A4M MMI | Anti-Aging Medical News - Winter 2023 by Tarsus Medical

Dear Esteemed Colleagues, We warmly welcome you to Las Vegas for The 31st Annual World Congress, themed LongevityFest 2023: Leveling Up Healthcare. As the leading anti-aging and longevity medicine enterprise, the American Academy of Anti-Aging Medicine (A4M) is delighted to have you here.

esteemed Thai Buddhist meditation teacher Master Wongsakon. Distinguished faculty joining them on the LongevityFest Main Stage include Mark Houston, MD, MS; Kara Fitzgerald, ND; Rhonda Patrick, PhD; and Michael Greger, MD, FACLM, among many others.

Last year, we broke industry records by hosting the largest longevity conference ever - with over 5,500 dedicated health professionals and nearly 500 market-shaping exhibiting companies. The inaugural LongevityFest was a historic event, heralding an exciting new age of innovation in our field.

Throughout the three-day conference, our acclaimed experts will deliver thought-provoking learning sessions, actionable protocols, and impactful discussions; they will present the latest research developments in longevity science and its related spheres, including endocrinology, preventive medicine, cellular resilience, and beyond. From revolutionary disease prevention protocols to longevity practice-building strategies and everything in between, we invite you to tailor your educational experience to your personal and professional needs.

This year, we’re taking it to the next level. At LongevityFest 2023, we unite the entire health innovation ecosystem to propel the evolution of the human healthspan. Over the next few days, Las Vegas will become the epicenter for trailblazing ideas and cross-disciplinary collaboration, bringing together modern medicine’s most influential voices to share the latest breakthroughs, insights, and research to accelerate the longevity movement. As the key longevity industry stakeholders and tenacious changemakers, your strategic direction and unified commitment will rally the field, igniting our collective purpose to reach new frontiers that redefine the limits of medicine and human potential.

Here is where we converge to transcend barriers and drive real change. Aging is the greatest risk factor for the majority of diseases, and today, we stand on the cusp of being able to intervene in the aging process. By harnessing the power of science, medicine, and technological advancements, visionary leaders like you can engineer a world in which aging is a treatable condition — and pioneer the solutions that treat it. That’s where we come in. Our organization’s mission and the goal fueling each LongevityFest is to equip future-minded health innovators with the most current medical education, supportive life-long connections, and leading-edge tools that empower them to transform the modern healthcare landscape. We begin on Thursday with a selection of interactive preconference workshops tackling today’s most pertinent topics, including vascular health, telomere biology, hyperbaric oxygen therapy, and weight loss. Friday marks the official start of the conference, kicking off a cutting-edge curriculum full of exclusive groundbreaking insights delivered by a star-studded panel of over 100 educators. This year, we’re honored to welcome renowned visionaries from the health spectrum, including lifestyle medicine pioneer and Emmy-winning television icon Mehmet Oz, MD, and

Beyond the sessions, LongevityFest 2023 serves as an invaluable networking platform ripe with opportunities to expand your network, establish lasting connections, and enjoy festivalstyle entertainment together — we hope you immerse yourself wholeheartedly in the experience. On behalf of the entire A4M team, we sincerely thank you for sharing your passion and brilliance with our global community and joining us at this pivotal moment. With advances in artificial intelligence and unprecedented scientific breakthroughs within reach, this gathering is our forum to harness these tools, propel progress through partnership, and ignite innovation for generations to come. Let’s get to work, share our boldest ideas, ask big questions, and shape the future of medicine together. The energy and excitement of LongevityFest 2023 await you. Here’s to limitless possibilities, Ronald Klatz, MD, DO & Robert M. Goldman, MD, PhD A4M Founders

Ronald Klatz MD, DO Co-Founder

ANTI-AGING MEDICAL NEWS | WINTER 2023

Robert Goldman

MD, PhD, DO, FAASP Co-Founder

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

The American Academy of Anti-Aging Medicine (A4M.) All rights reserved. ISSN 1533-6700. AntiAging Medical News publishes materials in good faith and makes no claims or endorsements for products, services or procedures that appear in the publication. Opinions expressed in articles and advertisements are not necessarily those of Anti-Aging Medical News, its owners, affiliates, or its staff. The publisher is not liable for advertiser product claims or representations. Advertisers assume total responsibility for the contents of their advertisements. Under no circumstances is the content of Anti-Aging Medical News to be construed as medical advice. Always consult your personal physician prior to beginning a new therapy, or changing any current regimen.

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ANTI-AGING MEDICAL NEWS | WINTER 2023

ANTI - AGING MEDICAL NEWS | WINTER 2023

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

Exhibitor Index ...........................144

PME Sessions ...............................12

Exhibit Hall Floormap .................150

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

Exhibitor Listings ........................151

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) Be A Front Line, Standard Of Care Therapy?

ARTICLES

By: Allen Meglin, MD

Tβ4 Frag By: Erika Schwartz, MD & Kristin Wright McKitish, MD

Addressing Uncomplicated and Complicated UTIs – A Holistic Approach By: Emily Hernandez, ND

TB006: Targeting Galectin-3 in Neurodegenerative Disease with a Novel Antibody By: Jenny Johansson, PhD, Akshaya Vijayareka & Xi Lan, PhD

Exploring Innovative Strategies for Promoting Healthy Aging in Women By: Danielle Moyer, MS, CNS, LDN & C. Ambrose, ND, MAT

A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports By: Akbar Khan, MD, IMD, DHS, FAAO & Mitchell Ghen, DO, PhD

Just A Number: The Role of N-Acetylcysteine and Glycine Supplementation to Reverse Hallmarks of Aging By: Taylor Stone, PharmD & Christopher Lorich, PharmD

Nitric Oxide is the Longevity Molecule. The Unified Theory of Aging By: Nathan S. Bryan, PhD

Mitochondrial Energy Support for Optimized Immune Function By: Kareem Kandil, MD, ND

Monitoring Menopausal Estrogen Replacement Therapy By: Jaclyn Smeaton, ND, Chief Medical Officer at Precision Analytical

Hormonal Health: Detoxification Strategies for Endocrine Receptor Function By: Lindsay Christensen, MS, CNS, LDN, A-CFHC, CKNS

What is the Endothelial Glycocalyx? By: Doreen Saltiel, MD

Telomerase Activator TA-65 Combats Immune Aging and Inflammation in Subjects Post-Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled Trial By: Joseph M. Raffaele, MD

The Gut-Thyroid Connection By: Felice Gersh, MD

ANTI-AGING MEDICAL NEWS | WINTER 2023

29 37 45 51 59 69 81 97 103 109 115 125 131 140 5

PLANNING COMMITTEE Andrew Heyman

Sahar Swidan

Director of Academic Affairs

Director of Professional Programming

MD, MHSA, ABFM, ABIHM PharmD, BCPS, ABAAHP, FAARFM

Pamela W. Smith MD, MPH, MS

Mark C. Houston

MD, MS, MSc, FAARM, ABAARM

James LaValle

Mark Rosenberg

RPh. CCN, MT

MD, FAARM, ABAARM

Ronald Klatz

Robert Goldman

A4M FOUNDERS MD, DO

MD, PhD, DO, FAASP

Co-Founder

ANTI-AGING MEDICAL NEWS | WINTER 2023

PME SESSIONS (NON-CME) WEDNESDAY | DECEMBER 13TH 6:15 pm The Longevity Quotient: How to Use Prolon and the L-Nutra Family Of Products as a Central Component to Patient

Presented by:

James LaValle, RPh, CCN, MT

Location:

Titian 2301

ANTI-AGING MEDICAL NEWS | WINTER 2023

Sponsored by:

THURSDAY | DECEMBER 14TH 6:15 pm Join TA-65’s Top Doctors in an Open Panel Discussion with Interactive Q&A Presented by:

Sebastian Conti, Ron Rothenberg, MD & Joseph M. Raﬀaele, MD

Location:

Titian 2301

6:15 pm Treating Adult Growth Hormone DeficiencyEverything You Need To Know About The Labs, Diagnosis And Treatment. Presented by:

Thierry Hertoghe, MD

Location:

Veronese 2401

6:15 pm TB006: A Breakthrough Alzheimer’s/Dementia Treatment Presented by:

Wililam Gael, MD, Arbella Sarkis, MD, & John Bumb, CEO, Metaverse One

Location:

Veronese 2404

Sponsored by:

FRIDAY | DECEMBER 15TH 6:15 pm Key Hormone Lab Tests That Make A Diﬀerence: RT3, E1, Pregnenolone Presented by:

Thierry Hertoghe, MD

Location:

Veronese 2404

6:15 pm Optimize Your Practice Longevity with Fullscript Presented by:

Jeﬀ Gladd, MD & Tieraona Low Dog, MD

Location:

Veronese 2401

ANTI-AGING MEDICAL NEWS | WINTER 2023

Sponsored by:

TB006: A Breakthrough Alzheimer’s/Dementia Treatment

Hope Reclai ming l ife A beacon of light in th e battle against Alzhe imer’s “Additionally, she n o longer requires reminders to take h er medications in the correct order and a t the designated times. “

Patient Testimo nial

Scan here to learn how to become a TB006 provider

Stunning potential to reverse dementia and Alzheimer’s! Visit our booth #6091 Attend our workshop December 14, 6:15pm 650-847-1117 info@truebinding.com www.Truebinding.com

PRODUCT SHOWCASE (NON-CME) Location:

Exhibit Hall

THURSDAY | DECEMBER 14TH 12:00 PM

Clinically Proven Age-Defying Skincare From Research Aboard the International Space Station

Sponsored by:

Presented by: Kyle Landry

4:30 PM

5:00 PM

Glutathione Next Era: On Demand in Seconds with HydraStat® Nano-Delivery

Sponsored by:

Presented by: Dr. Tanya Maximoff

in seconds. on demand.

Formulating for Longevity: Creating Personalized Supplements to Optimize Healthspan with VitaminLab

Sponsored by:

Presented by: Lydia Thurton, ND

ANTI-AGING MEDICAL NEWS | WINTER 2023

FRIDAY | DECEMBER 15TH Martial Arts Presentation

1:00 PM

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

4:30 PM

Unlocking the Power of Akkermansia: Healthy Weight and Blood Sugar Metabolism

Sponsored by:

Presented by: Philip Oubre, MD

Sponsored by:

5:00 PM

How to Optimize Your Mitochondria Presented by: Ken Swartz, Biogeochemist & Chief Science Officer

ANTI-AGING MEDICAL NEWS | WINTER 2023

THE LONGEVITY QUOTIENT:

EXPLORING THE LATEST IN LONGEVITY NUTRITION RESEARCH SPEAKER Dr. Jim LaValle Join us at A4M Vegas for a pre-show workshop, where you can discover the powers of Fasting Mimicking Technology and enjoy a free longevity gift and complimentary cocktails!

Wednesday Dec. 13 Time 6:15 PM

ROOM TITIAN 2301

During his discussion, Dr. James Lavalle will explore the latest breakthroughs in longevity nutrition, including fasting-mimicking technology and innovative solutions for healthy aging.

Non-CME

Best Practices Using TA-65® from a Physician’s Point of View Join Dr. Rothenberg, Dr. Raffaele, and Sebastian Conti for an enlightening Panel Discussion + Live Q&A (FREE, NON-CME WORKSHOP). When: Thursday, December 14th at 6:15 pm Location: Titian 2301, A4M Longevity Fest 2023, Las Vegas

Highlights: Discussion of TA-65® study outcomes. Master advanced efficacy tracking tools. Discover the ideal TA-65® patient profiles. Open Q&A with our expert panel! Exclusive TA-65® discounts for attendees.

Can’t attend? Stop by booth #5007 to talk to our experts. www.tasciences.com

NON-CME

SPONSORED WORKSHOP

December 14, 2023

Venetian Hotel Veronese 2404

6:15 PM

William Gael, MD

Arbella Sarkis, MD

John Bumb

CEO, Metaverse One

Stunning Potential to Reverse Dementia

www.Truebinding.com

Workshop | Non-CME

Optimize your practice longevity with Fullscript Hosted by Dr. Jeff Gladd, MD | CMO at Fullscript

Friday, December 15th, 2023 6:15 pm | Veronese 2401

IMPORTANT!

E N

! W

Your Voice Will Be Heard

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) (HBOT) Be A Front Line, Standard Of Be A Front Line, Standard Care Therapy? Of Care Therapy? By:

Allen Meglin, MD By: Allen Meglin, 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.

Could Hyperbaric Oxygen Therapy (HBOT) serve as both a combination therapy and stand-alone treatment? Hyperbaric oxygen therapy or HBOT is perhaps the best and greatest hope in treating complex diseasesthat result from multisystem failures. It is a single therapy, able to access and treat multiple organ systems simultaneously. It enhances survival mechanisms, helps modulate immune responses,activates, and promotes cell growth and repair, decreases inflammation, and provide increased energy and information to every single cell in the body. As a single variable (HBOT vs no HBOT) it is amenable to the requirements of evidence-based medicine (EBM). HBOT as the unique property of being able to address multiple medical problems at the same time. HBOT supports and drives regenerative changes. It drives stem

cell release and function. It helps prevent apoptosis of viable but stunned or damaged cells. If it can’t help salvaging a cell or tissue, it helps the immune system clean up the debris. HBOT strongly anti-inflammatory and helps modulate an overly aggressive immune and inflammatory response. It enhances immune regulation. It causes a shift in autonomic tone from sympathetic dominant to parasympathetic dominant. It is calming and activates vagal tone. It improves blood flow while also stimulating new blood vessel growth. It is cancer suppressive. In addition to the broad based application, Hbot is effective in both chronic and acute conditions. It is extremely easy to use and can be performed at home by experienced patients. It is extremely cost effective when performed on an outpatient basis. Costing far less than most competing therapies, outpatient centers typically charge between $200 and $300 per treatmen hour.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) Be A Front Line, Standard Of Care Therapy?

Once considered the primary mechanism of action, but now believed to be only the most obvious effect, HBOT delivers oxygen to tissues that are otherwise oxygen deprived. It is a trinity of dual modalities. The first duality: It is a combination therapy involving both the delivery or oxygen and the delivery of pressure. The second duality: patients derive great benefit from both being in the chamber and being out of the chamber (the Hyperbaric oxygen paradox). The third duality: HBOT turns on two biologic pathways which are usually competing. It turns on survival pathways (short term cellular danger responses) while simultaneously turning on long term survival pathways such as cellular regeneration and growth. Usually, when fighting for survival an organism diverts all resources towards enhancing the chances of immediate cell survival. Resources are directed away from long term gain pathways in support of short-term outcome enhancement. In the case of HBOT, both short term defenses and longterm enhancement is initiated, and promoted. With recurrent and repeated treatments, these changes become more permanent. It is as if cells receive the benefits of rest, restoration, regeneration while performing acutely mounted, intensive defensive strategies. HBOT stimulates a simultaneous defense of the present without sacrificing potential future gains. This is uncommon in biologic systems as the cellular energy, information and communication requirements of acute defense usually preclude the induction of longterm growth and repair. HBOT is perhaps the single most effective epigenetic tool known to man. It changes the expression of at least 8,101 (of the approximately 22,000 human genes). (1). It upregulates regenerative and antiinflammatory genes and down regulates inflammatory, apoptotic, oncogenic genes. It is gene therapy without the risk of unintended consequences. (2). It activates so many healthy metabolic processes that it is best considered a simultaneous, multichannel, multi-process multisystem treatment. (3). Perhaps a fourth duality is that HBOT, while enhancing cell growth, inhibits cancer growth. Cancers are known to prefer anaerobic pathways (Warburg Shift) and by driving aerobic pathways through

increased oxidative phosphorylation, HBOT drives healthy cell survival while decreasing cancer cell proliferation. HBOT decreases metastasis driving pathways. The combination therapy of increased pressure and increased oxygen delivery to cells and tissues provides the benefits of enhancing normal tissue function while hindering abnormal tissue metabolism. There is perhaps a fifth duality related to the concept of hormeses. Succinctly said, hormeses is the process by which “that which does not kills us makes us strong”. That is, subthreshold stress initially causes a transient potential threat, such as increased reactive oxygen and reactive nitrogen species. In response to this threat, metabolic adaptation occurs, resulting improved biochemical and metabolic resilience. If the health of an organism can be measured in terms of its ability to response to variable threats, and increased resilience, then the net effect of HBOT is greater overall health. It should be recognized that, in then initial period, the organism may be more susceptible to immediate additional threats. This in part, explains why HBOT must be repeated to be effective. The healthy metabolic shifts which occur require repetition, time to metabolically respond and practice. In the case of HBOT, there is benefitted to increased reactive oxygen (ROS) and reactive nitrogen species (NOS) as these are used by white blood cells to enhance immune function. As is common in biology, it is the concentration of reactive species that determines the outcome. For a short while, increased ROS and NOS does cause increased oxidative stress. It is the long-term result of an enhanced ROS and NOS defense that provide many of the benefits of HBOT. The multiple competing processes described above is sometimes called the Hyperbaric Oxygen Paradox. (4,5,6,). Seemingly newly apparent, EBM methods are revealing a counter intuitive property of HBOT. (7). Rather than HBOT benefits resulting from an increased oxygen environment (higher oxygen concentration) many or most of the benefits result from exposure to increased pressure. As will be seen below, there is a bias against what is known as mild HBOT, namely that the HBOT exposure must include pressures greater than 1.4 Ata.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) Be A Front Line, Standard Of Care Therapy?

In fact, Hyperbaric therapy increases the number of oxygen molecules available to biochemical reactions, without the need for supplemental O2. The total number of reactant oxygen molecules (but not percentage of oxygen molecules) increases as barometric pressure increases. This is the cause for altitude sickens. At high elevations, the air is still roughly 20% oxygen and 80% nitrogen. High elevations simply decrease the total number of oxygen molecules available. The stoichiometry of the biochemical reactions is independent of O2 concentration and instead depends upon the total number of O2 molecule reactants. Hence, at high altitude (lower barometric pressures) the absolute number Oxygen molecules is decreased, despite the consistency of concentration. Similarly, at increased pressure there is more oxygen available for metabolism. The relative concentration is unchanged. This is why Hyperbaric Oxygen is so effective, even when supplemental oxygen is not provided. This technique has been used since biblical times. Travelers to the Dead Sea experienced long term, 24-hour hyperbaric therapy. The Dead Sea is the lowest place on earth and has the highest long term barometric pressure, 1.05 Ata. The long-term exposure to increased pressure with constant air composition yields effective (albeit slow) hyperbaric therapy. As will be seen below, there may be inherent bias in assuming that HBOT is effective only in markedly increased pressure and supplemental, enriched oxygen environments.

So, if HBOT is so great, why isn’t it used all the time? Why didn’t I learn about HBOT in medical school? The answer lies in the bias towards EBM and away from easily explained, univariant therapies. What do you look for today in a front line, standard of care therapy? The modern gold standard for determining whether a medical therapy is valid, safe, and effective is “evidence-based medicine” (EBM) The wise, modern physician seeks therapeutic solutions to patient problems in practices that have demonstrated statistically significant responses to causal inputs of their validity, safety, and effectiveness. To provide practitioners with

such evidence, EBM currently employs a sequential, one problem at a time approach to isolating and proving effects that are demonstrably the result of known causes. Consider, however, that although compatible with the scientific method, and highly effective in the treatment of singular or simple medical problems, this one-at-a-time approach often fails with complex multisystem problems. Multivariable, multisystem problems and solutions are difficult to analyze satisfactorily and statistically significant results may be difficult to extract from the study of such a system because the interaction between multiple variables and/or multiple systems provokes inherent and hidden biases that devalue findings and treatments that do not readily fit into the model of testing one variable at a time. By insisting on measuring outcomes that result from manipulation of a single variable, there is inherent prejudice against problems that require multivariate, non-linear, nonsequential analysis to produce a solution. In one example, using a well-known case study, gastric ulcers were traditionally thought to be caused by excess gastric acid or insufficient gastric protection via a mucous barrier. This was the accepted pathophysiology, and those who suggested otherwise, namely that perhaps the real cause was more complex and included infection with H. Pylori, found themselves in jeopardy of losing their careers. The prevailing wisdom was so strong that evidence of a more complex situation was rejected without study. Inertia, in part the result of failing to accommodate multivariate analyses in conventional EBM, prevented a change in thinking, until the evidence to the contrary became overwhelming and indisputable. Evidence-based medicine eventually accepted the evidence that a more complex problem and solution was at hand, but not without great resistance and difficulty. The single variable testing model does not consider a more complex interplay of variables, but rather insists on analysis by strict isolation of variables. As systems engineers and statistical quality control specialists know, complex multisystem problems often require complex simultaneous

ANTI-AGING MEDICAL NEWS | WINTER 2023

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) Be A Front Line, Standard Of Care Therapy?

system failure problem solving approaches, such as design of experiments. Lifestyle and lifestyle-induced medical problems are similar. Patients in my practice often arrive without having found satisfactory answers to their medical questions, suggesting the need for parallel medical approaches that are multi-faceted but not mutually exclusive. Our personalized precision practice of medicine is often based on an individual’s genetic and epigenetic information. This patient-specific pathway employs a multivariate analysis that often suggests that previous treatment failures may be the result of failing to consider simultaneous multiple patient problems or medical solutions relevant to individual clinical presentations. The single problem analysis, sequential problem-solving approach practiced in the United States is at best reductionist. Although it promotes easy application of the scientific method and is highly effective in the treatment of single-cause or simple medical problems, it often fails in complex, multisystem medical problems. This current regime of medical practice is supported by classical researcher-blinded, randomized, crossover studies that contain adequate controls. While not actually a requirement of EBM, the EBM approach has encouraged testing one variable at a time and then measuring one (or a few outcomes) that result from manipulation of the single variable, because of the inherent simplicity of judging the validity of such tests. The bias in this approach, not EBM itself, is that problems that are not amenable to study in this fashion are improperly viewed as based upon poor or unsubstantiated data (such as provider experience). Consider again the foregoing example of gastric or post gastric ulcers. The prevailing wisdom, a result of plural single-variable analyses was that ulcers are caused by excess gastric acid and insufficient gastric protection via a mucous barrier. So strong was the evidence for the prevailing wisdom that new data points (the influence of H. Pylori) were rejected without study. The evidence just did not support a change in thinking — until it did due to the eventual acceptance of the multivariate analysis and result.

The issue of requiring a multi-faceted approach is particularly true of lifestyle-induced or lifestylerelated medical problems, such as in the patients I see. That is, a healthy pattern of diet, exercise, good sleep hygiene and stress reduction not only serves to reduce illness a lack of, or variations in, this complex pattern may be the root cause of inflammation and therefore complex medical problems. By creating multiple metabolic holes, complex medical problems may result that simply will not respond to a single intervention. The treatment plan must include methods to repair a threshold number of metabolic insults caused by the unhealthy lifestyle. Monotherapy is often ineffective in the face multivariate, multiple point failures. Rather than a one size fits all approach, it may be best to accept and more importantly adopt multiple different but not mutually exclusive medical approaches. Such approaches are just beginning to gain acceptance today, as evidence increases of new forms of treatment and analysis appear. This newest approach of “personalized, precision medicine” is often based upon an individual’s genetic and epigenetic information and including classical biomarker and imaging testing. This multivariate pathway suggests the need to abandon single-variable, aggregate data, evidence-based medicine. It suggests treatment failures are the result of inadequate precision in problem detection and inadequate attention to individualized responses to interventions. This practice pattern is still in its infancy but shows great promise. The fundamental flaw, which is likely to be overcome in the not-too-distant future, is that it sometimes ignores the highly personalized, precision-based properties of the inciting agent. As currently practiced, personalized, precision medicine sometimes views the solution to the root cause problem as a function of the multiple characteristics of the individual patient and omits the multiple characteristics of the individual pathogen (or multiple pathogens possibly acting in concert). Perhaps the end game will be to do precise personalized evaluation of the both the causative agent and the responding agent. We again, thus have a multivariate system, provoking the

ANTI-AGING MEDICAL NEWS | WINTER 2023

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) Be A Front Line, Standard Of Care Therapy?

inherent bias in EBM that suggests a precision solution cannot be found, indicating an approach is flawed and therefore inferior. It is the rejection of multivariate approaches that is reductionistic, and ultimately a false conclusion. A well-studied statistical tool such as design of experiments is one way to cope with such complex interactions effectively without having to isolate variables and responses that are inherently inseparable. This false and reductionist conclusion is the result of an improperly narrowed focus and improperly suggests that EBM and personalized medicine are competitors. The false suggestion is that one may obviate the need for the other. Complex medical problems may simply require complex solutions that have their origins in many different branches of medicine. Often, providers are highly literate in one area, but nearly completely illiterate in others. Areas not familiar to them are dismissed and ailments that do not fit neatly into known categories are often misdiagnosed. For example, some physical ailments or systemic conditions are misdiagnosed paradoxically, as being psychiatric in nature. It is forgotten that systemic illness may have psychiatric complications with the consequence that effect is mistaken for cause. There is no need for this error to perpetuate — EBM that considers multivariate problems and solutions will prove the viability of personalized medicine therapies. The long-standing culture of medicine brings us here. Complex problems which require complex solutions can be so complicated, they intimidate providers. Learning one approach is so daunting and so time consuming it almost excludes the possibility of learning both. Providers may find learning multiple specialties an insurmountable task. Changing medical focus from a “one at a time approach” to an all of them, together at the same time approach for an individual is extremely difficult. Changing the medical culture to adopt and accept the multivariate, personalized medicine approach is as a result also extremely difficult. Only after the culture has changed will the educational and training experience change.

The current situation includes this flawed feedback loop because one of the most effective ways to change medical culture is through education and training.

Hope for change: With the background presented above, it is easy to understand why change is slow in medicine. The question, now, is what processes should change to produce the appropriate standards of care for modern medicine to include multivariate approaches including HBOT. Those who resist change cite the need for new evidence as the impetus for resisting change. Until practitioners recognize that complex problems are not inherently antithetical to the classical EBM model, change will remain difficult. The normalization and structural proofs of multivariate solutions that produce evidence as required by EBM through rigorous, mathematical analysis will move this ball forward. Lifestyle interventions such as diet, exercise, sleep, and stress reduction are such problem solvers. They effect a broad range of cellular mechanisms simultaneously. They are neither single variable nor precise in their effects. Perhaps that is why lifestyle correctionbased medicine has such a low appeal to conventionally trained providers. Perhaps, in part, this is why these are so underrepresented in medical education and training. More evidence of the effects and designs of experiments that simultaneously examine matrices of multiple inputs and effects will prove the value of new approaches. (8). A gradual introduction of such methods into classical training is warranted.

So, why has it taken so long and what is required to obtain adoption of HBOT? All newly apparent technologies, including HBOT, are shrouded in bias. There is an inherent bias by innovators, early adopters, and leaders towards adopting new and innovation solutions. The newness alone may propel leaders towards using novel solutions, while the established base is concerned about whether their ox is the one that will be gored. In consumers, there is a bias

ANTI-AGING MEDICAL NEWS | WINTER 2023

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) Be A Front Line, Standard Of Care Therapy?

against adopting new technologies by late adopters and late majority users. There is fear of unproven methods. There is fear of the unknown or poorly understood. There is resistance to changing ritualized behavior. There is fear in governmental agencies to adopt new technologies because it could add new costs or require change in funding allocation already in place. There may be conflicting or competing priorities. It can be impossible to predict the downstream effects of a new technology (the devil you know). It may be difficult to predict long term consequences. There may be conflicting information about the indications, utilization, purpose, benefits, and risks of the new technology. The inherent ambiguity (Is it better, the same or worse than current approaches?) may cause distress. There are numerous other obstacles that individuals, agencies, and other bodies may raise, including some legitimate difficulties in making the turn towards a new technology that is still in the process of maturing. More data obtained using reproducible analyses, including more sophisticated multivariate analysis methods adopted from systems engineering and elsewhere, will go a long way towards tamping down fears of charlatanry and will encourage the effort required to bring new technologies online. In the case of HBOT, the mere definition of HBOT is even muddied. Some define HBOT as any pressure over atmospheric. Some define HBOT as requiring a minimum pressure of 1.4 Atm. Some practitioners describe HBOT as requiring 100% oxygen exposure. Most of these descriptions are motivated by financial concerns of the individuals or entities involved. Standards must be developed, even as to the description of the therapy and the equipment and practices it involves, just as exist in every other area of medicine. Similarly, some of the basic science presented in the field was based upon erroneous assumptions. (6). An entire sophistry was propagated by the early investigators of

HBOT. Evidence mounted that HBOT was not effective unless conducted in ways that misunderstood the basic premise. In highly cited studies, control or sham groups were utilized that in fact consisted of treatment groups. This was based upon historical and empiric evidence and experience rather than malfeasance. None the less, it was wrong. Highly regarded studies used what is now known to be effective dosage techniques as controls. That is, they used effective treatments as the control group and measured outcomes compared to the control group. These types of problem with early studies have appeared in other areas of medicine but were eventually weeded out as more rigorous studies based in a better understanding of the medicine, systems, and maladies being studied evolved. Evidence prevailed because it was provable and repeatable. This same approach but using multivariate approaches and rigorous multivariate analysis will ultimately prevail, as well.

Where do we go from here? HBOT is an incredibly effective, unbelievably safe treatment modality with a broad range of beneficial results. It mirrors diet, exercise, sleep, stress reduction as lifestyle interventions that, if adopted, could remediate a wide variety of maladies. Acceptance must begin with the HBOT community. The internecine fighting related to HBOT definition, reimbursement, utility, safety is based upon threats to practitioners concerns for turf, profit, recognition, authority and subsequently, regulation. The HBOT community needs to focus on the evidence. It needs to embrace the precision, personalized medicine movement and recognize that like every other treatment the dose response curve must be incorporated into the conversation. Regulatory bodies must be able to hear a unified voice to be able to successfully regulate the treatment. The multisystem, multichannel approach to solving complex problems with complex solutions must invite discussion and therefore acceptance. The bias must be minimized so that everyone can benefit. We have at our disposal as close to a panacea as I have seen in my career. (9). It can be offered in clinics at relatively low cost.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Shouldn’t Hyperbaric Oxygen Therapy (HBOT) Be A Front Line, Standard Of Care Therapy?

For those who are not disqualified by physical factors, it can be offered at home. Everyone can benefit. The beauty of HBOT is that it meets you whenever and wherever you are. If you are an Olympic athlete, it helps athletic performance. If you are suffering from cognitive or physical

decline, it helps you repair, rebuild, regenerate tissues to the extent you can. If you are in between these levels.

References: 1. Hyperbaric oxygen induces a cytoprotective and angiogenic response in human. microvascular endothelial cells Cassandra A. Godman, 1 Kousanee P. Chheda,1 Lawrence E. Hightower,1 Cell Stress Chaperones. 2010 Jul; 15(4): 431–442. Published online 2009 Dec 1. doi: 10.1007/s12192-009-0159-0 2. Hyperbaric oxygen therapy induces transcriptome changes in elderly: a prospective trial. Amir Hadanny, 1 , 2 , 3 , 4 Relly Forer, 5 Dina Volodasky, 5 Malka Daniel-Kotovsky, 1 Merav Catalogna, 1 Yonatan Zemel, 1 , 4 Yair Bechor, 1 , 4 and Shai Efrati 1 , 2 , 4 , 6. Aging (Albany NY). 2021 Nov 30; 13(22): 24511–24523. Published online 2021 Nov 24. doi: 10.18632/aging.203709 PMCID: PMC8660606 PMID: 34818212 3. The transcriptional landscape of age in human peripheral blood. Peters MJ, Joehanes R, Pilling LC, Schurmann C, Conneely KN, Powell J, Reinmaa E, Sutphin GL, Zhernakova A, Schramm K, Wilson YA, Kobes S, Tukiainen T, et al., and NABEC/UKBEC Consortium. Nat Commun. 2015; 6:8570. 10.1038/ncomms9570 4. Hyperbaric oxygen therapy for traumatic brain injury: bench-tobedside Qin Hu,1,2 Anatol Manaenko,2 Ting Xu,2 Zhenni Guo,2 Jiping Tang,2 and John H. Zhang, M.D., Ph.D.2,3,*Med Gas Res. 2016 Apr-Jun; 6(2): 102–110.Published online 2016 Jul 11. doi: 10.4103/2045-9912.18472

5. Hyperbaric Oxygen Treatment-From Mechanisms to Cognitive Improvement Irit Gottfried, Nofar Schottlender, Uri Ashery Biomolecules, 2021 Oct 15, doi: 11(10):1520 Published Oct 2021 6. Systematic Review and Dosage Analysis: Hyperbaric Oxygen Therapy Efficacy in Mild Traumatic Brain Injury Persistent PostConcussion Syndrome Paul G. Harch Frontiers Neurology, 2022: 13: 815056 Published: 17 March 2022 7. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial. Shani Zilberman-Itskovich, Merav Catalogna, Efrat Sasson, Karin Elman-Shina, Amir Hadanny, Erez Lang, Shachar Finci, Nir Polak, Gregory Fishlev, Calanit Korin, Ran Shorer, Yoav Parag, Marina Sova & Shai Efrati Scientific Reports volume 12, Article number: 11252 (2022) Published: 12 July 2022 8. Technology adoption and diffusion in healthcare at onset of COVID19 and beyond Lili Liu, PhD1 and Antonio Miguel-Cruz, PhD1,2,3 Healthc Manage Forum. 2022 May; 35(3): 161–167. Published online 2022 Mar 3. doi: 10.1177/08404704211058842 9. Hyperbaric oxygen therapy and Tissue Regeneration: A literature Survey J. Lindenmann, L. Kamolz, W. Graier, J. Smolle, F.-M. SmolleJuettner Biomedicines. 2022 Dec: 10(12):3145 Published: Dec 6, 2022

About the Author: Allen Meglin, MD and his wife Robyn Meglin RN operate a regenerative medicine clinic in Savannah Georgia called Advanced Regenerative Therapy (ART). Although Dr Meglin was classically trained in Radiology and then Interventional Radiology, he transitioned to regenerative medicine in the later part of his career. Dr Meglin is a self-proclaimed HBOT Evangelist. He would like to recognize the contributions of Gary Engelson Esq, Carlos Rivera MD, Pat Lovette and Robyn Meglin RN to this paper.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Tβ4 Frag

By: Erika Schwartz, MD & Kristin Wright McKitish, MD

Tβ4 Frag By:

Erika Schwartz, MD & Kristin Wright McKitish, MD

Thymosin beta 4 Fragment (Tβ4 Frag) is the active portion of the larger peptide thymosin beta (Tβ), which has been widely studied. It has been shown to be an excellent anti-inflammatory peptide that balances cytokine inflammation. Along with its tissue healing and regenerating properties, Tβ4

Chemical Structure of Thymosin beta 4

possesses an antimicrobial feature and limits scar formation, which makes it of great interest for treatment in wound healing as well as improvement in diabetes markers and associated comorbidities. Initially extracted from the calf thymus by Goldstein and White, Thymosin is a lymphocyte growth factor.1 The thymosin family consists of three groups: α, β, and γ thymosin. Fifteen types of β-thymosin have been identified, with Tβ4 being the most abundant. 1 Tβ4 was found to be present in all cells (except red blood cells) and was also detected outside of cells, in blood plasma and in wound and blister fluids.2 Tβ4 levels are highest in platelets and polymorphonuclear neutrophilic leukocytes (PMN), which are among the first formed elements and cells to enter a wound and release their factors, some of which recruit additional cells to the wound site.3

ANTI-AGING MEDICAL NEWS | WINTER 2023

Tβ4 Frag

Thymosin beta 4 fragment (Tβ4 Frag) is the active segment of larger peptide Tβ4, which allows it to replicate the activity of Tβ4. The shorter 4 amino acid length of Tβ4 Frag makes it orally absorbable, unlike full-length Tβ4 – at 43 amino acids long – which hinders its oral, sublingual and nasal absorption capabilities. Studies are ongoing to determine the optimal dose, efficacy, and safety of Tβ4 Fragment but dosage typically consists of 135 microgram capsules taken orally twice daily.

Wound Healing and Tissue Regeneration The most researched aspect of Tβ4 is its wound healing and tissue regenerating capabilities. Studies have been conducted on a variety of tissues – healthy, diseased, aged and injured – rendering it an important peptide that can be used for several injuries and populations with varying degrees of health. Inflammation and swelling in an early wound site exacerbate tissue damage, thus are essential to control. Thymosin Beta-4 is able to do so by inhibiting the release of cytokines such as tumor necrosis factor-a (TNF-a) and preventing further damage. Once the wound is protected, Tβ4 focuses on tissue regeneration by promoting stem cell mobilization, migration, and differentiation. It does this by sequestering actin monomers to maintain high concentrations of unpolymerized actin, which plays a pivotal role in cell movements.4 Tβ4 also decreases the number of myofibroblasts in wounds, resulting in decreased scar formation and fibrosis.5 One notable study created a 5mm bone defect in the skulls of rats and found new bone formation to be significantly greater in the Tβ4 group than in the control group. In some Tβ4 group individuals, the entire bone defect region was covered with newly formed bone. Immunostaining revealed a significant number of osterix-positive cells in the Tβ4 group.6 This is clinically important as Osterix (Osx) is an osteoblast-specific transcription factor which activates a repertoire of genes during differentiation of pre-osteoblasts into mature

osteoblasts and osteocytes. Osx is a major effector and essential for activation of bone-specific genes that support bone formation in embryos and adults.7 Another animal study evaluated the effects of Tβ4 on wound healing after tooth extraction. Tβ4 was injected intraperitoneally at the time of extraction and daily thereafter for six days. Tβ4 treatment suppressed apoptosis and inflammation; it accelerated the process of wound healing, including new bone formation. The findings demonstrated the usefulness of the Tβ4 partial peptide in wound healing of tooth extraction sockets, and its potential application for bone regeneration and osteogenesis in bone and bone-related tissues.8 Thymosin beta 4 was also active in accelerating wound repair in full-thickness dermal wounds in both diabetic and aged mice, two populations known to suffer from impaired and delayed healing. In the diabetic mice, it was specifically found that wound contracture and collagen deposition were significantly increased in the mice treated with Tβ4. In aged mice, Tβ4 showed increases in keratinocyte migration, wound contracture and collagen deposition. It was concluded that Tβ4 may have efficacy in chronic wounds in humans.9

Antimicrobial Effects Furthering its value in wound care, Thymosin beta 4 was found to have antimicrobial properties – not only increasing the rate of cell survival, but also ensuring that the site of the wound is kept safe from different infections.10

Cardiac Benefits Cardiac tissue seems to be no exception to the healing properties of Tβ4. Tβ4 reduced the infarct size and improved contractile performance in chronic myocardial ischemic injury through two phases: an acute phase that occurs immediately after injury, in which Tβ4 preserves the ischemic myocardium via anti-apoptotic or antiinflammatory mechanisms, and a chronic phase, in which Tβ4 activates the growth of vascular or cardiac progenitor

ANTI-AGING MEDICAL NEWS | WINTER 2023

Tβ4 Frag

cells.11 Tβ4 was also shown to improve ischemiareperfusion injury during congenital heart surgery in children less than one year old.12 A phase II clinical trial conducted in patients with acute myocardial infarction (MI), confirmed that Tβ4 may protect and repair the heart and reduce the volume of scars after heart attack.13 The size, location, composition, structure and mechanical properties of the healing scar are all critical determinants of the fate of patients who survive the initial infarction.14 It is common knowledge that people with larger scars have a higher risk of future cardiac conditions and death. Thus, it is absolutely crucial to limit scar formation post-MI, yet there is currently no mainstream solution.

Anti-inflammatory Properties TNF-α is a cytokine that has pleiotropic effects on various cell types. It has been identified as a major regulator of inflammatory responses and is known to be involved in the pathogenesis of some inflammatory and autoimmune diseases.15 A neonatal mouse fetal alcohol spectrum disorder model revealed that Tβ4 treatment effectively blocked the increase in ethanol-induced inflammatory factors and decreased the expression of TNF-α.16 Another study demonstrated Tβ4 inhibits TNF-α and determined Tβ4 to be an effective inhibitor of inflammatory diseases mediated by TNF-α.17 Tβ4 has also been shown to have potent anti-inflammatory effects even in diseased states, such as an environment exposed to endotoxins. Administration of 100 micrograms of Tβ4 lowered blood levels of a number of inflammatory cytokines, eicosanoids and other molecules that are highly elevated following endotoxin administration. In studies in human subjects given low doses of endotoxin and in patients with septic shock, significant decreases in blood levels of TB4 were observed.18

Improvement in Diabetes Tβ4 is known to have profound effects in diabetes mouse models including improving glucose intolerance and reducing insulin resistance.19 It was also shown to ameliorate hyperglycemia-induced renal damage.20 Diabetic patients often suffer from various comorbidities,

such as peripheral arterial disease, of which prevalence is more than two-fold compared with the general population.21 Tβ4 has demonstrated a useful effect in treating peripheral vascular disease and lowering limb ulcers, furthering its importance in diabetic patients.22

Athletic Performance and Recovery Athletes are often sidelined by recovery time inbetween workouts, injuries or both. Tβ4 seems to have the ability to accelerate the healing and regeneration process of tissues and decrease inflammation, combined with the ease of oral supplementation via Tβ4 Frag, this combination of peptides makes them among the most impressive tools for athletes of all levels.

About the Authors: Erika Schwartz, MD is a leading expert in preventative medicine, bioidentical hormone therapy, peptides, and longevity medicine. She is the founder and CEO of Evolved Science the premier longevity medical practice with multiple locations headquartered in Manhattan where she sees patients from all around the globe. Dr. Erika is the author of 8 bestselling books and a TEDx speaker. 477 Madison Avenue Suite 420, New York, NY 10022 | 212.873.3420 info@eshealth.com Kristin Wright McKitish, MD is a member of the Evolved Science team with Dr. Erika Schwartz. Graduate of the University of Miami, earning a Bachelor of Science in Kinesiology and Biology. She is Board-certified in medicine completing her residency at New York Medical College Hoboken, where she was chief resident. She completed University of Arizona’s Integrative Medicine Residency program. When she’s not treating patients or researching the latest in disease prevention, Kristin can be found exercising or spending time with her husband, three kids, and their dog. 477 Madison Avenue Suite 420, New York, NY 10022 | 212.873.3420 info@eshealth.com

ANTI-AGING MEDICAL NEWS | WINTER 2023

Tβ4 Frag

References: 1. Xing Y, Ye Y, Zuo H, Li Y. Progress on the Function and Application of Thymosin β4. Frontiers in Endocrinology. 2021;12. doi:https://doi. org/10.3389/fendo.2021.767785 2. Moon EY, Song JH, Yang KH. Actin-Sequestering Protein, ThymosinBeta-4 (TB4), Inhibits Caspase-3 Activation in Paclitaxel-Induced Tumor Cell Death. Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics. 2007;16(11):507-516. doi:https://doi. org/10.3727/096504007783438349 3. Sosne G, Qiu P, Kurpakus-Wheater M. Thymosin beta 4: A novel corneal wound healing and anti-inflammatory agent. Clinical ophthalmology (Auckland, NZ). 2007;1(3):201-207. Accessed October 2, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2701135/ 4. Morris DC, Chopp M, Zhang L, Zhang ZG. Thymosin β4: a candidate for treatment of stroke? Annals of the New York Academy of Sciences. 2010;1194(1):112-117. doi:https://doi.org/10.1111/j.17496632.2010.05469.x 5. Goldstein AL, Hannappel E, Sosne G, Kleinman HK. Thymosin β4: a multi-functional regenerative peptide. Basic properties and clinical applications. Expert Opinion on Biological Therapy. 2011;12(1):3751. doi:https://doi.org/10.1517/14712598.2012.634793 6. Adachi K, Matsuo K, Akasaki Y, et al. Effects of thymosin β4 on the bone formation of calvarial defects in rats. Journal of Prosthodontic Research. 2013;57(3):162-168. doi:https://doi.org/10.1016/j. jpor.2013.01.008 7. Sinha KM, Zhou X. Genetic and molecular control of osterix in skeletal formation. Journal of Cellular Biochemistry. 2013;114(5):975-984. doi:https://doi.org/10.1002/jcb.24439 8. Matsuo K, Akasaki Y, Adachi K, et al. Promoting effects of thymosin β4 on granulation tissue and new bone formation after tooth extraction in rats. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2012;114(1):17-26. doi:https://doi.org/10.1016/j. tripleo.2011.05.025 9. Philp D, Badamchian M, Scheremeta B, Nguyen M, Goldstein AL, Kleinman HK. Thymosin β4and a synthetic peptide containing its actin-binding domain promote dermal wound repair in db/db diabetic mice and in aged mice. Wound Repair and Regeneration. 2003;11(1):19-24. doi:https://doi.org/10.1046/j.1524475x.2003.11105.x 10. Huang LC, Jean D, Proske RJ, Reins RY, McDermott AM. Ocular Surface Expression andIn VitroActivity of Antimicrobial Peptides. Current Eye Research. 2007;32(7-8):595-609. doi:https://doi. org/10.1080/02713680701446653

cardioprotectants thymosin β4 and dexrazoxane during congenital heart surgery: proposal for a randomized, double-blind, clinical trial. Annals of the New York Academy of Sciences. 2012;1270:59-65. doi:https://doi.org/10.1111/j.1749-6632.2012.06710.x 14. Richardson WJ, Clarke SA, Quinn TA, Holmes JW. Physiological Implications of Myocardial Scar Structure. National Library of Medicine. Published September 20, 2015. https://www.ncbi.nlm.nih. gov/pmc/articles/PMC4727398/ 15. Bradley JR. TNF-mediated inflammatory disease. The Journal of pathology. 2008;214(2):149-160. doi:https://doi.org/10.1002/ path.2287 16. Zhang J, Wu J, Zeng W, Yao K, Zu H, Zhao Y. Function of Thymosin Beta-4 in Ethanol-Induced Microglial Activation. Cellular Physiology and Biochemistry. 2016;38(6):2230-2238. doi:https://doi. org/10.1159/000445578 17. Qiu P, Wheater MK, Qiu Y, Sosne G. Thymosin β4 inhibits TNF-αinduced NF-κB activation, IL-8 expression, and the sensitizing effects by its partners PINCH-1 and ILK. The FASEB Journal. 2011;25(6):18151826. doi:https://doi.org/10.1096/fj.10-167940 18. Badamchian M, Fagarasan MO, Danner RL, Suffredini AF, Damavandy H, Goldstein AL. Thymosin beta(4) reduces lethality and downregulates inflammatory mediators in endotoxin-induced septic shock. International Immunopharmacology. 2003;3(8):1225-1233. doi:https://doi.org/10.1016/S1567-5769(03)00024-9 19. Zhu J, Su LP, Ye L, Lee KO, Ma JH. Thymosin beta 4 ameliorates hyperglycemia and improves insulin resistance of KK Cg-Ay/J mouse. Diabetes Research and Clinical Practice. 2012;96(1):53-59. doi:https://doi.org/10.1016/j.diabres.2011.12.009 20. Zhu J, Su LP, Zhou Y, Ye L, Lee KO, Ma JH. Thymosin β4 Attenuates Early Diabetic Nephropathy in a Mouse Model of Type 2 Diabetes Mellitus. American Journal of Therapeutics. 2015;22(2):141-146. doi:https://doi.org/10.1097/MJT.0b013e3182785ecc 21. Soyoye DO, Abiodun OO, Ikem RT, Kolawole BA, Akintomide AO. Diabetes and peripheral artery disease: A review. World Journal of Diabetes. 2021;12(6):827-838. doi:https://doi.org/10.4239/wjd.v12. i6.827 22. Su L, Kong X, Loo S, et al. Thymosin beta-4 improves endothelial function and reparative potency of diabetic endothelial cells differentiated from patient induced pluripotent stem cells. Stem Cell Research & Therapy. 2022;13(1). doi:https://doi.org/10.1186/ s13287-021-02687-x

11. Ruff D, Crockford D, Girardi G, Zhang Y. A randomized, placebocontrolled, single and multiple dose study of intravenous thymosin β4 in healthy volunteers. Annals of the New York Academy of Sciences. 2010;1194(1):223-229. doi:https://doi.org/10.1111/j.17496632.2010.05474.x 12. Bao W, Ballard VL, Needle S, et al. Cardioprotection by systemic dosing of thymosin beta four following ischemic myocardial injury. Frontiers in Pharmacology. 2013;4:149. doi:https://doi.org/10.3389/ fphar.2013.00149 13. Stromberg D, Raymond T, Samuel D, et al. Use of the

ANTI-AGING MEDICAL NEWS | WINTER 2023

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Addressing Uncomplicated and Complicated UTIs – A Holistic Approach By:

Emily Hernandez, ND

Urinary tract infection (UTI) is one of the most common infections in women – affecting up to 40% of women in the United States in their lifetime. UTI refers to an infection of the bladder, urethra, ureters, and/or kidneys. Antibiotics are often used to treat the infection; however, some women get recurring UTIs that are resistant to antibiotics and can be very difficult to resolve. This is a result of both microbial resistance and the fact that biofilms are often involved. UTIs often accompany vaginal infections, further complicating the clinical picture. Vaginal and urinary tract infections are most often caused by pathogens that originate in the digestive tract. Therefore a holistic approach that aims to address infection and biofilms in the urinary tract, support a healthy urethral and bladder mucosa, balance the vaginal and gut microbiomes, and maintain an appropriate vaginal pH should be considered.

Epidemiology UTIs are most often bacterial infections and affect 150 million people each year worldwide. In 2007, in the United States alone, there were an estimated 10.5 million office visits for UTI symptoms and 2-3 million emergency department visits.

Physiology/Diagnosis/Clinical Relevance UTIs are divided into two categories – complicated and uncomplicated – with uncomplicated being the most common. They are defined by their location in the urinary tract, as well as by patient demographics. Recognizing the signs and symptoms of a complicated UTI is important because they have a higher risk of treatment failure and complications.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Addressing Uncomplicated and Complicated UTIs – A Holistic Approach

Uncomplicated UTI

Complicated UTI

Location

Lower urinary tract (urethra and bladder)

Lower and upper urinary tract (kidney, ureter)

Symptoms

• Pain or burning when urinating • Blood in the urine (also called hematuria) • Cloudy or smelly urine • Frequent and urgent need to urinate • Pain in the pelvic area

• All of the uncomplicated symptoms • Pain in the lower back or side • Fever and/or chills • Joint or muscle aches • Nausea and vomiting

Demographic

• Women (non-pregnant) • Children • Elderly

• Male • Pregnant women • Immunocompromised

• Vaginal dysbiosis or infections • Wiping back to front post-void • Sexual activity • Hormonal fluctuations2

• Urinary tract abnormalities • Indwelling catheters • Kidney stones • Unusual bacteria in the urinary tract • Overuse of antibiotics • Sexual activity • Hormonal fluctuations

Risk factors

A range of pathogens can cause UTIs. However, most frequently, they involve uropathogenic Escherichia coli, originating from the gastrointestinal tract. Other causative agents include Klebsiella pneumoniae, Staphylococcus saprophyticus, Enterococcus faecalis, Group B Streptococcus (GBS), Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus, or Candida spp.3 It is common practice to prescribe antibiotics based on symptoms alone; however antibiotic resistance is one of the leading factors in recurrent UTIs. This resistance, coupled with biofilm formation, may lead to chronic and complicated infections that are difficult to treat. Untreated UTIs or resistant strains can lead to upper UTI infections and kidney infections. Serious long-term effects may include frequent recurrence, pyelonephritis, sepsis, renal damage, pre-term birth and complications, and Clostridium difficile colitis caused by frequent antimicrobial use.3

The Gut-Urethra Connection Uncomplicated UTIs begin when uropathogens in the gut contaminate the periurethral area and colonize the urethra. Once in the urethra, bacteria can migrate to the bladder and – if conditions are right – even to the kidneys and bloodstream, leading to serious infection and bacteremia. These uropathogens can become resistant to host neutrophils and often form biofilm. Similarly, they can become resistant to antibiotics. In one study by researchers at Washington University School of Medicine in St. Louis and the Broad Institute of MIT and Harvard, antibiotics addressed the uropathogens in the bladder. Still, they did not eliminate the pathogenic bacteria from the gut. Furthermore, the antibiotics left the women more predisposed to recurring UTIs as beneficial organisms were negatively affected. Women with recurrent UTIs in the study had less diverse microbiomes that were deficient in a vital

ANTI-AGING MEDICAL NEWS | WINTER 2023

Addressing Uncomplicated and Complicated UTIs – A Holistic Approach

group of bacteria that helps regulate inflammation and a distinct immunological signature in their blood indicative of inflammation. Addressing gut dysbiosis

may provide an important therapeutic intervention for resolving the root cause of recurring UTIs.

Treat Biofilms

that biofilm formation is prevalent in about 55.8% of UTI cases, and therefore, treatment should focus on eradicating biofilm for best therapeutic outcomes.

Uropathogens form biofilms and undergo morphological changes, which allows them to persist and cause recurrent infection. In a study involving postmenopausal women with recurrent and isolated urinary tract infections, it was found that uropathogens isolated from those with recurrent UTIs had biofilm involvement 70% of the time, while those with isolated UTIs had biofilm involvement 38.6% of the time. Overall, it was found

The Urinary-Vaginal Connection Interestingly, high vaginal pH can increase susceptibility to getting UTIs due to their anatomical proximity to one another . Vaginal pH can increase due to changes in the vaginal microbiome, infections, and hormonal changes.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Addressing Uncomplicated and Complicated UTIs – A Holistic Approach

Menopausal women and cycling women around their periods often notice increased symptoms due to naturally shifting hormone levels. Natural hormonal solutions such as botanicals or bioidentical hormone replacement (BHRT) can help to return their pH to lower levels and ward off UTIs. It is important to support vaginal pH during times of fluctuating hormones to reduce the risk of UTIs. This can be done by: • Avoiding scented feminine hygiene products and harsh soaps • Replacing over-the-counter douches or suppositories that can raise the vaginal pH with natural alternatives like apple cider vinegar, boric acid, or antimicrobial botanicals • Changing tampons or menstrual cups regularly • Using barrier protection during sex • Taking oral botanicals or applying liquid versions topically following sex as a preventative • Using probiotics specific to vaginal health

Lifestyle Recommendations It’s a good practice to review basic hygiene measures for all woman, especially those who are susceptible to UTIs. Such hygiene considerations include: Wiping from front to back • Urinating after intercourse, • Changing out of wet swimsuits, workout clothes, or sweaty undergarments as soon as possible

capabilities but also provide mechanisms of action that support inflammation control, biofilm dismantling, and immune regulation. Some commonly researched herbs found to be effective for the management and cure of UTIs include Vaccinium macrocarpon, Tribulus terrestris, Trachyspermum copticum, Cinnamomum verum, and Hybanthus enneaspermus. These herbs can combat bacterial resistance, are easily available, and have minimal to no side effects. Garlic is another herb studied to combat E.coli-induced UTIs, with the constituent allicin significantly alleviating the infection in rats. Additional herbs that have successfully addressed UTIs and/or reduced their recurrence include uva ursi, oregano oil, and green tea, to name a few. Besides herbal extracts, certain nutrients and probiotics can offer effective adjunct therapy against UTIs. D-Mannose is a well-studied monosaccharide that can inhibit bacterial adhesion to the urothelium after oral intake. Several clinical studies have shown the efficacy of d-mannose in preventing recurrent UTIs and some evidence in supporting acute infections as well. Boric acid suppositories have long been used to support clearance of vulvovaginitis and regulation of vaginal pH, which we know can help prevent the risks of UTIs. Finally certain Lactobacillus probiotic strains, including Lactobacillus rhamnosus GR-1®, Lactobacillus reuteri RC-14®, and Lactobacillus crispatus, have been reported to support a healthy urinary microbiome in those who experience recurrent UTIs. Spore-based probiotics also offer a wide range of antimicrobial support, reconditioning the gut through microbial diversity. This is key in supporting the growth of beneficial bacteria needed to provide competitive inhibition of pathogenic organisms.

