Advanced Metabolic Endocrinology
Endocrinology, defined as "the study of the medical aspects of hormones, including diseases and conditions associated with hormonal imbalance, damage to the hormone synthesizing and secreting organs and tissues, or the use of synthetic or natural hormonal drugs", represents a dynamic and rapidly expanding biomedical discipline. Yet the practice of endocrinology continues to remain more of an art, as the diagnosis of many endocrine diseases still rely upon the clinical acumen of physicians, which is developed after years of encountering endocrine-related diseases of varying presentations, from mild to severe.
The Advanced Metabolic Endocrinology Certification is designed to introduce and familiarize the healthcare practitioner with the key topics that are part of an integrative endocrinology curriculum. Participants will complete four modules necessary to introduce the principles of endocrinology and hormonal therapies, and to provide a solid foundation for the development of more advanced and specialized clinical skills that are critical for healthcare practitioners.
This module provides a functional overview of hormonal changes that manifest in men and women with aging, including the functions and interplay of specific hormones in the body. It discusses how best to identify, test for and treat hormonal deficiencies and dysfunctions, such as with hormone replacement and medication compounding.
- Interpret the structure of the sex hormones & their metabolism
- Review key signs & symptoms of adrenal fatigue and relevant lab testing
- Evaluate the differences between specialized compounding and manufacturing medications
- Discuss the various patient care areas that involve specialized compounding
- Recognize the hormonal changes that manifest during the aging process, including functions of estrogen, progesterone, testosterone & DHEA in the body
- Review the literature on synthetic & bio-identical hormone replacement
- Assess treatment, dosages, and side effects of BHRT
- Discuss roles of iodine in the body, and treatment of iodine deficiency
- Recognize symptoms of PMS and accompanying treatment modalities
- Review conventional & metabolic treatments for PCOS
- Recognize clinical manifestations of hypothyroidism
- Discuss treatment for hormone replacement, including compounded thyroid medications
- Investigate the importance of measuring hormonal tissue levels, in diagnosing hormonal imbalances & in monitoring bio-identical hormone replacement
- Evaluate the urine monitoring of hormone levels & metabolites, with specific algorithms for practice
- Discuss the methodology of scientific support for & the differences in, saliva, urine & blood testing of hormones
This module will focus on advanced topics in adrenal health. Female sexual health will also be discussed. An in depth session on hyperthyroidism is also part of this advanced endocrinology module as well as learning how to personalize her hormone replacement protocols.
- Learn the complex biology of calcium and phosphorus regulation and the role of PTH, Vitamin D, Calcitonin.
- Lean the subtle diagnostic clues to primary hyperparathyroidism
- Learn the medical literature on the risks of elevated PTH
- Learn the expanding indications for surgical treatment of primary hyperparathyroidism
- Learn the functional medicine aspects of parathyroid hormone optimization including nutrition, inflammation and stress response
- Understand the multiple etiologies of female sexual dysfunction (FSD)
- Recognize FSD in clinical practice
- Perform diagnostic evaluations on patients with FSD
- Understand effective treatments of patients with female sexual dysfunction
- Know the signs and symptoms of hyperthyroidism
- Learn the kinds of thyroiditis that may predispose the patient to hyperthyroidism
- Understand precipitating factors that may lead to hyperthyroidism such as stress, infection, iodine supplementation, and pregnancy
- Understand that the signs and symptoms of hyperthyroidism may change with age
- Learn how to diagnosis hyperthyroidism
- Review the medical literature and case histories on hyperthyroidism
- Understand the Importance Estrogen Metabolism plays in bio-identical Hormone Replacement therapy.
- Be able to assess and improve methylation status in a patient.
- Understand the role methylation plays in the metabolism of hormones.
- Identify Single Nucleotide Polymorphisms (SNP’s) in both phase 1 and phase 2 of the metabolism pathways and know how these may contribute to a patient’s cancer risk.
- Know specific potential strategies to improve phase 1 and phase 2 metabolism.
- Be able to identify the role xenoestrogens and other toxins play in the metabolism of hormones.
