2 d ays c ourse p ractical & c linical a nti -a ging w orkshop p rof. d r. p aul l ing t ai...
TRANSCRIPT
2 DAYS COURSEPRACTICAL
& CLINICAL
ANTI-AGING WORKSHOP
PROF. DR. PAUL LING TAID.P.M., FACFS, ABPS, ABBARM, DACBN
PARAGUAYJULY 5 – 6, 2012
Prof. Dr. Paul Ling Tai D.P.M., FACFS, ABPS. ABAARM, DACBN
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Ankle & Foot Surgeon, Orthopedic Podiatric Surgical Reconstructive Team, Surgery Department Annapolis-Oakwood Hospital, Detroit, Michigan
Professor of Anti Aging Regenerative Medicine, University of Paulista (UNIP), Sao Paulo, BrazilCoordinator & Professor of Anti-Aging & Endocrinology
Pos Graduaco - Laco Sensu Universidate De Gama FKHO School of medicine Rio De Janero, Brasil
Chief of Surgical Residency - Board of Licensy of Pediatric Medicine & Surgery. State of Michigan
Professor of Integrative Medicine. NYCPM, New York, New YorkProfessor of Anti Aging Master Degree, Pontifical Univ. Catholic, Belo
Horizonte, Minas Gerais, BrazilCo-Coordinator Master of Science in Public Health, Anti Aging/Regenerative Medicine.
Approved Post Graduates Studies by the Ministry of Education, Sao Paulo, BrazilOfficial Latin American Delegate and Coordinator for the World Anti Aging Academy of
Medicine (WAAAM)Founder and Coordinator of A4M Brazil Society and Medical Congress.
Personal Representative for Latin America to Dr. Robert Goldman, MD, PhD, DO, FAASP- Chairman of A4M,
Past Adjunct Professor of Surgery. OCPM, Cleveland, Ohio Vice Chairman & Chief Examiner of State of Michigan
Faculty member, lecturer, workshop, authorAmerican Academy of Anti Aging Medicine (A4M)
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Dr. Tai doing surgery
at Oakwood Hospital
Prof. Dr. Paul Ling TaiD.P.M., FACFS, ABPS. ABAARM, DACBN
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Medical Board CertificationFellow – American College of Foot & Ankle Surgeons - FOTODiplomate – American Board of Podiatric Surgeons - FOTO
Diplomate - American Academy of Anti Aging Board (ABAARM): Oral Exam and Written Exam (A4M) - FOTO
The Grand Physician General – The Supreme Council of the Sovereign Medical Order of Knights Hospitaller
Professor, Dean of Endocrinology Dept. University of Natural Medicine, Quito, Ecuador.
Member - Royal College of Papal Knights in Americas. Granted by Vatican H.H. Pope Benedict XVI, signed by Vatican
Secretary of State Cardinal Bertone.Chairman & President, A4M Brazil (American Academy of Anti
Aging Medicine-Brazil)
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Prof. Dr. Paul Ling TaiD.P.M., FACFS, ABPS. ABAARM, DACBN
• Prof. Dr. Tai is a Knighted physician
• Helped thousands of patients and consulted countless doctors on difficult cases all over the world, earning him the title of the “Doctor’s doctor” and “Doctor of last resort”.
• Member of the Royal College of Papal Knights in Americas. Vatican, His Holiness H.H. Pope BENEDICT XVI.
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Prof. Dr. Paul Ling Tai D.P.M., FACFS, ABPS. ABAARM, DACBN
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AuthorBook Publication: Cordyceps Miracles, 2005
Book Publication: 8 Powerful Secrets to Anti Aging, 2007
Newsletter: Healthy Lifestyle, 2008Medical Journal: The Bariatrician, 2008
Book Publication: Fabulously Beautiful You! 2009Book Publication: Thin Factor, 2010
Medical Textbook: Non-Invasive Plastic Surgeryand Anti-aging 2010
DVD: Complete Courses, Weight Loss technology for Aging
Advanced Courses of Anti-AgingCopyrights:OIBConsultants, Inc.
