Physician Training . . .
Accredited. Insightful. Evidenced-Based. 

Module 1: Introduction to Age Management Medicine
1 Day
10 AMA PRA Category 1 Credits™

Discover the scope, theory and practice of age management medicine (AMM), including the synergistic components, nutrition and exercise. The course discusses preventive medicine (including risk factors and the role oxidation and inflammation play in degenerative diseases) and describes evaluation of the aging adult and laboratory panel.

Prior to arriving at the training site, three home-study sections must be completed, using the home-study materials, which include tests:

At the training site, you will personally experience a Clinical Executive Health Evaluation: complete physical exam, fitness and flexibility measurements, DEXA scan, hormone panel appropriate for gender, CBC, Chem 20 screen, HbA1C, serum insulin, homocysteine, serum iron, lipid panel, CRP, TIBC and U/A. 

Module Content

  • Definitions and disease targets

  • Cancer – age and risk-appropriate screening, e.g., colonoscopy, mammogram, Indole-3-Carbinol, lycopene, melatonin, omega 3 fatty acids

  • Diabetes mellitus – hemoglobin A1c, insulin resistance/insensitivity, percent body fat

  • Cardiovascular disease – LDL cholesterol, fiber, over-the-counter alternatives, HDL cholesterol and triglycerides, lipoprotein(a), homocysteine, C reactive protein, Metabolic Syndrome

  • Osteoporosis – bone densitometry (dual energy X-ray absorptiometry), pharmaceutical agents

  • Dementia – neurochronometric analysis

  • Diet and nutrition – minimum protein requirement, glycemic index, glycemic load, saturated, monounsaturated, polyunsaturated, trans fats

  • The exercise prescription



Outcome Objectives

After completing this module, the physician will be able to . . .

  • Comprehend the scope of AMM, rooted in nutrition, endocrinology and disease-risk management

  • Identify risk factors for chronic degenerative disease, including oxidation and inflammation

  • Describe the optimal balance of protein, carbohydrate and fat to delay the onset of degenerative disease

  • Describe the relationship of glycemic load (GL) to glycation, advanced glycation end-product (AGE) formation, oxidative stress, and degenerative disease

  • Describe the relationship of GL to serum lipoproteins and cardiovascular risk

  • Describe the role of fat and protein in limiting GL and managing cardiovascular risk

  • Describe GL and its relationship to blood glucose control

  • Calculate the GL of any carbohydrate, given the parameters of total carbohydrate and fiber content

  • Identify foods carrying a high GL and those with a low GL

  • Identify patients with Metabolic Syndrome and formulate a lifestyle approach for treatment

  • Review findings in the literature, regarding the value of exercise in the treatment and prevention of chronic disease

  • Formulate an exercise prescription for several patients

Module 2: Clinical Training
3 Days
34 AMA PRA Category 1 Credits™

Experience hands-on clinical training in a state-of-the-art patient care facility, acquiring diagnostic and treatment skills necessary to add AMM into your new or existing practice.

•  Hormonal Evaluation of the Aging Male
•  Hormonal Evaluation of the Aging Female
•  Human Growth Hormone Evaluation for Adult Onset GHD

You’ll work alongside faculty, becoming familiar with hands-on patient care. Patients in attendance at the training site and those participating in conference calls are the subjects for instruction. The number of initial
evaluations and follow-up phone consults varies, based on the scheduled patient flow on that given day.

The online home-study sections are rigorous, preparing you to diagnose and treat patients. The materials are mandated and must be completed prior to your training dates. Test results can be printed out.

Home-study materials examine the signs and symptoms, pathophysiology, clinical diagnosis and treatment of the aging adult. An online test must be done at the end of each home-study section; results can be printed out.
Once completed, clinical evaluation and patient management for an AMM program follows, including initial
evaluations and follow-up consults, resembling a mini-residency.
 

Home-Study Material

Testosterone Modulation for Men and Women - 2 hours
DHEA - 1 hour
Subclinical Hypothyroidism – 1.5 hours
Hormonal Modulation for Women - 1 hour
Osteoporosis - 1hour
Growth Hormone Evaluation of the Deficient Adult - 2 hours
 Legal Considerations in AMM – 1 hour
 

Hormonal Evaluation of the Aging Male 

The clinical syndrome—related to the decline in testosterone, DHEA (-S) and testosterone-to-estradiol
ratio—occurs in men gradually, beginning approximately at age 35.
 

Module Content

  • Testosterone physiology and measurement

  • Relationship between testosterone, muscle mass, strength and body composition

  • Relationship between testosterone, cardiovascular disease, blood pressure and glucose metabolism

  • Relationship between testosterone, libido and erectile quality

  • Relationship between testosterone, cognitive function and mood

  • Absolute and relative contraindications to testosterone replacement

  • Testosterone replacement dosing, delivery method and treatment goals

  • Testosterone replacement therapy concerns and side effects

  • DHEA (-S) physiology, measurement and replacement 

 

Outcome Objectives

After completing this module, the physician will be able to . . .

