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Conventional, orthodox, allopathic medicine is expensive, aggressive, invasive and toxic yet appropriate for people with end organ and advanced disease. Most of our health care resources go to fund this type of medicine This model or paradigm of medicine is not appropriate for people who are relatively healthy or with early or mild to moderate medical problems. We are genetically programmed on a biochemical and cellular level to maintain health and to heal ourselves (within limits) if we have the right conditions. Conditions which allow us to recover some measure of youthful physiology. Inflammation Oxidation/production of free radicals Endothelial cell dysfunction Insulin resistance Glycation (AGES) Accumulation of toxins Down-regulation of hormones Macro nutrition axioms Essential Micronutrition Replacement of individual micronutritional deficiencies Optimal sleep Detoxification Aerobic exercise Anaerobic (resistance) exercise Hormone replacement (to optimal, youthful levels) Telomere lengthening (telomerase activators) Stem cell transplant Platelet rich plasma (PRP) Low dose naltrexone GcMAF No junk food. Avoid food toxins. Never let yourself get severely hungry. Eat every 3 hours. Always eat a big breakfast Intermittent fasting Eat most of the daily carbohydrate intake in the first part of the day. No GMO. Avoid most grain especially wheat. Best diet is probably the Paleolithic diet The genetic engineering process creates massive collateral damage, causing mutations in hundreds or thousands of locations throughout the plant’s DNA. Natural genes can be deleted or permanently turned on or off and hundreds may change their behavior. Even the inserted gene can be damaged or rearranged. It may create proteins that can trigger allergies are promote disease. Soy Corn Canola cotton Sugar beats Wheat Can make you allergic to non GMO as well as GMO foods Causes liver atrophy in rats Increases mortality in the rat model Causes small-for-date offspring and a decreased number of offspring Rats fed GMO had altered testicles, ovaries and germ cells Third-generation offspring were infertile and showed increased numbers of tumors High fructose corn syrup High GI carbohydrates Trans-fats Fried foods Foods high in Nacl Soda/sugary sweets Herbicides Pesticides Insecticides Fertilizers Petrochemicals Halides Heavy metals BPAs Phthalates PVCs/PCBs/PBDE MSGs Aspartame Solvents Antibiotics Synthetic estrogens Nitrates and nitrites Glyphosate(Roundup) Disruption of mitochondrial function Decreases ATP production Causes insulin resistance and hyperglycemia Chronic hyperglycemia results in AGES Glyphosate itself breaks down into dioxalate which also increases AGES Enhances glycosylation of LDL cholesterol Increases cerebral glutamate concentration Enhances aluminum movement into the brain Interferes with vitamin D hydroxylation Reduces the beneficial bacteria in the soil Reduces pyrole production by intestinal flora Causes dysbiosis May increase serum ammonia level Inhibits cytochrome P450 system 30-40% Carbohydrates 40% Protein 20-30% Fat Organically grown fruits and vegetables Eliminate most grains No wheat Trend toward low GI Whole grain wheat has a GI of 72 Cross bred with other wheat grasses Extensively mutated Spliced with genetic material from other organisms. Gluten/gliadin/wheat germ agglutinins Causes: belly fat, colon leak, autoimmune problems, neuropsychiatric problems Wild fish Free range chicken Free range turkey. Grass fed beef. Buffalo/elk Whey isolate Up to 20-30% animal fat. Omega-3 fat. We get enough Omega 6 fat. Supplement with Omega 9 fat (mono-saturated fat) No trans-fat Multiple vitamin Vitamin C Vitamin D3. Omega 3 fatty acids. Polyphenols Iodine. Replete individual deficiencies Needed because soils are depleted in vitamins, minerals, coenzymes, cofactors and trace elements Collagen A and C/bone matrix Carnitine synthesis Immune system Adrenal hormone production Parent antioxidant 5000 mg a day Not a vitamin A secosteroid Up regulates 1/10 of the entire human genome Needed for vitamin D binding protein/ GcMAF Produces CAMP Usually low or suboptimal