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Saliva Hormone Testing
Evaluate a pooled saliva sample from multiple collections Possible to get reliable assessment
of hormone concentration in diurnal fluctuations
Hormone assessment from saliva allows Specific direct determination of
biologically active of “free” fraction of hormone
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Saliva Saliva is NOT an appropriate
matrix for conjugated steroids Estrone-sulfate DHEA-sulfate
Affected by flow rate
Saliva also not appropriate for thyroid Presence of T4 in saliva results from
blood contamination
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Physiology of Salivary GlandsMore than one mechanism exists
for blood components to pass the membrane barrier into the
salivary ducts Passing through the space between
the acinar cells (tight junctions) Only molecules with a relatively small molecular
weight (MW<1900) may pass through MW Hormones ca. 300 MW albumin = 66,000 MW CBG = 46,500 MW SHBG = 115,000
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Saliva Collection
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Saliva Hormone Blood Contaminations
As blood contains about 50 times higher concentrations of hormones, special
attention should be given to avoid blood contamination
0 0,01 0,019 0,038 0,075 0,156 0,312 0,625 1,25 2,5 %
The rejection point of blood contamination is when it is visible
to the naked eye at 0.156%
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The Saliva Collection Container
Saliva hormones are small non-polar molecules which tend to stick to plastic material
Polyethylene is highly absorptive for Progesterone Highly non-polar
Glass seems to be completely absorption-free
Stoppers made of polyethylene are highly absorptive
The best plastic material seems to be Ultra-Pure Polypropylene, not recycled plastic
Human Growt
h Hormo
ne
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New England Journal of Medicine, October 1999;
341: 1206-1216. HGH Restores normal body composition Improves muscle tone Normalizes serum lipid concentrations Improves quality of life
Energy level, mood & emotions
After six months of treatment Metabolism increased by six percent to
11%
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Growth Hormone Benefits
Better muscle tone
Loss of excess fat
Improved skin elasticity & thickness
Stronger bones
Improved immune system
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Growth Hormone Benefits
Improved energy & anti-fatigue, vitality
Increased creativity, positive outlook
Improved memory, thinking, mental clarity
Greater social friendliness
Positive & self confident
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Psychic Excessive emotions (72.9%) Sharp verbal retorts (64.6%) Permanent fatigue (72.9%) Easily exhausted after physical activity (89.6%) Low resistance to staying up after midnight (83.3%) Anxiety (70.8%) Insufficient aggressiveness (54.2%) Sense of powerlessness (75%) Depression (60.4%) Low self-esteem (50%) Low sociability (tendency for social isolation) (45%)
As reported by 48 adults (aged 27 – 82 years) with low plasma IGF-1
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Abdominal Scan
GH deficiency Excess abdominal
visceral fat
GH treatment Marked fat reduction
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Frequency of Psychic Complaints Before & After GH Treatment in Adult Patients
Perman
ent F
atigu
e
Easily
Exhau
sted
Low Resi
stance
to St
ying U
p After Midnigh
t
Depres
sion
Insufficie
nt Agre
ssive
ness
Low Se
lf-Este
em0
20406080
10073
89 8360 54 50
10 12 15 11 14 10
Before Treatment After GH Treatment
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Supplementation of Strontium
Vertebral fracture – 31%Non-vertebral fracture – 27%
Major non-vertebral fractures – 33%Hip fracture – 24%
n = 1489 Strontium ranelate 2 g/d Reduced risk
Seeman E, et al. Five years treatment with strontium ranelate reduces vertebral and non-vertebral fractures and increases the number and quality of life-years remaining in women over 80 years of age. Bone. 2010 Apr, 46(4): 1038-42. Epub 2009 Dec 21. PMID: 20026265
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Glucose SupplementationCynannon MHCP 5%, Fulvic/Humate, Quercetin, Alpha Lipoic
Acid, Corosolic Acid, Pancreatic Ext., Chromium PolynicotinateOne capsule three times a day with meals, or more, as needed
Corosolic acid & MHCP Improve the insulin sensitivity at the receptor site
Dr. Yamazaki, Hiroshima U. Sch. Medicine Improve modulation of blood sugar levels by 31.9%
Dr. William Judy, SW. Inst. Bio Res. Florida
Chromium Improve the glucose tolerance of Type I & Type II
Diabetes Anderson RA Chromium and glucose intolerance in Diabetes.
J. Am. Col. Nutr. 1998.
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ArthritisClematis Chinensis, Trichosanthes Kirilowii, Prunella
VulgarisPark, et al 1995; Ahn, et al 1996; Kim, et al1996. Seoul, Korea
96 patients osteo-arthritis of the knee – 5 weeks95.8% improvement from fair to very good
GingerolBliddal, et al 2000.
75 patients arthritis hip & kneeGinger vs. Ibuprofen
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Growth HormoneTreatment of Deficiencies
StandardInjection 0.2 mg – 0.5 mg per day
BestInjection 2 units – 8 units per week in divided daily dosages
Caution: Side effects of excess are more frequent Not Physiologic – HGH output highest 10 p.m. – 2 a.m. Best when given in small dosages/frequent shots
Signs of excess: Swollen feet, neuropathy, carpal tunnel, excessive muscle
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Growth HormoneSecretagogue
Human Growth MatrixOral spray sublingual Nanolyposome
Fulvic Ext., Humate Ext., Deer Antler Ext., IGF-1, IGF-2, EGF (Epidermal), NGF(Neuro), TGF(Transfer), VGF(Vascular), Cocoa, Stevia, Shugr™, Pituitary ext.,
Eurycoma Ext.
Directions: (Adjust dosage to individual needs) Maintenance: Take sublingual 2 pumps a.m. & p.m. – Hold for 1
minute before swallowing Treatment: Take sublingual 3 – 4 pumps a.m. & p.m. for specific
deficiency & for arthritis inflammation For Super Athletes: take 4 – 6 pumps a.m. & p.m.
Signs of excess: Swollen feet, neuropathy, carpal tunnel, excessive muscle
DHEA
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DHEA Clinical Applications
Aging (hormone marker) Bellino FL, Ann NY Acad Sci
1995; Belancer A, et al.
Immunodeficiency Syndrome Regelson W, et al. Ann NY
Acad Sci 1994; Khorram D, et al.
Obesity Jakubowicz DJ, et al. J Clin
Endoc Met 1005; Porter J, et al. Ann NY Acad Sci 1995.
