2006 Cenegenics. All rights reserved. Cenegenics
Transcription
2006 Cenegenics. All rights reserved. Cenegenics
© 2006 Cenegenics. All rights reserved. Cenegenics® is a registered trademark of Cenegenics Medical Institute. No part of this publication may be reproduced, stored in a retrievable system or transmitted by any means, electronic, mechanical or photocopied or otherwise, without the prior written permission of Cenegenics Medical Institute. Contents Contents ® Medical Institute.................................................. elcome W Welcome to Cenegenics To Cenegenics ®................................................................................................................................4 Tips For Tips Using For TUsing his Guide This. .............................................................................................................................5 Guide........................................................................... I. T heThe Cenegenics Story Cenegenics ® Story Meet Meet Cenegenics Cenegenics. ......................................................................................................................................8 .......................................................................................... Inspiration Behind Cenegenics .........................................................................................................9 The The Inspiration Behind Cenegenics. ............................................................. AnAn Interview Interview WWith ith AAlan lan M Mintz, intz, MD....................................................................................................12 MD . .......................................................... II. T heThe Universal Truth: Aging Universal Truth : Aging is aging , right ?............................................................................................................................16 Aging Aging Is Aging, Right?................................................................................. Facing Facing Facts Facts.................................................................................................. ..........................................................................................................................................17 Male -Female Connection ..............................................................................................................18 The The Male-Female Connection...................................................................... Libido Libido: : Where Where Did Did It G ItoGo?. ?.......................................................................................................................19 ............................................................................ isease: AAPPredator redator. ...................................................................................................19 Cardiovascular CardiovascularDDisease: ........................................................... : A ACChallenge hallenge F or B oth Sexes Sexes.................................................. ......................................................................................20 Osteoporosis Osteoporosis: For Both && Emotional : AARRoller oller Coaster............................. Coaster.................................................................21 Depression Depression EmotionalFluctuations Fluctuations: : The Sum OfOf All ...............................................................................................................22 Aging Aging: The Sum AllFears Fears....................................................................... Your ootOOff ff TThe he TThrottle. hrottle. ............................................................. ...................................................................................................26 Taking Taking YourFFoot Close && Personal : TTwo wo PPatients’ atients’ SStories. tories. ............................................... .....................................................................................27 UpUp Close Personal: III. The III. The Science Behind Cenegenics Science Behind Cenegenics ® Fundamentals FundamentalsofOf Age Age MManagement anagement MMedicine............................................. edicine. .....................................................................................30 Hormonal HormonalHHealth.......................................................................................... ealth..................................................................................................................................31 Hormones Hormones Identified..................................................................................... Identified .............................................................................................................................33 IV. Start Start TakingControl Control Taking It’It’s s AAll ll AAbout bout the TheEEvidence. vidence.................................................................................................................42 ......................................................................... Executive Executive HealthEEvaluation: Whole Health valuation: EExposing xposing TThe he W hole PPicture........................ icture..............................................................43 Getting GettingStarted Started.............................................................................................. .....................................................................................................................................44 Tax Tax Deductible DeductibleVVehicles............................................................................... ehicles . ....................................................................................................................46 Professional ProfessionalFFees.......................................................................................... ees..................................................................................................................................47 Patient PatientPrivacy Privacy.............................................................................................. ......................................................................................................................................47 V. Maximizing Maximizing Your Health Potential Your Health Potential Better BetterHHealth &M Maximum ealth & aximum LLongevity: ongevity: NNo o AAccident................................... ccident..........................................................................50 Hormonal HormonalOOptimization................................................................................ ptimization ........................................................................................................................51 Nutraceutical Nutraceutical SSupplementation. upplementation. ..........................................................................................................52 .................................................................... Sound Sound Nutrition Nutrition............................................................................................ ....................................................................................................................................52 Regular RegularEExercise. xercise. .................................................................................................................................54 .......................................................................................... VI. Commonly Commonly Asked Questions Asked Questions Conveniently ConvenientlyCategorized Categorized............................................................................ ....................................................................................................................58 Appendix Appendix Cenegenics CenegenicsTeam Medical Credentials Institute:.............................................................................................................64 Team Credentials.......................................... The The Cenegenics Cenegenics Teams Teams................................................................................. ...........................................................................................................................69 Press Press Room Room . ...........................................................................................................................................69 .................................................................................................. ® WWW.CENEGENICS.COM WWW.CENEGENICS.COM Welcome To Cenegenics Medical Institute ® Cenegenics Goes Beyond Medical Excellence. It’s Thorough—Extremely Thorough. “Cenegenics Medical Institute is good people, good service. Your program is exacting, thorough, competent and preeminent . . . just what I want.” —R. B., Houston, TX Welcome To Cenegenics Medical Institute ® Cenegenics Goes Beyond Medical Excellence. It’s Thorough—Extremely Thorough. C enegenics® Medical Institute presents a comprehensive, scientific approach to age management. We look where others usually don’t. Better health—not disease—is our primary focus. At Cenegenics, there are no generic approaches to your health. You are an individual with unique issues, goals and concerns . . . different from the patient before you and the ones who follow. Our focus is optimal health—yours. Cenegenics strives to achieve two things: the short-term benefits everyone seeks and the best opportunity to live well longer. We sidestep traditional medicine’s fixit-when-it’s-broken and diagnose-andtreat philosophies. Instead, we take a proactive approach to preventive medical care, enhancing health rather than waiting for disease to appear. Cenegenics is not part of the antiaging movement, nor does it claim to increase longevity or affect aging at cellular levels. We see aging as a natural process that can be managed. Admittedly, time and genetics are constants. Yet, we have learned it is possible to live out all our years with youthful energy and vitality, no matter how many candles were on that last birthday cake. Welcome to Cenegenics® WWW.CENEGENICS.COM Wel Our goal is arming you with sound information and insight, uncovering weak links through evaluations and c o m e t o Cen e g e n i c s diagnostic analyses. Then we guide you through options and alternatives so you can regain and maintain optimal health and vigor. You already make thoughtful business and life decisions. Your health shouldn’t be any different. Determining your personalized program puts—and keeps—you in the driver’s seat. Cenegenics Medical Institute is highly regarded in the medical community for pioneering work with a proactive, preventive approach. We offer locations worldwide, where we partner with you on your discovery of a healthier and more vigorous lifestyle . . . a lifestyle that defies conventional wisdom on aging. Tips For Using This Guide Health matters always involve significant data to review and consider. Our guide is no different. However, we divided it into six key sections (including an appendix) so our data remains accessible and manageable. Part I. An overview of our medical institute, along with a moving story that shaped the inspiration behind our program. Also, you’ll find an insightful interview with Alan Mintz, MD, co-founder, CEO and CMO of Cenegenics Medical Institute. Part II. A dialogue on aging and its effects, including insights on how aging impacts Corporate America. Also, a frank discussion on aging differences between men and women, along with case studies showing how Cenegenics helps patients turn around their health and lives. Part III. The careful science and solid medicine behind Cenegenics. Part IV. Getting started with Cenegenics, including a detailed explanation of our Executive Health Evaluation and how to take control of your health. Part V. Gaining the most from your personalized Cenegenics program. A walk-through of key components. Learn how we address and target your personal needs. Part VI. Our most commonly asked questions, where you’ll likely find answers to your health and medical concerns. Appendix. Supplemental information, including executive bios, an introduction to the Cenegenics team and media coverage. Tips For Using This Guide Wel c o m e t o Cen e g e n i c s Our entire professional team is available to answer questions. Their goal is solid education, building insight for patients and the public at large. Feel free to contact us anytime, without obligation. For a confidential discussion, call us toll-free at 866.953.1510. “Good health is not an accident. It requires your active participation. Even geneticists agree that over 60% of what happens to us is within our own control. Clearly, we have the power to control the future of our health.” —Dr. Alan Mintz WWW.CENEGENICS.COM WWW.CENEGENICS.COM Wel c o m e t o Cen e g e n i c s I. I. The Cenegenics Story ® Meet Cenegenics II. “Working with a Cenegenics doctor who really ‘knows his stuff’ has filled me with great confidence about my health and quality of life . . . almost like a rebirth!” III. IV. —M. S., Whitfield, Manchester, United Kingdom V. VI. I. The Cenegenics Story I. The Cenegenics Story ® Meet Cenegenics C enegenics® pioneered and developed the world’s largest, most-experienced medical age management organization. Thanks to our focus on proactive, preventive care, patients across America and around the globe—25% are doctors and their families—have made dramatic changes in health and vitality. Cenegenics Medical Institute’s individualized programs mean you will too. Simply put, Cenegenics is the genesis of age management medicine. Our team helps patients realize remarkable health goals 95% of the time: boosting energy and libido, reducing body fat and increasing lean muscle, improving cholesterol scores, strengthening immune systems, lifting moods, managing stress and improving cognitive function. Founded in 1997 by Alan Mintz, MD and John Adams, Cenegenics has established an important presence in the international medical community, bridging the gap between conventional medicine and a scientifically based, proactive intervention. I. The Cenegenics® Story Cenegenics Medical Institute is proud to be the only accredited teaching venue for physician training in age management medicine with mainstream medical credentials. Through university and medical school affiliations, we offer medical residents and practicing physicians unique learning opportunities in the medical and business aspects of age management. Meet Cenegenics WWW.CENEGENICS.COM I. Th e Cen e g e n i c s S t o ry I. The Cenegenics Story We also established the Cenegenics Education and Research Foundation for ongoing research and affiliation expansion, aimed at improving science and medicine. Around the world—from Las Vegas, Nevada, Charleston, South Carolina, Boca Raton, Florida and onto Hong Kong, Tokyo and Seoul—our Cenegenics team will guide you through a unique medical experience. Our commitment remains clear: promoting higher-quality life, delaying the onset of illness and helping you live well longer. It begins by contacting us for a confidential—no obligation— discussion. Call us toll-free at 866.953.1510 today. The Inspiration Behind Cenegenics Life is a series of choices, a distinctive journey. Over time, some grow passive or conventional. Others forge challenges, embody determination and ultimately inspire us all. Ida Mintz, mother of Co-founder Alan Mintz, MD, chose just such a journey. Dr. Alan Mintz Remembers In the late 1980s, my mother dazzled the global running community, defying a past filled with cultural and social constraints. At 74, she was the first woman over 70 to run a complete 26mile marathon. My mother finished 10 marathons, though she didn’t learn how to run until 70. Her amazing transformation, from depression to exuberance, inspired a desire to develop principles that ultimately led to Cenegenics having a successful approach to age management. Ida’s early years. My mother’s life began in the midst of devastating pogroms sweeping Eastern Europe, early in the 1900s. Such hostile times were incredibly difficult for Jews, like my mother’s family. Amidst that chaos, her father made his way to America with part of our family. My mother stayed in Poland, I. Th e Cen e g e n i c s S t o ry secreted in great-grandfather’s attic with the remaining family. She spent much of her childhood without the opportunity for formal education, playing or running. Nevertheless, she taught herself to read and write, becoming a model of perseverance. At 16, she made it to Chicago, during the Roaring ’20s. In that era of contradiction—Prohibition, bathtub gins, organized crime and the 19th Amendment—hard work was the rule, even for young women. My mother was no exception. She later met and married Lee Sol Mintz; together, they raised three children. My mother remained a pillar of strength through life’s ups and downs. Her caring, selflessness and intuitive wisdom were a beacon for friends and family alike. Becoming Ida. My mother took great pride in finding resourceful ways to look good, even with limited means. “Let me have one good dress,” she often would say, “instead of ten.” Her always-coiffed hair, minimal makeup and soft-spoken demeanor made for classic beauty. Beyond good looks, her innate intelligence and high ethics became my barometer for life and business decisions. Yet, my mother’s life was plagued with self-doubt. Her lack of formal education—compounded by the repressive cultural and social mores of her era—offered few opportunities. WWW.CENEGENICS.COM I. The Cenegenics Story She was trapped in a web of double standards. Ironically, these struggles later became a catalyst to my mother’s personal success. Key to that success was her focus on health. She said, “I noticed friends getting heavy, and I knew this wasn’t good. My doctor recommended exercises at home, an unconventional thing, and it really paid off. I didn’t know it was also good for my health.” Her doctor gave sage counsel: “Eat to live . . . don’t live to eat.” And so she did. My mother literally would sneak into a closet, doing 50 sit-ups, stretches and other exercises daily. She became diet conscious and an exercise aficionado long before it was trendy. “If something had a lot of fat, it would make you fat,” she reasoned. “I simply limited my fat intake; it was just common sense. And I raised my children on heart-healthy foods. There were plenty of fruits and vegetables in their diets and no fried foods.” Without realizing, my mother set in motion some of the exact components needed to ensure a healthy life as long as her biological clock would allow. A bump in the road. By 70, my mother began changing. Her zest for life diminished. Compounding that, many of her friends were ill or passing away. My mother became depressed, believing she hadn’t fully contributed to the world. As a doctor, I sought a scientific way to help. I knew exercise was essential for keeping cardiovascular and musculoskeletal systems in shape. I also held a growing interest in studies, substantiating how we can maintain 10 WWW.CENEGENICS.COM well-being and vigor as we age. That interest grew through firsthand experience. An avid runner in the mid70s, I expanded my regimen during the ’80s to include weight training. The change was dramatic. And that gave me an idea of how to help my mother. Since she was always active, I thought a little running might do her good. Precautionary x-rays revealed she was free of degenerative change, having the knees of a much younger person! That sparked even more thinking and research, which would later convince me we can retain or regain youthful vigor longer—if we have the right hormonal signals. Setting a new course. My mother started jogging. We shifted focus from the unattainable (starting life over with formal education) to goals she could accomplish. I hoped running would enrich her life. Did it ever. First came teaching her to run. Remember, hiding in her grandfather’s attic, my mother never had the opportunity. She could walk briskly, but not actually run. Before long, with my wife’s help, she caught on. Things were never quite the same. Starting slowly, my mother began feeling better. Running was oxygenating her blood. She rarely caught colds and never had a problem with arthritis. She would run without aches, without pain and without blisters. Then my mother would pull off her sneakers and slip into her favorite four-inch heels. Amazing for a 70-something woman. My father was her biggest fan, joining her on jogs around Lincoln Park, walking briskly just to keep I. Th e Cen e g e n i c s S t o ry her company while surrounded by considerably younger runners. My parents got plenty of attention being dubbed “Recycled Teenagers.” Wherever my mother ran, crowds gathered. She soon became something of a legend in Chicago. Imagine how her self-esteem catapulted . . . she truly was a new woman. The renaissance of Ida. “At first I was reluctant,” my mother reminisced, “but my son advised starting with a half mile. I tried it and loved it. I began with walks and worked my way up to a marathon.” In September 1980, she ran her first marathon at the age of 74—the oldest woman to finish a marathon, placing first in her age group. Three generations in the Mintz family made the record books that day, completing the memorable race with her: my mother, my son Ari, my wife Gloria and myself. We were the first family to ever have three generations in one marathon. My mother set the record for her age group that year: 4 hours, 39 minutes. She completed 10 marathons over the years, up to age 85, always first in her age group. Her records still stand. That discovery didn’t occur until after my mother’s passing; unfortunately, she never got to enjoy the benefits of hormone optimization, which may have enhanced her life even more. She was diagnosed with pancreatic cancer at age 85. Although running would never again be part of her life, my mother’s perseverance remained. She gathered the strength to rise from her wheelchair and dance with our son Jeffrey at his wedding. “When I ran my first marathon, I was first in the world to do something. Younger runners ask, ‘How did you do it?’ I tell them I worked up to it.” A new lease on life. “The minute I open my eyes, my feet are on the ground and I’m ready to go,” my mother once said, explaining her daily routine. Each day before sunrise, she would perform an hour-long warm-up of calisthenics, isometrics and stretching. Then she would run at least five miles. Some Sundays, she would run 14 to 16 miles, preparing for a marathon. Not surprisingly, my wife Gloria lovingly called my mother the “Energizer Bunny.” “She would always take a plastic bag with grapes to keep hydrated,” Gloria fondly remembers. “Ida had stickto-itiveness you couldn’t help but admire.” From depression to total selfconfidence, my mother had set her sails, inspiring others along the way. Letters poured in from around the world, saying, “If she can do it, then so can I.” That same sentiment followed her at events. “A young man approached me, wanting to thank me. He had thought of quitting until he saw me pass him. He told me he knew after that he had to finish the race.” Letters poured in from around the world, saying, “If she can do it, so can I.” Connecting the dots. What was the secret? Without refute, time and genetics remain our true constants. Yet my mother instinctively lived a lifestyle that studies would later define as promoting well-being and vigor: regular exercise, sound nutrition and nutraceutical supplementation. However, there was one other key component to living well longer that I was about to discover: hormone optimization. Diminished hormone levels can contribute to many of the symptoms we associate with aging. Incorporating hormone optimization in a synergistic approach (with exercise, sound nutrition and nutraceutical supplementation) led to the eventual creation of Cenegenics® and our innovative age management solution. I. Th e Cen e g e n i c s S t o ry We were blessed with immense joy, having my mother live with us for her last six months. My wife Gloria took time off from her career responsibilities to spend time with my mother. They walked every day, until it was no longer possible. There was time to talk, to let her know how much she was loved and to celebrate how she had become an inspiration to thousands all over the world. On the eve of her 86th birthday, my mother passed away. Gone, but not forgotten. Her inspiration still touches lives, from family and friends to strangers around the globe. Our oldest granddaughter has chosen to follow my mother’s footsteps, training for Olympic speed skating. She says, “I’m doing this because I remember what Nana accomplished.” My mother’s words of wisdom and favorite dictum have become the heart of the Cenegenics philosophy: Tell people to take care of their health . . . it really pays off in the long run. It keeps you young. It’s never too late. If I can do it, so can you. As long as you’re well, you can do anything. My favorite quote is: “An ounce of prevention is worth a pound of cure.” WWW.CENEGENICS.COM 11 I. The Cenegenics Story Running changed my mother’s life and helped her make a global impact. Interviews, magazine articles and newspaper headlines said it all: Galloping Grandma . . . Never too old to try . . . 84 and still knocking them dead on the racetracks. I. The Cenegenics Story Epilogue. My interest in hormone optimization grew. I searched the world, speaking with researchers and reading everything on the subject. The medical literature was mounting— reporting remarkable effects from hormone therapy. An Interview With Alan Mintz, MD Research was supportive: The synergy of hormonal optimization, nutraceutical supplementation, sound nutrition and smart exercise helps people live vigorously active lives throughout middle age and well into the golden years. My mother proved a strong example of this equation. I retired from a successful radiology practice and medical businesses, searching for something to blend my passions: traditional medicine, combined with a proactive and preventive approach to help people stay vital and healthier longer. As a result, John Adams (my longtime friend, workout buddy and business partner) and I developed the largest and most-experienced age management organization in the world. Bodybuilding at middle age? Let’s talk about the reasons why you created Cenegenics Medical Institute. There were four passions propelling me. The first was a desire to help people remain vital as they grow older. Second was my strong support for preventive medicine. Third came a drive to integrate conventional medicine into the equation. And fourth was my passion for business. Tell us more about the first . . . helping people stay vital. My mother would be proud. I’ve experienced this firsthand. I was a chunky teenager, who worked on getting fit in my 20s and 30s. In my 40s, I added hormonal therapies to my regimen, continued to run marathons and shifted my weight training into high gear. Nutrition was also a key factor—taking the nutrients needed to 12 WWW.CENEGENICS.COM My body image improved and wasn’t at all like my middle-aged friends. They were slowing down and I was just getting started. The more I worked out, the more efficient my metabolism became. I could eat well and not gain weight. In fact, my workout buddies eventually encouraged me to enter a bodybuilding contest. Cenegenics® Medical Institute truly is unique, helping people reverse symptoms of aging through comprehensive, individualized programs. Some of the finest people in medicine have joined us to establish a medical institute that stays focused on prevention and wellness, helping patients enjoy a longer health span with greater vitality. Regain your optimal health and vigor with evidence-based medical science. Call Cenegenics toll-free for a no-obligation, confidential discussion: 866.953.1510. build the body I knew was possible. It paid off. We can’t do much about living longer than our genetic potential. However, we can take control of our lifestyle choices and stop buying into the “aging” myth. Just because we grow older doesn’t mean having premature disabilities. I. Th e Cen e g e n i c s S t o ry It took hours of daily practice, working with coach Dan Vasic. I had to build and define muscles, practice poses and choreograph a routine to compete. Special diets and supplements played a big part in my success. By the day of the contest, I already felt like a winner. And the contest? The audience went wild. There I was at 58, getting a standing ovation and cheers—winning the bodybuilding title: 1996 AAU Mr. Illinois, Grand Master Division. I was healthy, fit and felt great! Your personal experience confirms we can stay vital, despite chronological age. What about your second reason for creating Cenegenics? Hands down, I am an advocate of proactive, preventive medicine. Much of today’s medicine is diseasebased. We wait until something bad happens, then pull out all the stops to correct the problem. That’s too late; disease starts before you know it. You may feel healthy today, but what if tomorrow brings a heart attack? You weren’t as healthy as you thought. unique opportunities to gain a deeper understanding of the practices of age management medicine. We also focus on the synergy of hormone optimization, nutraceutical supplementation, exercise and nutrition. The endocrine system is often overlooked, which is tragic because it secretes hormones needed for cellular communication, organ function and rejuvenation. I enjoy the challenge, and I’m good at it. As a result, we can generate funds needed to reinvest and promote better medicine. Our success helps us help patients, creating the best of all possible worlds. The endocrine system affects fat metabolism, muscle growth, bones, cardiovascular health, moods, cognitive ability, sexual performance and skin quality. Clearly, it demands our attention. How does conventional medicine factor into your advanced approach? I’m a mainstream guy. I received a Bachelor of Science degree from the University of Chicago in 1959, then graduated from medical school (University of Illinois) in 1963. In 1971, I became board-certified in radiology, after a residency at Michael Reese Hospital in Chicago. I love medicine and found my radiology practice rewarding and gratifying. That’s why I’ve made sure Cenegenics is well grounded in medical science and structure, which has helped Cenegenics gain much recognition from the medical community. I’m proud to say hospitals, medical schools and organized medicine have responded favorably to our approach. Through university and medical school affiliations, we offer practicing physicians and residents You truly bridged the gap between traditional medicine and preventive medicine. But what about business? Explain your latest initiatives, reaching out to Corporate America. Corporate America is engulfed in executives spending their health to gain wealth. Ironically, the stress, lack of quality sleep, excesses, overmedication, poor nutrition, sedentary lifestyle and an endocrine system whose functions are diminished actually limit the ability to generate wealth. Consequently, an executive is unable to protect the most valuable asset: personal health. Without vitality, sharp cognitive functions, energy or even a healthy, happy sexual life, the executive is working below par. Personal and business lives suffer. Every aspect of life comes tumbling down. Your work must be extremely rewarding. It is. After retiring from my radiology practice and management company, I had the luxury of enjoying my family and growing brood of grandchildren. But I longed to do more. I vowed I would only come out of retirement to do something needed, wanted and challenging. Inspired by my mother’s story and after reviewing years of research, Cenegenics was it. We have forged new ground, creating the field of age management medicine and becoming the teachers in this new field. Today, we have the distinct honor and pleasure of working with those physicians we have trained, who have become like-minded and help spread our important, innovative work around the world. That’s where Cenegenics can step in. We help businesspeople understand how to apply the same strategies used in their business success to take control of their health. Cenegenics is grounded in scientific structure and relies on evidence-based feedback, guiding businesses and their employees toward a higher-quality life on every level. As a result, executives emerge with fewer sick days, higher productivity, renewed attitude and a more secure fiscal future. And that makes corporations as a whole healthier. It’s a win-win all the way around. I. Th e Cen e g e n i c s S t o ry WWW.CENEGENICS.COM 13 I. The Cenegenics Story Why not move upstream and look at the earliest possible signs, seeing what might become a concern later? At Cenegenics, we begin each patient’s program with a comprehensive evaluation and periodically follow up to stay in front of potential problems. I. The Cenegenics Story 14 WWW.CENEGENICS.COM I. Th e Cen e g e n i c s S t o ry I. II. The Universal Truth: Aging Aging Is Aging, Right? II. “ I can’t express how appreciative I am about the open-minded paradigm and professionalism at Cenegenics. I witnessed encouraging results in my body appearance, my male virility and how I feel—all with III. IV. positive effects on my confidence” — L.R., Alexandria, VA V. VI. II. The Universal Truth: Aging Aging Is Aging, Right? II. The Universal Truth: Aging I t is, if you listen to conventional wisdom. Traditional thought has programmed us to expect aging and debilitating symptoms as an inevitable gloom, slowly penetrating our lives from middle age onward. That’s not necessarily true. Research and time-tested therapies prove differently. In the last decade, studies have redefined “healthy” as “living with the energy and vitality of someone years younger.” Achieving that level of health adds life to your years. Aging is not a disease. It is a natural process that can be managed. True, you can’t stop your biological clock. And there can be real challenges meeting you at various times in your individual aging process. The key is how you live out those years and meet those challenges. Cenegenics® Medical Institute can guide you on a course that defies conventional thinking and helps you take control of your health as you age. Start revitalizing your life now. Call us toll-free at 866.953.1510 for a confidential discussion about your personal needs and concerns. II. The Universal Truth: Aging Aging is aging, right? 16 WWW.CENEGENICS.COM II . T h e U n i v e r s a l Tr u t h : Ag i n g Studies reveal most adults have significantly lower levels of several essential hormones by age 40. Both men and women rely on a critical balance of estrogen, testosterone, thyroid, DHEA (dihydroepiandrosterone) and cortisol. Each has a specific job—yet overlaps the others to create a synergistic environment for better health. DHEA works closely with cortisol to protect against stress, cardiovascular disease, osteoporosis and Alzheimer’s, as well as preventing wrinkles and dry eyes, increasing libido, upping energy levels, boosting memory and immunity. Cortisol helps regulate blood pressure, increases energy and influences metabolism, as well as helps your body cope with stress and infection. Having lower levels of these hormones contributes to slow, steady deterioration: diminished libido, waning energy, decreased lean muscle and increased body fat, weakened bones and osteoporosis, reduction in skin tone and elasticity, memory lapses, cardiovascular concerns, sleeplessness, irritability and mood swings, among several other symptoms. As years pass, these symptoms become even more noticeable—as the relationship between them and hormone levels becomes undeniable. Take estrogen, for example. Estrogen alone helps protect against heart disease, osteoporosis, Alzheimer’s and incontinence, as well as enhancing libido, skin tone, emotional well-being, cognitive acuity, sensory function and digestion. In addition to impacting personal life, hormone imbalances and their effects encroach on job performance and business success. That’s best seen in the corporate world, where poor lifestyle choices, a diminished endocrine system and 21st century stress collide. On the way to fiscal nirvana, high performers notoriously spend their health to gain wealth. They labor over business strategies to ensure corporate success, leaving their health behind. The most costly event in their lives—loss of productivity— goes unnoticed. Eventually, poor nutrition, reduced exercise and overly prescribed antidepressants (coupled with plummeting hormone levels) take their toll in both the personal and corporate setting. The fact is, losing critical personnel proves incredibly costly. Chronic disease affects 125 million Americans, costing more than $500 billion annually. The effect on any company’s bottom line can be significant. Outwardly, a middle-aged man may have increased abdominal fat and reduced lean muscle mass—hallmarks of hormone imbalance. He no longer looks or feels virile, as his sexual functions fade. As a result, self-esteem begins to suffer. Testosterone improves libido and energy levels, enhances a sense of wellThe story isn’t that different for being, strengthens bones, builds muscle women. In fact, both genders suffer and promotes muscle tone, brain when hormone imbalances develop, function and heart health. which results in physical and emotional stress. II . T h e U n i v e r s a l Tr u t h : Ag i n g That’s why savvy corporations are championing a corporate culture, which fosters better health and subsequently improves productivity. How does all of this connect with having diminished hormone levels? Hormones perceptibly alter physical, sexual and cognitive functions, often with psychological complications. Until recently, these changes were accepted as “growing old,” forcing individuals into the background. WWW.CENEGENICS.COM 17 II. The Universal Truth: Aging Facing Facts II. The Universal Truth: Aging We now realize delaying premature disabilities is viable, since the body’s hormone receptors don’t lose their ability to respond to hormone messages. These receptors are waiting to be filled. Restoring hormonal balance with hormone optimization and healthier lifestyle choices really can turn the tide. The MaleFemale Connection Throughout time, a line has been drawn, dividing the sexes. But regarding the effects of aging, that line decidedly blurs. Aging is about diminishing hormones. Since both men and women have the same hormones, aging is aging—regardless of gender. However, the nuances in symptoms are distinguished only by amounts. For example, both males and females experience menopause. Male menopause (also termed andropause) is subtler than its female counterpart. Sparked by a decline in androgens (male sex hormones), male menopause typically begins in the 40s. Female menopause (marked by a dynamic drop in estrogen and testosterone 18 WWW.CENEGENICS.COM levels) occurs at a definitive point in time, while male menopause moves stealthily over a period of 20 years. FEMALE MENOPAUSE • Affects all women • Symptoms begin at a specific point, often abruptly • Dramatic drop in estrogen levels, beginning in 40s or 50s, along with progesterone and testosterone diminishment • Diminishing hormonal levels result in changes that can seriously affect physical and mental health • Resulting symptoms: difficulty in sexual arousal, vaginal dryness, cardio concerns, weight gain, osteoporosis, cognitive concerns, hot flashes, anxiety, emotional upheavals, irritability, lack of skin elasticity, aches, pains and stiffness • Unable to reproduce MALE MENOPAUSE • More subtle, affecting some men • Symptoms creep up over a period of 20 years • Reduction of testosterone, beginning in early 30s • Diminishing hormonal levels result in changes that can seriously affect physical and mental health • Resulting symptoms: difficulty in sexual arousal, weaker erections, cardio concerns, weight gain, osteoporosis, cognitive concerns, fatigue, depression, emotional upheavals, irritability, anxiety, lack of skin elasticity, aches, pains and stiffness • Maintains ability to produce sperm II . T h e U n i v e r s a l Tr u t h : Ag i n g Nonetheless, both genders battle the same symptoms: diminished interest in sex (due to vaginal dryness in women and weaker erections in men); cardiovascular concerns; shift in body composition; weight gain; osteoporosis; cognitive decline; fatigue; depression, emotional upheavals, irritability and anxiety; aches, pains and stiffness. However, in the male aging process, there are compound challenges. Testosterone output decreases approximately 2%3% per year, starting at age 30. Men also begin to form more estrogen, which stores in fat. A typical 50-year-old male at normal weight has more estrogen than his female, postmenopausal counterpart. These higher estrogen levels ultimately compete with testosterone for the same receptors. In addition, an increase in sex hormone-binding globulins (SHBG) takes up even more of the free testosterone. This loss of testosterone contributes to a middle-aged man’s “pot belly” and reduced muscle tone. The differences between the sexes are quantitative, not qualitative. And both genders may need other hormones to get their bodies back in balance, if testing reveals diminished levels. Men no longer corner the market on heart disease. Studies reveal it’s the number one killer of American women: over 500,000 die of cardiovascular disease each year. Libido: Where Did It Go? Loss of sex drive is a by-product of diminishing hormone levels for menopausal men and women. Sexual stimulation and erection begin in the brain. Neuronal testosterone-receptor sites ignite a surge of biochemical events, involving nerves, blood vessels and muscles. Free testosterone promotes sexual desire and facilitates both sensation and performance. Waning testosterone levels clearly affect the quality of a man’s sex life. Reduced levels also contribute to a woman’s low libido, even though she has only 5% -10% the testosterone levels of her male counterpart. Bolstering free testosterone is not the simple solution we would wish—if excess estrogen competes for the same cellular receptors. Estrogen impacts testosterone’s effectiveness by encouraging the rise of sex hormone binding globulin (SHBG). SHBG binds free testosterone into a non-active testosterone, which can’t be picked up by testosterone receptors. As a result, testosterone cannot produce the desired libidoenhancing effects because it must be in a free form—with excess estrogen suppressed. (See Part III for more about this.) Studies also reveal that hyperthyroidism and hypothyroidism negatively impact testosterone metabolism. A thyroid hormone deficiency can contribute to hypogonadism and, consequently, affect sexual behavior and performance. The result is erectile dysfunction and/or premature and delayed ejaculation. It also should be noted (as with any hormone supplementation) that when you bolster free testosterone, monitoring levels periodically is important. Whether stimulating hormone or direct testosterone injection is used, you may be producing estrogen