Hard to overdose Increased incidence of cancer Cardiovascular disease Autoimmune disease Type 2 diabetes mellitus Metabolic syndrome Neurocognitive disease Osteoporosis Osteoarthritis Chronic fatigue/fibromyalgia Influenza Depression Optimal ratio of Omega 6: Omega-3 is 2:1 to 4:1 Ensures that a arachidonic acid is not excessive and downstream series 2 eicosanoids are limited Series 1 and series 3 eicosanoids therefore predominate suppressing inflammation, vasoconstriction and platelet aggregation Catechins and cyanidins Antioxidant/free radical scavenger’s Decrease a large component of the bodies inflammation Slow telomere shortening Green tea extract EGCG Resveratrol Quercetin Pycnogenol Red wine extract Grapeseed extract Deficient in 96% of the American population. Average intake in US is 175 ug/day Average Japanese intake is 13,800 ug/day Concentrates in the thyroid gland. Also concentrates in the breast , ovaries, uterus prostate, stomach, pancreas, etc. Deficiency is thought to be a causative factor in fibrocystic breast disease, PCOS, uterine fibroids Inverse relationship of iodine level and LV function, elevated CRP, dyslipidemia, cardiovascular disease Is a cofactor for insulin receptors and up regulates insulin receptors Needed to synthesized thyroid hormones and conversion of T4-T3. Needed for steroid hormone function Chelates heavy metals Displaces and removes toxic halides. Is a broad-spectrum antimicrobial. Causes apoptosis of cancer cells and senescent cells Bowel cleanse Liver cleanse Increased intake of purified water Regular heavy exercise and sweating Infrared sauna Chelation therapy Eat only organic food Usually mesenchymal stem cells(MSCs) Are pluripotent and can differentiate into a variety of cell lines Work predominantly by secreting cytokines which up regulate host MSCs This results in the reduction of inflammation, modulation of the immune system and stimulation of regeneration Autism Cerebral palsy Congestive heart failure COPD Asthma Degenerative joint disease Spinal cord injury MS, rheumatoid arthritis, SLE, type 1 diabetes mellitus, Crohn’s disease, Sjogren’s syndrome, primary biliary cirrhosis and other autoimmune diseases Plasma is spun to yield the platelet rich component The platelet rich component is treated with fibrin and calcium chloride to activate the platelets and release growth factors It is then injected (preferably with ultrasonic guidance) into an area of injury This results in tissue (cartilage, tendon, bone) regeneration and repair Platelet derived growth factor Transforming growth factor beta Fibroblast growth factor Insulin like growth factor 1(IGF-1) Insulin like growth factor 2(IGF-2) Vascular endothelial growth factor Epidermal growth factor Interleukin-8 Keratinocyte growth factor Connective tissue growth factor Nerve injury Tendinitis/tenosynovitis Osteoarthritis Recurrent ankle sprains Sacroiliac joint dysfunction Muscle injury Cardiac muscle injury Partially torn or strained knee ligaments Partially torn tendons Bone repair and regeneration Given at bedtime and at doses of 1.5-3 mg it transiently blocks opioid receptors This up regulates endorphins and enkephalins by 200-300% This up-regulates and simultaneously modulates the immune system Large number of anecdotal reports and small clinical trials with LDN have shown stunning efficacy in the treatment of various cancers and auto-immune diseases Bladder cancer Breast cancer Carcinoid Colorectal cancer Glioblastoma Liver cancer Non-small cell lung cancer Chronic lymphocytic leukemia Lymphoma (Hodgkin’s and non-Hodgkin’s) Malignant melanoma Multiple myeloma Neuroblastoma Ovarian cancer Pancreatic cancer Prostate cancer Renal cell carcinoma Throat cancer Uterine cancer ALS Alzheimer’s dementia Autism Multiple sclerosis Parkinson’s disease Primary lateral sclerosis Ankylosing spondylitis Behcet’s disease Breast syndrome Crohn’s disease Number metal myositis Fibromyalgia Hashimoto’s thyroiditis Chronic fatigue syndrome Myasthenia gravis Primary biliary cirrhosis Psoriasis Rheumatoid arthritis Scleroderma Sjogren’s syndrome Systemic lupus erythematosus Occurs when vitamin D binding protein becomes