Memory Loss Majewska M. Ann NY Acad
Sci 1995; Melanoir CL, et al.
Neuroscience Abs. 1002.
Depression Wolkowitz O. Ann NY Acad
Sci 1995.
Lupus Erythematosus V. Vollenhoven, et al. Arthri
Rheum 1994.
Cancer Prevention Boone CW, et al. Cancer Res.
1990.
Osteoporosis Spector TD, et al. Clin Endoc
1991.
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DHEA Clinical Applications
Chronic Fatigue Syndrome Galabrese VP, et al. Lancet
1989; Lebihuber FE, et al. Am J Psych 1992.
Inhibition of Atherosclerosis Eich DM. Circulation 1993.
Myocardial Risk Hantgnena, et al. Athero
Sci 1994; J. Shihara F. Cardiology 1992.
Thyroid Hormone McIntosh MK, et al. J Nutr
Biochem 1992; Song MK, et al. J Biol Chem 1989.
Distribution of body fat Williams DP, et al. J Clin
Endoc Met 1993.
Anti-glucocorticoids Wright BE, et al. Int J
Obesity 1992; Brown E. Am J Med Res 1992.
Health & Longevity Shealy N. Book: DHEA:
The Youth & Health Hormone
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DHEA & Health Benefits
Improves mild to moderate lupus, skin, joint, headache, fatigue Stanford Univ. 1994
50% reduction of Atherosclerosis plaque in rabbits John Hopkins Univ. 1998
1029 men & 942 women 25% less CVD on higher levels of DHEA Univ. of San Diego
Double-blind DHEA 50 mg for adrenal exhaustion decrease anxiety & depression NEJM 1999
Higher DHEA better mental function in Alzheimer’s disease McGill Univ. 1999
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DHEATreatment of Deficiencies
DO NOT USE ORALFirst Pass Technology & Principle
Cause overstress to liver
Over-stimulate the production of SHBG creates binding of overall hormones Net decrease & deficiencies of free hormone
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DHEATreatment of Deficiencies
DHEA Maintenance:
DHEA: 12 – 20 mg a.m. transdermal
Treatment: Use double or triple doses
“DHEA oral route has only 10 – 15% of the active compound of
transdermal.”Labrie C, et al. J Endocrinol, 1996 Sep; 150 Suppl: 5107-18
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Studies on DHEA & Cancer
Dr. McCormick & Dr. Rao (doctors/authors) 1999 – Dr. McCormick & Dr. Rao found that rats
supplemented with DHEA & exposed to cancer seemed to be resistant to further developing other forms of cancer
“DHEA inhibits prostate cancer induction both when chronic administration is begun prior to carcinogen exposure, and when administration is delayed until pre-neoplastic prostate lesions are present.”
McCormick DL and Rao KVN, et al. “Chemoprevention of hormone dependent prostate cancer in wistar unilever rats.” The Journal of European Urology, 1999; 35: 464-467.
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DHEA & Breast Cancer
No association found between DHEA-S levels Breast cancer risk
Barret-Connor E, et al. Dehydroepiandrosterone sulfate and breast cancer risk. Cancer Res 1999 Oct 15; 50(20): 6571-4.
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University of California School of
Medicine, 1995What’s interesting about all these reported increases in mood & energy is that they were not what the tests were conducted to prove
13 men & 17 women were administered 50 mg of DHEA for 6 months Among other benefits, the men & women also
reported a “physical & psychological well-being” Men – 67% Women – 84%
Attributed boost of activity & frame of mind to the DHEA-influenced rise of serum IGF-1 levels & its increased bioavailability to target tissues
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UCSD School of Medicine,
La Jolla, CaliforniaStudy by Dr.’s Samuel Yen, Khorram & Vu
Immunological effects measured in 65-year-old men supplemented with 50 mg per day of DHEA Yen observed an IGF-1 rise of 18% Natural killer cells (the cells that fight cancer) rose by
1/3 Ability to ward off cancerous cells increased by 30 – 75%
T-cells & B-cells (combat bacteria) Responded more quickly to foreign attackers
IL-2 (cytokine imperative to immune cell communication) Rose significantly
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Labrie C, Flamand M, Belanger A, Labrie F. J Endocrinol. 1996 Sep; 150 Suppl: S107-18.
Laboratory of Molecular Endocrinology CHUL Research Center, Quebec, Canada.
High bioavailability of dehydroepiandrostero
ne administered cutaneous in rats
Pregnenolone
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Pregnenolone
Pregnenolone provides the
materials for other hormones to grow & multiply in number
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J.F. Flood, et al. “Memory-enhancing effects in male mice of
pregnenolone and steroids metabolically derived from it.” Proceedings from the National
Academy of Science of the United States of America, 1992; 89:
1567-71. Memory enhancing effects in male mice using pregnenolone
Pregnenolone helps the neurotransmission of the nerves
Neurons communicate
with each other through electrochemicals
Higher levels of pregnenolone able to think clearer by recalling information with less delay
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Functions of Pregnenolone
Pregnenolone Increases levels of acetylcholine in the
hippocampus & other memory regions in the brain
Modulates the neurotransmitter GABA Helps to repair nerve damage Promotes mood elevation Improves sleep Some women report lessening of hot
flashes or premenstrual symptoms
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PregnenoloneThe optimum level of
pregnenolone is at 35 years of age
By the age of 75, you will have lost 65% of your
pregnenoloneRoberts E. Pregnenolone from Selye to Alzheimer’s. Biochemical Pharma 1995. Vol. 49, No. 1, Pg. 1-16.