• Switching to wearing cotton underwear • Avoiding thongs to prevent cross-contamination • Avoiding processed sugar and other inflammatory foods to help reduce susceptibility and prolonged infections.

Holistic Therapeutic Interventions Botanical interventions offer an effective alternative to antibiotics that often lead to resistance and increased risk of dysbiosis. Herbs not only have broad spectrum

An 81-year-old postmenopausal woman who suffered from chronic UTIs and multiple rounds of antibiotic use that only resulted in short-term resolution of symptoms found that after eight weeks of using a liposomal delivery of a biocidal botanical formula, she remained symptom-free, which was the longest she’s gone in years without a UTI returning. The ability to address the root cause of her infection led to long-lasting results and greatly enhanced her quality of life.

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Addressing Uncomplicated and Complicated UTIs – A Holistic Approach

Another woman, 50 years old, with recurrent UTIs caused by E. coli, also suffered from elevated LPS antibodies, mixed hydrogen and methane SIBO, and chronic joint pain. Through diet changes, prioritizing sleep, hydration, and managing stress, as well as using a liposomal biocidal botanical formula and suppository version of the biocidal formula along with an olive leaf extract with uva ursi and spore-based probiotics, was able to resolve her long-standing UTIs and bring balance to her gastrointestinal microbiome.

Regardless of the severity, they can significantly affect quality of life and even become debilitating. A holistic approach that uses botanicals, nutrients, and lifestyle changes may offer the most well-rounded and successful long-term solutions for UTIs, especially when they are recurring. These tools and approaches demonstrate the importance of addressing the root cause of such infections and supporting the body’s natural ability to heal and return to homeostasis.

Conclusion UTIs are common infections ranging from mild symptoms to serious systemic complications.

References: 1. https://www.ncbi.nlm.nih.gov/books/NBK470195/

8. https://onlinelibrary.wiley.com/doi/10.1111/1440-1681.13092

2. https://pubmed.ncbi.nlm.nih.gov/33935619/

9. https://pubmed.ncbi.nlm.nih.gov/35246671/

3. https://pubmed.ncbi.nlm.nih.gov/25853778/

10. https://pubmed.ncbi.nlm.nih gov/35326777/#:~:text=d%2Dmannose%20 is%20a%20monosaccharide,d%2Dmannose%20in%20acute%20therapy.

4. https://www.goodrx.com/conditions/urinary-tract-infection/complicateduncomplicated-uti 5. https://medicine.wustl.edu/news/recurrent-utis-linked-to-gut-microbiomechronic-inflammation/ 6. https://pubmed.ncbi.nlm.nih.gov/34768258/#:~:text=Most%20 uropathogens%20produced%20biofilm%20(n,%25%2C%20P%20%3D%20 0.0033).

11. https://www.optibacprobiotics.com/learning-lab/in-depth/womenshealth/which-probiotics-are-best-for-women#:~:text=Urinary%20tract%20 infections,-Urinary%20tract%20infections&text=The%20probiotic%20 strains%3B%20Lactobacillus%20rhamnosus,those%20who%20 experience%20recurrent%20UTIs.

7. “Vaginal Ph Balance: Normal Levels and Natural Remedies.” Medical News Today, www.medicalnewstoday.com/articles/322537#what-causesunbalanced-vaginal-p-h. Accessed 10 July 2023.

Author Bio: Dr. Emily Hernandez is a Naturopathic Doctor and Clinical Consultant for Biocidin Botanicals. She owns Wildcraft Medicine, a family medicine practice in La Jolla, California, where she specializes in digestive health, preconception and fertility, hormone balancing, and chronic illness, including Lyme disease. With almost 10 years in practice, Dr. Hernandez believes that starting with gut health is often the best way to bring overall health back into balance.

Contact: Dr. Jocelyn Strand, Director of Clinical Education and Research

Biocidin Botanicals: 18 Hangar Way, Watsonville, CA 95076 (218) 600–5092 / drstrand@biocidin.com

ANTI-AGING MEDICAL NEWS | WINTER 2023

TB006:

Targeting Galectin-3 in Neurodegenerative Disease with a Novel Antibody By:

Jenny Johansson, PhD Xi Lan, PhD Akshaya Vijayareka 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.

Aging is the single highest risk factor for the development of Alzheimer’s disease (AD) and other dementias. Among the biological processes affecting

subcellular distribution and functions in the nuclear, cytoplasmic, and extracellular compartments.

the brain that are impaired in aging are immune

Galectin-3 in the Aging Brain

activation, cellular processes such as mitochondrial

Gal-3 expression is very low in healthy organs and tissues but is highly upregulated in the brains of neurodegenerative disease patients and corresponding animal models3. Gal-3 cellular localization is primarily observed in microglia immune cells. In the brains of young mice, Gal-3 expression is barely detectable but in normal healthy aging mice, Gal-3 is highly upregulated in areas involved in dopamine signaling and in white matter . In grey matter, Gal-3 expression appears localized mainly to microglia and in white matter, to astrocytes.

function and proteostasis, and dysfunction within the glial vascular network involved in clearance of brain interstitial fluid. Together this results in the accumulation of misfolded and aggregated proteins such as amyloid plaques and chronic inflammation. Galectins are a ubiquitous group of sugar-binding lectin proteins that bind to galactose-containing glycoproteins1,2. Galectins are found in a variety of cells and tissues, and are involved in numerous metabolic processes and functions. Galectin-3 (Gal-3), previously

Immune Aging

known as the macrophage/microglia marker Mac-

With age, there is an imbalance between proinflammatory and anti-inflammatory networks, a status termed inflammaging5. This results in chronic

2, is the only known family member which contains a domain for self-association. Gal-3 has ubiquitous

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TB006: Targeting Galectin-3 in Neurodegenerative Disease with a Novel Antibody

low-grade inflammation and immunosenescence. Mouse studies have shown that in various organs, changes in immune processes are most prominent with advancing age, which is reflected in increases in immune factors in the blood. Of the most differentially expressed genes with advancing age across different organs, Gal-3 was consistently among the top 30 genes6. AD and other neurodegenerative diseases have been described as a form of accelerated aging. Transcriptomic and proteomic studies of immune cells and blood factors have confirmed that similar processes are altered in both aging and AD6,7. Proteins identified in both aging and AD further correlate with cognitive and physical impairments. Blood or isolated immune factors from blood such as β2-microglobulin from a young mouse given to an old mouse can improve brain cellular and cognitive function8.

Cellular Dysfunction in the Brain Aging and neurodegenerative disease is characterized by impaired cellular processes. Particularly in neurons, mitochondrial function and the protein folding and degradation machinery including lysosomes and autophagy are affected. These processes are vulnerable in diseases such as Parkinson’s disease where intracellular alpha-synuclein aggregates are formed, generating inclusions called Lewy bodies. Dopaminergic neurons in addition are highly dependent on functional mitochondria due to their high energy demand. Gal-3 is involved in the regulation of lysosomal damage and was shown to localize in the vicinity of Lewy bodies9,10. Furthermore, Gal-3 mediated neuroinflammatory processes include the generation of oxidative stress, further damaging neuronal health11. In Amyotrophic Lateral Sclerosis (ALS), protein aggregates positive for TDP-43 are present in as many as 98% of sporadic and familial cases12, thus presence of such aggregates is widely regarded as a hallmark feature of ALS pathology. TDP-43 deposits occur in the cytoplasm of neurons and skeletal muscle13 and nuclear-to-cytoplasmic translocation of TDP-43 contributes to many of the

cellular characteristics observed in ALS14. The presence of TDP-43 deposits is highly suggestive of an imbalance between protein synthesis and degradation pathways.

Microglia Activation in Neurodegenerative Diseases Microglia, the primary immune cells and macrophages of the brain, are involved in surveillance, removing debris by phagocytic uptake and providing trophic support to neurons. In neurodegenerative diseases microglia are activated early by factors released by dystrophic neurons to clear aggregated proteins. This leads to chronically activated microglia and a state of sustained neuroinflammation. Release of pro-inflammatory cytokines is partly mediated by toll-like receptors and Gal-3 is a TLR4 ligand11. In various genome-wide association studies, more than half of the identified genes associated with AD risk are immune-related genes, pointing to an important role for microglia during disease development. Figure 1: Overview of cellular dysfunction in aging and neurodegenerative diseases. Intraneuronal ɑ-synuclein aggregates cause changes in mitochondrial function and lysosomes in Parkinson’s disease. Accumulating Aβ aggregates cause neurotoxicity and lead to microglia activation. Uptake of extracellular Aβ aggregates also leads to changes in lysosomal function in microglia. Activated microglia release pro-inflammatory molecules and Gal-3. This results in sustained release of Gal-3 and cytokines and oxidative stress, causing chronic microglia activation and neurodegeneration. Transcriptomic studies of microglia isolated from postmortem AD, ALS, and other neurodegenerative disease brains as well as mouse model studies have revealed signatures described as either primed microglia, damage associated microglia (DAM), or a microglial neurodegenerative phenotype (MGnD)15–17. The TREM2 receptor and the lipid carrier APOE were identified as signature genes in multiple transcriptomic studies. Both TREM2 and APOE genes are associated with a highly increased risk of developing AD, through rare variants in

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TB006: Targeting Galectin-3 in Neurodegenerative Disease with a Novel Antibody

Figure 1 Overview of cellular dysfunction in aging and neurodegenerative diseases.

TREM2, and the APOE4 allele is the highest genetic risk factor for late-onset AD. Trem2, which binds oligomeric Amyloid-β (Aβ) as well as Gal-3, appears to be particularly important for microglial transitioning to other stages and in microglial function in AD-related processes18,19. Furthermore, genetic targeting of Trem2 suppresses the APOE pathway and restores homeostatic microglia in APP-PS1 and SOD1 mice. Gal-3 was identified as a hub gene orchestrating the primed microglial activation phenotype and as part of the MGnD phenotype. Consistent with this, polymorphisms in the LGALS3 gene encoding Gal-3 have been associated with an increased risk of AD19.

Elevated Gal-3 serum levels distinguish between AD patients and healthy controls and correlate with the cognitive screening tool Mini-Mental Status Examination (MMSE) score21. In AD and ALS patient cohorts, serum and CSF Gal-3 levels correlated better with MMSE scores in AD than in ALS, where patients were older and where there was more memory loss22. Higher CSF Gal-3 levels early on correlated with intermediate MMSE scores in AD patients in the study by Boza-Serrano et al. 23. In this study, CSF Gal-3 levels correlated with the sensitive AD phosphorylated Tau biomarker p-Tau181, total Tau, and synaptic markers including Neurogranin.

Galectin-3 as a Neurodegenerative Disease Biomarker

Parkinson’s disease (PD) is the second most common neurodegenerative disease after AD and clinical manifestations include tremors, motor findings (rigidity, bradykinesia), and cognitive impairments. Serum Gal-3 levels were elevated in PD patients and correlated with disease stage24. Importantly, this study could differentiate between early and advanced stages of the disease by elevated Gal-3 levels both prior to and during disease onset.

Gal-3 is released from activated immune cells under disease conditions and therefore could be a promising biomarker for neurodegenerative disease1. Serum and cerebrospinal fluid (CSF) levels of Gal-3 have been found to be elevated in patient populations experiencing neurodegeneration and/or cognitive decline20. The rise in Gal-3 levels is generally indicative of increased inflammation and associated with worse prognosis. Gal-3 may be of diagnostic value similar to other markers of neuronal/axonal injury and neuroinflammation, however not specific to a particular disease.

In an ALS transgenic mouse model, Gal-3 levels are elevated in motor neurons and muscle cells25,26, which correlates preferentially with microglia activation in the region where motor neurons degenerate27. Gal-3 is also upregulated in ALS patients’ plasma and CSF, positively correlating with the duration of disease28. Gal-3 could

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TB006: Targeting Galectin-3 in Neurodegenerative Disease with a Novel Antibody

thus serve as a robust potential biomarker for a number of neurodegenerative diseases including AD, PD, and ALS.

Targeting Galectin-3 in Neurodegenerative Disorders Studies involving Gal-3 have demonstrated that Gal-3 is highly upregulated in the brains of patients and transgenic mouse models of AD and expression is high in microglia surrounding Aβ plaques19,23,29. This has been associated with both increased aggregation of Aβ plaques and neuroinflammation. Gal-3 deficiency resulted in reduced amyloid pathology and microglia activation markers and pro-inflammatory cytokines, and improved cognitive function. It is widely accepted that Aβ oligomers rather than monomers and fibrils play a critical role in AD progression. Aβ oligomers can trigger a series of toxic reactions in neurons, such as receptor disability, mitochondrial damage, Ca2+ homeostasis dysregulation and abnormal Tau phosphorylation. Boza-Serrano et al. demonstrated that in the presence of Gal-3, Aβ oligomer formation is accelerated in mouse brains. Gal-3 was also shown to bind Aβ directly to accelerate oligomerization. Injection of Aβ in Gal-3 knockout mice on the other hand, reduced Aβ oligomerization29.

TB006 TB006 is a breakthrough monoclonal antibody targeting Gal-3 developed by TrueBinding, representing a novel therapeutic approach for neurogenerative diseases. The literature indicates that Gal-3 is a viable target for Aβ oligomerization to help decrease neuroinflammation and provide a potential therapeutic approach to treating AD. Aβ42 oligomerization, intrinsically promoted by addition of Gal-3 to Aβ42 in vitro, when treated with TB006 results in the dissolving of the Aβ42 oligomers. Mouse studies found that the mouse surrogate for TB006 reduced Aβ plaque load, Iba1 positive microglia inflammation, and cognition loss compared to control treatments following 8 weeks of dosing in mice with AD-like symptoms.

phase I double-blind, randomized, single-dose sequential dose escalation study to assess the safety, tolerability, and pharmacokinetics in healthy subjects followed by a phase Ib/IIa study to assess the safety, tolerability, pharmacokinetics, pharmacodynamics, and efficacy in participants with Alzheimer’s disease. Mild, moderate, and severe Alzheimer’s patients were included in the study with MMSE scores ranging from 3-24 at admission. Escalating doses were well tolerated with no severe adverse events, so the highest dose was given by intravenous administration weekly for 5 weeks and patients were followed for 2 months post infusions. TB006 showed a sign of disease reversal at 1 month as measured by CDR-SB scores, a clinical dementia rating scale. At the end of the 3-month Phase IIa trial, TB006 resulted in a 63% CDR-SB reduction compared to placebo with no observed amyloid related imaging abnormalities (ARIA). TB006-treated patients also had a significant improvement in their MMSE scores at the end of the 5 infusions compared to placebo. Leading Alzheimer’s drugs from competitors, Lecanemab, Donanemab, and Aducanemab, all show signs of disease slowing after 18 months, but none show signs of disease reversal like TB006, and all three competitors’ drugs resulted in ARIA side effects at a greater rate than what would be expected in a normal aging Alzheimer’s population, compared to no ARIA side effects in the TB006 patients. The three competitors’ drugs also were only tested in early Alzheimer’s patients (MMSE scores ranging from 20-30) unlike TB006 also being tested in moderate and severe Alzheimer’s patients, so TB006 shows great promise as a novel treatment for Alzheimer’s and dementia with minimal side effects.

Following its great preclinical promise, TB006 entered a

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TB006: Targeting Galectin-3 in Neurodegenerative Disease with a Novel Antibody

Figure 2: Phase IIa Clinical Trial Results. Change in CDR-SB and MMSE scores across entire patient cohort (n=140). TB006 or placebo were given weekly for 5 weeks and patients were monitored for 2 months post-final infusion. TB006-treated AD patients showed a trend of disease reversal at the end of 1 month of treatment.

About the Authors: Jenny Johansson, PhD, earned her doctorate in neuroscience from the Karolinska Institute in Sweden. During her postdoctoral training at Stanford University, she developed a strong interest in immune responses in aging and Alzheimer’s disease. She was awarded a postdoctoral fellowship from the Swedish Research Council and her research was recognized by the Alzheimer’s Association. She has done translational research in the field for more than a decade, investigating nonsteroidal anti-inflammatory drug (NSAID) mediated effects and the Complement Receptor 1 (CR1), one of the identified risk genes in AD. Presently, she is a scientist at TrueBinding, where she tests the therapeutic efficacy of TB006 antibody therapy in neurodegenerative disease models.

Xi Lan, PhD earned her doctoral degree from Peking Union Medical College (PUMC) in Beijing, China, and then completed her postdoctoral training and earned an Instructor position in the field of neuroscience at Johns Hopkins School of Medicine in Baltimore, Maryland. During her academic career, she was awarded two postdoctoral fellowships and one Career Development Award as a principal investigator from the American Heart Association. She has also published more than 10 first-authored and co-firstauthored research papers in neurological diseases. Now she is a scientist in the Neurodegenerative Diseases group at TrueBinding. Her current interest is to develop new Galectin-3 antibodies to treat neurological disorders.

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Akshaya Vijayareka has a Master’s in Biomedical engineering from NYU and has been working on various projects related to biomaterials, biomedical device design, biosensors, drug delivery systems, and neurodegenerative diseases. Currently she is an Associate Scientist at TrueBinding, focusing on evaluating therapeutic efficacy of antibody therapy in neurodegenerative disease models.

TB006: Targeting Galectin-3 in Neurodegenerative Disease with a Novel Antibody

References: 1. Hara, A. et al. Galectin-3 as a next-generation biomarker for detecting early stage of various diseases. Biomolecules 10, 1–19 (2020).

19. Boza-Serrano, A. et al. Galectin-3, a novel endogenous TREM2 ligand, detrimentally regulates inflammatory response in Alzheimer’s disease. Acta Neuropathol. 138, 251–273 (2019).

2. Siew, J. J. & Chern, Y. Microglial lectins in health and neurological diseases. Front. Mol. Neurosci. 11, 1–17 (2018).

20. Mijailović, N. R., Vesic, K., Arsenijevic, D., Milojević-Rakić, M. & Borovcanin, M. M. Galectin-3 Involvement in Cognitive Processes for New Therapeutic Considerations. Front. Cell. Neurosci. 16, 1–12 (2022).

3. García-Revilla, J. et al. Galectin-3, a rising star in modulating microglia activation under conditions of neurodegeneration. Cell Death Dis. 13, (2022). 4. Russo, T. & Riessland, M. Age-Related Midbrain Inflammation and Senescence in Parkinson’s Disease. Front. Aging Neurosci. 14, 1–7 (2022). 5. Franceschi, C. et al. Inflammaging and anti-inflammaging: A systemic perspective on aging and longevity emerged from studies in humans. Mech. Ageing Dev. 128, 92–105 (2007). 6. Schaum, N. et al. Ageing hallmarks exhibit organ-specific temporal signatures. Yearb. Paediatr. Endocrinol. 583, 596–602 (2021). 7. Lehallier, B. et al. Undulating changes in human plasma proteome profiles across the lifespan Benoit. 25, 1843–1850 (2019). 8. Smith, L. K. et al. Β2-Microglobulin Is a Systemic Pro-Aging Factor That Impairs Cognitive Function and Neurogenesis. Nat. Med. 21, 932–937 (2015). 9. Burbidge, K. et al. LGALS3 (galectin 3) mediates an unconventional secretion of SNCA/α-synuclein in response to lysosomal membrane damage by the autophagic-lysosomal pathway in human midbrain dopamine neurons. Autophagy 18, 1020–1048 (2022). 10. Flavin, W. P. et al. Endocytic vesicle rupture is a conserved mechanism of cellular invasion by amyloid proteins. Acta Neuropathol. 134, 629–653 (2017). 11. Burguillos, M. A. et al. Microglia-secreted galectin-3 acts as a toll-like receptor 4 ligand and contributes to microglial activation. Cell Rep. 10, 1626–1638 (2015). 12. Feneberg, E., Gray, E., Ansorge, O., Talbot, K. & Turner, M. R. Towards a TDP-43-Based Biomarker for ALS and FTLD. Mol. Neurobiol. 55, 7789–7801 (2018). 13. Picchiarelli, G. & Dupuis, L. Role of RNA Binding Proteins with prionlike domains in muscle and neuromuscular diseases. Cell Stress 4, 76–91 (2020).

21. Wang, X., Zhang, S., Lin, F., Chu, W. & Yue, S. Elevated Galectin-3 Levels in the Serum of Patients with Alzheimer’s Disease. Am. J. Alzheimers. Dis. Other Demen. 30, 729–732 (2015). 22. Ashraf, G. M. & Baeesa, S. S. Investigation of Gal-3 Expression Pattern in Serum and Cerebrospinal Fluid of Patients Suffering From Neurodegenerative Disorders. Front. Neurosci. 12, 1–8 (2018). 23. Boza-Serrano, A. et al. Galectin-3 is elevated in CSF and is associated with Aβ deposits and tau aggregates in brain tissue in Alzheimer’s disease. Acta Neuropathol. 144, 843–859 (2022). 24. Yazar, H. O., Yazar, T. & Cihan, M. A preliminary data: Evaluation of serum Galectin-3 levels in patients with Idiopathic Parkinson’s Disease. J. Clin. Neurosci. 70, 164–168 (2019). 25. Ferraiuolo, L. et al. Microarray analysis of the cellular pathways involved in the adaptation to and progression of motor neuron injury in the SOD1 G93A mouse model of familial ALS. J. Neurosci. 27, 9201–9219 (2007). 26. Capitanio, D. et al. Molecular signatures of amyotrophic lateral sclerosis disease progression in hind and forelimb muscles of an SOD1G93A mouse model. Antioxidants Redox Signal. 17, 1333–1350 (2012). 27. Zhou, J. Y. et al. Galectin-3 is a candidate biomarker for amyotrophic lateral sclerosis: Discovery by a proteomics approach. J. Proteome Res. 9, 5133–5141 (2010). 28. Yan, J. et al. Increased expressions of plasma galectin-3 in patients with amyotrophic lateral sclerosis. Chin. Med. J. (Engl). 129, 2797– 2803 (2016). 29. Tao, C. C. et al. Galectin-3 promotes Aβ oligomerization and Aβ toxicity in a mouse model of Alzheimer’s disease. Cell Death Differ. 27, 192–209 (2020).

14. Suk, T. R. & Rousseaux, M. W. C. The role of TDP-43 mislocalization in amyotrophic lateral sclerosis. Mol. Neurodegener. 15, 1–16 (2020). 15. Holtman, I. R. et al. Induction of a common microglia gene expression signature by aging and neurodegenerative conditions: a co-expression meta-analysis. Acta Neuropathol. Commun. 3, 31 (2015). 16. Keren-Shaul, H. et al. A Unique Microglia Type Associated with Restricting Development of Alzheimer’s Disease. Cell 169, 12761290.e17 (2017). 17. Krasemann, S. et al. The TREM2-APOE pathway drives the transcriptional phenotype of dysfunctional microglia in neurodegenerative diseases. Immunity 47, 566–581 (2017). 18. Zhao, Y. et al. TREM2 is a receptor for β-amyloid which mediates microglial function. Neuron 97, 1023–1031 (2018).

ANTI-AGING MEDICAL NEWS | WINTER 2023

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Exploring Innovative Strategies for Promoting Healthy Aging in Women By:

Danielle Moyer, MS, CNS, LDN and C. Ambrose, ND, MAT

How the Postmenopausal Decline of Estrogen Can Impact Cardiovascular Health Menopause is a natural part of the healthy aging process in women, typically starting around the age of 50.1 However, it can be associated with unwanted complaints that can impact a woman’s quality of life. Moreover, menopause is associated with the development of chronic metabolic diseases, such as cardiovascular disease (CVD), which is the leading cause of death among women.1,2 Estrogen is a female sex hormone recognized for its cardioprotective properties in vitro and in rodent models.3,4 It plays a critical role in the development and physiology of multiple organs, including the cardiovascular system, breast, uterus, and bone.3 Research indicates estrogen promotes cardiovascular health by supporting mitochondrial function, normal vasodilation, endothelial health, and reducing oxidative stress.4 During the menopausal

transition, estrogen levels fluctuate and eventually decline and stabilize post-menopause.5,6 Epidemiological studies suggest that premenopausal women have a lower incidence of CVD when compared to age-matched men. Conversely, the incidence and severity of CVD in women increases after menopause compared to men of the same age. This is primarily attributed to the postmenopausal decline of estrogen.4 Oxidative stress is a key player in the development of CVD.3 Estrogen has been shown to help attenuate oxidative stress due to its antioxidant properties, including free-radical scavenging, neutralizing excess reactive oxygen species (ROS), and increasing antioxidant molecules like superoxide dismutase (SOD).7 Estrogen’s ability to mitigate oxidative stress extends to the brainstem neurons regulating the cardiovascular system via sympathetic/parasympathetic activity.8 Additionally, estrogen may promote healthy

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Exploring Innovative Strategies for Promoting Healthy Aging in Women

inflammatory responses by downregulating proinflammatory markers like chemokines and cell adhesion molecules that are associated with atherosclerosis and coronary artery disease.9,10 The decrease in estrogen levels that occurs during menopause is a normal aspect of the aging process in women. Therefore, it is of utmost importance for postmenopausal women to enhance their antioxidant status and cardiovascular health using clinically beneficial methods, including nutraceuticals and dietary strategies. Phytoestrogens like genistein and spruce lignans exhibit antioxidant and anti-inflammatory properties both in vivo and in vitro, potentially contributing to the promotion of cardiovascular health.11,12 These phytoestrogens are soy-free, plant-derived compounds that share structural similarities with estrogen, enabling them to bind to estrogen receptor transcription factors within the body and regulate their activation. Nonetheless, it is important to note that phytoestrogens possess only 1/100th to 1/1,000th of the potency and activation capability of endogenous estrogen when it comes to estrogen receptor interactions.13 Genistein and spruce lignans may also help diminish mild hot flashes, a common vasomotor complaint of menopause.1,14,15 There may be an association between vasomotor complaints and disrupted cardiovascular health.16 Two large-scale meta-analyses conducted on tens of thousands of women between the ages of 18 and 89 concluded that the women experiencing vasomotor complaints “have significantly higher systolic and diastolic blood pressures, higher circulating total cholesterol levels, and a higher body mass index than their counterparts with no symptoms.”16–18 Gamma-oryzanol (GO), derived from rice bran oil, may support cardiovascular health by

promoting normal lipid metabolism.19 In a small clinical study (n = 40), menopausal women with hyperlipidemia who supplemented with GO for 4 to 8 weeks experienced significant reductions in total cholesterol and triglycerides and an increase in high-density lipoprotein (HDL)-cholesterol levels. The GO experimental group also displayed decreased atherogenic index scores and serum lipid peroxide levels. Moreover, 90% of the women in the treatment arm who received GO supplementation experienced an overall improvement in menopausal symptoms.20 The postmenopausal decline of estrogen is indeed a natural part of the aging process in women despite estrogen’s known cardioprotective qualities.3,4,8 Exploring strategies to promote cardiovascular health through nutritional support, including phytoestrogens and gamma-oryzanol, may hold clinical significance for postmenopausal women, potentially promoting healthy aging and menopausal comfort.

The Power of Taurine for Healthy Aging and Menopausal Comfort Taurine, a sulfur-containing amino acid, has garnered significant attention in research for its potential role in supporting menopausal women through its ability to promote menopausal comfort and healthy aging. Taurine is one of the most abundant free amino acids in the brain and in the skeletal and cardiac muscles. In nature, it is found exclusively in animalbased foods, such as meat, seafood, fish, and milk. 21 Although taurine can be synthesized endogenously from methionine and cysteine, an exogenous supply of taurine through diet or supplementation may be beneficial to meet certain physiological needs.22 Taurine may help promote menopausal comfort due to its various roles in the body. Human and animal models reveal that taurine supports metabolic, mitochondrial, and cellular health. It promotes healthy bile acid conjugation, detoxification,

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Exploring Innovative Strategies for Promoting Healthy Aging in Women

osmoregulation, and neurotransmitter production.21 A recent article in Science highlights that serum taurine concentration declines with age in humans and may be associated with age-related conditions.23 Regarding metabolic health and its role in promoting healthy aging, a systematic review and meta-analysis of human clinical studies concluded that taurine contributes to the maintenance of normal insulin production and secretion, which are functions that may be compromised during menopause.24,25 Several hypertensive animal models demonstrate that taurine supplementation assists in maintaining normal blood pressure, both centrally and peripherally, primarily through its demonstrated antioxidant and antiinflammatory properties.26,27 In a double-blind study involving women aged 55 to 70 (with a sample size of 24), those who received taurine supplementation at a dosage of 1.5 g/day experienced increased antioxidant status, as evidenced by higher plasma levels of SOD, potentially supporting healthy aging.28 Taurine has shown promise in promoting physiological balance during the hormonal and neurotransmission changes that occur during menopause. However, it’s important to note that further research is needed to establish definitive conclusions in this regard. Human clinical studies reveal that taurine supports cardiovascular health, potentially assisting in mitigating the effects of estrogen withdrawal that occur during menopause.29–31 It’s worth reiterating that estrogen is well-known for its cardioprotective properties.4 In vitro studies reveal that taurine can help mitigate excitotoxicity by modulating the neurotransmission and intracellular homeostasis of glutamate and gamma-aminobutyric acid (GABA), potentially exerting a calming effect.21,22 This may help to compensate for reduced progesterone status during menopause, as progesterone is also a GABA-receptor agonist.32 Taurine also plays a crucial role in osmoregulation by acting as a mild diuretic, which may help to

compensate for the lack of progesterone’s mild diuretic properties during menopause.21,33 Lastly, excess norepinephrine secretion from the adrenal glands is associated with estrogen fluctuations during menopause and may trigger mild hot flashes.34 Rodent models demonstrate that taurine may help attenuate norepinephrine’s adverse effects.35 Considering these potential clinically relevant benefits and the diverse roles of taurine in the body, taurine may promote menopausal comfort and healthy aging. However, more extensive human clinical trials are needed to fully elucidate the role taurine may play during menopause.

Unlocking the Secrets of Resveratrol in Cellular Senescence, Healthy Aging, and Skin Elasticity Resveratrol (trans-3,4’,5 trihydroxystilbene) is a polyphenolic molecule in grape skin, berries (i.e., blueberries and raspberries), and peanuts.36 It is known for its role in supporting a healthy response to oxidative stress and inflammation and supporting cardiovascular and metabolic functions within the human body.37 In addition to aesthetic purposes, skin health is critical for protecting the body from the external environment, regulating temperature, and performing other bodily functions.38 The aging process affects all layers of the skin, which may involve a decreased barrier function, dermal thinning, and a loss of elasticity.39 Changes during the natural aging process, both in the skin and the rest of the body, can occur at the cellular level and often include increases in inflammation and oxidative stress.39 Cellular senescence is a cellular process that often occurs during normal aging in which certain cells, after becoming stressed or damaged, may become harmful to other tissues and organs in the body. It is a potential driver of many biological

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Exploring Innovative Strategies for Promoting Healthy Aging in Women

processes leading to age-related diseases.40 Senescent cells may harm neighboring cells by damaging the composition of the extracellular matrix and by secreting certain pro-inflammatory cytokines.41 Recent studies indicate that resveratrol may support skin health and the body’s response to senescent cells. It has been shown in animal and laboratory studies to influence the activity of pro-inflammatory cytokines such as interleukin (IL)-1β, IL-6, IL-17, and tumor necrosis factor-α.37 Resveratrol supports antioxidative status by targeting the transcription factor NRF2, helping support antioxidant protein expression, and modulating mitochondrial generation of ROS. It also inhibits cyclooxygenase (COX)-1 and COX-2, thus downregulating the synthesis of prostaglandins and leukotrienes and the expression of nuclear factor-κB (NF-κB).42 Further research indicates resveratrol may support age-related cellular changes and epithelial health. Resveratrol has been shown in laboratory studies to help support healthy apoptosis and mitochondrial function.43 Clinical studies on women have also demonstrated that resveratrol may help improve elasticity, moisture content, total wrinkled area, and total wrinkle volume.39 In addition, laboratory studies have observed increased levels of autophagy of senescent macrophages in the presence of resveratrol.44 A placebo-controlled double-blind study explored the potential efficacy of supplementation with resveratrol on parameters related to aging and skin health in 50 healthy women and men. The treatment group received 133 mg of resveratrol daily for 60 days. Improvements in antioxidative capacity, skin elasticity, skin roughness, and depth of wrinkles were observed in the treatment group, as well as significant decreases in the intensity of age spots.45

Beyond skin health, resveratrol may support many of the body’s systems in the presence of agerelated changes. For instance, a crossover study administered daily supplementation of 125 mg of resveratrol in postmenopausal women and found a significant 33% improvement in overall cognitive performance in the treatment group compared to a placebo. The study also reported improvements in cerebrovascular function and improved verbal memory in women aged 65 years and older.46 A randomized placebo-controlled trial evaluated the efficacy of resveratrol supplementation on bone health in postmenopausal women without overt osteoporosis. After 12 months of daily supplementation with 150 mg of resveratrol, improvements in bone density, T-scores, and hip fracture risk were reported as compared to a placebo.47 Resveratrol may support the healthy aging process in women in various ways – skin health, immune function, a healthy inflammatory response, and the body’s response to cellular senescence and aging. It may also support cardiovascular health, antioxidative status, and metabolic health.

Summary Exploring strategies to promote physical and psychological well-being is clinically relevant for all postmenopausal women. Various nutrients and compounds can help compensate for the postmenopausal decline of the cardioprotective hormone estrogen, including phytoestrogens and gamma-oryzanol, which aim to facilitate healthy aging and menopausal comfort. Taurine, widely recognized for its multifunctional roles in the body, is now emerging as a potential key player in healthy aging and providing support during the menopausal transition. Furthermore, resveratrol can help support healthy aging due to its demonstrated antioxidant and anti-

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Exploring Innovative Strategies for Promoting Healthy Aging in Women

inflammatory properties. These properties extend their benefits to various aspects of health, including the body’s response to cellular senescence and agerelated skin changes. Incorporating these beneficial

compounds into a woman’s daily routine, whether through dietary intake or supplementation, holds the potential to significantly influence the natural aging process by providing support at the cellular level.

References: 1. Peacock K, Ketvertis KM. Menopause. In: StatPearls. StatPearls Publishing; 2023. Accessed June 15, 2023. http://www.ncbi.nlm.nih.gov/books/ NBK507826/ 2. CDC. Women and Heart Disease. Centers for Disease Control and Prevention. Published May 15, 2023. Accessed September 7, 2023. https://www.cdc.gov/heartdisease/women.htm 3. Xiang D, Liu Y, Zhou S, Zhou E, Wang Y. Protective effects of estrogen on cardiovascular disease mediated by oxidative stress. Oxid Med Cell Longev. 2021;2021:5523516. doi:10.1155/2021/5523516 4. 4.Iorga A, Cunningham CM, Moazeni S, Ruffenach G, Umar S, Eghbali M. The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy. Biol Sex Differ. 2017;8:33. doi:10.1186/s13293-017-0152-8 5. Ososki AL, Kennelly EJ. Phytoestrogens: a review of the present state of research. Phytother Res PTR. 2003;17(8):845-869. doi:10.1002/ptr.1364 6. Su HI, Freeman EW. Hormone changes associated with the menopausal transition. Minerva Ginecol. 2009;61(6):483-489 7. Sánchez-Rodríguez MA, Zacarías-Flores M, Arronte-Rosales A, MendozaNúñez VM. Association between hot flashes severity and oxidative stress among Mexican postmenopausal women: a cross-sectional study. PLoS One. 2019;14(9):e0214264. doi:10.1371/journal.pone.0214264 8. Lagranha CJ, Silva TLA, Silva SCA, et al. Protective effects of estrogen against cardiovascular disease mediated via oxidative stress in the brain. Life Sci. 2018;192:190-198. doi:10.1016/j.lfs.2017.11.043 9. Pelekanou V, Kampa M, Kiagiadaki F, et al. Estrogen anti-inflammatory activity on human monocytes is mediated through cross-talk between estrogen receptor ERα36 and GPR30/GPER1. J Leukoc Biol. 2016;99(2):333-347. doi:10.1189/jlb.3A0914-430RR

bioavailability of plant lignan 7-hydroxymatairesinol and effects on serum enterolactone and clinical symptoms in postmenopausal women: a singleblinded, parallel , dose-comparison study. J Am Coll Nutr. 2013;32(6):428435. doi:10.1080/07315724.2013.849578 16. Biglia N, Cagnacci A, Gambacciani M, Lello S, Maffei S, Nappi RE. Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases? Climacteric J Int Menopause Soc. 2017;20(4):306-312. doi:10.1080/13697137.2017.1315089 17. Muka T, Oliver-Williams C, Colpani V, et al. Association of vasomotor and other menopausal symptoms with risk of cardiovascular disease: a systematic review and meta-analysis. PLoS One. 2016;11(6):e0157417. doi:10.1371/journal.pone.0157417 18. Franco OH, Muka T, Colpani V, et al. Vasomotor symptoms in women and cardiovascular risk markers: systematic review and meta-analysis. Maturitas. 2015;81(3):353-361. doi:10.1016/j.maturitas.2015.04.016 19. Agarwal N, Raghav PK, Sharma A. Gamma oryzanol a therapeutic agent. Int J Adv Res. 2016;4(6):78 83. doi:10.21474/IJAR01/617 20. Ishihara M, Ito Y, Nakakita T, et al. [Clinical effect of gamma-oryzanol on climacteric disturbance -on serum lipid peroxides (author’s transl)]. Nihon Sanka Fujinka Gakkai Zasshi. 1982;34(2):243-251 21. El Idrissi A. Taurine regulation of neuroendocrine function. Adv Exp Med Biol. 2019;1155:977-985. doi:10.1007/978-981-13-8023-5_81 22. Ramírez-Guerrero S, Guardo-Maya S, Medina-Rincón GJ, Orrego-González EE, Cabezas-Pérez R, González-Reyes RE. Taurine and astrocytes: a homeostatic and neuroprotective relationship. Front Mol Neurosci. 2022;15. doi:10.3389/fnmol.2022.937789 23. Singh P, Gollapalli K, Mangiola S, et al. Taurine deficiency as a driver of aging. Science. 2023;380(6649):eabn9257. doi:10.1126/science.abn9257

10. Su JH, Luo MY, Liang N, et al. Interleukin-6: a novel target for cardiocerebrovascular diseases. Front Pharmacol. 2021;12:745061. doi:10.3389/ fphar.2021.745061

24. Tao X, Zhang Z, Yang Z, Rao B. The effects of taurine supplementation on diabetes mellitus in humans: a systematic review and meta-analysis. Food Chem Mol Sci. 2022;4:100106. doi:10.1016/j.fochms.2022.100106

11. Jafari S, Shoghi M, Khazdair MR. Pharmacological effects of genistein on cardiovascular diseases. Evid Based Complement Altern Med. 2023;2023:8250219. doi:10.1155/2023/8250219

25. Ren Y, Zhang M, Liu Y, et al. Association of menopause and type 2 diabetes mellitus. Menopause. 2019;26(3):325-330. doi:10.1097/ GME.0000000000001200

12. Spilioti E, Holmbom B, Papavassiliou AG, Moutsatsou P. Lignans 7-hydroxymatairesinol and 7-hydroxymatairesinol 2 exhibit antiinflammatory activity in human aortic endothelial cells. Mol Nutr Food Res. 2014;58(4):749-759. doi:10.1002/mnfr.201300318

26. Yildiz O, Ulusoy KG. Effects of taurine on vascular tone. Amino Acids. 2022;54(12):1527-1540. doi:10.1007/s00726-022-03198-6

13. Philp HA. Hot flashes – a review of the literature on alternative and complementary treatment approaches. Altern Med Rev. 2003;8(3) 14. D’Anna R, Cannata ML, Atteritano M, et al. Effects of the phytoestrogen genistein on hot flushes, endometrium, and vaginal epithelium in postmenopausal women: a 1-year randomized, double-blind, placebocontrolled study. Menopause. 2007;14(4):648-655. doi:10.1097/01. gme.0000248708.60698.98 15. Udani JK, Brown DJ, Tan MOC, Hardy M. Pharmacokinetics and

27. Abebe W, Mozaffari MS. Role of taurine in the vasculature: an overview of experimental and human studies. Am J Cardiovasc Dis. 2011;1(3):293-311. 28. Abud GF, De Carvalho FG, Batitucci G, et al. Taurine as a possible antiaging therapy: a controlled clinical trial on taurine antioxidant activity in women ages 55 to 70. Nutrition. 2022;101:111706. doi:10.1016/j. nut.2022.111706 29. Sun Q, Wang B, Li Y, et al. Taurine supplementation lowers blood pressure and improves vascular function in prehypertension. Hypertension. 2016;67(3):541-549. doi:10.1161/HYPERTENSIONAHA.115.06624 30. Qaradakhi T, Gadanec LK, McSweeney KR, Abraham JR, Apostolopoulos V,

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Zulli A. The anti-inflammatory effect of taurine on cardiovascular disease. Nutrients. 2020;12(9):2847. doi:10.3390/nu12092847 31. Aryan L, Younessi D, Zargari M, et al. The role of estrogen receptors in cardiovascular disease. Int J Mol Sci. 2020;21(12):4314. doi:10.3390/ ijms21124314 32. Follesa P, Serra M, Cagetti E, et al. Allopregnanolone synthesis in cerebellar granule cells: roles in regulation of GABA(A) receptor expression and function during progesterone treatment and withdrawal. Mol Pharmacol. 2000;57(6):1262-1270 33. Regidor PA. Progesterone in Peri- and postmenopause: a review. Geburtshilfe Frauenheilkd. 2014;74(11):995-1002. doi:10.1055/s-0034-1383297 34. Bansal R, Aggarwal N. Menopausal hot flashes: a concise review. J -Life Health. 2019;10(1):6-13. doi:10.4103/jmh.JMH_7_19 35. Schaffer S, Kim HW. Effects and mechanisms of taurine as a therapeutic agent. Biomol Ther. 2018;26(3):225-241. doi:10.4062/ biomolther.2017.251 36. Koushki M, Amiri-Dashatan N, Ahmadi N, Abbaszadeh H, Rezaei-Tavirani M. Resveratrol: a miraculous natural compound for diseases treatment. Food Sci Nutr. 2018;6(8):2473-2490. doi:10.1002/fsn3.855 37. Li Q, Yang G, Xu H, Tang S, Lee WY wai. Effects of resveratrol supplementation on bone quality: a systematic review and metaanalysis of randomized controlled trials. BMC Complement Med Ther. 2021;21:214. doi:10.1186/s12906-021-03381-4 38. Kim JY, Dao H. Physiology, Integument. In: StatPearls. StatPearls Publishing; 2023. Accessed September 7, 2023. https://www.ncbi.nlm.nih. gov/books/NBK554386/ 39. Csekes E, Račková L. Skin aging, cellular senescence and natural polyphenols. Int J Mol Sci. 2021;22(23):12641. doi:10.3390/ ijms222312641

40. Kirkland JL, Tchkonia T. Senolytic drugs: from discovery to translation. J Intern Med. 2020;288(5):518-536. doi:10.1111/joim.13141 41. Bulbiankova D, Díaz-Puertas R, Álvarez-Martínez FJ, Herranz-López M, Barrajón-Catalán E, Micol V. Hallmarks and biomarkers of skin senescence: an updated review of skin senotherapeutics. Antioxid Basel Switz. 2023;12(2):444. doi:10.3390/antiox12020444 42. Jantan I, Haque MA, Arshad L, Harikrishnan H, Septama AW, MohamedHussein ZA. Dietary polyphenols suppress chronic inflammation by modulation of multiple inflammation-associated cell signaling pathways. J Nutr Biochem. 2021;93:108634. doi:10.1016/j.jnutbio.2021.108634 43. Hooda R, Madke B, Choudhary A. Photoaging: reversal of the oxidative stress through dietary changes and plant-based products. Cureus. 2023;15(4):e37321. doi:10.7759/cureus.37321 44. Hang R, Wang J, Tian X, et al. Resveratrol promotes osteogenesis and angiogenesis through mediating immunology of senescent macrophages. Biomed Mater Bristol Engl. 2022;17(5). doi:10.1088/1748-605X/ac80e3 45. Buonocore D, Lazzeretti A, Tocabens P, et al. Resveratrol-procyanidin blend: nutraceutical and antiaging efficacy evaluated in a placebo controlled, double-blind study. Clin Cosmet Investig Dermatol. 2012;5:159165. doi:10.2147/CCID.S36102 46. Thaung Zaw JJ, Howe PR, Wong RH. Long-term effects of resveratrol on cognition, cerebrovascular function and cardio-metabolic markers in postmenopausal women: A 24-month randomised, double-blind, placebocontrolled, crossover study. Clin Nutr Edinb Scotl. 2021;40(3):820-829. doi:10.1016/j.clnu.2020.08.025 47. Wong RH, Thaung Zaw JJ, Xian CJ, Howe PR. Regular supplementation with resveratrol improves bone mineral density in postmenopausal women: a randomized, placebo-controlled trial. J Bone Miner Res. 2020;35(11). doi:10.1002/jbmr.4115

Author Bio: Danielle Moyer has an M.S. in Nutrition and is a board-Certified Nutrition Specialist®. C. Ambrose is a Doctor of Naturopathic Medicine. They are Clinical Science Writers for Designs for Health; Danielle also teaches college-level nutrition.

Contact: Danielle Moyer: dmoyer@designsforhealth.com

C. Ambrose: cambrose@designsforhealth.com

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A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports By:

Akbar Khan, MD, IMD, DHS, FAAO & Mitchell Ghen, DO, PhD

OBJECTIVES • Introduce and review the metabolic theory of cancer (history and background) • Explain the application of metabolic theory to cancer therapeutics • Introduce the concept of a metabolic multitargeted approach to cancer therapeutics • Use case reports to illustrate the clinical viability of the multi-targeted approach to cancer therapeutics

ABSTRACT

sodium (“DCA”) could reverse the Warburg phenotype in cancer cells in vitro and in vivo resulting in natural cancer cell suicide and tumour shrinkage in rats. This phenomenon was previously thought to be impossible as it was believed that mitochondria in malignant cells were permanently altered and unable to trigger apoptosis. Despite the fact that no large clinical trial of DCA as a cancer therapy was ever completed, a small number of doctors in North America and Europe rapidly translated this new knowledge into clinical cancer protocols through independent observational research and creative thinking.

Despite Otto Warburg’s discovery of aerobic glycolysis in cancer cells in the 1920’s, the potential for developing therapeutics that targeted cancer cell metabolism was essentially ignored until 2007 when a groundbreaking publication was released from a group of Canadian researchers. Bonnet et al. (who paradoxically were not specialized in oncology) discovered that the generic drug dichloroacetate

Since off-label drug use is permitted in most jurisdictions, clinicians initially began to use DCA in patients who had failed all conventional therapies. Over the years, further novel anti-cancer mechanisms of DCA were discovered such as angiogenesis inhibition, immune activation and cancer stem cell targeting. Around 2011, the work of Seyfried (USA) began to

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A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports

illuminate the importance of glutamine inhibition and suggested that a multi-energetic targeted approach was superior to glycolysis inhibition alone. A collaborative effort of the authors incorporating Seyfried’s concepts resulted in the creation of a new metabolic protocol named “MOMENTUM” (Metabolic, Oncologic, Multi-ENergetic Targeted, Universal, Modified). In this protocol, glucose and glutamine metabolism were targeted simultaneously with a combination of multiple natural and pharmacologic agents administered intravenously. Surprising preliminary clinical results in several difficult cancer cases confirmed that metabolic multi-targeted methods are extremely promising, and more so than metabolic monotherapy. Life threatening side effects of this approach to cancer management are virtually non-existent and therapy costs are manageable. A disappointing absence of industry funding for large clinical trials has not curtailed the development of the metabolic approach as a clinically viable methodology, proving that unadulterated medical science can conquer the ongoing push for multibillion-dollar economic reward. Keywords: dichloroacetate; cancer; glycolysis; Warburg; glutamine; mitochondria; metabolic; apoptosis

Warburg and The Birth of Metabolic Cancer Therapy In the 1920s Dr. Otto Warburg proposed that cancer cells exhibit mitochondrial dysfunction which results in an abnormal metabolic phenotype of glycolysis (conversion of glucose to lactate without oxygen or anaerobic respiration or fermentation) even in the presence of adequate oxygenation1. This phenomenon is now known as the Warburg effect. Since healthy non-cancerous cells prefer aerobic respiration (glucose oxidation or oxidative phosphorylation) due to the efficiency of adenosine triphosphate

(“ATP”) generation, the Warburg effect promised to be a selective method of targeting cancer cells. Unfortunately, the Warburg effect was largely ignored for decades, perhaps related to scientific inertia2. Instead, the oncology community chose to focus on treatments based on cytotoxic chemotherapies despite their serious side effects and poor overall success rates3. The Warburg effect was revisited in the 1980s when fluorodeoxyglucose positron emission tomography (“FDG PET”) scan was developed4. The FDG PET scan took advantage of the enhanced glucose uptake of cancer cells as compared to healthy cells. Since aerobic glycolysis in cancer cells is inefficient at generating ATP (relative to oxidative phosphorylation) more glucose is required by cancer cell than normal cells5. This allowed cancer cells to be selectively imaged using radioactive glucose. FDG PET scans proved to be useful for almost all cancer types which suggested that metabolic cancer therapy could be similarly universal. In 2000 Hanahan and Weinberg re-invigorated Warburg’s idea of metabolic cancer targeting in their paper “Hallmarks of Cancer: The Next Generation”. They referred to 6 previously- described hallmarks of cancer (sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion / metastasis), but more importantly, added two more: reprogramming of energy metabolism and evasion of immune destruction6. Despite successful use of FDG PET scans for cancer imaging, and the Hanahan and Weinberg publication, therapeutic use of the Warburg effect was not realized until 2007. Bonnet, Archer et al. published a paper which would become the foundation of metabolic cancer therapeutics7. It was demonstrated that an off-patent drug called dichloroacetate sodium (“DCA”) could reverse the Warburg effect in a range of cancer types (breast,

ANTI-AGING MEDICAL NEWS | WINTER 2023

A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports

lung and brain) in vitro and in vivo (rats). The mechanism of action of DCA was proven to be inhibition of the enzyme pyruvate dehydrogenase kinase (“PDK”) which effectively caused a shift from glycolysis to glucose oxidation, resulting in depolarization of the mitochondrial membrane, activation of caspases and triggering of apoptosis. Tremendous excitement was generated worldwide by this publication since it elucidated a novel systemic method of treating cancer with an old nontoxic drug that could potentially be used for any cancer type.

Unique Features of Dichloroacetate Metabolic Cancer Therapy Immediately after the landmark 2007 publication was released, physicians began exploring the viability of DCA to treat cancer patients. DCA was a particularly promising metabolic therapy due to several unique features of this chemical: 1. it was a simple chemical resembling a fusion of table salt and vinegar, which could be easily manufactured; 2. it had been studied before in humans by Stacpoole et al. (USA) and was shown to have mild reversible side effects8; 3. it was demonstrated safe for long-term use9; 4. it had high oral bioavailability, close to 100%10; 5. it was off-patent and thus relatively inexpensive; 6. it had potential for use in children due to prior published pediatric research11 , thus raising a potential to reduce the suffering of pediatric patients and their parents who are continually looking to avoid harmful drug side effects; 7. it appeared to be far safer than cytotoxic chemotherapy, which potentially could open new options for the elderly and other patients too frail for chemo. In early 2007, one of the authors (Khan) began using DCA for cancer patients who had exhausted all conventional therapies, with dosing based on the prior clinical trials of DCA as a treatment for

congenital lactic acidosis. Systematic observation and data collection of 179 patients treated with DCA revealed over 60% of advanced-stage cancer patients had measurable short-term symptomatic and/or objective improvements. Thus, it was concluded that DCA was a viable cancer therapy in humans12. Almost immediately, there was backlash from the medical community. Concerns were raised that doctors and patients using unapproved DCA outside of clinical trials would somehow interfere with recruitment of patients into trials13. Curiously, the scientists critical of the early off-label use of DCA seemed to be oblivious to the viewpoint of cancer patients who were given a death sentence due to exhaustion of approved therapy options. Still other scientists recognized that the discovery of DCA as a metabolic cancer therapeutic might be the “dawn of a new era”14.

Observational Data Emerges from Around the World Within 3 years of the Bonnet DCA publication, human data began to emerge. In 2010, the world’s first clinical case report demonstrating that DCA had anticancer activity in humans was published (Flavin, USA/ Germany).15 It was demonstrated that metastatic medullary thyroid cancer was reversed to the point of radiologic and biochemical remission using oral DCA therapy. In 2011, the world’s first clinical case report was published that demonstrated DCA’s anti-neoplastic actions could demonstrably improve quality of life by dramatic and sustained pain reduction in a patient with cancer of unknown primary (Khan, Canada).16 In 2014 the world’s first case series of successful cancer therapy in a range of tumor types using intravenous DCA was published (Khan et al., Canada/USA)17. No doubt these exciting human publications provided an incentive to scientists around the world to continue research into DCA to learn more about its use as a cancer therapy.

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A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports

Many new DCA publications began to appear which illustrated the activity of DCA in a large number of cancer types in addition to those originally identified in the 2007 Bonnet publication (breast, lung, glioblastoma). These included bile duct / cholangiocarcinoma18 , bladder19 , colon20 , gastric21, head and neck (squamous cell)22 , leukemia23 , liver24, lymphoma25 , medulloblastoma26, melanoma27, multiple myeloma28, neuroblastoma29, neuroendocrine30, ovarian31, pancreatic 32, prostate33, renal34, sarcoma (osteosarcoma35, angiosarcoma36, rhabdomyosarcoma37, fibrosarcoma38), thyroid39, uterine (endometrial40, cervical41) and Wilm’s tumour42. Further exciting data revealed synergism between DCA and radiotherapy43, 44 and also chemotherapy45 , 46 , 47. The first human data illustrating the potential for strong synergism of DCA and radiotherapy was published in 2012 in a case report of long-term complete remission of a patient with a rare metastatic renal squamous cell carcinoma48. New publications also elucidated new mechanisms of action of DCA including angiogenesis inhibition49, immune enhancement by reduction of tumor lactate production50 and cancer stem cell targeting51. It was also established that DCA could not only kill cancer cells but could act as a cytostatic agent in humans. Two cases were published (Khan et al., Canada/ Australia) to illustrate this new mechanism: one case of a patient with metastatic colon cancer who stabilized for nearly 4 years52 and one case of a metastatic melanoma patient who stabilized for over 4 years53. In 2012 a case report was published (Ishiguro et al., Japan) of successful treatment of a 51-year-old patient with chemo-resistant metastatic cholangiocarcinoma using DCA in combination omeprazole and tamoxifen 54 . This publication proved to be another useful addition to the body of case reports supporting the clinical benefits of DCA, illustrating potential advantages over chemotherapy in treating a rare cancer type.

