expanding the volume of blood in the palm’s unique vascular networks while heat is simultaneously transferred from the computer managed palm pad into these expanded vascular networks. FDA Class11,OTC & EU Approved.

AYUMETRIX is a “smart lab of the future” and has been founded to empower individuals to take charge of their health and wellness using innovative sample collection and laboratory testing technologies. It is a global hormone testing laboratory that partners with clinicians all around the world and offers a practice building package that is inclusive of integrative and functional laboratory testing services, personal health data acquisition/ analysis-all under the guidance from industry experts.

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.

ANTI-AGING MEDICAL NEWS | WINTER 2021

173

BeamaLife Corporation

BENEV Company Inc.

Berkeley Life Professional Nitric

Booth #3047

Booth #6064

Booth #7043

1792 Bell Tower Lane, Weston, Florida, 33326 | United States

23263 Madero, Ste. A Mission Viejo, California, 92691 | United States

PO Box 11347, 355 East Ohio St., Ste. 200 Chicago, Illinois, 60611 | United States

Ph: (732) 508-7415

Ph: (424) 393-5859

Email: neil.jesani@beamalife.com

Email: Susan@BENEV.com

www.neiljesani.com

www.BENEV.com

My name is Neil Jesani and I’m a Certified Financial Planner (CFP). Over the last 20 years, I have helped more than 3,000 Physicians, 1,000 Dentists, 600 Independent Pharmacists and 3,000 other very successful business owners and professionals from across the country with reducing substantial taxes, increasing investment portfolio return with downside risk protection, almost doubling tax-free retirement income and creating an additional inheritance for their families. Please visit www.neiljesani.com for more information.

BENEV Company Inc. is an FDA registered pharmaceutical and cosmeceutical company, founded in Orange County, California that serves the medical skin care market with scientifically advanced, results-driven skin care solutions and medical devices. At BENEV our mission is to inspire a more vibrant life and create a more beautiful world by providing products and services that BENefit EVeryone.

Biocanic, Inc.

Biocidin

Booth #7073

Ph: (773) 750-7745 Email: john.halbert@lifes2good.com www.berkeleylife.com Berkeley Life Professional’s proprietary dietary nitrate blend provides the plant-based bioequivalents of a leafy green diet in each two capsule dose helping patients maintain their nitric oxide levels as they age. When paired with the patented Berkeley Life Nitric Oxide Test Strip, Practitioners have an complete treatment system to support their patient’s optimal circulation.

Biogena USA Inc. Booth #9049

4967 Foothill Blvd., San Diego, California, 92109 | United States

P.O. Box 2499, Aptos, California, 95001 | United States

8383 Wilshire Blvd., Beverly Hills, California, 90211 | United States

Ph: (619) 867-2318

Ph: (800) 775-4140

Ph: (213) 444-7902

Email: jeremy@biocanic.com

Email: clinical@biocidin.com

Email: service@biogena-usa.com

www.biocanic.com

www.biocidin.com

www.biogena-usa.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.

Biogena is a family-owned business that specializes in highly professional and meticulous research, development, and production of hypoallergenic dietary supplements. Good Health is our mission and science is our passion. Our extensive specialist knowledge, our sense of responsibility and, above all, our uncompromising commitment to quality are the cornerstones of our mission to promote better health throughout the world. Biogena products, with their broad spectrum of application and use, provide the basis for this mission.

174

ANTI-AGING MEDICAL NEWS | WINTER 2021

BioProtein Technology

Bio-Tech Pharmacal, Inc.

Biotics Research

Booth #5086

Booth #6027

Booth #6013

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

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

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

Ph: (800) 280-2456

Ph: (479) 443-9148 Ext 1118

Ph: (800) 231-5777

Email: info@bioproteintech.com

Email: lee@bio-tech-pharm.com

Email: biotics@bioticsresearch.com

www.bioproteintech.com

www.biotechpharmacal.com

www.bioticsresearch.com

Since 2009 BioProtein Technology has been providing physicians and their patients cutting edge alternatives to the industry’s most common pharmaceutical antiaging 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.

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 Corporation was formed in 1975 and from day one the foundation has been “Innovation and Quality.” Our goals remain unchanged - innovative ideas, carefully researched concepts, and product development with advanced analytical and manufacturing techniques to develop and produce nutritional products of superior quality and effectiveness available exclusively to healthcare professionals. 1-800-231-5777 www. bioticsresearch.com

BodyLogic

BrainMaster Technologies Inc.

BTL

Booth #2032

Booth #3064

Booth #9015

4850 T Rex Ave., Ste. 125 Boca Raton, Florida, 33431 | United States

195 Willis Street, Bedford, Ohio, 44146 | United States

Ph: (561) 319-1410

Ph: (440) 232-6000

362 Elm Street, Marlboro, Massachusetts, *01752 | United States

Email: sales@bodylogicsolutions.com

Email: assistantmanager@brainmaster.com

www.bodylogicsolutions.com

www.brainmaster.com

BodyLogic Solutions is thrilled to announce our partnership program. We are diversifying our offerings and want you to be a part of it at no cost. We’ve expanded our traditional model to offer a turnkey solution that provides you an alternative means of passive revenue. We hold the key to accessing comprehensive laboratory testing and providing high-quality nutraceuticals to your patients. You decide what combination of our offerings is right for your patient base.

BrainMaster offers the most cutting edge and comprehensive variety of Clinical EEG, 3D Brain Imaging, qEEG and Neurofeedback on the market. Application areas include real-time imaging utilizing sLORETA, normative databases and pre/post therapeutic comparison. Clinical and personal data-base driven Neurofeedback, biofeedback, peak-performance, research, Virtual Reality and brain-controlled systems. Add our system to your practice, and change lives, one brain at a time!

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (866) 285-1656 Email: info@btlnet.com www.bodybybtl.com BTL has grown to become one of the world’s major manufacturers of medical and aesthetic equipment. With over 1,900 employees located in more than 53 countries, BTL has revolutionized the way to offer the most advanced non-invasive solutions for body shaping, skin tightening & other medical aesthetic treatments, including women’s health and wellness. BTL Aesthetics’ brands include EMSCULPT NEO, EMSCULPT, BTL Emsella, and EMTONE. http://bodybybtl.com.

175

Canada RNA Biochemical Inc.

Calmoseptine, Inc.

Calroy Health Sciences

Canada RNA Biochemical Inc

Booth #4066

Booth #4026

Booth #4048

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

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

4400 Hazelbridge Way, Unit 680 Richmond, British Columbia, V6X 3R8 | Canada

Ph: (800) 609-6409

Ph: (604) 273-2233

Email: support@arterosil.com

Email: info@canadarna.com

www.arterosil.com

www.CanadaRNA.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 science-based innovations that transform human health with natural solutions, Calroy supports a robust research agenda.

We specialize in niche natural medicine for practitioners: 1. Boluoke™ (lumbrokinase), the most potent and best researched oral fibrinolytic agent hands-down; 2. CordImmune™ (Cordyceps sinensis), the only Cordyceps on the market that tests for and declares its cordycepin content; and 3. Corio-PSP™ (Coriolus versicolor), the best researched mushroom species for immune support. Remember to stop by our booth for a FREE coagulation health check ($85 value). Only 40 spots available.

Candela

Canfield Scientific Inc.

Carbon-60, Greska’s

Booth #2048

Booth #6048

Booth #8070

251 Locke Drive, Marlborough, Massachusetts, *01752 | United States

4 Wood Hollow Road, Parsippany, New Jersey, *07054 | United States

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

Ph: (800) 733-8550

Ph: (973) 434-1200

Email: cynthia.ratusz@candelamedical.com

Email: monet.davis-sinclair@canfieldsci.com

www.candelamedical.com

www.canfieldsci.com

Candela is a leading energy-based, device company with a comprehensive product portfolio and global distribution footprint in over 100 countries. With hundreds of patents issued, we’re dedicated to the development of innovative products that allow treatment providers to offer advanced solutions for a broad range of medical aesthetic applications.

Canfield Scientific is the global leader in developing and distributing imaging systems for the medical and skin care industries. Used in hospitals, medical and aesthetic practices, medical spas, and skin and wellness centers, Canfield’s advanced photographic imaging solutions are an integral part of consultations. Today thousands of surgical and non-surgical consultations begin with images being captured by Canfield’s powerful imaging tools that improve communications, align doctorpatient expectations, facilitate treatment planning, and highlight results.

Ph: (714) 840-3405 Email: Info@Calmoseptine.com www.calmoseptine.com Calmoseptine Inc. markets Calmoseptine Ointment in all 50 states, Canada, Australia, Philippines, 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.

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Ph: (720) 600-6040 Email: bob@c-60.com www.C-60.com Greska’s Carbon-60 is the worlds 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 as an orally as a dietary supplement. It supports a higher quality of live for healthy aging. Stop by Booth 8070 for a FREE SAMPLE. You’ll be glad you did.

CAREstream America

Carie Boyd’s Pharmaceutical

Celebrity Entrepreneur

Booth #7090

Booth #4087

Booth #5087

200 Technology Park, Ste. 1040 Lake Mary, Florida, 32701 | United States

8400 Esters Blvd., Ste 190 Irving, Texas, 75063 | United States

350 Fifth Ave., New York, New York, 10118 | United States

Ph: (855) 892-3872

Ph: (817) 282-9376

Ph: (212) 888-2999

Email: info@carestreamamerica.com

Email: info@carieboyd.com

Email: clint@clintarthur.tv

www.carestreamamerica.com

www.carieboyd.com

www.Clinttt.com

CAREstream America offers cutting-edge regenerative and pain management solutions to increase patient satisfaction. Our comprehensive portfolio includes: ALPHA2ACTIVE™ A2M Therapy with FACT, CAREprp™, 100% Pure Amniotic Fluid, Non-Centrifuge Bone Marrow Aspirate, VeinViewer HD Imaging device, and the intuitive body-jet® eco for water-jet assisted micronized fat harvesting. Top it off with our innovative Pro-Nox™, an FDA approved 50/50 Nitrous Oxide and Oxygen analgesia system for safe and effective relief of procedure pain and anxiety without opioids.

Carie Boyd is a state-of-the-art, FDA registered 503B outsourcing facility that provides healthcare practitioners, clinics, hospitals, GPOs, and other provider networks with the highest-quality compounded medications. Having innovated the modern pellet compounding process, we are one of the nation’s leading compounders of hormone pellets. We also have a specialty compounding pharmacy that offers unique medications specifically formulated for bio-identical hormone therapy, aesthetics and thyroid treatment. Contact us today to learn more!

Transforming Experts into Celebrities

Cell Science Systems Corp.

Celluma Light Therapy

Cellustrious Hair Restoration

Booth #9033

Booth #5060

Booth #2046

852 South Military Trail, Deerfield Beach, Florida, 33442 | United States

1000 E. Howell Ave., Anaheim, California, 92805 | United States

3717 Thousand Oaks Blvd, #215 Westlake Village, California, 91362 | United States

Ph: (714) 978-0080

Ph: (800) 872-5228 Email: customerservice@cellsciencesystems.com www.cellsciencesystems.com Cell Science Systems Corp. is a specialty clinical laboratory that develops and performs testing in immunology and cell biology supporting the personalized treatment and prevention of chronic disease. CSS is the developer and provider of the Alcat Test for food and chemical sensitivities, which has been independently validated in university studies. The laboratory additionally offers specialized genetic, serological, and functional cellular tests that help identify gastrointestinal disorders, methylation, cellular nutrient, and antioxidant status,

Email: jerry.gutierrez@biophotas.com www.celluma.com Celluma by BioPhotas, Inc. is a FDA-registered medical device manufacturer, producing Light Energy devices which use proprietary technology to treat skin, muscle and joint conditions. Unique in design, the award-winning Celluma Series is widely used by dermatologists, plastic surgeons, estheticians and pain management specialists. BioPhotas’ flagship product, the Celluma PRO has gained the distinction of market leader in aesthetic light therapy devices. BioPhotas’ products can be found in more than 40 countries around the globe.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (213) 536-9339 Email: info@cellustrious.com www.cellustrious.com We offer a non-invasive treatment for hair loss developed by a biochemist and trichologist, backed by clinical trials with a 90% success rate. We offer training that allows doctors and med spas to earn an extra $325 per hour with their existing staff, without buying expensive equipment, that pays for itself in just two patients.

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Central Drugs Pharmacy

Cerbo EHR

Chi’s Enterprise Inc.

Booth #2027

Booth #7074

Booth #5042

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

350 SE Mill Street, Ste 11 Portland, Oregon, 97214 | United States

1435 N. Brasher Street, Anaheim, California, 92807 | United States

Ph: (562) 691-6754

Ph: (541) 391-4600

Ph: (714) 777-1542

Email: nayan@centraldrugsrx.com

Email: slayde@cer.bo

Email: chimailing@gmail.com

www.centraldrugsrx.com

www.cer.bo/try-cerbo

www.chi-health.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.