- Know nutritional & conventional treatment modalities for hyperthyroidism
- Discuss the gut-immune-brain connection
- Review the gastrointestinal consequences of HPA axis dysfunction on the immune system
- Review etiologies of FMS & CFS & the role hypocortisolism plays in these conditions
- To learn the key roles of stress, inflammation, & nutrition in modifying steroid hormone metabolism
This module focuses on breast health, estrogen metabolism, and breast cancer risk. Memory and hormones along with hormonal influence on heart health will also be a focal point of this module. Difficult women's issues including advanced therapies in dysmenorrhea, vulvodynia, cervical dysplasia, endometriosis, fibrocystic breast disease, dysfunctional uterine bleeding, and amenorrhea will also be discussed. The toxicology of endocrine disrupters will furthermore be part of this advanced endocrinology module.
- Salivary Cortisol, DHEA, hormone testing & its relationship to neurotransmitter levels & behavioral manifestations
- Discuss estrogen metabolites & the link to breast cancer
- Learn tools for managing the issue of breast pain
- Learn strategies for identifying the cause of abnormal bleeding
- Learn the demographics associated with memory loss
- Discover the role of vitamin D receptors
- Learn that low vitamin D levels have been associated with an increased risk in cancer development
- Learn the mechanisms of the anticancer effects of calcitriol as related to growth arrest & differentiation, apoptosis, inhibition of invasion & metastasis, anti-inflammatory effects, regulation of prostaglandin metabolism & signaling, induction of mitogenactivated protein kinase phosphatase-5 & inhibition of stress-related kinase signaling, inhibition of NFkB activation & signaling, & inhibition of angiogenesis
- Learn toxins that are endocrine disrupters
- Learn new treatments for bacterial vaginosis
- Learn new treatment modalities for cervical dysplasia
- Learn new therapies to treat fibrocystic breast disease
- Learn new treatments for dysmenorrhea
- Examine the emerging paradigm of Neuroendocrineimmune testing.
- Recognize the role of neurotransmitters, hormones, and cytokines as chemical mediators of one interconnected supersystem.
- Describe the utility of biomarker assessments to guide treatment decisions.
- Salivary Cortisol, DHEA, Hormone testing and its relationship to neurotransmitter levels and behavioral manifestations.
- Understanding the role of inflammation and root cause etiology
- A new look at identifying Lyme, Metals, Nutritional, Bacterial, and Viral etiologies and order of treatment in restoring Neuroendocrineimmune balance.
- Case studies and clinical applications and the order of treatment protocols.
- A brief review of neuroanatomy through the use of imaging and neurotransmitter testing.
- Considerations and understanding in converting psychotropic medications to targeted amino acid precursor treatment.
- Preventing and reducing addictive behaviors through the applications of balancing the Neuroendocrineimmune system.
- Case studies in the overlap of multidisciplinary approaches for the collaboration of treatment and optimal patient outcomes.
- Review the literature on general biochemical pathways of estrogen synthesis, metabolism, and elimination.
- Discuss estrogen metabolites and the link to breast cancer.
- Present clinical studies that support and refute the role of specific estrogen metabolites and breast cancer risk
- Discuss methods and types of body fluids and tissues used to detect estrogen metabolites
- Assess the utility of estrogen metabolite testing in urine of women pre- and post-estrogen replacement therapy.
- Provide information on dietary, nutritional, and lifestyle modifications to lower formation of potentially dangerous estrogen metabolites that may increase breast cancer risk
- Discuss a rational, gradual approach to initiating BHRT
- Tools for managing the issue of breast pain.
- Learn strategies for identifying the cause of abnormal bleeding
- Understand the relationship between thyroid and estrogen
- Strategies for reducing breast cancer risk.