glycosylated with galactosamine at amino acid position 420 GcMAF markedly up regulates macrophages Macrophages are then able to identify cancer cells and viruses and phagocytize them Cancer cells and viruses produce an enzyme alpha-N galactosaminidase (nagalase) which deactivates GcMAF Adding GcMAF in sufficient quantities can overwhelm nagalase GcMAF has been found to have a number of other actions against cancer It causes apoptosis of cancer cells It inhibits angiogenesis of tumors It inhibits metastasis It stimulates the transformation of cancer cells back to its normal phenotype BIHRT makes more intuitive sense Better results Little or no side effects People feel better and function better on them. Physiologic aging is slowed (often dramatically) They are identical to the hormones which already exists in the body We don’t have receptors sites for synthetic hormones Progesterone Testosterone Cortisol DHEA Free T4/T3 HGH/IGF-I Estradiol Estriol Melatonin Vasopressin Oxytocin MSH Pregnenolone Calcitonin Parathyroid hormone Aldosterone E1–estrone E2–estradiol E3–estriol Promotes bone mineralization (inhibits osteoclasts) Thickens skin by promoting collagen buildup Maintains integrity of teeth and gums Increases basal metabolic rate Improves insulin receptor response Promotes T4 conversion to T3 Improves vascular elasticity Improves arteriolar vasodilation. Improves blood flow Inhibits platelet aggregation Prevents atheroma formation. Lowers LDL cholesterol. Lowers Lipoprotein a Lowers blood pressure Decreases homocysteine levels. Increases ACH by increasing choline acyltransferase activity Improves reasoning. Improves mood. Improves concentration Improves fine motor skills. Stimulates nerve growth factor Enhances libido Increases body fat Increases triglycerides Causes insulin resistance and elevated blood sugar Increases blood pressure Increases inflammatory cytokines and CRP Increases fibrinogen and a tendency to form thrombosis Increases risk of gallbladder stones Interferes with growth hormone effect on the liver to make IGF-I Increases production of 4(OH)estrone Between the ages of 35 and 50 women gradually make less estrogen (approximately 35% decrease) but make significantly less progesterone and testosterone (approximately 75% decrease) resulting in a condition of estrogen dominance Synthetic estrogens. Xeno- estrogens. Phytoestrogens Low iodine levels. Come from pesticides, herbicides, plastic byproducts etc. May account for severe estrogen dominance in women May account for the pandemic of low testosterone in men May account for early menarche in girls PMS Anxiety, agitation Depression Insomnia Fluid retention FBD, PCOS, uterine fibroids, endometriosis Mood swings Pain/fibromyalgia/chronic fatigue/migraines Heavy periods Diminished libido Abdominal fat gain Hypothyroidism Gallbladder disease Thrombus formation Night sweats Hot flashes Brain fog Memory lapses Fatigue Urogenital symptoms Palpitations Decreased libido Vaginal dryness/dyspareunia Weight gain Acne Hair loss Depression Do not need estrone No receptors to synthetic estrogens. Problems with oral estrogen(see above) Administer topically. Premarin is desiccated pregnant mare’s urine Premarin is high in estrone, high in horse estrogen, and given orally Estriol Progesterone Testosterone DHEA Melatonin Oxytocin Free T3 Human Growth Hormone Vitamin D3 Estradiol metabolizes to 2(OH) estrone which is a cancer protective metabolite. It also metabolizes to 16(OH) estrone and 4(0H) estrone which or cancer promoter metabolites A number of botanicals, vitamins and supplements push estradiol toward the 2(OH) estrone pathway and away from the 4(OH) and 16(OH)estrone pathways B6, B12, Folate Sulfur containing amino acids/peptides (methionine, acetylcysteine, trimethylglycine, SAMe) Cruciferous vegetables DIM, 3IC Omega-3 fatty acids OPCs/other antioxidant free radical scavengers Increases HDL cholesterol Decreases LDL cholesterol Up regulates insulin receptors Lowers blood pressure Decreases inflammatory cytokines Increases elasticity of arterial vessel walls Causes diuresis by blocking aldosterone receptors Protects against breast cancer Vasodilates