Cerbo is simply the best EHR + Patient Portal for functional medicine. Scheduling includes online requests, custom reminders, and native telehealth. Charting is ultra-flexible, with eRx and supplements, inventory, IVs, injections, pelleting, and your custom recommendations, plus powerful templating tools. Integrated merchant services include credit/ ACH, subscriptions, and payment plans. And your Patient Portal with custom patient forms is styled to match your website. And lots more! All with incredible configuration & support. Demo: cer.bo/try-cerbo.

Chi’s Enterprise offers supplements including MYOMIN, aromatase reducer. Jonathan Wright, MD and other doctors recommend Myomin to reduce estradiol/estrone, increase testosterone for men/ women including BHRT users. Research Genetic Cancer Center (RGCC) highly recommend ANGIOSTOP for inhibiting angiogenesis factors, inhibiting signal transduction pathways, inducing caspases for apoptosis. VEINLITE- CVD, reduces D-Dimer. OXYPOWERhypoxia, excellent for lung, heart, energy. With BAMBOOEXTRACT, excellent for COVID-19. LIVER CHI induce interferon for hepatitis. KIDNEYCHI for UTI and prevent sexual disease.

Clinicians Supplement

CNS Vital Signs

College Pharmacy

Booth #9014

Booth #4086

Booth #6038

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

598 Airport Blvd., Ste. 1400 Morrisville, North Carolina, 27560 | United States

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

Ph: (888) 750-6941

Ph: (800) 888-9358

Email: support@cnsvs.com

Email: customerservice@collegepharmacy.com

www.cnsvs.com

www.collegepharmacy.com

CNS Vital Signs is a world leader in computerizedneurocognitive assessment tools. Baseline, evaluate and help track the status and disease progression of your patients. FDA exempt and used by over 12,000 clinicians and researchers world-wide. Available in over 50 languages and can be administered in-person or virtually. Come by our exhibit or go to www.cnsvs.com for a free trial.

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.

Ph: (516) 222-2288 Email: dlc@cscprivatelabel.com www.cliniciansconcierge.com 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 a professional only brand, 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.

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PHARMACY Compound Connection

CosmoFrance

CRE8 Pharmacy

Booth #8066

Booth #4090

Booth #7046

7784 Constance Ave., Frisco, Texas, 75034 | United States

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

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

Ph: (469) 214-0786

Ph: (305) 538-0110

Ph: (888) 224-5181

Email: rhett@compoundconnection.com

Email: conference@cosmofrance.net

Email: david@cre8rx.com

www.compoundconnection.com

www.cosmofrance.net

www.cre8pharmacy.com

Compound connection is a web-based purchasing solution for medical professionals. The Compound Connection network connects you to compounded pharmacy products and supplies at a discounted price by leveraging the network’s purchasing power compared to going directly to the pharmacy.

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. • 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.

CS Health LLC

CuraMedix

Cynosure

Booth #9029

Booth #1052

Booth #6072

1402 West Main Street, Louisville, Kentucky, 40203 | United States

40 Albion Road, Ste. 103 Lincoln, Rhode Island, *02865 | United States

Ph: (502) 583-4402

Ph: (401) 333-6500

5 Carlisle Road, Westford, Massachusetts, 01886 | United States

Email: dsmith@caudillseed.com

Email: info@curamedix.com

www.cs-health.com

www.curamedix.com

Vertical Mfg processor of Broccoli Seed Food Supplement along with Broccoli Seed Oil, and Hand and Body Cream

CuraMedix is focused on regenerative medicine and is the US distributor of STORZ Medical EPAT devices. Extracorporeal Pulse Activation Technology (EPAT), sometimes referred to as ESWT or shockwave, is an evidence-based, non-invasive approach to treating musculoskeletal pain. Highlighted products include the OrthoPulse Ultra 100, DuoLith T-Top Ultra, and DuoLith RPW/FSW Modular.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (508) 317-2047 Email: kristin.brown@cynosure.com www.cynosure.com Cynosure (Westford, Mass.), is a leader in medical devices for aesthetic procedures and precise surgical applications. Our non-invasive and minimally invasive technologies enable plastic surgeons, dermatologists and other medical professionals to address skin revitalization, body contouring, fat removal, cellulite, scarring, tattoo removal, gynecologic health and other related applications. Cynosure also markets radiofrequency technologies for facial plastic and general surgery, gynecology, otolaryngology and other specialties.

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Growing Your Business Never Gets Old. Especially when you can offer your patients something new. Empower your practice to build additional revenue streams with no capital investment to get started, no inventory to carry, no order minimums, and no burden on your staff.* The BodyLogic turnkey anti-aging and wellness programs are designed to address your patients’ most pressing needs including: • weight loss • sexual wellness

• hormonal balance • overall well-being

And it’s all backed by science. Patients receive comprehensive testing plus support from industry experts who guide them to success via virtual visits. Patients see the results and they understand the science behind it, so they’re more likely to stay on track.

Stop by BodyLogic Booth #2032 at A4M to see if you qualify for free testing and consultations. See how the program works and what your patients will experience!

bodylogicsolutions.com Visit us at booth #2032 at A4M to see if you qualify for testing and discover firsthand how it works. * This is not a guarantee of increased revenue.

Clinically proven to protect and restore the endothelial glycocalyx NEW PATENT! Arterosil stabilizes and regresses vulnerable plaque* What It Is Arterosil® is a proprietary dietary supplement formulated with a rare seaweed that contains specialized polysaccharides clinically proven to support arterial and endothelial health.

Who It’s For Arterosil® delivers powerful support to patients with: • Arterial or Carotid Plaque • Coronary Artery Disease • Cardiovascular Disease • Erectile Dysfunction • Diabetic Neuropathy • Hyperglycemia Compromised Artery

• Raynaud’s • Angina • Diabetes • Hypertension • Hypercholesterolemia • Peripheral Artery Disease Endothelial Glycocalyx

How It Works

Healthy Artery

The special polysaccharides in Arterosil® help rebuild the endothelial glycocalyx—the slippery inner lining of every artery, vein, and capillary in the body. This supports endothelial health, protects and stabilizes plaque, may regress plaque, and enhances NO production.

“The amazing results that I’ve had in my practice: on average, we’re seeing about a

52% reduction in total carotid plaque, and that’s

in people that I’ve been working with for years and have had on every integrative intervention, and most of them with really stubborn and

difficult to reverse plaque.” KRISTINE BURKE, MD

U.S. Patent No. 11,135,238 *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.

This material is for licensed healthcare providers only.

arterosil.com

Cyrex Laboratories

Cytox Ltd

Daily Wellness Company

Booth #3032

Booth #9036

Booth #1050

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

John Eccles House, Robert Robinson Avenue, Oxford Science Park Oxford, , OX4 4GP | United Kingdom

1750 Kalakaua Ave., Ste.3001 Honolulu, Hawaii, 96826 | United States

Ph: (800) 650-4234

Email: dwcservice@dailywellness.com

Ph: (877) 772-9739 Email: michelle.c@cyrexlabs.com www.JoinCyrex.com

Email: alzheimers@vanguardpharma.com

Cyrex Laboratories® is a unique clinical immunology laboratory specializing in environmentally-induced autoimmunity. Cyrex delivers next generation assessments for antigenic intestinal and blood-brain barrier permeability – gateways to autoimmunity; environmental trigger screening including dietary antigens, pathogens and xenobiotics; and multitissue antibody testing for predictive biomarkers of autoimmune reactivity. Through continuous collaboration with leading experts in medical research and clinical practice, Cyrex develops innovative arrays that assess the cross-connections between the body’s immune, gastrointestinal and neurological systems.

Cytox provides non-invasive, risk assessment and patient stratification tools for Alzheimer’s disease and dementia. It’s primary technology is genoSCORE(TM) a genetic test to predict future risk of cognitive decline due to Alzheimer’s disease (AD). The test, which uses a simple blood or saliva sample, analyses patient genotypes against an array of over 100,000 single nucleotide polymorphisms (SNPs) associated with AD. The test is available in the US as the IBX Alzheimer’s Risk Test.

www.alzheimers-risk-test.com

Ph: (800) 988-4869 www.dailywellness.com Founded in 1996, the Daily Wellness Company has worked to develop natural solutions to address complex health issues - applying scientific expertise to ensure efficacy, safety, and quality. Over the past 2 decades, we have been fortunate to collaborate with highly credible institutions and talented researchers.The Daily Wellness Company values research, collaboration with academia, and the potential of nature. We approach our work with a sense of optimism and open-mindedness tempered with critical thinking.

Daiwa by U.S Jaclean, Inc.

DaVinci Laboratories

Deca Aloe Arborescens US

Booth #7085

Booth #6097

Booth #4084

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

929 Harvest Lane, Williston, Vermont, 05495 | United States

2626 Cole Ave., Ste. 300 Dallas, Texas, 75204 | United States

Ph: (310) 538-2298

Ph: (802) 872-1924

Ph: (214) 727-4126

Email: sales@usjaclean.com

Email: bkanya@foodsciencecorp.com

Email: twaid@decaaloe.com

www.daiwamassage.com

www.davincilabs.com

www.aloeproductscenter.com

U.S. Jaclean has been a pioneer in bringing healing techniques into your home through original, expertlydesigned products for over 35yrs. Headquartered in California with facilities nationwide, we run our own warehouses right here in the United States. Our mission: To improve health and wellness through quality products that can be used from the comfort of home. Our family of brands has grown and diversified, always staying on the cutting edge of health and wellness technologies.

NEARLY 50 YEARS OF COMMITMENT & KNOWLEDGE 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.

Deca Aloe Arborescens US (Deca Aloe) manufactures the Supreme Immune Health Formula™, a Nutraceutical “Medical Food Product” for the nutritional dietary management of a compromised immune system. The formula is a proprietary blend of two potent ingredients of organic whole leaf Aloe Arborescens juice and raw unpasteurized honey. The biological chemical constituents in these superfoods act in synergism to provide immunomodulatory and protective activation to help the body’s innate immune system restore health.

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Designs for Health

DEXA Plus, LLC

DHA Laboratory

Booth #2021

Booth #4065

Booth #1040

14 Commerce Blvd., Palm Coast, Florida, 32164 | United States

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

411 E. Business Center Drive, Ste.107 Mount Prospect, Illinois, 60056 | United States

Ph: (860) 752-7474

Ph: (586) 532-1150

Ph: (847) 222-9546

Email: info@designsforhealth.com

Email: torlando@dexaplus.com

Email: PractitionerSupport@DHALab.com

www.designsforhealth.com

www.dexaplus.com

www.DHALab.com

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 will keep discovering. We will keep connecting. We will keep fearlessly advocating for the greater good. 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.

DHA Laboratory is a family owned and operated laboratory most well-known for the kryptopyrrole quantitative urine analysis and functional blood chemistry like the whole blood histamine test, currently working with the top clinicians worldwide to provide reliable biochemical assays. DHA’s core tests have been used in research and treatment of over 100,000 patients with behavioral and emotional conditions ranging from Anxiety & Depression to Autism to Neurodegenerative Disorders.

Diagnostic Solutions Laboratory

DNA Health

DNALife

Booth #2020

Booth #5035

Booth #7042

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

21a Allen Ave., Allenhurst, New Jersey, 07711 | United States

1 Cybercity, Ebene, 72201 | Mauritius

Ph: (877) 485-5336

Ph: (800) 235-9602

Ph: (413) 344-7033

Email: andrea.harris@diagnosticsolutionslab.com

Email: support@trydnahealth.com

Email: hg@nordic-labs.com

www.diagnosticsolutionslab.com

www.trydnahealth.com

www.dnalife.healthcare

Diagnostic Solutions Laboratory is the leader in functional medicine testing using advanced DNA technology. The GI-MAP stool test uses qPCR DNA technology to accurately detect parasites, bacteria, fungi, and more, and provides fully quantitative results for each of the organisms tested. Our newest test, GenomicInsight™, uses the most advanced artificial intelligence powered by Opus 23 Explorer® to provide unique insight into patient genomics.

DNA Health is a healthcare and nutrition technology company. Our solutions support improved health outcomes for patients with inflammatory chronic health conditions by providing novel precision nutrition therapies. Our team has developed a portfolio of innovative clinical nutrition technologies and specialized nutrition products to provide superior solutions. These solutions target the support of chronic health conditions with underlying inflammation associated with aging.

We were pioneers in recognizing the potential of nutrigenomics testing to play a powerful role in precision medicine and the role of practitioner education in supporting this. The dnalife brand was established as a result of this and the number of dnalife trained practitioners using genetic testing continues to grow. Our goal is to make this science readily accessible to every clinical practice, while recognizing the complexities that surround DNA and functional testing.

ANTI-AGING MEDICAL NEWS | WINTER 2021

183

Doctor Multimedia

Doctor’s Data, Inc.

Doctors Supplement Store

Booth #3042, 8047

Booth #8037

Booth #7066

8070 La Jolla Shores Drive, La Jolla, California, 92037 | United States

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

250 Axminister Drive, St. Louis, Missouri, 63026 | United States

Ph: (800) 679-3309

Ph: (630) 377-8139

Ph: (877) 846-7122

Email: info@doctormultimedia.com

Email: info@doctorsdata.com

www.doctormultimedia.com

www.doctorsdata.com

Email: marketing@doctorssupplementstore. com

We’re a team of energetic, young professionals. We’re successful for one simple reason: no one can outwork us. We’re open 24 hours a day, 7 days a week, 365 days a year. We do it out of passion, and because that’s when our clients need help. We have graphic designers, WordPress developers, social media masters, content creators, SEO wizards, IT problem solvers, and marketing gurus, ready to help your medical practice thrive.