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PregnenoloneSigns of Deficiency
Forgetful
Can’t think well
Memory loss
Hair loss
Tired & irritated
Life & color seem dim
No interest in beauty & nature
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PregnenoloneSigns of Deficiency
Incurrent body aches & pains
Lack of muscle tone
Pessimistic
Crave salt
Frequent urination
Don’t concentrate well
Depression
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PregnenoloneTreatment of Deficiencies
DO NOT USE ORALFirst Pass Technology & Principle
Cause overstress to liver
Over-stimulate the production of SHBG creates binding of overall hormones Net decrease & deficiencies of free hormone
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PregnenoloneTreatment of Deficiencies
Pregnenolone Maintenance:
Pregnenolone: 18 mg – 30 a.m. transdermal
Treatment: Use double or triple doses
Testosterone
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Testosterone Production
2% of testosterone is free
98% is bound 38% bound to albumin 60% bound to SHBG
Bagatell CJ, et al. N Engl J Med. 1996 Mar 14; 334(11): 707-14.
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Relative Potency of Androgens
T – 100
DHT – 300
DHEA – 5
DHEA-S – 5
Androstenedione - 10
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Aromatase Testosterone
Aromatase Inducer (men)
Insulin resistance & diabetes II Inhibitors
Chinese herbal formula Aralia dasyphylla Curcuma zedoria Cyperus rotundus Smilax glabra
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Aromatase Testosterone
Aromatase Chrysin
A bioflavonoid component Herb passiflora
Melatonin Quercetin Grape seed extract
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AromataseMen & Women Over 45
YearsAromatase is an enzyme
Neutralize Aromatase
I3CDIMSoy
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Sinha-Hikim I, et al. Clin Endocrinol Metab. 2006 Aug; 91(8): 3024-33.
“Effects of testosterone supplementation on skeletal muscle fiber
hypertrophy & satellite cells in community-
dwelling older men.”
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Women Libido Sexual Function
Lower testosterone & free testosterone Lower libido
Desire Arousal Lubrication Orgasm
Int. J. Impot. Res. 2004.
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Testosterone & Metabolic Syndrome
Low levels of testosterone have several common features with metabolic syndrome T levels inversely associated with central obesity T inversely associated with systolic BP Men with diabetes had lower T levels Inverse association between T & HgA1C T may have a protective role in the development of
metabolic syndrome & subsequent diabetes mellitus & cardiovascular disease in aging men
Svartberg J. Epidemiology: Testosteorne & the Metabolic Syndrome
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Endogenous Sex Hormones & Progression of Carotid
Atherosclerosis in Elderly MenHigher
Testosterone = Less
Atherosclerosis
Higher Estrone = More
Atherosclerosis
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TRT & PC Review of 16 studies, some placebo controlled
Various T formulations
Up to 15 year studies
No increased risk over the background prevalence
Gould DC, Kirby RS. Testosteorne replacement therapy for late onset hypogonadism: What is the risk of inducing prostate cancer? Prostate Cancer Prostatic Dis. 2006; 9(1): 1408.
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Testosterone & BPH
“Multiple studies have failed to demonstrate exacerbation
of voiding symptoms attributable to benign
prostatic hyperplasia during testosterone
supplementation.”Rhoden NEJM 2004.
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Treatment of Elevated Testosterone
Saw palmetto
Metformin
Spironolactone
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Causes of High Levels of 5 Alpha-Reductase
Insulin resistance
Obesity
High-protein diets
Sodium restriction
Licorice
Hyperthyroidism
DHEA supplementation
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TestosteroneTreatment of Deficiencies
DO NOT USE ORALFirst Pass Technology & Principle
Cause overstress to liver
Over-stimulate the production of SHBG creates binding of overall hormones Net decrease & deficiencies of free hormone
Progesterone
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Progesterone Hormone that supports
conception & sustain pregnancy
Fast increase after 14 days of menses after ovulation
Highest level at 21 days – drops at 28 days
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Functions of Progesterone
Pro-gestation
Uses fat for energy Decreases TBG
Natural anti-depressant & anxiolytic
May increase libido
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Functions of Progesterone
Promotes cell differentiation
Promotes normal cell death
Decreases estrogen receptor synthesis
Improves estrogen receptor sensitivity
Decreases estrogen induced mitosis
Natural diuretic – blocks aldosterone
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Progesterone Transdermal showed significant
decreases of uterine lining hyperplasia Anasti, et al. 2001.
Laboratory study shows 20 times progesterone in brain cells than in blood serum Lee, et al. 1996.
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Progesterone Transdermal progesterone decreased breast
cell groth by 400% Chang, et al. 1995.
Progesterone lowers vascular endothelia growth factor (JEGF) potent angiogenic factor Heer, et al. 1998.
Incidence of breast cancer is 540% greater in women with low progesterone than normal levels Corovan, et al. 1981.