coronary artery Promotes sleep Increases parasympathetic tone. Activates neuronal stem cells to increase neurons. Protects of brain against traumatic brain injury Mitigates DUB Increases VO2 max Increases conversion of T4-T3 Improves migraine headaches in estrogen dominant women Improves libido in estrogen dominant women Raises pain threshold Improves immune system function Both men and women need it. Current worldwide pandemic of low testosterone. Causes of low testosterone include: Traumatic brain injury Xenoestrogens Phytoestrogens Synthetic estrogens Heavy metals/other causes of inflammation High stress (cortisol) High or low thyroid hormone levels Conditions which activate aromatase Decreased libido Erectile dysfunction Increase and visceral and belly fat Gynecomastia Decreased strength Decreased endurance Anxiety/depression Cognitive dysfunction Poor sleep Fatigue Mood swings Urogenital symptoms Dry skin/sagging skin Decreased facial and body hair Joint and muscle pain Risk factor for Alzheimer’s dementia. Risk factor for cardiovascular disease and death secondary to cardiovascular disease Osteoporosis and bone fractures Sarcopenia Decreased cardiac output/hypertension Elevated CRP Dyslipidemia Insulin resistance Sarcopenia Fat gain especially visceral fat Likely risk factor for prostate cancer Decreased libido Erectile dysfunction Decreased cardiac output Increased inflammation Mild anemia Muscle anabolism. Lipolysis (fat loss) Bone mineralization Improved cognitive function Improved mood Better sleep Improved libido Improved erectile function Improved cardio vascular function Increased differentiation of bone marrow stem cells to form endothelial progenitor cells (EPCs) Up regulation of insulin receptors with decrease in insulin levels Marked reduction of inflammatory cytokines Lower fasting blood sugar, fasting blood insulin and lipid levels Lose body fat Decrease alcohol intake, especially beer Paleolithic diet Heavy resistance training Stimulate luteinizing hormone release of the pituitary by: Tribulis terrestris Avena sativa D-aspartic acid SERM (clomiphene) Bromocriptine/ Cabergoline /zinc Human chorionic gonadotropin Optimal estrogen and progesterone levels Optimal thyroid levels Optimal cortisol levels Increased (optimal) growth hormone levels Inhibit aromatase Progesterone(slight effect). Zinc DIM Chrysin Anastrozole Inhibits testosterone conversion to DHT. Inhibits testosterone conversion to estradiol (slight). Metabolizes to 5-allopregnenolone Allopregnenolone promotes sleep and reduces cortisol Lower cortisol increases luteinizing hormone and turns off aromatase. Converts estradiol to estrone The active form of thyroid hormone. Optimal levels stimulate production of testosterone. Optimal levels acts synergistically with testosterone. High or low levels will activate aromatase High levels will inhibit testosterone conversion to dihydrotestosterone High levels increased sex hormone binding globulin (SHBG) Optimal cortisol level has a positive affect on the release of testosterone High cortisol levels inhibit the release of luteinizing hormone High cortisol levels activate aromatase Low cortisol levels increase the level of sex hormone binding globulin Stimulates release of testosterone directly. Increases, IGF-I, which augments increase of luteinizing hormone Inhibits aromatase Reduces SHBG Don’t give testosterone if active cancer present Digital rectal examination and PSA done on first visit and periodically thereafter Follow CBC/ testosterone can increase hemoglobin levels Check DHT levels Check free and total testosterone levels Check estradiol levels Free testosterone: 18-24 pg/mL Total testosterone: 800-1100 ng/mL Dihydrotestosterone: 50-80 ng/mL Estradiol: 20-35 pg/mL Bioavailable testosterone: 300-500 ng/mL Total testosterone: 50-100 ng/ml Free testosterone: 1-6 (2-8) pg/ml Bioavailable testosterone: 10-30 ng/ml Use bio-identical hormones rather than synthetic or animal hormones Give estrogen and testosterone as a topical cream Give progesterone as micronized capsules orally at bedtime Give estriol with estradiol Mimic normal youthful physiologic levels Pap, pelvic, mammogram