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.

Your online supplement dispensary solution! Uncommonly Good Customer Service …because personal service matters! Let us set up and run your personalized dispensary for FREE - Brands you know, electronic patient recommendations and more. Sameday shipping (including international), a flexible Auto Ship program - we do all the work! Call or email for fast, friendly support - you’ll love our full-service attitude and small company feel! It’s our pleasure to know you and serve you well.

DR. FUJI

www.DoctorsSupplementStore.com

Dp Derm LLC

Dr.Fuji / ACIGI

DrSummits

Booth #3081

Booth #3067

Booth #2088

14651 Biscayne Blvd., Ste. 292 North Miami, Florida, 33181 | United States

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

7040 Avenida Encinitas 104-284, Carlsbad, California, 92011 | United States

Ph: (305) 552-0550

Ph: (510) 651-9088

Ph: (619) 436-7750

Email: info@dpderm.com

Email: marketing@drfuji.com

Email: bret@drsummits.com

www.dpderm.com

www.fujichair.com

www.drsummits.com

The Dp Dermaceuticals range from Dermapenworld is the world’s first Meso-Infusion skin care range and are Non-Negotiables during skin needling. The active Meso-Glide combinations have proven protocol outcomes that are endorsed by 10s if thousands of practitioners, for safe, effective treatments without side effects. A treatment protocol would not be complete without an effective homecare regime. The combination of our portable LED system with Dp Dermaceuticals homecare line provides the complete package for the patient.

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.

DrSummits brings together some of the most soughtafter leaders on the front lines of health, wellness, and medicine. DrSummits delivers on-demand access to talks, summits, and more straight from the experts.

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ANTI-AGING MEDICAL NEWS | WINTER 2021

EBM Medical, LLC

eChef MD LLC

Eclipse

Booth #3075

Booth #2062

Booth #8033

722 Spirit of St. Louis Blvd., Ste. A Chesterfield, Missouri, 63005 | United States

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

5916 Stone Creek Drive, Ste. 120 The Colony, Texas, 75056 | United States

Ph: (985) 966-3670

Ph: (727) 648-2791

Ph: (800) 759-6876

Email: zach@EBMmedical.com

Email: info@eChefMD.com

Email: dhensley@eclipsemed.com

www.EBMmedical.com

www.echefmd.net

www.eclipsemed.com

EBM Medical is a virtual dispense medical company that offers innovative solutions for HCP’s to retail cash-only products without the complexity of selling through the office or carrying and managing inventory. Our product line features pharmaceutical-grade, scientifically proven active ingredients specifically formulated for acute & chronic conditions available exclusively through healthcare providers only. EBM Medical also features a proprietary two-way transactional software platform, ETHIC, that generates HCP revenue in “real-time”.

When planning your perfect day, look no further than us. Food lovers beware... you’re in for a tasty surprise. eChefMD is about the best medicine a doctor can prescribe-- A Healthy diet! eChefMD is a privately held meal prep company that prepares healthy meals to compliment diet programs prescribed by physicians and dietitians. Our meals have been carefully prepared to give you the best tasting “healthy” meal options.

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

Emerson Ecologics

Endothelix Inc.

Booth #8074

Booth #5013

Booth #1044

200 Forge Way, Ste. 205 Rockaway, New Jersey, 07866 | United States

1230 Elm Street, Ste. 301 Manchester, New Hampshire, 03101 | United States

7676 Hillmont Street, Ste.290Z Houston, Texas, 77040 | United States

Ph: (888) 903-2673 Email: CustomerService@electroCore.com www.gammaCore.com electroCore, Inc. is a commercial stage bioelectronic medicine company dedicated to improving patient outcomes through its non-invasive vagus nerve stimulation therapy. gammaCore (nVNS) is the first non-invasive, hand-held device applied at the neck to treat migraine and cluster headache through the utilization of a mild electrical stimulation to the vagus nerve. Designed as a portable, easy-to-use technology, gammaCore can be self-administered by patients, as needed, without the potential side effects associated with commonly prescribed drugs.

Ph: (603) 801-5185 Email: charmon@emersonecologics.com www.emersonecologics.com For 40 years, Emerson Ecologics has been a vital link between Functional healthcare practitioners and their patients. We are your complete dispensary solution, providing in-office or electronic dispensing through Wellevate, the only virtual dispensary with a patient mobile app. We are committed to providing access to the highest quality professional-grade supplements, clinical education resources, safe patient protocols, and innovative technological solutions that empower healthcare professionals to succeed in improving patient lives.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (650) 262-7084 Email: contact@endothelix.com www.endothelix.com Endothelix Inc. is the maker of VENDFYS; the first and only fully-automated noninvasive office-based vascular reactivity and endothelial function testing device in the market that is reimbursed by Medicare and is also used in ainti-aging, wellness and preventive care clinics. It can be purchased or leased. For more info visit www. endothelix.com, call 650-262-7084, text 650-2627084 or email contact@endothelix.com

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EndyMed Medical Inc

Eniva Health Corp

EPI / Alpha-Stim

Booth #5071

Booth #9039

Booth #3043

4400 Route 9 South, Freehold, New Jersey, 07728 | United States

2700 Campus Drive, Plymouth, Indiana, 55441 | United States

2201 Garrett Morris Pkwy, Mineral Wells, Texas, 76088 | United States

Ph: (646) 522-9332

Ph: (260) 615-8057

Ph: (940) 328-0788

Email: info@endymed.com

Email: rswedzinsk@aol.com

Email: alpha-stim@epii.com

www.endymed.com

www.eniva.com

www.alpha-stim.com

ENDYMED is dedicated to offering the most state-ofthe-art medical aesthetic skin care treatments available in the market today. ENDYMED’s line of aesthetic devices provide professional grade RF skin tightening, wrinkle reduction and body contouring treatments that are effective, painless, and completely safe with little to no downtime.

Eniva is a nutritional research and development company specializing in liquid nutraceuticals with emphasis on the minerals. We were founded in May of 1998 in the state of Minnesota with headquarters in Plymouth, MN. 90% of our nutraceuticals are liquid for ease of cell assimilation and use by the body. We develop, manufacture and distribute our products world wide and have a robust contract manufacturing segment of business for those seeking top drawer quality.

Alpha-Stim is an FDA cleared, handheld medical device that has been proven time and again to effectively treat anxiety, insomnia, depression, and pain. Alpha-Stim uses cranial electrotherapy stimulation (CES), delivered through a patented waveform via two earclip electrodes, along with microcurrent electrical therapy (MET) to treat pain at the source via two handheld Smart Probes. Unlike medications, Alpha-Stim has no risk of addiction or lasting side effects.

Epimorphy, LLC

Episciences Inc., DBA Epionce

EVOSKIN

Booth #7097

Booth #3066

Booth #4047

14762 Bentley Circle, Tustin, California, 92780 | United States

10211 W. Emerald Street, Boise, Idaho, 83704 | United States

6 Lincoln Knoll Lane, Ste. 100A lowell, Massachusetts, 01803 | United States

Ph: (833) 693-6243

Ph: (866) 374-6623

Ph: (786) 717-3883

Email: info@myDNAge.com

Email: info@epionce.com

Email: info@evoskin.com

www.mydnage.com

www.epionce.com

WWW.EVOSKIN.COM

The myDNAge® test is based on Dr. Steve Horvath’s Epigenetic Aging Clock. Our test is able to precisely determine biological age, as opposed to chronological age, using only a small amount of blood or urine. We utilize top-of-the-line, Next Generation Sequencing technology to scan over 2,000 biomarkers in the human genome that are subject to epigenetic changes in order to accurately determine your biological age.

Developed by a dermatologist, physician dispensed Epionce is an innovative skin wellness line designed to optimize the health of the skin by working with its own protective and reparative systems. Multiple independent clinical studies have proven the products effective in helping to reverse and prevent visible skin aging and symptoms of skin diseases. Simple, effective and proven, Epionce is the ideal cosmeceutical line for anyone who desires optimally healthy, beautiful skin.

Evoskin sources high-end aesthetic medical devices from innovative companies around the world for U.S. medical providers, including plastic surgeons, cosmetic physicians, dermatologists, and medical spas. Our products are hand-selected directly by us for their quality, level of innovation, and ROI for medical providers. We are committed to provide the best customer service and warranties for our products.

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Excite Medical

ExocelBio

Forum Health

Booth #5032

Booth #4043

Booth #7026

4710 Eisenhower Blvd., Ste. B-10 Tampa, Florida, 33634 | United States

3978 Sorrento Valley Blvd., Ste.310 San Diego, California, 92121 | United States

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

Ph: (813) 210-1000

Ph: (858) 255-4499

Ph: (855) 976-5578

Email: sm@excitemedical.com

Email: info@exocelbio.com

Email: info@forumhealth.com

www.excitemedical.com

www.exocelbio.com

www.forumhealth.com

Excite Medical is the manufacturer of the DRX9000, the most advanced non-surgical spinal decompression table in the world.

EXOCEL BIO is a biotechnology company focused on the research and development of cell based technology. The EXOVEX suite of products are designed to be applied topically in conjunction with facial, microneedling, and energy based aesthetic devices to accelerate recovery time and enhance treatment results by working synergistically to improve the appearance of discoloration, tone, texture, and fine lines.

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

Franz Skincare

GATC Health Corp

Booth #1027

Booth #6074

Booth #2054

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

6601 NW 26th Way, Boca Raton, Florida, 33496 | United States

2030 Main Street, Ste. 660 Irvine, California, 92614 | United States

Ph: (972) 598-9000

Ph: (929) 990-6416

Ph: (833) 333-4282

Email: info@fotona.org

Email: hello@franzskincareusa.com

Email: info@gatchealth.com

www.fotona.com

www.franzskincareusa.com.

www.gatchealth.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.

At FRANZ SKINCARE, we are committed to our promise to deliver flawless skin through scientific innovation. With more than 30 years of experience in the skincare industry, and a lifetime commitment to centuries old approaches to natural healing through high quality ingredients and tried and true methods, we pride ourselves on delivering results, especially when it comes to ensuring that you achieve all of your skincare goals.

GATC Health delivers personalized, predictive health insights by analyzing billions of biological data points for every individual. Our artificial intelligence is purpose-built to “think” like interactive human biology, allowing us to deliver solutions for disease detection and prediction, intervention and treatment guidance, and new drug discovery faster and more accurately than our competitors.

ANTI-AGING MEDICAL NEWS | WINTER 2021

187

GeneSavvy

Genova Diagnostics

Global Life Rejuvenation

Booth #8097

Booth #5021

Booth #5039

7900 SE 28th Street, Ste. 412 Mercer Island, Washington, 98040 | United States

63 Zillicoa Street, Asheville, North Carolina, 28801 | United States

168 East Main Street, Denville, New Jersey, 07834 | United States

Ph: (425) 686-0000

Ph: (828) 210-7362

Email: info@genesavvy.com

Email: KVandenberg@gdx.net

www.GeneSavvy.com

www.gdx.net

GeneSavvy was built for functional health practitioners, the most fierce warrior moms, and the most advanced biohacking geeks who want a more advanced genetic testing and reporting platform for true precision medicine.

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.

Ph: (973) 627-1750 Email: demetriaglaab@denvillemedical.com www.globalliferejuvenation.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.

HAIR SCIENCE DEVELOPERS OF ADVANCED HAIR LOSS FORMULAS

Great Plains Laboratory

GX Sciences

Hair Science Corporation

Booth #5038

Booth #3060

Booth #9021

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

4150 Freidrich Lane, Ste. H Austin, Texas, 78744 | United States

608 Point Vista Drive, Aledo, Texas, 76008 | United States

Ph: (913) 341-8949

Ph: (844) 258-5564

Ph: (951) 295-8087

Email: sales@gpl4u.com

Email: info@gxsciences.com

Email: dgrief@gmail.com

www.greatplainslaboratory.com

www.GXSciences.com

www.HairScienceCorp.com

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.

GX Sciences is an advanced genetic and biomarker testing laboratory that empowers providers with the most comprehensive Nutrigenomic and Pharmacogenomic testing and interpretation platform available. Designed by and for medical professionals: providers validate patients’ specific nutritional needs, laboratory recommendations, lifestyle recommendations, and health precautions based on individual DNA and biomarker findings; typically within 5-to-7 business days. We offer standard, white-labeled, and custom plans for easy-to-use, scientificallyvalidated provider reports to provide health, recovery, and personalized medicine.

Hair Science is a research and development company dedicated to advancing products that improve hair and scalp health. Come visit our booth to learn about our prescription-based hair loss treatments, Formulas 82M, 82F, and 82D and our over-the-counter hair loss shampoo, Formula 82S. Our corporate compounding pharmacy is ANAZAOHEALTH.