The Importance of Glutaminolysis Inhibition 72

Despite the clinical success of the metabolic approach using DCA, the results were not perfect. Some patients were resistant to therapy from the beginning and others developed resistance over time. It was noted that resistance could develop quickly in some cases or could take years55. The work of Seyfried provided a clue as to one possible resistance mechanism. In addition to his work on ketogenic diet56, Seyfried determined that glutamine targeting using the drug 6-diazo-5-oxo- L-norleucine (“DON”) would be an important addition to glycolysis inhibition since cancer cells could use the amino acid glutamine as an alternate fuel source if glucose was not available57. DON seemed like an ideal glutaminolysis inhibitor since it had an established human safety profile based on earlier clinical trials. However, it was not readily available as a pharmaceutical grade product.

Oxaloacetate - A Natural Glutaminolysis Inhibitor One of the authors (Ghen) became aware of new evidence of the potential for cancer cell lines to have amino acid fermentation capabilities (glutamine58, serine59, arginine60). He proposed the addition of high dose oral and/or intravenous oxaloacetate (“OA”) as a potent natural glutaminolysis inhibitor. OA, also known as 3- carboxy-3-oxopropanoic acid, is an intermediate of the Krebs citric acid cycle. Oxaloacetate is ubiquitous in the mitochondria and cellular mitochondrial density is tied to oxaloacetate concentration61. OA has inherent capability as a glutamate scavenger62 (glutamate being the metabolite of glutamine), making it unique for preventing amino acid fermentation to succinate, as seen in multiple cancers. OA inhibits the amino acid fermentation pathway, and reverses the Warburg effect63 making it an ideal adjunct to DCA. OA combines with glutamic oxaloacetic transaminase (“GOT”) which breaks down glutamate into 2-keto glutamate and aspartate 64 , 65 , 66 . The glutamate inhibitory effect is dose-dependent and can sequester and significantly reduce the

ANTI-AGING MEDICAL NEWS | WINTER 2023

A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports

deleterious activity of glutamate. In addition, due to its position in the Krebs cycle, OA can increase the ratio of oxidized to reduced nicotinamide adenine dinucleotide (NAD+/NADH ratio)67. In experiments with lower animals, OA has been shown to increase activation of sirtuin genes with subsequent improvement in lifespan68.

been shown to reprogram cancer cell populations back to normal metabolism. Ozone therapy also appears to be a useful addition to the protocol due to its ability to enhance anti-cancer immunity76. The combination of DCA, OA and NAD+ was termed “MOMENTUM” DCA metabolic therapy. The derivation is as follows:

Ghen developed and began using a buffered sterile solution of OA intravenously as part of his metabolic protocols in cancer patients to reduce free glutamate levels and help to reverse the cancer Warburg metabolic phenotype. In a small clinical trial, OA has been used successfully in the treatment of brain cancer with chemotherapeutic and targeted agents including temozolomide, everolimus, cabozantinib, carboplatin, nilotinib, and bevacizumab69,70,71. In gliomas, gain of function mutations occur in isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) which produce D-2 hydroxyglutarate (“D-2-HG”). OA is a competitive inhibitor of D-2-HG. Use of OA is extremely safe and doses up to 3000mg/ day have been shown to have no serious adverse effects in humans72. No toxicity of OA was observed in mice after an oral dose of 5000mg/kg. LD50 was not reached but reported conservatively as “> 5000mg/kg” (Method 425 OECD Acute Oral Toxicity Test, Oxaloacetic Acid, Test Performed May 2, 2006, Cash A, Terra Biological, San Diego, CA, USA). The OA molecule has a half-life in vivo of under 2 hours73.

The MOMENTUM DCA Protocol The use of OA proved to be an elegant solution to the lack of availability of DON, and seemed to be superior since OA is a natural product with no significant side effects. Due to a need to combine therapeutics to overcome potential resistance, the authors added nicotinamide adenine dinucleotide (“NAD+”) to their metabolic therapy cocktail. NAD+ has been demonstrated to inhibit glycolysis by inhibiting PDK74, and also to stimulate a T-cell response against malignant cells75. An increase of the NAD+ to NADH ratio has also

Metabolic - referring to targeting of cell metabolism Oncologic - referring to cancer cells as the focus of metabolism inhibition Multi-Energetic - referring to inhibiting multiple energetic pathways simultaneously Targeted - referring to selective targeting of cancer cells (sparing healthy cells) Universal - referring to the applicability of the therapy to potentially all cancer types Modified - modified from the origin DCA monotherapy approach New observational findings (Khan) revealed the first 7 out of 8 consecutive patients treated with the intravenous MOMENTUM protocol (DCA 60- 70mg/ kg + OA 300mg + NAD+ 100mg infused 2 days per week) responded rapidly (within 2 to 6 weeks) with objective stabilization /reduction / necrosis of tumors and/or reduction of serum cancer markers, confirming the exciting potential of this protocol. Selected cases are presented to illustrate the findings: Case 1 - 79 year old male with Stage 3 circumferential gastric cancer invading through stomach wall, declined surgery and chemotherapy due to high risk of complications, treated with MOMENTUM DCA protocol, reduction of thickness of cancer by more than 50% in under 2 months measured by pre- and post-treatment CT scans. Therapy was combined with intravenous

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A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports

ozonated saline and 2 anti-parasite medications that influence multiple molecular targets in cancer cells. Case 2 – 52 year old female with stage 4 melanoma metastatic to lungs, progressing on serial CT scans during treatment with low dose naltrexone, stabilization of lung tumours after only 6 weeks of MOMENTUM DCA infusion therapy (confirmed by pre- and post-treatment CT scans). Case 3 – 46 year old male with multifocal glioblastoma, resistant to temozolomide, MRI done immediately before starting MOMENTUM DCA therapy, MRI repeated after only 1 month of infusions showed necrosis (“treatment effect”) which was attributed to radiation by the radiologist. However, the patient did not have any radiation, only MOMENTUM DCA therapy. Case 4 - 56 year old female with left breast cancer metastatic to bone. The patient initially had sternal and rib pain secondary to the metastatic lesions. MOMENTUM DCA treatment was started in combination with olaparib. All previous elevated cancer markers returned to normal, PET/CT scan demonstrated complete remission, and the patient became pain-free. Inflammatory markers including interleukin levels were normalized. The current updated intravenous adult cocktail (2023) includes DCA ranging from 50-70mg/kg followed by OA 1000mg and NAD+ 200mg. Infusions are given twice per week. In summary, oxaloacetate has been shown to reverse the Warburg effect, inhibit glutamate, activate the Forkhead Box O3 tumor suppressor protein (“FOXO3”) inducing differentiation, increase the NAD+/ NADH ratio and synergize with NAD+ infusion.

Future Directions The observational findings described serve to confirm Seyfried’s concept that attacking multiple metabolic cancer targets is required for the best clinical outcomes.

On this basis, the authors are now exploring the addition of fatty acid oxidation inhibitors (such as beta-hydroxybutyrate77 or ranolazine78) to the cocktail. Beta-hydroxybutyrate is a ketone body that has been shown to inhibit fatty acid oxidation in cancer cells, and also has the potential to be a simpler alternative to the ketogenic diet. Ranolazine is an anti-anginal drug that also inhibits fatty acid metabolism. Another aspect to be explored is the addition of drugs to enhance the activity of the membrane transporter SLC5A8 as a method to boost entry of DCA into cancer cells, and thus reduce the required serum concentrations79. This could allow lower doses to be used which would minimize side effects. An additional method of increasing the anti-cancer effects while reducing side effects could be the use of a nanoparticle delivery system for DCA. This could allow more selective delivery of DCA to cancer cells while reducing the exposure of nerve cells to provide protection against neuropathy, which is a dose limiting side effect of DCA. Dosing of DCA is currently calculated on a mg/kg basis. This method is limited because it does not consider the inter-individual variation in hepatic DCA metabolism by the enzyme glutathione transferase zeta (“GSTz”). Based on the work of Stacpoole80, the authors believe it would be ideal to dose DCA based on pharmaco-genomics (identifying DNA sequences of GSTz variants) or pharmaco- epigenomics (identifying gene expression of GSTz variants).

Conclusions Based on the theory and observational findings to date, metabolic therapy (or perhaps it is more correctly labelled “immuno-metabolic therapy”) is not only a viable cancer treatment strategy, but it is the way of the future. Cancer patients should remain hopeful that ongoing clinical success and published observational data may serve as further encouragement to research scientists around the world to continue advancing this exciting field of cancer therapeutics.

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A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports

Grants or Financial Support: none Institutional review board statement: Not applicable

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A 15 Year Evolution of Dichloroacetate-Based Metabolic Cancer Therapy: A Review with Case Reports

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Supplement Facts Supplement Facts Serving Size 2 Capsules

Servings per container 30

Serving Size 2 Capsules

Servings per container 30 Amt Per Serv

Vitamin B6

(as Pyridoxal-5-Phosphate)

Amt Per Serv

%DV %DV

25 mg

1,471%

(as L-Methyltetrahydrofolate Calcium)

25 mg 400 mcg DFE

1,471% 100%

Folate (as L-Methyltetrahydrofolate Calcium) Vitamin B12 (as Methylcobalamin)

400 500 mcg mg DFE

100%

Vitamin B6

(as Pyridoxal-5-Phosphate)

Folate

Vitamin B12 (as Methylcobalamin) EvexiPel Proprietary blendx

500 mg 900.75 mg

PrimaVie® Shilajit fulvic acid complex, DIM® (starch, diindolylmethane,Vitamin E as tocophersolan, EvexiPel Proprietary blendx phosphatidylcholine, silica), CoEnzyme Q10, Sulforaphane 900.75 mg PrimaVie® Shilajit fulvic acid complex, DIM® (starch, diindolylmethane,Vitamin E as tocophersolan, phosphatidylcholine, silica), CoEnzyme Q10, Sulforaphane *Daily value not established.

w e N single formulation

*Daily Ingredients: value not established. Other hypromellose (capsule), microcrystallinecellulose, vegetarian leucine. Other Ingredients: hypromellose (capsule), microcrystallinecellulose, vegetarian leucine.

support hormone optimization support hormone optimization in a in a

single formulation

This comprehensive formulation combines three of our This comprehensive formulation combines three of our most popular formulations in a single nutraceutical most popular formulations in a single nutraceutical including vitamins A, D, and K, B Complex, DIM, and the including vitamins A, D, and K, B Complex, DIM, and the proprietary blend of our HRT (T) formula to deliver a proprietary blend of our HRT (T) formula to deliver a wholistic approach to achieving optimal health. wholistic approach to achieving optimal health.

EVEXIAS.COM/AUTOSHIP EVEXIAS.COM/AUTOSHIP

A4M-Winter092123-v1

25% off the HuMap thru December 31, 2023

HUMAP : HORMONE AND URINARY METABOLITES ASSESSMENT PROFILE TM

Estrogens, Progesterones, Androgens, and Corticoids

Hormone & Urinary Metabolites Assessment Profile Patient: Sample Patient Id: 999999 Age: 55 DOB: /01/1967 Sex: Female Body Mass Index: 20 Menopausal Status: Post-menopausal , Supplements:DHEA,E2,E3,P4

Order: 999999-9999 Test: X999999-9999-1 Client #: 999999 Doctor: Sample Doctor, MD Doctors Data Inc 123 Main St. St. Charles, IL 60174 USA

Sample Collection Date/Time Midsleep 05/13/2023 00:14 Dinnertime 05/12/2023 18:00 Bedtime 05/12/2023 20:35 Waking 05/13/2023 04:30 2 Hr. Post Waking 05/13/2023 06:30 Collection Period Multipoint daily 05/1 /2023 Date Received 05/2 /2023 Date Reported

ESTROGENS

Key Enzyme and Oxidative Damage Markers

Estradiol

Progesterone

E Corticoid

5α-Pregnanediol

4-OH: potential for DNA damage 16-OH: considered highly estrogenic

The pathway illustrates phase 1 and phase 2 metabolism of both E1 and E2. Phase 1 metabolites, also known as catechol estrogens, are active and can induce estrogenic actions. Phase 2 metabolism gives insight into a patient’s ability to methylate, or potentially inactivate harmful metabolites.

Estriol

Estrogen

2-OH: generally considered safest

The bar graph represents the relationship of the catechol estrogens (2-OH-E1, 4-OH-E1, 16-OH-E1) to each other. The expected percentage for each is represented by the shaded area.

Estrone

E1 2-OH E2

PHASE 1

E1 4-OH E2

COMT

16-OH-E1

COMT

E1 2-M E2

PHASE 2

E1 4-M E2

2-M-E1/2-OH-E1

Methylation Activity

4-M-E1/4-OH-E1

5β-Pregnanediol

CORTICOIDS

Androgen

2-OH-E1 % EXPECTED 40-88

4-OH-E1 % EXPECTED 2-10

16-OH-E1 % EXPECTED 10-50

Allopregnanolone

A 5α-Dihydrotestosterone C DHEA+DHEAS

Cortisol

Cortisone

11βHSD2 is responsible for the conversion of cortisol to cortisone. Inhibition of this enzyme may lead to the amount of cortisol being greater than cortisone, while increased enzyme activity can lead to higher levels of cortisone in comparison to cortisol.

Progesterone

C Cortisone/day Cortisol

Oxidization

Easy and Convenient Liquid Urine Collection

4-OH-E1:2-OH-E1

C Cortisol/day O 8-hydroxy-2’-deoxyguanosine A Testosterone C Metabolized Cortisol

11βHSD2

Cortisone

KEY RELATIONSHIPS The graphs to the right represent metabolism preference by key enzymes, indicated by the arrow. Metabolites in the 5-alpha pathway are more androgenic than their 5-beta counterparts and can be responsible for androgenic symptoms even when hormone levels appear normal. Aromatase is an enzyme found in the greatest amounts in peripheral fat tissue which can increase estrogens in both males and females. 4-OH-E1 is considered unfavorable due to its carcinogenic potential within breast and prostatic tissue as a reactive metabolite. When methylated by COMT, this reactive metabolite becomes stable and can be removed from the body.

Waking

2 Hr. Post Waking Dinnertime

5β preference

vs.

5α preference

AROMATASE/CYP19A1 ACTIVITY

TESTOSTERONE

vs.

ESTRADIOL

ANDROSTENEDIONE

vs.

ESTRONE

COMT/METHYLATION ACTIVITY

4-HYDROXYESTRONE

Page 1 of 17

Bedtime

5-Α REDUCTASE ACTIVITY

vs. 4-METHOXYESTRONE

Analyzed by DOCTOR’S DATA, INC. • 3755 Illinois Avenue, St. Charles, IL 60174-2420 USA • LAB DIR: Erlo Roth, MD • CLIA ID: 14D0646470

GI360 : EXTENSIVE ASSESSMENT OF THE GASTROINTESTINAL MICROBIOME TM

GI360™; stool Patient: Sample Patient Id: 999999 Age: 64 DOB: 0 /0 /1959 Sex: Female

Order: 999999-9999 Client #: 999999 Doctor: Sample Doctor, MD Doctors Data Inc 123 Main St. St. Charles, IL 60174 USA

Sample Collection Date Collected Date Received Date Reported Specimens Collected

Microbiome Abundance and Diversity Summary

Date/Time 08/19/2023 08/21/2023 08/31/2023 3

Actinobacteria

cte

roid

bia

ete

icro

rr Ve

The abundance and diversity of gastrointestinal bacteria provide an indication of gastrointestinal health, and gut microbial imbalances can contribute to dysbiosis and other chronic disease states. The GI360™ Microbiome Profile is a gut microbiota DNA analysis tool that identifies and characterizes more than 45 targeted analytes across six Phyla using PCR and compares the patient results to a characterized normobiotic reference population. The web chart illustrates the degree to which an individual's microbiome profile deviates from normobiosis.

GI Diversity & Abundance, Viruses, Pathogens, and Parasites by PCR

s ute

mic

Fir

Te n

eri c

ute

LEGEND

The web image shows the relative diversity and balance among bacteria belonging to the six primary Phyla. The white shaded area represents the patient's results compared to a normobiotic reference population. The center of the web represents less abundance while the outer edges represent more than normobiotic.

Proteobacteria Dysbiosis and Diversity Index These indexes are calculated from the results of the Microbiome Profile, with scores ranging from 1 to 5, and do not include consideration of dysbiotic and pathogenic bacteria, yeast, parasites and viruses that may be reported in subsequent sections of the GI360™ test. The Dysbiosis Index the (DI) is calculated strictly from the results of the Microbiome Profile, with scores from 1 to 5. A DI score above 2 indicates dysbiosis; a microbiota profile that differs from the defined normobiotic reference population. The higher the DI above 2, the more the sample deviates from the normobiotic profile. The dysbiosis test and DI does not include consideration of dysbiotic and pathogenic bacteria, yeast, parasites and viruses that may be reported in subsequent sections of the GI360™ test. A diversity score of 3 indicates an expected amount of diversity, with 4 & 5 indicating an increased distribution of bacteria based on the number of different species and their abundance in the sample, calculated based on Shannon’s diversity index. Scores of 1 or 2 indicate less diversity than the defined normobiotic reference population.

4 Dysbiosis Index

3 Diversity Score

Key Findings Butyrate producing bacteria

Elastase, Very Low

Enterobacter cloacae complex, Cultured

Gut barrier protective bacteria

Secretory IgA, Very Low

Klebsiella pneumoniae, Cultured

Gut intestinal health marker

Butyrate, High

Candida lambica, Cultured

Pro-inflammatory bacteria

Total SCFA's, Very High

Gut barrier protective bacteria vs. opportunistic bacteria

pH, Very Low β-glucuronidase, Low

= Expected Page: 1 of 22

= Imbalanced

Analyzed by DOCTOR’S DATA, INC. • 3755 Illinois Avenue, St. Charles, IL 60174-2420 USA • LAB DIR: Erlo Roth, MD • CLIA ID: 14D0646470

doctorsdata.com

Bacterial and Fungal Culturomics by MALDI-TOF with Direct Susceptibilities

Just A Number:

The Role of N-Acetylcysteine and Glycine Supplementation to Reverse Hallmarks of Aging By:

Taylor Stone, PharmD & Christopher Lorich, PharmD

Introduction: “Your age doesn’t define you, it’s just a number,” is a common phrase used by older adults; however, aging is an undeniable physiological process with great impacts on quality of life. Aging is associated with a massive increase in cancer risk along with other pathophysiologies, such as cardiovascular, neurological, and endocrine decline (National Cancer Institute 2017). Over the course of human history, the aging process has intrigued scientists. As technology improved, humanity’s knowledge of the mammalian aging process became very detailed. This correlates with a population that is aging at a greater rate than ever before. In the United States, the population of individuals 65 years old has increased from 3.1 million people in 1900 to 55.8 million people in 2020; the over65 population increased at a rate more than five times the general population (US Census Bureau). Between 2010 and 2020 alone, the over-65 population increased by 15.5 million people, while the under-65 population

increased only by 7.2 million (US Census Bureau). This can be attributed to medical advances, from something as small as education about basic hand hygiene, to huge advances such as the discovery of penicillin. Despite the myriad advances in medical care, aging still has unavoidable physiologic consequences. With the number of people over age 65 expected to double in the next three decades, there is growing interest in both living longer and having a better quality of life (US Census Bureau). People want to age in a healthier way, optimizing their physical and mental fitness for as long as possible. In other words, they want age to truly just be a number. Investigations into the aging process now focus on the microscopic level, looking at macromolecules such as proteins, amino acids, and lipids. Dysregulation of cellular activity is a crucial variable, contributing to many of the negative effects associated with aging

ANTI-AGING MEDICAL NEWS | WINTER 2023

Just A Number: The Role of N-Acetylcysteine and Glycine Supplementation to Reverse Hallmarks of Aging

(Aoyama 2015). Glutathione, a tripeptide present in nearly all mammalian cells, has been shown to change throughout our aging process. It’s complicated synthesis pathway provides insight into why aging occurs. Glutathione is synthesized from cysteine, glycine, and glutamine (Aoyama 2015, Averill-Bates 2023). This discussion will focus on the roles of N-acetylcysteine (a precursor of cysteine) and glycine in glutathione deficiency, and how new research is opening new doors to reveal how these two molecules can impact hallmarks of aging.

greatest antioxidants (Averill-Bates 2023). Glutathione is found in all cells in the human body, helping to protect them from oxidative stress by removing reactive species such as oxygen, nitrogen, and peroxides (Averill-Bates 2023). Declines in glutathione levels have been shown to contribute to various aging effects as humans get older (Iskusnykh 2022). When the body loses glutathione homeostasis, neurons may lose some of their function contributing to neurologic pathophysiological states such as Parkinson’s disease, Huntington’s disease, Alzheimer’s disease, and stroke (Iskusnykh 2022).

Hallmarks of Aging:

The function of glutathione in the central nervous system specifically is not completely understood. What is known is that glutathione is stored in mitochondria to be used as an antioxidant (Iskusnykh 2022). The brain comprises only 2% of our body’s weight, but consumes around 20% of our body’s oxygen supply (Iskusnykh 2022). Reactive oxygen species can come from exogenous or endogenous sources. The endogenous sources come from mitochondrial processes including cytochrome P450 metabolism, peroxisomes, and inflammatory cell activation. As mitochondria generate ATP from ADP via oxidative phosphorylation, ROS species are simultaneously created (Averill-Bates 2023). When ROS are kept at normal levels in the body (1-100 nM), they assist in various cellular processes without causing damage. When levels of ROS rise beyond this threshold they become damaging on a molecular level, putting the body in a state of oxidative distress (AverillBates 2023).

Despite the vast knowledge base about the aging process, many questions remain unanswered. As humans age, our bodies lose some of their ability to heal. DNA is continuously damaged and repaired throughout life, as endogenous and exogenous factors assault our genetic material (Sekhar 2011). These changes can be measured and compared between older and younger adults to examine the aging process. Research accumulated throughout the past century has given us indicators of aging commonly known as “hallmarks of age.” In 2023, geroscience researchers published nine hallmarks of aging: altered intercellular communication, genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, and stem cell exhaustion. (López-Otín 2023) These hallmarks are tied to our DNA integrity. Free radicals are a common cause of DNA damage; this discussion will focus on reactive oxygen species (ROS) free radical management (Averill-Bates 2023). Our body has multiple methods to defend against ROS, including glutathione stores that are ubiquitous in the human body (Averill-Bates 2023).

Glutathione: Glutathione is a molecule that regulates DNA synthesis, stabilizes cell membranes, and is one of our body’s

Two systems comprise the brain’s antioxidant defense mechanism: the antioxidant enzyme system and lowmolecular weight antioxidants; glutathione is involved in both systems. (Salim 2016). When mitochondrial glutathione becomes depleted, our brain loses an important part of its defense system, allowing increases in reactive oxygen species (Iskusnykh 2022). This puts the body’s proteins, lipids, nucleic acids, and membranes at risk of irreversible oxidative damage. Unchecked, they eventually lead to cellular death (Iskusnykh 2022).

ANTI-AGING MEDICAL NEWS | WINTER 2023

Just A Number: The Role of N-Acetylcysteine and Glycine Supplementation to Reverse Hallmarks of Aging

The devastating consequences of an imbalance in our antioxidant defenses emphasizes the importance of glutathione to prevent hallmarks of aging.

N-Acetylcysteine: N-Acetylcysteine (NAC) is an amino acid derivative best known for its role in reversing acetaminophen toxicity. At therapeutic doses, acetaminophen is metabolized into N-acetyl-pbenzoquinone imine (NAPQI), which is a toxic electrophilic substance that glutathione reduces into excretable, nontoxic metabolites (Raghu 2021). Excessive doses of acetaminophen raise the level of NAPQI high enough to overwhelm the ability of our body’s endogenous glutathione to convert and excrete it (Raghu 2021). When given intravenously, NAC plays an active role by crossing into liver cells where it is converted to cysteine (Raghu 2021). This cysteine is used to restore hepatic glutathione stores so the body can effectively clear the NAPQI metabolite and prevent permanent hepatic damage (Raghu 2021). While this is quite an incredible mechanism, how is it related to our human aging process? At first glance it seems unrelated, but the foundational aspects of this mechanism reflect glutathione’s defense role in the human body. NAC is a precursor to cysteine, one of the components the body uses to synthesize glutathione. It can have an indirect antioxidant effect by helping replenish the body’s glutathione stores. But why would one use NAC instead of cysteine, since that is the component used in glutathione synthesis? Cysteine has been shown to cause toxicities when given directly to patients, whereas NAC has been shown safe and effective, with a very low risk of negative side effects. It is suspected this is due to NAC slowly converting to cysteine, which reduces acute exposure of cells to cysteine, therefore protecting them from damage (Atkuri 2007). Preliminary studies have also suggested that NAC may have positive cognitive benefits, with potential improvements in diseases associated with aging such

as Alzheimer’s (Skvarc 2017). Early studies have shown signs of reducing various markers of oxidative stress and improving cognitive dysfunction in animal models (Iskusnykh 2022). Similar markers have been shown in humans, but more extensive studies must be done to understand fully how NAC affects our cognition.

Glycine: Glycine, the simplest amino acid, is necessary for cellular glutathione synthesis. It is paramount that our body has enough glycine to adequately create glutathione to protect us from oxidative stress, especially in older adults. When patients are in a state of glutathione deficiency, glycine supplementation can be used to increase glutathione synthesis (Díaz-Flores 2013). Data also suggests glycine may improve comorbidities associated with age. In patients with type 2 diabetes, daily glycine supplementation for three months reduced their level of pro-inflammatory cytokines and reduced HbA1c (Cruz 2008). Another clinical study showed systolic blood pressure in patients with metabolic syndrome was decreased with daily glycine supplementation for three months (Díaz-Flores 2013). These responses in patients may be related to decreasing inflammation and oxidative stress, which are elevated in these aging-associated disease states (Díaz-Flores 2013). Several studies reinforce the role of glycine as a geroprotector. The National Institute on Aging’s Interventions Testing Program has looked at data from mice across different geographical sites. With an 8% increase in glycine intake, there was a 3.7% increase in lifespan for females and a 6.2% increase in males (Miller 2019). A human study found that mitochondrial respiration was impaired in older adults, which was related to impaired glycine metabolism (Jonhson 2023). With glycine supplementation in these patients, they were able to reverse the mitochondrial dysfunction.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Just A Number: The Role of N-Acetylcysteine and Glycine Supplementation to Reverse Hallmarks of Aging

New Findings:

• Mitochondrial impairment

As curiosity surrounding nutraceuticals and their role in mammalian aging grows, clinical data is increasing along with it. NAC and glycine have been researched individually, showing positive indicators, but with a continuing need for more research. A new study, published January 2023, is the first randomized controlled trial to show reversal of aging markers using a combination therapy of glycine and NAC (GlyNAC). A group of 24 older adults and 12 young adults were randomized to receive alanine placebo or treatment with GlyNAC. After 16 weeks, changes in various markers were measured. These included glutathione concentrations, oxidative stress, mitochondrial fatty-acid oxidation, molecular regulators of energy metabolism, inflammation, endothelial function, IR, aging hallmarks, gait speed, muscle strength, 6-minute walk test, body composition, and blood pressure (Kumar 2023).

• Mitophagy

This treatment regimen is very much a synergistic relationship, where glycine and NAC work better together than either does on its own. GlyNAC showed improvements in red blood cell glutathione concentrations, oxidative stress, and inflammation (Kumar 2023). Previous trials with NAC alone did not return those results. One study in older mice showed GlyNAC improving cardiovascular function and inflammation, which was not replicated with NAC alone (Kumar 2022). When supplementing NAC or glycine alone, the glutathione synthesis is limited by the availability of the other component. With combination therapy, effects are seen which have not been reported in any trial that has evaluated just one of the components. The results of this novel, placebo based, randomized control trial using GlyNAC revealed improvements in many categories related to hallmarks of aging in older adults including: • GSH deficiency • Oxidative stress

• Inflammation • Insulin resistance • Endothelial dysfunction • Physical function and strength • Exercise capacity • Waist circumference • Systolic blood pressure Improvements in these categories were seen starting at two weeks, and continuing improvement was reported through sixteen weeks (Kumar 2023). Withdrawing treatment was associated with declines in these functions, suggesting maintenance treatment could be the best opportunity for older adults to receive the most benefit (Kumar 2023). A separate study found similar results in HIV patients who experience age associated physiological abnormalities at a younger age than normal adults (Kumar 2020). Their burden of geriatric conditions at 45-60 years old looks more like that of a 70-year-old adult without HIV. The mechanism of this is unclear. One possible explanation is that it occurs due to free radical accumulation and mitochondrial dysfunction which, as discussed, may be able to be reversed with adequate glutathione stores. This small study compared 8 people with HIV who were treated with GlyNAC to 8 other matched individuals who did not receive treatment (Kumar 2020). After 12 weeks of supplementation, aging markers were measured including oxidative stress, glutathione concentrations, mitochondrial fuel oxidation, proinflammatory biomarkers (Kumar 2020). Results included a 340% increase in muscle concentrations of glutathione, a significant increase in mitochondrial fuel oxidation, and a significant decrease in the levels of proinflammatory biomarkers (Kumar 2020). They also looked at cognitive decline, one of the main detriments of the aging process, and found progressive improvement throughout GlyNAC

ANTI-AGING MEDICAL NEWS | WINTER 2023

Just A Number: The Role of N-Acetylcysteine and Glycine Supplementation to Reverse Hallmarks of Aging

treatment (Kumar 2020). The study also found that improvement stopped or declined when the GlyNAC treatment was removed (Kumar 2020). These findings have prompted further studies in other mammals, such as mice, which indicate there may be even greater benefits than what this initial randomized controlled trial found. One study with two groups of mice found that those who ate a diet supplemented with GlyNAC increased their lifespan by 23.7% compared to those consuming a regular diet (Kumar 2022). This is likely associated with GlyNAC being able to effectively correct

glutathione deficiency, therefore preventing cellular oxidative stress and improving mitochondrial function. The ability to optimize glutathione synthesis with NAC and glycine to protect against the stresses associated with aging shows how continued research on aging is moving toward the future. While aging is inevitable, the research regarding “the power of three” with glycine, n-acetylcysteine, and glutathione, is promising as a new, safe treatment to reverse the hallmarks of aging. This will be a regimen to watch as further research is conducted so we may discover whether GlyNAC combination therapy may truly be able to make age just a number.

References: 1. Agrawal S, Khazaeni B. Acetaminophen Toxicity. [Updated 2023 Jun 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441917/ 2. Atkuri KR, Mantovani JJ, Herzenberg LA, Herzenberg LA. N-Acetylcysteine--a safe antidote forcysteine/glutathione deficiency. Curr Opin Pharmacol. 2007 Aug;7(4):355-9. doi:10.1016/j.coph.2007.04.005. Epub 2007 Jun 29. PMID: 17602868; PMCID: PMC4540061. 3. Aoyama K, Nakaki T. Glutathione in Cellular Redox Homeostasis: Association with the Excitatory Amino Acid Carrier 1 (EAAC1). Molecules. 2015 May 14;20(5):8742-58. doi: 10.3390/molecules20058742. PMID:26007177; PMCID: PMC6272787. 4. Averill-Bates D. A. (2023). The antioxidant glutathione. Vitamins and hormones, 121, 109–141.https://doi.org/10.1016/bs.vh.2022.09.002 5. Cruz, M., Maldonado-Bernal, C., Mondragón-Gonzalez, R. et al. Glycine treatment decreases proinflammatory cytokines and increases interferon-γ in patients with Type 2 diabetes. J Endocrinol Invest 31, 694–699 (2008). https://doi.org/10.1007/BF03346417 6. Díaz-Flores, M., Cruz, M., Duran-Reyes, G., Munguia-Miranda, C., LozaRodríguez, H., Pulido-Casas, E., ...& Hernández-Saavedra, D. (2013). Oral supplementation with glycine reduces oxidative stress in patientswith metabolic syndrome, improving their systolic blood pressure. Canadian journal of physiology and pharmacology, 91(10), 855-860. 7. Iskusnykh IY, Zakharova AA, Pathak D. Glutathione in Brain Disorders and Aging. Molecules. 2022 Jan 5;27(1):324. doi: 10.3390/molecules27010324. PMID: 35011559; PMCID: PMC8746815. 8. Johnson, A. A., & Cuellar, T. L. (2023). Glycine and aging: Evidence and mechanisms. Ageing research reviews, 87, 101922. https://doi. org/10.1016/j.arr.2023.101922 9. Kumar, P., Liu, C., Suliburk, J., Hsu, J. W., Muthupillai, R., Jahoor, F., Minard, C. G., Taffet, G. E., & Sekhar, R. V. (2023). Supplementing Glycine and N-Acetylcysteine (GlyNAC) in Older Adults Improves Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Physical Function, and Aging Hallmarks: A Randomized Clinical Trial. The journals of gerontology. Series A, Biological sciences and medical sciences, 78(1), 75–89. https://doi.org/10.1093/gerona/glac135 10. Kumar, P., Liu, C., Suliburk, J. W., Minard, C. G., Muthupillai, R., Chacko, S., Hsu, J. W., Jahoor, F., & Sekhar, R. V. (2020). Supplementing Glycine and N-acetylcysteine (GlyNAC) in Aging HIV Patients Improves Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Endothelial Dysfunction, Insulin Resistance, Genotoxicity, Strength, and Cognition: Results of an OpenLabel Clinical Trial. Biomedicines, 8(10), 390. https://doi.org/10.3390/ biomedicines8100390

11. Kumar, P., Osahon, O. W., & Sekhar, R. V. (2022). GlyNAC (Glycine and N-Acetylcysteine) Supplementation in Mice Increases Length of Life by Correcting Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Abnormalities in Mitophagy and Nutrient Sensing, and Genomic Damage. Nutrients, 14(5), 1114. https://doi.org/10.3390/ nu14051114 12. López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. Hallmarks of aging: An expanding universe. Cell. 2023 Jan 19;186(2):243-278. doi: 10.1016/j.cell.2022.11.001. Epub 2023 Jan 3. PMID: 36599349. 13. Miller RA, Harrison DE, Astle CM, Bogue MA, Brind J, Fernandez E, Flurkey K, Javors M, Ladiges W, Leeuwenburgh C, Macchiarini F, Nelson J, Ryazanov AG, Snyder J, Stearns TM, Vaughan DE, Strong R. Glycine supplementation extends lifespan of male and female mice. Aging Cell. 2019 Jun;18(3):e12953. doi: 10.1111/acel.12953. Epub 2019 Mar 27. PMID: 30916479; PMCID: PMC6516426. 14. National Cancer Institute. Age and Cancer Risk [Internet]. Bethesda, MD: National Institutes of Health; 2017 [cited 2023 September 19]. Available from: https://www.cancer.gov/about-cancer/causesprevention/ risk/age. 15. Raghu, G., Berk, M., Campochiaro, P. A., Jaeschke, H., Marenzi, G., Richeldi, L., Wen, F. Q., Nicoletti, F., & Calverley, P. M. A. (2021). The Multifaceted Therapeutic Role of N-Acetylcysteine (NAC) in Disorders Characterized by Oxidative Stress. Current neuropharmacology, 19(8), 1202–1224. https:// doi.org/10.2174/1570159X19666201230144109 16. Sekhar RV, Patel SG, Guthikonda AP, Reid M, Balasubramanyam A, Taffet GE, Jahoor F. Deficient synthesis of glutathione underlies oxidative stress in aging and can be corrected by dietary cysteine and glycine supplementation. Am J Clin Nutr. 2011 Sep;94(3):847-53. doi: 10.3945/ ajcn.110.003483. Epub 2011 Jul 27. PMID: 21795440; PMCID: PMC3155927. 17. Skvarc, D. R., Dean, O. M., Byrne, L. K., Gray, L., Lane, S., Lewis, M., Fernandes, B. S., Berk, M., & Marriott, A. (2017). The effect of N-acetylcysteine (NAC) on human cognition - A systematic review. Neuroscience and biobehavioral reviews, 78, 44–56. https://doi. org/10.1016/j.neubiorev.2017.04.013 18. U.S. Census Bureau. (n.d.). Population 65 Years and Over in the United States. U.S. Department of Commerce. Retrieved September 27, 2023, from https://data.census.gov/

ANTI-AGING MEDICAL NEWS | WINTER 2023

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Nitric Oxide is the Longevity Molecule The Unified Theory of Aging By:

Nathan S. Bryan, PhD

Today people may be living longer lives, but they are not living long healthy lives. Due to development of drugs that can prolong death and treat symptoms, people can live longer but today we know we have the sickest population than ever before. We have learned a tremendous amount about cellular biology and what constitutes good health and what biomarkers are associated with longevity. There are even test and objective measures of longevity. The three most studied and validated measures of longevity are:

from our father. When we turn genes into proteins, the DNA within the chromosomes must unwind and with each cell replication, the end of the chromosomes, the telomeres can become shorter. This is dependent upon an enzyme called telomerase. When telomerase enzyme is fully expressed and functional, then this enzyme prevents the telomeres from become shorter over time by providing the proper sequence to replace the

1. Telomere length 2. Mitochondria number and function 3. Stem cells I will review each of these one by one and show you how it is nitric oxide that controls and regulates each of these three main markers and controllers of longevity. Telomeres are the ends of the chromosomes of our DNA. Humans have 23 pairs of chromosomes with half coming from our mother and the other half coming ANTI-AGING MEDICAL NEWS | WINTER 2023

Nitric Oxide is the Longevity Molecule - The Unified Theory of Aging

otherwise missing ends of the telomeres. This discovery was deemed so fundamentally important, Nobel Prize in Physiology or Medicine was awarded to three scientists in 2009 for their discovery. From the Nobel website “The award recognizes the discovery of a fundamental mechanism that has added a new dimension to our understanding of the cell, shed light on disease mechanisms, and stimulated the development of potential new therapies.” Their work began in the 1980s that eventually revealed how the ends of chromosomes can be protected and preserved over many years. Now more than ten years later we certainly understand how we can develop potential new therapies to prevent telomere shortening and prolong life. In 1998 it was discovered that the loss of the function of the telomerase enzyme precedes telomere shortening and if we introduced a functional telomerase enzyme into human cells, it would prolong the life of those human cells. In 2003 it was revealed that shortening of the telomeres was associated with increased mortality rate from age related diseases. Furthermore, individuals with shorter telomeres had a mortality rate nearly twice that of those with longer telomeres. I would say this is pretty important. We certainly want to prevent our telomeres from shortening if we want to live longer. So how do we do that? In the early 2000s there was research published that revealed that nitric oxide could stimulate the telomerase enzyme and prevent telomere shortening. There was a very similar story playing out in the nitric oxide field showing that people who lost their ability to produce nitric oxide had earlier onset of cardiovascular disease and many other diseases. Was the loss of nitric oxide leading to a loss of function of the telomerase enzyme leading to shorter telomeres and early death? Other investigators starting looking at the regulation of the genetic coding of the telomerase enzyme. These geneticists found that the nitric oxide synthase enzyme, the enzyme that actually produces nitric oxide is required for the cell to actually transcribe the

telomerase enzyme from DNA. Wow, so if we lose the ability to produce nitric oxide, we not only get less telomerase enzyme produced in each cell but we also lose the function of what enzyme is being produced. Nitric oxide appeared to be the master switch for preventing telomere shortening and extending life. To further support this argument, scientists knocked out the nitric oxide synthase gene in mice and found that these mice lose the ability to regulate telomerase activity but if the mice were administered nitric oxide generating compounds, they could rescue the telomerase activity and prevent telomere shortening. This means that if your body cannot produce nitric oxide, if you take a nitric oxide producing substance, you can restore telomerase activity, prevent telomere shortening and extend your life. Nitric oxide is the master regulator of telomere length. Without nitric oxide, telomeres get shorter and you live a shorter life. The take home message is that if you want to live longer, you need nitric oxide and you need to take steps to restore your body’s ability to produce it on its own.

Mitochondria Everybody knows we need energy to do our job. Cells need energy to do their job. It is the job of the mitochondria to produce energy for every cell in the body. Each cell contains approximately 1000-2500 mitochondria. In fact, mitochondria make up as much as 25% of the volume of some cells. These mitochondria must continuously produce ATP, the energy currency of the cell in order for the cell to do its job. ATP cannot be stored in the cell so it must be produced upon demand or else the cell becomes dysfunctional and dies. Every cell must have sufficient mitochondria but also the function of those mitochondria must be maintained. The mitochondria of older animals are often larger and less efficient than those in younger animals. Studies between different species have demonstrated that longer-lived species typically have lower mitochondrial DNA oxidative damage and lower free radical production. This means that their mitochondria produce

ANTI-AGING MEDICAL NEWS | WINTER 2023

Nitric Oxide is the Longevity Molecule - The Unified Theory of Aging

less free radicals than those species that don’t live as long. When cells have lower numbers of mitochondria, they produce less energy, obviously. However, cells can have large numbers of mitochondria but if the mitochondria do not efficiently produce energy, then again, those cells become energy deficient and they cannot do their job. Efficient mitochondria produce very little free radicals, then very economically generate ATP from oxygen and they sensitively detect when the cells in which they reside become damaged and they signal the cell to die. We call this apoptosis or programmed cell death. A chain is only as strong as its weakest link. Organs and tissues are made of cells. It is the job of our organs, tissues and cells to recognize the weak cells and replace them with strong cells fully equipped to do their job. If the mitochondria do not sense this weakness, then the cells simply necrose or die a slow death and eventually kill the cells, then the tissues become dysfunctional and eventually leads to organ failure. That is one of the many functions of the mitochondria. We now know from several decades of research that it is the nitric oxide produced in the cell that controls the metabolic function of the mitochondria. Nitric oxide controls and regulates:

Stem cells

5. Metabolism/Bioenergetics

Each day we live, we are constantly wearing ourselves out. Some of us faster than others depending on our diet and lifestyle and occupations. We must constantly repair and replace dysfunction cells and tissues. That is the job of our own stem cells. In normal healthy people our skin renews every 27 days. The cells of our gastrointestinal system replace every 5-7 days. In our brain, there are 700-1500 new neurons created every day. Our liver can completely regenerate up to 90% of itself within days. The cells in the lung have to renew every 2-3 weeks. What happens if we don’t have enough stem cells in our body or worse, the stem cells in our body do not get the message to mobilize to go and replace and repair other cells and tissues. The answer is that we wear ourselves out and we get sick and eventually die, likely years before our true potential.

Everything we know about mitochondria numbers and function within individual cells is dependent upon the cells ability to produce nitric oxide. Without nitric oxide, the mitochondria cannot do their job of efficiently producing energy and the cells cannot function. How does nitric oxide do this? We start with important observations. We’ve known for many decades now that caloric restriction, intermittent fasting, resveratrol from wine and most recently NAD or nicotinamide adenosine dinucleotide all lead to an increase in the number of mitochondria referred to as mitochondria biogenesis.

There is an abundance of scientific evidence that nitric oxide is essential and fundamental for stem cell function. The number of stem cells in our bone marrow is much higher when we are young and slowly decline as we age. This is one of the reasons young people recover from injury much faster and are in generally better health. There is evidence over the past 20 years that our fat cells contain stem cells. This may be good news since most people accumulate more fat with age. Now we understand that perhaps it is not the

1. ATP production of the mitochondria 2. Production of reactive oxygen species (oxidative stress) 3. Cell signaling by the mitochondria (apoptosis) 4. Mitochondria biogenesis

ANTI-AGING MEDICAL NEWS | WINTER 2023

Nitric Oxide is the Longevity Molecule - The Unified Theory of Aging

number of stem cells in our body that matter but the ability of our own stem cells to get the message to go do their job. Aging is not just a matter of the increased damage to our bodies but the inability to repair. Back in the early 2000s it was discovered that nitric oxide is the requisite signal for stem cell mobilization and differentiation into different cell types. In this study, they deleted the enzyme that makes nitric oxide in mice and observed that the mice could not mobilize their own stem cells or progenitor cells. The authors concluded that the loss of nitric oxide production was what caused impaired regenerative processes in patients with cardiovascular disease which are known to have decreased nitric oxide production. This means that as we lose our ability to produce nitric oxide, our stem cell function is compromised and we lose the ability to repair and replace dysfunctional cells. This means we age faster, we don’t recover from injury and we feel awful. There are hundreds if not thousands of stem cell clinics popping up all over the U.S. and the world. These clinics take your own stem cells or stem cells from placenta or umbilical cords from new mothers and infants respectively and then inject it into patients. Now knowing what we know, does this even make sense? We have established that it is likely not the availability of stem cells that leads to aging but rather the lack of the signal to the stem cells, nitric oxide. One of my objectives is to educate these stem cell clinics on using nitric oxide in their patients prior to the deployment of stem cells so the cells know where to go and what to become. It only makes sense

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

100

to make these treatments more effective and allow the body to do what it is designed to do, heal and perform. It cannot and will do that without nitric oxide. We’ve established that the three objective read outs of health and longevity, telomere length, mitochondrial function and stem cell function are all dependent upon the ability of the body to produce nitric oxide. There are many products on the market that are marketed as telomere products to prevent telomere shortening. There are hundreds of mitochondrial products on the market and as I mentioned thousands of stem cell clinics around the world offering stem cells. Let us not forget that our body is much smarter than any scientist or physician. How about we give the body what it needs and let it do its job. If we restore and replete nitric oxide, the telomerase enzyme becomes more functional, extending our telomeres. If we restore and replete nitric oxide, the number of mitochondria per cell increases and the function of each mitochondria improves. The net effect is we have more mitochondria making more cellular energy more efficiently and giving us more energy. Who would not want that? If we restore and replete nitric oxide, our own stem cells get the message to go and repair and replace old dysfunctional cells and our organs work better. My job is to understand the mechanism of disease to the extent we can address the root cause of any condition. I’m not saying that nitric oxide will fix everything but I can confidently say that nothing else will work without first correcting nitric oxide production. Fortunately, we know how to do that.

Author Bio:

Bodnar et al. Science 1998 Jan 16;279(5349):349-52. Blasco Nature Reviews Genetics 6, Aug 2005;611-622 Cawthon et al Lancet 2003; 361: 393–95 Vasa et al Circulation Research. 2000; 87: 540-542 Grasselli et al Circulation Research. 2008 Jul 3;103(1):34-42 Farsetti et al J. Appl Physiol. 2009 Jan;106(1):333-7 Nisoli E et al. Circulation Research 2007;100:795-806 Aicher et al Nature Medicine 9, 1370 - 1376 (2003) Free Radic Biol Med. 2011 Dec 15;51(12):2150-7

Dr. Bryan is an international expert in nitric biochemistry and molecular medicine. His more than 20 years in academic research led to many seminal discoveries and has resulted in dozens of issued U.S. and International patents. Products from his innovations are the most successful nitric oxide products in the market and responsible for hundreds of millions of dollars in revenue around the globe and have improved patient care for more than a decade.

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Mitochondrial Energy Support for Optimized Immune Function By:

Kareem Kandil, MD, ND

Mitochondria, the powerhouses of our cells, are

in the form of adenosine triphosphate (ATP), which

essential for generating energy. As such, mitochondrial

is the key source of energy for all cells. To increase

dysfunction can result in excess fatigue as well as

mitochondrial output, there must be an adequate

other symptoms that are common to almost every

fuel supply for combustion as well as abundant

chronic disease. Mitochondrial dysfunction can

antioxidants to scavenge free radical by-products.

manifest as a wide range of health problems, such as neurodegenerative diseases, metabolic disorders,

The Micronutrient “Backbone”

cardiovascular disease and immune dysfunction.

To recharge cellular energy production efficiently, optimal levels of critical nutrients and enzyme cofactors

Lack of sleep, too much stress, poor nutrition and

must be achieved. The powerful antioxidant trio of

prescription medications can all draw on energy

alpha lipoic acid, N-acetyl cysteine and acetyl L-carnitine

reserves, using them up faster than they can be

are shown to recharge cellular energy production

replenished. The body’s cells and organ systems

and the primary cellular antioxidant pools of vitamin

depend on an adequate supply of energy to function

E, vitamin C and glutathione. Key micronutrients and

optimally. Mitochondria require key nutrients and

phytonutrients include green tea, broccoli seed extract

enzymes to recharge cellular energy production.

and resveratrol, which protect the mitochondria and

These enzymes help convert food to usable energy

continually renew the cycle of energy production.

ANTI-AGING MEDICAL NEWS | WINTER 2023

103

Mitochondrial Energy Support for Optimized Immune Function

Acetyl L-Carnitine† Acetyl L-carnitine (ALC) is an amino acid that is associated with recharged cellular energy production.

body.6 In addition to its antioxidant activity, glutathione supports immune function by activating T-cells.7

Alpha Lipoic Acid † Alpha lipoic acid (ALA) is an antioxidant and plays a synergistic role in recharging other antioxidants, such as vitamin C, vitamin E, CoQ-10 and glutathione. Lipoic acid also plays a key role in supporting detoxification capacity.8 Studies have shown that a combination of ALA and ALC helps minimize oxidative damage.9,10 Oxidative stress causes damage to DNA, RNA, proteins, mitochondrial membranes and lipids, and it contributes to the functional decline of mitochondria, cells, tissues and eventually organs, such as the brain.9,10

Resveratrol†

It has been shown to increase the flow of free fatty acids, the fuel source for mitochondria, resulting in a significant boost in energy production. With age, free radical production increases oxidative damage to the mitochondria, which can potentially decrease energy production. ALC has been shown to recharge cellular energy production and has been found, in combination with lipoic acid, to lower oxidative stress.2,3 Studies have also shown that ALC supports immune function by protecting CD4 and CD8 immune cells and by supporting the reproduction of lymphocytes for the identification and elimination of invading antigens.4,5

N-Acetyl Cysteine† N-acetyl cysteine (NAC) is an antioxidant that scavenges free radicals and supports detoxification capacity.6 NAC has been shown to increase production of glutathione, an important antioxidant found in the

104

Resveratrol is a polyphenol molecule found in many plant species, including grapes and cranberries, and it is found in high concentrations in wine. Polyphenols act as antioxidants that protect plants from damage that can be caused by bacteria, fungi and radiation.11 Resveratrol is believed to be the dietary factor behind the “French paradox,” which is the high rate of cardiovascular wellness in the French population, despite their high fat intake. In addition to its antioxidant properties and support for cardiovascular function, resveratrol has been shown to support immune function.11

Broccoli Seed Extract† Broccoli seed extract contains a high amount of glucoraphanin, a compound that is a precursor to sulforaphane. Sulforaphane is an antioxidant and supports detoxification capacity and immune response. Sulforaphane has been shown to induce Phase II detoxification enzymes and raise intracellular glutathione levels.12

ANTI-AGING MEDICAL NEWS | WINTER 2023

Mitochondrial Energy Support for Optimized Immune Function

Green Tea (EGCG)† Green tea polyphenols have demonstrated significant antioxidant, probiotic- and immunesupporting properties.13 The hydroxyl group of green tea polyphenols increases antioxidant protection by forming complexes with free radicals and neutralizing them, minimizing oxidative damage throughout the body. Green tea polyphenols also stimulate the activity of liver detoxification enzymes, supporting detoxification capacity.13

Addressing lifestyle factors, particularly a nutrientdense diet, as well as adequate sleep and movement, can all help to optimize mitochondrial function and recovery. By supplementing key micronutrients and antioxidants, clinicians can help to improve mitochondrial health and enhance cellular energy production needed for energy-demanding systems. Educating patients about the importance of these interventions and encouraging healthy habits can help improve health outcomes, vitality and overall well-being.

In Summary Preserving energy reserves and increasing energy output is a critical part of maintaining optimal immune health.

References: 1. Kaiser JD, Campa AM, Ondercin JP, Leoung GS, Pless RF, Baum MK. Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blind, placebo-controlled trial. J Acquir Immune Defic Syndr 2006; 42(5): 523-528. 2. Shigenaga M K, Hagen T M,et al. Oxidative damage andmitochondrial decay in aging. Proc Natl Acad Sci U S A. 1994; 91(23):10771-10778.

6. N-Acetylcysteine. Altern Med Rev 2000; 5(5):467-471. 7. Patrick, L. Nutrients and HIV: part three - N-acetylcysteine, alphalipoic acid, L-glutamine, and L-carnitine. Altern Med Rev 2000; 5(4):290-305. 8. Alpha-lipoic acid. Monograph. Altern Med Rev 2006; 11(3):232-237. 9. Ames, B. N. Optimal micronutrients delay mitochondrial decay and age-associated diseases. Mech Ageing Dev 2010; 131(7-8):473-479.

3. Hagen, TM, Liu J, et al. Feeding acetyl-L-carnitine and lipoic acid to old rats significantly improves metabolic function while decreasing oxidative stress. Proc Natl Acad Sci U S A. 2002; 99(4):1870-1875.

10. Ames, B. N. and Liu, J. Delaying the mitochondrial decay of aging with acetylcarnitine. Ann N Y Acad Sci 2004; 1033:108-116.

4. Di Marzio L, Moretti S, et al. Acetyl-L-carnitine administration increases insulin-like growth factor 1 levels in asymptomatic HIV1-infected subjects: correlation with its suppressive effect on lymphocyte apoptosis and ceramide generation. Clin Immunol 1999; 92(1):103-110.

12. Fahey JW, Talalay P. Antioxidant functions of sulphoraphane: a potent inducer of phase II detoxification enzymes. Food Chem Tox 1999:37:973-979.

11. Resveratrol: Monograph. Altern Med Review 2010; 15(12):152-158.

13. Green Tea. Altern Med Review 2000; 5(4):372-5

5. Deufel, T. Determination of L-carnitine in biological fluids and tissues. J Clin Chem Clin Biochem 1990; 28(5):307-311.

† 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.

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105

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DUTCH methods align with validated research so providers can confidently treat hormone-related issues. DUTCH Urine Monitoring of Topical Estrogen Featured in the Journal, Menopause

Comparative estrogen exposure from compounded transdermal estradiol creams and FDA-approved transdermal estradiol gels and patches Mark S. Newman, MS, Doreen Saltiel, MD, JD, Jaclyn Smeaton, ND, and Frank Z. Stanczyk, PhD At DUTCH, we are committed to providing you with an evidence-based approach to integrative care. We know that questions exist in the integrative medicine community about the best way to provide hormones to patients as well as the best way to monitor dosing. This study, peer-reviewed by the rigorous team at Menopause, highlights the accuracy of urine metabolite testing for monitoring of estrogen replacement therapies. KEY HIGHLIGHTS INCLUDE: • DUTCH methods are again validated in the peer-reviewed literature. When you choose to partner with DUTCH, you can rest assured that our lab is willing to stand up to independent evaluation for accuracy and clinical relevance, even against the toughest critics. • The first peer-reviewed study to compare FDA approved patches and gels to compounded estrogen creams, a key therapeutic choice for many providers in the integrative medicine community. • Estrogen exposure from compounded transdermal E2 creams increases in a dose-dependent manner; however, the amount of estrogen exposure associated with compounded creams is significantly lower than estrogen exposure associated with FDA-approved transdermal E2 patches and gels.