  • Recognize the hormonal manifestations of the aging male

  • Analyze the laboratory results obtained in the male hormone evaluation

  • Discuss benefits and risks of various testosterone supplementation methods

  • Initiate individualized hormone treatment of the aging male

  • Monitor the efficacy of treatment, adjust the dose of hormones and related therapies and address side effects


Hormonal Evaluation of the Aging Female

The clinical syndrome related to the decline in estradiol and progesterone occurs in women, beginning around their late 40s and early to mid-50s. This module examines menopause signs and symptoms, pathophysiology, clinical diagnosis and treatment. Risks and benefits of hormone replacement therapy, various modes of administration and side effects are discussed.

Clinical evaluation and patient management for an AMM program follows, including initial evaluations and follow-up consults.

Module Content

  • Estrogen physiology and measurement

  • Menopause

  • Relationship between estrogen/hormone replacement therapy (ERT/HRT) and related disease states

  • Estrogen replacement dosing, delivery method and treatment goals

  • Absolute and relative contraindications to ERT/HRT and alternative therapies

  • ERT/HRT concerns and side effects

  • Progesterone physiology, measurement and replacement

  • Testosterone physiology, measurement and replacement


Hormone Evaluation of the Aging Female/Outcome Objectives.

After completing this module, the physician will be able to . . .

  • Recognize the physiological and emotional symptoms of menopause

  • Discuss estrogen and progesterone physiology and laboratory measurements

  • Describe the latest findings from current research regarding hormone replacement therapy (HRT)

  • Analyze the laboratory results obtained in the female hormone evaluation

  • Discuss the risks and benefits of hormone replacement therapy (HRT)

  • Discuss the differences between plant-derived and synthetic hormones

  • Initiate individualized hormone treatment of the aging female

  • Monitor the efficacy of treatment, adjust the doses of hormones and related therapies, and address side effects

  • Describe absolute and relative contraindications to ERT/HRT and alternative therapies

  • Discuss issues related to female sexual dysfunction and new therapies to treat it

Human Growth Hormone Evaluation for Adult GHD (AGHD)

This study module provides an overview and rationale for the reasoned use of growth hormone modulation therapy for AGHD in the clinical setting when a comprehensive evaluation reveals an adult deficiency. This module is not about growth hormone alone, but rather it is about evaluating growth hormone levels and their consideration as one clinical factor among many in a comprehensive adult patient-oriented diagnosis, prevention and lifestyle alteration program. DHEA and thyroid are also evaluated in conjunction with growth hormone.

Examined are the signs and symptoms, pathophysiology, clinical diagnosis and treatment of AGHD plus DHEA and thyroid imbalance. Also discussed are risks and benefits of human growth hormone replacement therapy in a proven adult deficiency, including mode of growth hormone replacement and side effects—as well as risks and benefits of thyroid and DHEA supplementation, various forms of thyroid supplementation and side effects. Clinical evaluation and patient management for an AMM program follows, including initial evaluations and follow-up consults.
 

Module Content

  • Hypothalamic-pituitary-adrenal axis physiology and measurement

  • Relationship between hGH, muscle mass, visceral adiposity, strength and bone density

  • Relationship between hGH, cardiovascular disease, blood pressure and glucose metabolism

  • Relationship between hGH, cognitive function and mood

  • Absolute and relative contraindications to hGH replacement

  • hGH Replacement dosing, delivery method and treatment goals

  • hGH Replacement therapy concerns and side effects

  • Legal issues relating to the prescribing of hGH

  • Hypothyroidism and thyroid imbalance

  • Absolute and relative contraindications to thyroid replacement 

  • Thyroid replacement dosing, delivery method and treatment goals

  • Thyroid replacement therapy concerns and side effects

  • DHEA (-S) physiology, measurement and replacement


Outcome Objectives

After completing this module, the physician will be able to . . .

  • Describe the metabolic pathway of human growth hormone

  • Identify the signs and symptoms of AGHD patients

  • Describe the research studies concerning growth hormone therapy in AGHD patients, particularly in relation to prostate and breast cancer

  • Diagnose AGHD including clinical presentation and lab studies

  • Discuss the benefits and risks of hGH replacement in AGHD deficient patients

  • Describe the route of administration and dosing of hGH in AGHD patients

  • Discuss legal issues relating to the administration of hGH

  • Recognize the clinical manifestations of thyroid imbalance

  • Analyze the laboratory results obtained in a thyroid imbalance evaluation

  • Discuss the benefits and risks of thyroid supplementation

  • Initiate individualized treatment of the thyroid imbalance patient

  • Describe the metabolic pathway of DHEA

  • Discuss the literature on DHEA and its replacement value in heart disease, mood and well-being, auto-immune and inflammatory diseases, bone health, brain function and erectile dysfunction

  • Determine an individualized dosing protocol, based on patient lab values and response

  • Monitor the efficacy of treatment, adjust the doses of hormones and related therapies and address side effects