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Hallandale Pharmacy

Hawaiian Moon

Hopkinton Drug Compounding

Booth #6055

Booth #2061, 7071

Booth #6095

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

1226 Turner Street, Clearwater, Florida, 33756 | United States

Ph: (954) 455-3822

Ph: (888) 256-3276

52 Main Street, Hopkinton, Massachusetts, 01748 | United States

Email: jmaman@hallandalerx.com

Email: customerservice@hmaloe.com

www.Hallandalerx.com

www.aloecream.biz

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.

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.

Hormone Therapy Centers of America

Ideal Protein of America

Booth #6071

Booth #9025

7784 Constance Ave., Frisco, Texas, 75034 | United States

3135 SR 580, Ste. 5 Safety Harbor, Florida, 34695 | United States

Ph: (469) 214-0786

Ph: (866) 314-4447

Email: rhettrichardson@ht-ca.com

Email: info@idealprotein.com

www.HT-CA.com

www.idealprotein.com/healthcare-providers

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.

Ideal Protein is a medically-developed weight loss protocol designed to optimize fat loss through nutritional ketosis. This low-carb, low-fat, adequateprotein protocol helps reverse the imbalance of insulin that occurs with the typical Western diet while protecting muscle mass. Personal coaches help patients lose weight and keep it off through healthy habits.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (508) 435-4441 Email: pharmacy@rxandhealth.com www.rxandhealth.com Hopkinton Drug Compounding prepares a wide range of medications including compounds for Functional/Integrative, Lyme/Mold, Environmental, Detoxification, HRT, Endocrinology and more. One of our specializations is working with practitioners who treat Lyme, mold & environmental illnesses. Some of the compounded medications we prepare for these conditions include but are not limited to; LDN, VIP, EDTA/Silver, BEG, whISOBAX, Cholestyramine, Synapsin, Liposomal. Antibiotics, Methylene Blue, and Disulfiram.

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FOR BETTER PATIENT OUTCOMES, START WITH THEIR GUT.

BOOTH #9046 928.421.2241 INFO@COLOSTRUMTHERAPY.COM

and COVID-19 WHAT ARE THE UNUSUAL CONSEQUENCES OF COVID-19

New onset of health complications correlate to COVID-19 particularly in younger patients under the age of 50.

Unusual Health Consequences Following COVID-19 May Include: Unexpected death in younger patients due to blood clots, heart attacks and strokes Severe pneumonia followed by a cytokine storm due to an overreactive immune response Severe endothelial damage (lining of the artery) Endotheliopathy (inflammation of the artery lining)

PULS Cardiac Test Clinical Utility and COVID-19 Patients

Identifies Individuals with Clinically Significant Residual Arterial Inflammation Due To COVID-19 Infection

HOW PULS CARDIAC TEST CAN HELP PATIENTS AFTER COVID-19

It is important to discover how COVID-19 affects the patient’s cardiovascular system during and after COVID-19 infection.

2 Identifying and quantifying endothelial injury after COVID-19 infection is essential to predict or prevent heart attacks, strokes and blood clots.

The PULS Cardiac Test measures signals from blood vessels’ injury, providing early intervention and prevention for improved patient outcomes.

Evaluates the Severity and Provides Guidance to Mitigate the Risk of Blood Clots Heart Attacks Strokes

DETECTION • PREVENTION • MA NAGE M E NT

Immunosciences Lab, Inc.

ImmunoStim Therapeutics

ImprimisRx

Booth #1035

Booth #9020

Booth #8064

822 S. Robertson Blvd., Ste.312 Los Angeles, California, 90035 | United States

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

12264 El Camino Road, Ste. 350 San Diego, California, 92130 | United States

Ph: (310) 657-1077

Ph: (832) 814-2185

Ph: (844) 446-6979

Email: immunsci@gmail.com

Email: care@immunostim.io

Email: info@imprimisrx.com

www.Immunoscienceslab.com

www.immunostim.io

www.imprimisrx.com

Immunosciences Lab., Inc. (ISL) is a state-of-the-art clinical reference and research laboratory, a leader and innovator in the field of molecular medicine. Licensed in California and CAP-approved, ISL specializes in utilizing the most highly sensitive and accurate testing methods for detecting lyme disease, autoimmunity, gluten sensitivity and viral infection. ISL’s unique tests have resulted in several patents and are the product of over 4 decades of meticulous training, painstaking research, and extensive clinical laboratory experience.

Based in Cancun, ImmunoStim Therapeutics provides a revolutionary cancer immunotherapy. Utilizing a novel technique of educating a patient’s dendritic cells, our therapy is unique in creating a full immune response and immunological memory. ImmunoStim’s therapy has resulted in successful human treatment and is currently being evaluated in 2 FDA clinical trials. With a dedicated staff in Cancun and the US, the ImmunoStim Team has worked together for years on a variety of treatment modalities.

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!

InBody

Innovation Compounding

Innovations Group Inc.

Booth #9032

Booth #5047

Booth #1043

13850 Cerritos Corporate Drive, Unit C Cerritos, California, 90703 | United States

6095 Pine Mountain Road NW, Ste 108 Kennesaw, Georgia, 30152 | United States

669 West 900 North, North Salt Lake, Utah, 84054 | United States

Ph: (562) 306-5960

Ph: (800) 547-1399 Ext 230

Ph: (888) 222-2956

Email: convention@inbody.com

Email: shodges@innovationcompounding.com

Email: rcampbell@mqrx.com

www.inbodyusa.com

www.innovationcompounding.com

www.medquest.com

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.

Innovation Compounding is a compounding pharmacy that supports over 7,000 prescribers, 70,000+ patients and annually provides 100,000 prescriptions across the nation. We commit to individualized pharmaceutical care through being Relentless in our drive for personalized medicine, Compassionate toward our patients and doctors, as well as being a Wellness Advocate for our patients’ lives and state of well being.

We are a national compound and full-service retail pharmacy licensed in all 50 states. We specialize in customized medications as we focus on meeting the individual needs of providers and patients “Because Compounding Should be About YOU!”

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ANTI-AGING MEDICAL NEWS | WINTER 2021

INTEGRATIVE

PRP

Integrative Peptides

IntegrativePRP

IQ Technologies Inc. & Irest

Booth #3097

Booth #9023

Booth #2091

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

953 Franklin Ave., Garden City, New York, 11530 | United States

4731 W/Post Road, Ste.130 Las Vegas, Nevada, 891187 | United States

Ph: (310) 955-6278

Ph: (518) 648-3388

Ph: (702) 260-8829

Email: lori@integrativepeptides.com

Email: contact@integrativeprp.com

Email: info@iqskyline.com

www.integrativepeptides.com

www.integrativeprp.com

www.iqskyline.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.

The IntegrativePRP system is one of the only dualspin systems on the market that also has FDA 510(k) clearance. Not only can the IntegrativePRP system provide PurePRP with a consistent concentration of 7-10X baseline, but it can also perform six different processes including adipose, bone marrow, & PRF and all with only a 7-minute spin. IntegrativePRP provides the necessary support to ensure that you can focus on your patients. Contact our office to get started!

IQ Technologies Inc. has been the top distribution company in the health and wellness industry for over ten years. Within that time the company has mastered the capability of bringing forth the very best products time and time again to satisfied customers worldwide. With this in mind, IQ. Technologies would like to introduce to you the most innovative and technically advanced massage chair product in the Health and Wellness market, the IQ Skyline Massage Chairs.

Jigsaw Health

KBMO Diagnostics

Kimera Labs, Inc.

Booth #2044

Booth #3027

Booth #6091

9035 E. Pima Center Pkwy, Ste. 3 Scottsdale, Arizona, 85258 | United States

4 Business Way, Hopedale, Massachusetts, 02332 | United States

2810 N Commerce Pkwy, Miramar, Florida, 33025 | United States

Ph: (866) 601-5800 Email: help@jigsawhealth.com www.JigsawHealth.com Since 2005, Jigsaw Health (aka. “The Magnesium People”) has been developing the highest-quality nutritional supplements with a focus on Magnesium featuring Sustained Release Technology (w/SRT®), which controls the release of active ingredients so absorption can happen over time. MagSRT® by Jigsaw Health is America’s #1 Time Release Magnesium® with over 1,000 five-star Amazon reviews (five times more than the second-closest brand) and clinically shown to increase Magnesium in the body.*

Ph: (617) 933-8130 Email: jwhite@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.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (305) 454-7836 Email: brett@kimeralabs.com www.kimeralabs.com Kimera Labs Inc. is a biotechnology company that develops perinatal exosome products for research and therapeutic purposes. Since 2012, Kimera Labs has invested significant resources into exosome isolation and therapy protocols. As a regenerative medicine focused biotechnology company, Kimera Labs develops therapies that heal from within. By providing regenerative cellular signals under the control of messenger and miRNA, we believe it is possible to initiate the healing processes that can benefit patients of any age.

193

Kyani

L-Nutra

Booth #7062

Booth #4007

880 W 800 N, Mapleton, Utah, 84664 | United States

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

Ph: (801) 717-7962

Ph: (310) 775-3655

Email: kaylenecandrew@gmail.com

Email: aperez@l-nutra.com

www.eastbaywellness.kyani.com

www.l-nutra.com

Kyani is a health and wellness company which prides itself in “Wellness Simplified”. Our focus is quality over quantity. We offer whole food, full-spectrum, liquid nutrition supplements. It’s like juicing in a pouch! The ingredients are cold pressed naturally sourced from wild grown foods to ensure the most natural and bioavailable form of vitamins and minerals for daily consumption. Experience the power of Nitro Nutrition! Our mission is to bring hope through wellness and opportunity.

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.

LeadingResponse

LightStim

Booth #2094

Booth #6086

Booth #3046

6 Sunset Way, Ste. 108 Henderson, Nevada, 89131 | United States

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

16552 Von Karman Ave., Irvine, California, 92606 | United States

Ph: (800) 330-4262

Ph: (866) 616-3747

Ph: (949) 502-4088

Email: ExpandWithUs@LasVegasHEALS.org

Email: johnm@leadingresponse.com

Email: tracey@lightstim.com

www.Lasvegasheals.org

www.leadingresponse.com

www.LightStim.com

Consider expanding or relocating your practice to the most dynamic city in the World, Las Vegas, Nevada. Representatives from Las Vegas HEALS (Health, Education, Advocacy, and Leadership in Southern Nevada) are on-site to share the benefits of Las Vegas where Practice Makes Perfect. Expand your practice to a global market place serving 2.4 million residents and 43 million annual visitors. Learn about tax incentives and the financial benefits of practicing in our dynamic city.

LeadingResponse, the premier provider of customer acquisition solutions for the financial, legal, elective medical, and senior living markets, understands the consumer journey that leads to a meaningful engagement with our professional clients. LeadingResponse is uniquely qualified to help our clients grow and scale their organizations. Via our proven multi-channel solutions, online and offline, we consistently drive over 170,000 consumers/per month to our clients for scheduled appointments.

Throughout the past two decades LightStim has earned a reputation as a trusted manufacturer of the highest quality LED technology used for low level light therapy (LLLT) in the world. FDA cleared and designed to treat multiple conditions, all LightStim devices are manufactured in the USA at our corporate headquarters. In house manufacturing ensures that attention to detail, quality control, and rigorous product testing practices are adhered to in the production of every device.

Las Vegas HEALS

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ANTI-AGING MEDICAL NEWS | WINTER 2021

Liquivida

LivOn Labs

Booth #3063

Booth #6067

3708 Ocean Blvd., Ft. Lauderdale, Florida, 33308 | United States

2654 W. Horizon Ridge Pkwy, Ste. B5-108 Henderson, Nevada, 89052 | United States

Ph: (954) 398-3889 Email: jeff@liquividalounge.com www.liquividalounge.com Liquivida is a full-service wellness center that’s helping people across America to replenish, rehydrate, and revitalize through vitamin IV therapy, medical aesthetics, and innovative weight loss solutions. We believe that sustainable health and wellness can be achieved by knowing the body and caring for it through targeted nutrition, while combining preventative and functional medicine. Our mission is to help people feel younger, more energetic, and in control of their health.

Ph: (866) 790-2107 Email: rachael@livonlabs.com www.LivOnLabs.com LivOn Labs is the first dietary supplement company to utilize liposomal encapsulation technology, releasing the original liposomal Vitamin C in 2004. Our patented Lypo-Spheric® technique encapsulates nutrients — which are ordinarily difficult to absorb when taken orally —in double-layer spheres (liposomes) that pass through the intestinal wall and into the bloodstream. Based in Las Vegas, the family-run company now has distribution in more than 70 countries. Sample our supplements at booth 6067.

Longevity Labs

McGuff Company Inc.