prior to starting therapy Supplement and balance other hormones into youthful range Necessary as principal anti-inflammatory in the body Will die without it Severe low levels referred to as adrenal insufficiency (Addison’s disease) Profound fatigue/decreased level of consciousness Hypotension Hypoglycemia Hyponatremia Type IV renal tubular acidosis Positive diagnosis by ACTH stim test Chronic emotional or physiologic stress Chronic disease Chronic depression Chronic pain Poor nutrition Excessive exercise Inadequate rest High intake of sugar Severe fatigue (worse in the morning ) Difficulty recovering from exercise Agitation and irritability Depression and anxiety Orthostatic hypotension Symptoms of hyperadrenergia Salt and sugar cravings Narcotic intolerance Decreased libido/sexual dysfunction Diffuse bone and muscle pain Food allergies Seasonal rhinitis/asthma GI disturbance (GERD and IBS) Palpitations Sleep disturbance Removed stressors if possible Optimize diet (Paleolithic/Mediterranean diet) Decrease or stop caffeine and alcohol Exercise Deep sleep(treat with progesterone/melatonin) Up regulate testosterone to optimal levels Up regulate DHEA, pregnenolone and progesterone to optimal levels Eventually correct thyroid hormones if low Multiple vitamin, high-dose vitamin C, highdose chromium, vitamin D3 at 5-10,000 units per day, Omega 3 fatty acids, etc. Botanicals/adaptogens Glandular extracts (adrenal rebuilder) Consider low-dose cortisol for 1-3 months May be due to chronic stress, but eventually down regulates to suboptimal levels referred to as adrenal fatigue High cortisol can also be caused by Cushing’s disease or Cushing’s syndrome Hypertension. Insulin resistance/type 2 diabetes mellitus Dyslipidemia/metabolic syndrome Suppression of the immune system Sarcopenia (muscle wasting) Abdominal fat (visceral adiposity) Osteoporosis (bone demineralization) Direct neurotoxicity (especially to the hippocampus) Dysmorphic features (moon face, buffalo hump, striae) In youth, when stressed, the pituitary produces ACTH which stimulates the adrenal gland to release cortisol and concurrently to release abundant amounts of DHEA which functions, among other things, to oppose the many harmful effects of high cortisol Decrease his blood pressure Up-regulates insulin receptors and decreases insulin as well as blood sugar Inhibits the development of dyslipidemia and metabolic syndrome Up-regulates the immune system. Prevents sarcopenia Prevents visceral adiposity Stimulates bone mineralization Protects the brain and promotes cognitive function While cortisol may rise slightly or decline slightly or stay the same with aging, DHEA typically declines dramatically with aging. By the age of 50, many people have less than 25% of their youthful levels Typically, patients with adrenal fatigue have concurrent low levels of DHEA and often low levels of other hormone such as progesterone, testosterone, pregnenolone and thyroid hormones Pregnenolone is the parent steroid hormone synthesized in the adrenal gland from cholesterol and gives rise to the entire adrenal cascade of hormones Pregnenolone is produced de novo in the brain and significantly up regulates ACH The parent hormone of the adrenal cascade Balances the inhibitory and stimulatory neurotransmission in the brain Up regulates the stress response Improves fatigue Improves memory/cognitive function Down regulates pain sensation Up regulates the immune system Decreased memory Fatigue Cold intolerance Dry skin Depression Increased pain issues Arthritis Depression Fatigue/adrenal fatigue Decreased energy states Mood swings Fibromyalgia Postpartum depression Spinal cord injuries Impaired memory Diagnoses is usually presumed if the TSH > 3iu/ml. TSH is the pituitary’s response to insufficient T4 and T3(in the pituitary and the brain) Other typical criteria is a low freeT4 (however T4 is a pro-hormone) A free T3 of between 3.5 and 4.4 pg/ml is the best indicator of optimal thyroid function Unfortunately a free T3 is rarely ordered It stimulates cellular DNA to make messenger RNA which in turn makes ribosomal RNA Ribosomal RNA codes for the production of uncoupling