It is our mission to profoundly change lives by guiding providers through the complex hormone questions they face every day. Visit us at booth 4021 or go to DUTCHTest.com to learn how DUTCH Testing can help you profoundly change your patients’ lives.

Monitoring Menopausal Estrogen Replacement Therapy By:

Jaclyn Smeaton, ND, Chief Medical Officer at Precision Analytical

Menopausal hormone replacement therapy (HRT) most commonly consists of estrogen, progesterone, or testosterone, and can come in a variety of forms—some that are FDA-approved prescriptions and others that are custom compounded. The North American Menopause Society (NAMS) currently does not recommend routine monitoring of menopausal women on HRT, but this is one of the few patient populations where monitoring is NOT standard of care. In most clinical situations, such as with thyroid hormone therapy or testosterone replacement in males, monitoring is part of the course of treatment. The reason for this may be that there is a relative low risk of serious side effects at commonly prescribed doses; however, the many providers who practice a precision medicine-based approach look to monitor to optimize hormone prescriptions, and we agree there is significant benefit to doing so, particularly for

patients taking transdermal (topical) estrogen therapy. Second, once a patient is on therapy, monitoring can ensure that your patient is in an optimal therapeutic range to maximize their outcomes. In this article, we will discuss some of the most commonly used testing methodology and the evidence supporting it.

HRT THERAPIES CAN BE MONITORED WITH HORMONE TESTING When it comes to choosing a method to monitor patients on hormone replacement therapy, you must take into consideration which hormone you are measuring as well as the route of administration of the hormone (oral, topical, etc). There are some HRT questions that lab testing cannot help elucidate and others where testing may be crucial to optimizing treatment The differing chemical properties of each hormone, along with the pharmacokinetics of various preparations can change the best monitoring

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approach. The most common modes of monitoring HRT in the functional and integrative medical community include serum, saliva, and urine.

with periodic applications such as gels and creams.

TOPICAL (TRANSDERMAL) ESTROGEN REPLACEMENT THERAPY (ERT) Transdermal (topical) estrogen replacement therapy is the most commonly used hormone replacement therapy in menopausal women, primarily for vasomotor symptoms, vaginal comfort, and bone preservation. Topically applied forms of estradiol include patches, gels, and creams. When considering how to monitor topical estrogen therapies, integrative providers typically consider monitoring through serum, urine, or saliva. In this article, we’ll review the literature support and pros and cons of each.

Serum Many providers prefer to test in serum when possible, considering ease of access and cost to the patient, particularly if insurance would cover the cost. Serum is a suitable medium to test many analytes in the body, but estradiol levels for women on therapy may be more difficult than others. One challenge, and likely one reason monitoring is not conventionally recommended for topical ERT, is that levels in serum rise and fall quickly after some topical applications. In this study by Jarvinen et al, subjects were monitored through serum on estrogen gel and patch therapy. What was observed was that with gels, there was a significant variation in serum estradiol levels based on time after application. This would be expected, as the gel would be applied, absorbed, and metabolized and could be expected to be variable over time. With patches, there is a slower, more constant exposure of the skin to the hormone replacement, resulting in a more stable serum estradiol level over time. For this reason, serum may be a suitable method to monitor estradiol in women on a steady-state dose such as patches, but would be difficult for topical applications

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It is important to note that far more studies exist in regards to FDA-approved patches and gels. Compounded estrogen creams have fewer peerreviewed publications in literature and no true outcome studies. In 2013, one of the only studies measuring serum levels of compounded topical estrogen creams was published and showed a similar time-dependent level of serum estradiol after application of the cream. You can imagine that the time that the patient applied a cream or gel would drastically influence the levels of estradiol expected in serum. Furthermore, what providers really want to know is the total exposure to estrogen with the use of the HRT, which would be represented more accurately by the area under the curve. This can’t be estimated based upon only a single time point of a serum draw. . It may be easy to overdose a patient using serum testing if the provider is unaware of this potentially rapid rise-and-fall of serum levels. The potential for overdosing increases if providers target serum levels higher than the 20-60pg/ mL levels proven to correlate with clinical improvement.

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Monitoring Menopausal Estrogen Replacement Therapy

Urine Urine measurement of topical estrogen replacement therapies have recently been validated in literature in several publications. It is critical to note that these studies were all completed using one specific method of analyzing a dried urine sample. Each clinical lab in the industry uses its own method and only one has been validated in research.

from compounded estrogen creams to previously published data on patches and gels. It found that estrogen exposure from compounded creams also increased in a dose-dependent manner, but that the overall estrogen exposure from creams was lower than that of gels and patches. Urine was demonstrated as a suitable means to evaluate estrogen exposure on all forms of transdermal estrogen replacement therapy.

In the August 2022 issue of Steroids, estrogen exposure from FDAapproved transdermal estradiol gels was evaluated in urine. The study evaluated the urinary estrogen levels in cycling females, postmenopausal females not on therapy, and postmenopausal females on various doses of estrogen replacement therapy and observed expected doseproportional changes in estrogen exposure in the on-therapy groups. In a similar study in 2023, estrogen exposure from transdermal patches was evaluated in urine, showing, again, a dose-dependent increase in urinary E2, other estrogen metabolites and total urinary estrogen . In both of these studies, clinically effective doses of estrogen replacement therapies (based upon previously published clinical outcome studies) resulted in urinary levels of estradiol between the postmenopausal (not on therapy) and mid- luteal ranges (in cycling females). This may represent a suitable therapeutic target for women on HRT. As with serum testing, when providers target the middle of the luteal range, they may use excessive doses of estradiol. If, however, careful consideration is given to the levels needed for clinical success, appropriate dosing and absorption can be affirmed using urine testing. In November 2023, an addition study was published in the journal Menopause comparing estradiol exposure

Measuring urinary estradiol with the published 4-point collection (where 4 urine samples are taken across a 24 hour period) for topical routes of administration of estrogen therapies may help to average out the daily up and down patterns that are seen in serum after the application of creams and gels. The aggregate clinical data suggests that a serum E2 level of about 20-60 pg/mL improves clinical outcomes of vasomotor symptoms and bone mineral density. This correlates with an approximate dried urine value of about 0.7-1.8 ng/mg using the test methodology in the studies. There are additional benefits to urine monitoring of estradiol and metabolites for a woman on HRT. In an initial evaluation of a female patient, urinebased hormone testing can assist a practitioner in understanding a patient’s unique estrogen detoxification

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pathways with the inclusion of hormone metabolites on the test report. For example, is estrogen being pushed into carcinogenic 4-OH estrogen catechols increasing the risk for breast cancer? Or is estrogen being pushed into proliferative 16-OH-E1 metabolites that can contribute to heavy bleeding, breast tenderness, or fibroid growth? Knowing this in advance may help you identify patients at higher risk for undesirable effects of HRT, or help you craft a more comprehensive treatment plan to avoid those risks and ensure optimal detoxification and eliminate exogenous hormones through the additional of supplements that support a slow detoxification process.

to be effective, but not an overdose of estrogen. The outrageously high levels seen in the study are often not experienced by providers because labs encourage collection 24 hours or more after the application of therapy, at which point levels are still elevated. Assuming these elevated saliva levels reflect a clinical reality likely drives providers to use much less estrogen than the test implies. It should be noted, this phenomenon of supraphysiological saliva levels using moderate doses of transdermal estrogen products is true only of gels and creams. Saliva values for patients on estradiol patches are more in alignment with serum and urine values.

Saliva

More research is necessary to validate whether saliva could be a suitable method to monitor topical estrogen replacement therapy, but at this time, there is a lack of published evidence to be able to support its use, particularly when the estrogen is applied to the skin as a gel or cream.

Providers are often surprised to learn there is very little data to evaluate saliva as an appropriate way to monitor estrogen replacement therapy. There is one study available that looks at estradiol levels in saliva after use of topical estrogen gel. In this study, a conventional estrogen gel (visualized as a square on the graph) was being used as a control to compare to an experimental gel with nanoparticles (the diamonds on the graph). It was observed that application of a 0.75 mg dose of a standard estrogen gel resulted in salivary levels over 2000 pg/mL. Saliva labs in our industry report expected luteal range values (in cycling females) to be well below 10 pg/mL and baseline postmenopausal levels in this study were less than 1 pg/mL. This would suggest that a 0.75 mg dose of estrogen gel, which is a moderate dose per dosing guidelines and clinical studies, would be almost 100 fold higher than a cycling female’s luteal range and would be a tremendous amount of estrogen exposure, much more than needed. This does not resonate with clinical outcomes studies which show that a 0.75 mg dose of estrogen gel appears

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In integrative and functional medicine, clinicians are often put in a position where they have to evaluate the science themselves to drive decision-making in their practice. This includes therapeutic approaches as well as diagnostic. When it comes to hormone testing and monitoring, this can be challenging, as much of the education comes from labs themselves- either claims made without data to back it up, or using lab-published data that has not been subject to rigorous peer review.

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Monitoring Menopausal Estrogen Replacement Therapy

When it comes to monitoring of estradiol for women on HRT, serum measurement appears suitable for steadystate applications such as patches, and urine monitoring with a 4-point dried urine collection can be used for gels,

creams, and patches, so long as the validated methods are used. Saliva has very little peer-reviewed data to evaluate, but the one study that exists does not appear to represent results consistent with clinical outcomes data.

References: 1. Sood R, Warndahl RA, Schroeder DR, Singh RJ, Rhodes DJ, Wahner-Roedler D, Bahn RS, Shuster LT. Bioidentical compounded hormones: a pharmacokinetic evaluation in a randomized clinical trial. Maturitas. 2013 Apr;74(4):375-82. doi: 10.1016/j. maturitas.2013.01.010. Epub 2013 Feb 4. PMID: 23384975.

4. Newman MS, Saltiel D, Smeaton J, Stanczyk FZ. Comparative estrogen exposure from compounded transdermal estradiol creams and Food and Drug Administration-approved transdermal estradiol gels and patches. Menopause. 2023 Nov;30(11).

2. Newman MS, Curran DA, Mayfield BP, Saltiel D, Stanczyk FZ. Assessment of estrogen exposure from transdermal estradiol gel therapy with a dried urine assay. Steroids. 2022 Aug;184:109038. doi: 10.1016/j.steroids.2022.109038. Epub 2022 Apr 26. PMID: 35483542.

5. Martina Nicklas, Wolfgang Schatton, Sascha Heinemann, Thomas Hanke & Jörg Kreuter (2009) Preparation and characterization of marine sponge collagen nanoparticles and employment for the transdermal delivery of 17β-estradiol-hemihydrate, Drug Development and Industrial Pharmacy, 35:9, 1035-1042, DOI: 10.1080/03639040902755213

3. Newman MS, Mayfield BP, Saltiel D, Stanczyk FZ. Assessing estrogen exposure from transdermal estradiol patch therapy using a dried urine collection and a GC-MS/MS assay. Steroids. 2023 Jan;189:109149. doi: 10.1016/j.steroids.2022.109149. Epub 2022 Nov 19. PMID: 36414155.

6. Järvinen A, Bäckström A, Elfström C, Viitanen A. Comparative absorption and variability in absorption of estradiol from a transdermal gel and a novel matrix-type transdermal patch. Maturitas. 2001 Apr 20;38(2):189-96. doi: 10.1016/s03785122(00)00222-x. PMID: 11306208.

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Why gammaCore? gammaCore non-invasive vagus nerve stimulator (nVNS) is a hand-held, user-administered therapy that is proven to stimulate the vagus nerve1,2. The device is FDA-cleared with 6 indications for migraine and cluster headache, is easy for patients to use, and can be used alone or in combination with other treatments you are currently offering in your practice. References: 1. Nonis, R., D’Ostilio, K., Schoenen, J., & Magis, D. (2017, June 26). Evidence of activation of vagal afferents by non-invasive vagus nerve stimulation: An electrophysiological study in healthy volunteers. Cephalalgia, 37(13), 1285–1293. https://doi.org/10.1177/0333102417717470 2. Frangos, E., & Komisaruk, B. R. (2017, January). Access to Vagal Projections via Cutaneous Electrical Stimulation of the Neck: fMRI Evidence in Healthy Humans. Brain Stimulation, 10(1), 19–27. https://doi.org/10.1016/j.brs.2016.10.008 ©2023 electroCore, Inc. All rights reserved. electroCore, the electroCore logo, gammaCore, the gammaCore logo,gammaCore Sapphire, and gammaCore Sapphire logo are trademarks of electroCore, Inc. EPM-015249 Rev 3 Rel: 09/2023

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Hormonal Health:

Detoxification Strategies for Endocrine Receptor Function By:

Lindsay Christensen, MS, CNS, LDN, A-CFHC, CKNS

In functional medicine, there is a strong emphasis on the maintenance of optimal hormone levels and healthy hormone metabolism. However, little attention is paid to the health and function of hormone receptors, the “locks” into which our hormones, the “keys,” must fit to initiate hormone-dependent processes. Why is this important? The scientific research tells the story of endocrine-disrupting chemicals being at the forefront of not only receptor and hormone health but a host of other downstream effects. A high toxic burden may be to blame. It used to be that

Hormones and their Receptors: The Lock and Key Mechanism Hormone or endocrine receptors are proteins in or on our cells that bind to specific chemical messengers. They are nestled in cell membranes and float within the cell’s cytoplasm. The chemical messengers that bind to endocrine receptors encompass an array of substances, including thyroid and steroid hormones, vitamin D, and fatty acids. When a chemical messenger binds to its respective hormone receptor, it initiates a characteristic response or group of responses, with pivotal health effects.1

supporting a patient’s detoxification pathways was reserved for specific toxicities like metals or mold. However, in today’s modern, toxin-laden environment, detoxification protocols should be at the foundation of a patient’s treatment plan and regularly assessed, especially with patients that are experiencing endocrine-related symptoms or conditions.

Hormones and endocrine receptors are analogous to a lock and key. The hormone (key) attaches to the receptor (lock) to initiate a process inside the body (unlock the door). When a hormone binds to its respective receptor, it becomes a hormone-receptor complex. The hormone-receptor complex subsequently switches

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biological processes on or off in cells, tissues, and organs. Interference with normal hormone and endocrine receptor interactions thus has enormous health implications. A growing body of research indicates that environmental toxins are an insidious threat to our hormone receptors and overall hormone health.

Endocrine-Disrupting Chemicals (EDCs) and their Impact on Hormone Receptors Current research indicates that numerous environmental toxins interact with endocrine receptors, disrupting their “lock and key” interaction. Interference with hormone-receptor binding disrupts countless downstream processes, with frightening health consequences. Environmental toxins that interfere with the endocrine system are known as endocrine-disrupting chemicals, or EDCs. EDCs are “exogenous substances that can mimic endogenous hormones with similar structures or activities to influence their synthesis and metabolism.”2 Essentially, environmental toxins poison our hormone receptors. Therefore, it is critical to understand how to effectively detoxify endocrine receptors to facilitate healthy hormone-endocrine receptor activity and overall hormone balance. In the laboratory, the healthy function, or lack thereof, of hormone receptors is indicated by: • The number of receptor sites • The affinity of a hormone for its receptor • Whether EDCs have blocked receptors • Whether the appropriate cofactors are present to aid binding of the hormone to its receptor.3 At present, it is impossible to assess these hormone receptor function indicators in clinical settings. However, we can help patients identify the toxins that may be affecting their hormone receptors, minimize

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their exposure to these disruptive compounds, and guide them through a comprehensive detoxification protocol to reduce their burden of EDCs and promote healthy endocrine receptor activity. A growing number of studies demonstrate that a plethora of environmental toxins interfere with endocrine receptors. The primary culprits include polycyclic aromatic hydrocarbons (PAHs), heavy metals, parabens, phthalates, bisphenols, pesticides and herbicides, per- and polyfluoroalkyl substances (PFAS), and polychlorinated biphenyls (PCBs).

Polycyclic Aromatic Hydrocarbons Polycyclic aromatic hydrocarbons (PAHs) are a class of chemicals that occur naturally in coal, crude oil, and gasoline. They are also produced by burning coal, oil, wood, gas, and tobacco and when cooking meat and other foods at high temperatures.4 Detectable levels of PAHs exist in almost all of the body’s internal organs, particularly in fat tissue, suggesting that exposure to PAHs is ubiquitous and that these compounds persist in the body.5 PAHs bind to estrogen receptor beta (ERβ) and may exert estrogenic effects.6 These toxins may also interfere with androgen receptors, acting as anti-androgens.7

Heavy Metals When one hears the term “endocrine disruptor chemicals,” heavy metals don’t immediately come to mind. However, various heavy metals including lead, cadmium, arsenic, and mercury, are potent endocrine disruptors.8 Barium, cobalt, and lead interfere with glucocorticoid and mineralocorticoid receptors, disrupting the hypothalamic-pituitary-adrenal (HPA) axis and, potentially, the body’s ability to handle stress.9 Cadmium and nickel activate estrogen receptors, initiating a signaling cascade that

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may drive aberrant breast cell proliferation.10 Concerningly, even low-level exposures to heavy metals may precipitate endocrine-disrupting effects. In other words, the dose does not make the poison and exposure at levels previously considered safe may be harmful.11

Parabens Parabens are synthetic chemicals often used as preservatives in cosmetics and pharmaceutical drugs. They are well-established endocrine disruptors with a particular affinity for estrogen receptors.12 In addition, parabens interact with peroxisome proliferator-activated receptors (PPARs), a type of nuclear hormone receptor, and glucocorticoid receptors; these interactions may explain the obesogenic effects of parabens, as these receptors are involved in body fat regulation.13 Women demonstrate a higher body burden of parabens than men, presumably because they use more personal care products. Women may thus be at an increased risk of experiencing paraben-associated endocrine receptor dysfunction than men.14

Phthalates Phthalates are a group of chemicals widely incorporated into plastics to increase their durability. These chemicals exist in soft plastic toys, food packaging, IV tubing and bags, lubricating oils, and personal care products. Phthalates interfere with both cell membrane receptors and nuclear hormone receptors.15 They disrupt various receptors along the hypothalamicpituitary-gonadal (HPG) axis, including gonadotropinreleasing hormone (GnRH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) receptors. In addition, they exert anti-androgenic properties via inhibition of androgen receptors.14

receptors may explain why they are consistently associated with female and male infertility.16

Bisphenols Bisphenols are ubiquitous synthetic chemicals used in the production of plastics, particularly hard plastics such as water bottles, and in thermal paper and dental materials. Bisphenols are estrogen receptor agonists and androgen receptor antagonists, which may translate to estrogen dominant and/or low testosterone symptoms in patients.17 In addition, they may also antagonize the thyroid hormone receptor.18,19

Pesticides and Herbicides Endocrine-disrupting pesticides and herbicides are routinely used worldwide in agricultural, municipal, and residential settings. Chlorpyrifos, an organophosphate insecticide, is an anti-androgen. Atrazine, an herbicide applied to soy, corn, sugarcane, and residential lawns, decreases the expression of luteinizing hormone receptors, disrupting the HPG axis.20,21

Per- and Polyfluoroalkyl Substances Per- and polyfluoroalkyl substances (PFAS) are a significant public health concern, as recent findings indicate these chemicals systemically contaminate U.S. water supplies.22 PFAS interfere with G-proteincoupled receptor 40 on pancreatic islet cells, stimulating insulin secretion. Excessive insulin secretion can modify the synthesis of other sex hormones. For example, high insulin can suppress testosterone production in the testes and testosterone levels. Therefore, PFAS may indirectly disrupt sex hormones by stimulating endocrine receptors that activate insulin.23,24,25 In vivo and in vitro studies indicate that PFAS bind to nuclear receptors (receptors found either in the cytoplasm or nucleus of the cell), including estrogen receptors, androgen receptors, and thyroid hormone receptors.26

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PCBs Polychlorinated biphenyls (PCBs) agonize ERα and ERβ and antagonize the androgen receptor. The impact of PCBs on estrogen and androgen receptors may explain why exposure to PCBs is associated with decreased sperm motility, reduced fertility, and early puberty.27

A “Chemical Soup” The effects of complex mixtures of chemicals and yet-tobe-identified chemicals on endocrine receptors are only starting to be explored. In addition, EDCs exert low-dose and nonmonotonic toxic effects, meaning the slope of the dose-response curve between the EDC and its biological effects changes from positive to negative or vice versa at some point along the spectrum of doses.28 A recent study required participants working in office buildings to wear wristbands that detect chemicals during their work shifts. They found that of the numerous “known and suspect” chemicals detected, 99% antagonized the thyroid hormone receptor, 96% antagonized androgen receptors, and 58% agonized estrogen receptors.29These shocking findings demonstrate that we are swimming in a “chemical soup” of endocrine-disrupting chemicals daily that wreak havoc on our endocrine receptors.

The Health Outcomes of Impaired Endocrine Receptors Research indicates that impaired endocrine receptor function may influence multiple health conditions increasingly prevalent today. Premature menopause, female and male infertility, breast cancer, precocious puberty, and polycystic ovary syndrome (PCOS) are all linked to endocrine receptor alterations.30,31,32,33,34,35 The interplay between environmental toxins and endocrine receptors may explain why toxin exposures are frequently implicated in the development and progression of these health conditions.

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A Comprehensive Detoxification Strategy for “Cleaning” Endocrine Receptors Toxin avoidance is the first step towards reducing the body’s burden of EDCs and restoring healthy endocrine receptor function. However, avoidance may not be enough to effectively detoxify the body of these persistent compounds and repair endocrine receptor activity. A two-step “push-catch” detoxification approach can open the way for EDCs to leave cells and tissues and enter the gut, where the toxins can then be bound and eliminated through the stool. In addition, a process called “proteasomal degradation,” which can be facilitated by consuming specific phytonutrients, may regulate the turnover of hormone receptors compromised by toxins, enabling new, healthy receptors to take their place.

Step 1: “Push” + Proteasomal Degradation The nuclear factor erythroid 2-related factor (Nrf2) system is a transcription factor, a protein that turns genes “on” or “off” by binding to sections of DNA. It encodes multiple cellular detoxification elements, including two enzymes in glutathione synthesis: Glutathione reductase and glutathione synthetase. Glutathione influences Phases II and III of detoxification, in which toxins are activated and conjugated in preparation for elimination and then “pushed” out of cells and tissues into bile and urine. Nutrients and nutraceuticals that activate Nrf2 include R-lipoic acid, glutathione, quercetin, milk thistle, and DIM.36,37,38,39,40 Bitter herbs such as gentian, dandelion, myrrh, and Solidago promote bile flow, a critical component of Phase III detoxification.41,42,43,44 In addition, proteasomal degradation may be essential for turning over compromised endocrine receptors. Proteasomal degradation is one of the

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Hormonal Health: Detoxification Strategies for Endocrine Receptor Function

main pathways inside the body for breaking down damaged, misfolded, or otherwise dysfunctional proteins. Research shows that proteasomal degradation regulates receptor turnover, receptors being just another class of proteins inside the body.45

A critical and often overlooked aspect of successful detoxification protocols is using binding agents or ‘binders.’ Binders are supplements that adsorb toxins in the gut and usher the toxins out of the body via the stool, inhibiting the enterohepatic recirculation of toxins.

Measures that support proteasomal degradation may thus help turn over compromised receptors so new, healthy receptors can take their place. We also need to lower toxin levels in the body to stop the vicious cycle of hormone receptor “poisoning.”

Binders that can “catch” EDCs in the gut, facilitating their elimination from the body, include activated charcoal, clay, and zeolite. For example, studies that have applied activated charcoal in industrial settings indicate it can adsorb BPA, arsenic, and parabens.50,51,52 In addition, clay adsorbs BPA and BPS.53

The aryl hydrocarbon receptor system (AhR) regulates proteasomal degradation of steroid hormone receptors.46 The aryl hydrocarbon receptor is also involved in Phases I and II of detoxification. It activates the xenobiotic response element (XRE), which codes for enzymes involved in Phases I and II detoxification of environmental toxins.47 Specific nutraceuticals activate AhR and may promote proteasomal degradation of compromised endocrine receptors. For example, both quercetin and DIM activate AhR.48,49

Step 2: “Catch” The ‘catch’ principle refers to capturing processed toxins in the GI tract using binding agents to support the safe and effective elimination of toxins from the body.

It is best to use binders alongside products that promote bile flow since bile binding is a primary mechanism through which these substances capture toxins.

Conclusion Our understanding of the relationship between endocrine-disrupting chemicals and human endocrine receptors is complex and only in its infancy. EDCs pose a substantial threat to normal endocrine receptor expression and function, with vast health implications. There has never been a more important time to engage in comprehensive detoxification as a means of clearing EDCs from the body and supporting healthy endocrine receptor activity.

References: 1. Goodman HM. Chapter 1 - Introduction. ScienceDirect. Published January 1, 2009. Accessed September 8, 2023. https://www. sciencedirect.com/science/article/abs/pii/B978012373975900001X

4. CDC. Polycyclic aromatic hydrocarbons (PAHs) factsheet. National Biomonitoring Program, CDC. www.cdc.gov. Published May 24, 2019. https://www.cdc.gov/biomonitoring/PAHs_FactSheet.html

2. Liu D, Shi Q, Liu C, Sun Q, Zeng X. Effects of endocrine-disrupting heavy metals on human health. Toxics. 2023; 11(4): 322. doi: https://doi.org/10.3390/toxics11040322

5. Abdel-Shafy HI, Mansour MSM. A review on polycyclic aromatic hydrocarbons: Source, environmental impact, effect on human health and remediation. Egypt J Pet. 2016;25(1):107-123. doi: https://doi.org/10.1016/j.ejpe.2015.03.011

Tenschert W, Vetter H, Siegenthaler W, Vetter W. Receptor dysfunction as a pathogenetic principle in hormone resistance and metabolic diseases. Schweiz. Med. Wochenschr. 1981;111(6):174181. Accessed September 8, 2023. https://pubmed.ncbi.nlm.nih. gov/6261324/

6. Sievers CK, Shanle EK, Bradfield CA, Xu W. Differential action of monohydroxylated polycyclic aromatic hydrocarbons with estrogen receptors α and β. Toxicol Sci. 2013; 132(2): 359-367. doi: https:// doi.org/10.1093/toxsci/kfs287

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7. Vondráček J, Pivnička J, Machala M. Polycyclic aromatic hydrocarbons and disruption of steroid signaling. Curr Opin Toxicol. 2018;11-12:27-34. doi: https://doi.org/10.1016/j. cotox.2018.12.003 8. Liu D, Shi Q, Liu C, Sun Q, Zeng X. Effects of endocrine-disrupting heavy metals on human health. Toxics. 2023; 11(4):322. doi: https://doi.org/10.3390/toxics11040322 9. Zhang J, Yang Y, Liu W, Liu J. Potential endocrine-disrupting effects of metals via interference with glucocorticoid and mineralocorticoid receptors. Enviro Pollut. 2018; 242: 12-18. doi: https://doi. org/10.1016/j.envpol.2018.06.056 10. Aquino NB, Sevigny MB, Sabangan J, Louie MC. The role of cadmium and nickel in estrogen receptor signaling and breast cancer: metalloestrogens or not? J Environ Sci Health C Environ Carcinog Ecotoxicol Rev J. 2012; 30(3): 189-224. doi: https://doi.org /10.1080/10590501.2012.705159 11. Iavicoli I, Fontana L, Bergamaschi A. The effects of metals as endocrine disruptors. J Toxicol Environ Health – B Crit. 2009; 12(3): 206-223. doi: https://doi.org/10.1080/10937400902902062 12. Liang J, Liu QS, Ren Z, et al. Studying paraben-induced estrogen receptor- and steroid hormone-related endocrine disruption effects via multi-level approaches. Sci Total Environ. 2023; 869: 161793. doi: https://doi.org/10.1016/j.scitotenv.2023.161793 13. Xu X, Wu H, Terry PD, Zhao L, Chen J. Impact of paraben exposure on adiposity-related measures: An updated literature review of population-based studies. Int J Environ Res Public Health. 2022; 19(23): 16268. doi: https://doi.org/10.3390/ijerph192316268 14. Vindenes HK, Svanes C, Lygre SHL, Real FG, Ringel-Kulka T, Bertelsen RJ. Exposure to environmental phenols and parabens, and relation to body mass index, eczema and respiratory outcomes in the Norwegian RHINESSA study. Environ Health. 2021; 20(1). doi: https://doi.org/10.1186/s12940-021-00767-2 15. Hlisníková H, Petrovičová I, Kolena B, Šidlovská M, Sirotkin A. Effects and mechanisms of phthalates’ action on reproductive processes and reproductive health: A literature review. Int J Environ Res Public Health. 2020; 17(18): 6811. doi: https://doi.org/10.3390/ ijerph17186811 16. Panagiotou EM, Ojasalo V, Damdimopoulou P. Phthalates, ovarian function and fertility in adulthood. Best Pract Res Clin Endocrinol Metab. 2021; 35(5): 101552. doi: https://doi.org/10.1016/j. beem.2021.101552 17. Cimmino I, Fiory F, Perruolo G, et al. Potential mechanisms of bisphenol A (BPA) contributing to human disease. Int J Mol Sci. 2020; 21(16): 5761. doi: https://doi.org/10.3390/ijms21165761 18. Zoeller RT, Bansal R, Parris C. Bisphenol-A, an environmental contaminant that acts as a thyroid hormone receptor antagonist in vitro, increases serum thyroxine, and alters RC3/neurogranin expression in the developing rat brain. Endocrinology. 2005; 146(2): 607-612. doi: https://doi.org/10.1210/en.2004-1018 19. Moriyama K, Tagami T, Akamizu T, et al. Thyroid hormone action is disrupted by bisphenol A as an antagonist. J Clin Endocrinol Metab. 2002; 87(11): 5185-5190. doi: https://doi.org/10.1210/jc.2002020209 20. Kang HG, Jeong SH, Cho JH, Kim DG, Park JM, Cho MH. Chlropyrifosmethyl shows anti-androgenic activity without estrogenic activity

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in rats. Toxicology. 2004; 199(2-3): 219-230. doi: https://doi. org/10.1016/j.tox.2004.02.025 21. Wirbisky S, Freeman J. Atrazine exposure and reproductive dysfunction through the hypothalamus-pituitary-gonadal (HPG) axis. Toxics. 2015;3(4):414-450. doi: https://doi.org/10.3390/ toxics3040414 22. EWG. Interactive Map: PFAS Contamination Crisis: New Data Show 2,230 Sites in 49 States. www.ewg.org. Published 2021. https:// www.ewg.org/interactive-maps/pfas_contamination/ 23. Fenton SE, Ducatman A, Boobis A, et al. Per- and polyfluoroalkyl substance toxicity and human health review: current state of knowledge and strategies for informing future research. Environ Toxicol Chem. 2020; 40(3): 606-630. doi: https://doi.org/10.1002/ etc.4890 24. Ahn SW, Gang GT, Kim YD, et al. Insulin directly regulates steroidogenesis via induction of the orphan nuclear receptor DAX-1 in testicular Leydig cells. J Biol Chem. 2013; 288(22): 15937-15946. doi: https://doi.org/10.1074/jbc.m113.451773 25. Schianca G, Fra G, Brustia F, et al. Testosterone plasma concentration is associated with insulin resistance in male hypertensive patients. Exp Clin Endocrinol. 2017; 125(03): 171-175. doi: https://doi.org/10.1055/s-0042-121492 26. Mokra K. Endocrine disruptor potential of short- and longchain perfluoroalkyl substances (PFASs)—A synthesis of current knowledge with proposal of molecular mechanism. Int J Mol Sci. 2021; 22(4): 2148. doi: https://doi.org/10.3390/ijms22042148 27. Bell MR. Endocrine-disrupting actions of PCBs on brain development and social and reproductive behaviors. Curr Opin Pharmacol. 2014; 19: 134-144. doi: https://doi.org/10.1016/j. coph.2014.09.020 28. Vandenberg LN, Colborn T, Hayes TB, et al. Hormones and endocrine-disrupting chemicals: Low-dose effects and nonmonotonic dose responses. Endocrin Rev. 2012; 33(3): 378-455. doi: https://doi.org/10.1210/er.2011-1050 29. Young AS, Herkert N, Stapleton HM, et al. Hormone receptor activities of complex mixtures of known and suspect chemicals in personal silicone wristband samplers worn in office buildings. Chemosphere. 2023; 315: 137705. doi: https://doi.org/10.1016/j. chemosphere.2022.137705 30. Aydemir D, Ulusu NN. The possible role of the endocrine disrupting chemicals on the premature and early menopause associated with the altered oxidative stress metabolism. Front Endocrinol. 2023; 14: 1081704. doi: https://doi.org/10.3389/fendo.2023.1081704 31. Beatriz A, Filipa Carreiró, Ramos F, Sanches-Silva A. The role of endocrine disruptors in female infertility. Mol Biol Rep. 2023; 50: 7069-7088. doi: https://doi.org/10.1007/s11033-023-08583-2 32. Rehman S, Usman Z, Rehman S, et al. Endocrine disrupting chemicals and impact on male reproductive health. Transl Androl Urol. 2018; 7(3): 490-503. doi: https://doi.org/10.21037/ tau.2018.05.17 33. Calaf GM, Ponce-Cusi R, Aguayo F, Muñoz JP, Bleak TC. Endocrine disruptors from the environment affecting breast cancer. Oncol Lett. 2020; 20(1): 19-32. doi: https://doi.org/10.3892/ ol.2020.11566

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Hormonal Health: Detoxification Strategies for Endocrine Receptor Function

34. Lucaccioni L, Trevisani V, Marrozzini L, et al. Endocrine-disrupting chemicals and their effects during female puberty: A review of current evidence. Int J Mol Sci. 2020; 21(6): 2078. doi: https://doi. org/10.3390/ijms21062078 35. Srnovršnik T, Virant-Klun I, Pinter B. Polycystic ovary syndrome and endocrine disruptors (bisphenols, parabens, and triclosan)—A systematic review. Life. 2023;13(1):138. doi: https://doi. org/10.3390/life13010138 36. Minich DM, Brown BI. A review of dietary (phyto)nutrients for glutathione support. Nutrients. 2019; 11(9): 2073. doi: https://doi. org/10.3390/nu11092073 37. Suh JH, Shenvi SV, Dixon BM, et al. Decline in transcriptional activity of Nrf2 causes age-related loss of glutathione synthesis, which is reversible with lipoic acid. Proc Natl Acad Sci USA. 2004; 101(10): 3381-3386. doi: https://doi.org/10.1073/pnas.0400282101 38. Granado-Serrano AB, Martín MA, Bravo L, Goya L, Ramos S. Quercetin modulates Nrf2 and glutathione-related defenses in HepG2 cells: Involvement of p38. Chem-Biol Interact. 2012; 195(2): 154-164. doi: https://doi.org/10.1016/j.cbi.2011.12.005 39. Vargas-Mendoza N, Morales-González Á, Morales-Martínez M, et al. Flavolignans from silymarin as Nrf2 bioactivators and their therapeutic applications. Biomedicines. 2020; 8(5): 122. doi: https://doi.org/10.3390/biomedicines8050122 40. Saw CLL, Cintrón M, Wu TY, 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. doi: https://doi.org/10.1002/bdd.759

48. Ciolino HP, Daschner PJ, Yeh GC. Dietary flavonols quercetin and kaempferol are ligands of the aryl hydrocarbon receptor that affect CYP1A1 transcription differentially. Biochem J. 1999; 340(Pt 3): 715722. Accessed September 10, 2023. https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC1220303/ 49. Chen I. Aryl hydrocarbon receptor-mediated antiestrogenic and antitumorigenic activity of diindolylmethane. Carcinogenesis. 1998; 19(9): 1631-1639. doi: https://doi.org/10.1093/carcin/19.9.1631 50. Martín-Lara MA, Calero M, Ronda A, Iáñez-Rodríguez I, Escudero C. Adsorptive behavior of an activated carbon for bisphenol A removal in single and binary (bisphenol A—heavy metal) solutions. Water. 2020; 12(8): 2150. doi: https://doi.org/10.3390/w12082150 51. Meez E, Tolkou AK, Giannakoudakis DA, Katsoyiannis IA, Kyzas GZ. Activated carbons for arsenic removal from natural waters and wastewaters: A review. Water. 2021;13(21):2982. doi: https://doi. org/10.3390/w13212982 52. Moreno-Marenco AR, Giraldo L, Moreno-Piraján JC. Parabens adsorption onto activated carbon: Relation with chemical and structural properties. Molecules. 2019; 24(23): 4313. doi: https:// doi.org/10.3390/molecules24234313 53. Orr AA, He S, Wang M, et al. Insights into the interactions of bisphenol and phthalate compounds with unamended and carnitine-amended montmorillonite clays. Comput Chem Eng. 2020; 143: 107063. doi: https://doi.org/10.1016/j. compchemeng.2020.107063

41. McMullen MK, Whitehouse JM, Towell A. Bitters: Time for a new paradigm. Evid-Based Complement Altern Med. 2015; 2015: 1-8. doi: https://doi.org/10.1155/2015/670504 42. Schütz K, Carle R, Schieber A. Taraxacum—A review on its phytochemical and pharmacological profile. J Ethnopharmacol. 2006; 107(3): 313-323. doi: https://doi.org/10.1016/j. jep.2006.07.021 43. Cui J, Huang L, Zhao A, et al. Guggulsterone Is a farnesoid X receptor antagonist in coactivator association assays but acts to enhance transcription of bile salt export pump *. J Biol Chem. 2003;278(12):10214-10220. doi:https://doi.org/10.1074/jbc. M209323200 44. Fursenco C, Calalb T, Uncu L, Dinu M, Ancuceanu R. Solidago virgaurea L.: A review of its ethnomedicinal uses, phytochemistry, and pharmacological activities. Biomolecules. 2020; 10(12): 1619. doi: https://doi.org/10.3390/biom10121619 45. DeFranco DB. Navigating steroid hormone receptors through the nuclear compartment. Mol Endocrinol. 2002; 16(7): 1449-1455. doi: https://doi.org/10.1210/mend.16.7.0880 46. Luecke-Johansson S, Gralla M, Rundqvist H, et al. A molecular mechanism to switch the aryl hydrocarbon receptor from a transcription factor to an E3 ubiquitin ligase. Mol Cell Biol. 2017; 37(13): e00630-16. doi: https://doi.org/10.1128/MCB.00630-16 47. Kou Z, Dai W. Aryl hydrocarbon receptor: Its roles in physiology. Biochem Pharmacol. 2021; 185: 114428. doi: https://doi. org/10.1016/j.bcp.2021.114428

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IMPROVEMENTS IN NPRS AND WOMAC 50

Average Percent Improvement

IMPROVEMENTS IN NPRS AND WOMAC 60 40 20 0 -20

Initial

30-Day

60-Day

40 30 20 10 0

Initial

90-Day

30-Day

Days After Application WOMAC

NPRS

60-Day

90-Day

Days After Application WOMAC

NPRS

Initial

30-Day

60-Day

90-Day

NPRS

35%

33%

32%

WOMAC

32%

Age Range

Initial

30-Day

60-Day

90-Day

NPRS

32%

35%

39%

33%

WOMAC

17%

26%

35%

Total

# Clinics

Age Range

Total

# Clinics

178

143

36-89

54-92

This data is based on a sample of 178 patients with structural knee defects from 29 clinics enrolled in our observational study. There are 82 males and 96 females, aged 54 to 92. Ninety days after the Wharton’s jelly application, patients reported a 32% improvement in NPRS (current pain) and a 33% overall WOMAC improvement (pain/stiffness/function). The progress shown is from only one application, although most care providers apply two Wharton’s jelly allografts for this area.

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What is the Endothelial Glycocalyx? By:

Doreen Saltiel, MD

Cardiovascular disease (CVD) is a chronic inflammatory disease

1,2,3,4,5,6

and the leading cause of death

shear stress from blood flow to the endothelial

globally. CVD is driven by cardiovascular risk factors and inflammatory triggers.

1-7,8

oxide (NO), barrier and filtration functions, facilitating

The first step in the

cells with responsive vasodilation, immune modulation, and regulating blood coagulation.

atherosclerotic process is endothelial dysfunction.

1-7,9

The “endothelial structure” is made up of the endothelial

EGX barrier functions

glycocalyx (EGX) and the endothelial cells (ECs).9,10,11

The EGX serves as a barrier protecting endothelial

EGX damage precedes endothelial cell dysfunction.9,10,11,12,13,14 In other words, you must violate the EGX for endothelial dysfunction to occur. The EGX’s importance in CV health cannot be overstated. Therefore, this writing will briefly review the vascular endothelial glycocalyx’s functions and structure.

cells from spontaneous leukocyte and platelet adhesion. Its negative charge repels red blood cells and large macromolecules, thus preventing access to the endothelial cells. A healthy EGX’s importance is demonstrated by its action as a physical barrier to LDL particles and inflammatory cells like monocytes that evolve into macrophages and subsequently foam cells and plaque.15

Glycocalyx (EGX) functions The vascular EGX has many physiologic functions.

EGX damage renders the endothelium “sticky”

EGX functions include endothelial cell protection

and permeable. This allows LDL, inflammatory

and signaling the endothelial cell to release nitric

cells, and platelets to penetrate or adhere to

ANTI-AGING MEDICAL NEWS | WINTER 2023

125

Hormonal Health: Detoxification Strategies for Endocrine Receptor Function

the endothelium. Violating the glycocalyx, the first step in the atherosclerotic process, subjects the vulnerable endothelium to atherosclerotic plaque formation, stiff and rigid blood vessels, and possibly thrombosis and plaque rupture.11,12,15

EGX mechanotransduction functions The glycocalyx signals the endothelium to release NO.16 The glycocalyx is very sensitive to shear stress and blood flow patterns. High shear stress, as is seen with laminar blood flow in straight blood vessel segments, is associated with a robust and healthy glycocalyx that protects the endothelium, leads to endothelial nitric oxide synthase (eNOS) upregulation, and constant NO release and vasodilation.10

inhibitor.14 For example, glypican has a high affinity for binding antithrombin III, which localizes antithrombin III to the endothelial cells surface.17 In addition, Syndecan-4, which contains HS, specifically interacts with antithrombin III. Antithrombin III binds to syndecan4’s HS and stimulates endothelial cells to produce prostacyclin, which suppresses neutrophil and platelet adhesion to endothelial cells, thus supporting a possible decrease in inflammation and thrombus formation.18

Endothelial Glycocalyx Structure The EGX is a negatively charged, heavily hydrated, sugar-rich, mesh-like layer with hair-like projections that blankets the vascular endothelium’s inner wall facing the vascular lumen. The EGX consists of: • Core proteins (syndecans, glypicans),

Low shear stress, as is found in complicated blood vessels segments like bifurcations, branch points, and curvatures, is associated with non-laminar, oscillatory, and turbulent blood flow. In these areas, the glycocalyx is thin with impaired glycocalyx barrier properties, i.e., decreased NO signaling, decreased NO release, and a predisposition to atherosclerosis.10

EGX immune modulation functions The EGX has an important role in immune modulation. The EGX protects endothelial cells against damage by various oxidative stress mediators. Under healthy physiologic conditions, the EGX docks major enzymes. Extracellular superoxide dismutase, one of the most important enzymes, is bound to heparan sulfate and contributes to decreasing oxidative stress by quenching free radicals and maintaining NO availability. In addition, the EGX may modulate inflammatory responses by decreasing cytokine binding to cell surface receptors.14

EGX coagulation regulatory functions Studies suggest that the EGX may play an important role in regulating coagulation. The EGX houses coagulation pathway mediators like antithrombin III, heparin cofactor II, thrombomodulin, and tissue factor pathway

126

• Glycosaminoglycans (GAGs, heparan sulfate [HS], chondroitin sulfate [CS]), and • Hyaluronic acid (HA). The combination of core proteins (syndecans, glypicans) and GAGs (HS, CS) are termed proteoglycans. The GAGs are attached to the core proteins. These core proteins are anchored to the endothelial cell membrane that serves as the foundation for the remaining EGX components.9-14 In addition, plasma proteins like albumin are also embedded in the EGX, creating a concentration gradient. These plasma proteins are tightly bound to the EGX and contribute to its thickness, prevent EGX collapse, and support EGX-mediated vascular integrity.10,13,14 There are 4 syndecan subtypes which bind 3-5 heparan sulfate or chondroitin sulfate chains. The major vascular endothelial syndecan is syndecan-2. Most syndecans bind HS; however, the larger syndecan -1 and -3 can also bind CS. Syndecan-4 is important in regulating coagulation. There are 6 glypican subtypes that exclusively bind HS close to the endothelial cell surface. Also, CD44, a transmembrane protein, binds EGX’s hyaluronic acid.10 Heparan sulfate bound to syndecans is the most

ANTI-AGING MEDICAL NEWS | WINTER 2023

Hormonal Health: Detoxification Strategies for Endocrine Receptor Function

is the only GAG not linked to a core protein. It can be bound to the endothelial cell membrane.10 Negatively charged heparan sulfate and chondroitin sulfate account for the EGX’s biophysical properties and create inter-GAG repulsion forces protecting the endothelium. GAG length and negative charge both contribute to the EGX’s extension into the vascular lumen.13,14 While syndecans are the main contributor to cell adhesion or shape change via their interaction with the cytoskeleton, glypicans mediate flow-induced endothelial nitric oxide synthase (eNOS) activation. In fact, studies with cultured endothelial cells have shown that EGX heparan sulfate breakdown alters shear stress and impairs nitric oxide production, the hallmark of endothelial dysfunction.13

Conclusion Figure. The endothelial glycocalyx’s main constituents are represented by the chondroitin sulfate, hyaluronan, heparan sulfate (blue and purple), showing the glycoproteins that make up this dynamic layer in the top image. Representative shedding of the endothelial glycocalyx is displayed in the lower image.

prominent EGX proteoglycan member expressed, accounting for 50-90%. The interactions between most syndecans and extracellular matrix molecules, growth factors, and/or cell adhesion molecules seem to be mediated by their heparan sulfate chains.10

The endothelial glycocalyx is a complex, fragile structure with pleiotropic functions including barrier and filtration, immune modulation, mechanotransduction, and regulating coagulation.

When the glycocalyx is damaged, these functions may become compromised. Therefore, it is easy to see why a healthy vascular endothelial glycocalyx is necessary for a healthy cardiovascular system.

Chondroitin sulfate is another abundant GAG in the EGX. The ratio of HS to CS is approximately 4:1. Hyaluronic acid ANTI-AGING MEDICAL NEWS | WINTER 2023

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Hormonal Health: Detoxification Strategies for Endocrine Receptor Function

References: 1. Libby P, et al. Inflammation and Atherosclerosis. Circulation. 2002; 105(9): 1135-1143. 2. Rocha VZ, Libby P. Obesity, Inflammation, and Atherosclerosis. Nat Rev Cardiol. 2009; 6(6): 399-409. 3. Libby P. History of Discovery: Inflammation in Atherosclerosis. Arterioscler Thromb Vasc Biol. 2012; 32(9): 2045–2051. 4. Hurtubise J, et al. The Different Facets of Dyslipidemia and Hypertension in Atherosclerosis. Curr Atheroscler Rep. 2016; 18(12): 82. 5. Ormazabal V, et al. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018; 17(1): 122. 6. Alloubani A, et al. Relationship between Hyperlipidemia, Cardiovascular Disease and Stroke: A Systematic Review. Curr Cardiol Rev. 2021; 17(6): e051121189015. 7. Libby P, et al. Nat rev Dis Primers. 2019; 5(1): 56. 8. Tsao CW, et al. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Disease. Circulation. 2022; 145(8): e153-e639. 9. Noble MI, Drake-Holland AJ, Vink H. Hypothesis: arterial glycocalyx dysfunction is the first step in the atherothrombotic process. QJM. 2008;101(7):513-518. doi:10.1093/qjmed/hcn024 10. Kolárová H, et al. Modulation of Endothelial Glycocalyx Structure under Inflammatory Conditions. Mediators Inflamm. 2014; 2014: 694312.

11. Mitra R, et al. Glycocalyx in Atherosclerosis-Relevant Endothelium Function and as a Therapeutic Target. Curr Atheroscler. Rep. 2017; 19(12): 63. 12. Tarbell JM, Cancel LM. The glycocalyx and its significance in human medicine. J Intern Med. 2016; 280(1): 97-113. 13. Villalba N. The Endothelial Glycocalyx as a Double-Edged Sword in Microvascular Homeostasis and Pathogenesis. Front Cell Dev Biol. 2021; 9:711003. 14. Hellenthal KEM, et al. Regulation and Dysregulation of Endothelial Permeability during Systemic Inflammation. Cells. 2022; 11(12): 1935. 15. Banerjee S, et al. Regeneration and Assessment of the Endothelial Glycocalyx To Address Cardiovascular Disease. Ind Eng Chem Res. 2021; 60(48): 17328-17347. 16. Zeng Y. Endothelial glycocalyx as a critical signaling platform integrating the extracellular hemodynamic forces and chemical signaling. J Cell Mol Med. 2017; 21(8): 1457-1462. 17. Moore KH, et al. The glycocalyx: a central regulator of vascular function. Am J Physiol Regul Integr Comp Physiol. 2021; 320(4): R508-R518. 18. Terasawa M, et al. Anti-inflammatory Activity of Orally Administered Monostroma nitidum Rhamnan Sulfate against LipopolysaccharideInduced Damage to Mouse Organs and Vascular Inflammation. Mar Drugs. 2022; 20(2): 121.

Author Bio: Doreen Saltiel, MD, JD, FACC: Medical Director at Peak Health and Wellness and a Biote Medical, LLC consultant. She completed her cardiology fellowship at Walter Reed Army Medical Center. She is a renowned author, educator, and clinician.

128

ANTI-AGING MEDICAL NEWS | WINTER 2023

Did you know that TA-65®? Activates Telomerase to Lengthen Telomeres in Humans1 Improves Cardiovascular Markers in Patients with Metabolic Syndrome2 Helps Support Healthy Immune System3, 4 Enhances Immunity and Reduces Inflammation4 Scan Me

Review selected studies at www.telomerescience.com/studies References 1. Salvador L, Singaravelu G, Harley CB, Flom P, Suram A, Raffaele JM. A Natural Product Telomerase Activator Lengthens Telomeres in Humans: A Randomized, Double Blind, and Placebo Controlled Study. Rejuvenation Research. December 2016. 16(5). 2. Fernandez ML, Thomas MS, Lemos BS, DiMarco DM, Missimer A, Melough M, Chun OK, Murillo AG, Alyousef HM, Medina-Vera I. TA-65, A Telomerase Activator improves Cardiovascular Markers in Patients with Metabolic Syndrome. Current Pharmaceutical Design. 2018;24,1-7. 3. Singaravelu G, Harley CB, Raffaele JM, Sudhakaran P, Suram A. Double-Blind, Placebo-Controlled, Randomized Clinical Trial Demonstrates Telomerase Activator TA-65 Decreases Immunosenescent CD8+CD28-T Cells in Humans. OBM Geriatrics. 2021 vol. 5, issue 2. 4. Bawamia B, Spray L, Wangsaputra VK, Bennaceur K, Vahabi S, Stellos K, Kharatikoopaei E, Ogundimu E, Gale CP, Keavney B, Maier R, Hancock H, Richardson G, Austin D, Spyridopoulos I. Activation of telomerase by TA-65 enhances immunity and reduces inflammation post myocardial infarction. Geroscience. 2023 Apr 22:1–17.