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Progesterone Lyposome
20 mg progesterone dose
PMS One dose per day at night Start on 12th day of menses to 28th day or bleeding
Perimenopause One dose per day or one dose a.m. & night Start on 8th day of menses to 28th day or bleeding
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Progesterone Lyposome
20 mg progesterone dose Endometriosis
Use one dose a.m. & 2 doses p.m. Start on 6th day of menses to 28th day – wait 5 days Severe bleeding may persist or worsen the first few
days, then improve
Birth control pills – synthetic Use the dose in the p.m. while on the bill Start on 6th day of menses to 28th day – wait 5 days
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Progesterone Lyposome
20 mg progesterone dose Osteoporosis
One dose daily a.m. & p.m. Start on 6th day of menses to 28th day –
wait 5 days
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PCOS
Three criteria set up by the National Institutions of Health Irregular or absence of menstruation Excess androgen production Lack of other reasons for irregular or
absence of cycles & excess androgens
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PCOS Having ovarian
cysts is not one of the three criteria for the diagnosis of PCOS
Ovaries with many cysts does not necessarily mean that the patient has PCOS
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ProgesteroneTreatment of Deficiencies
Progesterone Pre-menopause
20 – 60 mg Transdermal – 14th – 28th Day Post-menopause
20 – 100 mg Transdermal – 14th – 28th Day Post-partum Depression
50 – 300 mg Transdermal – Daily Infertility
50 – 150 mg Transdermal – 14th – 28th Day Birth Control
100 – 200 mg Transdermal - Daily
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ProgesteroneTreatment of Deficiencies
Progesterone Specialist(5 mg Progesterone per pump)
Fulvic Ext. EPL, Evening Primrose Oil, Shea Butter, Glycerin, Progesterone, USP, Chastetree,
Dong Quai, Rhodiola, Panax Ginseng, Aloe Vera, Lavender Oil, Almond Oil, Hemp Oil, Alpha Lipoic Acid, Vitamin E, Vitamin A, Allantoin, NaPca, Dimethicone
Directions: (Adjust dosage to individual needs) Apply 2 pumps to soft skin area – rub vigorously – for
25 days – Discontinue for 5 days or if bleeding – Repeat cycle.
Signs of excess: Sleepiness, dizziness, droopy breasts, low libido,
sleeping too much, short menstruation
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Sitruk-Ware, et al. Treatment of Benign Breast Diseases by Progesterone Applied Topically. International Symposium on Percutaneous
Absorption of Steroids, Academic Press, 1980,
pp 219-229.
Number +++ + 0
Mastodynia 250 78 19 3
Increased Nodulatiry 80 80 10 10
Fibroadenomas 30 0 20 80
Cysts 30 0 40 60
Fibrocystic Disease 80 75 18 7
Telethermographic modifications after 3 months
of percutaneous progesterone treatment in diverse benign breast diseases:
+++ good results, + partial improvement, 0 failures (Lafaye & Aubert, 1978)
Estrogen
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Estrogen Contributes
Development of secondary sex characteristics
Defining difference between men & women
In women characteristics include: Breasts Widened pelvis Increased amounts of body fat in the buttock, thigh &
hip region Less facial hair Smoother skin than men
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Estrogen Sources Ovaries
Fat
Aromatized from DHEA & Testosterone
Estrone E1 – Menopausal
Estradiol E2 – Productive years
Estriol E3 – Pregnancy
SHBG liver protein binder
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Estrone (E1)
Predominant estrogen post-menopausally
Aromatized from androstenedione in peripheral tissues; also derived from E2
Reproduction, sexual development, bone health
Positive correlations with insulin & BMI
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Estradiol (E2)
Most potent estrogen
Predominant estrogen pre-menopausally
Derived from both Estrone & testosterone
Assists in female reproduction, sexual development, bone health, arterial blood flow, neuroprotection
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Estriol (E3) Least potent estrogen
Derived from E1 & E2
Competes with E2 binding at estrogen receptor, therefore considered safer than E1 & E22006 HRT study: E3 was not associated with breast cancer – Lyytinen H, 2006.
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Enzyme-Inducing & Inhibitors
Estrogens increase 2-OH Estrone: 16α Estrone
“Brassica” family vegetables Exercise Linseed Indole 3-carbinol (I3C) Diindolylmethane (DIM) Soy Progesterone
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Functions of Estradiol
Helps Maintain potassium Absorb calcium,
magnesium & zinc Maintain bones Maintain memory Improve sleep
Increases HDL Growth hormone Serotonin
Endorphins
Decreases LDL Total cholesterol Triglycerides Platelet stickiness Fatigue
Works as an antioxidant
Vliet E, Women Weight & Hormones. New York: M. Evans & Company, 2001; pg 85.