proteins These proteins uncouple oxidative phosphorylation which is thermogenic Optimal levels of free T3 are also anabolic for protein, stimulate glycogenesis and lipolysis Fat gain. Difficulty losing weight/fat Cold intolerance Fatigue and low energy Decreased cognitive function Dry skin Constipation Fluid retention Anxiety and depression Muscle joint and tissue pain Brittle, thinning hair Inability to sweat with exercise Loss of appetite Heavy menses Palpitations/arrhythmias Recurrent headaches Dyslipidemia Signs and symptoms of estrogen dominance Hypotension/hypertension Diminished hearing Decreased body temperature Narrowing of the pulse pressure/bradycardia Periorbital edema Hertogue’s sign Thick tongue Hoarseness Goiter/enlarged thyroid Hyporeflexia Cold hands and feet Age Decreased nutrition Inflammation Acute illness Chronic illnesses Alcoholism Heavy metals Fertilizers, pesticides and insecticides Vitamins A,C and B vitamin deficiencies Depletion of the following minerals: Selenium Zinc Iodine Iron Chromium Copper Amiodarone Beta blockers Oral estrogens Birth control pills Lithium Radioiodine Aminophyllin Dilantin Corticosteroids Alpha lipoic acid Type 2 diabetes mellitus Obesity Halide toxicity Recent x-ray therapy Recent surgery Positive TPO antibody status Cigarette smoking. Low level of hGH Hemochromatosis High cortisol levels Chemotherapy Elevated level of bioflavonoids/soy products T4/T3 (thyroid Armour /Nature-thyroid vs. conjugated T4/ T3) Vitamin/mineral supplementation Replete iodine (Iodoral at 12.5-50 mg a day) If cortisol depleted, replete it first Optimal nutrition/exercise Replete other hormones if low with bioidentical hormones Thin skin Sagging skin Wrinkles Hair loss Graying hair Decreased short-term memory Difficulty learning new information Worsening presbyopia Anxiety/depression Poor/nonrestorative sleep Decreased endurance Increased belly fat Increased visceral fat Loss of muscle mass and strength Osteoporosis/osteopenia Decreased libido/erectile function Elevated CRP/elevated IL-6 Elevated lipoprotein a Dyslipidemia Increase beta amyloid Elevated homocysteine level Decreased NO production Decrease conversion of T4-T3 Insulin resistance Down-regulation of all other hormones Decreased basal metabolic rate Somatostatin Prolactin Elevated hGH/ IGF-I Increased fat intake Increased carbohydrate intake Elevated cortisol Obesity/sedentary lifestyle Oral estrogen Tamoxifen Tetracycline Growth hormone releasing hormone (GHRH) Sermorelin/CJC 1295 Ghrelin/GHRP-1, 2, 6, Ipamorelin, Hexarelin Heavy resistance training High-protein/decrease carbohydrate and fat Testosterone Optimal E2, P4, DHEA, melatonin Dopamine and serotonin Amino acids stacks Improved hippocampal function (improved memory learning) Improved vision Improved skin fold-thickness Improved cardiac output/decreased systemic vascular resistance Improved vital capacity and VO2 max Increased muscle mass Decreased visceral fat Increase bone mineral density Improved RBF and GFR Improved cytochrome P-450 function Marked up-regulation of the immune system including regeneration of the thymus Increases interferon gamma Needed for sleep Facilitate cycling through the stages of sleep Potent antioxidant/free radical scavenger Potent anti-inflammatory agent Protects the brain against beta amyloid Is potent anti-carcinogen Up regulates the immune system Increases lab rat age by 30% over controls Up regulates insulin receptors Lowers CRP Increases cardiac output and lowers BP Increase his HDL cholesterol Lowers LDL cholesterol Inhibits LDL cholesterol oxidation May have an antidysrythmic effect Stimulates bone mineralization Enhances release of hGH/IGF-I Dosage: 1-10 mg by mouth at bedtime daily Usually very effective for sleep at high enough dosages By age 50 most patients make very little Often times works well in conjunction with an appropriate dose of progesterone at bedtime Consider use of melatonin for sleep in the younger population Decreased with age Decreased with stress May be decreased with electromagnetic radiation Release augmented with darkness and inhibited by light Low levels currently seen in younger population