through aromatization: a process adding to the indigenous estrogen already present. The key is restoring a youthful hormone balance. Our goal isn’t to replace hormones—but rather to encourage the body to do what it can on its own. So the first step is to stimulate the body to make hormones on its own, then complement hormones, shown to be diminished (through medical testing) with bioidentical hormones. Personalized hormone optimization programs at the Cenegenics® Medical Institute can revive male and female sexuality. It begins with an intensive evaluation and ends with you enjoying a vibrant life, an enhanced libido, more energy and improved health. II . T h e U n i v e r s a l Tr u t h : Ag i n g Heart disease is responsible for over half the deaths of women over 50. The incidence increases in menopausal years, as a lowering estrogen level ups the risk. With diminished estrogen levels, LDL (bad cholesterol) appears to increase, while HDL (good cholesterol) decreases. Fat accumulates on artery walls after menopause begins. On the male side, diminished testosterone levels can contribute to the weakening of heart muscle. Testosterone is not only responsible for maintaining heart muscle protein synthesis, but promotes coronary artery dilation (good circulation) and helps maintain healthy cholesterol levels. Perhaps that’s why an increasing number of studies reveal an association between high-normal testosterone and low cardiovascular disease rates in men. Naturally, other factors come into play. Smoking and heredity escalate the risk of developing cardiovascular disease in both men and women. Prevention and knowledge are paramount to vitality and quality of life. Not recognizing or misinterpreting symptoms poses a serious threat with long-lasting consequences. Early recognition, lifestyle changes and hormone optimization—all key to the Cenegenics approach—have proven quite effective in reducing the incidence and severity of cardiovascular disease. WWW.CENEGENICS.COM 19 II. The Universal Truth: Aging Cardiovascular Disease: A Predator Osteoporosis: A Challenge For Both Sexes Many people link osteoporosis to women. That’s not always the case. II. The Universal Truth: Aging Although osteoporosis is more prominent in women, men are gaining a greater awareness of how osteoporosis can impact their health as well. Aerobic athletes with their high metabolic rate have a fast bone turnover, subjecting them to osteopenia and osteoporosis at a higher rate than the normal lessphysically active population. Regardless of gender, bones lose calcium as we age, becoming fragile, thin and prone to fracture. It’s estimated that one out of every two menopausal women will suffer some degree of osteoporosis. After age 50, one in every eight men will suffer an osteoporosis-related fracture. The National Institute on Aging stated, “Estrogen saves more bone tissue than even very large daily doses of calcium.” Calcium cannot be deposited and stored unless the hormonal milieu is correct. Also, the May 2004 Journal of the American Medical Association (JAMA) released findings by British researchers, describing a link between hormone replacement therapy (HRT) and a reduced risk of bone fractures in women who entered menopause. Building bone density prior to menopause is the best strategy for prevention; afterward, the most effective therapy is hormonal. Other factors leading to osteoporosis are poor nutrition (reduced calcium intake), lack of adequate exercise, unhealthy lifestyle (cigarettes, excessive alcohol (family history and race OSTEOPOROSIS (Caucasian, Hispanic Know the risk factors and Asian). Thinner and fair-skinned individuals seem more prone to osteoporosis. On the other hand, men with larger skeletons and bigger build tend to begin bone loss later, progressing slower than people with a slight frame. • Hormonal: diminished estrogen and testosterone levels • Nutrition: low calcium intake • Exercise: inadequate physical exercise • Lifestyle habits: smoking, excessive alcohol • Prolonged exposure to certain medications: steroids used to treat asthma or arthritis, anticonvulsants, certain cancer treatments and aluminum-containing antacids • Chronic disease: altering hormones and affecting kidneys, lungs, stomach and intestines • Age: bone loss increases with age and sedentary behaviors • Heredity: propensity via family history The top factors contributing to the disease are low estrogen and testosterone levels. That’s why drugs that treat osteoporosis may offer minimal help, yet don’t solve the problem. In actuality, they could prove counterproductive. Imagine diminished hormones as a drain in a tub. These drugs increase flow, trying to fill the tub. However, unless you block the drain, it doesn’t work. Hormonal optimization for men and women with diminished bone density is vital. 20 WWW.CENEGENICS.COM The Cenegenics® approach of hormone optimization, smart nutrition, bone-specific exercise and a healthier lifestyle helps reverse osteoporosis. II . T h e U n i v e r s a l Tr u t h : Ag i n g “I have been to numerous doctors (gynecologist, endocrinologist and II. The Universal Truth: Aging internal medicine) looking for some answers to certain problems. Thanks to the extensive lab tests at Cenegenics and their incredible medical team, I found answers to my questions. I have confidence that I will get better. And I’m grateful to finally obtain hard Depression & Emotional Fluctuations: A Roller Coaster proof of why I had been feeling the way I did.” —J.M., Aurora, IL Loss of hormones often catapults men and women onto a wild emotional ride. Depression is all too frequent. Changes in body composition and reduced sexual pleasure, compounded with lifestyle factors—such as changing family roles, shifting social networks and an “empty nest”—can push depression into overdrive. Since our society ignores the core issue—diminished hormone levels— we feed into the “magic pill” approach with its inexorable side effects. Prescription antidepressants reduce libido, creating a sense of loss and a reduced quality of life. Consequently, more frustration and depression set in—producing a downward spiral. New studies show low testosterone correlates with chronic symptoms of depression and other psychological disorders. The rise in availability and use of antidepressant drugs compounds the problem. Using antidepressants is simply a Band-Aid®, covering the issue. It doesn’t address the basic concern, which is restoring energy and self-esteem. And if antidepressant drugs are discontinued (with hopes of having a somewhat normal sex life), individuals are left with their original problems . . . an ongoing battle with depression. It’s a lose-lose situation. II . T h e U n i v e r s a l Tr u t h : Ag i n g Cenegenics has a path around this slippery slope, discovering a much better way of life. Hormone optimization can stabilize hormone levels and stimulate natural coping mechanisms. Testosterone supplementation, a foundation of our personalized program, often enhances libido. At least one study revealed patients with major depression experienced an improvement equal to that achieved with standard antidepressant drugs, when given testosterone. WWW.CENEGENICS.COM 21 I wish I had a picture of me last year, but I refused to have any taken. I was so bedraggled, fat, bloated and stressed. Now I’m clear, together, calm and finding pleasure in everything. I was walking around Boston the other day in my Jimmy Choo’s size 10 jeans, long hair down II. The Universal Truth: Aging and blond . . . and I am 51! Every guy who walked by me stared and smiled. That alone made me feel ten years younger. It’s like, “Hey, I still got it!” —P.R., Nanant, MA Aging: The Sum Of All Fears What’s the common denominator in all these age-related symptoms? Diminished hormone levels. And there’s more. The combination of low testosterone levels and the effects of fundamental aging creates an excess production of a potentially dangerous stress hormone, cortisol. Excess cortisol can contribute to degenerative effects, such as immune dysfunction, brain cell injury, arterial wall damage, fat accumulation, bone loss and blood-sugar problems. Overabundance of cortisol can also suppress testosterone production, “I’m so excited because I’m doing so well on the program and think it’s just great.” —R.P., Glendora, CA 22 WWW.CENEGENICS.COM promoting premature aging. That’s a critical reason why testosterone therapy shields against the overproduction of cortisol—based on needs discovered in your initial comprehensive evaluation. fat, reduced muscle and bone mass, as well as breast enlargement or tenderness are all signs of lowered testosterone levels. Clearly, reduction of hormone output seriously affects the health span, both physically and mentally. With thorough evaluation, the Cenegenics® Medical Institute guides you in a personalized program for a vibrant, healthy life. Estrogen levels, on the other hand, increase with age, so men never need estrogen therapy. On the contrary, aging men often suffer dual effects of too little testosterone and estrogen dominance. The resulting imbalance directly causes many debilitating health and performance problems associated with normal aging. Whatever your menopausal profile— male or female—a tailor-made program of hormone optimization, sound nutrition, nutraceutical supplements and regular exercise will reflect your specific needs. As men age, testosterone increasingly converts to estrogen. One report compared estrogen levels of both genders, showing an average 54-yearold man’s higher than an average 59year-old woman’s. Synergy of these components frees you from the debilitating physical, emotional and mental consequences of male and female menopause. Taking testosterone by itself, without monitoring other hormones, is not judicious. Testosterone may convert into even more estrogen (a process called aromatization), potentially worsening the already existing hormone imbalance. Too much estrogen and not enough testosterone can increase risk of a heart attack or stroke. High levels of estrogen The Male Difference A decrease in free testosterone is the most significant hormone imbalance in aging men. Erectile disorders, decreased beard growth, increased II . T h e U n i v e r s a l Tr u t h : Ag i n g Your personal Cenegenics team will explain the exact nature of any imbalance in your testosterone/ estrogen profile. With careful guidance, they’ll demonstrate how our intensive Executive Health Evaluation and related programs will help you take control of the situation and improve it. The Female Difference Menopause: that time in every woman’s life when menstruation ceases completely. As ovaries decrease their estrogen and progesterone output, women experience effects of diminished hormone levels. Menopause not only signifies the end of a woman’s ability to have children, but it also purports the decline of these particular female hormones, which ultimately affects the entire endocrine system. This menopausal process takes approximately three to five years. The early (transitional) phase is referred to as the climacteric, also known as perimenopause. In her mid-30s, a woman’s hormone balance begins to shift. When it occurs and the level of that imbalance depend on a range of factors: heredity, age menses began, lifestyle, nutrition, stress, adrenal hormones, exercise and more. Perimenopause: What’s happening? The follicles’ ability to mature and release an egg starts to fluctuate. Ovaries continue to produce sufficient estrogen for shedding the egg, but estrogen production becomes erratic. During down times of estrogen production, ovulation doesn’t occur (anovulatory cycles). Menopausal symptoms ensue, such as bloating, mood swings and weight gain. Estrogen surges create additional effects, such as sleep disturbance, breast swelling or tenderness. For years, a woman may experience an irregular cycle of menses and the consequential symptoms: diminished libido; fatigue; depression; headaches; inability to cope with stress; hot flashes; cognitive difficulties; itchy skin; joint pain and backache; fibrocystic and sagging breasts; uterine fibroids and endometriosis; reduced metabolism; morning sluggishness; unstable blood sugar; symptoms of hypothyroidism (despite “normal” T3/T4 hormone levels). Many symptoms occur gradually and initially may appear unrelated, often causing women to be misdiagnosed. Everyone immediately links hot flashes to the onset of perimenopause, but what if your first symptoms are different—sleep disturbances, fatigue or depression? II . T h e U n i v e r s a l Tr u t h : Ag i n g You might not make the connection and blame the symptoms on a hectic lifestyle. Without the appropriate tests, it’s possible to wind up with the wrong treatment and symptoms becoming worse. That’s precisely why Cenegenics embraces a comprehensive evaluation, with periodic diagnostics. Your body is in a continual state of change, so your needs alter from time to time. Hormonal optimization therapy, hormone-regulating nutrition, nutraceuticals and sound exercise in the right combination address your personal health situation. Menopause: What to expect. Menopause is considered complete when a woman has no periods for a full year. Timing varies from woman to woman, though the onset of menopause generally is complete by the early 50s. There really is no such thing as “post menopause” since menopause simply means the end of menses. Once a woman enters this momentous passage, she is, technically speaking, menopausal the rest of her life. Every woman is an individual, yet there are a number of general side effects that tend to occur. Some may seem as temporary nuisances to “tough out.” However, the reality is more serious. Diminishing hormone levels result in changes, which seriously affect a woman’s physical and mental health as well as her prospects for vitality. In addition to diminished estrogen and progesterone levels, reduced testosterone (produced in the ovaries) levels also become a factor during menopause. Profound degenerative changes begin to occur, as levels of these key hormones diminish. WWW.CENEGENICS.COM 23 II. The Universal Truth: Aging have also been implicated as a cause of benign prostate hyperplasia (noncancerous enlargement of prostate) and even prostate cancer. These changes affect the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, cardiovascular system, skin and energy levels. They include . . . II. The Universal Truth: Aging • Hot flashes and sweats: Sudden sensations of intense heat sneak up, unexpectedly. Some women break out with red blotches on the chest, back or arms. Typically, hot flashes or sweats are followed by feeling cold and shivering until the body adjusts. Night sweats may be so profuse that bed sheets and sleepwear have to be changed during the night. While some women never experience hot flashes, others endure them 30 minutes at a time. Hot flashes are generally considered a direct result of decreasing estrogen levels. Hormone optimization can prevent (or relieve) hot flashes, which could linger for years if not treated. • Vaginal dryness, itchy skin and urinary tract discomfort: As hormone levels decrease, walls of the vagina become thinner, dryer, less elastic and more susceptible to infection. This atrophy can also make intercourse uncomfortable, causing a woman to feel depressed and undesirable, sparking yet another round on the emotional battlefield. 24 Similarly, dry or “crawly” skin problems may occur, occasionally accompanied by blotchy, red patches. Tissues in the urinary tract also change with the diminished hormonal levels. Some women experience incontinence, while others become more susceptible to infections. WWW.CENEGENICS.COM As with hot flashes, restoring hormones to optimal levels can make the vaginal mucosa thicker, more moist, more elastic and healthier . . . making you and your partner happier. • Sleep disturbances and fatigue: Not surprisingly, many of these symptoms go hand-in-hand. Struggling with frequent night sweats disturbs sleep. After awhile, fatigue engulfs a woman. She may feel anxious, become moody or even feel mentally and physically exhausted. • Forgetfulness: Hormone deficiencies impact cognitive functions. This situation is compounded by sleep disturbance, anxiety, stress, moodiness and exhaustion. It becomes difficult to think clearly and recall events when the hormonal imbalance is wreaking havoc. • Mood swings: The aftermath of hormonal imbalance is emotional upheaval. Inability to sleep soundly, the battle of hot-andcold sensations, tiredness, loss of sexual pleasure and depression snowball into mood swings. Cenegenics® makes you the focus, not menopause. Traditional doctors tend to treat menopause, rather than the person experiencing menopausal symptoms. Many don’t even bother determining hormone levels. A quickly prescribed fixed dosage of artificial (nonhuman) hormones— such as Premarin, made from horse urine—becomes a knee-jerk response. Yet the fact remains: Every woman is different, and each will experience this time in a unique way. That’s why it is crucial to run comprehensive tests before beginning any hormone program, followed by periodic blood checks to ensure hormone levels are in the ideal range. Our highly intensive baseline evaluation, with its subsequent diagnostic analysis, takes this exact approach. We look at your particular symptoms: hot flashes, night sweats, fatigue, low libido, weight gain, mood swings, cognitive fuzziness, uncomfortable intercourse, dry or itchy vaginal tract, bouts of incontinence or loss of skin elasticity. Then our Cenegenics team designs a program specifically tailored to your needs, rather than treating a generalized concept of menopause, which may not apply to you. “What Cenegenics Medical Institute can offer the world is immeasurable. I would like to express my gratitude and appreciation for what you’re accomplishing. With past scientific and medical facts, along with our most recent discoveries in age management medicine, things are really getting exciting.” —J.O., New York, NY II . T h e U n i v e r s a l Tr u t h : Ag i n g And like other women who haven’t undergone surgery, these women will experience perimenopause and the resulting change, occurring thanks to diminished hormones. Cenegenics takes into consideration every woman’s unique needs, personalizing a program to keep her body functioning optimally. Complete hysterectomy—surgical menopause. This operation removes the uterus and ovaries, dramatically altering a woman’s life. Besides cradling a fetus, the uterus produces menses. Ovaries, in concert with that, produce eggs (ova) and essential hormones needed to regulate menstruation, overall health, vitality and libido. After a hysterectomy, menses stop and the ability to have children ceases. The ovaries, however, continue producing essential hormones, unless both are removed in a total hysterectomy. When a premenopausal woman has both ovaries removed with the uterus, she abruptly enters menopause. There is no gradual passage. Consequently, she often experiences heightened menopausal symptoms that can be overwhelming, since they come on so suddenly. Loss of ovaries also halts her ability to produce testosterone. Consequently, libido wanes. And, since there no longer are uterine contractions or pressure against the cervix, sexual pleasure may be disturbed. Diminished hormones resulting from ovary removal cause vaginal dryness, making intercourse uncomfortable or painful. Additional concerns come into play, such as increased risk for osteoporosis and heart disease. Is it any wonder women experiencing surgical menopause often become depressed and feel totally overwhelmed? (JAMA) on July 17, 2002. The article reported results of the Women’s Health Initiative Trial—a study that incorrectly blamed estrogen for some negative effects. The study, which largely has been repudiated, really was about artificial hormones, such as Premarin and progestin, made from horse urine . . . not natural hormones. After a hysterectomy, women experience such an extreme thrust into menopause, they need to have their estradiol and progesterone levels determined and treated immediately. Hormone Replacement Therapy (HRT) began in the 1940s and has been refined considerably over the past 60 years. At Cenegenics Medical Institute, experience shows bioidentical estrogen and progestin therapy will dramatically improve a woman’s quality of life, if performed in a clinical setting where therapeutic levels are monitored and dosing is adjusted accordingly. Unlike their synthetic counterpart, bioidentical hormones are created in a laboratory, using the same molecular structure as naturally occurring hormones produced in our bodies. At Cenegenics, we deal with surgical menopause patients exactly as we do with menopausal patients. We use the same test for hormonal levels and suggest the same bioidentical hormones. Does hormonal optimization help? Yes. A study in the September 2000 New England Journal of Medicine examined the effects of transdermal testosterone treatment in women with impaired sexual function after oophorectomy (both ovaries removed). The women, ages 31 to 56, showed significant improvement in sexual function, mood and overall well-being. If you’re considering having your ovaries removed, we recommend seeing a Cenegenics physician or a doctor trained in bioidentical hormone replacement therapy before surgery, helping ease your transition and discuss the best approach for you. Just how safe is hormone replacement therapy? Recent controversy surrounding estrogen and progestin use in healthy menopausal women is a result of an article, published in the Journal of the American Medical Association II . T h e U n i v e r s a l Tr u t h : Ag i n g Contraindications still exist for some women, such as patients with a history of breast and uterine cancer. However, for most women, Cenegenics believes benefits far outweigh the risks. We agree estrogen and progestin replacement therapy can . . . • reduce the risk of osteoporosis • relieve hot flashes • reduce the risk of cardiovascular disease • positively affect mood and psychological well-being WWW.CENEGENICS.COM 25 II. The Universal Truth: Aging What about a hysterectomy? Women who have had a hysterectomy—an operation removing the uterus but leaving the ovaries in tact—transition through menopause as a typical female would. II. The Universal Truth: Aging We use bioidentical hormonal creams, compounded in a pharmacy. Periodically, we also check hormone levels to keep you in optimal ranges. That is a totally different approach from traditional medicine, which puts most women on the same dose of potentially unsafe artificial hormones and never monitors blood levels. Whether you are experiencing perimenopause, natural menopause or surgical menopause, you can count on our professional staff at Cenegenics® to create viable programs, targeting your individual concerns for a healthier, happier quality of life. “Before Cenegenics, I was basically a healthy person, walking an average of two miles a day. Now, at 76, I can go on the treadmill covering a longer distance! Cenegenics supplements gave me the added strength and pep to do that. Thanks to Cenegenics, I’m feeling and looking great . . . while aging younger!” —L.R., Naperville, IL It is possible to get your foot off that accelerator and put balance back into your life. You can improve your health span and expect a much more vigorous life. Taking Your Foot Off The Throttle Aging may be inevitable, but how you age is up to you. While it may not be possible to slow your biological clock, you certainly can accelerate it with poor lifestyle choices. Stress, excessive alcohol, lack of quality sleep, smoking, drug use, depression, emotional upheavals, sedentary lifestyle, poor nutrition and untreated hormonal imbalances all contribute to putting you on the fast track to aging. 