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Telomerase Activator TA-65 Combats Immune Aging and Inflammation in Subjects Post-Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled Trial By:

Joseph M. Raffaele, MD

Telomerase Activator TA-65 Combats Immune Aging and Inflammation in Subjects Post-Myocardial Infarction: A Randomized, Double-Blind, PlaceboControlled Trial Myocardial infarction (MI), commonly referred to as

axis through an inflammation-related mechanism,

a “heart attack,” is a catastrophic event resulting in

which enhances secretion of glucocorticoids. In turn,

irreversible damage to the heart due to prolonged

elevated circulating glucocorticoids induce trafficking

oxygen deprivation. As one of the leading causes

of blood lymphocytes to the bone marrow, resulting

of human morbidity and mortality, MI affects

in a reduced level of circulating lymphocytes and

around 3 million people worldwide annually, with

other changes to cellular immunity.4 Lymphopenia is

approximately 805,000 cases in the United States.1,2

therefore a strong risk factor for immunosenescence,

An estimated 200,000 of those in the United States

a state of immune function dysregulation and

are recurrent attacks. Despite advances that have

organ reorganization that leads to an impaired

led to significant improvements in short- and long-

capacity to mediate appropriate immune responses.5

term prognosis for MI, patients who experience

Immunosenescence has been implicated as a

an MI remain a high-risk population, even in

those whose disease is stable 1 year post-MI.

major contributing factor in age-related functional decline and chronic inflammation, including the

A growing body of evidence underscores a close

development of cardiovascular disease.6 Numerous

relationship between immune status and both

studies have demonstrated that MI precipitates

cardiovascular and noncardiovascular diseases. Some

accelerated immunosenescence and telomere

patients exhibit lymphopenia after an MI, By: Joseph M. Raffaele, MDtriggered by

shortening in leukocytes.7-10 Since lymphocyte

the activation of the hypothalamic-pituitary-adrenal

proliferation is mediated by telomerase activation,

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Telomerase Activator TA-65 Combats Immune Aging and Inflammation in Subjects Post-Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled Trial

this suggests that reversing lymphopenia through telomerase activation might enhance the clinical outcomes for patients post-acute MI. A recent study by Bawamia et al. delved into the potential of TA-65 to counteract immunosenescence in patients post-MI.11

Telomere Length - A Potential Therapeutic Target? Telomeres are protective end caps of chromosomes that preserve the integrity of our genome during DNA replication. In humans, telomeres’ critical role in cellular senescence — the irreversible cell cycle arrest — has been well documented.12 An inverse relationship also exists between telomere length and human chronological age; thus, telomere length has long been regarded as an important hallmark of organismal aging.13 Telomerase is a DNA polymerase that consists of two subunits: telomerase reverse transcriptase (TERT), the catalytic subunit of telomerase; and an RNA component called telomerase RNA component (TERC). Other proteins such as Reptin, Nhp2, Pontin, Gar1, and Tcab1 are also required for proper telomerase assembly and recruitment to chromosomes.14 The mRNA expression of human TERT is strictly controlled at the transcription level and is closely linked to telomerase activity and homeostasis. Experimental evidence suggests that TERT expression may be the limiting factor in human telomerase activity.14,15 TERT was once thought to be only expressed in highly proliferating cells or stem cells. It was also believed that TERT was localized in the nucleus, where it protects telomeres from shortening. However, it is now evident that TERT is also expressed in non- or low-proliferating tissues, including the heart.16 Moreover, TERT demonstrates non-telomeric functions in mitochondria where it helps protects mitochondrial DNA by decreasing levels of reactive

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oxygen species, a key factor in senescence. TA-65 is an encapsulated form of cycloastragenol, a triterpenoid saponin compound isolated from Astragalus membranaceus (Fisch.) Bunge. In vitro evidence suggests that TA-65 influences lymphocyte proliferation in a TERT-dependent way.17 It also acts as a mitochondrial telomerase activator, where it has been shown to increase TERT within the mitochondria, thereby improving the outcomes of ischemia/reperfusion injury.18

The TACTIC Trial The Telomerase ACTivator to reverse Immunosenescence in Acute Coronary Syndrome (TACTIC) trial was a single-center, randomized, double-blind, parallel-group, placebo-controlled phase 2A pilot study involving 90 subjects with coronary heart disease who had experienced an acute MI within 6 months prior to enrollment. Participants had to meet the following additional criteria to be eligible for the study: • Sixty-five years of age or older • Successful completion of revascularization or under medical management following MI • Evidence of obstructive coronary artery disease on invasive coronary angiography (≥1 major epicardial vessel stenosis ≥70%) • Enrollment occurred more than 24 hours post-MI Exclusion criteria included: • Conditions associated with immunological dysfunction (e.g., HIV) • Clinical instability (e.g., arrhythmias, cardiogenic shock) • Severe, uncontrolled hypertension • Severe comorbidity likely to affect outcome within 2 years • Use of immunosuppressants and/or nutritional

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Telomerase Activator TA-65 Combats Immune Aging and Inflammation in Subjects Post-Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled Trial

of other leukocyte subsets

supplements derived from Astragalus root

• Serum levels of high-sensitivity C-reactive protein (hsCRP)

• Known malignancy • Current or previous substance addiction

• Nuclear telomerase activity in peripheral blood mononuclear cells, measured using the Telomerase Repeated Activation Protocol (TRAP) - quantitative polymerase chain reaction (qPCR) assay

• Diagnosis of insulin-dependent diabetes mellitus Subjects received 8-mg doses of either TA-65 or the placebo twice daily for 12 months. At the end of the study, flow cytometric assays were used to measure the proportion of terminally differentiated effector memory CD8+ T cells (CD8+ TEMRA; CD3+CD4− CD8+CCR7−CD45RA+) in peripheral blood. Recent studies suggest CD8+ TEMRA cells have a strong potential as a biomarker for immunosenescence.19

• Oxidative stress, measured using the TBARS colorimetric assay • Microvascular endothelial function, evaluated using the EndoPAT device • Cardiac function, evaluated using transthoracic echocardiography and serum levels of NTproBNP (N-terminal pro-B-type natriuretic peptide), a marker of myocardial stretch that correlates with left ventricular function

Secondary outcome measures were as follows:

• Adverse events and adverse reactions • Proportions and absolute counts

Results

Figure 1 Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122201/

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Telomerase Activator TA-65 Combats Immune Aging and Inflammation in Subjects Post-Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled Trial

TA-65 Reverses Lymphopenia

and fibrillation, risk of heart failure, and death.27-32

The investigators observed considerable increases in CD4+ and CD8+ T-lymphocytes, B-lymphocytes, and natural killer cells in the TA-65 group, all of which contributed to a higher total lymphocyte count for the group. Figure 1 presents a comparison of absolute leukocyte counts (cells/μL from Trucount assay) between the TA-65 and the placebo groups at baseline, 6 months, and 12 months.

At baseline, the TA-65 and the placebo groups had similar hsCRP levels at 11.9 and 10.9 mg/L, respectively. However, at the end of the 12-month trial, hsCRP levels in subjects in the TA-65 group were 62.1% lower than those in placebo group subjects. Figure 2 depicts changes in mean hsCRP (mg/L) levels between the TA-65 and the placebo groups stratified by type of MI at baseline.

The mechanism by which TA-65 induced reversal of lymphopenia remains unclear. While the increase from baseline in total lymphocyte count was significant, the changes in specific lymphocyte subsets, such as T-cells and B-cells were not significant. Had the reversal been due to enhanced lymphocyte proliferation – indicating nuclear telomerase activation – certain subpopulations such as naïve CD8+CD57- cells should have differed in their response to TA-65 from CD8+CD57- cells. This, then, suggests a different mechanism of action.

TA-65 May Reduce Inflammation Inflammation following acute MI plays a critical role in healing and scar formation.20 The inflammatory response occurs in two phases: an initial pro-inflammatory response followed by an anti-inflammatory, reparative phase.21 There is evidence that an excessive and persistent pro-inflammatory response to acute MI can worsen post-MI adverse left ventricular (LV) remodeling, a process associated with worse clinical outcomes. Therefore, therapeutic targeting of inflammation may improve outcomes in acute MI patients.21 High-sensitivity C-reactive protein (hsCRP) level, a surrogate marker for systemic inflammation, has been evaluated as a prognosticator of various adverse cardiovascular events and other human malignancies.22-26 Specifically for MI, several studies have found that hsCRP level may correspond to late microvascular obstruction size, size of myocardial necrosis, new-onset atrial fibrillation, recurrence of ventricular tachycardia

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These findings indicate that TA-65 may mitigate inflammation in patients following acute MI. In turn, reduced inflammation may help delay the progression of coronary atherosclerosis and prevent adverse LV remodeling. Notably, unlike many drugs that improve acute MI clinical outcomes at the expense of a robust immune system, the results of the TACTIC trial did not show significant changes in myeloid cells in subjects treated with TA-65 compared to those treated with placebo. Subjects in the TA-65 group instead showed enhanced adaptive immunity, demonstrated by the increase in mean total lymphocyte count. TA-65 May Activate Mitochondrial Telomerase Mitochondrial dysfunction declines with age, contributing directly to senescence.33 DesdínMicó and colleagues demonstrated in mice that T-cells with dysfunctional mitochondria instigate senescence, triggered by the accumulation of proinflammatory cytokines. The results were characteristic of “inflammaging,” including alterations to metabolic, cognitive, physical, and cardiovascular fitness. Together, the changes resulted in premature death of the mice. Over the last several decades, studies have demonstrated that senescence accumulates in multiple cardiovascular cell populations, including those associated with myocardial dysfunction.34,35 This evidence highlights the role of senescence in cardiovascular disease and the potential for senolytics to prevent or reverse disease progression. Furthermore, because mitochondria are required for the expression of the senescence-associated

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Telomerase Activator TA-65 Combats Immune Aging and Inflammation in Subjects Post-Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled Trial

Figure 2 Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122201/

secretory phenotype, the authors hypothesize that the activation of mitochondrial TERT by TA-65 is the mechanism behind the reduced inflammation observed.

Conclusion The TACTIC trial was the first study to investigate the effects of the telomerase activator TA-65 in patients following an MI. Given the favorable safety profile in addition to the significant increase in lymphocytes and reduction in hsCRP levels, TA-65 serves as a promising novel therapeutic approach to post-MI senescence.

References: 1. Kim SJ. Global Awareness of Myocardial Infarction Symptoms in General Population. Korean Circulation Journal. 2021;51(12):997. doi:10.4070/kcj.2021.0320 2. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association. Circulation. 2023;147(8). doi:10.1161/ cir.0000000000001123 3. Jernberg T, Hasvold P, Henriksson M, Hjelm H, Thuresson M, Janzon

M. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a longterm perspective. European Heart Journal. 2015;36(19):1163-1170. doi:10.1093/eurheartj/ehu505 4. Ma Y, Yang X, Villalba N, et al. Circulating lymphocyte trafficking to the bone marrow contributes to lymphopenia in myocardial infarction. American Journal of Physiology-heart and Circulatory Physiology. 2022;322(4):H622-H635. doi:10.1152/ ajpheart.00003.2022

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5. Sun H, Kang X, Chen X, et al. Immunosenescence evaluation of peripheral blood lymphocyte subsets in 957 healthy adults from 20 to 95 years old. Experimental Gerontology. 2022;157:111615. doi:10.1016/j.exger.2021.111615 6. Shirakawa K, Sano M. T Cell Immunosenescence in Aging, Obesity, and Cardiovascular Disease. Cells. 2021;10(9):2435. doi:10.3390/ cells10092435

19. hto Salumets, Liina Tserel, Anna Pauliina Rumm, et al. Epigenetic quantification of immunosenescent CD8 + TEMRA cells in human blood. Aging Cell. 2022;21(5). doi:10.1111/acel.13607 20. Entman ML, Smith CW. Postreperfusion inflammation: a model for reaction to injury in cardiovascular disease. Cardiovascular Research. 1994;28(9):1301-1311. doi:10.1093/cvr/28.9.1301

7. Spray L, Park C, Cormack S, et al. The Fractalkine Receptor CX3CR1 Links Lymphocyte Kinetics in CMV-Seropositive Patients and Acute Myocardial Infarction With Adverse Left Ventricular Remodeling. Frontiers in Immunology. 2021;12. doi:10.3389/fimmu.2021.605857

21. Ong SB, Hernández-Reséndiz S, Crespo-Avilan GE, et al. Inflammation following acute myocardial infarction: Multiple players, dynamic roles, and novel therapeutic opportunities. Pharmacology & Therapeutics. 2018;186:73-87. doi:10.1016/j. pharmthera.2018.01.001

8. Boag SE, Das R, Shmeleva EV, et al. T lymphocytes and fractalkine contribute to myocardial ischemia/reperfusion injury in patients. Journal of Clinical Investigation. 2015;125(8):3063-3076. doi:10.1172/jci80055

22. Park HE, Cho GY, Chun EJ, et al. Can C-reactive protein predict cardiovascular events in asymptomatic patients? Analysis based on plaque characterization. Atherosclerosis. 2012;224(1):201-207. doi:10.1016/j.atherosclerosis.2012.06.061

9. Hoffmann J, Shmeleva EV, Boag S, et al. Myocardial Ischemia and Reperfusion Leads to Transient CD8 Immune Deficiency and Accelerated Immunosenescence in CMV-Seropositive Patients. Circulation Research. 2015;116(1):87-98. doi:10.1161/ circresaha.116.304393

23. Geenen LW, Vivan J.M. Baggen, van, et al. Prognostic value of C-reactive protein in adults with congenital heart disease. Heart. 2020;107(6):474-481. doi:10.1136/heartjnl-2020-316813

10. Spyridopoulos I, Hoffmann J, Aicher A, et al. Accelerated Telomere Shortening in Leukocyte Subpopulations of Patients With Coronary Heart Disease. Circulation. 2009;120(14):1364-1372. doi:10.1161/ circulationaha.109.854299 11. Bawamia B, Spray L, Wangsaputra VK, et al. Activation of telomerase by TA-65 enhances immunity and reduces inflammation post myocardial infarction. Geroscience. 2023;1-17. doi:10.1007/s11357023-00794-6 12. Victorelli S, Passos JF. Telomeres and Cell Senescence - Size Matters Not. EBioMedicine. 2017;21:14-20. doi:10.1016/j. ebiom.2017.03.027 13. Vaiserman A, Krasnienkov D. Telomere Length as a Marker of Biological Age: State-of-the-Art, Open Issues, and Future Perspectives. Frontiers in Genetics. 2021;11. doi:10.3389/ fgene.2020.630186 14. Leão R, Apolónio JD, Lee D, Figueiredo A, Tabori U, Castelo-Branco P. Mechanisms of human telomerase reverse transcriptase (hTERT) regulation: clinical impacts in cancer. Journal of Biomedical Science. 2018;25(1). doi:10.1186/s12929-018-0422-8 15. Avilion AA, Piatyszek MA, Gupta J, Shay JW, Bacchetti S, Greider CW. Human telomerase RNA and telomerase activity in immortal cell lines and tumor tissues. PubMed. 1996;56(3):645-650. 16. Zurek M, Altschmied J, Kohlgrüber S, Ale-Agha N, Haendeler J. Role of Telomerase in the Cardiovascular System. Genes. 2016;7(6):29. doi:10.3390/genes7060029 17. Richardson GD, Sage A, Bennaceur K, et al. Telomerase Mediates Lymphocyte Proliferation but Not the Atherosclerosis-Suppressive Potential of Regulatory T-Cells. Arteriosclerosis, Thrombosis, and Vascular Biology. 2018;38(6):1283-1296. doi:10.1161/ atvbaha.117.309940 18. Ale-Agha N, Jakobs P, Goy C, et al. Mitochondrial Telomerase Reverse Transcriptase Protects From Myocardial Ischemia/Reperfusion Injury by Improving Complex I Composition and Function. Circulation. 2021;144(23):1876-1890. doi:10.1161/circulationaha.120.051923

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24. Mao Y, Liu J, Li J, et al. Elevation of preoperative serum hs-CRP is an independent risk factor for malnutrition in patients with gastric cancer. Frontiers in Oncology. 2023;13. doi:10.3389/ fonc.2023.1173532 25. Gardini AC, Carloni S, Scarpi E, et al. Prognostic role of serum concentrations of high-sensitivity C-reactive protein in patients with metastatic colorectal cancer: results from the ITACa trial. Oncotarget. 2016;7(9). doi:10.18632/oncotarget.7166 26. Ridker PM, Koenig W, Kastelein JJ, Mach F, Lüscher TF. Has the time finally come to measure hsCRP universally in primary and secondary cardiovascular prevention? European Heart Journal. 2018;39(46):4109-4111. doi:10.1093/eurheartj/ehy723 27. Mayr A, Klug G, Schocke M, et al. Late microvascular obstruction after acute myocardial infarction: Relation with cardiac and inflammatory markers. International Journal of Cardiology. 2012;157(3):391-396. doi:10.1016/j.ijcard.2010.12.090 28. Bouzidi N, Messaoud MB, Maatouk F, Gamra H, Ferchichi S. Relationship between high sensitivity C-reactive protein and angiographic severity of coronary artery disease. PubMed. 2020;17(5):256-263. doi:10.11909/j.issn.1671-5411.2020.05.003 29. Yoshizaki T, Umetani K, Ino Y, et al. Activated Inflammation is Related to the Incidence of Atrial Fibrillation in Patients with Acute Myocardial Infarction. Internal Medicine. 2012;51(12):1467-1471. doi:10.2169/internalmedicine.51.7312 30. Kobayashi Y, Tanno K, Ueno A, et al. In-Hospital Electrical Storm in Acute Myocardial Infarction�- Clinical Background and Mechanism of the Electrical Instability. Circulation Journal: Official Journal of the Japanese Circulation Society. 2018;83(1):91-100. doi:10.1253/circj. CJ-18-0785 31. Bursi F, Weston SA, Killian JM, Gabriel SE, Jacobsen SJ, Roger VL. C-reactive protein and heart failure after myocardial infarction in the community. Am J Med. 2007;120(7):616-622. doi:https://10.1016/j. amjmed.2006.07.039 32. Shrivastava AK, Singh HV, Raizada A, Singh SK. C-reactive protein, inflammation and coronary heart disease. The Egyptian Heart Journal. 2015;67(2):89-97. doi:10.1016/j.ehj.2014.11.005

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33. Passos JF, Saretzki G, von Zglinicki T. DNA damage in telomeres and mitochondria during cellular senescence: is there a connection? Nucleic Acids Research. 2007;35(22):7505-7513. doi:10.1093/nar/ gkm893

35. Owens WA, Walaszczyk A, Spyridopoulos I, Dookun E, Richardson GD. Senescence and senolytics in cardiovascular disease: Promise and potential pitfalls. Mechanisms of Ageing and Development. 2021;198:111540. doi:10.1016/j.mad.2021.111540

34. Dookun E, Passos JF, Arthur HM, Richardson GD. Therapeutic Potential of Senolytics in Cardiovascular Disease. Cardiovascular Drugs and Therapy. Published online September 26, 2020. doi:10.1007/s10557-020-07075-w

Author Bio: Joseph M. Raffaele, MD Initially trained and board certified in internal medicine, Dr Raffaele has been exclusively practicing in longevity medicine in New York City for 25 years with a focus on personalized hormone optimization and physiological age assessment. In 2007, he co-founded PhysioAge LLC, a web-based health analytics data collection and reporting system used by health care practices around the world to monitor and assess the effectiveness of their treatments. Since 2009, he has been involved in clinical telomere biology research and published 4 studies of the effect of oral telomerase activation on the immune system, metabolism, and telomere length in aging adults. He has lectured nationally and internationally on the clinical application of telomere biology. He routinely posts about telomere biology, geroscience research, hormone optimization, and biomarkers of aging. He received his B.A. in philosophy from Princeton University and his MD from Drexel University Medical School in 1989.

Websites: www.raffaelemedical.com

www.physioage.com

Instagram: @raffaelemd

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The Gut-Thyroid Connection By Felice Gersh, MD

Introduction A bidirectional relationship exists between the gastrointestinal system and the thyroid gland and its hormones. While the subject of increasing scientific inquiry, this “gut-thyroid axis” is often underappreciated by clinicians.1,2 Recognizing and addressing the complex interconnections between these two entities is essential for the achievement of optimal clinical outcomes.

The Thyroid-Gut Autoimmune Connection As previously reported, the gastrointestinal tract hosts trillions of diverse microbes which play an important role in maintaining the gut lining. Through fiber fermentation, the formation of short-chain fatty acids (SCFAs) aids in the maintenance of the GI tract’s protective mucous coating.3 This protective coating supports immune tolerance and impacts the number of regulatory T-cells (TREGs) that contribute to the integrity of the immune system.4 Leaky gut is a clinical phenomenon observed when enterocytes separate, increasing intestinal permeability and allowing toxins to leak into the body.5 When proteins, microbes, and portions of endotoxins pass from the bowel into gut-associated lymphoid tissue (GALT), immune cells recognize them as antigens and generate antibodies in response. This process can contribute to the development of autoimmune thyroid diseases like Hashimoto’s thyroiditis and Graves’ disease.6

Hashimoto’s thyroiditis, the most common autoimmune disease, affects 10-12% of the population. It is marked by thyroid inflammation and the presence of autoantibodies against thyroid peroxidase (TPO) and thyroglobulin (TG). According to numerous investigators, these autoantibodies can damage the thyroid gland, which correspondingly reduce the level of circulating thyroid hormones and cause hypothyroidism.7 Less common, Graves’ disease results from autoantibodies reacting with thyroid stimulating receptors (TSHRs), causing thyroid overactivity. Hashimoto’s and Graves’ often coincide with autoimmunity and gut barrier damage.8 Research has revealed that gut dysbiosis not only promotes autoimmune thyroid diseases, but results in malabsorption of essential micronutrients necessary for both thyroid function and repair, such as iron, zinc, iodine, Vitamin D, and selenium.1,9-11

Felice Gersh, MD, is a multi-award-winning physician with dual board certifications in OBGYN and Integrative Medicine. She is the founder and director of the Integrative Medical Group of Irvine, a practice that provides comprehensive health care for women by combining the best evidence-based therapies from conventional, naturopathic, and holistic medicine. For 12 years, she taught obstetrics and gynecology at Keck USC School of Medicine as an Assistant Clinical Professor, and she now serves as an Affiliate Faculty Member at the Fellowship in Integrative Medicine through the University of Arizona School of Medicine. Felice is a prolific writer and lecturer who speaks globally on women’s health and regularly publishes in peerreviewed medical journals.

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Gut Manifestations of Abnormal Thyroid Function

In a reciprocal process, thyroid hormones impact gut health, and gut health impacts production of thyroid hormones by its effect on the small bowel and stomach.1,12,13 Triiodothyronine (T3) and thyroxine (T4) protect the gut mucosa. Low levels of each are linked to ulcer formation, and adequate amounts can promote ulcer healing.14 Thyroid-stimulating hormone, as well as T3 and T4, can influence the development of the GALT, potentially reducing gut and systemic inflammation, a relationship that further illustrates the codependency of a healthy gut to thyroid function.15,16 Digestive symptoms can arise from hyper- or hypothyroidism. An example of this can be found in patients with hyperthyroidism. Many of these patients present to clinicians with persistent vomiting, abdominal pain, or altered bowel functioning, including diarrhea. Hyperthyroidism can heighten esophageal wall contractions, leading to dyspepsia, epigastric pain, fullness, eructation, and sometimes dysphagia.17

Hypothyroidism: Impact on the Gut While gut function can affect the production of critical thyroid hormones, the lack of sufficient thyroid hormones can correspondingly affect the gut. It has been reported that hypothyroidism is associated with gastric dysmotility, reduced stomach emptying, altered esophageal peristalsis, esophagitis, hiatal hernia, dysphagia, and hypochlorhydria.18 A strong association also exists between atrophic gastritis and autoimmune thyroid disease.19 In the small intestine and colon, changes to the intestinal wall can modify hormone receptor function and create neuromuscular changes that result in myopathy. Reduced peristalsis contributes to constipation, and, in severe cases, life-threatening megacolon.20 Hypothyroidism can also lead to small intestinal bacterial overgrowth (SIBO) – a consequence of reduced small bowel motility – which may also impact gallbladder function.21

Treating the Thyroid-Gut Axis: An Integrative Approach Managing the thyroid-gut relationship requires simultaneous attention to both thyroid and gut wellbeing. This involves appropriate medication management as well as the introduction of dietary support and other nonmedicinal interventions necessary to optimize patient care. The choice of thyroid hormone replacement is often the first consideration in the treatment of hypothyroid disease. In clinical practice, this can prove challenging. Thyroid hormones like levothyroxine are narrow therapeutic index drugs that require precise dosing to optimize their therapeutic effects. The presence of GI comorbidities has been established as a significant factor that can affect the performance of levothyroxine due to their effects on drug dissolution or absorption. In a study of 925 patients taking levothyroxine, McMillan et al established that up to 47% of levothyroxine-treated patients reported having GI disease. Most cited were gastroesophageal reflux disease (GERD) (33.8%), irritable bowel syndrome (IBS) (9.7%), and lactose intolerance (7.8%).22 Furthermore, up to 15% of levothyroxine-taking patients reported having sensitivities to excipient ingredients commonly found in levothyroxine tablet formulations. These can lead to intolerances that may negatively affect drug persistence. Reports of the clinical consequences of GI disease on levothyroxine therapy are numerous. Centanni and others have reported that the absorption of levothyroxine tablets and its dose requirements can be significantly affected by diseases of the GI tract such as inflammatory bowel disease (IBD), H. pylori infection, celiac disease, atrophic body gastritis, and gastroparesis.23 The frequency of LT4 dose changes, the need for unexpectedly high doses of levothyroxine, and the failure of LT4 tablets to control the symptoms of hypothyroidism are known to correlate with the presence of such conditions.24 Medications to treat GI disease can also have the unintended consequence of exacerbating thyroid dysfunction. In a retrospective study of 11 000 hypothyroid patients treated with levothyroxine, the presence of proton pump inhibitors (PPIs) was demonstrated to increase serum TSH concentrations compared with baseline by 0.12 mU/L (P < 0.01), effectively reducing the effectiveness of levothyroxine tablets.25

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Alternative Therapeutic Options Tablet formulations represent most levothyroxine prescriptions dispensed. However, their need for low gastric pH for dissolution and their use of sensitizing excipients may not make them ideal choices for many hypothyroid patients with impaired gut function. By contrast, newly introduced LT4 oral solutions may offer an alternative. They do not require dissolution prior to absorption and contain limited ingredients. One such formulation, Tirosint®-SOL (levothyroxine sodium) oral solution, comes in monodose ampules for convenience and dosing precision. In a clinical study, it was shown to be significantly less affected by the presence of PPI therapy versus LT4 tablets.26 It has been shown effective in many populations with impaired GI function.27,28 It has also been studied among patients without known drug absorption or GI disease. In one such study, it was demonstrated to sustain TSH within the ATA/AACE guideline-recommended range better than LT4 tablets at both 12 and 24 months.29

Prospective study among patients taking proton pump inhibitor therapy switched from LT4 tablets to LT4 liquid TSH in Patients with LT4 Replacement P < 0.0001

TSH in Patients with Suppressive Therapy P < 0.0001

5.4

-68% 1.7 LT4 Tablets LT4 Liquid

2.1

-95% 0.1

LT4 Tablets LT4 Liquid

Prospective cohort study among patients with confirmed LT4 tablet malabsorption due to the ingestion of proton pump inhibitors who were switched to LT4 liquid therapy for thyroid hormone replacement therapy (n = 14) or suppressive therapy (n = 10). Dosing for Replacement Group was 1.6 ug/kg/day. Dosing for Suppression Group was 1.8 ug/kg/day. The mean duration of follow-up after the medication switch was 23.7 ± 11.9 weeks. Adapted from Vita, et al.26

Integrative and functional medicine offer a comprehensive approach for addressing clinical problems produced by the thyroid-gut axis. It begins with a thorough patient history. This includes a physical exam and comprehensive thyroid function testing measuring TSH, free T4, free T3, antiTPO, thyroglobulin antibodies, and possibly rT3. Comprehensive micronutrient testing or select micronutrient testing should also be considered.

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TSH control at 12 and 24 months: LT4 tablets vs LT4 liquid30 % Patients Within AACE/ATA Recommended TSH Range (LT4 Tablets vs LT4 Liquid) P < 0.05

82%

89%

-12%

86%

74%

At 12 Months

At 24 Months

Normal TSH defined as ATA/AACE recommended range for thyroid hormone replacement therapy: 0.4-4.0 IU/L.Adapted from Antonelli, et al.30

LT4 Tablets

LT4 Liquid

Gut health restoration must be addressed simultaneously to manage nutrient deficiencies that affect thyroid function. A trial elimination diet to optimize liver and gallbladder function and restore a healthy gut microbiome is vital. Nutritional education and targeted supplementation are also typically required. In most instances, a diet rich in plants, fiber, and probiotic foods is advisable. Lactobacilli and Bifidobacteriaceae probiotics can potentially reduce thyroid hormone fluctuations and thereby reduce the need for levothyroxine dose adjustments by enhancing deconjugation enzyme availability. Other nonmedicinal interventions are also critical. These include lifestyle changes such as stress reduction, enhanced fitness, toxin reduction, infection management, and sleep optimization. Together, these can help to repair the thyroid-gut axis and restore euthyroidism.31-33

Conclusions Indeed, a thyroid-gut axis clearly exists, and only by fostering the health of both can there be optimal functioning of either. A comprehensive functional medicine approach that includes nutrient optimization for gut barrier repair, proper choice of thyroid hormone medication, and lifestyle changes can help restore thyroid health and ultimately improve patient outcomes. For correspondence with the author, Dr. Felice Gersh can be reached by emailing fgersh@integrativemgi.com.

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143

EXHIBITOR INDEX

144

A3x4 Genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3100

Bioclinic Naturals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9027

4Ever Young Anti-Aging Solutions . . . . . . . . . . . . . . . . 1044

BIOLabs Pro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1061

A4M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6001

BioProtein Technology . . . . . . . . . . . . . . . . . . . . . . . . . . 6099

Access Medical Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . 5013

Biotics Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5027

Acella Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . . . . . 7099

BodyLogicMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1020

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

BodySite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2048

ADVANCED Light Devices . . . . . . . . . . . . . . . . . . . . . . 4104

Boston Heart Diagnostics . . . . . . . . . . . . . . . . . . . . . . . 5044

A Fashion Hayvin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Foyer

BPI Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7117

AgeRate, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1046

BrainMaster Technologies Inc. . . . . . . . . . . . . . . . . . . . 2062

Alletess Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9013

BrainTap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3071

American Biotech Labs, LLC . . . . . . . . . . . . . . . . . . . . . 6039

Brickhouse Capital LLC . . . . . . . . . . . . . . . . . . . . . . . . . 8118

American Cell Technology . . . . . . . . . . . . . . . . . . . . . . . 9033

Broadcast Your Authority . . . . . . . . . . . . . . . . . . . . . . . 1057

American Herbal Labs & Nano Herbs Light . . . . . . . . 4038

Brooksville Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . 9010

American Wellness Pharmacy . . . . . . . . . . . . . . . . . . . 1016

C60 Shop, Inc. / C60 Power . . . . . . . . . . . . . . . . . . . . . 4114

Ammortal Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8112

Calmoseptine, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3039

Ananda Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4078

Calocurb Limited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2054

AnazaoHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3055

Calroy Health Sciences . . . . . . . . . . . . . . . . . . . . . . . . . 4026

Apex Energetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9009

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

Arete Regenerative Technologies . . . . . . . . . . . . . . . . 9038

Canadian Pine Pollen . . . . . . . . . . . . . . . . . . . . . . . . . . . 3066

Argentyn23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2043

Candela Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2038

Asteria Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3093

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

Atlantia Clinical Trials . . . . . . . . . . . . . . . . . . . . . . . . . . . 3116

Capenergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5070

Avacen, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9046

Cardio Vision Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2114

Ayumetrix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6046

Carie Boyd Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . 6079

Ayush Herbs Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4090

Cellcore Biosciences . . . . . . . . . . . . . . . . . . . . . . . . . . . 4060

BENEV Company, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . 2032

Cell Life USA LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2063

Berkeley Life Nitric Oxide . . . . . . . . . . . . . . . . . . . . . . . 6032

Cell Science Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . 7102

Best 365 Labs, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2091

Cell Surgical Network . . . . . . . . . . . . . . . . . . . . . . . . . . 1040

BHG Financial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5098

Central Drugs Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . 2027

Bio-Tech-Pharmacal Inc. . . . . . . . . . . . . . . . . . . . . . . . . 1026

Cerbo EHR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9035

BioAntiAge LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1050

Chi’s Enterprise Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5042

Biocanic, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3044

Chromadex Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7063

Biocidin Botanicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4033

Civic Center Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . 2047

ANTI-AGING MEDICAL NEWS | WINTER 2023

Clarke Bioscience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9037

Ergo-Flex Technologies . . . . . . . . . . . . . . . . . . . . . . . . . 8046

ClearLight Infrared Saunas . . . . . . . . . . . . . . . . . . . . . . 3102

European Wellness Biomedical Group . . . . . . . . . . . . 1035

Clinical Resolution Lab., Inc. . . . . . . . . . . . . . . . . . . . . . 5043

EverHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3080

Clinicians Supplement Consultants . . . . . . . . . . . . . . . 6033

EVEXIAS Health Solutions . . . . . . . . . . . . . . . . . . . . . . 4091

CNS Vital Signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4098

Fagron Genomix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3062

CofixRX Nasal Spray . . . . . . . . . . . . . . . . . . . . . . . . . . . 4103

Fatty15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1039

College Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6038

Finvi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6103

CompoundLive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2085

Flore by Sun Genomics . . . . . . . . . . . . . . . . . . . . . . . . . 4108

Cool Blue VA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8098

Flowpresso® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2109

CosmoFrance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7098

Formula30A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2090

CPMT Laser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9008

Forum Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1060

CRE8 Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4042

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

CRMLab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7115

Fullscript . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6007

CuraMedix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1058

GAINSWave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7027

Cyrex Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3032

GastroDefense (by Sovereign Laboratories) . . . . . . . . 3105

Dahlia Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3108

Gencor / Pharmko Biotechnologies . . . . . . . . . . . . . . 8104

Darmerica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1063

Genova Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2015

DaVinci Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . 7104

German-French Society for Thymus Therapy . . . . . . 1038

Da Vinci Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4085

Global Life Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . 4043

Delavie Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3049

GlycanAge Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7047

Designer Drugs Pharmacy . . . . . . . . . . . . . . . . . . . . . . 8092

Good Idea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9043

Designs for Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2021

Hair Science Corporation . . . . . . . . . . . . . . . . . . . . . . . 6085

DEXA+ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7064

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

Diagnostic Solutions Lab . . . . . . . . . . . . . . . . . . . . . . . . 1021

Harmony Care LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8101

Doctor Multimedia . . . . . . . . . . . . . . . . . . . . . 3042 & 7044

Hawaiian Moon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3095

Doctors Supplement Store . . . . . . . . . . . . . . . . . . . . . . 8060

Health and Beauty Connection LLC . . . . . . . . . . . . . . 7087

Doctor’s Data, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7021

HealthExpertsAlliance . . . . . . . . . . . . . . . . . . . . . . . . . . 2112

Dr. Fuji / ACIGI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3067

Healthgevity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8023

Dr. Pati’s Blue-Zone Model for Gut Health . . . . . . . . 3098

Hormone Therapy Centers of America . . . . . . . . . . . . 5091

Drtalks.com . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3074

Host Defense Mushrooms . . . . . . . . . . . . . . . . . . . . . . 8105

Drucker Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2046

Hue Light USA . . . . . . . . . . . . . . . . . . . . . . . . 5071 & 6071

EGOH Shot XL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2115

HumanN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8009

electroCore, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2035

Human Touch LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7109

Empower Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4079

IBSA Pharma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3090

EndoAxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7046

Ideal Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2108

Eng3 Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9042

Immunocine LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7043

EPIi / Alpha-Stim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2075

Immunosciences Lab, Inc. . . . . . . . . . . . . . . . . . . . . . . . 1049

Epionce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8032

Impactful Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3045

Epoch Lasers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1024

InBody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7086

EPS Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1034

Infiniwell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8097

Erchonia Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . 7112

Infusive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3064

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145

EXHIBITOR INDEX

146

Inid Research Lab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8080

MD-Triage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2092

Innergy Development, LLC . . . . . . . . . . . . . . 4061 & 5061

Medeia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3047

Integrative Peptides . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3037

Medical Marketing Whiz & Women’s Choice Award 7101

IntegrativePRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7084

MediPro Direct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9049

Intelligent Threads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8119

Medisca . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6078

IntellxxDNA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8064

MedisourceRx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2105

International Hyperbaric Association . . . . . . . . . . . . . 7036

Medizap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3081

ION* Intelligence of Nature . . . . . . . . . . . . . . . . . . . . . 3043

Med Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7061

Jigsaw Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7065

menMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8093

Jinfiniti . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7060

Merchant Preferred Zero . . . . . . . . . . . . . . . . . . . . . . . 9029

Just Thrive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9020

Meridian Valley Lab . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7113

JuveXO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7079

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

Kadara Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3079

mescreen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4075

Kashi Clinical Laboratories . . . . . . . . . . . . . . . . . . . . . . 3063

Metabolic Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . 7037

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

Metagenics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6073

Kimera Labs, Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6084

MI Direct Marketing . . . . . . . . . . . . . . . . . . . . . . . . . . . 1055

Kinas Medical Technologies . . . . . . . . . . . . . . . . . . . . . 8084

Microbiome Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3009

King Kongin LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2093

Mito Q Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6087

Klotho Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3112

Mosaic Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5093

KnowingLabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1043

Muscle & Fitness+ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2096

Koncentrated K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9045

MyAdvice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8108

L-Nutra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4007

Myers Cocktail, Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8034

Labs First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2060

Mymycolab, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2067

LaserCap Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9025

Natrusolate Americas Inc: . . . . . . . . . . . . . . . . . . . . . . . 4102

LC Cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9021

NBX Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7108

LeaderMed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2117

Neo7Bioscience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2039

Lifewave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8110

Neobiosis LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1033

Light Tree Ventures USA . . . . . . . . . . . . . . . . . . . . . . . 3118

NES Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6037

LightStim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3046

NeuroScience - Sanesco . . . . . . . . . . . . . . . . . . . . . . . . 8091

Lightwave LED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6109

NMS Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1048

Lisa Fraley Legal Coach, LLC . . . . . . . . . . . . . . . . . . . . . 6036

NOVOS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7110

LivOn Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6067

Novus Optimum Lab dba A Best Supplements . . . . 7042

Longevity X-Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2102

NuBioAge, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8027

Lumisque . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8070

NuCare Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . 7100

LunaMedicalTechnology . . . . . . . . . . . . . . . . . . . . . . . . 2056

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

MaxGen Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8103

Nutrafol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6105

Marek Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1015

Nutramax Laboratories Consumer Care, Inc . . . . . . . 8074

McArthur Insurance Agency, Inc. . . . . . . . . . . . . . . . . . 3091

NutriDyn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5045

McGuff Company Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . 1052

Olympia Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6013

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR INDEX Organicell Regenerative Medicine . . . . . . . . . . . . . . . 4055

Quest Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6054

Organo Leaf . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4092

QuickSilver Scientific . . . . . . . . . . . . . . . . . . . . . . . . . . . 5021

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

Qunol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7085

OxyHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6021

RaDoTech . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3111

PathRight Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3103

Rapid Release Technology LLC . . . . . . . . . . . . . . . . . . . 7039

PatientNow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9036

Recharge Biomedical . . . . . . . . . . . . . . . . . . . . . . . . . . . 8090

Pendulum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4045

Redd Remedies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7071

Performance Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2071

Red Light Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7073

Pharmanex / Get Healthy USA . . . . . . . . . . . . . . . . . . 2055

Reelabs Private Limited . . . . . . . . . . . . . . . . . . . . . . . . . 7072

PhysAssist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1017

Refine USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8037

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

Regenative Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4047

Physicians Lab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1022

Regen Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1030

PhysioAge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3114

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

PlusCBD by CV Sciences . . . . . . . . . . . . . . . . . . . . . . . . 7074

Relax Saunas of Momentum . . . . . . . . . . . . . . . . . . . . . 9041

Pneuma Nitric Oxide LLC . . . . . . . . . . . . . . . . . . . . . . . 5032

Relicus Medical Holdings LLC . . . . . . . . . . . . . . . . . . . 7038

PNOE, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3070

Researched Nutritionals . . . . . . . . . . . . . . . . . . . . . . . . 4015

Power2Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1062

Revelation Pharma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4099

Practitioner Depot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8036

Revers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2095

Precision Analytical (Dutch Test) . . . . . . . . . . . . . . . . . 4021

Revive RX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7093

Precision Compounding Pharmacy . . . . . . . . . . . . . . . 9026

RP Therapies, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8117

Precision Diabetes, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . 2099

Rupa Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3021

Premier Research Labs . . . . . . . . . . . . . . . . . . . . . . . . . 8043

Rx Harmony (The JOI Group) . . . . . . . . . . . . . . . . . . . . 8072

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

SALT Chamber Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3115

Prism Light Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8015

Scarf King . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Foyer

Private Practice Brokers . . . . . . . . . . . . . . . . . . . . . . . . 4032

seca . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6092

Procell Therapies LLC . . . . . . . . . . . . . . . . . . . . . . . . . . 5079

SeeBeyond™ Medicine . . . . . . . . . . . . . . . . . . . . . . . . . 6047

Prodrome Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8100

SelfDecode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5038

Professional Health Products . . . . . . . . . . . . . . . . . . . . 7103

Selphyl PRFM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2049

ProgenaBiome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8089

SensIQ Nootropics + Adaptogens . . . . . . . . . . . . . . . . 2116

ProHealth Longevity . . . . . . . . . . . . . . . . . . . . . . . . . . . 8116

Sexual Wellness Centers of America . . . . . . . . . . . . . . 2045

ProMed Solutions, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . 5072

SignatureMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7062

Protocol For Life Balance . . . . . . . . . . . . . . . . . . . . . . . 9055

SilverCeuticals Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7070

PUR-FORM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6042

Sinclair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8042

Push Patch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9032

Slate Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2118

QCRXUSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5055

Sleep America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2119

Qest, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9047

SmartGraft by Vision Medical . . . . . . . . . . . . . . . . . . . . 3099

Qualgen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2079

Sofwave . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6090

Quantiom Energy Science . . . . . . . . . . . . . . . . . . . . . . . 8095

SottoPelle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8066

Quartermaster Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1064

Source One Beauty . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8109

ANTI-AGING MEDICAL NEWS | WINTER 2023

147

EXHIBITOR INDEX Stemregen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5102

Vasolabs, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2110

Strategic Tax Planning . . . . . . . . . . . . . . . . . . . . . . . . . . 2113

Vertisis Custom Pharmacy . . . . . . . . . . . . . . . . . . . . . . 2044

Strive Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8055

VibraGenix LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8086

Sunlighten . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4064

Vibrant Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7033

Swish30 / Doctors Nano . . . . . . . . . . . . . . . . . . . . . . . . 7119

Vintage Labs Collection . . . . . . . . . . . . . . . . . . . . . . . . . 9028

Synca Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3109

Viola Threads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3094

Synerchii . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3078

Vita Aid Professional Therapeutics . . . . . . . . . . . . . . . 7049

T.A. Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5007

VitaminLab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4036

Tailor Made Compounding . . . . . . . . . . . . . . . . . . . . . . 3085

Wave Neuroscience . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9059

Tatt2Away . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4112

Wavi Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1066

Texas Star Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . 8078

Wellness Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1036

Thaena, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1042

Wells Pharmacy Network . . . . . . . . . . . . . . . . . . . . . . . 1047

The Aesthetic Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . 2094

WETHRIVV LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6061

The DNA Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8047

Woodbridge Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . 7067

The Girlfriend Doctor . . . . . . . . . . . . . . . . . . . . . . . . . . 8062

World Health.net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2100

The Soul Resort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2103

Y Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5033

The Upsize Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7091

Young Goose LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2042

Thera Wellness Solutions, LLC . . . . . . . . . . . . . . . . . . . 2061

Zemits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4071

Therasage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8044

Zimmer Medizin Systems . . . . . . . . . . . . . . . . . . . . . . . 4100

Thermi Aesthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3060

Zizion Group Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5085

THOR Photomedicine . . . . . . . . . . . . . . . . . . . . . . . . . . 6043

ZRT Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7007

Timeline Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5037 Toolbox Genomics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9039 TouchMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1037 & 6115 Trinity School of Natural Health . . . . . . . . . . . . . . . . . . 2101 Trocar Supplies / Bond Therapeutics . . . . . . . . . . . . . 9023 Troscriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2065 TruDiagnostic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7066 TrueBinding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6091 TruGen3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3061 Tyrian . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8102 U.S Jaclean, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8033 Uberlube . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2104 Ublockout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2111 Ulta Lab Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3036 University Compounding Pharmacy . . . . . . . . . . . . . . 7013 Upgraded Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1056 US Biotek Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . 5039 Vale Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8021

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EXHIBITOR LISTINGS ANTI-AGING MEDICAL NEWS | WINTER 2023

151

EXHIBITOR LISTINGS

3x4 Genetics

4Ever Young Anti-Aging Solutions

AC Grace Company

Booth #3100

Booth #1044

Booth #2033

3120 139Th Ave., STE 500 Bellevue, Washington, 98005 US

5458 Town Center Rd., STE # 19 Boca Raton, Florida, 33486 US

PO Box 570, Big Sandy, Texas, 75755 US

Ph: (425) 818-5333

Ph: (561) 320-8111

Ph: (800) 833-4368

Email: info@3x4genetics.com

Email: marketing@fyinstitute.com

Email: info@acgrace.com

www.3x4genetics

www.4everyoung.com

www.acgrace.com

The 3X4 Blueprint looks at 157 of your genes, revealing the decisions that have the biggest impact on your health and weight goals. Through just a single test, you will gain access to a paradigmshifting health and wellness tool. Our testing and analysis process uses rock-solid science and 25 years of research to generate a custom Blueprint Report on each user’s unique genetic map.

4Ever Young is a vitality center that offers a wide range of Anti-Aging solutions, medical aesthetics, like Botox and dermal fillers, hormone replacement therapy, IV Vitamin therapy, Skin Services, like Microneedling and HydraFacial, medical weight loss, nutraceutical therapy and total body wellness. Franchise Opportunities Available

The A.C. Grace Company was founded in 1962 The AC Grace company, located in Big Sandy, Texas and managed by the next generation of family, continues to manufacture and provide exactly the same product Roy Erickson invented many years ago under the name UNIQUE E®. We believe our product is the one of the highest quality Vitamin E supplements on the market. Our product contains no additives or fillers. It is simply a pure Vitamin E product.

Access Medical Labs

Acella Pharmaceuticals

Advanced Light Devices, LLC

Booth #5013

Booth #7099

Booth #4104

5151 Corporate Way, Jupiter, Florida, 33458 US

1880 Mcfarland Pkwy, STE 100 Alpharetta, Georgia, 30004 US

10501 W. Gowen Rd., STE 260 Las Vegas, Nevada, 89129 US

Ph: (866) 720-8386

Ph: (770) 815-6721

Ph: (702) 530-4913

Email: info@accessmedlab.com

Email: swatts@avionrx.com

Email: info@aldmed.com

www.accessmedlab.com

www.acellapharma.com

www.aldmed.com

Access is the nation’s premier specialty diagnostic lab. Weoffer 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, LLC is a specialty pharmaceutical company committed to innovating the healthcare field by bringing quality and affordable products to our customers and patients.

The Company manufactures the TheraLumen wearable wellness device and represents NanoBlu Liposomal Methylene Blue.in oral and IV form. Along with the TheraLumen the company developed and manufactures The Hemealumen Polychromatic System for the treatment of viruses and bacteria in the blood. Other products include the Hercules MultiLaser, MultiLumen and Portable MultiLumen for the treatment of pain, Neuropathy and other issues your patients may have.

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Alletess Medical Laboratory

American Biotech Labs, LLC

Booth #1046

Booth #9013

Booth #6039

175 Longwood Rd South, STE B21 Hamilton, Ontario, L8P0A1 CA

PO Box 343, Rockland, Massachusetts, 02370 US

705 E. 50 S. American Fork, Utah, 84003 US

Ph: (905) 251-5636

Ph: (800) 225-5404

Ph: (801) 756-1000

Email: cole@age-rate.com

Email: alletess@foodallergy.com

Email: info@ablsilver.com

www.age-rate.com

www.foodallergy.com

www.silverbiotics.com

AgeRate empowers physicians with revolutionary aging solutions, offering an at-home blood collection kit for comprehensive biological age analysis. Utilizing advanced DNA methylation and machine learning, we provide detailed insights into cellular aging, chronic inflammation, immune, and metabolic health. Tailored recommendations, accessible via our mobile app, enable users to enhance longevity outcomes. By repeating the process biannually or annually, individuals can monitor progress effectively, making AgeRate a pivotal tool for advancing health and aging mastery.

Founded in 1980, Alletess Medical Laboratory has been providing allergy and immunology testing services to clinicians worldwide. Our highly knowledgeable staff, cutting-edge medical technology, and customized wellness programs allow us to provide high-quality laboratory testing and services to our clients. We understand that test results impact patient lives, every day we strive to provide test results with actionable information to clinicians to improve patient’s health and quality of life. The test result is the beginning of the journey.

The core of our philosophy is to provide products that will assist the body to heal itself. We are constantly striving to develop new products and improve existing ones so that we can offer people the best possible silver solutions. We have a team of experts who are passionate about their work and are always looking for new ways to improve our products.

American Cell Technology

American Herbal Labs & Nano Herbs Light

American Wellness Pharmacy

Booth #4038

Booth #1016

13794 NW. 4Th Street, STE 212 Sunrise, Florida, 33325 US

8526 Garvey Ave., Rosemead, California, 91770 US

2775 S. Jones Blvd., STE 100A Las Vegas, Nevada, 89145 US

Ph: (844) 443-2355

Ph: (626) 307-0928

Ph: (702) 405-9500

Email: info@americancelltechnology.com

Email: dr.luke@newvita.com

Email: accounts@americanwellnesspharmacy.com

www.americancelltechnology.com

www.newvita.com

www.americanwellnesspharmacy.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.

We offer a simple & effective system which is Artificial Intelligence in Chinese Medicine® to take care many difficult cases, becoming VITALITY and LONGEVITY. It includes Meridian Energy Analysis, Nano Herbs®, Nano Vita® Water and acupuncture without needles--Nano Herbs® Light. One-day training class, book “CHINESE MEDICINE MADE SIMPLE” are available. Dr. Luke Cua will provide TCM service on site.

American Wellness Pharmacy, a leading specialty compound pharmacy located in Las Vegas, Nevada. With licensing spanning multiple states, our vision is to spearhead advancements in wellness and regenerative medicine. Our commitment to excellence is evident in the diverse array of peptides and cutting-edge wellness medications we offer, empowering our cherished patients and partners with a wealth of healthcare options.

Booth #9033

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

AgeRate, Inc.

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EXHIBITOR LISTINGS

Ananda Professional

AnazaoHealth

Apex Energetics

Booth #4078

Booth #3055

Booth #9009

190 Corporate Blvd., Georgetown, Kentucky, 40324 US

5710 Hoover Blvd., Tampa, Florida, 33634 US

16592 Hale Ave., Irvine, California, 92606 US

Ph: (888) 388-1119

Ph: (800) 995-4363

Ph: (800) 736-4381

Email: elissa.kerpen@anandahealth.com

Email: jvillalona@anazaohealth.com

Email: Inez@apexenergetics.com

www.anandaprofessional

www.anazaohealth.com

www.apexenergetics.com

Ananda Professional is the leading CBD brand for healthcare practitioners. We are committed to providing the highest quality, clinically-supported CBD products. Backed by over $40 million in research, we are constantly working to advance the clinical evidence of hemp extract. Ananda Professional offers multiple dosage options including tinctures, gummies, capsules, topicals, and pet products with everything being third-party tested for purity and potency. We strive to improve patient outcomes for a variety of conditions, including pain, anxiety, insomnia, and inflammation.

AnazaoHealth is a specialty compounding pharmacy focusing on Wellness, Pain Management and Nuclear Medicine. We have a 30,000-squarefoot 503B FDA-Registered 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, the District of Columbia, and selected U.S. territories (AL & ND patientspecific only). Compounding preparations for Age Management, Weight Management, IV Therapy, Sexual Health, Vitamin Injections, Hormone Replacement, Hair Care Solutions and Aesthetics.

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.

since 2001

Argentyn 23 by NaturalImmunogenics

Arete Regenerative Technologies Booth #9038

Asteria Health

Booth #2043

Booth #3093

224 S. Main Street, STE 107 Springville, Utah, 84663 US

7504 Pennsylvania Ave., Sarasota, Florida, 34243 US

7004 Champion Blvd., STE 100 Birmingham, Alabama, 35242 US

Ph: (801) 376-9423

Ph: (941) 702-6100 x303

Ph: (888) 771-0505

Email: glade@joinsoftwave.com

Email: Seth@Argentyn23.com

Email: info@asteriahealth.com

www.joinsoftwave.com

www.Argentyn23.com

www.asteriahealth.com

Arete Regenerative Technologies is a medical marketing company that specializes in SoftWave technology. SoftWave® patented technology is FDA 510(k) cleared for the activation of connective tissue, the treatment of diabetic foot ulcers, and registered for pain reduction and improved blood supply. As an authorized distributor of SoftWave® TRT, our services consist of sales, marketing, and the training of medical professionals who are using SoftWave technology in order to better serve their patients.

Since its launch in 2001, thousands of clinics worldwide have chosen Argentyn 23 Bio-Active Silver Hydrosol™ and Silver First Aid Gel. Argentyn 23 has an unprecedented particle size as small as 0.8 nm (nanometers). This equates to >98&#37; bioavailability and therefore extremely little waste as almost all of the silver is able to provide immune support* for the body. Visit our booth #2043 to learn how to incorporate Bio-Active Silver and BioActive Copper Hydrosol™ into your practice.

Asteria Health is an Outsourcing Facility registered with the FDA under Section 503B of the Federal Food, Drug, and Cosmetic Act. Located in Birmingham, Alabama; Asteria Health is a growing company dedicated to making a difference in the lives of patients. At the center of this mission is an evolving line of qualitydriven products. Currently Asteria Health specializes in manufacturing bio-identical hormone pellets for hormone replacement therapy. Future health and wellness products are in the works for Asteria Health.

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AVACEN Medical

AYUMETRIX LLC

Booth #3116

Booth #9046

Booth #6046

142 E. Ontario, STE 1200 Chicago, Illinois, 60611 US

6451 El Camino Real, STE C Carlsbad, California, 92009 US

17387 63Rd Ave., Lake Oswego, Oregon, 97035 US

Ph: (312) 535-9440

Ph: (888) 428-2230

Ph: (503) 344-1344

Email: bskillington@atlantiatrials.com

Email: djforsgren@avacen.com

Email: info@ayumetrix.com

www.atlantiatrials.com

www.AVACEN.com

www.ayumetrix.com

Atlantia Food Clinical Trials Ltd is world class in delivering ICH-GCP standard clinical studies. We own our clinics, in Cork (Ireland) and Chicago (USA), where we conduct human studies on Pharmaceuticals,medical devices, nutraceuticals, biotics, medical foods, supplements, microbiome-based therapeutics. We have extensive clinical expertise in the areas such as digestive health,Pain, stress and cognitive health, cardiovascular , joint and bone, immunity, metabolism, sports performance, healthy ageing, weight management, skin health, nutrient uptake, women’s health and microbiome health. Call us Today.

AVACEN Medical® is a leading provider of drug-free, noninvasive, over-the-counter pain relief and wellness devices, as well as diagnostics for cardiovascular stress and disease. Our devices provide pain relief using heat therapy and negative pressure on the palm of your hand and are classified as FDA Class II Cleared medical devices indicated for: minor muscle pain, join pain and stiffness, joint pain associated with arthritis, muscle spasms, minor strains and sprains, muscle relaxation, and temporary increase of local circulation.

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/ analysisall under the guidance from industry experts.

EXHIBITOR LISTINGS

Atlantia Clinical Trials Inc.

Global partner in medical aesthetics ™

Ayush Herbs Inc.

Benev Company, Inc.

Berkeley Life

Booth #4090

Booth #2032

Booth #6032

2239 152Nd Ave. NE, Redmond, Washington, 98052 US

23263 Madero., STE A Mission Viejo, California, 92691 US

1449 South Michigan Ave., 449 Chicago, Illinois, 60605 US

Ph: (425) 637-1400

Ph: (949) 457-2222

Ph: (989) 600-6887

Email: customerservice@ayush.com

Email: sales@benev.com

Email: info@berkeleylife.com

www.ayush.com

www.BENEV.com

www.Berkeleylife.com

Ayush Herbs, Inc. was founded in 1988 by Ayurvedic and Naturopathic physicians who believe in healthy living in body, mind and spirit. High quality, organic herbs and years of Ayurvedic wisdom have culminated into a company with a mission of education and creating trusted formulas. Ayush Herbs® is a name that represents quality and purity; for the sake of our customers, our families, and the Ayurvedic community.

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

At Berkeley Life, we’re committed to generating awareness of Nitric Oxide’s crucial role in healthy aging. And we’re focused on helping proactive healthcare practitioners incorporate NO for patients who aspire to live long and age well. Our science-backed NO solutions are offered exclusively to healthcare practitioners as we believe use of our products is best through trusted conversations between practitioners and patients. Our products deliver clinically proven, consistent results to support and amplify NO levels in non-invasive, easy-to-use forms.

ANTI-AGING MEDICAL NEWS | WINTER 2023

155

EXHIBITOR LISTINGS

BHG Financial

Bio-Tech-Pharmacal Inc.

BioAntiAge

Booth #5098

Booth #1026

Booth #1050

10234 W. State Rd., 84 Davie, Florida, 33324 US

3481 N. Hwy. 112, Fayetteville, Arkansas, 72704 US

72 SE. 6 Ave., Delray Beach, Florida, 33483 US

Ph: (954) 682-1204

Ph: (479) 443-9148 x1118

Ph: (212) 518-8484

Email: rudy@bhg-inc.com

Email: info@bio-tech-pharm.com

Email: info@bioantiage.com

bhgfinancial.com

www.biotechpharmacal.com

www.BioAntiAge.com

BHG Financial is the original disruptor in business working capital and unsecured consumer loans. We exist to create the most innovative financial solutions for business professionals, consumers, and financial institutions nationwide.