Med Results

Booth #6060

Booth #1056

Booth #8048

1550 Wewatta Street, Denver, Colorado, 80202 | United States

3524 West Lake Center Drive, Santa Ana, California, 92704 | United States

412 W Broadway, Ste. 303 Glendale, California, 91204 | United States

Ph: (740) 817-0523

Ph: (800) 854-7220

Ph: (424) 521-2460

Email: don.moxley@spermidinelife.com

Email: Trevorm@mcguff.com

Email: katerina@med-results.com

www.spermidinelife.us

www.mcguff.com

www.med-results.com

Longevity Labs is dedicated to helping people get more life out of their years. At the forefront of advances to improve human health and lifespan, Longevity Labs works with university partners to research, develop and test products that promote cellular replenishment and renewal. Longevity Labs introduced its first all-natural dietary supplement, spermidineLIFE®, to the European market in 2019 and to the U.S. market in 2020.

McGuff Medical Products is a distributor of more than 4,000 products including; oral and injectable pharmaceuticals, medical devices, IV solutions, IV therapy, exam room supplies, physician office supplies and the only F.D.A. approved Ascorbic Acid Injection (Ascor).

At Med Results, we are dedicated to providing innovative solutions in the aesthetic industry by bringing high-class products and technologies to your fingertips. We are the manufacturers of new technologies like Plexr plasma, Italian-made HDpdo threads, and the Uplifting creams. Our amazing team at Med Results is committed to bring the technologies of the future into your hands today. We promise to upgrade your perception of results, because we believe Results Matter!

ANTI-AGING MEDICAL NEWS | WINTER 2021

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Medical Wave

Medicore, Co. Ltd.

Meditime Co. Ltd.

Booth #4067

Booth #7086

Booth #7049

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

D Dong #827~828, Hangang Misa2nd, Hyundai Knowledge Industrial Center, 520 Hanam-Sl, Kyonggi-do, 12925 | Republic of Korea

605 Medical Device Complex Center 200 Gieopdosi-ro, Jijeongmyeon, Kangwon-do, 26354 | Republic of Korea

Ph: (82)(31) 8027-7070

Ph: (82)(31) 777-3900

Email: bkyoo@medi-core.com

Email: paulkammeditimeusa@gmail.com

www.medi-core.com

www.meditimekorea.com

Medicore is established in 1999 as a medical device manufacturer of measuring the autonomic nerve system and plethysmography by using a finger sensor. By using Heart Rate Variability and Arterial Blood Circulation technology, it can prevent the cardiovascular disease and cardiac health at the first step and also it is possible to monitor the overall health caused by the mental stress and depression. All international certificates such as FDA and CE are available in US.

Meditime is a global distributor of advanced medical & aesthetic solutions in the competitive heath & skincare market since 1993. We specialize in high-end laser, ultrasound, RF, IPL systems, and other newest equipment for skin care and medical treatments that incorporate up-to-date trends and technology. We value a level of innovation, expertise, and customer understanding, and we promise to continuously provide our clients with the highest quality of products and excellent customer service.

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.

Mp Z

ERO

Advanced Sterilization

196

MERCHANT PREFERRED ZERO

Medizap

Merchant Preferred Zero

Booth #4096

Booth #4046

600 B Street, Ste. 300 San Diego, California, 92101 | United States

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

Ph: (775) 386-6677

Ph: (540) 484-3429

Email: customerservice@medizap.co

Email: dgalbraith@merchantpreferred.com

www.medizap.co

www.mpzero.net

MediZap is North America’s premier Turn-key provider of E-Beam Sterilization Services for all 503a, 503b, and small pharma. Our all-inclusive 4 Pillar Service includes E-beam Sterilization, Packaging Solutions, Compliance and Regulatory. MediZap’s offers exclusive line capacity, group pricing and shared industry knowledge. USP 797 Guidelines require Terminal Sterilization and E-Beam is the most advanced and superior solution. Ensure 10-6 sterility assurance and elevate your product offerings through our technology and best-in-class service.

Merchant Preferred Zero lets the business owner stop paying merchant processing 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.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Merit Pharmaceutical

Metagenics

Microbiome Labs

Booth #4037

Booth #6032

Booth #3007

2611 N. San Fernando Road, Los Angeles, California, 90065 | United States

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

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

Ph: (323) 227-4831

Ph: (800) 692-9400

Ph: (904) 940-2208

Email: solutions@meritpharm.com

Email: Info.customerservice@metagenics.com

Email: info@microbiomelabs.com

www.meritpharm.com

www.metagenics.com

www.microbiomelabs.com

Offering IV Infusion from Merit? Getting your med/ surg/pharma from us? Your colleagues are and they have higher profits. Merit supplies Anti Aging/ Aesthetic/Integrative practitioners better prices on the products you use. Stop by our booth and learn why successful clinics partner with Merit. IV Therapy Nutrition/Hydration, Weight Loss, Hormones, IV solutions, PRP products, exam/surgical supplies and more. Merit offers pharmaceuticals (2, 3, 3N, 4), and related medical products. www.meritpharm.com or (800) 69-MERIT!

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.

MINT™ (HansBiomed USA Inc.)

Mito Q Ltd.

Modern Doc Media

Booth #3079

Booth #5061

Booth #1030

10350 Heritage Park Drive, Ste. 201 Santa Fe Springs, California, 90670 | United States

139 Pakenham Street West, Ground Floor Auckland, Auckland, 10101 | New Zealand

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

Ph: (760) 822-4833

Ph: (866) 509-5054

Email: caprice@mitoq.com

Email: info@moderndocmedia.com

www.MitoQ.com

www.ModernDocMedia.com

MitoQ is a positively-charged antioxidant health brand, created with word-first, multi-patented biotechnology in New Zealand.

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.

Minimally Invasive Nonsurgical Thread

Ph: (562) 777-7043 Email: hansusa@hansbiomed.com www.mintpdo.com The award-winning global brand, MINT™ offers the most robust PDO threads on the market. In 2020, it became the only medical device of its kind with dual FDA clearances. MINT™ is backed by clinical studies for its efficacy & manufactured through an innovative patented technology to offer a broad product portfolio. HansBiomed USA Inc., makers of MINT™, is committed to delivering safe and innovative treatments.

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Mushroom Science

Neurobiologix Nutrition

Nu Xtrax

Booth #2065

Booth #6070

Booth #9026

1025 Conger Street, Ste. 6 Eugene, Oregon, 97402 | United States

13376 N. Highway 183, Ste. 126 Austin, Texas, 78750 | United States

1798 Melson Ln Studio X, Westville, Florida, 32464 | United States

Ph: (888) 283-6583

Ph: (866) 500-5388

Ph: (562) 244-8948

Email: sales@mushroomscience.com

Email: mk@neurobiologix.com

Email: bret@capaproductions.com

www.jhspro.com

www.DrNeurobiologix.com

www.nuxtrax.com/bret

JHS Natural Products, located in Eugene, Oregon has been a pioneer in the field and a premier mushroom supplement company since 1994. We provide various mushroom supplements that have been developed with a commitment to science and customer education. You can also check out our retail line of products, Mushroom Science at www.mushroomscience.com.

What makes Neurobiologix different? Dr. Kendal Stewart MD, our Chief Medical Officer, is clinically known for treating complex medical cases. Besides being a practitioner, he is a scientist, biochemist and researcher. When he formulates a supplement, it is based on combinations of therapeutic measurements of key nutrients. Nutrigenomic testing has allowed us to create genetically guided supplementation that’s geared towards a patient’s genetic make up. Neurobiologix offers custom designed nutritional formulas manufactured in the US.

An exclusive new science protection plant extract technology product with uncontaminated premium food extracts designed and targeted for superior telomere support to promote biological cellular reverse aging possibilities.

NuMedica

NuSkin

Nutrafol

Booth #7032

Booth #2055

Booth #1049

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

2251 N Rampart Blvd., 353 Las Vegas, Nevada, 89128 | United States

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

Ph: (800) 869-8100

Ph: (702) 363-5343

Ph: (888) 454-3320

Email: nicole.gemper@numedica.com

Email: russkarlen@icloud.com

Email: partners@nutrafol.com

www.numedica.com

www.nuskinusa.com

www.Nutrafol.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.

AgeLOC Youth delivers an all-encompassing anti-aging protection. It promotes a wide range of functions from your heart to your brain, your bones to your metabolism. A variety of aging aggressors cause us to age, but our aging defense mechansims help keep us young. Now you can hold onto your youth so you can keep doing what you love throughout your life.

Nutrafol is the category creator of hair wellness, providing an innovative, science-backed approach to hair health in men and women. Nutrafol’s clinically effective 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 whole body health from within. Nutrafol is currently recommended by over 3,000 healthcare providers and hair professionals for trusted, reliable results.

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Officite

Olympia Pharmacy

Omega Diagnostics Ltd

Booth #2035

Booth #7033

Booth #8032

3010 Highland Parkway, Ste. 200 Downers Grove, Illinois, 60515 | United States

6700 Conroy Road, Ste. 155 Orlando, Florida, 32835 | United States

Ph: (888) 606-8943

Ph: (407) 673-2222

Henry Crabb Road, Littleport Cambridgeshire, England, CB6 1SE | United Kingdom

Email: marketing@officite.com

Email: inquiries@olympiapharmacy.com

www.officite.com

www.olympiapharmacy.com

Officite is a leading provider of website and digital marketing solutions for over 8,000 healthcare practices. Officite provides professional website design, robust marketing programs, and telemedicine solutions to help practices connect to patients. Every website leverages current design techniques and coded to work great on any device, ensuring new patients and search engines will find your practice. Visit Officite.com and discover how our solutions will help you attract new patients.

At Olympia Compounding Pharmacy, we understand the importance as well as the necessity of offering both 503A and 503B compounding pharmacy capabilities. Each of these designations of compounders plays a crucial role in filling today’s compounding landscape. With our two separate, stateof-the-art facilities, Olympia supports both patientspecific and office-use needs across the U.S., enabling our customers to comply with all national and state regulatory requirements while having the convenience of a single-source pharmacy partner.

Ortho Molecular Products

OxyHealth

PatientNow

Booth #4027

Booth #3021

Booth #7021

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

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

115 Invernes Drive E, Ste 100 Englewood, Colorado, 80112 | United States

Ph: (815) 206-6541 Email: l.grendel@ompimail.com www.orthomolecularproducts.com 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.

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

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (00)(44)(0)1353-863279 Email: jane.mccormack@omegadiagnostics.co.uk www.camnutri.com Omega is an international diagnostics testing business that is passionate about improving lives around the world by accurately informing health decisions. Collaborating with laboratories and partner organisations, we provide world-leading food sensitivity tests in over 60 countries. We passionately believe in promoting a more personalised approach to health. Using pioneering diagnostic technologies, we enable healthcare professionals and their patients to accurately identify lifestyle and dietary changes that can significantly improve long-term health and well-being.

Ph: (407) 793-9254 Email: aneff@patientnow.com www.patientnow.com PatientNow provides leading EMR, practice management, CRM, digital marketing & photo management solutions to help launch, grow, and scale the modern anti-aging practice.

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PedsPal Group Purchasing

Pellecome LLC

Pharmacy Solutions

Booth #3091

Booth #8060

Booth #7084

801 7th Ave., Ft. Worth, Texas, 76104 | United States

111 Canfield Ave., Ste. A-7 Randolph, New Jersey, 07869 | United States

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

Ph: (877) 923-2233

Ph: (973) 714-9136

Ph: (817) 274-0050

Email: debbie.standridge@cookchildrens.org

Email: melissa@pellecome.com

Email: Kim@Rxcompound.com

www.pedspal.org

www.pellecome.com

www.RxCompound.com

Save on your medical supplies and equipment by joining our group purchasing organization. Membership is free, please ask us for a quote.

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 43 states specializing in: • Formulas for Hair growth • Men’s health and wellness • Women’s health and wellness • Medical weight loss • 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.

Physician Compounding Alliance

Physicians Longevity

Podcasting & Videos Made Easy

Booth #8038

Booth #2037

Booth #2042

2690 White Rock Lane, Colorado Springs, Colorado, 80904 | United States

555 Maple Ave., Carpinteria, California, 93013 | United States

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

Ph: (805) 796-6990

Ph: (218) 705-7893

Email: hello@physicianslongevity.com

Email: shawnsmith@themobilepro.net

www.physicianslongevity.com

www.podcastingandvideosmadeeasy.com

Physicians Longevity believes that building good lifestyle habits is essential for a long and healthy life. We offer only the highest quality longevity supplements available, because the Longevity lifestyle is science-backed supplementation. Physicians Longevity is continually working to expand our product line with the most effective longevity supplements. Physicians Longevity is a subsidiary of a company that has been serving the nutritional supplement needs of people since 1988.

Podcasting and Videos Made Easy exists to train you and your staff to create pro-quality marketing content designed to 10X the sales of your services - 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 doctors to exponentially increase their sales, by marketing ALL of their services to their existing patient base, and new patients alike. Harness the power of online marketing.

Ph: (719) 201-9268 Email: twbader@aol.com PhysicianCompoundingAlliance Office Dispensed Compounded Therapies. Physician Compounding Alliance makes it possible for your practice to dispense compounded drug therapies directly from your office to your patients at their point-of-care, improving patient compliance and convenience while increasing your practice’s revenues. Available dosage forms include, but are not limited to: creams, oral/SL/SR tablets, capsules, pellets, suppositories, and troches.