26 WWW.CENEGENICS.COM Speculating about what you need or don’t need is futile . . . a real waste of time. You can’t determine your individual needs by comparing your symptoms to a neighbor or coworker—or by looking merely on the outside. These symptoms and conditions are correctable with bioidentical hormonal optimization, proper exercise and sound nutrient therapies. Based on three factors—a thorough and comprehensive assessment of your personal history, an analysis of your blood and an evaluation of other biomarkers of aging—the Cenegenics team can guide you into a lifestyle, which maximizes your individual health potential so you can enjoy youthful aging. The answer begins with our extensive Executive Health Evaluation. Its focus on discovery will reveal your unique deficiencies and strengths. No product or superficial discussion can accomplish that. Thanks to our sophisticated, medical approach to age management, you can finally take control of your health with a personalized program, designed to make a significant difference in your life. Never too early, never too late. Significant data have been compiled, indicating we begin experiencing hormone-related conditions from our 30s through the 50s—and beyond. Optimize your health and begin managing your aging process today. Call Cenegenics toll-free at 866.953.1510 for a no-obligation, confidential discussion about regaining your health and vigor. II . T h e U n i v e r s a l Tr u t h : Ag i n g The following testimonials describe our patients’ experiences with Cenegenics Medical Institute programs. A 55-Year-Old Male Patient I signed on for the Cenegenics program after completing my Executive Health Evaluation. Within a few days, I received a complete packet: printouts from the diagnostic tests, my personalized program and my pharmaceuticals. I not only achieved all of my original goals, but attained five additional ones I hadn’t expected: • My body fat is now 12%, down from 32% a year ago. • My strength and muscle mass are at the highest level I’ve ever had in my life! • My bone density (hips/spine) has improved to normal. • My skin looks at least ten years younger. • My libido and sexual energy are like when I was in my 30s. my goals of more energy, mental alertness, vigor, leanness, fitness and great health. And I’m amazed at the difference I feel; it just keeps getting better every day. I want to thank everyone at Cenegenics for their thoroughness, VIP treatment, ongoing communication, continued quality care and the wonderful program they developed for me. I know it’s up to me to do my part, but I couldn’t have done it without the Cenegenics Medical Institute. They really care about me and have been there every step of the way. —J.L., Tunkhannock, PA Six weeks into the program, I had my first follow-up blood tests. I was extremely delighted! A 42-Year-Old Female Patient My muscle-to-body-fat ratio, libido, energy levels, attitude and creativity improved. I was even enthusiastic about going to the gym, looking forward to my workouts rather than dreading them, just as I had a few years ago. I’ve been on the Cenegenics program for just over a year and am delighted with the results of my annual evaluation. I achieved all my initial goals: increased energy, mental alertness, vigor, leanness, fitness and great health. My strength and endurance also started to return to levels I’d had 20 to 30 years ago. Finally, I was making progress, getting rid of my large belly. My family and friends remarked about the differences they could see in my appearance and attitude. I tried not to pay too much attention to their flattery, but I must say I was feeling better than I had in years. I’ve been on my program for a little over a year now, just completing my annual comprehensive evaluation. In fact, my family and friends can’t believe the changes they’ve seen in me over the past year. I used to get flu-like symptoms three or four times a year, but I haven’t had any infections since I started the program. I get up early every morning so I can go to the gym and work out with people 20 to 30 years younger. And I give them a run for their money! I must admit I was somewhat skeptical at first, but have become a true believer in the Cenegenics program. I’m delighted to have met II . T h e U n i v e r s a l Tr u t h : Ag i n g The year before starting the program, I underwent an emergency total hysterectomy, which created diminished hormonal levels. Fortunately, my Cenegenics physician suggested an HRT program that worked. Now, despite eight previous abdominal surgeries and giving birth to my two children, my stomach has never been flatter! I’ve lost weight and have the energy to work out with people half my age. And I don’t move like a snail any more. WWW.CENEGENICS.COM 27 II. The Universal Truth: Aging Up Close & Personal: Two Patients’ Stories “Every woman should know about this synergistic program . . . it’s a lifesaver. After a complete hysterectomy at 39—and several other surgeries before II. The Universal Truth: Aging turning 40—I had packed on an extra 50 pounds. Then If I get a muscular injury, it heals quickly. Most of the significant scarring I had from many surgeries has lightened. The benefits from my Cenegenics® program continue to amaze me: • My body fat is now 22%—down from 32%. Cenegenics Medical Institute helped turn my life around with a doable exercise program (for a busy mom of two), sound nutritional advice (for a Type 2 diabetic) and hormonal therapy. One year later, it was a whole • My bone density (hips and lumbar spine) has improved from near osteoporotic levels to almost normal. different story. I feel great and am so grateful.” —N.K., Las Vegas, NV • My skin looks at least ten years younger. • My struggle with night sweats and vaginal dryness is over. • My libido is enhanced—sexually I feel better than I did at 23! • My blood sugars are better than when I was in my early 30s—I’m no longer a Type 2 diabetic. Most importantly, I feel good . . . about myself, my life and my family. I’m more positive and can handle stress in a much better way. Cenegenics has made a true believer out of me. Thanks to everyone for the successful program developed for me. I’ve got to continue to do my part, but I couldn’t have gone this far without your incredible Cenegenics team. —S. P., Chicago, IL 28 WWW.CENEGENICS.COM II . T h e U n i v e r s a l Tr u t h : Ag i n g I. III. The Science Behind Cenegenics ® Fundamentals Of Age Management Medicine II. “I reviewed my latest blood draw results tonight on the telephone with my Cenegenics physician . . . he has been caring, thoughtful and informative. It’s unusual to find a medical doctor who evidences such patience and concern as he does.” —E.T., Creve Coeur, MO III. IV. V. VI. III. The Science Behind Cenegenics ® Fundamentals Of Age Management Medicine O III. The Science Behind Cenegenics ur integrity rests on evidencebased medicine: Scientific answers and physician research, which combine to create our unprecedented, proprietary position in the medical community. There are no magic-bullet solutions, unsubstantiated claims or pseudo-science. As we stated in the beginning of this guide, the Cenegenics® Medical Institute is not about anti-aging, increasing longevity or affecting aging at the cellular level. We walk the medical high ground, taking a pro-aging stance. We believe aging is a natural process that can be managed with our innovative programs, designed to help individuals regain and maintain optimal health and vigor. Cenegenics is forging new ground, maintaining an ardent commitment to bridge mainstream modern medicine with a unique proactive, preventive approach. Our unique methodology has earned us a high level of recognition from medical colleagues. III. The Science Behind Cenegenics® Furthermore, our approach provides the knowledge, technology and expertise to delay onset of degenerative disease, as well as the medical signs and symptoms associated with aging. Fundamentals of Age Management Medicine 30 WWW.CENEGENICS.COM III . T h e S c i e n c e Beh i n d Cen e g e n i c s Each has completed the mandatory Physician Training in Age Management Medicine, jointly sponsored by the Cenegenics Education and Research Foundation and the Foundation for Care Management—providing our physicians with the competency to practice age management medicine without supervision. Consequently, Cenegenics is the most-advanced, best-credentialed and longest-established medical age management facility in the world. We start with facts. Cenegenics begins with a comprehensive evaluation to determine your specific metabolism, endocrine system’s functionality and overall physiology. Next, we take corrective actions to help your body function at the highest-possible level, integrating a synergistic program of nutraceutical supplementation, sound nutrition, specific exercise and, if our intensive evaluation reveals diminished levels, hormone optimization. Our specialty—age management medicine—incorporates well-known and widely accepted markers of disease risk into an analysis that serves as the foundation for proactive medical management. Bioidentical hormone modulation is used to restore healthy endocrine levels. For most hormones, that level is in the upper 33% of the optimal range for a patient’s age. Notably, the exceptions are insulin and cortisol, which should be modulated to the lower 33% of the normal range. Hormonal Health Hormonal health plays an intricate part in determining overall wellbeing. The endocrine system—made up of hormone-secreting glands— often is overlooked in conventional healthcare. Since it regulates our internal environment and maintains system integration, the endocrine system demands attention. Regaining and maintaining metabolic and endocrine functions at the upper end of the normal range (for your age) gives the best opportunity for a healthier and more vigorous life. We encourage you to read the latest research, studies and concepts behind our programs, available on CD by request. Discover your personal journey to optimal health. Call us toll-free at 866.953.1510 for a confidential discussion and a CD. III . T h e S c i e n c e Beh i n d Cen e g e n i c s WWW.CENEGENICS.COM 31 III. The Science Behind Cenegenics Expert science, expert staff. At Cenegenics, you can count on progressive, evidence-based solutions for your health, delivered by dedicated doctors who are specifically trained and certified in age management medicine. Eight major endocrine glands comprise this system, communicating from various points throughout the body. Although all glands have secondary and tertiary functions, the following list focuses on their primary ones. • pituitary gland — regulating other endocrine glands • pineal glands — regulating biological rhythms, moods and stimulating puberty • thyroid gland — regulating metabolic rate III. The Science Behind Cenegenics • parathyroid glands — regulating blood calcium performing in perfect balance— without one instrument, section or singer eclipsing the others. The hormonal symphony. Hormones produced in the endocrine glands and other places in the body circulate through the bloodstream. Hormones interact with receptor proteins of specific enzymes, igniting biological responses in target tissues. Cellular activity changes and is dispatched across the plasma membrane, reflective of the hormone type. • gonads — testes or ovaries involved in sex organ functions and secondary sex characteristic development Think of it as a symphony orchestra, playing Beethoven’s Ninth Symphony. Producing this beautiful work takes 100 instruments and a large choir, 32 WWW.CENEGENICS.COM • plasma concentrations of nutrients/ions • neuron/mental activity The entire endocrine system can significantly impact your ability to enjoy youthful aging and vigorous health. At Cenegenics, we concentrate on reducing levels of two major age-promoting and degenerative disease-promoting hormones: insulin and cortisol. We also work, in concert with nature, stimulating the body to make its own needed hormones. We are vehemently against the use of foreign substances, frequently used to mimic our hormone activity—as used traditionally in conventional practices. To the largest extent possible, we supplement with bioidentical hormones, which function as closely as humanly possible to hormones produced by the body. • pancreas — producing hormones, such as insulin The relationship among endocrine glands causes them to work together with a unified purpose and function, releasing chemical messengers that impart cellular instructions. • environmental changes That is how Cenegenics® approaches endocrine therapy, believing all the “instruments” should play together harmoniously. • adrenal glands — regulating fluid and sodium balance, as well as warning of stress There are many other components of the system, where hormones are being created and secreted into parts of the body—such as the stomach, small intestines and heart. These also provide hormonal activity to help regulate physiological function. A number of other factors stimulate or inhibit hormonal secretions: Every hormone has specificity, housing an individual chemical form corresponding to a particular receptor protein. When the two meet, they interlock like puzzle pieces. This receptor protein can exist in different organ cells, so the body can use the same hormone for various effects. A complex negative-feedback pathway regulates fluctuating hormone levels. As hormone levels rise, the pathway is inhibited to maintain homeostasis. Regulation depends both on production levels plus the excretion and metabolism of hormones. III . T h e S c i e n c e Beh i n d Cen Bioidentical hormonal therapy: in tandem with nature. Bioidentical hormones mirror the chemical and molecular structure of your body’s naturally occurring hormones, so they metabolize easily. Unlike their artificial counterpart, bioidentical hormones don’t produce troublesome side effects and can be compounded to your specific needs. There is no rationale for a onesize-fits-all dose that may be totally inappropriate. Our mission is supported by scientific research, shown in numerous studies. Results clearly indicate there is no need to suffer consequences of premature disabilities and aging. e g e n i c s Hormonal evaluation and relevant therapy, with a conscientious program of lifestyle management, can set a course to vitality, better sleep, enhanced libido and sexual performance, improved cognitive function, an enhanced immune system, improved skin tone and facial appearance. THE HUMAN HORMONE SYSTEM Hormones Identified Testosterone, estrogen & progesterone. Throughout this brochure, we demonstrate that the differences between each gender’s need for hormones are quantitative, not qualitative. A Cascade of Events • At the top of this cascade is your brain, followed by the pituitary gland and target organs (i.e., ovaries, thyroid, testicles). Physical and mental functions follow (e.g., skin thickness, menstrual periods, sex characteristics, aggression, hair distribution, etc.) • Hormone release originates in the hypothalamus, part of the brain. It starts a cascade, secreting “releasing hormones,” which activate the pituitary “master gland.” The pituitary, at the brain’s base, communicates directly with the hypothalamus via special nerves and blood vessels. • Releasing hormones stimulate formation and release of pituitary hormones into the circulatory system. Pituitary hormones exert their effects on many parts of the body, such as the thyroid gland, adrenal glands, testicles, ovaries and breasts. • Pituitary hormones have effects on specific targets, which release hormones of their own. Thus, pituitary hormones act as traffic controllers, determining what is needed and telling the organs in the body when to release other hormones. Both sexes have and require levels of androgens/androgen precursors (testosterone, androstenedione and DHEA) and estrogen. However, the main androgen of the testes (testosterone) is also found in a female’s body . . . just as estrogen is found in a male’s. Men seldom need estrogen supplementation because they make a significant amount on their own. A 50-year old male actually has more estrogen than a 50-year old menopausal female. Women frequently experience the effects of diminished testosterone even before perimenopause and, certainly, after undergoing a surgical menopause. Testosterone, estrogen and progesterone are essential for normal reproductive function. Each plays a vital role in secondary sexual characteristics and overall health. They are fat-soluble steroids, derived from cholesterol molecules converted to pregnenolone—a precursor to all III. The Science Behind Cenegenics Gonadal Steroids gonadal steroid hormones. These sex steroids enter target cells via plasma membranes, then alter cell activity by binding to a receptor protein, creating a complex structure and permeating the cell nucleus to bind to DNA. Some steroidal hormones repress protein synthesis, while others stimulate it. III . T h e S c i e n c e Beh i n d Cen e g e n i c s Cascading hormones. Interestingly, all these hormones can convert into other hormones, depending on the body’s need. It’s nature’s way of maintaining hormonal balance. WWW.CENEGENICS.COM 33 For instance, progesterone can cascade into estrogen, testosterone, DHEA or cortisol. DHEA could cascade into testosterone or estrogen. If your body has too much of one hormone, that sex steroid can transform into another. The converse is also true. If a woman is either menopausal or has had a hysterectomy, she needs more estrogen since her ovaries aren’t producing required levels. Her body attempts to compensate by converting stored testosterone or DHEA from fat cells into estrone, which is one of three major types of human estrogen. III. The Science Behind Cenegenics Testosterone isn’t just a sex hormone. Testosterone is essential for sexual function, but has many other uses as well. With receptor sites in the brain, heart and throughout the entire body, this steroidal hormone plays a pivotal role for both men and women in maintaining lean body mass, skin elasticity, libido and a healthy immune system. It ensures proper heart function, regulates mood and aids brain function (cognition), controls blood sugars, regulates healthy cholesterol levels, controls blood pressure, prevents heart attacks and even reduces risk of prostate cancer. Testosterone also aids bone growth and anabolic functions, as well as augmenting protein synthesis. The fact men produce more testosterone than women is evidenced by increased bone and muscle mass. Gonadotropic hormones, released from the pituitary gland, impact testosterone and sperm production. Stimulating hormones become less effective as we age, making supplementation more significant with passing years. 