Module XX A Course Description

The Metabolic Systems Triad system creates a framework to assess & treat patients by first understanding these important interrelationship hierarchies & then provides specific treatment recommendations. The Metabolic Systems Triad Training is a breakthrough approach in clinical medicine that serves to organize complex patient presentations into a unified treatment approach.

The module will cover five triads that together underlie the clinical framework of the Metabolic Systems. Case-based teaching forms a central part of the training, ensuring that the learner gains specific tools & techniques to effectively treat patients immediately after completing the course.

Triad 1: Adrenals - Thyroid - Pancreas - Reviews the significant physiologic, reciprocal relationships between cortisol levels, thyroid functions & insulin sensitivity. Patients often report fatigue & depression, while progressing towards insulin resistance & auto-immunity when this triad deteriorates. This lecture will explore these interactions, common clinical presenting symptoms & how to effectively manage them therapeutically.

Triad 2: Gut - Immune - Brain - Reviews the physiologic relationships between the digestive tract, immune system & brain. We will also examine the important role stress plays as a mediator of these interconnections. Understanding Triad 2 is critical to evaluating patients with complex presentations such as fibromyalgia, auto-immune diseases, cancer, mood disorders, cognitive impairments & digestive problems.

Triad 3: Cardio - Pulmonary - Neuro-Vascular - Reviews the physiologic relationships between mood, the central & peripheral nervous systems & cardiac function. The brain, mind, lungs & heart are connected in intimate ways, with early disturbances leading to endothelial dysfunction, a precursor to hypertension, vascular pathologies & heart disease.

Triad 4: Liver - Lymph - Kidney - Reviews the interrelationships between the 'drainage' systems of the body including the liver, lymph & kidneys. There is a growing awareness of the impact environmental toxins have on human physiology. Organophosphates, chemical byproducts, heavy metals, antibiotics & hormones all contribute to many chronic diseases. It is critical that health practitioners learn methods to assess the clinical burden of environmental exposure & acquire tools to safely remove these factors from their patients.

Triad 5: Estrogen - Progesterone - Testosterone - Reviews the role sex hormones play in human health. Their decline with age contributes to the worsening of the most common chronic illnesses & creates a large burden on quality of life for many men & women. Understanding how to balance & restore when appropriate, these hormones is a centerpiece of any anti-aging practice. Estrogen, progesterone & testosterone will be explored in detail with regard to normal functioning & in particular how they interrelate in the context of human physiology. Methods of assessment & treatment will be reviewed for both men & women.

Learning Objectives

• Learn how the Metabolic Systems Triad works
• Look at an example of a triad, The Brain-Gut-Inflammation Triad & see how triad organizational thought would be helping organize complex patient therapies
• Review normal physiology of adrenals, thyroid & pancreas
• Review common ways patients present with multiple metabolic abnormalities
• Review natural & hormonal treatment strategies for cortisol, insulin & thyroid
• Be familiar with the physiologic relationships between the digestive tract, immune system & brain
• Review common clinical presentations within the proposed framework of Gut-Immune Brain
• Review treatment options & strategies specific for Gut-Immune-Brain pathologies
• Learn basic physiologic connections between the mind, brain & heart mediated through mechanisms such as heart rate variability, depression, stress & the immune system
• Review common clinical presentations within the cardiopulmonary-neuro-vascular triad
• Learn ways to treat complex conditions within this triad framework
• Learn the physiology of the most important detoxification organs & their pathways to remove toxins
• Review the most common toxins, both exogenous & endogenous, which contribute to medical illness
• Review treatment strategies for removal of toxins safely & effectively
• Review ways to mitigate toxins in the home environment
• Review the role of sex hormones in the aging male & female
• Review common presentations of sex hormone dys-regulation & the associated signs & symptoms
• Examine methods of balancing & replacing estrogen, progesterone & testosterone safely & effectively through the use of natural products & hormone replacement therapy

Module XX-B Course Description

Further delve into the five primary triad relationships & begin to explain the concept of "stacking". For example, relationships between Triad 1 (Thyroid-Adrenal-Pancreas) & Triad 2 (Gut-Immune-Brain) can be difficult to correct. Development of food intolerances & immune shifts (Triad 2) can lead to autoimmune thyroiditis (Triad 1). In this module you will learn relationships between:

• Triad 1 (Adrenal-Thyroid-Pancreas) mitochondrial regulation & it's effect on Sex hormones (Triad 1)
• Triad 2 (Gut-Immune-Brain) stacking with Triad 4 (Kidney-Liver-Lymph), the role of intoxication & it's role in GI integrity & immunity. In addition clinical case break out sessions will be included to drive home applying the Metabolic Triad Stacking approach
• Triad 4 Role of environmental toxins (Liver-Lymph-Kidneys) & disruption of Thyroid- Adrenal-Thyroid (Triad 1) relationships
• Triad 5 (Testosterone-Estrogen-Progesterone) relationships with Triad 2 (Gut-Immune - Brain), focusing on the role of sex hormones in brain health

In addition, six full hours of depth discussion of clinical nutrition & diet strategy as a core component to the success of patient outcomes will be taught

Upon completion of this module, the participants will:

• Know the role that environmental pollutants play in disrupting the thyroid-adrenalpancreas relationships
• Learn the importance of heavy metal toxicity & its effect on the thyroid-adrenalpancreas relationships
• Learn how halogens may affect the thyroid-adrenal-pancreas relationships
• Recognize the role that persistent pollutants play in the thyroid-adrenal-pancreas relationships
• Know strategies for removal of toxic metals from the body
• Learn treatment modalities for environmental toxin removal
• Learn new aspects of digestive health & key drivers of pathology including endotoxins, acetaldehyde, mycotoxins & enterocytes
• Review different diet based eating programs
• Know that affect that cortisol, DHEA & insulin have on energy regulation & metabolism in the body
• Be familiar with the role sex hormones have in maintaining memory & focus including pregnenolone, estrogens, progesterone, DHEA & testosterone in both men & women
• Be familiar with the role that liver dysfunction plays in cognitive function, immune regulation, GI integrity & immune expression
• Be familiar with the relationship between adrenal-thyroid-pancreas on endothelial dysfunction
• Know the role that adrenal-thyroid-pancreas plays with insulin resistance & lipid profile alterations
• Know the interface between immune regulation, hormone production & cognitive function
• Recognize the role of endotoxemia plays in cardiovascular health