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TM ®

Power2Practice

Precheck Health Services

Precision Analytical Inc.

Booth #7028

Booth #3061

Booth #7027

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

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

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

Ph: (800) 590-7459

Ph: (305) 203-4711

Ph: (503) 687-2050

Email: sales@power2practice.com

Email: Support@precheckhealth.com

Email: nreed@dutchtest.com

www.power2practice.com

www.precheckhealth.com

www.dutchtest.com

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.

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

Precision Analytical’s 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 three peer-reviewed studies proving the effectiveness of our 24-hour, four spot, dried urine testing as an alternative to serum (blood) or saliva for monitoring a variety of hormone therapy applications.

C A R D I AC T E ST

Precision Compounding Pharmacy

Precision Point Diagnostics

Predictive Health Diagnostics Co.

Booth #9016

Booth #3049

Booth #4042

2640 Merrick Road, Bellmore, New York, 11710 | United States

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

13885 Alton Parkway, Ste. B Irvine, California, 92618 | United States

Ph: (516) 833-6262 Ext 2

Ph: (678) 736-6374

Ph: (866) 299-8998

Email: compounding@precisionpharmacy.net

Email: info@precisionpointdiagnostics.com

Email: info@pulstest.com

www.precisioncompoundingpharmacy.net

www.precisionpointdiagnostics.com

www.pulstest.com

Patients need to be recognized as individuals with different genetic makeups. Prescription regimens need to be viewed as unique protocols as specific as a fingerprint. 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.

The PULS Cardiac Test™ identifies the vulnerable patient who is missed by current conventional tests to facilitate timely intervention and prevention that improves cardiac patient care. The PULS Cardiac Test measures inflammatory biomarker signals that are secreted directly by the arteries injured by free radicals, infections, or toxins. Integrating all this information into a 5-year CVD risk score predicts the risk of a heart attack at an optimal time to improve outcomes.

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Prestige Products Direct

Prevencio, Inc.

ProCBD by CV Sciences

Booth #9051

Booth #1047

Booth #7075

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

6424 Lake Washington Lake, NE #13, Kirkland, Washington, 98033 | United States

10070 Barnes Canyon Road, San Diego, California, 92121 | United States

Ph: (800) 325-7734 Ext 2529

Ph: (425) 576-1200

Ph: (619) 876-4326

Email: triaddirect@gmail.com

Email: cpeters@prevenciomed.com

Email: kamila.castaneda@cvsciences.com

www.triadaer.com

www.prevenciomed.com

www.pluscbdoil.com/ProCBDinfo.html

Triad Aer. Professional Air Purification system

Prevencio offers highly accurate, novel AI-driven HART blood tests for cardiovascular disease developed in partnership with Massachusetts General Hospital (MGH). HART tests use Machine Learning + Multiple Proteins + Proprietary Algorithms to surpass accuracy of currently available cardiovascular tests. Two tests available for patients: • HART CVE™ – blood test for 1-year risk of heart attack, stroke or cardiac death; • HART CADhs™ – blood test for obstructive coronary artery disease diagnosis.

CV Sciences creates practical health solutions to better promote everyday wellness. As a leader in the CBD industry and the first to bring hempderived CBD products to the consumer market, CV Sciences supports practitioners with comprehensive training, industry-best partnership programs, and by spearheading legislation for a robust legal CBD market. Brands include ProCBD, PlusCBD, and its first-ever non-CBD formulas in the CV Immunity line.

Prodome Sciences

Professional Health Products

Progressive Medical Solutions

Booth #4078

Booth #7070

Booth #5037

40880 County Center Drive, Ste. R. Temecula, California, 92591 | United States

PO Box 97227, Pittsburgh, Pennsylvania, 15229 | United States

239 Hillsborough Road, Ste. 2 Hillsborough, New Jersey, 08844 | United States

Ph: (800) 245-1313

Ph: (732) 740-0690

Email: hlord@phpltd.com

Email: john@ejmedicalsolutions.com

www.phpltd.com

www.celluwaveESWT.com

Cutting corners when it comes to quality is an all too common practice in the supplement industry. We at PHP have been committed to using the highest quality ingredients, backed by science, in our formulations since our beginning in 1978. Our integrity and ingenuity goes into every product in our comprehensive line; making the partnership we have with clinicians above industry standard.

Turn key business solutions including training, education & marketing specific to ESWT for Erectile Dysfunction & Cellulite

Ph: (951) 550-0505 Email: info@prodrome.com www.prodrome.com Prodrome Sciences is a specialty blood test laboratory, supplement manufacturing, and research company. Products are the result of extensive evidence from large clinical studies of thousands of blood samples from around the world. Prodrome researches and develops solutions to prevent disease, improve health and vitality, and achieve longevity.

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PromoItalia LLC

Prosoma LLC

Protocol For Life Balance

Booth #7094

Booth #2060

Booth #8043

1401 Brickell Ave., Ste 550 Miami, Florida, 33131 | United States

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

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

Ph: (786) 360-3878

Ph: (727) 648-2791

Ph: (877) 776-8610

Email: office.usa@webpromoitalia.com

Email: jrios@prosomacorp.com

Email: laura.danaher@protocolforlife.com

www.us.webpromoitalia.com

www.prosomacorp.net

www.protocolforlife.com

Promoitalia, an Italian company leader in the aesthetic medicine field, has the main goal to manufacture and sell advanced technology, methodology and consumable products, letting people to achieve their own beauty and wellness. The engine that drives company activity is the continuous pursuit of excellence, exclusive design and research.

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

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

Purium Health Products

Qest, LLC

Qualgen

Booth #7061

Booth #6039

Booth #9059

317 2nd Ave #3, New York, New York, 10003 | United States

70 W Canyon Crest Road, 100 Alpine, Utah, 84004 | United States

301 Enterprise Drive, Edmond, Oklahoma, 73013 | United States

Ph: (646) 415-2106

Ph: (385) 335-8514

Ph: (405) 562-8805

Email: myleffel@gmail.com

Email: benjamin@qest4.com

Email: jpeverley@qualgen.us

www.ishoppurium.com/ products?giftcard=bigapple

www.qest4.com

www.qualgen.us

Qest is the world leader in Bioenergetic Technology. At Qest we pride ourselves in creating an environment that helps practitioners to create or build upon the success that they have in their clinics. We manufacture and sell the latest and greatest bioenegertic testing unit, QEST4. Our goal is to provide practitioners with equipment that will enable them to work with clients by focusing on primary and root cause issues instead of endlessly chasing symptoms.

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 and B-12 injectables. Qualgen offers same-day shipping, easy account set up and superior customer service.

PURIUM’S ORGANIC non GMO foods. The foods give you high energy and health; so that the body heals and builds itself. Try our Forty Day for great nutrition and energy. Biome Medic -for Gut Health and Glyphosate removal. Purium Foods- CBD- Biome Medic for Gut Health and Glyphosate removal

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PLASMALOGEN SUPPLEMENTS

Restore the lipid of life.

“We have been deploying plasmalogen precursors at the Regenesis Project and have found that within the timeframe of a few weeks, people have become more alert and cognizant.” -Sheldon Jordan, MD, FAAN, DABPN, DABCN, Medical Director, the Regenesis Project

Plasmalogens are depleted with age and disease. There are no effective dietary sources.

Plasmalogens restore and enhance the function of neurons, muscles, and white matter to improve cognition and mobility and reduce inflammation.

Don’t risk your life and vitality with insufficient plasmalogens.

Dr. Goodenowe is an invited speaker at the 29th Annual A4M World Congress. Learn about the science and clinical results of plasmalogen therapy at his Saturday, December 11 presentation. See you there! Dayan Goodenowe, PhD Founder and CEO, Prodrome Sciences

prodrome.com 951-550-0505

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.

Wells Pharmacy Network is a privately held, nationwide 503A and 503B compounding pharmacy specializing in: ▪ ▪ ▪ ▪ ▪

Anti-Aging Weight Management Sexual Wellness Aesthetic Dermatology Thyroid & Adrenal Health

A decade later, our goals are still the same. To improve quality of life for our patients by providing the highest quality compounded medications at an aﬀordable price and demonstrating the highest quality standards to put families at ease.

It’s time to go with the future of 503A and 503B compounding. It’s time to make the move to Wells Pharmacy Network. wellsrx.com | (800) 622.4510

Quest Cardiometabolic Center of Excellence

Quicksilver Scientific

Rapid Release Therapy

Booth #9038

Booth #4021

Booth #9043

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

1960 Cherry Street, Louisville, Colorado, 80027 | United States

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

Ph: (330) 285-8212

Ph: (303) 531-0861

Ph: (949) 870-2692

Email: Katherine.A.OMalley@questdiagnostics.com

Email: support@quicksilverscientific.com

Email: jeff@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. Give us 2 or 3 minutes to relax your pain and tension. It will change your day.

RealTime Laboratories, Inc.

Refine USA

Regenative Labs

Booth #8086

Booth #6061

Booth #6033

2540 KIng Arthur Blvd., Ste. 200 Lewisville, Texas, 75056 | United States

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

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

www.questdiagnostics.com The Quest Diagnostics-Cleveland HeartLab Cardiometabolic Center of Excellence is committed to advancing the prevention of the most costly and debilitating cardiovascular events. Our broadlyavailable, comprehensive menu of novel biomarkers spanning the cardiometabolic continuum provides deeper insights into hidden risk that go well beyond traditional testing. By combining this enhanced diagnostic capability with solutions to help engage patients in their care, we empower people to take action to reduce cardiometabolic risk, while improving long-term health outcomes.

Ph: (972) 492-0419 Ext 157

Ph: (866) 590-5533

Email: selene.feyerabend@realtimelab.com

Email: support@refineusa.com

www.realtimelab.com RealTime Lab’s mycotoxin test panel is the most comprehensive available, testing for the presence of 16 of the most common and toxic mycotoxins produced by indoor mold contaminants. RealTime Laboratories is accredited by CAP and CLIA to perform Clinical Mycotoxin testing and has been the gold standard for over 15 years. Using our patented technology we have brought routine mycotoxin testing to patients with chronic health issues brought about by mold.

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www.refineusa.com 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 “marketchanging” technologies.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (800) 891-3452 Email: tyler@regenativelabs.com www.regenativelabs.com Regenative Labs is a human tissue allograft manufacturer, specializing in birth tissue (amniotic membrane, umbilical cord).

Regenerative Kits

RegenLab USA LLC

Rejuvenation Science

Booth #5064

Booth #4072

Booth #4039

3683 Garden Court, Grove City, Ohio, 43235 | United States

140 58th Street 2nd Floor, Bldg A Sunset Park, New York, 11220 | United States

5334 Torrance Blvd., 2nd Floor Torrance, California, 90503 | United States

Ph: (888) 789-8855

Ph: (917) 617-2911

Ph: (310) 798-2830

Email: Regenerativekits@gmail.com

Email: Jzayes@regenlab.com

Email: Roxanne@rejuvenation-science.com

www.regenerativekits.com

www.regenlabusa.com

www.Rejuvenation-Science.com

Regenerative Kits is the world’s leading manufacturer of Platelet-Rich Plasma, A2M and other Autologous blood medical kits. Our Better Blood advanced PRP kit is unlike any other PRP kit on the market today. Our Better Blood, PRP kit utilises a patent pending technology that puts the platlets under pressure. This pressure greatly enhances the growth factor secretion from any PRP harvested using our kits. More growth factors means MUCH stronger PRP and MUCH better results

RegenLab® is a certified global leader in medical device biotechnologies, specializing in cellular therapies. The RegenKit® products provide expertly designed medical devices for the preparation of platelet-rich plasma and cellular therapies which continue to set the standard for product quality, patient safety, and preparation efficiency.

Sophisticated supplements for integrative, regenerative and functional medicine practices begin with top-rated Maximum Vitality multivitamin. Support brain health with nootropics and cholinebound omega-3s, endocannabinoid management for pain, inflammation, anxiety and sleep, mitochondrial and organ energy with metabolic optimizer protocol, including cellular optimizer, mitochondrial biogenesis, and ubiquinol, and much more. Please chat with us to understand our quality, knowledge, integrity, and attention to individual clinicians.

Relax Saunas of Momentum 98

RepeatMD

Researched Nutritionals

Booth #8084

Booth #7091

Booth #6073

3509 N. High Street, Columbus, Ohio, 43214 | United States

1800 West Loop South, Ste. 1700 Houston, Texas, 77027 | United States

PO Box 224, Los Olivos, California, 93441 | United States

Ph: (626) 200-8454

Ph: (713) 496-0261

Ph: (805) 693-1802

Email: reginald.tapo@gmail.com

Email: megan@repeatmd.com

www.relaxsaunas.com

www.repeatmd.com

Email: customerservice@ researchednutritionals.com

Relax Saunas are portable, affordable, personal use saunas with two 700 watt radiators that continuously emit Far Infrared Rays (FIR) while the sauna temperature may vary between 140-170 degrees Fahrenheit. Relax Saunas warm up instantly, and cause a detoxifying sweat within 20 minutes. Relax Saunas increase body temperature 3-4 degrees in 25-60 minutes which triggers a sequence of benefits including immune system stimulation, increased nitric oxide and decreased body inflammation.