34 WWW.CENEGENICS.COM Women, men & testosterone. In the female, testosterone is produced in the ovaries and adrenal glands. If a woman is thrown into surgical menopause (by having her ovaries removed), she abruptly loses 50% of her natural testosterone—along with 80% of her natural estrogens. Ebbing estradiol and progesterone levels after entering menopause are compounded by falling testosterone and thyroid hormone. A declining hormonal environment is bound to spark bodily changes: a flux in metabolism, altered libido, effects on breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, cardiovascular system, skin, mental acuity and energy levels. On the male side, testosterone production is initiated by the pituitary gland, deep within the brain. The gland secretes luteinizing hormone (LH), which stimulates Leydig cells in the testicles to produce testosterone. Having low testosterone levels—with its subsequent health and emotional impact—can become a valid concern for some men. Here are some ways that happens: Like men, women need adequate testosterone for peak mental acuity, healthy bone density and muscle tissue, as well as prevention of unwanted body fat, heart disease and cognitive decline. Women without supplementation have a 50% chance of experiencing a pathological fracture of their hip or vertebra at some point in their lives. That’s especially frightening since hip fracture results in a 25%, 6-month mortality rate and a 50%, 2-year mortality rate. III . T h e S c i e n c e Beh i n d Cen e g e n i c s • Estrogen: Men need a certain amount of estrogen. But if a male body converts more testosterone to estrogen than required, the levels become too high. Consequently, the estrogen interferes with whatever free testosterone exists and both hormones compete for receptor sites. In these cases, there are ways of blocking the estrogen— problem easily solved. A similar—but different—story unfolds for men in general. Through enzymatic action, testosterone can convert to dihydrotestosterone (DHT) and estrogen. The enzyme 5alpha reductase (found in high concentrations in the prostate gland and skin) converts testosterone into DHT. Aromatase (found in skin, brain, fat and bone) transforms the hormone into estrogen (estradiol). As years pass, increasingly more testosterone converts to estradiol, leading to prostate cancer, heart disease and stroke. • Sex hormone binding globulin: Only about 2% of testosterone is free—but a critical amount that must be unencumbered for full effectiveness. As men age, sex hormone binding globulins (SHGB) increase, which compete with estrogen and cause a decrease in free testosterone. complicated because the added testosterone (in patients with low LH) shuts down the biofeedback mechanism, causing testicular atrophy. • Diminished Leydig cells: Testosterone production, created via Leydig cells in the testicles, usually peaks in males in the late teens. Men have an estimated 700 million Leydig cells at birth, but that number declines by 6 million annually, after they reach 20 years old. Aging enters the picture, diminishing the number of these testosterone-producing cells. And then for some men, the rheostat and the bulb are issues. Relying on a 50-year age span (from ages 20 to 70) is not useful. A decline of 70% from more youthful levels will produce the previously mentioned clinical problems, yet is declared “within normal range.” A more accurate approach is using the upper end of normal range, adjusted for age—then maintain these levels over time, rather than letting them continually decline. This is the healthy range. When the rheostat is the problem, hormonal therapy helps relieve men from the devastating symptoms that negatively impact the male psyche, hinder intimate relationships and affect work performance: decreased libido and poor sexual performance; thinning hair; increased body fat, especially abdominal or pectoral fat; reduced lean muscle tissue; lack of focus or drive; cognitive impairment and depression; and decreased bone mass. The Cenegenics® approach arrests falling hormone levels and prevents their decline. Testosterone levels provide enough clinical information to decide whether replacement is indicated. Ideally, they should be considered in context of other hormonal and laboratory studies. A Prostate Specific Antigen (PSA) measurement and Digital Rectal Exam (DRE) must accompany testosterone testing at your initial evaluation: (1) as screens for preexisting prostate disease, (2) to direct further medical evaluation should elevated levels or abnormal exam be detected and (3) for use as a baseline in follow-ups. Younger men face different problems than older ones, when it comes to low testosterone levels. Imagine walking into a dimly lit room. You look at the 300-watt light bulb and wonder why the room isn’t brighter. Is there something wrong with the rheostat— or the bulb? In younger men—30s, 40s and even early 50s—the rheostat is the issue. The pituitary gland slows down or stops producing the stimulating Luteinizing Hormone (LH). Testicles aren’t receiving a signal, so they don’t produce testosterone. Simply giving these men direct testosterone supplementation usually is contraindicated. They might feel better, but the problem just became The appropriate therapy is to stimulate the LH, causing the testicles to produce more testosterone on their own. As a result, patients enjoy a more physiologic benefit, keeping testicles active. The older man is another matter. The problem isn’t the rheostat: the bulb needs replacing. In this case, hormonal therapy restores levels to their age-appropriate norm. Testosterone measurement. Clinical indicators of testosterone decline may give a care provider the notion an individual may be a candidate for testosterone replacement. However, objective measures must be obtained to properly institute and manage III . T h e S c i e n c e Beh i n d Cen e g e n i c s therapy as well as rule out and address accompanying medical problems. Both total and free testosterone studies should be measured to adequately evaluate testosterone levels. For males, 260-1,000 nanograms per deciliter (ng/dL) are given as a normal laboratory range, for men age 20-70. For females, this range is 15-70 ng/ dL. Free testosterone levels average approximately 2% of the total, 50210 picograms per millilitre (pg/ml) for men and 1-10 pg/ml for women. Free testosterone is the more valuable of the two, reflecting the amount of hormone available to perform useful work. WWW.CENEGENICS.COM 35 III. The Science Behind Cenegenics • Obesity: Estrogen is stored in fat—and fat cells have sizeable amounts of that enzyme discussed earlier, aromatase, which transforms converted testosterone into estrogen. These high levels of estrogen compete for receptor sites. Obesity presents more problems with potential cancer, heart disease and diabetes concerns as well as the emotional ramifications of having a demasculinizing body. It should be noted that excessive alcohol use, specific drug interactions and a zinc deficiency also can promote aromatization and subsequent high estrogen levels. A complete endocrine profile is necessary to create the most effective testosterone supplementation program, including thyroid hormones, luteinizing hormone (LH), estrogen, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), blood count, lipid profiles and other laboratory and metabolic marker tests (such as body composition and bone density). Once therapy begins, followup tests for testosterone (and other markers) must be monitored, ensuring adequate safety and effectiveness. III. The Science Behind Cenegenics Estrogen: A real powerhouse. Estrogen occurs in men and women. Men make sufficient estrogen for their needs. That is not the case for women, particularly as they head toward and enter those menopausal years. Estrogen is proven beneficial for libido and secondary sex characteristics, collagen production, vaginal/bladder tissue elasticity, heart-valve health, menses regulation, electrolyte and nitrogen metabolism, pregnancy maintenance, reproductive tissue, skin, breasts, brain health, artery lining protection and HDL (good cholesterol) production. Estrogen is also shown to be a powerful antioxidant, helping combat free radicals and their effects on the aging process. Smaller amounts are produced in the adrenals, liver and kidneys. • Estradiol: The primary and most active estrogen in a woman’s reproductive years. Produced in the ovaries, estradiol’s beneficial properties include protecting against osteoporosis and heart disease, enhancing cognitive functions, relieving menopausal maladies and increasing serotonin and endorphin levels for better emotional health and restful sleep. • Estrone: More prevalent in “post” menopausal women. Derived from stored hormones in body fat, estrone’s functions mirror estradiol with weaker effects. • Estriol: Seen as “weakest” of the three estrogens. Yet, it adds much to combating menopausal symptoms and aging effects, such as wrinkles and diminished skin texture. It also is beneficial in the vagina, cervix, vulva and urethra, as well as providing protective properties against cancerous cells. Balance is key. The right estrogen levels prove good for your health. Estrogen aids memory, promotes brain and nerve cells, protects the heart, increases HDL (the good cholesterol), stimulates skeletal growth and maintains healthy bones, among other benefits. A majority of scientists believe byproducts of estrogen dominance could influence health issues in both men and women, including prostate and breast cancers. An estrogen dominance can also accelerate the aging process and lead to weight gain and bloating, reduced libido, fibrocystic or sensitive breasts, migraines, foggy thinking, fatigue, mood swings, insomnia, fibroids and ovarian cysts. Also, it has been linked to autoimmune disorders and allergies, as well. Conversely, diminished estrogen levels could produce undesirable effects: vaginal dryness, urinary concerns, hot flashes, loss of skin elasticity and bone loss, as well as potentially hastening dementia. Progesterone, the feel-good hormone. Progesterone is a genderneutral gonadal steroid, produced in the ovaries, testes and adrenals, sharing a similar chemical structure with estrogen. This hormone functions as a precursor for androgens and glucocorticoids. Progesterone delivers diverse benefits for women: Like testosterone, the pituitary gland produces gonadotropic hormones to regulate estrogen and progesterone. In women, these are follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin. • Progesterone uses fat for energy and normalizes blood sugar, influencing insulin/glucose metabolism. There are three naturally occurring estrogens: estradiol, estrone and estriol. For men, estradiol begins in the testes as well as through extraglandular conversion of androgens. In women, the estrogens are produced primarily in the ovaries (90%). 36 WWW.CENEGENICS.COM • Progesterone restores libido and cell oxygen levels. • Progesterone aids thyroid III . T h e S c i e n c e Beh i n d Cen e g e n i c s when pregnancy doesn’t occur. It aids fetal membrane and mammary gland development. • Progesterone stimulates osteoblasts for bone strength. • Progesterone, when metabolized, binds with gamma-aminobutric acid (GABA) brain receptors. GABA, an amino acid acting as a neurotransmitter, produces a tranquil effect and generates feelings of well-being. Lower progesterone levels can augment anxiety and irritability. • Progesterone determines whether an abundance or scarcity of other hormones exists. As a regulator, it cascades into estrogen, testosterone, DHEA and cortisol. Reduced progesterone levels can result in more intense PMS or menopausal discomforts. • Progesterone augments the sensitivity of estrogen receptors, stabilizes estrogen-sensitive tissues and competes with cortisol at nuclear receptor levels. • Progesterone aids myelin sheath formation (the insulating envelope around nerve fibers) facilitating nerve impulses. Research shows its role in the sense of touch, motor function and nervous system maintenance. • Progesterone regulates changes during menses and proves vital for maintaining pregnancy, protecting the uterus lining. Along with preparing the uterus for fertilized egg implantation, progesterone alerts the uterus to shed its lining Thyroid, Adrenal Steroids & DHEA Much of the thyroid hormone secreted by the thyroid gland is in T4 form. T4, a major hormone needed to control basal metabolic rate, increases enzyme secretions and is connected to cell energy production. T4 is converted to T3, the active hormone. Thyroid hormone—your survival depends on it. Thyroid hormone significantly affects metabolic rate and body temperature. Thyroid hormone supplementation, an inexpensive simple process, restores T3 and T4 cells to their natural ratio and blood concentrations. As we age, thyroid levels sometimes decrease. Low thyroid levels cause decreased body temperature, lowerthan-normal metabolism, increased cholesterol and increased body fat. Often undetected in traditional medicine, low thyroid levels make it fiendishly difficult to lose weight and can contribute to sluggishness, low energy and depression. Adrenal steroids—essential for life. Adrenal glands release hydrocortisone (cortisol) and other hormones, known as adrenal steroids. These steroids are critical for life and the key to physical and emotional stress response. Unlike other hormones, adrenal steroids generally don’t diminish with age. Both adrenal and gonadal steroids are derived from the basic cholesterol molecule. Through biosynthetic pathways, cholesterol is transformed into different steroid hormone Recent studies reveal that most patients with thyroid hormone disorders experience some sexual dysfunctions, which can be reversed by normalizing thyroid hormone levels. Despite the Gonadal & Adrenal Steroid associated changes in sex hormone levels, the high Biosynthesis prevalence of ejaculatory disorders and their prompt reversibility suggest a direct involvement of thyroid hormones in the physiology of ejaculation. Since low thyroid isn’t correct, maintaining other activity in the healthy range goes hand in hand with healthy cholesterol. Appropriate T3 levels must be established (before statin drugs are considered) to understand the true need for additional therapy. III . T h e S c i e n c e Beh i n d Cen e g e n i c s WWW.CENEGENICS.COM 37 III. The Science Behind Cenegenics hormone activity, functions as a natural diuretic and normalizes zinc/copper levels. molecules before becoming estrogen, progesterone or testosterone. (The chart on page 37 shows the progression.) Among its functions, cortisol rouses bodily activities on awakening: It influences protein, carbohydrate and fat metabolism; helps regulate blood pressure; and improves the integrity of blood vessels. Cortisol is also vital for immune function, helping mobilize against inflammation as well as fighting bacterial and viral infections. Escalated levels of cortisol can actually suppress immune function. III. The Science Behind Cenegenics Called the “stress hormone,” cortisol floods your body when emotional upheavals or emergencies arise. Afterward, the brain stops cortisol production to normalize levels. If you’re under chronic pressure and stress, escalated cortisol levels may saturate your body. DHEA—most abundant steroid hormone in the body. DHEA (dehydroepiandrosterone) is a precursor of testosterone and other hormones. The source for almost all DHEA is the adrenal glands, though small amounts are synthesized in the gonads, skin and brain. After production, DHEA circulates the bloodstream, where it can cascade into either estrogen or testosterone, as needed. Some studies show DHEA may help heighten energy and libido, eliminate abdominal fat, build muscle and promote muscle tone, improve immune function, regenerate Taking adrenal steroids, such as pregnenolone or androstenedione, may significantly influence the levels of their end products: testosterone, estrogen and progesterone. For this reason, Cenegenics® Medical Institute monitors levels of both the administered hormone and its end products. 38 WWW.CENEGENICS.COM Cenegenics only prescribes hGH if a comprehensive evaluation reveals an adult growth hormone deficiency. Our prescribing protocols and analyses are based on multiple controlled studies in peer-reviewed journals, in adherence with FDA regulations regarding the indicated uses of the hormone. In fact, we asked an outside source—the law firm of Parson, Behle, Short and Latimer—to review our clinical hGH protocols. They confirmed that Cenegenics is in compliance with all legal and regulatory issues concerning the use of this hormone. Our evidence-based approach incorporates hormone modulation to help patients regain and maintain metabolic and endocrine functions at the upper end of the normal range, adjusted for the patient’s age— creating the best opportunity for a healthier and more vigorous life. Over time, these elevated cortisol levels lead to fat accumulation, bloodsugar problems, fatigue, bone loss and immune system impairment. Chronic stress (physical or emotional) can also exhaust the adrenal glands, resulting in subnormal cortisol production—an insidious cycle that can cause premature aging of tissues and total body burnout. Human Growth Hormone tissue (bones, muscles and skin), keep cholesterol in check, maintain emotional well-being and improve the ability to cope with stress. Once a stressful situation subsides and cortisol production is stopped, DHEA restores tranquility and balance. Sadly, DHEA production drops 50% by age 45, increasing heart disease risks and sexual dysfunction. Optimizing your system with DHEA therapy helps restore youthful levels of the hormone, producing more energy, improved immune function, enhanced well-being and better cognitive function. III. Th e S c i e n c e Beh i n d Cen The science of hGH. The master hormone, secreted by cells called somatrophs, acts on the liver and almost every other tissue in the body. It stimulates IGF-1 (insulin-like growth factor) production, which ultimately yields growth-promoting effects. Exercise, stress, emotional excitement, diet and aging all affect the quantity of hGH production. By measuring levels of IGF-1, we determine the amount of the growth hormone in your body. In youth, hGH is critical to bone, organ and all aspects of development. Having too little causes dwarfism; occasionally, a tumor of the pituitary gland produces excess growth, which can result in gigantism. Both growth hormone and its metabolite IGF-1 begin decreasing e g e n i c s pituitary gland and released in pulses, mostly during sleep and after heavy resistance training. This master hormone affects all other hormones, organs and body cells. It is necessary for repair and restorative abilities at the cellular level, beyond those of any other hormone. A cell generator, hGH carries the singular title of “master hormone.” It is a complex protein molecule, made up of 191 amino acids that are synthesized in the anterior Also known as somatotropin, hGH aids growth, healing, immune system function, muscle mass and strength, body fat reduction, cholesterol level control, bone strength STUDIED & PUBLISHED BENEFITS and energy maintenance— of growth hormone including sexual energy and in hGH-deficient adults performance. Adult growth hormone deficiency does exist, DECREASED significantly impairing an • body fat individual’s ability to obtain • skin wrinkling optimal physiology. • hospitalization rate by 50% • sick days from work Identifying hGH. The • diastolic blood pressure hormone was first isolated • waist/hip ratio in the mid-50s. Its structure • bone loss, which increases with age wasn’t identified until the INCREASED • libido • lean muscle • bone density • skin thickness • exercise capacity • renal blood flow • feeling of well-being/improved socialization IMPROVED • cholesterol profile • memory • cognitive function BETTER • wound healing with lower infection rate III . T h e Is hGH safe—are there side effects? Studies overwhelmingly point toward the safety of growth hormone therapy in hGH-deficient adults. Per a 1999 article in the New England Journal of Medicine: “Side effects of growth hormone therapy for adult deficiency are minor, dose-related, and totally reversible.” early ’70s. By the mid-80s, the only hGH source was collected, post mortem from pituitary glands. Genetic engineering has changed all that. Recombinant hGH is now available from FDA-approved pharmaceutical manufacturers and is absolutely bioidentical. Also, a cover story on growth hormone, published in a 2003 issue of Newsweek, Dr. Pinchas Cohen, Director of Pediatric Endocrinology– UCLA, states “all the evidence shows that growth hormone is one of the safest drugs we have. Thousands of patients have been followed for the last 16 years.” Is hGH for everyone? Absolutely not. Cenegenics only prescribes hGH for patients with a proven growth hormone adult deficiency. Of course, before starting on any hormonal therapy, a comprehensive evaluation is essential. Any program should focus on hormonal balance with careful monitoring to minimize the potential of mild side effects. It should also be noted that individuals with certain specific medical diagnoses should avoid growth hormone therapy for adult deficiency because it could exacerbate their illness. STRENGTHENED • immune system These contraindications include uncontrolled diabetes; unusual lung diseases, such as pulmonary fibrosis, sarcoidosis, pneumoconiosis and bronchiolitis obliterans; HermanskyPudlak Syndrome; or systemic sclerosis. Currently, growth hormone is contraindicated in the history of cancer. There is not sufficient medical literature to use hGH safely in this context—although we do believe that literature will appear in the not-toodistant future. If you have ever been diagnosed with any of these medical problems, be sure to inform your Cenegenics physician. S c i e n c e Beh i n d Cen e g e n i c s If your evaluation assessment shows an adult hGH deficiency, your personal Cenegenics physician will help you understand and assess all the available information, objectively as possible. WWW.CENEGENICS.COM 39 III. The Science Behind Cenegenics between 15 and 20 years old, continuing to decline rapidly from that point. Although growth hormone is no longer needed for growth in adulthood, it remains essential for many other vital functions. Experience has shown us that the benefit of growth hormone therapy for deficient adults far outweighs the risk. Ultimately, the decision is yours. III. The Science Behind Cenegenics An hGH distinction: FDA regulations. The FDA established strict regulations, limiting how human growth hormone (hGH) can be prescribed, manufactured, distributed and sold. The FDA actually licenses and oversees companies manufacturing hGH. These manufacturers must register and verify their methods and product, uniformity, bioavailability, safety and demonstrated effectiveness. Only FDA-approved pharmacies may dispense hGH. Therefore, by federal law, any claim that a product contains hGH would require its production be overseen and approved by the FDA, meeting standards for quality and content. These patent parameters make hGH manufacturing complex and pricey. However, adult-deficient patients must avoid the lure of “cheaper” hGH. Drug-dispensing Web sites sprawl across the Internet, promising deep discounts and “anti-aging hGH.” According to the findings of Parson, Behle, Short and Latimer, lowerpriced/non-FDA-approved drugs do more than break federal law. These “alleged” hGH products pose inherent risks since they could be contaminated, counterfeit, subpotent or superpotent. There is one other point to consider. Often these advertisements promote over-the-counter pills, elixirs, sprays and creams, claiming to have valued amounts of hGH. Since hGH must be dispensed by prescription only, none of these products could contain the hormone. 