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 is a partner of leading international pharmaceutical companies, scientific research agencies, advocacy, and non-profit organizations, as well as individual clients around the world.

The ANTI AGING BLUEPRINT is A BioSynergistic Formula Of 3 Vital Elements, Light, Magnet, and Oxygen Harmonizing Together On A Cellular Level To Revive, Restore & Energize Your Body

Biocanic, Inc.

Biocidin Botanicals™

Bioclinic Naturals

Booth #3044

Booth #4033

Booth #9027

4967 Foothill Blvd., San Diego, California, 92109 US

18 Hanger Way, STE A Watsonville, California, 95076 US

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

Ph: (619) 867-2318

Ph: (800) 775-4140

Ph: (888) 826-9625

Email: hello@biocanic.com

Email: BBRevents@biocidin.com

Email: customerservice@bioclinicnaturals.com

www.biocanic.com

www.biocidin.com

www.bioclinicnaturals.com

Biocanic is the first of its kind health program intelligence system specifically designed to streamline personalized health programs for functional and integrative health practitioners. Biocanic helps practitioners effectively onboard, build and implement personalized health programs for their clients. www.biocanic.com

Biocidin Botanicals™ is a leader in botanical supplements and a pioneer in the arena of microbiome health. Its flagship broad-spectrum botanical blend Biocidin® was formulated in 1989 in response to challenging health conditions related to microbial imbalances. More than 30 years later, the company offers a curated line of targeted support products to boost patient health and target the entire GI tract and oral cavity, supporting microbiome balance for healthy digestion and elimination.

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

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ANTI-AGING MEDICAL NEWS | WINTER 2023

BioProtein Technology

Biotics Research

Booth #1061

Booth #6099

Booth #5027

701 Palomar Airport Rd., STE #170 Carlsbad, California, 92011 US

5706 Benjamin Center Dr., STE 114 Tampa, Florida, 33634 US

5245 Business Park Drive, Rosenberg, Texas, 77469 US

Ph: (760) 297-6942

Ph: (800) 280-2456

Ph: (800) 231-5777

Email: partner@biolabspro.com

Email: info@bioproteintech.com

Email: biotics@bioticsresearch.com

www.biolabspro.com

www.bioproteintech.com

www.bioticsresearch.com

BIOLabs PRO® is a leading partner to Integrative Health Professionals who want to sell over-thecounter products.The “BIO” in BIOLabs PRO® stands for “bio identical.” We are experts in the area of manufacturing topical cosmetic creams that contain bio-identical hormone ingredients such as Dhea, Pregnenolone, Progesterone, and Estrogen. You can sell BIOLabs PRO-branded products, private label one of our formulas, or work with us to create a custom product. Contact us today!

BioProtein Technology is the home of BioPro+, the first of its kind Bioidentical alternative to synthetic HGH Growth Hormone treatments. All the benefits of the synthetic treatments without any of the needles, regulations, or side effects, at a fraction of the cost. Since its launch in 2021, BioPro+ has become an international success making its way to over 20+ countries on 6 out of 7 continents. A favorite among pro-athletes, celebrities, elite military & international private security, and top physicians.

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

BodyLogicMD

BodySite

Boston Heart Diagnostics

Booth #1020

Booth #2048

Booth #5044

4850 T Rex Ave., Boca Raton, Florida, 33431 US

230 N. Congress Avenue, Bay A12 Lake Park, Florida, 33403 US

200 Crossing Blvd., Framingham, Massachusetts, 01702 US

Ph: (561) 425-9912

Ph: (561) 247-3839

Ph: (877) 425-1252

Email: dastern@bodylogicmd.com

Email: info@bodysite.com

Email: customercare@bostonheartdx.com

www.BodyLogicMD.Com

www.bodysite.com

www.bostonheartdiagnostics.com

Founded in 2003, BodyLogicMD continues to grow! We are one of the nation’s largest networks of highly-trained practitioners specializing in integrative medicine, bioidentical hormone replacement therapy, and supplements. BodyLogicMD is a turn-key solution for practitioners who are looking to maximize their practice revenue and personal time, while gaining clinical support from a network of practitioners with diverse board certifications and specializations.

Automate patient education and care between encounters. Our integrated web platform and mobile app has everything you need to easily improve patient outcomes and scale your practice. Our customizable care plans provide automated patient education and lifestyle guidance everyday. Remotely monitor patient progress and communicate with HIPAA-compliant messaging and telemedicine. Easily schedule and charge for programs, virtual meetings and more. Powerful features. Turnkey solution. Branded for your practice.

Boston Heart Diagnostics is transforming the treatment of cardiovascular disease and related diseases with novel diagnostics, reports, and personalized, scientifically designed nutrition and lifestyle programs that have the power to change the way healthcare providers and patients communicate about heart health. Reports with color coded test results, interpretations and clinical treatment considerations help characterize risk, provide individualized, actionable steps, and help communicate and drive engagement with patients. Visit www.bostonheartdiagnostics.com to learn more.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

BIOLabs Pro®

157

Ask us about BPC-157!

Push Patch High Dose NAD+ Patch WITHOUT the needles Unlock the Future of NAD+ Supplementation

A cutting edge 14 hour transdermal NAD+ and Glutathione delivery system

Why Push Patch?

Beneﬁts

Push Patch is the industry leader in the use of iontophoresis technology for the delivery of peptides and coenzymes that may be beneﬁcial for a variety of different conditions. By

Boosted Metabolism & Energy

utilizing the slow release and direct to bloodstream advantage of iontophoresis clinicians are able to maximize the time under dose and pharmacokinetics of a variety of these products that in most situations have very short

Improved Longevity

half-lives thus making other methods of administration of the exact same products less than ideal.

Improved Performance/Recovery

How does it Work?

Reduced Inflammation

Push Patch employs iontophoresis, utilizing minimal electrical charges to transmit medication through the

Better DNA Repair

skin-absolutely pain-free. Think of it as a magnet-like operation, but with two electrodes instead or magnets. Applying the patch initiates a charge, propelling the

Better Mental Clarity

medication through your skin and directly into your bloodstream. This is advantageous as it evades the gastrointestinal system, where medication is often compromised. www.pushpatch.com

EXHIBITOR LISTINGS

BrainMaster Technologies Inc.

BrainTap

C60 Shop, Inc. / C60 Power

Booth #2062

Booth #3071

Booth #4114

195 Willis St., Bedford, Ohio, 44146 US

2861 Trent Rd., New Bern, North Carolina, 28562 US

4845 Pearl E. Circle, STE 101 Boulder, Colorado, 80301 US

Ph: (440) 232-6000

Ph: (302) 721-6677

Ph: (800) 367-9364

Email: assistantmanager@brainmaster.com

Email: support@braintap.com

Email: support@shopc60.com

www.brainmaster

www.braintap.com

www.shopc60.com

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!

BrainTap, the Brain Fitness Company, provides a mobile app and optional headset to strengthens your brain. Our scientifically proven products are effortless to use and provide significant benefits in just 15 minutes. Our friendly technology empowers you to think, sleep, and perform better, improving every area of your life, including the ability to better handle life’s stress. With over 1800 unique audio sessions, we created BrainTap to address the most important focused life outcomes.

C60 Power is dedicated to helping people take back control over their health. We are a team of passionate health and wellness advocates who are intrigued by the science of Carbon 60 and inspired by the body’s potential and ability to heal itself.We are honored to be a trusted resource as you explore your individual healing potential. Visit us at booth #4114 and online at shopc60.com. Use the code A4M20 for 20% off your first order of C60 products.

Calmoseptine, Inc.

Calocurb Limited

Calroy Health Sciences

Booth #3039

Booth #2054

Booth #4026

16602 Burke Lane, Huntington Beach, California, 92647 US

17B Farnham Street, STE 13517 Auckland, Auckland, 1052 NZ

14362 N Frank Lloyd Wright, STE 1000 Scottsdale, Arizona, 85260 US

Ph: (714) 840-3405

Ph: (833) 225-2872

Ph: (800) 609-6409

Email: kim@calmoseptine.com

Email: hello@calocurb.com

Email: support@calroy.com

www.calmoseptine

www.calocurb.com

www.calroy.com

Calmoseptine® Ointment protects and helps heal skin irritations from moisture such as urinary and fecal incontinence. It is also effective for irritations from perspiration, wound drainage, fecal & vaginal fistulas and feeding tube site leakage. Calmoseptine® temporarily relieves discomfort and itching. Free samples at our booth!

Calocurb is a 100% natural GLP-1 activator and patented appetite control supplement sold in NZ, Australia, USA, and China. Amarasate the active ingredient in Calocurb, has been clinically proven to reduce changes in hunger and cravings by up to 30% and calorie intake by an average of 18% after one hour. Amarasate was developed and clinically proven by a group of NZ government scientists at Plant and Food Research (www.plantandfood.com) over 13 years with $25 million of NZ government funding.

Advancing Science.Enhancing Health. At Calroy, we translate breakthrough science into products without parallel. Through rigorous research and formulation, we develop transformative solutions for foundational health*. Our team leads emerging scientific research and applies expertise on world-class natural ingredients to create our formulas. *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. **NOTE: Please make the FDA statement bolded and in a box**

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ANTI-AGING MEDICAL NEWS | WINTER 2023

Canada RNA Biochemical Inc

Canadian Pine Pollen

Candela Medical

Booth #4048

Booth #3066

Booth #2038

4400 Hazelbridge Way, UNIT 680 Richmond, British Columbia, V6X 3R8 CA

889 Harbourside Dr., #120 N. Vancouver, British Columbia, V7P3S1 CA

251 Locke Dr, Marlborough, Massachusetts, 01752 US

Ph: (604) 273-2233

Ph: (604) 281-2767

Ph: (800) 733-8550

Email: info@canadarna.com

Email: info@canadianpinepollen.com

Email: marketing.na@candelamedical.com

www.CanadaRNA.com

www.canadianpinepollen.com

www.candelamedical.com

We specialize in niche natural medicine for practitioners, and best known for our product Boluoke (lumbrokinase). It is the most potent and researchbacked oral fibrinolytic agent with over 30 years of safe and effective clinical usage. It is applicable for situations associated with a hypercoagulable blood state. Remember to stop by our booth for a FREE coagulation health check ($105 value)! Only 30 spots available.

LIMITED HARVEST + CERTIFIED ORGANIC. Our teams forages RAW + LIVING + WILD pine pollen from forests of British Columbia, Canada. Never heat-treated, UV irradiated, ethylene oxide gas or microwave sterilized, compared to imported varieties of pine pollen. Our proprietary ultrasonic dual extraction process efficiently concentrates the four classes of beneficial compounds: stamina promoting androgens, longevity related plant hormones, flavonoid antioxidants, and immune supporting polysaccharides. REPLENISH YOUR VITAL ENERGY WITH CANADIAN PINE POLLEN.

Canfield Scientific

Carie Boyd Pharmaceuticals

Cell Life USA

Booth #6048

Booth #6079

Booth #2063

4 Wood Hollow Road, Parsippany, New Jersey, 07857 US

8400 Esters Blvd., STE 190 Irving, Texas, 75063 US

7427 SW. 105 Place, Miami, Florida, 33173 US

Ph: (973) 434-1200

Ph: (817) 282-9376

Ph: (786) 518-2629

Email: info@canfieldsci.com

Email: info@carieboyd.com

Email: sales@celllifeus.com

www.canfieldsci.com

www.carieboyd.com

www.celllifeusa.com

Canfield Scientific is the global leader in imaging systems, services and products for scientific research and healthcare applications. For over 35 years Canfield has been the premier worldwide supplier of digital photographic systems, imaging software, and associated support services. Our solutions aid healthcare professionals in improving patient communications and managing treatment outcomes. We believe in a seamless client partnership that connects us as a unified team to collaborate on innovative solutions to help your business.

Carie Boyd Pharmaceuticals is a state-of-the-art, wellness-focused compounder. Our cutting-edge, patient-centered office stock (503B) and personalized prescription solutions (503A) extend to clinics, hospitals, dental offices, and beyond. Amongst our many accomplishments is delivering unrivaled 6x higher than regulatory requirements potency in hormone pellet compounding. From Women’s & Men’s Sexual Wellness to Weight Loss, Hair Regrowth, and Aesthetic Skincare, we’ve got your health and wellness needs covered. Don’t just read about it. Visit our booth 6079 and experience wellness redefined.

USA - Our Organ Cell Therapy dietary supplement products are distributed to Doctors throughout the USA. Cell therapy is the administration of specific peptides, or processed cells from specific organs, to support human health problems and prevent deterioration due to aging of the targeted organs and organ systems. The purpose of cell therapy is to repair or enhance the function of aged tissues or organs.

EXHIBITOR LISTINGS

ANTI-AGING MEDICAL NEWS | WINTER 2023

Candela is a leading global 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.

161

EXHIBITOR LISTINGS

Cell Science Systems corp

Cell Surgical Network

CellCore Biosciences

Booth #7102

Booth #1040

Booth #4060

852 S. Military Trail, Deerfield Beach, Florida, 33442 US

72780 Country Club Drive, STE 301 Rancho Mirage, California, 92270 US

3750 E. Pewter Falls St., STE 100 Meridian, Idaho, 83642 US

Ph: (407) 729-1429

Ph: (760) 424-8263

Ph: (866) 902-1525

Email: Rweldon@cellsciencesystems.com

Email: sean@cellsurgicalnetwork.com

Email: events@cellcore.com

www.cellsciencesystems.com

www.cellsurgicalnetwork.com

www.cellcore.com

Cell Science Systems Corp. is a specialty clinical laboratory that develops and performs laboratory testing in immunology and cell biology supporting the personalized treatment and prevention of chronic disease.Cell Science Systems, Corp. operates a CLIA certified laboratory and is a FDA inspected and registered cGMP medical device manufacturer meeting ISO EN13485 standards.

Cell Surgical Network provides physicians technology that automatically isolates their patients’ adipose derived stem cells for regenerative purposes. CSN prevailed in a landmark federal court case against the FDA, allowing their use of personal stem cells isolated from adipose (fat) tissue. This ruling will allow doctors to continue the practice of medicine and provide potentially healing stem cells to their patients, while systematically collecting outcome data along with CSN’s over 500 international physicians.

CellCore Biosciences offers root cause solutions with supplements designed to support cellular health through proper drainage, mitochondrial support and detoxification.

Central Drugs Compounding Pharmacy

Cerbo

Chi’s Enterprises Inc.

Booth #2027

Booth #9035

Booth #5042

520 W. La Habra Blvd., La Habra, California, 90631 US

350 SE. Mill St., STE 11 Portland, Oregon, 97214 US

1435 N. Brasher St., Anaheim, California, 92807 US

Ph: (562) 691-6754

Ph: (541) 391-4600

Ph: (714) 777-1542

Email: clinicalrph@centraldrugsrx.com

Email: sales@cer.bo

Email: wchi29@yahoo.com

www.centraldrugsrx.com

www.cer.bo

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 31+ states.

Cerbo is a leading HIPAA-compliant EHR system that is used by 1000’s of functional and integrative medicine, direct primary care, and cash-based practitioners. Developed to meet the needs of a busy medical practice, Cerbo is packed with features to make managing a practice seamless, so that practitioners can focus on delivering quality care to their patients. Cerbo offers functional charting, configurable patient portal, inventory management, secure messaging, integration with labs, and a simplified billing system. For more information, visit www.cer.bo.

Chi’s Enterprise offers supplements including MYOMIN, an aromatase reducer. Jonathan Wright, MD, and other doctors recommend Myomin to reduce estradiol/ estrone and increase testosterone for men/women including BHRT users. Research Genetic Cancer Center (RGCC) highly recommends ANGIOSTOP for inhibiting angiogenesis factors, inhibiting signal transduction pathways, inducing caspases for apoptosis. VEINLITECVD, reduces D-Dimer. OXYPOWER- hypoxia, excellent for lung, heart, and energy. BAMBOO EXTRACT, great for COVID-19. LIVERCHI induces interferon for hepatitis. KIDNEYCHI for UTI and prevent sexual disease. CHI HAPPINESS for anxiety.

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Civic Center Pharmacy

Clarke Bioscience

Booth #7063

Booth #2047

Booth #9037

1735 Flight Way, STE 200 Tustin, California, 92782 US

7331 E. Osborn Dr., STE 208 Scottsdale, Arizona, 85251 US

17448 Highway 3, STE 140 Webster, Texas, 77598 US

Ph: (949) 410-3984

Ph: (480) 945-9519

Ph: (832) 434-3574

Email: practitioner@truniagen.com

Email: melinda@civiccenterpharmacy.com

Email: chris@clarkebioscience.com

www.Pro.truniagen.com

www.civiccenterpharmacy.com

www.clarkebioscience.com

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

With a steadfast commitment to excellence, serving Arizona since 1996, specializing in custom sterile and non-sterile medications. Guided by a patientcentric approach, our unwavering dedication has propelled us to new heights in both size and reputation. At the heart of our success is a closeknit team of passionate professionals, united in our mission to deliver top-notch, effective, and affordable compound medications to patients and their healthcare providers. Trust us to meet your medication needs with unrivaled expertise and care.

Clarke Bioscience focuses on manufacturing specialized nutraceutical compounds to support overall health and wellbeing, including brain, bone, and immune health. With neuroscientist Dr. Lewis Clarke as the founder, Clarke Bioscience uses the same protocols Dr. Clarke has been using in hospital and clinical settings for decades. We emphasize a biochemical-based approach to health maintenance, completely backed by a strong foundation of cutting-edge scientific research and evidence.

Clearlight Infrared Saunas & Wellness Solutions

Clinical Resolution

Booth #3102

Booth #5043

1077 Eastshore Hwy, Berkeley, California, 94710 US

1530 Moonstone, Brea, California, 92821 US

180 Froehlich Farm Blvd., Woodbury, New York, 11797 US

Ph: (800) 798-1779

Ph: (213) 384-0500

Ph: (516) 222-2288

Email: info@infraredsauna.com

Email: info@clinicalresolution.com

Email: dlc@cscprivatelabel.com

www.infraredsauna.com

www.skincarecrl.com

www.cliniciansconcierge.com

Clearlight® saunas are designed with your health and well-being as our highest consideration. As a wellness company with over 25 years of experience in the infrared sauna industry, we only use non-toxic materials in our saunas and we adhere to the highest manufacturing standards. Designed and refined in California. Handcrafted and built for daily use. Unrivaled fit, finish and refinement; built especially for you. We don’t just make saunas, we make investments for your home, health and happiness.

Clinical Resolution prides itself in being a medical device and pharmaceutical manufacturer since our conception in 2000. We specialize in clinical skincare, aesthetic devices, and proprietary formulations designed for personal and professional use. Our dedicated team of chemists is committed to innovative research, formulating proprietary blends that consistently deliver the best results.

Founded in 2012, Clinicians Supplement Consultants by industry veteran Daniel L. Cajigas. CSC works directly with Clinicians to develop programs and products that meet the needs of their patients. CSC has works with practitioners and formulators to develop cutting edge formulas. The result is a program that allows practitioners to focus on their practice and the patient and provide products they believe in. It is through knowledge, experience, and relationships that CSC can develop a custom program tailored for you.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

ChromaDex, Inc.

Clinicians Supplement Consultants Booth #6033

163

AVACEN Medical® Advanced VAscular Circulation ENhancement

BOOTH #9046 A4M Special:

1 CSS, 1 PRO+ & 1 HOME+

Circulation in Non-Treatment Hand

MSRP: $24,485 | A4M Price: $15,990

TEST TREAT TEST

Before Treatment

Use our AVACEN CSS to test your patients’ before and after Treatment or Treatment Plan.

AVACEN TREATMENT

After 20 Minutes

Use With AVACEN Device Start with: 1-minute CSS Test Then: 20-minute Treatment Finish with: 1-minute CSS Test

CARDIAC & STRESS SCREENING (CSS™)

FDA Cleared, Class II

Engages Parasympathetic Nervous System

CPT Codes: 95921, 95922 & 93922

Increases Microcirculation

2-Page Summary Report

Noninvasive & Drug-Free

1, 3, & 5-Minute Tests

25 Million+ Safe Treatments

Cardiac & Stress Evaluation

BOOTH #9046

EXHIBITOR LISTINGS

CNS Vital Signs

CofixRX Nasal Spray

College Pharmacy

Booth #4098

Booth #4103

Booth #6038

598 Airport Blvd., STE 1400 Morrisville, North Carolina, 27560 US

2983 Waterview Dr., Rochester Hills, Michigan, 48309 US

3505 Austin Bluffs Pkwy, STE 101 Colorado Springs, Colorado, 80918 US

Ph: (888) 750-6941

Ph: (248) 617-4488

Ph: (800) 888-9358 x171

Email: support@cnsvs.com

Email: sales@cofixrx.com

www.cnsvs.com

www.cofixrx.com

Email: customerservice@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 worldwide. 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.

CofixRX Nasal Solution and Throat Spray are Innovative, Safe and Effective Nasal and Throat Cleansers that provide an Additional Layer of Protection and Support a Healthy Body. “Top 5 Notable Products for 2023” as featured in Drug Store News.

CompoundLive

Cool Blue VA

CosmoFrance

Booth #2085

Booth #8098

Booth #7098

310 Comal St., STE 270 Austin, Texas, 78660 US

2492 Walnut Ave., STE 104 Tustin, California, 92780 US

2121 SW. 3Rd Ave., STE 500 Miami, Florida, 33129 US

Ph: (855) 271-1790

Ph: (714) 695-8000

Ph: (305) 538-0110

Email: sales@compoundlive.com

Email: admin@coolblueva.com

Email: office@cosmofrance.net

www.compoundlive.com

www.coolblueva.com

www.cosmofrance.net

Connecting Patients, Physicians, & Pharmacists in one place!! A one stop shop for a customized patient telehealth experience with a built in network of board-certified doctors and compounding pharmacies to fulfill your needs.

At Cool Blue VA, we pride ourselves on being perfectly matched to the needs of our clients. We offer a wide range of VA services, from handling everyday office tasks to transforming your practice altogether. And because we’re virtual, we can save you up to 70% compared to hiring in-house staff.

CosmoFrance Inc. - established in 1997 in Miami, FL - specializes in the import & distribution of medical devices for non-invasive aesthetic procedures. CosmoFrance manufactures & distributes the following products in the US: • ezPRF® Platelet-Rich Fibrin, the ultimate blood concentrate. • ezGEL®, the 100% Natural biostimulating gel. • The DermaSculpt® blunt-tipped microcannula. • The CosmoPen® microneedling pen. • NovaThreads® absorbable US-made PDO threads. Visit cosmofrance.net

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ANTI-AGING MEDICAL NEWS | WINTER 2023

www.collegepharmacy Experience The College Pharmacy Difference: Professional Custom Compounding Quality, Innovation, and Expertise Since 1974. Consistently providing high quality compounded formulations and services for over 40 years. BHRT, Chelation, Mesotherapy, Pellets, Injectables and IV’s.

PHARMACY CuraMedix

Cyrex Laboratories

Booth #4042

Booth #1058

Booth #3032

3700 NW. 126Th Avenue, Coral Springs, Florida, 33065 US

40 Albion Rd., STE103 Lincoln, Rhode Island, 02865 US

2602 S. 24Th Street, STE 307 Phoenix, Arizona, 85034 US

Ph: (888) 224-5181

Ph: (401) 333-6500

Ph: (602) 759-1245

Email: communications@cre8pharmacy.com

Email: info@curamedix.com

Email: michelle.c@cyrexlabs.com

www.cre8pharmacy.com

www.curamedix.com

www.JoinCyrex.com

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.

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 and Magnetolith EMTT.

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 – the gateways to autoimmunity; environmental trigger screening including dietary antigens, pathogens and xenobiotics; and multitissue antibody testing for predictive biomarkers of autoimmune reactivity to a variety of key antigens. Cyrex continues to develop innovative tests that assess the cross-connections between the body’s immune, gastrointestinal and neurological systems.

by ®

Da Vinci Medical

Dahlia Health

Darmerica

Booth #4085

Booth #3108

Booth #1063

220 Newport Center Dr., STE 11-239 Newport Beach, California, 92660 US

10052 Justin Dr., STE L Urbandale, Iowa, 50322 US

4380 Oakes Rd., UNIT 800 Davie, Florida, 33314 US

Ph: (888) 391-5350

Ph: (515) 257-6868

Ph: (416) 594-1881

Email: info@davincimedicalusa.com

Email: sales@dahliahealth.com

Email: SalesTeam@Darmerica.com

www.davincimedicalusa.com

www.dahliahealth.com

www.Darmerica.com

Da Vinci develops and provides technology that optimizes health and performance. Creators of the Superhuman Protocol; a state-of-the-art technology utilizing PEMF, Oxygen and Light Therapy. Come to our booth and experience SUPERHUMAN.

Dahlia Health provides the most advanced light therapy devices for pain, fat reduction, circulation improvement, and wellness. We provide professional clinics with highend revenue solutions that can be run using existing staff. Ask us about our zero-gravity, full treatment solution with treatment times at just 10 minutes. With solutions for clinics, med spas, and physical therapists Dahlia systems are the most versatile you can buy. Intelligent systems. Great opportunity. Be Enlightened™

Darmerica is a Florida based, FDA Inspected, GMP Compliant, and State Licensed distributor of API’s, Nutraceuticals, Peptides, and other bulk chemicals for the Pharmaceutical and Compounding Pharmacy Industries. Darmerica is licensed to ship nationwide, and is also an FDA Inspected and state licensed relabeling and repacking facility.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

CRE8 Pharmacy

167

EXHIBITOR LISTINGS 168

DaVinci Laboratories

Delavie Sciences

Designer Drugs Pharmacy

Booth #7104

Booth #3049

Booth #8092

929 Harvest Lane, Williston, Vermont, 05495 US

100 Barber Ave., Worcester, Massachusetts, 01605 US

7304 Jarnigan Rd., Chattanooga, Tennessee, 37421 US

Ph: (800) 325-1776

Ph: (508) 459-8803

Ph: (423) 954-2585

Email: tjohnson@foodsciencecorp.com

Email: info@delaviesciences.com

Email: form-submission@squarespace.info

www.davincilabs

www.delaviesciences.com

www.designerdrugs.us/

For 50 years we have had one important mission, helping people live healthier lives. And every day, we ask ourselves, “How can we do better?” Our focus is on improving lives by producing quality doctor-formulated supplements derived from natural nutrients—create supplements that make a difference and take standards to a higher level. Within every DaVinci product, you can trust that you will always receive the very best.

Delavie’s mission is to bring novel and functional ingredients to the personal care industry. Delavie Sciences is founded by Dr. David Sinclair, worldrenowned longevity expert, and developed hero skincare line, Aeonia, to target the signs of aging. Aeonia’s specialty ingredient is Bacillus Lysate, Delavie’s patented technology only available in Aeonia products. Innovating superior, sciencebacked, and safe products is Delavie’s main priority.

For more than 20 years, Designer Drugs has been working with patients and physicians to provide specialty solutions for their pharmaceutical and clinical needs. Our technicians are certified to compound sterile and non-sterile medications. Our pharmacy proudly compounds injections, dermatologics, hormone replacement options, and much more. These preparations are designed specifically to meet individual needs with the highest level of safety and accuracy proven by testing. Designer Drugs is licensed to ship prescriptions to all fifty states.

DESIGNS FOR HEALTH, INC.

DEXA+

Diagnostic Solutions Laboratory

Booth #2021

Booth #7064

Booth #1021

980 South Street, Suffield, Connecticut, 06078 US

141 Peyerk Ct., UNIT D Romeo, Michigan, 48065 US

31 Lupi Court, STE 250 Palm Coast, Florida, 32137 US

Ph: (352) 603-1042

Ph: (586) 532-1150

Ph: (877) 485-5336

Email: Sciencefirst@designsforhealth.com

Email: torlando@dexaplus.com

Email: cs@diagnosticsolutionslab.com

www.designsforhealth.com

www.dexaplus.com

www.diagnosticsolutionslab.com

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

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.

Diagnostic Solutions Laboratory bridges the gap between healthcare providers and the laboratory, offering cutting-edge tests such as GI-MAP®, OMX™ (Organic Metabolomics), CytoDX®, and GenomicInsight®. Identifying root causes gives practitioners the tools for optimized patient outcomes. Our commitment to education and service ensures practitioners and patients benefit from the latest research.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Doctor’s Data, Inc.

Booth # 3042 & 7044

Booth #7021

8070 La Jolla Shores Dr., #528 La Jolla, California, 92037 US

3755 Illinois Ave., St. Charles, Illinois, 60174 US

Ph: (800) 679-3309

Ph: (630) 377-8139

Email: info@doctormultimedia.com

Email: info@doctorsdata.com

www.doctormultimedia.com

www.doctorsdata.com

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

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

DR. FUJI

Dr. Pati’s Blue-Zone Model for Gut Health

Doctors Supplement Store

Dr. Fuji / ACIGI

Booth #8060

Booth #3067

250 Axminister Drive, St. Louis, Missouri, 63026 US

4399 Ingot Street, Fremont, California, 94538 US

954 Lake Baldwin Lane, Orlando, Florida, 32814 US

Ph: (877) 846-7122

Ph: (510) 651-9088

Ph: (407) 697-4125

Email: support@dssorders.com

Email: marketing@drfuji.com

Email: info@mdprescriptives.com

www.DoctorsSupplementStore.com

www.drfuji.com

www.sajune.com

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. Same-day 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 Health & Wellness massage equipment, is the fruit of further evolution of intelligent pneumatic and mechanical milt-technology designed to partner with medical and health professionals in their clinical stress managements.

Over 20 years with over 15,000 patients, we learned that if you optimize 5 areas, over 85% of all symptoms and conditions resolve, including GERD, IBS, bloating and leaky gut. This 5-Point Model System adopts 5 foundational ways of the Long- thriving who bask in nature’s gifts the; 1) Sun 2) Earth 3) Water 4) Oxygen and 5) Joyful Purpose through connections. Anyone can turn on innate self-healing using this model. Come see how. Come get your free Gut Protocols.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Booth #3098

EXHIBITOR LISTINGS

Doctor Multimedia

169

EXHIBITOR LISTINGS

Option 02

DrTalks

Drucker Labs

electroCore, Inc.

Booth #3074

Booth #2046

Booth #2035

7040 Avenida Encinitas, 104-284 Carlsbad, California, 92011 US

1600 Capital Ave., STE 100 Plano, Texas, 75074 US

200 Forge Way, STE 205 Rockaway, New Jersey, 07866 US

Ph: (619) 436-7750

Ph: (972) 881-2344

Ph: (813) 404-6348

Email: bret@drtalks.com

Email: sales@druckerlabs.com

Email: CustomerService@electroCore.com

www.drtalks.com

www.druckerlabs.com

www.gammaCore.com

DrTalks grants people direct access to leading experts in health, wellness, and medicine. Our exclusive partnerships deliver up-to-date, tailored content on topics of interest. Whether you seek insights into unlocking your genetics, enhancing your health through nutrition and exercise, staying informed about cancer breakthroughs, or managing chronic conditions and pain, we provide the latest insights from medical experts themselves.

Introducing Drucker Labs, a liquid dietary supplement developer and manufacturer located in Plano, Texas. As a leading nutraceutical manufacturer, Drucker Labs has been committed to innovation, research, and development for over 20 years. Through the integration of premium natural nutrients and our exclusive technology, Drucker Labs has successfully surpassed other liquid nutraceuticals in the industry. Our products are meticulously crafted, manufactured, and preserved using our proprietary technology, which sets Drucker Labs apart from the rest.

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.

Empower Pharmacy

EndoAxis

Eng3 Corporation

Booth #4079

Booth #7046

Booth #9042

7601 North Sam Houston Pkwy W, STE 100 Houston, Texas, 77064 US

8920 Wilshire Blvd, STE 610 Beverly Hills, California, 90211 US

2234 Eastlake Ave. E, Seattle, Washington, 98102 US

Ph: (877) 562-8577

Ph: (301) 375-0835

Ph: (206) 525-0227

Email: info@empowerpharmacy.com

Email: hello@endoaxis.com

Email: customer.care@eng3corp.com

www.empowerpharmacy.com

www.endoaxis.com

www.eng3corp.com

Houston-based Empower Pharmacy is the nation’s most advanced compounding pharmacy PCAB®-accredited 503A. Their 503B outsourcing facility strictly adheres to the FDA’s current good manufacturing practices (CGMPs). Empower’s vision is to expand access to quality, affordable medications, and our mission is to be the premier compounding pharmacy and outsourcing facility delivering innovative pharmaceutical solutions to patients and providers.

EndoAxis, founded and led by doctors, is on a mission to support fellow physicians. Our innovative algorithm simplifies the analysis of complex functional hormone labs, offering an instant, comprehensive clinical interpretation. Our report considers 31 hormone markers to provide a holistic view, pinpointing the root cause of dysfunction, then suggests targeted supplements and lifestyle recommendations based on findings. EndoAxis empowers providers overwhelmed by integrative hormone health, making every doctor a hormone expert through our algorithmic clinical consults.

Eng3 is the Seattle-based company behind NanoVi® technology, a unique and innovative way to initiate repair and regeneration at the cellular level. NanoVi supports protein activities by influencing the water that surrounds all proteins. Based in biophysics, these devices are completely drug and substancefree. Both health professionals and individuals rely on NanoVi to slow the aging process, improve mental and physical performance, accelerate recovery, and address age-related diseases.

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ANTI-AGING MEDICAL NEWS | WINTER 2023

Epionce

Booth #2075

Booth #8032

2201 Garrett Morris Parkway, Mineral Wells, Texas, 76067 US

10211 W. Emerald Street, Boise, Idaho, 83704 US

Ph: (940) 328-0788

Ph: (866) 374-6623

Email: info@epii.com

Email: info@epionce.com

www.alpha-stim.com

www.epionce.com

EPI is a leading medical device company in non-invasive brain stimulation for the treatment of psychiatric disorders and microcurrent therapy for the relief of pain. EPI manufactures the Alpha-Stim® brand of patented devices that are FDA cleared to provide fast, safe, and effective treatment of anxiety and insomnia via cranial electrotherapy stimulation (CES) and pain via microcurrent electrical therapy (MET). Alpha-Stim is available in more than 50 countries worldwide and is available via prescription in the U.S.

Epionce is a dermatologist-developed, medical-grade skincare brand that has been obsessed with a healthy skin barrier for over 20 years. Sold by medical skincare professionals, our elegant formulations are made with barrier-boosting cholesterol and ceramides, and antioxidant-rich botanical blends that show measurable benefit in the skin. Formulas have undergone over 15 rigorous independent clinical trials to prove safety and efficacy. Our philosophy is simple: put your skin barrier first, and beautiful skin will follow.

Epoch Lasers, LLC

EPS Health

Erchonia Corporation

Booth #1024

Booth #1034

Booth #7112

5233 Male Springs Dr., Chagrin Falls, Ohio, 44022 US

15 Somerset St., STE 602 Clearwater, Florida, 33767 US

650 Atlantis Rd., Melbourne, Florida, 32904 US

Ph: (805) 748-8238

Ph: (727) 480-0094

Ph: (888) 242-0571

Email: info@epochlasers.com

Email: sales@epshealth.info

Email: Jdshanks@erchonia.com

www.epochlasers.com

www.epshealth.info

www.erchonia.com | www.emeraldlaser.com

Epoch® Lasers, the founder of high powered therapeutic lasers, offers the Epoch 980 Class IV Laser and the Epoch 980 Helios, a home-based pain management system. Made in the US and engineered to address pain and expedite injury recovery, Epoch’s therapy systems stimulate cellular healing via photobiomodulation. This effectively diminishes pain-related compounds, reduces inflammation, enhances mitochondrial function, and promotes rapid tissue regeneration— all achieved non-invasively in brief 10-minute treatment sessions that feel soothing and relaxing.

EPS Health specializes in providing value added products and services to the Anti-Aging/ Functional medicine community. Our goal is to help practitioners increase their bottom line. Our Product Lines include: Supplements, Medical Devices, Healthy Meals, and Merchant services.

Erchonia Corporation, World Leader in Low Level Lasers

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

EPIi / Alpha-Stim

171

Ergo-Flex Technologies Booth #8046 13622 Poplar Circle, STE 403 Conroe, Texas, 77304 US Ph: (936) 588-5510 Email: sales@ergoflextechnologies.com

Ergo-Flex Technologies, LLC. is the developer, manufacturer, and distributor of innovative equipment to help patients with pain relief and offer healthcare practitioners the opportunity to set themselves apart, taking their practices to the next level. Products include Back On Trac, Knee On Trac, CerviTrac and Total Brain & Body O2 (IHHT System).

EXHIBITOR LISTINGS

EverHealth Inc.

Booth #1035

Booth #3080

Unit 67 & 68, Blo9Ck K, Alamesra Plaza Utama, Jalan Sulaman Kota Kinabalu, Sabah, 88450 MY

9903 Santa Monica Blvd., STE 281BH Beverly Hills, California, 90212 US

Ph: +60 17-672 8888

Email: cashelford@transofrmationsclinic.com

Email: info@european-wellness.com

www.ergoflextechnologies.com

172

European Wellness Biomedical Group

www.european-wellness.eu European Wellness Biomedical Group was established in 1991 in Switzerland. They focused on early cell therapeutic research in Switzerland, Germany, Russia, and Austria since the mid-’80s. Today, EW Group is renowned for groundbreaking work in organ-specific precursor stem cell therapeutics, peptides, regenerative medicine, immunotherapies, nutraceuticals, and cosmeceuticals. With divisions in research, biomanufacturing, academies for education, anti-aging centers, and product distribution in 80 countries, EW Group is a leading multinational enterprise.

Ph: (213) 798-7400 www.lymph360.com EverHealth Inc. is an innovative prevention and wellness company with programs for individuals and corporations. These programs are offered through integrative and functional medicine practitioners who are listed on EverHealth’s directory and partnered with a local community of Health Promoting Professionals. Together, they become the Carousel of Wellness and as a result, this community begins referring to one another and they are referred business from local companies helping employees make better lifestyle choices.

EVEXIAS Health Solutions

Fagron Genomics US

Fatty15

Booth #4091

Booth #3062

Booth #1039

920 S. Kimball Ave., Southlake, Texas, 76092 US

807 Las Cimas Pkwy, STE 145 Austin, Texas, 78746 US

2907 Shelter Island Dr., STE 105-411 San Diego, California, 92106 US

Ph: (833) 839-4735

Ph: (512) 258-5564

Ph: (619) 407-9225

Email: marketing@evexias.com

Email: info@gxsciences.com

Email: info@fatty15.com

www.evexias.com

www.gxsciences.com

www.fatty15.com

EVEXIAS Health Solutions is an emerging leader in the advancement of medicine toward a preventive care model that positively impacts patient lives while also allowing practitioners to grow their practice. Every EVEXIAS program includes medical training and education, strategic business plans and operational practices exclusively developed for private medical practices to achieve the highest level of patient experience and outcomes for the practices served.

Fagron Genomics US is an advanced genetic testing company and laboratory based in Austin, TX that empowers providers and their patients with the most comprehensive Nutrigenomic (NGx) and Pharmacogenomic (PGx) testing interpretation platform available. Our customized reporting platform is specifically designed for medical professionals by medical professionals and allows the provider to validate a patient’s specific nutritional needs, laboratory recommendations, lifestyle recommendations, and health precautions based on the patient’s individual DNA findings.

Fatty15 is a health and wellness brand dedicated to advancing global health through the discovery of essential fatty acids and micronutrient therapeutics. Through rigorous breakthrough science, the company develops fatty acid supplements, food fortifiers, and nutritional interventions to strengthen cells, keep mitochondria working and advance cellular homeostasis to counter age-related breakdown. With its team of industry-leading scientists, fatty15 challenges long-held approaches to nutrition, enabling the creation of novel health products designed to support quality of life.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Floré by Sun Genomics

Flowpresso®

Booth #6103

Booth #4108

Booth #2109

1150 West Kilgore Ave., Muncie, Indiana, 47305 US

5151 Shoreham Place, STE 185 San Diego, California, 92122 US

144 Third Ave., UNIT 7 Tauranga, Bay of Plenty, NZE83110 NZ

Ph: (317) 331-6213

Ph: (858) 900-9698

Ph: (64) 275443424

Email: info@finvi.com

Email: floreclinical@sungenomics.com

Email: sales@flowpresso.co.nz

www.finvi.com

https://flore.com/pages/flore-clinical

www.flowpresso.co.nz

Finvi Payments Enhance Your Offerings & Empower Your Clients With text-to-pay convenience and next-day funding capabilities, you can advance your competitive advantage by integrating with Finvi’s secure, modern, and flexible Payments Solution. Increase satisfaction and loyalty by arming providers with frictionless, digital payment options that their patients demand. All while earning money on every transaction in your ecosystem.

Floré is the leader in the next generation of customized synbiotics and comprehensive stool analysis via Whole Genome Sequencing of the Gut Microbiome. Our stool testing provides clinically relevant insight into gut dysbiosis, microbiome diversity, pathogenic bacteria, IBS, IBD, and more. This allows us a unique ability to custom formulate and micro-manufacture a truly personalized solution in the form of a once-daily probiotic and prebiotic.

Flowpresso® is a breakthrough, non-invasive natural therapy that enhances overall health which delivers a 3-in-1 sensory treatment, comprising of Compression, Deep Pressure Therapy and Thermodynamic Heat. This unique combination of therapies releases toxins and puts the body into a ‘rest and restore’ state, working with our physiological processes to switch off fight or flight mechanisms, and facilitate healing and repair. It’s like CTRL ALT DEL for the body.

Formula30A

Forum Health

Fotona

Booth #2090

Booth #1060

Booth #1027

1992 Lewis Turner Blvd., Fort Walton Beach, Florida, 32547 US

601 S. Saginaw St., 5Th FL Flint, Michigan, 48502 US

4343 W. Royal Lane, STE 116 Irving, Texas, 75063 US

Ph: (850) 801-3377

Ph: (855) 976-5578

Ph: (972) 804-2391

Email: info@formula30a.com

Email: info@forumhealth.com

Email: info@fotona.org

www.formula30a.com

www.forumhealth.com

www.fotona.com

Formula30A produces premium full-spectrum hemp extracts, including CBD and CBG, for healthcare providers and their patients. Patented water-based manufacturing processes and multistage third-party lab testing ensure products meet the purity, quality, and efficacy standards healthcare professionals expect. Our goal is to become the most trusted cannabinoid source for the medical community by aligning with industry experts, researching and educating on the endocannabinoid system, and offering products containing pure ingredients only accessible through healthcare providers.

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!

Globally recognized for exceptional product performance and versatility, Fotona’s award-winning aesthetic lasers include the revenue-boosting SP Dynamis, TimeWalker and StarWalker. 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’s reputation for excellence is earned from its dedication to R&D, unparalleled quality, reliability, ease-of-use and durability.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Finvi

173

Power up your energy, clarity & vitality

Have you met C60? Carbon 60 is the Ultimate Antioxidant 1

C60 is one of the most powerful antioxidants ever discovered

C60 lifts the oxidative burden & neutralizes toxic free radicals

C60 increases energy & mental clarity by optimizing mitochondrial function

20% off code: A4M20 ShopC60.com

Join us for a 30-minute presentation:

“How to Optimize Your Mitochondria”

Friday, Dec. 15, 2023 at 5:00 pm with Biogeochemist & Chief Science Officer, Ken Swartz

Learn how to optimize your mitochondria for increased energy, enhanced performance, and balanced immune function.

Visit us at booth # 4114

EXHIBITOR LISTINGS 176

GastroDefense (by Sovereign Laboratories)

Fullscript

GAINSWave®

Booth #6007

Booth #7027

9185 E. Pima Center Pkwy., STE 200 Scottsdale, Arizona, 85258 US

2980 NE. 207Th St., STE 503 Aventura, Florida, 33180 US

30 N. Alamos Dr., Cottonwood, Arizona, 86326 US

Ph: (866) 807-3828

Ph: (855) 383-5779

Ph: (928) 421-2241

Email: marketing@fullscript.com

Email: team@gainswave.com

Email: info@gastrodefense.com

www.fullscript.com

www.gainswave.com

www.gastrodefense.com

Fullscript® is the leading online platform for practitioners to manage and dispense healthcare’s best supplements — in-office or to patients’ doors. Practitioners become a safe, convenient source for trusted wellness products with the choice to offer savings, earn revenue, or both. Time-saving features, automated adherence tools, and more help physicians minimize admin, grow their practices, and keep patients engaged.

GAINSWave® is a leading B2B provider in the medical industry, specializing in advanced non-invasive technology for treating erectile dysfunction and optimizing male sexual health. Our innovative, clinicallyproven solutions utilize low-intensity shockwave therapy, empowering healthcare professionals to offer safe and effective treatment options to their patients. With a commitment to excellence, GAINSWave® continues to drive groundbreaking advancements, transforming the lives of men worldwide. Partner with us and elevate your practice with cutting-edge solutions for male sexual wellness.

GastroDefense® (by 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 repairing leaky gut (intestinal permeability), promoting 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 and adding liposomal delivery for enhanced bioavailability into dietary supplements for professionals.

Gencor / Pharmko Biotechnologies

Genova Diagnostics

Booth #8104

Booth #2015

German – French Society for Thymus Therapy

7801 N. Lamar Blvd., STE E210 Austin, Texas, 78752 US

63 Zillicoa St., Asheville, North Carolina, 28801 US

Place Du Marche, Grimaud, 83310 FR

Ph: (949) 502-5760

Ph: (828) 210-7362

Ph: (66) 81 6639399

Email: info@gencorpacific.com

Email: info@gdx.net

Email: info@thymus-therapie.org

www.gencorpacific.com

www.gdx.net

www.thymus-therapy.org

Gencor and Pharmako Biotechnologies are sister companies that offer innovative, award-winning solutions for human health. Investing heavily in rigorous scientific research and innovation, Gencor, with Pharmako Biotechnologies, offers novel ingredient solutions to meet varying consumer needs. We specialize in developing ingredients, and technologies to enhance the changing health needs through all of life’s stages.

Genova Diagnostics is a leading force in the world of healthcare, transforming the way chronic diseases are diagnosed, treated, and prevented. With a focus on empowering individuals to achieve optimal well-being, our advanced lab testing methodologies target crucial areas like gut health, nutritional status, immune function, and hormonal health. At Genova, we’re shaping a brighter and healthier future, where innovative approaches to personalized healthcare empower individuals to thrive. Learn more at www.gdx.net.

German-French Society for Thymus Therapy Thymus Therapy and many other natural Therapies used in medicine for stimulating the immune system, but mostly applied in beauty for skin rejuvenation, mesotherapy, anti-wrinkles and cell vitality. Ask us and we will educate you.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Booth #3105

Booth #1038

GlycanAge Ltd.

Good Idea

Booth #4043

Booth #7047

Booth #9043

168 East Main Street, Denville, New Jersey, 07834 US

The Catalyst, 3 Science Square, Newcastle Upon Tyne, England, NE4 5TG UK

PO Box 606, Corte Madera, California, 94976 US

Ph: (973) 627-1750

Ph: (44) 75 25717807

Ph: (855) 346-6348

Email: demetriaglaab@denvillemedical.com

Email: partners@glycanage.com

Email: hello@goodidea.us

www.globalliferejuvenation.com

www.glycanage.com

www.goodidea.us

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.

GlycanAge is a biological age test measuring chronic inflammation, focusing on glycosylation, a process influenced by genetics, epigenetics, and inflammation. Our trial offers an accurate estimate of biological age, and is responsive to interventions that reduce inflammation, predicting disease states before they manifest. GlycanAge’s ability to respond to lifestyle changes makes it an effective tool for managing ageing. Collaborating with over 600 partners globally, helping individuals optimize their lives. Interested in incorporating this unique test into your practice? Contact us!

GOOD IDEA began with our female-inventor, a PhD in Applied Nutrition, Dr. Elin Östman, who spent 20 years researching natural properties in foods. She discovered pairing five essential amino acids with chromium helped to improve metabolism and lower post meal blood sugar. She joined forces with Bjorn & Rickard Öste with a mission to develop the world’s first clinically proven functional beverage to help balance blood sugar, while tasting refreshing and delicious. After 10+ clinical trials, she perfected the formula.

Hair Science

Hallandale Pharmacy

Harmony Care LLC

Booth #6085

Booth #6055

Booth #8101

608 Point Vista Drive, ALEDO, Texas, 76008 US

2666 SW. 36Th St., Lauderdale, Florida, 33312 US

8940 Sunriver Meadows Ave., Las Vegas, Nevada, 89148 US

Ph: (866) 558-1744

Ph: (954) 455-3822

Ph: (562) 338-6995

Email: info@hairscience.com

Email: jmaman@hallandalerx.com

Email: expo@harmonycarellc.com

www.hairscience.com

www.Hallandalerx.com

www.harmonycarellc.com

Hair Science is a focused on the development of advanced hair loss formulas, including some of the most popular regrowth formulas prescribed in the United States, Formulas 82M, 82F, & 82D. Formula 82S, a 3-in-1 (shampoo + conditioner + anti-hair loss) product that leaves hair feeling soft, healthy and easy to comb, without the need for a separate conditioner, and a general restorative shampoo for dry, thin and damaged hair, will be available at our booth.

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.

Health and wellness products

HAIR SCIENCE DEVELOPERS OF ADVANCED HAIR LOSS FORMULAS

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Global Life Rejuvenation

177

Health and Beauty Connection LLC

Healthgevity

Booth #7087

Booth #8023

321 S. Missouri Ave., Clearwater, Florida, 33756 US

2642 Rosselle St., #9 Jacksonville, Florida, 32204 US

21A Allen Ave., Allenhurst, New Jersey, 07711 US

Ph: (888) 256-3276

Ph: (407) 517-8188

Ph: (833) 940-4898

Email: customerservice@hmaloe.com

Email: info@hnbc.us

Email: support@healthgev.com

www.aloecream.biz

www.hnbconnection.com

www.healthgev.com

Say Goodbye to Dry Skin with Hawaiian Moon Organic Aloe Skin Cream. Our cream is free from perfume, parabens, petroleum, chemicals, dyes and mineral oil. It penetrates into the skin instantly and won’t wash off because it is in the skin, not on it. It has been known to help with dry skin, wind burn, sunburn, bruises, cuts & scrapes as well as sore muscles and various skin issues.

We sell whole body vibration machines for home and commercial usage. Please come over and find out all the benefits for you and your business.

Healthgevity is focused on supporting healthcare providers to optimize healthy aging and increase healthspan by identifying ways to best harness the hallmarks of aging. We partner with leading healthcare professionals and organizations around the globe to translate breakthrough science into advanced nutritional supplements. Our innovative formulas feature orally bioavailable peptides and unique ingredients all at therapeutic doses such as PeptiStrong anabolic peptides, DNF-10 satiety peptides, spermidine, L-BAIBA, dihydroberberine, ImmunoLin, NAD3, 2-HOBA, L-Ergothioneine, fisetin and ginsenoside Rg1.

Hawaiian Moon

EXHIBITOR LISTINGS

Booth #3095

Hormone Therapy Centers of America

Host Defense Mushrooms

Booth #5091

Booth #8105

5 Cowboys Way, STE 300 Frisco, Texas, 75034 US

PO Box 7634, Olympia, Washington, 98507 US

Ph: (469) 214-0816

Ph: (877) 504-6926

Email: tyrichardson@ht-ca.com

Email: order@hostdefense.com

www.HT-CA.com

www.hostdefense.com

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.

Host Defense® Mushrooms™ was founded by renowned mycologist Paul Stamets with the goal of building a bridge between people and fungi. Always at the cutting edge of mycological research, they continuously strive to find new and innovative ways to make mushroom mycelium more accessible. Offering multiple delivery formats is one way they work to offer convenience and ease-of-use to any supplement regime. Host Defense myceliumbased products are currently available in capsules, extracts, powders, drink mixes, and more!

178

ANTI-AGING MEDICAL NEWS | WINTER 2023

Human Touch LLC

HumanN

Booth # 5071 & 6071

Booth #7109

Booth #8009

146 Rock Hill Dr., Rock Hill, New York, 12775 US

4600 E. Conant St., Long Beach, California, 90808 US

1250 S. Capital Of Tx Hwy.1-360, Austin, Texas, 78746 US

Ph: (845) 796-9951

Ph: (562) 733-7351

Ph: (512) 487-7025

Email: info@huelightusa.com

Email: healthcare@humantouch.com

Email: kimg@humann.com

www.huelightusa.com

www.humantouch.com

pro.humann

Hue Light is a high-tech medical startup corporation dedicated to providing you with cost-effective and dependable health care products.

Human Touch® Massage Chairs and Perfect Chairs are developed in cooperation with the medical community and wellness professionals. For over 40 years, Human Touch has been helping people feel better through our patented, award-winning, state-of-the-art products. With our long history of successful innovation, Human Touch continues to pioneer groundbreaking products that deliver life-changing benefits proven to aide in recovery, relieve back pain and help reduce stress.

HumanN was founded in affiliation with a leading academic research program and is committed to promoting healthy circulatory and blood flow for cardiovascular health as well as other functional foods and supplements. HumanN brings forth scienceled formulations to meet the demands of modern, health-conscious consumers. A pioneer in the field of beet-based and polyphenol promotion of Nitric Oxide, a vital molecule in healthy circulation, HumanN’s product lines include SuperBeets, the #1 Doctor Recommended Beet Brand for Heart Health Support.

IBSA USA

Immunocine LLC

Immunosciences Lab, Inc.

Booth #3090

Booth #7043

Booth #1049

8 Campus Drive, STE 201 Parsippany, New Jersey, 07054 US

3422 Business Center Dr., STE 1123 Pearland, Texas, 77584 US

822 S. Robertson Blvd., STE 312 Los Angeles, California, 90035 US

Ph: (908) 280-1597

Ph: (832) 814-2185

Ph: (310) 657-1077

Email: info@ibsapharma.com

Email: jay@immunostim.io

Email: immunsci@gmail.com

www.ibsapharma.com

www.immunocine.com

www.Immunoscienceslab.com

IBSA Pharma Inc. distributes two unique levothyroxine formulations in the US: Tirosint® and TirosintSOL®. Tirosint-SOL contains only 3 ingredients and provides effective treatment for the full spectrum of hypothyroid patients regardless of age.

Immunocine provides innovative cancer treatment to patients in need through personalized Dendritic Cell Immunotherapy. Our proprietary technique allows us to educate each patient’s Dendritic Cells with their own unique cancer genomics and markers – a technique never before accomplished. Immunocine patients have experienced incredible results despite being deemed incurable. Backed by 18 years of academic research, numerous publications, and multiple ongoing clinical trials, our treatment is a less invasive and more precise way to treat multiple types of solid cancer.