RepeatMD grows high-margin services by building each aesthetic practice its own private label mobile rewards program. We don’t think it’s fair to spend more time and money each month on marketing and get fewer results. We understand that aesthetic practices don’t have time to do it all, which is why we created a proven solution that has helped hundreds of practices grow their cashbased, high-margin services automatically.

ANTI-AGING MEDICAL NEWS | WINTER 2021

www.researchednutritionals.com Researched Nutritionals® is passionate about research because we know facts make all the difference. This is why we publish peer-reviewed clinical research on our industry-leading formulations. With products focused on key areas of health such as mitochondrial function, immune support, detoxification, and cytokine health, Researched Nutritionals® is a leader within the practitioner-exclusive dietary supplement market and is dedicated to working directly with healthcare practitioners for their most challenging patient needs.

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R HEIN C ONSULTING L ABORATORIES

ReviveMD

Rhein Consulting Labs

Rupa Health

Booth #5084

Booth #5044

Booth #4032

PO Box 273, Huntertown, Indiana, 46748 | United States

4475 SW Scholls Ferry Road, Ste. 101 Portland, Oregon, 97225 | United States

Ph: (844) 974-9277

Ph: (503) 292-1988

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

Email: info@revivemdcbd.com

Email: ingridnordt@rheinlabs.com

www.revivemdcbd.com

www.rheinlabs.com

ReviveMD was founded on the principles of integrity and trust. We are dedicated to producing the safest, highest-quality, hemp-derived cannabidiol (CBD) products. Moreover, our products are produced exclusively for healthcare professionals, to ensure quality CBD options for their patients. Patients can not obtain any of our product line without obtaining it from a partnering healthcare professional.

Rhein Consulting Laboratories, specializing in hormone profiling, is a research driven facility, which provides patients and their physicians with state-ofthe-art, cost-effective means of assessing sex and adrenal hormone levels. In contrast to salivary and spot testing, hormones assayed in urine are clinically relevant, accurate, and reproducible as well as widely accepted in medical and academic scientific circles.

SandsRx Pharmacy

Sciton

SeeBeyond™ Medicine

Booth #3044

Booth #2071

Booth #4064

4 Regency Drive, Wylie, Texas, 75098 | United States

925 Commercial Street, Palo Alto, California, 94303 | United States

2 Overhill Road, Ste. 260 Scarsdale, New York, 10583 | United States

Ph: (214) 334-9212

Ph: (650) 493-9155

Ph: (914) 722-9440

Email: stevesands@sandsrx.com

Email: info@sciton.com

Email: info@seebeyondmedicine.com

www.SandsRx.com

www.sciton.com

www.seebeyondmedicine.com

SandsRx is a Specialty and Compounding Pharmacy that holds multiple accreditations. We have a state of the art Sterile & Non-Sterile Compounding Lab that is USP 797 & USP 800 compliant as well as Board Certified Sterile Compounding Pharmacists.

Sciton is committed to providing best-in-class laser and light solutions for medical professionals who want superior durability, performance and value. Sciton offers best-in-class medical devices for laser-assisted lipolysis, fractional and full-coverage skin resurfacing, hair removal, phototherapy, wrinkle reduction, treatment of vascular and pigmented lesions, scar reduction and acne. For more information, and a complete list of Sciton systems, visit www.Sciton.com.

We strive to see you clearly. We see you holistically. We discover your body and mind through genetics and bio-makers. We see you beyond your age, weight, and chronic illness. We see your potential and possibility for a healthy future. SeeBeyond™ Medicine offers cutting-edge Functional Medicine Testing to discover your “root cause” of your disease. Our doctors are board-certified in Functional Medicine, Integrative Family Medicine, and Obesity Medicine. We are here to solve your problem.

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Ph: (954) 821-7917 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.

Selphyl PRP/PRFm

Signature Biologics

Smarter Not Harder, Inc.

Booth #8062

Booth #6007

Booth #8044

940 Town Center Drive, Langhorne, Pennsylvania, 19047 | United States

4040 W Royal Lane, Ste. 100 Irving, Texas, 75063 | United States

4695 Chabot Drive, Ste. 200 Pleasanton, California, 94588 | United States

Ph: (972) 807-5916

Ph: (925) 558-2717

Email: info@testvalleyresearch.com

Email: admin@snhlife.com

www.neilriordan.com/about

www.troscriptions.com

Signature Biologics’ mission is to use innovative techniques to manufacture human perinatal-derived products to support and improve the natural healing processes of the body. Proven through rigorous scientific and clinical study, we provide best-in-class products to enhance patients’ lives. Based in Dallas, Texas.

Pioneered by Dr. Ted Achacoso, Troscriptions (Tx) is a line of precision dosed, pharmaceutical grade, and physician formulated buccal troches for cognition, calm, pain, sleep, and more. A portion of Tx proceeds goes to supporting our nonprofit Health Optimization Medicine and Practice (HOMe/HOPe), the first and only multiomics specialty that defines and delivers the standard of care for health, not disease.

SottoPelle

Sovereign Laboratories

Specialist Training by The Institute

Booth #3096

Booth #9046

Booth #5066

8412 E. Shea Blvd., Ste. 101 Scottsdale, Arizona, 85260 | United States

30 N Alamos Drive, Cottonwood, Arizona, 86326 | United States

200 Glades Road, Boca Raton, Florida, 33432 | United States

Ph: (323) 986-5100

Ph: (928) 421-2241

Ph: (561) 368-1880

Email: response@sphrt.com

Email: service@colostrumtherapy.com

Email: info@stcell.com

www.sottopelletherapy.com

www.sovereignlaboratories.com

www.stcell.com

SottoPelle® is a renowned international training company dedicated to improving the quality of life during all phases of aging for men and women with pellet therapy. The late, Dr. Gino Tutera MD, FACOG, Founder of SottoPelle®, was the premier doctor pioneering bio-identical hormonal therapy science with preventing and mitigating many diseases and conditions. Our Services goes beyond simply providing physicians with training. We develop long-term relationships built on trust, strive to be knowledgeable and compassionate

Sovereign Laboratories is a worldwide leader in the bovine colostrum supplement industry. For 25 years, we’ve dedicated ourselves to developing natural products that provide efficacious solutions for optimal health, vitality, aesthetics, and healthy aging. Company founder Douglas Wyatt is a leading authority on colostrum and is credited with establishing the gold standard in processing raw bovine colostrum into supplements. Mr. Wyatt is also an early developer of liposomal delivery for enhanced bioavailability of colostrum supplements.

Specialist Training by The Institute offers 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 autologous cell therapy using bone marrow, adipose tissue, blood and other biologic modalities to help qualified patients reduce musculoskeletal pain.

Ph: (480) 664-9490 Email: ryan@skintechsystems.com www.selphyl.com The Selphyl® System is designed for the safe and rapid preparation of PRFm from a small sample of blood at the patient point of care. Many PRP systems require operator skill, have varying results and have extensive contamination with red blood cells and white blood cells. PRP is converted to PRFm through a controlled process, creating a fibrin scaffold that serves to protect and preserve platelets. Think of Selphyl® PRFm as the next generation PRP.

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Standard Process Inc.

Sun Genomics, Inc.

TA Sciences

Booth #8021

Booth #1026

Booth #5007

1200 W. Royal Lee Drive, Palmyra, Wisconsin, 53156 | United States

5151 Shoreham Place, Ste.180 San Diego, California, 92122 | United States

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

Ph: (800) 558-8740

Ph: (515) 988-6325

Ph: (212) 588-8805

Email: info@standardprocess.com

Email: neal@sungenomics.com

Email: eric@tasciences.com

www.standardprocess.com

www.sungenomics.com

www.tasciences.com

Since 1929, Standard Process® has been a visionary leader in whole food nutrient solutions. The company creates quality nutritional supplements based on the whole food philosophy of its founder, Dr. Royal Lee. Headquartered in Palmyra, Wisconsin, Standard Process offers nutritional supplements, Veterinary Formulas™, and is the exclusive U.S. Distributor of MediHerb® herbal supplements.

Sun Genomics is the only custom probiotic with the secret ingredient. That secret ingredient is your gut microbiota. We create custom probiotics tailored and formulated to your unique DigestiveDNA to improve your digestion, increase your energy, and reduce bloating to help you perform at your best.

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®.

TMP

Tailor Made Compounding

The Mold Pros

TherapellET dba Atrocars.com

Booth #5027

Booth #8090

Booth #7047

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

12940 Express Ct., Ste # 6 Fort Meyers, Florida, 33913 | United States

960 Caughlin Crossing, Ste. 100 Reno, Nevada, 89519 | United States

Ph: (859) 887-0013

Ph: (239) 262-6653

Ph: (775) 224-0000

Email: ataylor@tailormadehealth.com

Email: dr.matt@themoldpros.com

Email: mv@therapellet.com

www.tailormadecompounding.com

www.themoldpro.com

www.atrocars.com

Tailor Made Compounding medications are designed to complement existing therapies but, more often, provide a more suitable alternative to standard prescription and over-the-counter medicines. We don’t believe in a ‘one size fits all’ approach. Our patients and physicians have unique needs and can rely on us for the highest quality, custom, compounding solutions. Specializing in peptides, hormone replacement therapy, IV formulations and pharmacist formulated supplements. Tailor Made Compounding, positively disrupting medicine using innovative technology.

We are an environmental services company with the client in mind, having worked with doctors across the country for over a decade. The Mold Pros offer affordable services, knowledgeable staff, and Eco-friendly treatment products. We can provide consultations on your structure or how medical tests could give us insight into what problems might be involved in the building, we do multiple types of inspection, and we do multiple types of remediations to solve environmental problems

TheraPellET is the spec developer of the atraumatic trocar used for the subcutaneous insertion of bioidentical hormone pellets. The device preserves the delicate vasculature that is necessary for proper absorption. The Atraumatic Insertion technique eliminates extrusions and hematomas associated with the pellet insertion procedure. Patients are happier and physicians save money on pellet cost.

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THOR Photomedicine

Toolbox Genomics

TouchMD

Booth #6043

Booth #2038

Booth #1055

5021 Michaels Meadow Drive, Hampstead, Maryland, 21074 | United States

2950 Buskirk Ave., Ste.300 Walnut Creek, California, 94597 | United States

99 N. Main Street, Ste. 7 Cedar City, Utah, 84720 | United States

Ph: (877) 355-3151

Ph: (312) 898-8728

Email: mark.granic@thorlaser.com

Email: scott@toolboxgenomics.com

www.thormedical.com

www.toolboxgenomics.com

THOR Photomedicine is the internationally recognized authority in Photobiomodulation (PBM)equipment and have presented to the US Congress, United Nations, and NICE (UK) on the use of PBM for pain management. While analgesics cover up pain, our devices actually treat the source of the pain. THOR products are indispensable tools at world class institutions including Harvard, NYU, The Veterans Administration, and others — revolutionizing pain management and injury recovery programs.

Ph: (435) 867-0077 Email: hello@touchmd.com www.touchmd.com TouchMD is a visual consultation, marketing and imaging software utilizing touchscreen technology that enhances the patient experience with proven revenue generation.

Trocar Supplies

Tru Niagen / Chromadex

TruDiagnostic

Booth #9037

Booth #6046

Booth #5033

126 Nulf Drive, Columbiana, Ohio, 44408 | United States

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

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

Ph: (740) 314-9959

Ph: (800) 480-7544

Ph: (833) 963-1700

Email: brandon@trocarsupplies.com

Email: practitioner@truniagen.com

Email: support@trudiagnostic.com

www.trocarsupplies.com

www.truniagen.com

www.trudiagnostic.com

Trocar Supplies, a family-owned business, is the pioneer and worldwide standard for the disposable trocar medical kit industry. We take great pride in offering an affordable price for the highest quality products. Through patient feedback and research-based treatment, our trocar kits have been the optimal way to treat hormone deficiencies for over fifteen years. The utilization of our disposable trocar kits are the most efficient method and safest product for hormonal replacement therapy.

Our mission is to provide a clinically proven, vital resource to increase levels of NAD+, a critical healthy living molecule while continuing to lead the industry in safety compliance and efficacy. Your cells are the foundation of your health. They work tirelessly to keep you resilient. Cellular care doesn’t just revitalize one part of you—it nourishes every cell, supporting all of you.

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.

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Ulta Lab Tests

You Order the Test. We’ll Do the Rest!

TruGen3

U.SK Under Skin

Ulta Lab Tests

Booth #7060

Booth #5065

Booth #4061

15 Wabash Street, PO Box 8512 Pittsburgh, Pennsylvania, 15220 | United States

2885 Mesa Rim Road, Unit 123 San Diego, California, 92121 | United States

9237 E. Via De Ventura, Ste.220, Ste. 102 Scottsdale, Arizona, 85258 | United States

Ph: (310) 422-0734

Ph: (480) 329-0110

Email: paula@underskin.us

Email: johnroehm@ultalabtests.com

www.underskin.com

www.Ultalabtests.com

U.SK Under Skin is a premium skincare brand founded in Brazil, backed by science with over 100 studies, specializing in medical grade, physician dispensed cosmeceuticals. U.SK develops each formula with guidance from world renowned dermatologists and laboratories globally, including Italian R&D laboratory, Monteresearch® where they are able to acquire the highest-performing and up-to-date active ingredients and create luxurious products that focus on the Science Behind the Beauty.