40 WWW.CENEGENICS.COM Furthermore, many of these products rely on topical, sublingual or nasal administration. Federal law weighs heavily against purported “oral” and other forms of hGH: (1) these products don’t contain any significant amount of hGH; (2) they are illegal without a prescription for adult deficiency and without a statement of their exact content disclosure or production origin. To date, science hasn’t been able to produce any true precursors or stimulating compounds, which create a rise in human growth hormone. The fact is all the published benefits of using the master hormone for proven adult deficiencies are based on injected hGH. None of its prized benefits have been objectively measured with oral tablets, capsules or sprays. There are no published physiologic studies demonstrating any appreciable improvements in systemic hGH/IGF-1 levels delivered orally or by sprays. The 191 amino acids in this large, fragile polypeptide hormone (hGH) are in exact sequence with a specific 3-dimensional shape, which fits cell receptors like a key in a lock. Even if the chemical formula remains the same, a change in shape blocks hGH activity. Once dissolved in a solution, the cross-linkages maintaining the shape break quite easily and can become unstable. Claims that hGH can be absorbed in the oral mucosa and transported to the pituitary gland are nonsense. The hormone doesn’t act nor does it offer any beneficial effect at the pituitary level, but is secreted by the gland (normal source of hGH in young adults) to affect organ systems throughout the body. Such statements of a “stimulating dose” III . T h e S c i e n c e Beh i n d Cen working by absorption into the pituitary’s feedback system are marketing attempts, intended to deceive scientifically unsophisticated consumers. The only safe, accurately assembled hGH is one using recombinant DNA technology, which requires elaborate, precise methods. Using hGH from any other source—even other animals—doesn’t work in humans. Animal molecules have been shown to be species-specific and are unable to mimic the human molecule. There is absolutely no naturally occurring plant source of hGH. Bottom line, the only current method for adult hGH-deficient patients to administer this hormone is via injection with a prescription under the supervision of a licensed physician and through an FDA-approved hGH manufacturer and pharmacy. Get More Facts Additional information and insights about how our hormone modulation protocol works are available in Part V of this guide. Results from thousands of satisfied patients around the world show how our evidence-based therapies and synergistic approach can guide you toward a healthier, vibrant life. Contact Cenegenics® toll-free at 866.953.1510 for a confidential discussion about how you can manage your aging process. e g e n i c s I. IV. Start Taking Control It’s All About The Evidence II. “I have lost a total of 22 pounds. My PSA, blood pressure and cholesterol are all normal. I’ve witnessed several other real improvements . . . I’ve experienced informative and successful therapy III. IV. from your magnificent Institute.” —D.B., Ardmore, OK V. VI. IV. Start Taking Control It’s All About The Evidence R eal answers to your health questions and concerns rest in a comprehensive evaluation and medical evidence . . . not mere speculation. A cursory routine exam or guesstimate based on body type, gender and age won’t deliver real answers. The focus must be discovery, unlocking hidden truths about your specific physical conditions, diminished hormones and needs—vital facts often ignored by disease-based medical practitioners. IV. Start Taking Control At Cenegenics® Medical Institute, our goal is informing you about your unique health issues, based on substantiated information uncovered by our extensive Executive Health Evaluation. You’ll understand your weakest health links and learn about different ways to address your most significant medical concerns. We will also assist you in prioritizing options since our programs never rely on an all-or-nothing approach. IV. Start Taking Control Call us toll-free at 866.953.1510 to discuss how you can regain health and vigor. It’s All About the Evidence 42 WWW.CENEGENICS.COM What does that mean? We put you in control. Ultimately, your program plan and cost are determined by the focus you and your physician choose, typically addressing the most critical concerns. IV . S ta rt Ta k i n g C o n t r o l Executive Health Evaluation: Exposing The Whole Picture medical puzzle. With only that, it’s nearly impossible to grasp the whole picture and find solutions. Real progress is nearly unattainable, setting the stage for frustration. The Cenegenics Executive Health Evaluation is more than a snapshot of your health. It reveals an entire picture of what’s happening inside your body. The more thorough our investigation, the better your outcome. A physician with all the puzzle pieces and specializing in the interaction of those pieces can use scientific evaluation to see the whole picture and solve the puzzle. Frustration and conjecture disappear, putting you on your way to optimum health. That’s exactly what our Executive Health Evaluation does. Diagnostic testing allows us to track your progress objectively. We repeat tests periodically for continued, objective comparisons. You’ll soon realize our programs are designed for results, centered on our commitment to keep patients as disease-free as possible. “I was impressed with your team’s IV. Start Taking Control Think of health as a complex picture puzzle with a thousand pieces. Even a well-intentioned doctor may only have limited pieces of your unique By establishing your hormonal and metabolic baseline, the intensive Executive Health Evaluation arms you and your Cenegenics physician with vital medical information about your unique body needs. professionalism, expertise, politeness and attire—as well as their helpfulness and attention to details. Cenegenics appeared superior to any clinical program I’ve participated in.” —V.C., St. George, UT IV . S ta rt Ta k i n g C o n t r o l WWW.CENEGENICS.COM 43 Based on intensive data from the evaluation process, we will recommend a four-faceted approach, personalized to your specific medical needs: hormonal optimization, sound nutrition, sensible exercise and nutraceutical supplementation. Your health can turn around, resulting in increased energy levels, enhanced sexual performance, reduced body fat and increased lean muscle, better bone density, improved thinking and memory, better cholesterol scores and a strengthened immune system. Getting Started Step One Preparing for the Executive Health Evaluation. It begins with scheduling. Setting an appointment takes approximately 15 minutes. We’ll gather general information, then help you select an available date and a facility location. Complete the questionnaires. Typically, you will receive a package within five days, which includes a Health & Lifestyle Assessment, BDI Analysis, Neurologic Chronometric Assessment (NCA) and Essential Evaluation Day Details. You’ll need to complete the in-depth Health & Lifestyle Assessment, BDI Analysis and the NCA, then return them to Cenegenics® so we have this data well in advance for the physician’s review. IV. Start Taking Control “Cenegenics Medical Institute . . . a wonderful experience, positive staff and a real joy to work with.” —M. S., MD, Oklahoma City, OK 44 WWW.CENEGENICS.COM If your evaluation is done at home, you’ll have to obtain a thorough physical examination by your primary care physician and have it forwarded to us. Men should include results from a rectal exam, performed within one year of the physical examination; women should include a recent Pap smear as well as documentation of an annual mammogram (for women 40 and over). Have blood drawn. Approximately two weeks after scheduling your Executive Health Evaluation, our phlebotomy network will contact you to make an appointment for a highly comprehensive blood test. Unlike typical testing by primary care physicians, this intensive workup includes a CBC (complete blood count) and evaluations on hormone levels, cardiac disease risks, lipid panels, liver panels, homocysteine IV . S ta rt Ta k i n g C o n t r o l levels, prostate problems (in men) and urine analysis, among others. The results will reveal markers for disease risk and low levels of hormones below the healthy range, which our programs can restore. A phlebotomist will visit you, or you may have blood drawn at one of our facilities, if you live in the area. Testing requires a 12-hour fast, drinking plenty of water. Typically, testing can be performed Mondays through Thursdays. The phlebotomist will send your blood and urine sample to our lab for analysis. It takes two to three weeks to receive lab results, so we schedule your Executive Health Evaluation with that in mind. Ideally, your blood draw and lab results will be received before the actual day of the evaluation. If you live outside the U.S., or must schedule your evaluation within four weeks, it is possible to perform the blood draw on the day you visit our medical facility. Every segment of the Executive Health Evaluation can be completed, except final recommendations. In this situation, we schedule a phone consultation to review the lab results and offer medical suggestions. Step Two The Executive Health Evaluation. Thoroughly investigating your body demands center stage. Our evaluation process is highly personalized and lasts approximately six hours. We promise it will be anything but dull and may include these diagnostics: Diagnostic testing. Wear your comfortable sweats (or shorts) and tennis shoes. Be sure to bring a formfitting top for the optional baseline photographs. You’ll want to avoid garments with metal zippers or metal “I hardly know how to thank you and your staff. Just 3 ½ months from my Executive Health Evaluation, I’ve gone from 251 pounds down to 219. I’ll continue on down to 200 pounds or so before I stop the weight loss. The good news is with my weight down significantly and the testosterone doing its thing, I am really doing very well!” —W.P., Vancouver, WA Our plush terry cloth robes are available, should you feel cold. Tests include vital signs, body fact percentage and flexibility/range-ofmotion evaluations. Lunar densitometry and body composition exam. Simply lie back and let the instrument do the work. The total body scan helps us determine bone density, lean muscle mass and body fat percentile. Then the AO Spine Scan examines the bone density of your lumbar vertebrae and hips—vital for detecting osteoporosis. Body measurements and hip-to-waist ratios are then completed. Digital Photography. You may opt for us to take 14 digital photographs, archived in our system for before-andafter comparisons. Of course, these pictures (of the face, abdomen, legs and torso) are strictly confidential. Generally, women wear shorts and a form-fitting top. Men wear loose (but not baggy) shorts. The objective is an unobstructed view of your shape for tracking future progress. Arm-strength testing. Studies reveal that after age 20, we begin losing approximately half a pound of lean muscle weight annually. Using weights, you’ll perform an exercise test by alternating biceps curls to determine muscular strength. There is a brief instructional period to demonstrate proper technique. The number of repetitions completed before your muscles fatigue provides a baseline measurement for annual comparisons. Over time, hormone optimization, supplements and exercise can help you rebuild lean body mass and strength. Discuss findings with your Cenegenics physician. Based on labs, diagnostics, medical history and lifestyle, you and your Cenegenics physician will sit down to discuss the findings—spending approximately two hours of quality time together. Take a break along the way. Enjoy a nutritional—and totally delectable— meal on us, which mirrors the smart food choices recommended in our programs. Meet with our nutritionist and exercise physiologist. Spend an informative one and a half hours discussing your current dietary habits and exercise, determining personal goals and learning how the right food and exercise program promotes health and vigor. Meet with a Cenegenics associate. Review your recommended program and corresponding fees. You decide what you wish to do with those suggestions. Do some, or do it all; it’s totally up to you. After every issue has been thoroughly discussed and all questions answered to your satisfaction, a comprehensive program will be designed and presented to you for your acceptance, allowing for short-term and long-term fitness and health goals to be realized. IV . S ta rt Ta k i n g C o n t r o l WWW.CENEGENICS.COM 45 IV. Start Taking Control accents, ensuring accuracy on the bone densitometry diagnostics. “We are excited about the tremendous turnaround my husband is experiencing. Battling diabetes, he previously had to be on a medication that was harmful to his kidneys. Now, with his Cenegenics program, he doesn’t need that medication any longer. The other day we went for a six-block walk. Instead of resting after 40 minutes, he kept going and I had to hurry to keep up! Thanks, Cenegenics!” — J.S. & T.S., Chatsworth, CA IV. Start Taking Control Step Three Embark on your new health journey. After beginning your program, you can expect ongoing communication and follow-up from the Cenegenics® team members. Your Cenegenics physician will manage your program medically, based on follow-up lab results and phone consultations. Most importantly, your physician will remain available via phone, email or in person. Our Patient Services Team will manage your automatic monthly pharmacy shipments and schedule follow-up blood testing, in your home or office. Follow-up consultations will be scheduled to discuss results with your Cenegenics physician. 46 WWW.CENEGENICS.COM Tax Deductible Vehicles Here are the four programs, as defined by the IRS Web site at the time of this publication: As you’ve discovered, our programs do not focus on disease, but rather on maintaining and optimizing health. Consequently, insurance companies and the government do not cover professional fees, prescriptions or labs. Since Cenegenics does not accept insurance, you may want to consider programs designed to give individuals tax advantages, which help offset healthcare costs, such as Health Savings Accounts (HSAs), Medical Savings Accounts (MSAs), healthflexible spending arrangements (FSAs) and Health Reimbursement Arrangements (HRAs). IV . S ta rt Ta k i n g C o n t r o l • An HSA may receive contributions from an eligible individual or any other person, including an employer or a family member, on behalf of an eligible individual. Contributions, other than employer contributions, are deductible on the eligible individual’s return whether or not the individual itemizes deductions. Employer contributions are not included in income. Distributions from an HSA used to pay qualified medical expenses are not taxed. • An Archer MSA may receive contributions from an eligible individual and his/her employer, • • A health FSA may receive contributions from an eligible individual; employers may also contribute. Contributions are not includible in income. Reimbursements from an FSA used to pay qualified medical expenses are not taxed. An HRA must receive contributions from the employer only; employees may not contribute. Contributions are not includible in income. Reimbursements from an HRA used to pay qualified medical expenses are not taxed. For detailed information about these plans and eligible medical expenses, please visit the IRS Web site. Professional Fees Patient Privacy Cenegenics guides you on a lifeenhancing experience. We proudly offer you ready access to our expert medical staff and sophisticated services. As a medical facility, Cenegenics Medical Institute is required by law to protect the privacy of health information about you and whatever can be identified with you, called protected health information (PHI). One-on-one care and resources are provided through semiannual professional fees, which cover ongoing personal service, guaranteed throughout your Cenegenics program: • behind-the-scenes work of the entire clinical staff on your behalf, from nursing and laboratory correlation to outside source research you might request We are required to give notice of our legal duties and privacy practices, concerning PHI: • We must protect the PHI we created or received about your past, present or future health condition and healthcare we provide to you or payment for your healthcare. • continual communication with our expert team—from scheduled calls about your laboratory evaluations to spontaneous calls initiated by you to address questions or concerns • We must notify you how we protect PHI about you. • in-person and on-the-phone visits with your Cenegenics physician • We may only use and/or disclose PHI as described in our Notice of Private Practice handout. • We must explain how, when and why we use and/or disclose PHI about you. We are required to follow the procedures defined in our Notice of Private Practice, available to every Cenegenics patient. IV . S ta rt Ta k i n g C o n t r o l WWW.CENEGENICS.COM 47 IV. Start Taking Control but not both in the same year. Contributions by the individual are deductible whether or not the individual itemizes deductions. Employer contributions are not included in income. Distributions from an MSA used to pay qualified medical expenses are not taxed. IV. Start Taking Control 48 WWW.CENEGENICS.COM IV . S ta rt Ta k i n g C o n t r o l I. V. Maximizing Your Health Potential Better Health & Maximum Longevity: No Accident II. “We scheduled everything over the phone, then flew to Las Vegas for our Executive Health Evaluation. It was a wonderful experience—and, needless to say, we started on the full program. Into our third week, we are thrilled with the newest III. IV. addition to our health and wellness program.” —K.R., Virginia Beach, VA V. VI. V. Maximizing Your Health Potential Better Health & Maximum Longevity: No Accident E njoying a conscientious lifestylemanagement program—one that embraces hormone optimization, nutraceutical supplementation, sound nutrition and relevant exercise—is a proven catalyst to significant health benefits. Mapping such an essential lifestyle plan begins with our comprehensive Executive Health Evaluation, described in Part IV. That’s where we at Cenegenics® “look under the rocks and between the leaves,” searching in places others usually wouldn’t for answers to your particular medical concerns and ways to promote and maintain better health. V. Maximizing Your Health Potential You are different from the patients before you and from those that will follow. Recognizing that, we take great care to evaluate your individual needs, then put critical data from diagnostic analyses to work. Your Cenegenics physician will create a program based on our four-faceted approach, uniquely designed for your needs and goals. Each segment is a vital building block, supporting your prime objective—realizing your health goals and enjoying a life filled with verve, vigor and a heightened sense of well-being. V. Maximizing Your Health Potential Better Health & Maximum Longevity: No Accident 50 WWW.CENEGENICS.COM V. M a x i m i z i n g Y o u r H e a lt h P That’s not a singular event. Since the body changes, you’ll engage in periodic dialogue and consultations with your Cenegenics doctor: tracking progress, reviewing test results, discussing your annual exams and determining adjustments to your personal program, along the way. o t e n t i a l In fact, our entire team offers their medical expertise and caring service so your health journey stays on course. HORMONES The Principal Players Primary functions listed only; secondary actions are not included. Begin yours today by calling us toll-free at 866.953.1510. • Testosterone: Produced in testes, ovaries and the adrenal glands. Enhances libido, erectile function and energy levels; strengthens bones; builds muscle; promotes muscle tone; creates a sense of well-being. Hormonal Optimization • DHEA: Formed by adrenal glands, a precursor to testosterone, estrogens and androgens. A protein builder and repair, DHEA protects against stress, cardiovascular disease, osteoporosis and Alzheimer’s; aids in preventing wrinkles and dry eyes; increases