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Estrogen In Men Active in every
tissue studied Brain
Hypothalamus High concentrations
of Erα & Erβ
Pro-optic High in Ers & Ars
Controls sexuality Libido Erectile function
eNOS
Pelvic & penile arteries Pre-optic sexuality centers
Estradiol needed Vascular system through
eNOS activation Pro-inflammatory activity
of vascular plaque iNOS, MMPs, IL-6, COX2
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2-OH Estrone: 16α-OH Estrone
Data provides support 2:16 ratio
Associated with Reduced breast cancer risk Prostate cancer
Ideal ratio range Between 2 - 4
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2-OH Estrone/Methylation Good estrogen
Does not stimulate cell growth Blocks action of stronger estrogen products that may be
carcinogenic
2-OH Estrone Protective against cancer when methylated by catechol-
O-methyltransferase (COMT) into 2-methoxy-estrone
Ratio of 2-methoxyestrone to 2-hydroxyestrone can be measured in urine Good gauge of the body’s ability to methlate
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Diurnal Changes of Estradiol in Plasma
in 2 Females During Luteal PhaseEstradiol in Plasma, Diurnal Fine Profile
0
50
100
150
200
250
300
8:00AM
12:00PM
4:00PM
8:00PM
12:00AM
4:00AM
8:00AM
Co
ncen
trati
on
in
pg
/ml
Plasma sampling every 20 minutes: C.V.: ~20%Single values between 90 pg/ml (minimum) – 265 pg/ml (maximum)
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Archives of Dermatology, December 1997; 133:
339-342. Estrogen therapy decreases skin wrinkling & dryness
Estrogen increases dermal thickness as it preserves skin texture
Collagen decreases by 30% after menopause Skin changes are reversible with estrogen
replacement therapy
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Phyto-Estrogen Increases bone mass
Lowers LDL & triglycerides St. Germain, et al. 2001.
Friendly estrogen – Estriol-like from Genistein, Daidzen, Glycetein Setchell, et al. 2001.
Genistein & Daidzen shown to protect against breast & uterine cancer & CVD Hawrylewicz, et al. 1995; Goodman, et al. 1997;
Anthony, et al. 1998; Olive, et al. 1998.
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EstrogenTreatment of Deficiencies
Bi-Estro 0.6 mg E2 1.5 mg E3
An optimum physiologic ratio of 20% E2 & 80% E3
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EstrogenTreatment of Deficiencies
Max Estro E(1 pump phyto Estrogen is 0.3 mg E2 & 1.5 mg E3)
Fulvic Extract, Essential Phospholipids, Evening Primrose Oil, Shea Butter, Glycerin, Aloe Vera, Black Cohosh, Genistein, Daidzen, Pueraria Mirifica, Gynostema, Rhodiola,
Lavender oil, Almond oil, Hemp oil, Alpha Lipoic, Vitamin E, Vitamin A, Allantoin, NaPca
Directions: (Adjust dosage to individual needs) Apply to soft parts of skin 3 pump per day a.m. or
in divided doses. May repeat 3 pump in p.m.
Signs of excess: Tender breast, swollen abdomen, heavy periods,
anxiety, irritable, emotional, moody, short temper
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Dr. Tai’s Health Pearl
Too much Estrogen
Need more Estrogen
Estrogen level OK – Progesterone OK
Need more Progesterone
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EstrogenTreatment of Deficiencies
Estrogen Defense
Idole-3-Carbinol (I-3-C), Diindolymethane (DIM), Evodia, Resveratrol, Fermented Grape Skin & Seed, Chrysin, Piperine Extract
Lower dosages of Estrogen supplements
Indol-3-Carbinol & Diindolylmethane proven to lower circulating Estrogen
Directions: (Adjust dosage to individual needs) Take one capsule twice daily or more as needed
Thyroid
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Importance of Optimal Thyroid Function
Effects on cellular metabolism
Activates brain & neurological function
Cardiac contractile support
Osteoblastic support of bone
Menstrual cycle regulation
Activates all other hormone receptors Hormone restoration
must start with thyroid
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Thyroid Gland Function
Control metabolic rate
Control body temperature
Skin & mental health
Mitochondria
Control infections
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Thyroid
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Metabolism of Thyroid Hormone
Requires about 50 mg of iodine per year
About 70% of the T4 secreted daily is deiodinated to yield T3+rT3 in equal parts
80% of circulating T3 comes from peripheral monodeionization of T4 at the thyrosyl ring Occurs in the liver, kidney & other tissues Circulating rT3 is made the same way
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Thyroid & Muscle
No thyroid – No increase in muscle Thyroid hormones influence muscle
metabolism Low thyroid does not build muscle
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Interesting Facts About Thyroid
Low thyroid directly causes low pregnenolone Tagawa, N., Clinc Chem 2000; 46: 523-5828.
Thyroid dysfunction is associated with heart disease Rouzier, N., Longevity and Preventive Medicine Symposium, 2002.
Decreased T3 hormone causes increase of cholesterol up to 50% & LDL Brownstein, D. Overcoming Thyroid Disorders. Medical Alt. Press,
2002. p. 8.
Low thyroid hormone is associated with chronic fibromyalgia Brownstein, D. Overcoming Thyroid Disorders. Medical Alt. Press,
2002. p. 8.
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Thyroid
Affects all organs Metabolism Body composition Energy levels Mood Hair & skin
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rT3/T3 Ratio rT3/T3 ratio may increase with
Pregnancy Estrogen therapy Fasting Liver disease Renal disease Drugs (PTU, some beta blockers,
amiodarone) Stress
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Tissues & Organs Most Readily Affected by Cellular
Energy Declines(In order of Impact)
Central nervous system Hearty & skeletal muscle Kidneys Hormone-producing tissues
Wallace D. Mitochondrial DNA is aging and disease. Scientific American, August 1997.