- Learn the demographics associated with memory loss
- Learn the role that toxic metal exposure plays in cognitive decline
- Examine the position alcohol may play in memory loss
- Review the importance of hormonal balance in brain fitness
- Understand the role that some medications may play in cognitive decline
- Learn the effect closed head injuries may have on memory
- Examine the possible function that fluoride may have as an etiology of cognitive decline
- Learn the kinds of degenerative dementia
- Understand cognitive reserve
- Know which labs and other studies to order in the evaluation of a patient for memory loss
- Learn the prevalence of vitamin D deficiency in the general population
- Understand the diverse biological actions of vitamin D
- Discover the role of vitamin D receptors
- Review the medical literature related to the transcriptional activity of vitamin D
- Learn that low vitamin D levels have been associated with an increased risk in cancer development
- Learn the mechanisms of the anticancer effects of calcitriol as related to growth arrest and differentiation, apoptosis, inhibition of invasion and metastasis, anti-inflammatory effects, regulation of prostaglandin metabolism and signaling, induction of mitogen-activated protein kinase phosphatase-5 and inhibition of stress-related kinase signaling, inhibition of NFkB activation and signaling, and inhibition of angiogenesis
- Learn a variety of mechanisms that toxins can affect endocrine function
- Explore methods of laboratory testing for toxic effects to the endocrine system
- Explain the role that toxic exposure may play in the development of thyroid disorders
- Understand the role that toxic exposure may play in the development of adrenal function
- Explain the role that toxic exposure may play in the development of diabetes
- Explore the role that toxic exposure may play in the development disorders of calcium and bone metabolism
- Evaluate the role that toxic exposure may play in the development of pituitary gland disorders
- Learn toxins that are endocrine disrupters
- Learn new treatments for bacterial vaginosis
- Learn new treatment modalities for cervical dysplasia
- Understand new therapies for chloasma
- Discover the risk factors, causes, symptoms, and treatments for endometriosis
- Learn new therapies to treat fibrocystic breast disease
- Learn the psychological changes that are causes and contributors to menstrual migraines
- Realize new treatments for menstrual migraines
- Gain knowledge concerning premenstrual dysphoric disorder
- Learn new treatments for dysmenorrhea
- Gain knowledge concerning premature ovarian decline and premature ovarian failure and with new treatments
This module with focus on advanced endocrinology in the male patient. Male sexuality, late-life hypogonadism, benign prostatic hyperplasia, lower urinary tract symptoms, prostate cancer and the use of hormonal therapies, nutrition and the aging male, osteoporosis in men and sarcopenia will all be subjects of discussion in this module. The male athlete will also be a focus of this very interesting course.
- Provide a brief overview of the function and hormones of the HPA axis
- To discuss the systemic effects of HPA axis dysfunction on various aspects of men’s health.
- To discuss the multidimensional diagnostic and treatment approach to treating the male patient who has concomitant HPA axis dysfunction.
- To utilize patient cases to illustrate teaching points in men patients with various subjective and objective medical ailments.
- Understand the complex possibilities for the etiology of Insulin Resistance and the Metabolic Syndrome.
- Be able to use lifestyle changes and education to prevent and treat this problem.
- Be acquainted with the scientific literature for the use of supplements and herbal medicine in the treatment program.
- Discuss the methodology of scientific support for, and the differences in, saliva, urine and blood testing of hormones
- Analyze scientific and clinical studies that suggest conventional venipuncture serum testing underestimates tissue uptake of sex-steroids delivered topically
- Discuss basis of steroid synthesis
- Recall the urine monitoring of hormone levels and metabolites. Specific algorithms will be shared to facilitate ease of use in clinical practice
- Discuss hormonal changes that occur with aging in males
- Discuss cardiovascular, cognitive, bone, sexual, and emotional effects of hormone depletion and hormone restoration in males
- Review how to monitor and restore optimal hormone levels in males
- Discuss the differences between compounding and manufacturing medications
- Review the various licensure needs to compound medications
- Discuss the various patient care areas that involve specialized compounding
- Review various medication dosage forms that can be compounded
- Discuss the various types of equipment needed in compounding
- Identify how to evaluate a patient for iodine deficiency
- Review the roles iodine plays in the body
- Describe how to treat iodine deficiency