libido, energy levels, memory and immunity. Your Executive Health Evaluation opens a window to your particular physiology, from metabolism to endocrine system and beyond. • Estrogen: Produced in ovaries, body fat and adrenal glands. Helps protect against cardiovascular disease, osteoporosis, Alzheimer’s and incontinence; enhances libido, skin tone, emotional well-being, sleep, cognitive acuity, mood, sensory function and digestion. Hormonal optimization is often an integral part of a Cenegenics program, helping patients regain a healthy, balanced endocrinologic state so their bodies can function optimally. • Progesterone: Produced by ovaries (testes in men) and adrenal glands. Helps enhance mood and sense of well-being, aids brain function, stimulates bone-building osteoblasts and regulates/balances other hormones. That is accomplished safely, using bioidentical hormones, rather than dubious artificial alternatives. Since bioidentical hormones specifically emulate the chemical and molecular structure of the body’s naturally produced hormones, the body can metabolize them easily without bothersome and potentially dangerous side effects. V. Maximizing Your Health Potential • Thyroid: Produced in thyroid gland. Helps every cell, by monitoring and regulating metabolic rate. • Cortisol: Formed in adrenal glands. Regulates blood pressure, increases energy, influences metabolism and glucose balance, helps cope with stress and infection. • hGH: Only prescribed when comprehensive testing reveals an adult deficiency. Produced by pituitary gland. Stimulates body tissue growth and skin hydration; promotes bone and muscle growth; regulates energy and metabolism. If warranted, we’ll focus on reducing insulin and cortisol levels, which promote aging and degenerative disease, then concentrate on supplementing diminished hormone levels. V. M a x i m i z i n g Y o u r H e a lt h P o t e n t i a l WWW.CENEGENICS.COM 51 Delivery methods differ. For example, women typically use testosterone in cream form, while men use the injectable hormone, stimulating hormone or both. After hormone therapy begins, laboratory markers (including hormone blood levels) are followed at regularly scheduled intervals with adjustments to ensure effectiveness, safety and appropriate levels, at the upper percentile norm for your age. We highly recommend reviewing Part II (about hormones, aging and health) and Part III (the science and specific hormones in our programs, plus findings and bioidentical hormone therapy). Nutraceutical Supplementation minerals (which once were part of our food) from years of over-farming, chemical toxins and acid rain. Nutraceutical supplementation is not an indulgence—it’s imperative to arm the body with the weapons to battle modern enemies. Even the healthiest diet demands supplementing with vitamins, minerals, essential fatty acids and antioxidants. Not all supplements or supplement formulations are on equal footing. Numerous lab reports demonstrate that commonly available commercial formulas vary widely in quality. Some supplements don’t contain the amount of nutrient their label claims; others use inferior ingredients, are less absorbable or appear in less-effective forms of the nutrient. You don’t always get what you pay for. V. Maximizing Your Health Potential Add to that the reality of our soils being depleted of vitamins and 52 WWW.CENEGENICS.COM Cenegenics® Nutraceuticals are “Pharmaceutical Grade.” As such, Cenegenics Nutraceuticals meet pharmaceutical specifications for potency and bioavailability. They are made exclusively for us by one of the most respected pharmaceutical labs in the country. Cenegenics Nutraceuticals are always fresh as well as free of allergens and filler material, ensuring quality and purity. In fact, our prestigious nutritional and medical advisory board meets frequently to share information. The board also updates and improves our formulations, incorporating the latest research on vitamins, minerals, herbs and optimal doses. All dosing decisions are based on effectiveness— unlike many of the over-the-counter products, which have ineffective and minimal amounts of a nutrient so they can list that ingredient on the label. Nutraceuticals help correct nutrient issues and profoundly impact your health. Every study of the American diet reveals a sub-optimal intake of many micronutrients. As a result, degenerative diseases related to diet and nutrient deficiencies are a major killer, worldwide. It’s no wonder. Health risks inundate our cyber-speed world: environmental carcinogens; second-hand smoke; toxins in our food supply; over-thecounter and prescription medications; refined sugar, processed fast foods and trans-fats; escalated stress factors, household cleaners, beauty products and pesticides; automobile exhaust; and an overwhelming number of other substances, identified as xenoestrogens—hormone disrupters, playing havoc in our bodies. reflects the exact amount of ingredient present within each capsule or pill. On the contrary, “Food Grade” supplement labeling is misleading in that the amount listed is the maximum that might be present but in most cases there is only a trace amount. Food grade vs. pharmaceutical grade. “Food Grade” supplements, like most sold in health stores, contain only substandard raw ingredients, which are virtually ineffective. Plus “Food Grade” products have no labeling, whereas “Pharmaceutical Grade” products always have either USP, NF, Pharmacy Grade or by physician’s prescription. Sound Nutrition The quality of “Pharmaceutical Grade” products is substantially higher because the raw ingredients are the most pure and the best absorbed in the body. Also, the label accurately Ancient paths. The diet most synergistic with hormone therapy is reminiscent of our Paleolithic-era ancestors: high in nutrient-dense foods (fruits, vegetables, lean meats V. M a x i m i z i n g Y o u r H e a lt h P Nutrition isn’t about a single “perfect” diet. Our nutritional program is shaped by a patient’s individual needs. Every nutri-therapy and eating program varies from individual-toindividual, based on results of the Executive Health Evaluation. o t e n t i a l PRIME COMPONENTS IN SUPPLEMENTS • Antioxidants: Powerful age management nutrients, shown to reduce free radicals, strengthen immunity as well as help prevent cancer and heart disease. Includes vitamins A, C, E, selenium, acetyl L-carnitine, coenzyme Q1O (Co-Q1O), quercetin and melatonin. • B-vitamins: Critical for skin, proper brain function, energy production, alleviating anxiety, adrenal hormone production, antibody formation, muscle tone in the gastrointestinal tract, hair, liver, weight loss, red blood cell production and more. Many health problems are related to poor absorption or low intake of B-vitamins. The B-complex vitamins in our formulas include B-1, B-2, B-3, B-6, B-12, pantothenic acid and folic acid. • Calcium: Vital for bone density, healthy gums, lowering cholesterol, muscular growth, energy, neuromuscular activity, healthy skin. Must be in a bioavailable (absorbable) form. • Chromium: Helps stabilize blood sugar and aids insulin function; vital in synthesis of cholesterol, fats and protein. Some anecdotal reports suggest it has a modifying effect on cravings. • Digestive Aids: Restore ability to digest and absorb nutrients. Aging causes diminished stomach acidity and digestive enzymes, resulting in less absorption of vital nutrients. Our formulas use several digestive aids, such as pancreatic enzymes, lactase and letaine. • Liver Detoxifiers & Protectants: The liver is an essential clearing house, ridding the body of toxins, cleaning blood, aiding hormonal balance and supporting energy levels. Alpha-lipoic acid, glutathione and silymarin are used, regarded as highly effective in protecting the liver against toxins (including alcohol). • Magnesium: Required for over 300 body functions. A catalyst in enzyme activity, aids calcium/potassium uptake for healthy bones, prevents kidney stones, lowers blood pressure, promotes nerve-muscle transmission and energy levels as well as prevents calcification of soft tissue. An estimated 72% or more adult Americans fall short of U.S. dietary allowances for the mineral. Magnesium glycinate is used for its excellent absorption. • “Smart” Drugs*: Mental alertness and concentration tend to deteriorate with age. These Smart Drugs enhance memory, aid cognitive function and potentially prevent cerebrovascular disease. Ginkgo biloba, phosphatidyl serine, phosphatidyl choline and acetyl L-carnitine help relax smooth muscles in arteries, increasing circulation to the brain. *Most of them are not really drugs. • Zinc: Essential for prostate gland function and libido, protein synthesis, collagen formation, immune system health, liver protection, healing wounds, acne prevention and over 30 bodily functions. Zinc picolinate is the most effective form for absorption. and essential fats) and low in refined, overly processed foods, fats and simple carbohydrates. Our digestive system’s adaptation to grains and dairy products took thousands more years. For thousands of years, human diet was simple: We ate what grew from the ground, fell from the trees, ran across our path or swam the waters. Obviously, our bodies haven’t caught up to the inundation of additives, chemically altered fat V. M a x i m i z i n g Y o u r H e a lt h P (trans-fats), preservatives, colorings, faux flavorings and copious sugar consumption, dominating modern diets. In fact, government research indicates that in 2002, American sugar consumption averaged 170 pounds per person annually. o t e n t i a l WWW.CENEGENICS.COM 53 V. Maximizing Your Health Potential • Prostate Protection: More than half of men 50 and over have significant prostate enlargement. Three natural herbs help prevent prostate enlargement, possibly decreasing prostate cancer potential: saw palmetto, Africanum Pygeum and nettle. • Boost your body’s immune function: The immune system is nothing short of miraculous. With proper nutrients, it fends off colds, bacteria, viruses and even cancer without your knowing. That’s a far cry from our huntergatherer days. No wonder heart attacks, obesity, Type 2 diabetes, strokes, cancer, hypertension and gastrointestinal disorders are escalating. The ball is in your court. You can greatly improve and even avoid medical conditions with deliciously nutritious dietary changes. The goals of the Cenegenics® food plan are simple. • Maximize results of your hormone therapy program: Your personalized food program will be designed to keep blood sugar and insulin levels low. V. Maximizing Your Health Potential • Prevent illness: Toxins lead to diminished health, from the overuse of antibiotics and chemicals to dietary “poisons” and empty calories, such as saturated fats and transfats, refined flour, sugars, preservatives, artificial colors, artificial flavors and artificial sweeteners. 54 Revamping your diet to include nutrient-dense foods and removing chemicals can reclaim better health. Appetizing phytonutrients (such as carotenoids, flavonoids, isoflavones, lignans, omega-3 fatty acids) can promote age management and help fight cancer. WWW.CENEGENICS.COM Your personalized food plan will center on eating a diet high in phytonutrients (natural disease resisters); essential fats (basic building blocks needed by every living cell and for prostaglandin production); lean protein (critical for growth and energy, hormone, antibody, enzyme and tissue production plus acidalkali balance); and fiber (helpful in lowering cholesterol, stabilizing blood sugar levels and preventing obesity, constipation, colon cancer and hemorrhoids). fitting your lifestyle and overall health goals. There are three main exercise categories: resistance/weight training, cardiovascular exercise and flexibility. Each offers specific benefits, creating a well-balanced exercise program with dynamic results. Resistance Training/Weight Training Resistance is found in many forms, from weight machines and free weights to stretch tubing and swimming pool activities. Body weight can add resistance in exercises such as push-ups, standing squats and crunches. Resistance training benefits: Regular Exercise • Reduced body fat and lowered cholesterol: Weight training is the best way to burn fat; it’s more effective for losing weight than aerobic activity because it burns calories while you’re exercising and at rest (Darden 1985). Stiff joints, slower metabolism and loss of lean muscle are all too familiar. Often, aging is equated with decreased exercise and these consequences. It all comes down to choices. You achieved your position in life by making intelligent decisions; now you can apply that same determination to your health and body. After your resistance workout, metabolic rates remain elevated, as muscle fibers are being rebuilt. Many of the calories you consume will be put to work in the repair and rebuilding process, rather than being stored as fat. Conversely, metabolic rate typically returns to normal shortly after aerobic activity. No significant “after burn” occurs. Once you succeed in adding lean muscle tissue, metabolism will be higher at rest than it was prior to your exercise program. Every pound of muscle added to your body increases the calories needed to get you through the day. Through consistent exercise, you can rebuild muscles, increase metabolic rates, lower heart disease risk, improve posture and increase quality of life. Hormonal optimization can facilitate your ability to exercise more effectively, helping achieve desired results. During your Executive Health Evaluation, you’ll have an opportunity to discuss your current exercise routine with an exercise physiologist. Together, you can develop a plan V. M a x i m i z i n g Y o u r H e a lt h P o t e n t i a l Here’s the math: The body requires approximately 30-50 calories daily, per pound of muscle. When you add 5 pounds of lean muscle, you’ll burn an additional 150-250 calories every day, even on days you don’t exercise (NASM 1996). This adds up to 15 ½ to 26 pounds of fat loss every year. • Increased bone density: A 1988 study from Washington University School of Medicine concluded weight-bearing exercise leads to significant increases in bone mineral content, which are maintained with continued training in older subjects (Dalsky et al). That’s good news for preventing osteoporosis since resistance training puts added demands on bones, bolstering their density. • Increased body strength: Most people, regardless of their age, experience strength improvements in a matter of weeks. A study conducted in December 1993 (McCartney et al) examined the effects of a 42-week progressive weight-lifting program on subjects in their 60s, 70s and 80s. After approximately 10 months, they found significant strength gains (up to 65%) in the exercising group, but no gain in a non-exercising, control group. Most substantial strength increases occurred at 6 and 12 weeks into the program. Noted fitness expert and researcher Dr. Wayne Westcott explains the relationship: “Stronger muscles lead to stronger bones and connective tissue, all of which work together to increase our functional capacity and decrease injury potential.” • Daily tasks eased: For many, activities like lifting a child, stooping or trying to get up require great effort. Suppose the maximum your biceps can carry is 20 pounds, and you have to carry a 20-pound suitcase through an airport. That requires 100% effort. Participating in a resistancetraining program can increase your biceps’ strength to 40 pounds and enhance your stamina. Now carrying the suitcase becomes manageable. • Emotional stability: Exercisestimulated neurotransmitters create what some call “postexercise euphoria” or endorphin response. These mood mediators make us feel better and less stressed (ACE 1996). One 20-minute (or longer) exercise session generates 90 to 120 minutes of this relaxation response. The American Council on Exercise recommends 20 minutes (cardiovascular, resistance training or flexibility), 6 or 7 days a week to promote emotional well-being. • Reduced muscle atrophy: Most people over age 20 lose one half to one pound of muscle mass each year, due to inactivity. You don’t have to since resistance training helps maintain, and even increase, lean muscle. • Improved body appearance: “Spot reducing” won’t improve body composition. Sit-ups won’t get fat off your abdomen. Only burning calories and reducing fat will. Weight training can help you directly target and build shapely arms, legs, abdomen and more—adding lean muscle in the process. Cardiovascular Exercise “Cardio” is among the most popular forms of exercise, such as walking, cycling, swimming and aerobics. Actually, any exercise causing an increase in heart rate for a sustained period of time is included. Cardiovascular exercise benefits: • Increased health span: A study following Harvard grads through 30 years showed those who were moderately active—from gardening to sports—were at a substantially decreased risk of death. • Reduced injuries: Muscle strength decreases stress on bones during impact exercises (such as walking, jogging and tennis) and improves dynamic balance to make a person less susceptible to falls and other mishaps (Nelson et al 1994). V. M a x i m i z i n g Y o u r H e a lt h P o t e n t i a l WWW.CENEGENICS.COM 55 V. Maximizing Your Health Potential • Reduced body fat: Aerobic exercise uses both stored carbohydrates and fats for fuel. The longer and more vigorous, the more total calories are burned. aerobics four times a week fall asleep faster than their inactive peers. • Decreased risk of heart attack: Lowering insulin levels helps reduce rates of arteriosclerosis. Physical exercise lowers these levels, helping lower the risk of heart attacks. After four months, those who exercised regularly reported falling asleep in less than half the time and sleeping almost an hour longer than before (Harvard Health Letter, March 1997). Some experts believe stretching can relieve up to 80% of low back pain cases. One common cause: short, tight hip-flexor muscles. A stretching program to lengthen these muscles may reduce the risk of pain (Rebus, Inc. 1987). The American Arthritis Foundation advises moving joints through their full range of motion daily. They caution everyday activities do not accomplish this. • Increased heart fitness: The American Heart Association stresses a minimum of 20 minutes of cardiovascular exercise, at least 3 days a week, is vital to good heart health. • Reduced stress: In today’s hectic world, we face stress on many fronts. Tense or tight muscles may be linked to that stress and can be eased with flexibility exercise. V. Maximizing Your Health Potential Studies have shown exercise to be an effective way to lower blood pressure. Aerobic exercise strengthens the heart muscle, enabling it to circulate blood throughout the body with less effort. This helps decrease blood pressure, reduce stroke risk and prevent coronary, circulatory and respiratory problems. Flexibility Exercise • Reduced stress: Twenty minutes or more of cardiovascular exercise at moderate intensity has been shown to significantly reduce stress. Flexibility exercise also can help reduce stress, alleviate low back pain and greatly diminish the chance of injury. A program can be simple (such as stretching major muscle groups upon waking in the morning) or involved (such as power yoga class). • Increased endurance: Regular aerobic exercise helps increase muscle endurance, making everyday activities (such as walking a flight of stairs without becoming winded) far easier. • Improved quality of sleep: Researchers at Stanford and Emory Universities, as well as University of Oklahoma, reported older people who participate in brisk walking and/or low-impact 56 WWW.CENEGENICS.COM Flexibility is defined as the range of possible motion around a joint. As we age, joint mobility proves crucial for muscular strength, proper posture and full range of motion. Flexibility exercises—with their gentle movements—help increase the length of connective tissues and muscles. The recommended method to increase flexibility is a regular stretching program, three to seven days a week. Flexibility exercise benefits: • Increased flexibility and range of motion in joints: Vital for good posture, increasing flexibility (especially hip flexors and hamstrings) and help alleviating a majority of low back pain. V. M a x i m i z i n g Y o u r H e a lt h P Michael J. Alter, former gymnastics coach and author of The Science of Flexibility states, “One of the greatest benefits of stretching is that it can help reduce stress. From a purely physiological perspective, relaxation is the cessation of muscular tension. Tension wastes energy; a contracting muscle requires more exertion than a relaxed one. Everyday experience has shown that a relaxed muscle is less susceptible to fatigue and aches and pain.” All In Synergy Hormone optimization works with nutraceutical supplementation, sound nutrition and exercise to promote optimal health and vigor. Cenegenics® is here to help you live well longer. Call us toll-free at 866.953.1510. o t e n t i a l I. VI. Commonly Asked Questions Conveniently Categorized II. “Thank you for being a pioneer in the age management field and thinking outside the box. And also, thanks for helping other physicians (like me) learn from your practice. Your facility is professional, filled with knowledgeable and extremely qualified doctors.” — D. P., MD, Alpharetta, GA III. IV. V. VI. VI. Commonly Asked Questions Conveniently Categorized A lthough this information appears throughout our guide, here are the most common questions posed to us—conveniently categorized in a topic format. About Cenegenics Medical Institute What is Cenegenics all about? We’re here to guide men and women in regaining vitality and vigor, regardless of their age—helping them maintain health and live well longer. Cenegenics® is focused on preventive care: averting premature disability related to aging via medically sound strategies. In fact, our medical strategies have helped countless successful men and women regain their edge through optimal health, which is essential to their quality of life. We rely on sophisticated diagnostics and evaluation to guide patients through a synergy of hormone management, optimal nutrition, nutraceutical supplementation and proper exercise. VI. Commonly Asked Questions As a result, patients typically experience remarkable boosts in energy, increased mental acuity, revitalized sex drive and performance, strengthened immune systems, increased lean muscle, decreased fat and improved skin tone. VI. Commonly Asked Questions Conveniently Categorized 58 WWW.CENEGENICS.COM VI . C o mm o n l y As k e d Q u e s t i o n s 4. Have you documented or published your clinical age management outcomes? Why Cenegenics, rather than other physicians or medical facilities? The most important element is the expertise and experience of the physician involved. That’s critical for any medical therapy’s success. Our physicians are highly skilled, experienced and have completed Physician Training in Age Management Medicine. They offer a wealth of experience in hormone therapies, nutritional strategies and exercise science. Our primary objective is guiding and informing patients, helping them become comfortable with the science and therapies that have made Cenegenics Medical Institute a world leader in age management. We encourage due diligence. Ask your physician these questions: 1. What specific training have you had in the field of age management medicine? 