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Most Common Signs & Symptoms of
Hypothyroidism Fatigue & loss of
energy
Increased susceptibility to infection
Weakness
Weight gain or increased difficulty losing weight
Decreasing memory & mental slowing
Dry, rough, pale, cold skin
Thinning hair & eyebrows (outer 1/3)
Cold intolerance to hands & feet
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Most Common Signs & Symptoms of
Hypothyroidism Muscle cramps & frequent muscle aches
Depression
Irritability, emotional instability
Dry, coarse skin &
brittle nails
Decreased libido & sexual performance
High cholesterol
Voice change (deepening & hoarseness)
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Dr. Broda Barnes’ Recommendations
Thyroid must be taken on an empty stomach at least 20 – 30 minutes before meals
Add ½ grain each month & continue to increase each month as needed
Our bodies usually require at least one month to respond to the increase in dosage
Stop when patients feel well, experience any side effects, or reach the dosage of 4 grains (occasionally 5 grains were used)
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Thyroid Intolerance
Number one sign of intolerance is an increased heart rate More than 10 – 15 beats per minute above
baseline
Worsening of hypothyroid symptoms is a red flag for Mild adrenal fatigue Iodine deficiency Environmental toxicity
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Compounded T4/T3
1 “grain”T3 – 9 mcg
T4 – 38 mcg
½ “grain”T3 – 4.5 mcgT4 – 19 mcg
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Optimal Thyroid Replacement
TSH-0.3 – 5.5 (N)
Below 2.0 (Optimal)Below 1.0 (Personal)
FT3-2.3 – 4.3 (N)
-3.5 – 4.3 (Optimal)
rT3-90 – 350 pg/ml (N)-50 – 150 (Optimal)
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Metabolism Supplementation
Homeopathic Thyroidinum 3C with rare minerals & amino acids Selenium – 30 Selenol enzymes
conversion T4 to T3
Manganese, Zinc, Fulvic/Humate
L-Thyrosine
Homeopathic Thyroidinum 3C, Ashwangandha, Rhodiola
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Selenium Study looked at critically ill patients
supplemented with 200 mcgs selenium
Normalization of T3 & T4 with improvement of T3/rT3 ratio with selenium supplementation Berger N, et al. Influence of selenium
supplementation on post-traumatic alterations of the thyroid axis: a placebo-controlled trial. Intensive Car Med 2001; 27(1): 91-100.
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Iodine Deficiency
Up to 72% of the world’s population is affected by an iodine deficiency disorder WHO Nov 12, 1998.
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Hypothyroidism & Breast Cancer
Areas of the world with high iodine intake (Japan) Low rate of breast cancer
Estimates are that the breasts need approximately 5 mg of iodine per day 50 kg woman
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Iodine/Iodide The reduced form of iodine is
iodide with an extra electron
Both forms are needed for optimal function of every organ & cell in the human body Abraham GE, Flechas JD, Hakala JC.
Orthoiodosupplementation: Iodine sufficiency of the whole human body. The Original Internist, 9: 30-41, 2002.
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RDA of Iodine The recommended daily amount of iodine
for supplementation by clinicians 12.5 – 37.5 mg
Turns out to be the exact range for sufficiency of the whole human body Based on a recently developed loading test
Abraham GE, Brownstein D, Flechos J. The Saliva/serum iodine ratio as an index of sodium iodine symporter efficiency. The Original Internist. Vol 12: 4: 152-6.
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Iodine & Fibrocystic Breasts
Iodine has been shown to be extremely
effective in treating & preventing fibrocystic
breasts Ghent W, et al. Iodine Replacement in
Fibrocystic Disease of the Breast. Can J Surg. 36: 453-460, 1993.
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Thyroid & WeightT3/T4 falls during acute & chronic calorie restriction
Is this a factor why lost weight is usually regained?
Weinsier RL, et al. Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the self-point theory. Am J Clin Nutr 2000 Nov, 75(5): 1088-94.
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Hans Selye’s Mode of Stress
Adrenal fatigue
Stress reactions affect mainly the adrenal cortex (not the medulla)
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Stress Response
Three phases of response1. Alarm phase2. Stage of
resistance3. Stage of
exhaustion
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Alarm PhaseInitial Reaction Phase
Adrenal congestion & hypertrophy with deletion of vitamin C in cortex
Increased secretion of cortisol followed by a decrease in secretion
Thymic atrophy
Lymphoid tissue atrophy
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Stage of Resistance
Accumulation of secreting granules in cortex
Blood diluted – receptor resistance
Increased ability to withstand stress
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Stage of Exhaustion
Decreased ability to withstand stress
Decreased cortisol levels
Severe fatigue
Premature aging
Adrenal Fatigue
& Chronic Fatigue
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Adrenal Fatigue Daily Energy Patterns
Morning fatigue – Low cortisol a.m. Difficulty waking up early in the morning
(doesn’t really wake up until approx. 10 a.m.)
Usually feels much better & fully awake after noon meal
Afternoon low 2 – 4 p.m.
Usually feels best after 6 p.m.