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, and viral infections. The information provided by these tests can help clinicians not only to pinpoint the cause of the illness but to treat and perhaps even reverse the course of the disease’ development.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Hue Light USA

179

IMPACTFUL MEDICINE

EXHIBITOR LISTINGS

ELEVATE YOUR IMPACT

Impactful Medicine

InBody

Infiniwell

Booth #3045

Booth #7086

Booth #8097

587 Orchard Street, Ashland, Oregon, 97520 US

13850 Cerritos Corporate Drive, UNIT C Cerritos, California, 90703 US

881 Corporate Dr., Lexington, Kentucky, 40508 US

Ph: (541) 299-3999

Ph: (323) 932-6503

Ph: (859) 447-0591

Email: support@impactfulmedicine.com

Email: convention@inbody.com

Email: shop@infiniwell.com

www.impactfulmedicine.com

www.inbody.com

www.infiniwell.com

We make Root-Cause and Functional Medicine expertise available to any practice through our turn-key Total Health Reset Platform (THR), a 9-Week educational and experiential ‘boot-camp’. THR gives patients the basic understanding and actual body transformational experience required to slow, stop, or reverse chronic health conditions and long-term symptoms, and optimize health from a deep FM perspective. We also educate and mentor practitioners to learn and use important basic principles of Functional and Root-Cause Medicine.

Since 1996, InBody has helped our medical clients to provide the highest standard of care. We equip healthcare professionals with in-depth insights and custom solutions that empower you to design personalized treatment plans for your patients. Utilizing non-invasive technology proven in over 5,500 clinical studies, InBody’s BIA devices deliver highly accurate assessments of fluid balance, muscle mass, and fat distribution. This data has versatile applications for the anti-aging, functional, sports, bariatric, diabetes, and regenerative medical fields.

Infiniwell has long been a leader in the dietary supplement industry, providing consumers with the highest quality products and delivering unrivaled results. This helped us become a trusted name, but our dedication to research and development is what propelled us to the forefront. Now, Infiniwell is bringing the most advanced and the highest quality supplements directly to you. Infiniwell has supplements for healthy aging, post-exercise recovery, mood support, and more products are being unveiled regularly.

Infusive

Inid Research Lab LLC

Booth #3064

Booth #8080

441 North Wendover Rd., Charlotte, North Carolina, 28211 US

17641 Telge Rd., STE 101 Cypress, Texas, 77429 US

Ph: (980) 256-2022

Ph: (832) 953-2791

Email: Tanner@goinfusive.com

Email: rajan@inidresearchlab.com

www.goinfusive.com

www.inidresearchlab.com

Infusive streamlines 797-compliant IV treatment preparation, administration, and billing. With smart inventory management, it optimizes both operational efficiency and clinic profitability for any integrative medical practice.

Inid Research Lab LLC produces the unique ingredient Glyteine (the proprietary form of the dipeptide gamma-glutamylcysteine) and retails Continual-G (www.continualg.com) range of dietary supplements in two dosage forms – powder and capsules. Only Continual-G supplements contain Glyteine which rapidly increases cellular glutathione levels above homeostasis in a single dose. Glyteine is synthesized in the USA using a patented process. Continual-G supplements are formulated in the USA and Australia.

180

ANTI-AGING MEDICAL NEWS | WINTER 2023

INTEGRATIVE

PRP

Integrative Peptides

IntegrativePRP

Booth # 4061 & 5061

Booth #3037

Booth #7084

215 S. Mountainlands Dr., Orem, Utah, 84058 US

30 N. Gould St., #33697 Sheridan, Wyoming, 82801 US

953 Franklin Avenue, Garden City, New York, 11530 US

Ph: (801) 903-2747

Ph: Text Us: (443) 732-5272

Ph: (518) 648-3388

Email: info@innergydev.com

Email: CS@IntegrativePeptides.com

Email: contact@integrativeprp.com

www.innergydev.com

www.integrativepeptides.com

www.integrativeprp.com

Brain Science and Alternative Wellness Technologies INNERgy Development Technologies are non-invasive and state-of-the-art tools. Whether you are a clinician or just an individual, our innovative technologies may support you on your journey towards optimal health and wellness. We bring you the latest in technology, with a price tag that you can afford.

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.

Integrative PRP offers one of the leading systems in therapeutic autologous biologics. Integrative PRP supplies FDA cleared PRP centrifuges and PRP kits for hair restoration, facial aesthetics, sexual wellness and pain management. Our products meet the highest level of quality and efficacy producing the best desired and intended results. We provide virtual and on-site training, free practice kits, and on-demand support to help you get started. We look forward to starting a collaborative long-term relationship!

IntellxxDNA

International Hyperbaric Association

ION* Intelligence of Nature

Booth #7036

Booth #3043

3410 Far West Blvd., STE 100 Austin, Texas, 78731 US

33 Woodcraft Circle, Madison, Wisconsin, 53719 US

4351 Seminole Trail, Charlottesville, Virginia, 22911 US

Ph: (512) 717-3300

Ph: (213) 880-0186

Ph: (844) 432-5488

Email: info@intellxxdna.com

Email: info@ihausa.org

Email: info@intelligenceofnature.com

www.intellxxdna.com

www.ihausa.org

www.intelligenceofnature.com

IntellxxDNA is a clinical decision support software that provides comprehensive, accessible medical reports and scientific explanations of specific genomic patient data using over 700 SNPs and over 10,000 references. A genomics intelligence services company created to individualize the practice of medicine by empowering functional and integrative clinicians with molecular-level insight into each patient, realizing evidence-based, precision treatment.

The International Hyperbaric Association was founded with the goal of increasing the awareness of hyperbaric oxygen therapy (HBOT) to both the medical community and consumers alike. Through a combination of strategic initiatives, our mission continues today to educate the community at large on the benefits of HBOT and provide accessibility for those in need to improve health and wellness. The IHA offers unique benefits for clinics and consumers as a part of our membership program to provide support and resources.

The ION* path was first laid in 2012 when an obscure soil science article showed Dr. Zach Bush, Founder and CEO, a family of carbon molecules capable of partnering with the human body. Our team set off to better define how we support the microbiome. The answer didn’t lie in the probiotics industry, but through our bodies’ innate drive to heal and thrive. The domino effect of good health, they found, was a function of supporting, not supplementing.

Booth #8064

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Innergy Development, LLC

181

R E D E F I N I N G H E A LT H

CellCore Biosciences is the Leader in Root Cause Solutions. CellCore provides supplements that support proper drainage, cellular energy and detoxification. With BioActive Carbon® - a proprietary blend of fulvic acids, CellCore products help bind, protect and deliver nutrients to the body. CellCore offers turnkey kits and protocols, clinical tools and business solutions to elevate your practice.

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B R I N G C E L L C O R E I N T O YO U R P R A C T I C E T O D AY

EXHIBITOR LISTINGS

Jigsaw Health

Jinfiniti Precision Medicine

Just Thrive

Booth #7065

Booth #7060

Booth #9020

9035 E. Pima Center Pkwy, STE 3 Scottsdale, Arizona, 85258 US

1235 Walton Way, Augusta, Georgia, 30901 US

810 Busse Hwy., Park Ridge, Illinois, 60068 US

Ph: (866) 601-5800

Ph: (706) 831-8882

Ph: (800) 455-8939

Email: help@jigsawhealth.com

Email: hello@jinfiniti.com

Email: support@justthrivehealth.com

www.JigsawHealth.com

www.jinfiniti.com

www.justthrivehealth.com

Since 2005, Jigsaw Health 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. We deliver only the highest quality nutritional supplements. Every batch of our products is tripletested, and the lab results are posted online for all to see. We believe that what’s on the label is what should be in the bottle, and nothing else.

Jinfiniti Precision Medicine offers clinicians and individuals solutions to optimize their health and extend healthspan. We develop clinically-proven interventions that will correct discoverable subhealth issues for the prevention of age-related diseases and improve efficacy of treatment. Jinfiniti’s at-home Intracellular NAD test kit is the first test of its kind. Jinfiniti also offers biomarker panels and senescence tests. Our Accuri® Vitality Boost is the only NAD product that not only improves, but optimizes, intracellular NAD levels.

Just Thrive Probiotic is guaranteed to arrive 100% alive in your gut and has 1000x better survivability vs. leading probiotics. It’s also the only retail-available probiotic containing the propriety, Bacillus Indicus HU36™. This super strain produces antioxidants at the site of peak absorption for unmatched digestive, immune, and total-body health support.

JuveXO

Kadara Medical

Kashi Clinical Laboratories

Booth #7079

Booth #3079

Booth #3063

1728 Coral Way, STE 600 Miami, Florida, 33145 US

301 W. 28Th Street, STE E National City, California, 91950 US

9570 SW. Barbur Blvd., Portland, Oregon, 97219 US

Ph: (833) 436-8372

Ph: (775) 297-4778

Ph: (503) 206-4989

Email: info@juvexo.com

Email: general@kadaramedical.com

Email: tthomas@kashilab.com

www.juvexo.com

www.kadaramedical.com

www.kashilab.com

JuveXO is a topical serum that has revolutionized aesthetics by harnessing the extraordinary power of exosomes. Through the most cuttingedge biotechnology and decades of research, JuveXO delivers a non-invasive and non-surgical method to revitalize and rejuvenate your body’s largest organ – your skin. Rich in hyaluronic acid, collagen, elastin, other essential proteins, and over 100 billion exosomes, JuveXO is a biocosmetic that targets damaged and aging tissue and activates the body’s natural healing response.

kadara™ medical is a market leader and cutting-edge biomedical device company specializing in superior Disposable Trocar Kits and Reusable Trocar Sets for pellet implantation. Family-owned, American-made, FDA Registered, and ISO13485 Quality Management System certified. Our innovation provides practitioners with precision instrumentation and delivers patients’ procedural comfort for return visits. Unmatched sterility assurance of 10__ delivered by our state-of-the-art E-beam terminal sterilization facility. See us to elevate your practice and experience firsthand why kadara medical: Usability, Quality, and Exceptional Service.

Kashi Clinical Laboratories is a fully-accredited lab that specializes in a range of genomic healthcare services from HLA testing for Bone Marrow Transplants to UA /drug testing, genetic testing and now COVID19 testing. Kashi Lab offers a distinctive one-on-one approach in developing laboratory services to meet organization and project requirements. We promote well-being and quality of life by delivering the highest standard of laboratory work. We recognize our service as more than a test result.

184

ANTI-AGING MEDICAL NEWS | WINTER 2023

medical technologies healing amplified

Kimera Labs, Inc.

Kinas Medical Technologies

Booth #3027

Booth #6084

Booth #8084

4 Business Way, Hopedale, Massachusetts, 02332 US

2810 N. Commerce Pkwy, Miramar, Florida, 33025 US

2160 Kingston Ct, STE D Marietta, Georgia, 30067 US

Ph: (617) 933-8130

Ph: (305) 454-7836

Ph: (770) 612-8245

Email: jwhite@kbmodiagnostics.com

Email: info@kimeralabs.com

Email: info@KinasMedical.com

www.kbmodiagnostics.com

www.kimeralabs.com

www.KinasMedical.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.

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

Kinas Medical equips practitioners to go the extra mile for their patients and practice. By using non-invasive and clinically-proven shockwave therapy, patients get healthier faster. By partnering with our family-owned and operated company, practices thrive with cuttingedge solutions and first-class, personalized support. As a business partner, we provide resources to help identify opportunities and increase revenue. With Kinas Medical Technologies, you become part of our family—and inherit over 30 years of industry expertise.

King kongin LLC

Klotho Skin

KnowingLabs

Booth #2093

Booth #3112

Booth #1043

183 Thorton Drive, Palm Beach Garden, Florida, 33418 US

909 Hyde Street, STE 330 San Francisco, California, 94939 US

PO Box 4003, McAllen, Texas, 78502 US

Ph: (650) 608-1348

Ph: (310) 874-8706

Ph: (512) 855-1295

Email: info@kingkongin.com

Email: drgail@drgailhumble.com

Email: partners@knowinglabs.com

www.kingkongin.com

www.klothoskin.com

knowinglabs.com

Are you ready to drink your way to greatness? With ZERO calories, ZERO sugar, ZERO carbs, and ZERO artificial colors and flavors, KING KONGIN gives you the energy and motivation you need to follow your dreams and never give up! Our energy drinks are designed with empowerment in mind while supporting enhanced immunity, hydration, and a great taste that inspires you to greatness. kingkongin.com Partner with Us.

Klotho Skin is a biotech company introducing an innovative skin care line. Our patented process utilizes mesenchymal stem cells genetically modified to upregulate the age suppressor gene Klotho. We have the first and only viable human cell line modified to produce second generation growth factors and the Klotho protein. Our cellular studies suggest Klotho Skin reverses skin atrophy and increases type IV collagen after exposure to UVB insult. Klotho Skin is regenerative, protective, and preventative.

Our laboratory is nationally accredited for the highest quality of practices and results. Our Mission is to Advance Preventive Healthcare through Personalized Laboratory Testing. We are dedicated to empowering individuals with access to accurate and reliable health data, enabling them to take a proactive approach to their health and wellness. Order Any Test at Any Time From any Country at the Convenience and Privacy of Your Home.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

KBMO Diagnostics

185

EXHIBITOR LISTINGS 186

Koncentrated K

L-Nutra

Booth #9045

Booth #4007

535 Delta Ave, Manistique, Michigan, 49854 US

1260 15Th Street, STE 1101 Santa Monica, California, 90404 US

Ph: (715) 612-5858

Ph: (310) 775-3655

Email: koncentratedk@yahoo.com

Email: aperez@l-nutra.com

www.k-vitamins.com

www.l-nutra.com

Vitamin K is an indispensable vitamin, and many people are deficient. Our website summarizes the peer-reviewed research on vitamin K and the vital role that Vitamin K play in the well-being of the body. Koncentrated K contains a therapeutic dose of several different types of Vitamin K, along with astaxanthin. We also offer our personal experience and knowledge of the health benefits of Vitamin K.

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.

Labs First

LaserCap Company

LC Cell

Booth #2060

Booth #9025

Booth #9021

11211 White Oak, Granada Hills, California, 91344 US

26 Alpha Park, Highland Heights, Ohio, 44143 US

800 W. Cummings Park, Woburn, Massachusetts, 01801 US

Ph: (213) 973-6968

Ph: (440) 241-1846

Ph: (877) 920-2281

Email: Admin@LabsFirst.com

Email: info@lasercap.com

Email: support@lovebeautypro.com

www.labsfirst.com

www.LaserCap.com

www.lovebeautypro.com

LabsFirst helps healthcare providers, doctors and other medical practitioners to focus on patients by simplifying business processes and decreasing hassle associated with provider management.

LaserCap is the original low-level laser therapy (LLLT) device, FDA-cleared for hair regrowth in men and women with pattern hair loss.

Manufactured in the United States, LC Cell develops innovative skin and hair care products that improve skin health and appearance using the most advanced active ingredient technologies available. Our regimens are recommended by skincare experts to optimize the healthy appearance of all skin types and conditions.

ANTI-AGING MEDICAL NEWS | WINTER 2023

LED Light Therapy

Topical Light Infusion

Lightwave LED Therapy / ENVY Light Capsule

LifeWave

LightStim

Booth #8110

Booth #3046

3238 Del Monte Street, Laughlin, Nevada, 89029 US

16552 Von Karman Avenue, Irvine, California, 92606 US

2205 W. Lone Cactus Dr, STE 11 Phoenix, Arizona, 85027 US

Ph: (949) 945-8695

Ph: (949) 502-4088

Ph: (480) 751-1060

Email: lisapettit11@gmail.com

Email: tracey@lightstim.com

Email: info@lightwavetherapy.com

www.lifewave.com/lisalauren

www.LightStim.com

www.LightwaveTherapy.com

LifeWave, Inc. is the owner of patented wearable, virtually weightless technology that sits inside a simplelooking patch. A family of “patch” products uses light to communicate with bio-receptors at the cellular level to help the healing body function at optimal levels. For pain, sleep, energy, stress, skin, sports performance, wound healing and more. Over 100 worldwide patents/patents pending. Over 80 clinical and research studies, many published. Using is believing!

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.

LIGHTWAVE (Phx,AZ) has been an innovator and industry leader of professional light therapy systems since 2002. Our professional LED technology has 5 FDA clearances for the effective reduction of inflammation, wrinkles, acne, pain and pigmentation. LIGHTWAVE’s treatments are accomplished without pain, negative side effects or down time and can easily be incorporated into any practice. The ENVY Light Capsule is the first full body LED bed to offer both Red and Infrared to address pain, healing, anti-aging and wellness concerns.

LivOn Laboratories

Lumisque

LunaMedicalTechnology

Booth #6067

Booth #8070

Booth #2056

2654 W. Horizon Ridge Pkwy, B5-108 henderson, Nevada, 89052 US

304 Indian Trace, STE 276 Weston, Florida, 33326 US

11954 Narcoossee Rd., STE 220 Orlando, Florida, 32832 US

Ph: (866) 790-2107

Ph: (954) 780-8739

Ph: (916) 846-6781

Email: service@livonlabs.com

Email: support@co2lift.com

Email: info@lunaesthetic.com

www.livonlabs.com

www.lumisque.com

www.lunaesthetic.com

Founded in 2004 with a mission to heal the world, LivOn Labs is the first dietary supplement company to target the cells using liposomal encapsulation technology. Our Lypo-Spheric® goo delivers critical nutrients for better absorption and cellular health benefits you won’t find in other products — without sugar, artificial flavors, or GMO ingredients. After two decades, we’re still a familyowned, women-led business producing premium cellular nutrition supplements in Las Vegas.

Lumisque Skincare presents CO2LIFT – a medicalgrade brand of cosmeceuticals that utilizes the powerful benefits of Carbon Dioxide to lift, tighten and regenerate your skin. It acts as a topical “hyperbaric oxygen chamber”, delivering a rush of carbon dioxide, and is clinically proven to improve hydration, elasticity, and re-epithelialization. CO2LiftV is doctor recommended at-home vulva / vaginal rejuvenation treatment clinically proven to improve lubrication, arousal, orgasm, and aesthetic appearance in just 3 applications.

Medical aesthetic device provider specialised in laser and body contouring technology.

EXHIBITOR LISTINGS

ANTI-AGING MEDICAL NEWS | WINTER 2023

Booth #6109

187

EXHIBITOR LISTINGS 188

MaxGen Labs

McArthur Insurance Agency, Inc.

McGuff Company Inc.

Booth #8103

Booth #3091

Booth #1052

102 Fairways Dr., Hendersonville, Tennessee, 37075 US

12605 Ulmerton Rd., Largo, Florida, 33774 US

3524 West Lake Center Dr., Santa Ana, California, 92704 US

Ph: (832) 683-1574

Ph: (800) 982-0398

Ph: (800) 854-7220

Email: accounts@maxgenlabs.com

Email: mikem@mcarthuragency.com

Email: answers@mcguff.com

www.MaxGenLabs.com

www.mcarthuragency.com

www.mcguff.com

MaxGen Lab offers physician-created DNA reports that empower individuals to understand their bodies better. Backed by cutting-edge research and endorsed by thousands of physicians, our actionable reports guide proactive health decisions. With a focus on privacy, we pioneered data protection in genetic testing. As a family-owned company, MaxGen Lab prioritizes your health and healing goals.

McArthur Insurance Agency Inc. is an independent agency specializing in Professional Liability Insurance for Clinics and Medical Providers. We have programs for specifically for Regenerative Medicine that can cover the non-FDA approved procedures many integrated and advanced medicine clinics are providing.

McGuff Medical Products distributes 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 FDA-approved Ascorbic Acid Injection (ASCOR®).

edeia

Designed for Clinicians MD-Triage

Med Results Inc.

Medeia

Booth #2092

Booth #7061

Booth #3047

385 Ethel Ave., Battle Mountain, Nevada, 89820 US

1111 N. Brand Blvd., STE 350 Glendale, California, 91202 US

7 W. Figueroa St., STE 215 Santa Barbara, California, 93101 US

Ph: (949) 887-1445

Ph: (310) 707-3223

Ph: (800) 433-4609

Email: info@mdtriage.net

Email: Office.Admin@med-results.com

Email: info@medeia.com

www.mdtriage.net

www.med-results.com

www.medeia.com

MD-Triage is a combined telephone answering system AND a medical triaging system. These two functions are combined into one system. Experienced MAs triage calls to either RNs or APNs depending on the level of intervention that is perceived. Around 90% of all in-coming calls are handled this way with only 10% needing to be routed to the on-call provider. In addition, we can provide Virtual Receptionists to relieve front office congestion.

Med Results Inc. is the exclusive US distributor of GMV Srl from Italy, the company who manufactured Plexr Plasma Technology for non invasive & minimal invasive procedures. With 3 decades of experience in the medical equipment industry, we excel in providing innovative solutions, medical professionals can rely on. Our cutting-edge tech & top-notch products empowers medical professionals to address previously untreatable indications, ensuring patients satisfaction. From our training to our technical department & customer service, we are committed...

Since its inception in 1992, Medeia Inc has been on the forefront in the manufacture and distribution of Neuro Diagnostic and Heart Rate Variability / ANS products. Medeia Inc specializes in the development of state of the art biometrical software and hardware products intended to monitor physiology for research and educational purposes.

ANTI-AGING MEDICAL NEWS | WINTER 2023

MediPro Direct

Medisca

Booth #7101

Booth #9049

Booth #6078

6977 Kennesaw Rd., Canton, Michigan, 48187 US

PO Box 725, Banks, Oregon, 97106 US

661 Route 3, STE # 3 Plattsburgh, New York, 12901 US

Ph: (888) 418-8065

Ph: (877) 268-1021

Ph: (855) 850-5855

Email: lori@medicalmarketingwhiz.com

Email: support@mediprodirect.com

Email: MUS-CustomerServices@medisca.com

www.medicalmarketingwhiz.com

www.mediprodirect.com

www.medisca.com

Medical Marketing Whiz is a medical marketing agency for private practice women’s health and functional medicine providers. We provide social media marketing, local SEO, reputation management, email marketing, podcasts, webinars and in-office events. The Women’s Choice Award Best Doctors program allows qualified doctors to distinguish themselves, providing a competitive edge that comes only with the credibility, recognition, and influence of the Women’s Choice Award.

MediPro Direct provides nationwide mobile specimen collection to help customers expand their service area, improve patient care, and exceed customer expectations. With advanced technology, real-time patient feedback, and one of the largest networks in the nation, MediPro Direct has you covered.

Medisca® Medisca is a global corporation with locations throughout North America, Australia, and Europe, that contributes to healthcare by leveraging strong partnerships that deliver customized solutions with an unwavering commitment to quality. Backed by 30+ years and a strong foundation in pharmaceutical compounding, Medisca delivers extensive solutions as Partners in Wellness.

Advanced Sterilization

MedisourceRx

Medizap

menMD

Booth #2105

Booth #3081

Booth #8093

10525 Humbolt St., Los Alimitos, California, 90720 US

301 W 28Th Street, UNIT F National City, California, 91950 US

14444 Myerlake Circle, Clearwater, Florida, 33760 US

Ph: (574) 274-5189

Ph: (775) 386-6677

Ph: (857) 233-5837

Email: kharrington@nivagen.com

Email: customerservice@medizap.co

Email: orders@menmd.com

www.Medisourcerx.com

www.medizap.co

www.menmd.com

MedisourceRx is an FDA (503b) Registered Outsourcing Facility licensed and located in California. We are Committed to Maintaining Stringent Regulatory Compliance and our most recent FDA and California Board of Pharmacy inspections yielded no 483’s. We follow FDA Guidance, cGMP, and are striving to be a reliable wellness partner. Please stop by our booth and meet some experts to learn more.

MediZap is the only contract terminal sterilizer by E-Beam | X-Ray irradiation built for compounders. Our 4 Pillar Service includes Advanced Sterilization, Packaging Solutions, Compliance, and Exclusive Partnerships. We offer 48-hour processing, dedicated capacity, group pricing, and a compounding center of excellence. USP 797 and cGMP guidelines start with terminal sterilization, and our technology is the most advanced solution, ensuring low-risk 10-6 SAL and delivers the safest drug products to hospitals, practitioners, and patients.

Since 2010, menMD has helped over 3,000 providers keep patients on therapy and ease the patient education and refill burden on office staff. Our partnerships with providers set us apart from other platforms and are a key factor in optimizing your patients’ health journey. menMD is here to support your practice and provide your patients with care that extends beyond their office visits. Ensuring they have the support they need to achieve their health and wellness goals.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Medical Marketing Whiz & Women’s Choice Award

189

Instant Health Assessments Improved Health Outcomes Backed By Research Remote Technology Learn about our 60 day trial

Mp Z

ERO

EXHIBITOR LISTINGS

MERCHANT PREFERRED ZERO

Merchant Preferred Zero

Merit Pharmaceutical

Metabolic Maintenance

Booth #9029

Booth #4037

Booth #7037

170 Chestnut Ridge Road, Queensbury, New York, 12804 US

2611 N. San Fernando Road, Los Angeles, California, 90065 US

601 N. Larch St., Sisters, Oregon, 97759 US

Ph: (540) 484-3429

Ph: (323) 227-4831

Ph: (800) 772-7873

Email: dgalbraith@merchantpreferred.com

Email: solutions@meritpharm.com

Email: info@metabolicmaintenance.com

www.mpzero.net

www.meritpharm.com

www.metabolicmaintenance.com

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. Merchant Preferred Zero provides the hardware at no cost.

For over 50 years, Merit Pharmaceuticals is capable of being your optimum source. Let us assist you in increasing your profits while lowering your costs with our branded line of Medigrative® products that includes: IV Safety Catheters, Administration Sets/Extension Sets and Safety Winged Infusion kits and more. If you are new to IV Therapy, we offer a starter IV Hydration Kit as well as Aesthetic cannulas, IV Therapy, Weight Loss, Hormones, IV solutions, PRP products, exam/surgical, etc.

Our role in the healthcare industry is an important responsibility. We are continually looking to grow our brands and enhance our products to support and improve the quality of life for our many valued clients. As one of the first companies of its kind in the industry, and family-owned for close to 40 years, Metabolic Maintenance continues its mission of providing patients and medical professionals with superior nutritional healthcare supplements.

Metagenics

Microbiome Labs

MitoQ Ltd.

Booth #6073

Booth #3009

Booth #6087

25 Enterprise, STE 200 Aliso Viejo, California, 92656 US

101 E. Town Pl., STE 210 Glenview, Illinois, 60025 US

139 Pakenham Street West, Ground FL Auckland, Auckland, 1010 NZ

Ph: (800) 692-9400

Ph: (904) 940-2208

Ph: (64) (0) 210686508

Email: Info.customerservice@metagenics.com

Email: info@microbiomelabs.com

Email: jmarshall@mitoq.com

www.metagenics.com

www.microbiomelabs.com

www.mitoq.com

With a heritage of breakthrough science, innovative products, unsurpassed quality, practitioner education, and dedicated partnerships, Metagenics is one of the most trusted health and wellness brands worldwide. For over 30 years, Metagenics, a globally certified B Corp, has developed highquality, science-based nutritional supplements, medical foods, and lifestyle programs to support the growing number of people seeking to improve their health and achieve their 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.

MitoQ is a New Zealand company that has developed a unique and game-changing cellular health technology, which directly targets and enhances mitochondrial performance, offering a potent antioxidant that works beyond conventional options. MitoQ enables direct delivery of our patented antioxidant precisely where it is needed most - within the mitochondria - optimizing energy production and protecting against oxidative damage, now and into the future.

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ANTI-AGING MEDICAL NEWS | WINTER 2023

Muscle & Fitness+

MyAdvice

Booth #5093

Booth #2096

Booth #8108

8400 W 110Th Street, #500 Overland Park, Kansas, 66210 US

2025 S. Airport Blvd., Chandler, Arizona, 85286 US

1850 West Ashton Blvd., STE 500 Lehi, Utah, 84043 US

Ph: (913) 341-8949

Ph: (773) 528-6100

Ph: (435) 575-7470

Email: domesticsales@mosaicdx.com

Email: rfletcher@muscleandfitness.com

Email: sales@myadvice.com

www.mosaicdx.com

www.muscleandfitness.com

www.myadvice.com

Mosaic Diagnostics delivers the industry’s most respected diagnostics, research, and educational support providing practitioners with actionable data from a partner they can trust. With over 25 years of experience, first as Great Plains Laboratory and now as Mosaic Diagnostics, we have been at the forefront of functional medicine testing, bringing clarity to complex health conditions and providing practitioner with the tools to create personalized treatment protocols.

Free marketing & promotional opportunities for companies, leaders and experts in the anti aging industry. Discover the benefits and value joining forces with Muscle & Fitness+ Educate & raise awareness about your product’s & services.

MyAdvice empowers business professionals to increase revenue through digital marketing. The platform enables hands-on control and visibility into performance, backed by 20+ years of expertise. MyAdvice provides a step-by-step plan for implementing tactics, including websites, local directories, client reviews, social media, SEO, and paid advertising. Learn more at myadvice.com.

Myers Cocktail Inc

Mymycolab, LLC

Natrusolate Americas Inc

Booth #8034

Booth #2067

Booth #4102

2816 11Th Street Ne, 301 Calgary, Alberta, T2E7S7 CA

17849 Hunting Bow Circle, STE # 102 Lutz, Florida, 33558 US

2343 Brittan Avenue, San Carlos, California, 94070 US

Ph: (403) 928-3624

Ph: (281) 796-1140, (561) 631-3901

Ph: (650) 346-7176

Email: tcs@nutragroupInc.com

Email: spenaranda@mymycolab.com

Email: mark@fenuseeds.com

www.myerscocktailoral.com

www.mymycolab.com

www.natrusolate.com

Myers Cocktail Oral Therapy (MCOT) takes the benefits of IV therapy to the next level, without the IV and into your home! MCOT is a nutraceutical powdered supplement that is therapeutically dosed to maintain micronutrient levels in the body, support human metabolism, ensure proper hydration, slow sarcopenia, and increase natural energy levels throughout the whole day. For anyone who is feeling “sick & tired,” MCOT is a costeffective solution to get you “well and energized.”

MyMycoLab is a blood serum testing laboratory that services patients and professionals globally. Our laboratory provides IgG and IgE antibody testing for 12 mycotoxins in the blood.

Natrusolate Americas is a company focused on marketing and selling innovative, sciencebacked, and doctor-formulated nutritional supplements for a better health span.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Mosaic Diagnostics

193

EXHIBITOR LISTINGS

NBX Wellness

Neo 7 Bioscience

Neobiosis LLC

Booth #7108

Booth #2039

Booth #1033

10921 E. Crystal Falls Pkwy, STE L901 Leander, Texas, 78641 US

539 W. Commerce St., STE 2886 Dallas, Texas, 75208 US

305 SW. 7Th Terrace, Gainesville, Florida, 32601 US

Ph: (866) 500-5388

Ph: (469) 619-7252

Ph: (352) 631-7440

Email: info@nbxwellness.com

Email: info@neo7bioscinece,com

Email: info@neobiosis.com

www.nbxwellness.com

www.neo7bioscience.com

www.neobiosis.com

Our goal at NBX Wellness is to empower health and wellness professionals because together, we thrive. We provide more than just supplements and testing services—we offer a way to scale business and revenue through a powerful eCommerce solution.

Neo7Bioscience specializes in the development of individualized peptide designs for patients with active diseases as well as for patients seeking to prevent disease and enhance longevity. Every custom design is based on genetic and expressed risk factors unique to each patient and guides the manufacturing of individualized peptide therapies.

As a biotechnology company, Neobiosis is focused on the development and manufacturing of innovative perinatal products for research and clinical trials.

Brain health leader since 2000

NES Health

NeuroScience - Sanesco

NMS Labs

Booth #6037

Booth #8091

Booth #1048

3702 West Spruce St., Tampa, Florida, 33607 US

375 280Th Street, Osceola, Wisconsin, 54020 US

200 Welsh Road, Horsham, Pennsylvania, 19044 US

Ph: (888) 242-5933

Ph: (888) 342-7272

Ph: (866) 522-2206

Email: customerservice@neshealth.com

Email: conference@neurorelief.com

Email: clinical@nmslabs.com

www.neshealth.com/en

www.neuroscienceinc.com

www.nmslabs.com

At NES Health, we believe in a comprehensive approach to wellness. Understanding that life is a symphony of information guiding energy, which in turn shapes our very being, we’ve developed technology and therapies that consider this intricate dance. While traditional medicine offers a wealth of knowledge, there are nuances it might miss. That’s where we step in, focusing on the body’s energy flow and the fields that influence our physiology.

NeuroScience is a family-owned, brain health leader with 23 years of expertise formulating impactful, comprehensive supplements that target the science behind sleep, stress, mood, cognition, and energy. NeuroScience also offers exclusive services to help healthcare providers streamline their supplement selection. Featuring access to laboratory assessments of neurotransmitter and hormone activity, Sanesco empowers providers with understanding and promoting Neuro-Endocrine health. With an outstanding user experience and tailored provider support, wellness journeys start with Sanesco.

NMS Labs is a clinical reference and forensic laboratory that is unsurpassed in its scope of PFAS, metals and exposure toxicology tests delivering the highest quality accurate results, scientific expertise, and innovation. The state-of-the-art CLIA certified laboratory staffed by more than 350 highly trained professionals. For more information on NMS Labs and to learn more about our clinical assays for Functional Medicine, please visit us at www.nmslabs.com.

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ANTI-AGING MEDICAL NEWS | WINTER 2023

NuBioAge, LLC

Booth #7042

Booth #8027

100 Park Avenue, FL 16 New York, New York, 10017 US

6625 S. Valley View Blvd., STE 222 LAS VEGAS, Nevada, 89118 US

8144 Okeechobee Blvd., UNIT A West Palm Beach, Florida, 33411 US

Ph: (480) 748-9797

Ph: (702) 405-7999

Ph: (855) 212-1997

Email: sales@novoslabs.com

Email: novusoptimum.sales@gmail.com

Email: info@nubioage.com

www.novoslabs.com

www.Novusoptimumlab.com

www.nubioage.com

NOVOS is consumer-longevity biotech offering the most powerful and proven over-the-counter solution to slow-down and track aging. Our threepronged approach gives consumers access to biological testing, scientifically-tested formulas, and extensive educational content to surpass the life expectancy norm by improving their overall health. NOVOS’ longevity solutions include NOVOS Core, Boost, and Age. NOVOS is on a mission to make the latest scientific advances in longevity accessible and achievable for all. #YoungerForLonger

A natural supplements company dedicated to the wellbeing and quality life of everyone of all ages.

NuBioAge is the only cellular medicine development resource lead by expert clinical pharmacists that offers collaborative, forward-thinking medical practitioners optimized health and wellness protocols designed to improve patience healthcare outcomes.

NuMedica

Nutrafol

Booth #7032

Booth #6105

Nutramax Laboratories Consumer Care, Inc.

9503 E. 55Th Place, Tulsa, Oklahoma, 74145 US

236 Fifth Avenue, 7th fl new york, New York, 10001 US

946 Quality Dr., Lancaster, South Carolina, 29720 US

Ph: (800) 869-8100

Ph: (212) 674-5312

Ph: (888) 886-6442

Email: mail@numedica.com

Email: partners@nutrafol.com

Email: contactus@nutramaxlabs.com

www.numedica.com

www.Nutrafol.com

www.nutramaxlabs.com

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

Nutrafol is the category creator of hair wellness, providing 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.

Avmacol® Extra Strength and Avmacol® Physician’s Formula are formulated with beta-glucans for immune health support. All versions of Avmacol® are manufactured in the United States from globally sourced ingredients and distributed by Nutramax Laboratories Consumer Care, Inc. Avmacol® is formulated with glucoraphanin and active myrosinase enzyme for sulforaphane production to help increase phase 2 enzyme activities essential for the elimination of certain toxins from the body. Avmacol® has been selected for numerous clinical trials in the US and other countries.

Booth #7110

ANTI-AGING MEDICAL NEWS | WINTER 2023

Booth #8074

EXHIBITOR LISTINGS

Novus Optimum Lab dba A. Best Supplements

NOVOS

195

EXHIBITOR LISTINGS 196

NutriDyn

Olympia Pharmaceuticals

Organo Leaf

Booth #5045

Booth #6013

Booth #4092

5414 Hwy.12, PO Box 219 Maple Plain, Minnesota, 55359 US

6700 Conroy Road, STE 155 Orlando, Florida, 32835 US

1720 Diplomacy Row, Orlando, Florida, 32809 US

Ph: (800) 444-9998

Ph: (407) 673-2222

Ph: (407) 730-4137

Email: info@nutridyn.com

Email: inquiries@olympiapharmacy.com

Email: info@organoleaf.com

www.nutridyn.com

www.olympiapharmacy.com

www.organoleaf.com

Our mission is to advance health and longevity through innovative clinical nutrition and education. We collaborate with trusted manufacturers who meet our high standards for quality assurance. Over 20,000 healthcare practitioners worldwide trust us for pure, potent, and effective products. Since the late 1970s, we have been pioneers in educating the industry, hosting conferences and workshops. Our goal is to support healthcare practitioners in improving patient lives through clinical nutrition. NutriDyn™ is your Partner in Health.

With our two separate, state-of-the-art facilities, Olympia supports both patient-specific and officeuse 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. We specialize in anti-aging, weight loss, IV nutrition, women’s health, and erectile dysfunction medications.

OrganoLeaf is a trusted name in the nutraceutical industry, offering quality products and reliable services to businesses and consumers alike. Allulose Gummies and Cannabinoids are among out best-selling products, providing health benefits that are backed by science. With our FDA registered facility and Good Manufacturing Practices, we ensure that you receive only the safest and purest products that meet the industry’s highest standards. We also offer, wholesale, white Label, and custom manufacturing Services.

Ortho Molecular Products

OxyHealth

PathRight Medical

Booth #4027

Booth #6021

Booth #3103

540 W. NW. Hwy., Barrington, Illinois, 60010 US

10719 Norwalk Blvd., Santa Fe Springs, California, 90670 US

1349 W. 760 N., Orem, Utah, 84057 US

Ph: (800) 332-2351

Ph: (562) 906-8888

Ph: (877) 228-5147

Email: contactus@ompimail.com

Email: events@oxyhealth.com

Email: support@pathrightmedical.com

www.orthomolecularproducts.com

www.oxyhealth.com

www.restorex.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.

OxyHealth has forever changed the way the medical industry practices hyperbaric therapy. Since our inception, we are devoted to providing quality and brilliantly safe portable hyperbaric chambers to physicians, professional athletes, wellness centers, and families. All OxyHealth chambers are designed for patients to easily self-treat, which has fostered a cutting-edge trend in hyperbaric technology.

RestoreX® Next Generation Penile Traction Therapy Device RestoreX was developed in cooperation with Mayo Clinic and was invented by a board-certified Urologist specializing in Men’s Sexual Health. RestoreX treats Peyronie’s disease as well as lost penile length resulting from urological surgeries and treatments or chronic disease. Learn more about the results you can expect using RestoreX for 2, 30-minute treatments/day for 12 weeks.

ANTI-AGING MEDICAL NEWS | WINTER 2023

PatientNow Pendulum Therapeutics

Performance Health Systems

Booth #9036

Booth #4045

Booth #2071

6833 S. Dayton Street, STE 1016 Greenwood Village, Colorado, 80112 US

933 20Th Street, San Francisco, California, 94107 US

401 Huehl Rd., STE 2A Northbrook, Illinois, 60062 US

Ph: (407) 793-9254

Ph:

Ph: (877) 877-5283

Email: sales@patientnow.com

Email: hcpinfo@pendulumlife.com

Email: info@powerplate.com

www.patientnow.com

www.PendulumLife.com

www.powerplate.com

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

Pendulum is improving the lives of millions by unlocking the power of the gut microbiome with evidencebacked probiotics you can’t find anywhere else.

Performance Health Systems specializes in delivering advanced technology solutions through its health and wellness equipment, including Power Plate and bioDensity. Our expertise is grounded in years of product innovation, published scientific research and evidence-based practice.

Pharmanex / Get Healthy USA

Physician Compounding Alliance

Physicians Lab Inc.

Booth #2055

Booth #8038

Booth #1022

2251 N. Rampart Blvd., 353 Las Vegas, Nevada, 89128 US

9319 Springview Loop, Estero, Florida, 33928 US

4850 T-Rex Ave., STE 150 Boca Raton, Florida, 33431 US

Ph: (561) 972-1122

Ph: (719) 201-9268

Ph: (877) 316-8686

Email: drsteve@gethealthyusa.net

Email: drinfo.pca@gmail.com

Email: info@physicianslab.com

www.go.gethealthyusa.net

www.PhysicianCompoundingAlliance.com

www.PhysiciansLab.com

Pharmanex offers an end-to-end solution of objective assessment, nutrigenomics, and product solutions coupled with the ability to monitor a patient’s progress while adding significant cash revenue to the practice. Featured on the Discovery Channel, Yale University, and the Dr. Oz Show.

PHYSICIAN COMPOUNDING ALLIANCE enables Physicians to Dispense Compounded Drug Therapies Directly to their Patients “at point-of-care”, thereby Improving Patient Compliance, Convenience and Clinic Revenues. RETAIN INCOME YOU NOW GIVE AWAY.

Physicians Lab is one of the nation’s leading urinary hormone testing laboratories, delivering State-of-the-art Science with Superior Solutions. We beat the competition in price and turnaroundtimes, while providing accurate, reliable LC/MS/ MS results. With our tools, education, and training, we give you everything needed to offer patients convenient, affordable, and error-free testing.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

PatientNow

197

Your ultimate healthy aging

BIOHACK Repair age-related damage with 36+ cellular benefits of fatty15, your revolutionary supplement that’s 3x better than omega-3.*

Order today at fatty15.com Nerd out at DiscoverC15.com

HUMAN STEM CELL TECHNOLOGY FOR REGENERATIVE AESTHETICS

2023 A4M LONGEVITYFEST LAS VEGAS BOOTH #9021 FOUND EXCLUSIVELY AT LOVEBEAUTYPRO.COM.*

*Love Beauty Pro & Medical is the official exclusive US distributor for LC Cell's Renew, Bright, Hair, AntiAging Kit, Dual C, and Hair Solution.

Stronger Together 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 a network of physicians who've realized there's more to medicine.

Join our network of integrative and functional healthcare providers who share your passion.

855.976.5578 joinforumhealth.com forumhealth.com

Visit Booth #1060

Nitric Oxide The Science of Age Defiance brought to you by

We Know Nitric Oxide

EXHIBITOR LISTINGS

N1o1.com

PhysioAge

PlusCBD™ Oil by CV Sciences

Pneuma Nitric Oxide LLC

Booth #3114

Booth #7074

Booth #5032

30 Central Park South, 8A New York, New York, 10019 US

9530 Padgett Street, STE 107 San Diego, California, 92129 US

2407 S. Congress Ave., STE E-134 Austin, Texas, 78704 US

Ph: (212) 776-4956

Ph: (855) 758-7223

Ph: (877) 4-PNEUMA

Email: info@physioage.com

Email: help@pluscbdoil.com

Email: support@pneumanitricoxide.com

www.physioage.com

www.pluscbdoil.com

www.PneumaNitricOxide.com

The ultimate software platform for assessment, treatment, and monitoring outcomes in longevity medicine. Our algorithms calculate the physiological age of 10 important body systems by comparing individual results against our database of 6,000 patients. Tracking physiological age over time provides a clear and detailed profile of the individual aging process. 800+ Biomarkers Explained and Tracked AI-Driven Personalized Recommendations Validated Biomarkers of Aging -Physioage, CardioAge, PhenoAge, TruAge, GlycanAge and more.

Since 2014, CV Sciences™ has been in the business of developing, producing, marketing and selling consumer hemp extracts containing cannabidiol (CBD). Their primary focus is on developing trusted, high-quality consumer products under the industryleading brand, PlusCBD™ Oil, which sells to numerous markets including health care practitioners, natural product retailers, and functional food sectors. CV Sciences™ is committed to providing hemp derived CBD products that are proven to be both safe and effective through clinical research and data.

Pneuma Nitric Oxide, LLC was established to commercialize scientifically proven nitric oxide based technologies for use in skin care and cosmetics. Our mission is to revolutionize the beauty industry through the development of products that improve blood flow and circulation to the skin based on the production of nitric oxide. There are no such products currently on the market. Our technology connects wellness to beauty.

Practitioner Depot PNOE, Inc.

Power2Practice

Practitioner Depot

Booth #3070

Booth #1062

Booth #8036

67 Maplewood St., Malden, Massachusetts, 02148 US

601 S. Saginaw St., 5Th Fl, Flint, Michigan, 48502 US

11365 Sixth St. E., Treasure Island, Florida, 33706 US

Ph: (650) 670-4450

Ph: (331) 645-2310

Ph: (513) 966-5877

Email: kostas@pnoe.com

Email: sales@power2practice.com

Email: contact@practitionerdepot.com

www.pnoe.com

www.power2practice.com

www.practitionerdepot.com

PNO_ enables health professionals to provide sciencebacked bio-optimization through breath analysis. For 100+ years, breath analysis (AKA metabolic testing, VO2max) has been the gold standard in anti-aging quantification, nutrition prescription, and evaluation of most critical systems, including the heart, lungs, cells, and nervous system. Until recently, it was only available in sophisticated clinics and regarded as the most valuable but underutilized assessment in medicine. PNO_ changed that through the first easy-to-use clinical-grade breath analysis device and metabolic expert support.

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.

With so many different sources for supplements and labs stuck behind complicated application forms and far from transparent pricing....We set out to create a solution for Practitioners looking to help their patients with world-class supplementation and labs in a singular place. Welcome to Practitioner Depot.

202

ANTI-AGING MEDICAL NEWS | WINTER 2023

Precision Compounding Pharmacy

Precision Diabetes, Inc.

Booth #4021

Booth #9026

Booth #2099

3138 NE. Rivergate ST, #301c McMinnville, Oregon, 97128 US

2657 Merrick Rd., Bellmore, New York, 11710 US

5540 Centerview Drive,, STE 200 Raleigh, North Carolina, 27606 US

Ph: (503) 687-2050

Ph: (516) 833-6262

Ph: (919) 641-5546

Email: marketing@dutchtest.com

Email: compounding@precisionpharmacy.net

Email: jbutton@precisiondiabetesinc.com

www.dutchtest.com

www.precisioncompoundingpharmacy.net

www.precisiondiabetesinc.com

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.

Precision Compounding Pharmacy is a technology enabled pharmacy supporting DTC telemedicine companies by offering fulfillment They have full API integration and are licensed in 45 states.

Precision Diabetes, Inc. is an emerging leader in enabling precision medicine for diabetes through the use of novel diabetes biomarkers and algorithms. Our mission is to revolutionize the diagnostic assessment of diabetes by providing unique diabetes tests, spanning the risk of developing diabetes to developing diabetes complications. Precision Diabetes’ is the exclusive supplier of the GlycoMark test and partnered with Patia Europe to distribute a new type 2 diabetes genetic test, DIABETESpredict, and a genetic test for gestational diabetes, Matergen.

Premier Research Labs

Prestige Products Direct

Prism Light Pod

Booth #8043

Booth #9051

Booth #8015

3500 Wadley Place, BLDG B Austin, Texas, 78728 US

12440 SW. 117 Ct., Miami, Florida, 33186 US

13303 E. Adams Aircraft Circle, Englewood, Colorado, 80112 US

Ph: (800) 325-7734

Ph: (305) 234-8081

Ph: (720) 231-5384

Email: info@prlabs.com

Email: triaddirect@gmail.com

Email: infoprismlightpod@gmail.com,

www.prlabs.com

www.triadaer.com

www.prismlightpod.com

Premier Research Labs (PRL) merges quantum healing and biomedicine to provide comprehensive, clinically tested dietary supplements specifically developed to meet the needs of healthcare practitioners. Globally recognized as the leader in cellular resonant formulations, PRL ensures premium quality through in-house, advanced laboratory testing and 3rd party verification of each ingredient from raw material to finished product. Unlock the body’s healing potential with micronutrient-rich whole-food nutrition and experience the power of cellular resonance for optimal well-being.

Triad Aer. Professional Air Purification system

Prism Light Pod is the industry’s leading producer of whole-body red light therapy solutions for the natural health and wellness industry. We design, manufacture, sell, and service the most-innovative and awardwinning red light therapy solutions for maximizing energy and wellness throughout the body. Prism Light Pod has the most-powerful and energy-efficient whole-body red light therapy systems that offer natural solutions to aid in weight-loss and anti-aging, relieve chronic pain and inflammation, and accelerate the body’s natural recovery process 4-10 times.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Precision Analytical Inc.

203

EXHIBITOR LISTINGS

Private Practice Brokers

Procell Therapies LLC

Prodrome Sciences

Booth #4032

Booth #5079

Booth #8100

636 US Highway 1, STE 103 North Palm Beach, Florida, 33408 US

8868 Research Blvd., Austin, Texas, 78758 US

40880 County Center Drive, STE R. Temecula, California, 92591 US

Ph: (561) 832-9222

Ph: (855) 577-6235

Ph: (951) 550-0505

Email: rcave@sunbeltnetwork.com

Email: info@procelltherapies.com

Email: info@prodrome.com

www.privatepracticebroker.com

www.procelltherapies.com

www.prodrome.com

Private Practice Brokers specializes in the valuation and confidential sale of longevity clinics, anti-aging centers, and medical spas. Our partners have over 30 years of experience owning and operating age management centers, as well as successfully facilitating hundreds of small business transactions. We take a consultative approach in order to quietly sell your practice at the right price. We excel at guiding clients through seamless transitions, including initial valuation, confidential marketing, contract negotiations, due diligence support, and more.

Microchanneling and growth factor serums skincare supplier

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.

Professional Health Products

ProgenaBiome

ProHealth Longevity

Booth #7103

Booth #8089

Booth #8116

2104 Babcock Blvd., Pittsburgh, Pennsylvania, 15209 US

1835 Knoll Dr., Ventura, California, 93003 US

555 Maple Ave., Carpinteria, California, 93013 US

Ph: (412) 760-1115

Ph: (805) 339-0549

Ph: (800) 366-6056

Email: hlord@phpltd.com

Email: drhazan@progenabiome.com

Email: customerloyalty@prohealth.com

www.phpltd.com

www.progenabiome.com

www.prohealth.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.

Who we are A genetic sequencing research laboratory dedicated to continuing the work of the late Dr. Finegold, who recognized the power of anaerobic bacteria and spent his life correlating microbes to diseases. Our mission Crack the genetic code of a trillion bacteria, fungi and viruses that live in our gut. Our hopes Find cures to diseases that we feel are caused by alteration of the gut flora, following the vision and pioneer work on Fecal Transplant of Dr. Borody.

Since 1988, ProHealth Longevity has provided consumers with top-quality supplements that are rigorously tested to guarantee purity, potency and efficacy. We believe that science-backed supplementation is an important part of every longevity goal. In addition to our incredible line of specialized, research-proven formulations, we provide breaking news in longevity research and personal on-line nutrition advice. ProHealth Longevity’s wholesale and affiliate programs make our products available at discounted prices to qualified businesses and healthcare professionals.

204

ANTI-AGING MEDICAL NEWS | WINTER 2023

Protocol For Life Balance

PUR-FORM

Booth #5072

Booth #9055

Booth #6042

10349 Los Alamitos Blvd., Los Alamitos, California, 90720 US

244 Knollwood Drive, Bloomingdale, Illinois, 60108 US

3600 Fau Blvd., STE 101 Boca Raton, Florida, 33431 US

Ph: (562) 326-5720

Ph: (877) 776-8610

Ph: (561) 368-1880

Email: info@promedbeauty.com

Email: sales@protocolforlife.com

Email: info@purformhealth.com

www.promedbeauty.com

www.protocolforlife.com

www.purformhealth.com

ProMed Beauty has exclusive global relationships, best-in-class technology, and end-to-end support, we empower the best aesthetic providers to achieve more. Coolifting, Apollo Duet, Ace of Face, Blossom ultraNano, Oligio (mono-polar RF), Blossom B-BWT and now introducing MoreNova (intimate rejuvenation for male/female) are a few of our amazing products.

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

At PUR-FORM, we strive to redefine the boundaries of healthcare by merging science, art, and compassion. Our goal is to utilize regenerative medicine to empower our patients to live their best lives, radiate confidence, and embrace wellness at every level. We train other physicians to do the same by administering EBO2, extracorporeal blood oxygenation & ozonation, to reduce inflammation and heal from within.

Push Patch

Qest, LLC

Qualgen

Booth #9032

Booth #9047

Booth #2079

3683 Garden Court Grove City, Grove City, Ohio, 43123 US

70 W. Canyon Crest Road, 100 Alpine, Utah, 84004 US

301 Enterprise Dr., Edmond, Oklahoma, 73013 US

Ph: (937) 840-8769

Ph: (801) 209-2454

Ph: (405) 562-8805

Email: Regenerativekits@gmail.com

Email: nate@qest4.com

Email: sales@qualgen.us

www.pushpatch.com

www.qest4.com

www.qualgen.us

Push Patch the industry leader in the use of iontophoresis technology for the delivery of peptides and coenzymes that may be beneficial for a variety of different conditions. By utilizing the slow release and direct to bloodstream advantage of iontophoresis clinicians are able to maximise the time under dose and pharmacokinetics of a variety of these products that in most situations have very short half lives thus making other methods of administration of the exact same products less than ideal.

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.

At Qualgen, Quality is in Our Name. As an FDA registered 503B outsourcing facility, we house state-of-the-art sterile labs meeting stringent cGMP standards. Our expansive selection features premium compounded bio-identical hormone pellets, including estradiol and testosterone. Renowned for our commitment to quality products, we empower healthcare providers to elevate patient care. With same-day shipping, seamless account setup, and unwavering customer service, Qualgen ensures that quality is not just our name, but our promise.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

ProMed Solutions, Inc.

205

High Profitabi I ity Deliberate Design - Multiple (9) Speed Settings - Precise Infinite Dial - Market-leading Torque - Patent pending ISO Seal - Plug-in Digital Motor - Ergonomic and lightweight medical grade aluminum

- Excellent ROI - Quick treatment time - Lowest cost per procedure of FDA cleared microneedling devices - Various combination treatment options

Remarkable Results - Proven to be safe and effective for all skin types - Naturally stimulates collagen and elastin production - Rejuvenates the skin - Improves the appearance of fine lines and wrinkles

body

rejuvapen � �lL�c�.lJo?e�

refineusa.com I BSS-59O-5533 Schedule your free Rejuvapen NXT® demonstration, TODAY!

THE FUTURE OF PHARMACY "Quality, aﬀordable pharmacy care delivered to your door"

Revive RX is a premier licensed compounding and mail order pharmacy that supports 36 states. We focus on treating the source and not just the symptoms. Unlike commercialized medicine, we use industry-leading technology to optimize your treatment. We collaborate with the most innovative pharmacists, healthcare providers, and pharmaceutical manufacturers to provide the highest quality of care to our patient. We oﬀer the following unique therapy options: Hormone Optimization

Anti-Aging

Fertility

Weight loss

Peptide Therapy

Nutrition

Sexual Performance

Custom Compounded Formulas

For Sales Inquiries Email: info@reviverx.com or call 888-689-2271

The most comprehensive anti-aging supplement ever created!