Ulta Lab Tests offers healthcare professionals deep discounts on laboratory testing services plus a free practice management solution. We have taken the cumulative buying power of thousands of healthcare professionals in our network to leverage incredibly low prices and then pass these on to our partners and their patients. Healthcare professionals and their patients/clients can order lab tests directly online 24/7 through a personalized microsite provided at no charge by Ulta Lab Tests.

UnCraveRx

University Compounding Pharmacy

US Biotek Laboratories

Booth #2043

Booth #6021

Booth #6037

Suite 500, Anaheim, California, 92806 | United States

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

16020 Linden Ave. N., Shoreline, Washington, 98133 | United States

Ph: (714) 462-4880

Ph: 800-985-8065 Ext 5700

Ph: (206) 365-1256

Email: Donnie@biocorrx.com

Email: dave@ucprx.com

Email: info@usbiotek.com

www.UnCraveRx.com

www.ucprx.com

www.usbiotek.com

The UnCraveRx program is a 3-month weight loss program that includes a sustained release naltrexone pellet therapy and a virtual platform that helps you create healthy habits & lifestyles through nutritional coaching and lifestyle behavioral support groups.

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.

US BioTek Laboratories is an industry-leading international laboratory that pioneers testing methods that deliver quality results with the highest degree of reproducibility. US BioTek provides the most comprehensive food sensitivity and inhalant testing and the most convenient collection method for organic acids and environmental pollutants tests utilizing dried urine.

Ph: (412) 668-3831 Email: mlioon@trugen3.com www.trugen3.com TruGen3® is built on the bedrock of three trusted generations of nutraceutical knowledge and experience. And yet, we’re a new kind of company, delivering a carefully selected, limited group of exceptionally high quality, condition-specific nutritional supplements. Every product is backed by the highest ethical standards and clinically-researched ingredients and available only through certified health care professionals.

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Vertisis Custom Pharmacy

Vibrant America

Viora

Booth #4045

Booth #2047

Booth #4080

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

1021 Howard Ave., Ste. B San Carlos, California, 94070 | United States

213 West 35th Street, Ste. 500 New York, New York, 10001 | United States

Ph: (303) 476-3447

Ph: (866) 364-0963

Ph: (888) 415-1192

Email: matthewb@vertisis.com

Email: support@vibrant-america.com

Email: info@vioramed.com

www.vertisis.com

www.vibrant-wellness.com

www.vioramed.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.

Vibrant Wellness is a leading science and technology company delivering life-transforming laboratory services using an integrated microarray platform that enables multiplex testing at an affordable cost.

Viora, a leading provider of medical aesthetic solutions, helps customers deliver the most effective results to their patients. Viora improves upon treatment experiences by enhancing existing technology to give customers the best non-invasive solutions available. With a presence in over 65 countries, Viora’s products address a wide range of symptoms, treating today’s most commonly requested applications for anti-aging, body & facial contouring, cellulite reduction, acne clearance, stretch mark reduction, hair removal, skin lightening and more.

Ward Photonics Vita Aid Professional Therapeutics

Vivos Therapeutics

Ward Photonics LLC

Booth #8042

Booth #3037

Booth #8091

#302-20285 Stewart Crescent, Unit 303 Maple Ridge, British Columbia, V2X 8G1 | Canada

9137 S Ridgeline Blvd., Ste. 135 Highland Ranch, Colorado, 80129 | United States

1980 N Atlantic Ave., Ste. 1030 Cocoa Beach, Florida, 32931 | United States

Ph: (800) 490-1738

Ph: (816) 853-8667

Email: info@vitaaid.com

Email: ndegennaro@vivoslife.com

www.vitaaid.com

www.vivoslife.com

With 20+ years of experience in the natural health industry, Vita Aid Professional Therapeutics strives to provide high-quality and effective nutraceuticals for health care practitioners worldwide. We focus on products for professional, safe, and effective therapeutic use and follow strict pharmaceuticalgrade standards. What differentiate Vita Aid from others are: • Exclusive to health care practitioners • Clinical evidence based formulations • No added stearic lubricants – for higher bioavailability of active ingredients • Vegetarian formulas

More than one billion people suffer from mild-tomoderate obstructive sleep apnea. The Vivos System is an advanced therapeutic protocol which combines the use of oral appliance technology developed by Vivos and prescribed by specially-trained independent dentists in cooperation with their medical colleagues. The Vivos System is indicated for use to treat mild-tomoderate obstructive sleep apnea and snoring in adults. The Vivos System offers an all-natural, non-surgical, non-pharmaceutical, and pain free approach.

ANTI-AGING MEDICAL NEWS | WINTER 2021

Ph: (800) 392-5950 Email: tradeshow@Wardphotonics.com www.WardPhotonics.com Ward Photonics develops and manufactures the most powerful FDA-Cleared Photonic technology for noninvasive body contouring. Ward Photonics was founded in 2015 by Terry J. Ward M.H.A., a Duke University Alumni and successful body contouring expert. With the constant frustration dealing with medical device manufacturers, Terry resolved by creating better technology and business by providers for providers.

215

WAVi Co.

Well Cell Global

Wellness Pharmacy

Booth #1066

Booth #3071

Booth #1024

3459 Ringsby Ct., #305 Denver, Colorado, 80216 | United States

11511 Katy Frwy., Ste. 102 Houston, Texas, 77079 | United States

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

Ph: (713) 823-1945

Ph: (888) 991-1012

Ph: (800) 227-2627

Email: info@wavimed.com

Email: Glenn@wellcellglobal.com

Email: info@wellnesspharmacy.com

www.wavimed.com

www.wellcellglobal.com

www.wellnesspharmacy.com

WAVi is an all-in-one brain measurement platform which provides objective information about brain function. Using well-established evoked EEG technology to record electrical signatures of the brain, the WAVi system provides doctors, researchers and wellness experts with actionable, data-driven reports.

Physiologic Insulin Resensitization Modality for Patients with Metabolic Disorders

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.

Wells Pharmacy Network

Young Goose

Your Energy Systems, LLC

Booth #2015

Booth #2056

Booth #4036

3420 Fairlane Farms Road, Ste. 300 Wellington, Florida, 33414 | United States

3007 W Commercial Blvd., Ste. 105 Fort Lauderdale, Florida, 33309 | United States

555 Bryant Street, #305 Palo Alto, California, 94301 | United States

Ph: (561) 793-1568

Ph: (407) 729-3423

Ph: (877) 303-3238

Email: khaines@wellsrx.com

Email: service@younggoose.com

Email: jon@readisorb.com

www.WellsRx.com

www.younggoose.com

www.readisorb.com

Wells Pharmacy Network (WPN) is a privately held nationwide compounding pharmacy (503A and 503B) specializing in wellness, anti-aging, weight management, sexual wellness, aesthetic dermatology, and thyroid and adrenal health. WPN’s mission is to improve the quality of life for our patients by providing quality compounded medication at an affordable price, exceeding our customers’ expectations with excellent customer service and timely delivery, and demonstrating the highest quality standards to put families and patients at ease.

Young Goose is the world’s first biohacking skincare. Our products aim to elevate the skins NAD+ levels, and activate age-reversing genes (Sirtuins), to stop and reverse signs of aging.

ReadiSorb is well known for its uniquely formulated Liposomal Glutathione (patented in 2013) that has been manufactured in the U.S.A. since 2004. It has been the subject of 12 peer-reviewed studies archived on PubMed including 2 double-blind placebo controlled clinical trials that showed absorption and immune support. Our popular Liposomal Melatonin and Methyl B-12 sprays are easy to use and work fast. Stop by our booth for more information or a sample!

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ANTI-AGING MEDICAL NEWS | WINTER 2021

Zizion Zhittya Genesis Medicine

Zingit Technology Services LLC

Zizion Group Inc.

Booth #5073

Booth #3045

Booth #6085

3017 Carbondale Street, Las Vegas, Nevada, 89135 | United States

544 Lakeview Parkway, Ste. 201 Vernon Hills, Illinois, 60061 | United States

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

Ph: (702) 572-8083

Ph: (866) 587-5572

Ph: (561) 221-1000

Email: vika@zhittyamedicine.com

Email: sales@zingitsolutions.com

Email: bruce@zizion.com

www.zgm.care

www.zingitsolutions.com

www.zizion.com

Why You Will Live 30 Years Longer than You Think: Medical Breakthroughs are Happening Now! Heart disease, Stroke, Alzheimer’s disease, MS and Parkinson’s disease: Can these disorders be treated or even cured with angiogenesis? Zhittya Genesis Medicine (ZGM) is a Biopharmaceutical company, developing for FDA approval a biological drug, which triggers angiogenesis and neurogenesis. Does ZGM has a possible treatment for diseases that kill over 50% of the people in the world?

Zingit’s technology grows healthy practices with superior patient engagement. Our easy-to-use textbased patient experience platform engages patients with timely, intelligent, and customized text campaigns, resulting in a massive influx of Google reviews, new patients, and reactivated patients all driven by Zingit’s 100+ EHR/PMS integrations and automations.

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.

At-Home Collection for Wellness Testing

ZRT Laboratory

ZYTO

Booth #4079

Booth #1033

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

1172 W 700 N, Ste. 300 Lindon, Utah, 84042 | United States

Ph: (503) 597-1889

Ph: (801) 224-7199

Email: tlcorbin@zrtlab.com

Email: sales@zyto.com

www.zrtlab.com

www.zyto.com

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.

ZYTO strives to empower personal wellness through innovative technologies, education, and improved application with a focus on functional, emotional, and energetic elements. The innovative ZYTO scan technology facilitates an interface between a computer and the human body. As a result of this innovative process, suggestions for wellness products and services are provided with the aim at improving a person’s quality of life.

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SCINATURE is a premium product line that consists of scientifically formulated, clinically validated, plant based and safe health formulas that target different health related issues and conditions in men, women and children. SCINATURE nutraceutical and herbal products possess identical clinical properties to pharma grade products, without side effects

www.scinature.in

Glowing Skin

Craves the Right CollaGEN • Stimulates connective tissue regeneration • Hydrates and firms • Nourishes and protects 25 human clinical studies on proven ingredients

NEW! Visit booth #4027 at the A4M World Congress for your chance to win

a box of CollaGEN StickPacks* *While supplies last. Must be a licensed healthcare provider to qualify. No purchase necessary. 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.

Cell Renewal Made Simple.

SPERMIDINELIFE.US

Clinically Studied, Whole Food-Based Nutrition

SP Detox Balance™ Program — a science-based approach to supporting healthier habits Our bodies are exposed to toxins every day. That’s why SP Detox Balance powder is full of whole food-based nutritional ingredients, packed with 17 grams of vegetable protein, and part of the SP Detox Balance™ Program. The program supports all three phases of metabolic detoxification, with a clinical study showing support of Phase I and Phase II detoxification.

^Includes ingredients grown on the Standard Process certified organic farm

Buckwheat^

Oat^ Alfalfa^

Spanish Black Radish^

1, Genoma, 1999. 4-Akih Tripterpene alcohols from the flowers of Compositae and their antiinflammatory effects. Phytochemistry, 43, 1996. 5-Parente, M.L. et al. Wound healing and anti-inflamm ny, G.B.N. et al. Anethole blocks bo 7-Ilhami Gulçin et al. Screening o 1- Clinical Assessment of the Exfo .103 Report). Medcin. São Paulo/ Medcin. São Paulo/BR. 2015. 4-Kurtz, E. 1- Clinical assessment of the makeu h (LSE-f068/15.102 Report). M 2015. 4-Gasparetto, J.C. et al. Ethnob . Topical anti-inflammatory potencial of s Pomegranate rind extract and ellagic acid in contact dermatitis. Phytother. Res., 28, 2014. 6-Kaithwas G. et al. Anti-inflammatory, analgesic and antipyretic activities of Lin 1- Clinical assessment of the makeup removing potential (RFE-EM0078-1 São Paulo/BR. 2015. 3-Assessment e 5-alfa reductase gene expression (LSE1- Assessment of skin hydration by corneometry (RFE-EM082-14-E-R2 Report). Medcin. São Paulo/ icle ID 279356, Volume 2015. 4- As moscience. São Paulo/BR. 2015 Bio Chem. 286(8), 2011. 3- S Elixir Colloid orts) Kosmoscience São Paulo/ Assessment of increase of skin firmness, elasticity and viscoelasticity by cutometry (EM081-14-C Report). Kosmoscience. São Paulo/BR 2015. 3- Ji-hoon Kim et al. Anti-gly of Gold Nanoparticles on Collagen.Biol. Pharm. Bull. 35(2), 2012. 4- Assessment of efficacy in the improvement of overall skin appearance (EN6029-15 Report). Medicin. S

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