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Functions of Cortisol
Balances blood sugar
Weight control
Immune system response
Bone turnover
rate
Stress reaction
Sleep
Protein synthesis
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Diurnal Rhythm of Salivary Cortisol
Different Wake-Up Times
0
2
4
6
8
10
12
14
16
4 6 8 10 12 14 16 18
Time of day [h]
Salivary C
ortis
ol [n
g/m
l]
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CortisolTreatment of Excess
Max Glucose Specialist Directions: Take one capsule three times a day with
meals or more as needed by your specific condition or recommended by your physician
Max Performance Specialist (Adaptogen) Directions: Take 1 tablet 3 times daily
Max Sea Extract Directions: Take 6 drops in a drink once daily
Max Metabolism Directions: Take 1 capsule a.m. & 1 capsule at noon with
large glass of water. May increase the dosage to 3 capsules per day
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CortisolTreatment of Deficiencies
Max Performance (Adaptogen) Directions: Take 1 tablet 3 times daily
Max Adrenal Specialist Directions: Take 1 capsule daily as needed
DHEA PleoLyposome Directions: Apply to soft skin area.
Female: 3 pumps daily a.m.; Male: 5 pumps daily a.m.
Melatonin
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Light at Night Chronodisruption,
Melatonin Suppression & Cancer Risk Crit Rev Oncog. 2007 Dec; 13(4):
303-28. Reiter RJ, Tan DX, Korkmaz A, Erren
TC, Piekarski C, Tamura H, Manchester LC
Department of Cellular and Structural Biology, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
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(Blue-Green Wavelengths) 460 – 480 nm
Most Inhibitory to Melatonin Synthesis & Regulating SCN
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Genetic
Defines the
Amplitude of the
Nocturnal Melatonin
Peak
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Duration of Darkness
Direct Proportion to the
Production of
Melatonin
0
10
20
30
40
50
60
70P
las
ma
Me
lato
nin
(p
g/m
l)
0000 0800
0
10
20
30
40
50
60
70
Pla
sm
a M
ela
ton
in (
pg
/ml)
1800 0800
L:d 16:8
L:d 10:14
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The Brightness of Light at
NightProportion
ally suppresses melatonin
levels
0
20
40
60
80
100
120
0
20
40
60
80
100
120
0
20
40
60
80
100
120
12 20 22 24 01 03 08 10
0
20
40
60
80
100
120250 lux
500 lux
1500 lux
Time of date (h)
pg m
ela
tonin
/ m
l se
rum
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Melatonin
Inhibits Growth of
MCF-7(Human Breast
Cancer Cells)
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Melatonin
Inhibits Tumor
Growth & Tumor
Metastases J Pineal Res, 2003.
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Melatonin Levels Decrease
With Increasing Age(Cancer is an age-related disease)
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Symptoms of Melatonin Deficiency
Mental Light, anxious, agitated sleep Easily woken Difficult to fall asleep Poor dreaming Hypersensitive Irritable
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Melatonin Excess Very deep sleep during 3 – 5
hours + too early waking up + “heavy” head in the morning
Sometimes Deep & prolonged sleep(iness) the
whole night through until late in the morning
Too vivid dreams
Combination of L-Citrulline & L-
Arginine Increases Nitric Oxide Production
Cardiovascular, Immune Boosting, Sexual Health
Benefits
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How are Citrulline & Arginine Related?
Citrulline converted into arginine assoon as it enters Kidney Vascular endothelium Other tissues
Plasma & tissue levels of arginine Necessary for production of nitric oxide & relaxation of
blood vessels
Romero MJ, Platt DH, Caldwell RB, Caldwell RW. Therapeutic Use of Citrulline in Cardiovascular Disease. Cardiovasc Drug Rev. 2006 Fall-Winter; 24(3-4): 275-90.
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Citrulline & Arginine
Help Improve Sex Life Arginine has been well studied
for its ability to enhance sexual satisfaction
Both men & women report longer & more intense orgasms when their intake of arginine increases
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Citrulline & Arginine
Help Improve Sex Life
Arginine is often used by men to achieve long lasting & harder erections
Citrulline & arginine can be combined for enhanced sexual pleasure & vascular health Citrulline is a precursor for arginine Arginine is a precursor for nitric oxide
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Importance of Nitric-Oxide
to Healthy Blood Flow Helps prevent blood aggregation or platelets from becoming sticky When platelets are not sticky,
they can move single file through capillaries
When vascular system is working efficiently – less chance blood clot will form Less chance of having a heart
attack or stroke
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References• Dessy C, Ferron O. (2004). “Pathophysiological Roles of Nitric
Oxide: In the Heart and the Coronary Vasculature.” Current Medical Chemistry – Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry. 3(3):207-216.
• Osanai T, Fujiwara N, Saitoh M, Sasaki S, Tomita H, Nakamura M, Osawa H, Yamabe H et al. (2002). “Relationship Between Salt Intake, Nitric Oxide and Asymmetric Dimethylarginine and Its Relavance to Patients With End-Stage Renal Disease.” Blood Purification 20(5):466-8. doi: 10.1159/000063555. PMID 12207094.
• Kang L, Reyes RA, Delp JM. “Aging Impairs Flow-Induced Dilation in Coronary Arterioles: Role of NO and H2O2.” Am J Physiol Heart Circ Physiol. 2009 September; 297(3):H1087-H1095. Published online 2009 July 17.
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