Supports mitochondria, nitric oxide,

methylation, redox, metabolic and immune function.

Improves patient compliance, reduces ‘pill burden’, and saves $2500 annually over purchasing separately on-line

SAVES PATIENTS MONEY Packed with 30 key ingredients! Formulated by a committee of expert doctors and pharmacists.

Top Quality! Made in the USA under FDA cGMP standards. no GMO, fillers or preservatives

Retail Price: $99 (Single) or $79 ea for 6 or more Medical Professional Price: $49 Available only through medical professionals!

Email: longevityxfactors@gmail.com Phone/Text: 800-644-9431 Website:longevityxfactors.com

Quartermaster Tax Management, LLC

Quest Diagnostics

Booth #1064

Booth #6054

1309 Coffeen Ave., STE 4702 Sheridan, Wyoming, 82801 US

805 Trade St. NW., STE 101-A Concord, North Carolina, 28027 US

6701 Carnegie Ave., Cleveland, Ohio, 44103 US

Ph: (484) 222-9351

Ph: (704) 490-4111

Ph: (216) 767-3638

Email: info@quantiom.org

Email: info@quartermastertax.com

Email: Diane.Downing@Impact-XM.com

www.quantiom.org

www.quartermastertax.com

www.Questdiagnostics.com

Quantiom is a global impact health and wellness movement creating an innovative healthcare shift into Energy Science, where ancient wisdom and technology meets modern science. Our mission is to redirect the pre-defined notions of “medicine”, shifting instead to a verifiable Energy Science platform of energy, frequency, and vibrational medicine. Quantiom offers an innovative platform of globally recognized, advanced Energy Science modalities and bioinformation protocols that assist to restore, regenerate, revitalize, and rebalance the physical, mental, emotional, and spiritual energetic body.

Quartermaster Tax Management is a proactive tax management firm that elevates our clients’ financial well-being through collaborative services designed to reduce taxes, increase revenue, profits and net worth, through proactive tax planning and Research & Development credits.

As the world’s leading provider of diagnostic information services, our employees work every day to uncover insights about your body that empower you with the information you need to make your healthcare decisions count.

Quicksilver Scientific

Qunol

RaDoTech

Booth #5021

Booth #7085

Booth #3111

1960 Cherry St., Louisville, Colorado, 80027 US

10 Bloomfield Ave., Building B Pine Brook, New Jersey, 07058 US

228 Wiswall Rd., Newton, Massachusetts, 02459 US

Ph: (303) 531-0861

Ph: (561) 660-1409

Ph: (617) 429-1139

Email: support@quicksilverscientific.com

Email: kim.hassett@mkmkting.com

Email: usa@radotech.com

www.quicksilverscientific.com

www.qunol.com

www.radotech.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.

Result-Focused Products include Heart Health, Joint Health, Rest and Recover, Bone and Nerve Health, and Better Sleep supplements. “It’s our mission to bring best results with the best ingredients.”

Production and distribution of personal health scanner and supplements

Quantiom Energy Science

EXHIBITOR LISTINGS

Booth #8095

210

ANTI-AGING MEDICAL NEWS | WINTER 2023

Recharge Biomedical

Red Light Wellness

Booth #7039

Booth #8090

Booth #7073

330 3 Harbor Blvd., STE D-10 Costa Mesa, California, 92626 US

3980 Wilshire Boulevard, UNIT 735 Los Angeles, California, 90010 US

4515 Miami Street, Saint Louis, Missouri, 63116 US

Ph: (949) 870-2692

Ph: (714) 369-8633

Ph: (314) 772-7000

Email: jeff@rapidrelease.com

Email: drpark@rechargebiomedical.com

Email: info@redlight-wellness.com

www.rapidreleasetech.com

www.rechargebiomedical.com

www.RedLight-Wellness.com

High Speed Vibration Therapy precisely targets fascia and connective tissue for quick relief of aches, pains and restrictions. Short wavelength provides comfortable treatment on extremities, joints, tender and bony areas, easing or eliminating restrictions, tightness, knots, trigger points, stress and tension. Your ease of movement is paramount, so you can do the things you love to do, maintain your independence, and thoroughly enjoy this “Dance of Life”. The future of pain relief is here.

Recharge Biomedical provides three things: Concierge regenerative medical care using exosomes in five states (CA, NY, FL, TX, & HI) Distributor Sales of exosomes to health care providers Provider online education for clinical use of exosomes (12 hours online)

We manufacture and distribute photobiomodulation (PBM) equipment. With over 40 years in the lighting and wavelength industry, our hard-earned knowledge has led the industry with medical-grade, commercial equipment built for heavy usage in doctor offices, sports facilities, and medspas. Our 360 beds are designed to deliver optimal therapeutic results with powder-coated steel, plug-in components, and easy-to-maintain housing. Our devices will be the highest return on your investment.

Redd Remedies

ReeLabs Private Limited

Refine USA

Booth #7071

Booth #7072

Booth #8037

211 S. Quincy Ave., Bradley, Illinois, 60915 US

1St Floor, K.K. Chambers, Sir P.T. Road, Fort, Mumbai, Maharashtra, 400001 IN

340 3Rd Ave South, STE C Jacksonville Beach, Florida, 32250 US

Ph: (888) 453-5058

Ph: (91) 9820180076

Ph: (866) 590-5533

Email: customercare@reddremedies.com

Email: aps@reelabs.com

Email: support@refineusa.com

www.reddremedies.com

www.reelabsanti-ageing

www.refineusa.com

Why the name Redd Remedies? Redd means “to put in order”, which is exactly what we do at Redd Remedies. We deliver natural health solutions to help you put your health in order. Our formulations are created by our very own Master Herbalist and are backed by our Purity Promise to ensure we deliver only the highest quality ingredients and that you’re getting exactly what’s on the label in every bottle!

ReeLabs (India) has devoted the past decade to establish itself as a recognised authority in the field of stem cells and regenerative medicine. ReeLabs is committed to the idea of utilising the potential of stem cells to change people’s lives. We firmly believe that stem cells are the future for prevention of age related organ and tissue degeneration. ReeLabs has numerous national and international patents granted, showcasing its unique, proprietary stem cell processing and application protocols including anti-aging.

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

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Rapid Release Technology LLC

211

EXHIBITOR LISTINGS

ReGen Pod

Regenative Labs

Rejuvenation Science

Booth #1030

Booth #4047

Booth #4039

921 Main Street, Louisville, Colorado, 80027 US

1700 West Main St., STE 500 Pensacola, Florida, 32502 US

5334 TORRANCE BOULEVARD, 2nd FL Torrance, California, 90503 US

Ph: (303) 641-4100

Ph: (800) 891-3452

Ph: (310) 798-2830

Email: info@regenpod.com

Email: info@regenativelabs.com

Email: Roxanne@rejuvenation-science.com

www.regenpod.com

www.regenativelabs.com

www.Rejuvenation-Science.com

Biophotonica is dedicated to creating the best light therapy products, including the ReGen Pod and ReGen Laser. We prioritize science, engineering, and user feedback in the development of our healthcare and wellness solutions. Our core values emphasize ethical practices and the enhancement of well-being through PhotoBioModulation (PBM). The ReGen Pod and ReGen Laser reflect our commitment to quality and innovation, offering advanced solutions for improved health. Join us on the path to wellness with Biophotonica’s pioneering PBM technology.

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

Presenting MMM Theory: A new Paradigm in Medicine: The Inflammation Treatment Book - Revealing the Root Cause of Disease, Its Prevention, and Treatment. #1 new release on Amazon in Preventive Medicine and Gastroenterology categories. Supplements supporting MMM (microbial mucosal milieu) Theory include Diversity Probiotics, Detox Probiotics, 12hour Colostrum, Cellular Optimizer, & Maximum Vitality – the anti-toxicant multi. Please visit us for book signing and to learn more about MMM Theory. Supplements available for private labeling.

solutions for life Relax Saunas of Momentum

Relicus Medical Holdings LLC

Researched Nutritionals

Booth #9041

Booth #7038

Booth #4015

3509 N. High St., Columbus, Ohio, 43214 US

10601 N. Frank Lloyd Wright Blvd., STE 115 Scottsdale, Arizona, 85259 US

PO Box 224, Los Olivos, California, 93441 US

Ph: (626) 200-8454

Ph: (602) 316-1063

Ph: (805) 693-1802

Email: moment98@aol.com

Email: info@relicusmedical.com

www.relaxsaunas.com

www.relicusmedical.com

Email: customerservice@ researchednutritionals.com

Relax Saunas are portable, personal far-infrared saunas that improve blood circulation, reduce inflammation, and relieve pain. They also are an effective way to raise your core body temperature. Studies show that increasing your body temperature activates and enhances the immune system. Relax Saunas feel warm instantly and cause a detoxifying sweat, faster, and at a lower temperature than traditional saunas do. Relax Saunas make you sweat profusely in less than 15 minutes.

A premiere retail health acquisitions company specializing in regenerative and longevity medicine. If you are looking for an exit and a healthy collaboration for your Anti-Aging, Longevity, Med Spa, Regenerative, Aesthetic, Anti-Aging, and Wellness Practice or Company, we can provide you with the answer. We are actively screening successful practices or companies and offering secure options for the future.

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www.researchednutritionals.com Researched Nutritionals® is known for peer-reviewed, published clinical research on their formulations that prove efficacy your patients will feel.

Revers

Revive RX Pharmacy

Booth #4099

Booth #2095

Booth #7093

9777 Pyramid Court, STE 230 Englewood, California, 80112 US

661 E. Palisade Ave., STE # C3 Englewood Cliffs, New Jersey, 07632 US

3831 A Golf Dr., Houston, Texas, 77018 US

Ph: (480) 326-4765

Ph: (718) 640-6787

Ph: (888) 689-2271

Email: sales@revcustomrx.com

Email: info@naturezymes.com

Email: info@reviverxpharmacy.com

www.revcustomrx.com

www.reversu.com

www.reviverx.com

Revelation Pharma is a national network of 503A and 503B compounding pharmacies providing innovative and quality pharmacy preparations and services through “industry best” patient care and solutions for customers.

“ReVeRs Clinical Health Recovery Program gives you the power to change yourself from within by returning your cells to the days before years of unhealthy habits. By utilizing fermentation and natural enzymes, ReVeRs triggers the human body’s most fundamental way of self-healing: autophagy. Then new, healthy, properly functioning cells can be made, replacing the older, malfunctioning cells with years of damage. This serves as a reset for the whole body, and you will get another opportunity to start new lifestyle.

Revive RX is a premier licensed compounding and mail order pharmacy. We focus on treating the source and not just the symptoms. Unlike commercialized medicine, we use industry-leading technology to optimize your treatment. We collaborate with the most innovative pharmacists, healthcare providers, and pharmaceutical manufacturers to provide the highest quality of care to our patient. We offer unique therapy options: Hormone Optimization, Fertility, Peptide Therapy, Sexual Performance, Anti-Aging, Weight loss, Nutrition, and custom compounded formulas.

Rupa Health

Rx Harmony | The JOI Group

SALT Chamber Inc.

Booth #3021

Booth #8072

Booth #3115

177 Townsend St., #528 San Francisco, California, 94107 US

45 Technology Parkway S., STE 225 Peachtree Corners, Georgia, 30092 US

120 NW. 11Th Street, Boca Raton, Florida, 33432 US

Ph: (954) 821-7917

Ph: (770) 838-3570

Ph: (855) LUV-SALT

Email: hello@rupahealth.com

Email: info@thejoigroup.com

Email: hello@saltchamberinc.com

www.rupahealth.com

www.thejoigroup.com

www.SALTChamberinc.com

Rupa Health, the best way to order functional and integrative tests from 30+ lab companies. Order, track, and get results from over 3,000 tests in one place. Effortlessly order labs and scale your practice with no pre-existing lab accounts! We provide patient support, so you can streamline your ordering altogether. Rupa is FREE for practitioners: Sign up to receive a special conference first order coupon only at: www.rupahealthconferences (expires 1/31/24). We’re bringing root cause medicine to everyone on the planet!

Rx Harmony is a management services organization that connects doctors, pharmacies, and patients to enhance the patient experience while reducing practitioners and staff workload. With clinical programs for men’s health, women’s health, peptides, sexual function, and weight loss, we act as an extension of your practice to remove the burden of prescription management, billing, and patient support so you can enjoy predictable, recurring revenue and restore your joy for practicing medicine.

SALT Chamber is a pioneer and innovator of salt therapy, a natural and holistic way of improving respiratory and skin health. SALT Chamber offers a range of products and services, from designing and building customized salt rooms, to providing highquality halogenerators, SALT Booths, salt decor, and salt therapy equipment. SALT Chamber has completed more than 3,500 salt therapy projects worldwide. SALT Chamber is the world’s authority for educating, consulting, marketing, training, and distributing the best salt therapy products and services.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Revelation Pharma

213

EXHIBITOR LISTINGS

seca

SeeBeyond™ Medicine

SelfDecode

Booth #6092

Booth #6047

Booth #5038

13601 Benson Avenue, Chino, California, 91710 US

2 Overhill Rd., STE 260 Scarsdale, New York, 10583 US

13727 SW. 152Nd Street, STE 896 Miami, Florida, 33177 US

Ph: (800) 542-7322

Ph: (914) 722-9440

Ph: _(949) 328-4072

Email: info.us@seca.com

Email: info@seebeyondmedicine.com

Email: support@selfdecode.com

www.secambca.com

www.seebeyondmedicine

www.selfdecode.com

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

Welcome to SeeBeyond, an elite concierge medicine service. We provide 24/7 access and guaranteed same-day appointments, eliminating barriers to healthcare. Rooted in Functional Medicine, we use specialty testing to tailor a unique treatment plan focusing on nutrition, supplements, lifestyle, and prevention. With a dedicated Care Team including a Provider, Health Coach, and Patient Concierge, we offer personalized care in a safe and comfortable space. Experience a new level of healthcare at SeeBeyond Medicine, where you are at the center.

SelfDecode is the world’s only AI genomics software that provides personalized health recommendations. Find out which supplement, diet and lifestyle changes you should make based on your DNA, labs and lifestyle.

Sexual Wellness PLATELET-RICH FIBRIN MATRIX (PRP

PRFM)

Centers of America

Sexual Wellness Centers of America

SignatureMD

Booth #2045

Booth #7062

2436 Emrick Blvd., Bethlehem, Pennsylvania, 18020 US

6225 Colleyville Blvd., STE 100 Colleyville, Texas, 76034 US

6001 Broken Sound Pkwy, STE 340 Boca Raton, Florida, 33487 US

Ph: (877) 735-7495

Ph: (214) 556-1300

Ph: (561) 309-5242

Email: info@selphyl.com

Email: info@swcoftexas.com

Email: Sales@signaturemd.com

www.selphyl.com

www.swcofusa.com

www.SignatureMD.com

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. 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.

Sexual Wellness Centers of America is the only patent holder for reversing Erectile Dysfunction, REGENmax. We proudly enjoy a 97.6% efficacy rate and are now selling licenses to perform REGENmax to physicians and practitioners nationwide.

SignatureMD enables physicians and patients to partner in the pursuit of optimal health and wellbeing. We enable physicians to remain independent and focus on creating relationships with patients that are based on understanding and trust. At SignatureMD, we pride ourselves on developing customized concierge medical programs that meet the individual needs of both physicians and patients. Our concierge program does not require affiliated physicians to terminate patients, but rather provides patients options that best fit their personal goals and objectives.

Selphyl PRFM Booth #2049

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Sinclair

Slate Technology Inc.

Booth #7070

Booth #8042

Booth #2118

1396 W. 200 South, STE 2C Lindon, Utah, 84042 US

1239 Broadway, STE 1103 New York, New York, 10001 US

10 W. 15Th Street, STE 321 New York, New York, 10011 US

Ph: (385) 212-4044

Ph: (888) 415-1192

Ph: (917) 796-1100

Email: Sales@SilverCeuticals.com

Email: marketing.usa@sinclair.com

Email: Alan@slatetech.net

www.silverceuticals.com

www.sinclair.com

www.slatetech.net

SilverCeuticals utilizes the most modern and effective nano-silver technology which we implement into immune products, beautifying and healing cosmetics, oral care products, and more. All these products assist us in fulfilling our purpose to help alleviate suffering worldwide.

Sinclair is an international company operating in the fast growth, global aesthetics market. Sinclair has built a strong portfolio of differentiated, complementary aesthetics technologies, which are experiencing significant growth, targeting unmet clinical needs for effective, high quality, longer duration, natural looking and minimally invasive treatments. The Group has an established sales and marketing presence in North America, the EU markets, Brazil, Mexico, Colombia, UAE, Hong Kong and South Korea, and a network of international distributors.

Design, manufacture & Install the newest technology in the field of LED signage for all indoor & outdoor applications....including but not limited to residential home cinemas, commercial development retail, convention halls, sports stadiums,. We apply our technology to the medical field, automotive etc.

Sleep America

SmartGraft by Vision Medical, Inc.

Sofwave

Booth #2119

Booth #3099

Booth #6090

5158 Clareton Drive, #26 Agoura, California, 91376 US

46 Regency Plaza, Glen Mills, Pennsylvania, 19382 US

1211 Puerto Del Sol, STE 200 San Clemente, California, 92673 US

Ph: (844) 744-9448

Ph: (610) 680-7676

Ph: (855) 763-9283

Email: office@sleep-america.com

Email: sales@smartgraft.com

Email: info@sofwave.com

www.sleep-america.com

www.SmartGraft.com

www.sofwave.com/physicians

Sleep-America provides concierge level, 3rd party validated - home sleep testing. We are patient centric taking care of your patients in a professional manner. Our team of board certified sleep specialists are licensed in 50 states. Our streamlined process helps you identify, test and treat patients with Obstructive Sleep Apnea. In addition to testing, we provide CPAP therapy ensuring continuity of care, creating positive outcomes for your patients.

SmartGraft by Vision Medical Inc. alongside hair regenerative partner, LOCKrx Hair Support products, collectively offer long-term successful innovations toward the advancement and treatment of hair loss. Minimally invasive and non-invasive medical aesthetic and hair restoration technologies include ingestible, topical, and surgical solutions to physicians and patients on six continents.

Sofwave™ breakthrough, non-invasive Synchronous Ultrasound Parallel Beam Technology SUPERB™ FDA-cleared to lift the eyebrow, lift submental tissue, improve facial lines and wrinkles. Sofwave™ is also FDA-cleared for the improvement in the appearance of cellulite.

SLEEP-AMERICA.COM

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

SilverCeuticals Inc.

215

EXHIBITOR LISTINGS

SottoPelle

Source One Beauty

Stemregen

Booth #8066

Booth #8109

Booth #5102

8412 E. Shea Blvd., STE 101 Scottsdale, Arizona, 85260 US

1735 Fasana Rd., Duarte, California, 91010 US

1205 Sheldon Cove Building # 1, STE # H2 Austin, Texas, 78753 US

Ph: (480) 874-1515

Ph: (877) 716-7770

Ph: (833) 525-9436

Email: response@sphrt.com

Email: info@source1beauty.com

Email: care@stemregen.co

www.sottopelletherapy.com

www.source1beauty.com

www.stemregen.co

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

We are a trusted supplier of treatment chairs and beds for a variety of procedures and practices. Our treatment and exam chairs are comfortable, aesthetically pleasing, offer a variety of features and are available is several color combinations to match your practice, all while being affordable. We are a family-owned company and we pride ourselves in unmatched customer service and after-sale support. We own the Spa Numa brand, which means we stock all parts and service our own warranty.

Kalyagen is a paradigm-shifting company that pioneered natural plant-based biotech products that support stem cell function and promote cellular regeneration. Its flagship product, STEMREGEN, is the most potent plant-based stem cell enhancer that supports the body’s innate ability to repair, bringing the regenerative power of adult stem cells to anyone, anywhere.

in seconds. on demand. Strive Pharmacy

Sunlighten

Swish30 / Doctors Nano

Booth #8055

Booth #4064

Booth #7119

1275 E. Baseline Rd., STE 104 Gilbert, Arizona, 85233 US

7373 W. 107Th Street, Overland Park, Kansas, 66212 US

6130 W. Flamingo Rd., STE 865 Las Vegas, Nevada, 89103 US

Ph: (801) 913-8796

Ph: (877) 292-0020

Ph: (888) 321-1235

Email: mike@strivepharmacy.com

Email: Biz@sunlighten.com

Email: lukeskyms@pm.me

www.strivepharmacy.com

www.sunlighten.com

www.DoctorsNano.com

Strive is flipping the script on personal medicine. We’re an exceptional compounding pharmacy, and we’re more than that. We’re on a mission to positively disrupt the healthcare industry as we know it. Don’t settle when it comes to your health. Strive.

Sunlighten® is the industry leader in personalized infrared light treatment. Since 1999, Sunlighten has been committed to innovating wellness products that empower its customers to improve their quality of life. Its patented SoloCarbon® sauna heater technology rejuvenates the body by delivering the highest dose of infrared energy at a cellular level. Sunlighten has built a global community to support each other along the way and bring light, hope, and happiness to people all over the world.

Glutathione Next Era’ in seconds, on demand. Swish30® and PrimaSkin® feature HydraStat® nano-delivery for internal and skin transformation. This patent-pending technology crafts ultra-pure water for water-cluster protection of nano particles. This increases bioavailability and transference into the organic cell, producing exceptional outcomes. Doctors Nano LLC team advisors champion these revolutionary health and beauty advances with professional retail distribution and total support for wellness, performance and longevity clinics. Registered trademarks held by Biotech Nutritional Sciences, LLC.

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Synerchii

TA Sciences

Booth #3109

Booth #3078

Booth #5007

1600 Landmark Drive, Cottage Grove, Wisconsin, 53527 US

1100 South Coast Hwy., STE 206A Laguna Beach, California, 92651 US

7975 N. Hayden Rd., STE C-101 Scottsdale, Arizona, 85258 US

Ph: (608) 640-8633

Ph: (714) 713-4531

Ph: (212) 588-8805

Email: info@synca-wellness.us

Email: drlaura@synerchii.com

Email: info@tasciences.com

www.synca-wellness.us

www.synerchii.com

www.tasciences.com

Premiere manufacturer of Japanese design and manufactured massage chairs. As a manufacturer, our quality control and service network cannot be matched by anyone. Visit our booth to see the difference in massage quality with our Synca Wellness (Fujiiyroki of Japan) 5DAI Made in Japan massage chairs.

SynerChii comes in a Liposomal-Micellized easy and highly absorbable liquid you consume by the spoonful or put in your smoothies, coffee, AM cereal, etc… We combine the Omega-3 DHA with the best and most powerful form of vegan Vit E or Vit D-3 available combining the supplements the body needs most benefiting your brain, eyes, skin, cardiovascular system, etc.

T.A. Sciences® is dedicated to creating researchbased, clinically tested wellness products to address telomere shortening through the science of Telomerase Activation. T.A. Sciences® is the leader in the field of Telomere Biology and spends over $1 million each year on cutting edge scientific research and has produced 5 double-blind, placebocontrolled studies in humans and 11 peer reviewed published clinical studies proving the safety and effectiveness of its premiere product TA-65®.

Tailor Made Compounding

Tatt2Away

Booth #3085

Booth #4112

Texas Star Pharmacy and Wellness Center

200 Moore Drive, Nicholasville, Kentucky, 40356 US

4 North Main Road, Hurricane, Utah, 84737 US

3033 W. Parker Rd., STE 100 Plano, Texas, 75023 US

Ph: (859) 887-0013

Ph: (855) 252-2929

Ph: (972) 519-8475

Email: support@tailormadecompounding.com

Email: itsus@tatt2away.com

www.tailormadecompounding.com

www.tatt2away.com

Email: marketingcontacts@texasstarpharmacy.com

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

Tatt2Away is a non-laser tattoo removal patented technology that removes up to 35% of the ink from your tattoo, skin each treatment! ]Tatt2Away works by physically removing the ink from the skin through the TEPR technique. This allows for the effective removal of a broader range of ink colors and may require fewer sessions compared to laser treatments. However, the best method for tattoo removal depends on the individual’s specific tattoo and personal preferences.

ANTI-AGING MEDICAL NEWS | WINTER 2023

Booth #8078

EXHIBITOR LISTINGS

Synca Wellness

www.texasstarpharmacy.com Texas Star Pharmacy is built on one philosophy; that our patients’ health and well-being are our primary focus. We are committed to delivering the best quality solutions for our patients’ health at the best possible cost. We ensure the best solutions through our compound pharmacy, allowing us the ability to create new medications suited for your needs.

217

EXHIBITOR LISTINGS

Thaena Inc.

The Aesthetic Guide

The DNA Company

Booth #1042

Booth #2094

Booth #8047

5951 E. 18Th St., STE # 110 Vancouver, Washington, 98661 US

36 Discovery, STE 170 Irvine, California, 92618 US

1217 6Th St., STE 2b Norco, California, 92860 US

Ph: (503) 506-8732

Ph: (212) 600-3490

Ph: (805) 732-6857

Email: info@thaena.com

Email: info@theaestheticguide.com

Email: clientcare@thednacompany.com

www.thaena.com

www.theaestheticguide.com

www.thednacompany.com

Thaena®: It Takes an Ecosystem to Heal an Ecosystem™. With its flagship, stool-derived dietary supplement, ThaenaBiotic®, Thaena is on a mission to reduce human suffering by leveraging the therapeutic potential of the human microbiome. Femalefounded and PNW-based, Thaena®’s ecosystem approach informs all it does as it continues to shift the paradigm of traditional medicine through the products it creates, the education it shares, and the research it pushes. Join the ecosystem today.

The Aesthetic Guide covers the latest developments in aesthetic medicine as well as comprehensive product comparisons, clinical roundtable discussions and practice development strategies. The Aesthetic Guide is the most influential global print and digital publication in the field of aesthetic medicine.

The DNA Company is a leading provider of personalized genetic testing and analysis services. Our comprehensive approach combines cuttingedge science with advanced technology to unlock the secrets of your DNA, enabling personalized health insights and actionable recommendations. Experience the power of genetic knowledge to optimize your well-being with The DNA Company.

LUXURY WELLNESS AND MINDFULNESS RESORT

The Girlfriend Doctor

The Soul Resort

The Upsize Clinic

Booth #8062

Booth #2103

Booth #7091

133 Center Street, Saint Simmons Island, Georgia, 31522 US

99/9 Village #10, Song khon, Kaeng Khoi Saraburi, Saraburi, 18110 TH

5 Medical Plaza Dr., STE 150 Roseville, California, 95661 US

Ph: (904) 452-8432

Ph: (66) 99 7821777

Ph: (916) 347-7755

Email: team@drannacabeca.com

Email: info@thesoulresort.com

Email: info@UpsizeMatters.com

www.drannacabeca.com

www.thesoulresort.com

www.UpsizeMatters.com

Whether you are before, during or after menopause. I’m the first call for women who have questions she would only ask her best girl friend, if her best friend was a triple board certified OB-GYN. I’m an expert in: Hormones & Menopause Integrative Medicine, and Anti-aging and Regenerative Medicine Functional Medicine Sexual Health Bioidentical Hormone Replacement Therapy Longevity and Performance Optimization for both men and women

The Soul resort is the first wellness and mindfulness destination that blends the world of luxury to the world of harmony. The location is within reach of unseen pristine mountain so sacred and private. The vibration from dedicated meditation retreat nearby where thousands of people come to practice gives undeniably peaceful vibe. Guests will be embedded among the beauty of eye catching architecture in every detail and empowered by special Gurus session that Dr. Robert Goldman have experienced first hand.

The Upsize Clinic provides non-surgical male enhancement, male-focused sexual enhancement, and cosmetic services. We are the inventors of The Upsize Procedure and provide training to healthcare practitioners throughout the country.

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Therasage

Thermi Aesthetics

Booth #2061

Booth #8044

Booth #3060

10411 Motor City Drive, STE 615 Bethesda, Maryland, 20817 US

9730 Variel Avenue, LA, California, 91311 US

4719 S. Congress Ave., Autstin, Texas, 78745 US

Ph: (240) 442-1919

Ph: (888) 416-4441

Ph: (512) 637-6745

Email: office@therawellness.us

Email: support@therasage.com

Email: CustomerServiceCelling@thermi.com

www.therawellness.us

www.therasage.com

www.thermi.com

THERA WELLNESS™ 5 - in - 1 Biofield Technology delivers non-invasive energy therapy to address a great number of issues. With over 800 applications you can create highly targeted and personalized therapies to help your clients achieve faster results. • Non-invasive • Fast results for your clients • Easy to learn • Over 40 years of experience with energy healing • Made in Germany

Therasage is the gold standard in integrated infrared technology with over 20 years of first-hand experience in the development and manufacturing of cuttingedge infrared wellness products. Harnessing the benefits of nature through red light frequencies, full infrared spectrum, negative ions, grounding, natural bamboo, non-toxic materials, the elimination of harmful EMFs, ELFs and RFs, and our interface of natural gemstones and earth elements, Therasage has pioneered healing devices like no other in the world!

Thermi’s radio frequency devices are designed to make skin appear smoother, utilizing temperature-controlled radio frequency technology to gently heat targeted areas of the skin and naturally stimulate collagen. Thermi is the maker of ThermiVa, ThermiSmooth, and ThermiTight. Best-in-class procedures that bring multiple revenue streams in one system. We believe that healthy skin is beautiful skin, which is why we only offer the premier radio frequency technology.

THOR

Timeline Nutrition

Toolbox Genomics

Booth #6043

Booth #5037

Booth #9039

8375 Jumpers Hole Road, STE 110 Millersville, Maryland, 21108 US

1160 Battery Street East, STE 100 San Francisco, California, 94111 US

2901 W. Bluegrass Blvd., STE 200 Lehi, Utah, 84043 US

Ph: (877) 355-3151

Ph: (888) 631-3359

Ph: (877) 400-0824

Email: mark.granic@thorlaser.com

Email: care@timelinenutrition.com

Email: info@toolboxgenomics.com

www.novothor.com

www.timelinenutrition.com

www.toolboxgenomics.com

THOR is revolutionizing pain management and injury recovery through the use of red and nearinfrared light. Our customers include Navy Special Warfare, the US Air Force, US Special Forces, and dozens of professional sports teams. THOR is partnered with renowned institutions including the Department of Veterans Affairs, Harvard Medical School, the University of Pennsylvania, and New York University. When it comes to red light therapy, THOR is the recognized leader in the field.

Timeline® Nutrition is a Swiss longevity brand committed to delivering products, backed by cutting edge science, which help promote cellular health by targeting the biological pathways that prolong healthspan. Timeline powered the postbiotic Mitopure®, a Urolithin A supplement clinically-proven to trigger a well conserved anti-aging pathway in the human body, improving cellular bioenergetics and increase muscle strength and endurance. See our clinical trials and learn more about Timeline Nutrition at www.timelinenutrition.com

ToolBox Genomics is the first DNA company to offer DNA Health & Wellness, Epigenetics and Pharmacogenomics all in one. With one swab, your patient can access over 1 million snps worth of information, conveniently packaged into precurated panels that provide insights, supplement, diet and further testing recommendations. For individuals looking to use insurance, we now take insurance for pharmacogenomics! Is white labeling of interest? We have you covered! You can customize the report, landing page, kit & much more.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Thera Wellness Solutions, Inc.

219

EXHIBITOR LISTINGS

TouchMD

Trinity School of Natural Health

Trocar Supplies

Booth #1037 & 6115

Booth #2101

Booth #9023

99 N. Main Street, STE 7 Cedar City, Utah, 84720 US

220 Parker Street, Warsaw, Indiana, 46580 US

126 Nulf Dr., Columbiana, Ohio, 44408 US

Ph: (435) 867-0077

Ph: (800) 428-0408

Ph: (937) 478-0469

Email: hello@touchmd.com

Email: info@trinityschool.org

Email: trocarsupplies@gmail.com

www.touchmd.com

www.trinityschool.org

www.trocarsupplies.com

TouchMD™ is your words, images, and patient education curated into a beautifully branded app for iPad, or Windows touchscreen devices. Guide your prospective patients through important decisions with gorgeous, high-resolution videos, images, and text curated by you. Using our photography module, personalize patient photos photos by drawing and annotating during consultations and saving directly to your their myTouchMD app to reflect upon later. Take your consultation from good to great with and deliver the elegant, impactful experience your patients expect.

Trinity School of Natural Health, Inc. is a nonprofit founded in 1991. We provide people with hope, solutions, and support to transform their lives and improve the world. We offer LODs, Live Events, and Merchandise.

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 researchbased 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 hormone pellet therapy.

Troscriptions

TruDiagnostic

TrueBinding

Booth #2065

Booth #7066

Booth #6091

4695 Chabot Drive, STE 200 Pleasanton, California, 94588 US

881 Corporate Drive, Lexington, Kentucky, 40503 US

300 Lincoln Centre Dr., STE 200 Foster City, California, 94404 US

Ph: (925) 558-2717

Ph: (833) 963-1700

Ph: (650) 847-1117

Email: admin@snhlife.com

Email: support@trudiagnostic.com

Email: info@truebinding.com

www.troscriptions.com

www.trudiagnostic.com

www.truebinding.com

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 multi-omics specialty that defines and delivers the standard of care for health, not disease.

TruDiagnostic is a leading health data company and CLIA-certified laboratory that specializes in epigenetic testing and research. We are transforming the healthcare potential of epigenetic data into actionable applications and aim to improve people’s lives by arming patients and physicians with novel biological insights; enabling them to make the right lifestyle and medical decisions through information found in the fluid epigenome. Our TruAge biological aging tests provide the most in-depth results, and multi-omic correlations to accelerated aging.

TrueBinding Inc. is a pioneering clinical-stage biotherapeutic company at the forefront of creating groundbreaking molecules to address a wide spectrum of challenging medical conditions. We focus on neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and ALS, as well as stroke, metabolic disorders, oncology, and other areas with significant unmet medical needs, dedicated to advancing therapies that hold the potential to transform patient outcomes.

220

ANTI-AGING MEDICAL NEWS | WINTER 2023

Tyrian

U.S Jaclean, Inc.

Booth #3061

Booth #8102

Booth #8033

PO Box 8512, Pittsburgh, Pennsylvania, 15220 US

PO Box 148, Hinton, Iowa, 51024 US

1816 W. 135Th St, Gardena, California, 90249 US

Ph: (412) 668-3831

Ph: (800) 235-2673

Ph: (800) 5241-2221

Email: mlioon@trugen3.com

Email: contact@tyrianhealth.com

Email: sales@usjaclean.com

www.trugen3.com

www.tyrianhealth.com

www.daiwamassage.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, conditionspecific nutritional supplements. Every product is backed by the highest ethical standards and clinically-researched ingredients and available only through certified health care professionals.

Tyrian is a health and wellness company founded in 2017, although it’s true “roots’’ began many years previously with the discovery of a remarkable berry called Aronia. This relatively unknown superfruit is native to the U.S. and contains some of the highest levels of antioxidants and polyphenols found in nature. All of the founders at Tyrian proudly grow and harvest Aronia because we care about giving the consumer the highest quality ingredients possible – right from our own orchards.

One of the leading massage chairs distributors in the US. Our mission: To improve the health and wellness through quality products that can be used from the comfort of home.

Ulta Lab Tests

You Order the Test. We’ll Do the Rest!

Uberlube

UBlockout

Ulta Lab Tests

Booth #2104

Booth #2111

Booth #3036

7316 Ridgeway, Skokie, Illinois, 60076 US

10580 Newkirk St., STE 301 Dallas, Texas, 75220 US

9237 E Via de Ventura, STE 102 Scottsdale, Arizona, 85258 US

Ph: (773) 454-5188

Ph: (626) 496-2733

Ph: (480) 681-4081

Email: med@uberlube.com

Email: hello@ublockout.com

Email: contactus@ultalabtests.com

www.uberlube.com

www.ublockout.com

www.Ultalabtests.com

Uberlube Luxury Lubricant Samples Available Not harmful to healthy bacteria or pH levels Physician recommended, used in OB-GYN practices Cruelty free with no animal products and vegan friendly No alcohol, no gluten, no glycerin, no parabens, no scents and flavors Latex safe Made in USA Uberlube for Sex: smooth and silky, never sticky Uberlube for Sport: long lasting anti-chafe Uberlube for Style: finish hair with a perfect understated sheen

Our journey began in 2017 when our first-generation blackout solution ‘ScreenAway’ became a runaway success in Australia. _ Responding to global demand, we evolved and continued to innovate to deliver a more accessible, more effective and more user-friendly solution. _ UBlockout is the Ultimate Blackout Solution for better sleep. Based in Dallas, we’re on a mission to provide exceptional experiences for our customers. Great care is taken with every product we make and every interaction we have with our customers.

Trusted by over 60,000 doctors, Ulta Lab Tests is a premier digital lab testing platform. It provides physicians with a seamless, comprehensive, and economical lab testing solution. With the capability to order from a catalog of more than 2,000 tests via a user-friendly portal, physicians can manage testing efficiently. Ulta also provides up to 90% discount on patient self-pay prices and offers additional income opportunities for test reviews. Ulta Lab Tests enhances patient care and helps doctors expand their practice.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

TruGen3

221

WELLNESS NETWORK

Pharmacists specializing in

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A deep understanding of cellular medicine is essential in combining supplementation, small molecules and peptide therapy for optimal patient outcomes. For more information, please call (855) 212-1997 or visit nubioage.com

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EXHIBITOR LISTINGS

University Compounding Pharmacy

US Biotek Laboratories

Vale Medical

Booth #7013

Booth #5039

Booth #8021

1875 3Rd Ave., San Diego, California, 92101 US

16020 Linden Ave. N., Shoreline, Washington, 98133 US

7231 S. 900 East, STE 200 Midvale, Utah, 84047 US

Ph: (800) 985-8065 x5700

Ph: (206) 365-1256

Ph: (800) 699-9570

Email: customersupport@ucprx.com

Email: info@usbiotek.com

Email: carmine@valemedical.com

www.ucprx.com

www.usbiotek.com

www.valemedical.com

UNIVERSITY COMPOUNDING PHARMACY (UCP) a nationally recognized leader in drug and device therapies. For 30 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 INHIBITORS- BIOIDENTICAL 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, inhalant, and microbiome testing and the most convenient collection method for organic acids, environmental pollutants tests utilizing dried urine.

Vale Medical is the leading provider of shockwave technology by STORZ Medical, the world leader in shockwave. We represent the full line of STORZ products, including the Masterpuls One, D-Actor 50, D-actor 100, Duolith Sd-1 T-Top, and Magnetolith (EMTT). Our state-of-the-art shockwave devices offer non-invasive treatment options that are highly effective, safe, and reliable. With our advanced technology and range of devices, clinicians can address a wide range of conditions, getting patients better faster.

Vertisis Custom Pharmacy

VibraGenix LLC

Vibrant Wellness

Booth #2044

Booth #8086

Booth #7033

9343 E. Bahia Drive, STE 200 Scottsdale, Arizona, 85260 US

1119 Columbia Park Trail, Richland, Washington, 99352 US

3521 Leonard Ct, Santa Clara, California, 95054 US

Ph: (303) 476-3447

Ph: (800) 761-0511

Ph: (866) 364-0963

Email: matthewb@vertisis.com

Email: Info@vibragenix.com

Email: support@vibrant-wellness.com

www.vertisis.com

www.VibraGenix.com

www.vibrant-wellness.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.

VibraGenix is a revolutionary, one of a kind healing technology, infusing Sound Frequency Medicine with Sonic Vibration. Over 1000 frequency formulas bridging Western, Naturopathic and Eastern Medicine are included in this comprehensive devise. Manufactured in the US, VibraGenix sets an unrivaled standard for delivery of comprehensive Rife, TBSW Brain balancing, Scalar Wave technology, Ancient Tones, Chakra balancing, Pain management, Mental Health, Anti-Aging and Rapid Recovery from injury and training. Comprehensive technology in one device!

Vibrant Wellness is a leading biotech company based in Santa Clara, CA, delivering life-transforming lab testing that enables health and wellness providers to discover the root of patient health issues. We’re at the forefront of modern medicine and research, providing personalized health analytics using cutting-edge, high-quality technology. We believe that anyone can achieve better health and vibrant longevity through individualized solutions based on testing—not guessing.

224

ANTI-AGING MEDICAL NEWS | WINTER 2023

° T.H.R.E.A.D.S 40.6402° n, 73.9061° W

Vintage Labs Collection

Viola Threads

Vita Aid Professional Therapeutics

Booth #9028

Booth #3094

Booth #7049

3027 Bond Drive, Merrick, New York, 11566 US

605 Medical Device Complex Center 200 Gieopdosi-Ro, Jijeongmyeon, Kangwon-do, 26354 ROK

#302-20285 Stewart Crescent, UNIT 303 Maple Ridge, British Columbia, V2X 8G1 CA

Ph: (82) 31 777 3900

Email: info@vitaaid.com

Ph: (516) 524-6267 Email: support@vintagelabscollection.com

Email: info@violathreads.com

www.vintagelabscollection.com

www.violathreads.com

Full service professional grade supplementation fulfillment and private labeling

www.vitaaid.com With over 20 years of experience in the nutraceutical industry, we pride ourselves on delivering clinically effective therapeutics to healthcare professionals. Our work starts with a thorough screening process on every raw material, following pharmacopeial standards, to eliminate the risk of adulteration and contamination. We earn clinician’s trust through strict quality system and synergistic formulas yielding consistent results.

VitaminLab

Wave Neuroscience

Wavi Medical

Booth #4036

Booth #9059

Booth #1066

619 Discovery St., Victoria, British Columbia, V8T5G4 CA

1601 Dove St., STE # 205 Newport, California, 92660 US

3857 Steele St., STE 1293 Denver, Colorado, 80205 US

Ph: (778) 288-5509

Ph: (760) 484-0144

Ph: (713) 823-1945

Email: prosupport@getvitaminlab.com

Email: contact@waveneuro.com

Email: info@wavimed.com

www.getvitaminlab.com

www.waveneuro.com

www.WAVimed.com

VitaminLab revolutionizes supplements, empowering health practitioners like you to create personalized formulations that address each patient’s unique needs. Improve compliance by crafting a custom blend using a selection of 200+ meticulously sourced, highquality, bioavailable ingredients. Our integrations with testing partners like CSS, IGS and Genova help you uncover new deficiencies and give specific dosage recommendations needed to improve health symptoms. Say goodbye to overwhelming options and hello to a new era of personalized supplement solutions.

Wave Neuroscience is elevating brain healthcare for your practice with a turn-key platform that brings precision personalized care to all of your patients. Wave’s approach pinpoints abnormal default mode network activity using a rapid 10-minute EEG recording. This data is used to generate an individualized brain health report & frequency and location specific protocol for Transcranial Magnetic Stimulation therapy.

The WAVi device provides objective brain health measurements. It empowers you, the dedicated healthcare provider, to delve into the depths of objective biomarkers - unveiling intricate details and offering insights that subjective tests cannot. With WAVi, observe the unseen and obtain instantaneous and valuable information that is essential for informed clinical decision-making. WAVi bolsters your ability to anticipate and adeptly address a plethora of brain and behavioral health concerns, contributing to enhanced patient outcomes and satisfaction.

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Viola Threads offers a wide range of competitivelypriced, high-quality and fully biodegradable threads for medical aesthetic practitioners. These threads are available in various shapes, sizes, and materials. Our PDO threads have obtained US FDA 510(k) Clearance (#K190264) for barbed suture. Viola Threads are suitable for various treatment areas on the face and body, such as enhancing facial contour, boosting volume, reducing wrinkles and fine lines, and lifting sagging skin tissue for a rejuvenated appearance.

Ph: (800) 490-1738

225

PLASMALOGEN R E P L E N I S H M E N T

E X P L A I N E D

Hi, I am a neural cell..

This is my axon membrane covered by a protective myelin sheath.

My Plasmalogens can get worn out over time, leaving a degraded myelin sheath. How? Read below.

Here’s a close up of my myelin sheath cell membrane made up of phospholipids - which is where I stash my Plasmalogens.

My myelin sheath can be degraded by time as you age, trauma such as concussions, diseases such as Alzheimer’s and Dementia and defects such as MS and Autism. When my myelin sheath goes, so does your optimal cognitive and neurological function. Your health depends on strong and healthy cells - and everything in them.

Welcome to my new best friends, Prodrome Glia™ & Prodrome Neuro™ Plasmalogens from Prodrome Science.

But it’s not too late! With my plasmalogens replenished, my myelin sheath feels good as new - which leads to healthy nervous, cardiovascular, and respiratory systems.

Prodrome Glia helps rebuild the membranes of the myelin sheath and thus protects and tunes the signals in nerve-tonerve communication throughout your body.

Prodrome Neuro enhances the membrane of the nerve cells which includes the cell body, dendrite, and synaptic bulb membranes - to name a few. This is critical for neurotransmitter release and fusion between two nerve cells - which effectively cranks up the volume for every cell in your body.

To order or learn more about C I E N C E Plasmalogens callS or visit:

S C I E N C E

951-550-0505 l www.prodrome.com

Unique Formulas from Protocol For Life Balance®

Ache Action™

Methyl-Action Methyl-A

• Unique Botanical Blend • For Occasional Minor Aches & Pains of Overexertion* • With Clinically Validated AprèsFlex®

• New Unique B-complex & Betaine Formula • Helps Maintain Homocysteine Levels Already Within the Normal Range* • With Clinically Validated Quatrefolic®

Protocol For Life Balance® is a well-researched, potent, and efficacious brand of high-quality dietary supplements and natural products sold through licensed healthcare practitioners. protocolforlife.com • 877-776-8610 • sales@protocolforlife.com

Family Owned and Operated *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.

EXHIBITOR LISTINGS

Wellness Pharmacy

Wells Pharmacy Network

WETHRIVV LLC

Booth #1036

Booth #1047

Booth #6061

3401 Independence Dr., STE 231 Birmingham, Alabama, 35209 US

3420 Fairlane Farms Rd., STE 300 Wellington, Florida, 33414 US

3805 Old Easton Road, #305 Doylestown, Pennsylvania, 18938 US

Ph: (800) 227-2627

Ph: (561) 793-1568 x2631

Ph: (877) 676-8875

Email: info@wellnesspharmacy.com

Email: info@wellsrx.com

Email: amy@wethrivv.com

www.wellnesspharmacy.com

www.wellsrx.com

www.wethrivv.com

With over 55 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 is a privately held, nationwide, compounding pharmacy specializing in solutions for wellness and anti-aging medicine including: Bio-Identical Hormone Replacement Therapy, Peptide & Regenerative Therapies, Weight Management, Sexual Wellness, Aesthetic Dermatology and Thyroid & Adrenal Health. This includes operating a 20,000SF 503A pharmacy and a 21,000SF FDA Registered 503B Outsourcing Facility that produces bulk medication. Our mission is to elevate compounding industry standards through a unique combination of superior science and service.

Dive into the future of beauty with WETHRIVV®! We’re not just any aesthetics brand - we’re a unique blend of scientists, tech gurus, marketing mavens, and product pioneers. Our commitment? Innovating best-in-class skincare and hair health solutions just for you. Curious? Enthusiastic? So are we! Come, experience the difference at our booth. Let’s thrive together in beauty and beyond!

Woodbridge Pharmacy

Worldhealth.net

Y LIFT

Booth #7067

Booth #2100

Booth #5033

4950 Barranca Pkwy, STE 102 Irvine, California, 92604 US

1510 W. Montana St., Chicago, Illinois, 60614 US

2 E. 61St St., STE 413 New York, New York, 10065 US

Ph: (949) 857-2141

Ph: (773) 528-6100

Ph: (212) 861-7787

Email: prshealthgroup2@gmail.com

Email: members@worldhealth.net

Email: info@ylift.com

www.woodbridgerx.com

www.worldhealth.net

www.store.ylift

We are an independent full-service 503A non-sterile compounding pharmacy proudly serving patients state-wide throughout California. We specialize in creating custom medications for our patients’ individualized treatment plans and offer bioidentical hormone replacement therapy, dermatological cosmetics, ED solutions, pain management, thyroid prescriptions, and veterinary preparations. We utilize state-of-the-art lab equipment and compounding techniques to ensure that our preparations meet the highest quality standards in the industry. Our services include free shipping, customized prescription banks and next day turn-around time.

Worldhealth.net is the original voice of the American Academy of Anti-Aging, Preventative, and Regenerative Medicine (A4M) and is dedicated to the advancement of healthcare technologies and transformations that can combat chronic diseases associated with aging. Co-founded by Dr. Ronald Klatz and Dr. Robert Goldman, WHN seeks to disseminate information concerning innovative science and research as well as treatment modalities designed to improve the human healthspan and prolong the human lifespan.

Y LIFT is a leading medical technology and training company geared with the comprehensive Y LIFT portal that provides medical professionals a central place to shop, learn, and teach from anywhere in the world. Y LIFT has developed cutting edge minimally invasive procedures such as the renowned Y LIFT, SurgYlift, and MagnYm and offers Live and online training in these cutting edge procedures via the Y LIFT portal.

228

ANTI-AGING MEDICAL NEWS | WINTER 2023

Zemits

Zimmer MedizinSystems

Booth #2042

Booth #4071

Booth #4100

1730 S. Federal Hwy, # 301 Delray Beach, Florida, 33483 US

4101 Ravenswood Rd., STE 103A Ft. Lauderdale, Florida, 33312 US

3 Goodyear, STE B Irvine, California, 92618 US

Ph: (407) 729-3423

Ph: (888) 999-3996

Ph: (800) 327-3576

Email: service@younggoose.com

Email: brand.manager@zemits.com

Email: info@zimmerusa.com

www.younggoose.com

www.advance-esthetic.us

www.ZimmerUSA.com

Founded in 2017 with the goal of introducing science to the skin care industry, Young Goose has developed bio-hacking treatments that use NAD+ elevation and gene activation (Sirtuins) for anti-aging and skin repair. With our diverse team of researchers, we ensure every single product is backed by decades of proven science from around the globe. Young Goose is dedicated to reinventing skin regeneration with the help of advancing cellular science, and creating breakthrough treatments that are genetically programmed to work!

Zemits LLC is dedicated to providing you with the finest MedSpa Equipment to tailor a wide variety of your needs. Our mission is to support your MedSpa to boost your business with the highest quality products, outstanding customer service, and a lifetime of client support.

Zimmer MedizinSystems in Irvine, California, with its parent company in Neu-Ulm, Germany, has over 50 years of expertise in manufacturing high quality medical devices. Zimmer MedizinSystems’ flagship products, Z Wave and our Cryo family of devices, utilize advanced Radial Pulse Therapy and Cryo Therapy technologies. The company has set the gold standard for Cryotherapy and skin cooling systems and is introducing the new Cryo 7 and the water-cooled, ultra-quiet Z Wave Q.

Zizion Group Inc.

ZRT Laboratory

Booth #5085

Booth #7007

141 NW. 20Th Street, STE G1 Boca Raton, Florida, 33431 US

8605 SW. Creekside Pl., Beaverton, Oregon, 97008 US

Ph: (561) 221-1000

Ph: (503) 466-2445

Email: A4M@Zizion.com

Email: info@zrtlab.com

www.zizion.com

www.zrtlab.com

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

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

ANTI-AGING MEDICAL NEWS | WINTER 2023

EXHIBITOR LISTINGS

Young Goose LLC

229

A Future Without Forgetting FDA-Approved

Expanded Access Program (EAP)

Cash-pay No start-up costs Providers may charge as desired

650-847-1117 info@truebinding.com www.Truebinding.com

TB006: A Breakthrough Alzheimer’s/Dementia Treatment

Stunning Potential to Reverse Dementia and Alzheimer’s! Attend our workshop Thursday December 14, 6:15pm in Veronese 2404 to learn more!

Come visit us at BOOTH 6091

One-stop shop to support your practice. With over 5,000 products available, McGuﬀ provides healthcare professionals with high-quality wholesale medical supplies, pharmaceuticals and compounded drugs.

Medical Products 503B Compounded Drugs

Same-Day Order Processing

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mcguff.com/ASCOR

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Save up to 20% on

The Akkermansia Company Healthy Weight with Glucose Control TM

Buy 6 or more bottles of select products and receive 10% off; buy 12 or more and receive 20% off†

Metagenics invites you to take advantage of this special offer to help you integrate what you’ve learned into your practice. Contact our customer service staff or your Metagenics representative to place your order today! †

Customer service 800.692.9400

Maximum order value of $5,000. This offer valid on The Akkermansia Company Healthy Weight with Glucose Control, Berberine GT, UltraFlora® Control, and Wellness Essentials® Healthy Balance only. Offer cannot be combined with other offers.

Promo code A4MAD23

*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.

Offer expires 12/14/23-1/14/24

A Partner

You Can Trust Wells Pharmacy Network is a privately held nationwide compounding pharmacy specializing in wellness, anti-aging, weight management, sexual wellness, aesthetic dermatology and thyroid and adrenal health.

www.wellsrx.com Main Phone: (800) 622-4510

ELEVATE YOUR PRACTICE WITH GAINSWAVE® Unlock New Revenues and Expand Patient Care Horizons.

JOIN THE GAINSWAVE® REVOLUTION – TRANSFORMING LIVES ONE PATIENT AT A TIME!

WHY GAINSWAVE®?

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Attract Patients: Distinguish your practice by

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offering cutting-edge solutions for Erectile

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innovative shockwave therapy to enhance blood

with GAINSWave®!

flow and tissue health without invasive procedures or drugs. Boost Revenue: Introduce a sought-after service that not only improves patient well-being but also contributes to your practice's financial growth.

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Total Gut Restoration The Proven Gut Health Support Solution

Total Gut Restoration is a comprehensive 3-month program designed to support restored gut health. Protocols that address only one aspect of gut health are often ineffective. Combined support from three unique supplements in Total Gut Restoration promotes a healthy gut, including maintaining a healthy microbial ecosystem and a protective gut barrier. The Total Gut Restoration program is supported by research, proven by practice, and approved by clients.**

The Total Gut Restoration program employs this triple-action approach**

Maintain a diverse microbial ecosystem

Promote a healthy gut mucosal barrier

Support the gut-associated immune system

What’s in the Total Gut Restoration Program? 1

Recondition

MegaSporeBiotic™ is the trendsetting 100% spore-based probiotic shown to RECONDITION the gut by promoting greater microbial diversity and encouraging health-supportive gut bacteria growth.**

Reinforce

MegaPre™ Precision Prebiotic™ REINFORCES the health-supportive microbial changes created by MegaSporeBiotic™.**

Rebuild

MegaMucosa™ is innovative mucosal support formulated to REBUILD a healthy mucosal barrier and promote optimal immune function in the gastrointestinal mucosa.**

Visit us at microbiomelabs.com to order your Total Gut Restoration kit today!

**These statements have not yet been evaluated by the Food and Drug Administration (FDA). Products and claims are not intended to diagnose, treat, cure, or prevent any disease.