2. Do you practice age management medicine full-time? If you needed surgery, would you choose a doctor who performs the procedure once a month, or a physician who is an internationally recognized specialist in that specific surgery? The more experience with specialized therapies, the better the results. There is often a wide breach between a physician’s excellent intentions and his/her limitations due to lack of specific training and/or experience. By far, Cenegenics Medical Institute is the largest and most-experienced age management medicine practice, having patients worldwide. In fact, 25% of our patients are physicians and their families. Cenegenics consistently receives regional, national and international media exposure and has been widely featured in GQ, Men’s Health, The New York Times, USA Today and The Wall Street Journal as well as on ABC’s 20/20, CBS’s 60 Minutes and 48 Hours, CNBC and NPR. We continually expand our affiliations. University of Nevada School of Medicine residents have opportunities to learn from the expert and experienced physicians at Cenegenics, as part of their VI . C o mm o n l y As k e d Q u e s t i o n s Practice Development rotation. Residents spend time at our medical institute, training with our physicians and patients to gain a deeper understanding of age management medicine. At the University’s Family Practice Center, Cenegenics physicians supervise the residents’ chart review and patient evaluation in the clinical setting. Family practice residents rotate through our program as an elective in their advanced medical training. Additionally, we conduct ongoing research with one of the most prestigious schools in the country. Cenegenics Education and Research Foundation provides the most highly regarded learning opportunity with mainstream credentials offering Physician Training in Age Management Medicine through the joint sponsorship with the Foundation for Care Management for a maximum of 60 AMA PRA Category 1 Credits™. Cenegenics also is committed to upholding the highest business ethics. Our company holds the top rating (for a private entity) with Dun & Bradstreet; the Better Business Bureau confirms that since our 1997 inception, we have never received a negative comment or complaint. WWW.CENEGENICS.COM 59 VI. Commonly Asked Questions 3. How many age management patients have you treated? What are semiannual professional fees? How long before the Cenegenics program produces results? Your Cenegenics® program is a life-enhancing experience with ready access to our expert medical staff and sophisticated services. Personal care and extensive use of our resources are provided through semiannual professional fees, which cover ongoing one-on-one service, guaranteed throughout your Cenegenics program. This varies with each person. Some experience results within days. Like a beginning exercise program, you generally can expect results within three to six months after beginning hormone therapies. Often our patients report benefits, such as an increase or improvement in libido, energy, lean muscle, stronger bones, skin tone and elasticity, memory, cognition, cardiovascular system, sleep, moods and an overall heightened sense of well-being. You have access to behind-the-scenes work of our entire clinical staff: (1) request nursing and laboratory correlation between Cenegenics and research from outside sources; (2) talk with our expert team, from scheduled calls to spontaneous inquiries, addressing questions or concerns; (3) visit with your Cenegenics physician, in-person or by phone. The Cenegenics Program What is hormone optimization and how does it work? Hormone optimization is the science of optimizing hormones to levels that are no longer adequately produced by the body. Genetic programming takes us to the age of reproduction and nurturing, then our “prime function” is finished and we begin to fail. Much of what we consider “aging” can be seen as diminished hormone levels—substances our bodies once produced in abundance. VI. Commonly Asked Questions Regaining and maintaining metabolic and endocrine functions at the upper end of the normal range give you the best opportunity for a healthy and vigorous life. 60 WWW.CENEGENICS.COM On the other hand, individuals younger than 35 who are facing developmental difficulties and other symptomology may also be candidates. It’s never too early for any adult to begin the nutraceutical program. A person doesn’t need to begin hormone optimization therapy unless those levels are diminished. How long will I be on Cenegenics therapies? Give the program at least six months to see significant results. Most patients experience benefits before three months and continue to see improvement. Your body needs that much time to heal and rebuild. Once there, stay on the program as long as you want to optimize health. How many pills will I take daily? That depends on your specific medical, hormonal and nutritional needs. Of course, your Cenegenics physician will also consider your individual comfort level of taking pills. Hormones and nutritional supplements are conveniently supplied and mailed to you on a predetermined schedule. Starting, Stopping & Age Concerns At what age should a person start with Cenegenics? For the initial baseline evaluation, 35 or older. VI . C o mm o n l y As k e d Q u e s t i o n s Are you ever too old to start? Age is not a barrier. Many people over 60 erroneously believe it’s too late. Quite the contrary. Older adults are likely to have greater hormone diminishments; therefore, the response to hormone optimization and supplementation is usually excellent and almost immediate. Early intervention can reduce rapid advancement of diseases, such as osteoporosis and Alzheimer’s. Less progress is expected when such conditions are advanced. What happens if I stop the program? The Cenegenics age management program improves health, vitality and vigor. Should you elect to stop, aging won’t accelerate; the body will begin again to age at the normal rate. It’s a lot like exercising in a program to stay in shape. Stop and the benefits Hormonal therapies improve your physiology and overall quality of life. If you stop, those benefits will fade over time . . . yet, you’ll still be better off because your physiologic baseline most likely will be higher. Your Present Physician & Medications Will the Cenegenics treatment interfere with currently prescribed medications? Generally not. In some instances, medications may actually be reduced or no longer needed. Your Cenegenics doctor will consider these issues and advise you, working with your personal physician, if you choose. Will Cenegenics Medical Institute take over as my doctor and healthcare facility? Not at all. Cenegenics is a wellness program, happy to communicate with your current healthcare team. We encourage you to continue usual visits with your regular doctors. Using Hormones For Better Health What about the negative press coverage concerning hormone replacement therapy for women? Cenegenics Medical Institute only recommends hormones and dosages supported by evidence-based evaluation. Most women over 35 need some form of hormone supplementation. That applies to premenopausal women and those who have reached menopause. At Cenegenics, we perform a baseline evaluation and diagnostic analysis to help determine exactly which hormones are diminished. Menopause is part of the aging process, resulting in a hormonedeficiency condition. To regain and maintain optimal health, it’s essential to supplement (not replace) lost hormones with natural, bioidentical hormones whenever possible. Identical hormone molecules are natural hormones and as close as possible to your own hormonal secretions; artificial hormones are not natural to the human body. Is hGH FDA approved? There are no oral, nasal, sublingual or transdermal growth hormone products (including secretagogues and precursors) with any merit, whatsoever. Companies promoting “oral hGH” or “nasal spray hGH” are currently under federal investigation. Pharmaceutical manufacturers Merck and Pfizer report having spent some $100 million, attempting to develop non-injectable hGH products. They failed. Evidence-based medical research shows injection is the only effective way to introduce human growth hormone into the body. If you have other considerations or questions, call us toll-free at 866.953.1510 or email our Cenegenics team. We’re always ready to help. In 1996, the master hormone hGH was FDA approved for treatment in adults with demonstrated growth hormone deficiency. Cenegenics adheres to the strict regulations, set by the FDA. Our comprehensive baseline evaluation determines if you have an adult hGH-deficiency. Only patients with a proven adult deficiency are given hGH hormonal therapy balanced with other hormones, typically 7% of our patients. As with any of our synergistic programs, that therapy is given in conjunction with sound nutrition, relevant exercise and nutraceutical supplementation. Does hGH have to be injected? Yes. Taken orally, human growth hormone (hGH) breaks down into simple amino acids or small protein chains. Injection is the only effective way to realize its benefits in adults with demonstrated growth hormone deficiency. VI . C o mm o n l y As k e d Q u e s t i o n s WWW.CENEGENICS.COM 61 VI. Commonly Asked Questions fade over time—but you were still better off for having been actively in the exercise program because your baseline will be higher. VI. Commonly Asked Questions 62 WWW.CENEGENICS.COM VI . C o mm o n l y As k e d Q u e s t i o n s Appendix “You are doing a great job, setting the pace and establishing the standards of what I believe excellent, first-rate, high-quality [age management] healthcare should be. Keep up the good work!” —L.R., Alexandria, VA Cenegenics Medical Institute ® Team Credentials Alan P. Mintz, MD Chief Medical Officer, Chief Executive Officer Dr. Mintz is board-certified in radiology, nuclear medicine and radiation therapy. He is a Diplomate of the American Board of Radiology, including nuclear medicine and radiation therapy. Dr. Mintz’s dynamic vision and commitment to excellence have set the tone for Cenegenics®. He proudly serves as chief medical officer, chief executive officer and co-founder, offering his esteemed experience and passion in age management. Dr. Mintz has completed the Physician Training in Age Management Medicine jointly sponsored by the Cenegenics Education and Research Foundation and the Foundation for Care Management. Appendix Cenegenics Team Credentials ® 64 WWW.CENEGENICS.COM A University of Chicago graduate, Dr. Mintz earned the Degree of Doctor of Medicine from the University of Illinois - School of Medicine. A p p e n d i x He went on to serve as a physician with the United States Navy, prior to postgraduate training in radiology. Throughout his career, Dr. Mintz was appointed chairman of the Department of Radiology for several Chicago-area hospitals and remains an adjunct professor for the Center for Cardiovascular Research, at Northeastern Illinois University. He is no stranger to business success, previously holding the positions of chief executive officer, president and co-founder of the world’s largest radiology management company, Medicon, Inc. Thanks to his professional expertise and guidance, Cenegenics Medical Institute (with the joint sponsorship of Foundation for Care Management) has been recognized by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education to physicians. Dr. Mintz also has been a driving force behind implementing Cenegenics’ university-affiliated research. Complementing his outstanding career as a physician and businessman, Dr. Mintz has attained international recognition as a lecturer and published author in such prestigious publications as the Journal of Age Management Medicine and Total Health. Dr. Mintz is an avid athlete, who has run many marathons. With a zeal for skiing, he has served as medical advisor for the National Ski Patrol and is a member of the Steinmetz Academy for Wellness and Sports Science Board of Directors. At age 58, Dr. Mintz further demonstrated his personal commitment to health and wellness, earning the title of 1996 AAU Mr. Illinois, in the Grand Masters Division. Currently, Dr. Mintz remains active as the chief executive officer and chief medical officer of Cenegenics Medical Institute, lecturing throughout the world on age management medicine. His lectures provide opportunities for both the medical professional and lay public, allowing them to explore proactive, preventive medicine and understand health from a new perspective, rather than from the current disease-based methodology. Good health is not an accident. It requires each individual’s active participation. We do have the power to control the future of our health. The Executive Health Evaluation is the critical step in understanding the unique needs of each individual. With factual information, a program can be structured to give you the best opportunity—not only for short-term benefits, but for continuing a high quality of life and to live well longer. A Word From Dr. Alan Mintz America’s current medical care system is based on the treatment of disease. It’s about having something negative happen and then trying to fix it after the fact. Cenegenics Medical Institute focuses on optimal health. By regaining and maintaining metabolic and endocrine functions at the upper end of the normal range, which is the healthy range adjusted for age, we have the best opportunity for a healthy and vigorous life. A p p e n d i x John E. Adams, CPA President John Adams’ keen business sense, exceptional leadership abilities and financial acuity form the foundation for his unparalleled success as president and cofounder of Cenegenics Medical Institute. WWW.CENEGENICS.COM 65 A University of Illinois at Chicago graduate, Mr. Adams was appointed to the Dean’s Business Advisory Council of the College of Business Administration. His path to success began in Chicago as a certified public accountant. Before long, Mr. Adams was acknowledged for his consummate work ethic, earning him the role of senior consultant for Arthur Andersen & Company’s Emerging Business Group. Mr. Adams’ first entrepreneurial venture was as co-founder, executive vice president and chief operating officer of Medicon, Inc.—the world’s largest radiology management company. There, he demonstrated his extraordinary ability for developing and implementing a business model from a medical vision. To complement his success as an entrepreneur, Mr. Adams serves on the board of the elite Young Presidents’ Organization. It is with Mr. Adams’ direction, perseverance and incomparable drive that Cenegenics® Medical Institute continues on the progressive edge of patient care, maintaining its position as a leader in age management medicine, nationally and internationally. A Word From John E. Adams There is a reason why Cenegenics Medical Institute maintains a wellguarded presence in the medical community. The Cenegenics approach is not a singular event, but a process that envelopes and enriches every part of your life. Its success stems from purposeful excellence at critical junctures—education, research, sophisticated protocols and patient care. Cenegenics offers you a straightforward, comprehensive 66 WWW.CENEGENICS.COM experience like no other . . . an experience that far surpasses today’s conventional, perfunctory methodologies. You’ll discover our commitment to your individual medical needs and concerns evident within the Cenegenics Medical Institute’s dynamic: We’ve created a team of world-renown physicians, professionals and administrators to deliver outstanding clinical outcomes and five-star patient services. Michale Jill Barber, MD Chief Executive Officer of Cenegenics South Carolina Dr. Mickey Barber is a board-certified anesthesiologist, a Diplomate of the American Board of Anesthesiology and former assistant professor of Tulane University. Dr. Barber has completed Physician Training in Age Management Medicine, jointly sponsored by the Cenegenics Education and Research Foundation and the Foundation for Care Management. After earning a medical degree from the Medical University of South Carolina, Dr. Barber completed her residency (anesthesiology) and internship (general surgery) at Tulane University Medical Center as well as a fellowship in obstetrical anesthesia at Harvard Medical School/Brigham & Women’s Hospital. A p p e n d i x Committed to excellence, Dr. Barber has received several awards for clinical performance and teaching skills throughout her career, such as Outstanding Faculty of the Year (Tulane University), Robert D. Dripps Memorial Award (Outstanding Graduate Resident in Anesthesiology), Chief Resident (Tulane University), Surgical Intern of the Year (Tulane University), among others. Her achievements also include several appointments, research contributions and lecture presentations. Dr. Barber is a member of the American Society of Anesthesiologists, American Medical Association, South Carolina Medical Association and Charleston County Medical Society. Her work with recognized experts in the mind-body sciences paved the way for an affiliation with Cenegenics as Chief Executive Officer of Cenegenics South Carolina, where Dr. Barber ensures patients the same comprehensive and dynamic approach that Cenegenics has become famous for the world over. Alvin B. Lin, MD Senior Institute Physician Dr. Lin is board-certified in family medicine. He is a Diplomate of the American Board of Family Medicine and a Fellow of the American Academy of Family Physicians. Dr. Lin has completed Physician Training in Age Management Medicine, jointly sponsored by the Cenegenics Education and Research Foundation and the Foundation for Care Management. Dr. Lin earned his bachelor of science in biology and a post-baccalaureate in computer science from the University of California, Riverside. After receiving a medical degree from the Bowman Gray School of Medicine at Wake Forest University, Dr. Lin completed his residency in Family Medicine at the University of California, Davis. Dr. Lin joins the Cenegenics Medical Institute team with a desire to inform and educate others in the area of age management and wellness. health and fitness and has written a chapter on “Exercise, Fitness and Lifestyle” for a popular medical textbook, published 2002. Gaining substantial experience over several years, Dr. Lin returned to complete a fellowship in geriatrics at the Brody School of Medicine, East Carolina University. He earned the Certificate of Added Qualifications in geriatric medicine, then re-certified in family medicine. Dr. Lin continued at East Carolina, where he was appointed director of the Ambulatory Geriatrics Center and assistant clinical professor in the Department of Family Medicine at the Brody School of Medicine. In this capacity, Dr. Lin had the opportunity to train the next generation of family physicians, geriatricians, physician assistants and nurse practitioners, while delivering babies and caring for our elderly. Jeffry S. Life, MD, PhD Senior Institute Physician Dr. Life joins Cenegenics Medical Institute with a fervent desire to share with our patients the same lifestyle changes and knowledge that have made a positive impact on his life. Currently, Dr. Lin is a clinical assistant professor in the Department of Family and Community Medicine at the University of Nevada School of Medicine, where he teaches in the Las Vegas Family Medicine Residency program. His diverse professional background, coupled with ACLS, ALSO, ATLS, BLS, NRP and PALS certifications, has made him an influential and successful mentor. He also lectures frequently for the American Academy of Family Physicians on the use of handheld technology in medicine. Dr. Life is board-certified in family medicine. He is a Diplomate of the American Board of Family Practice and a Fellow of the American Academy of Family Physicians. In addition, Dr. Life has completed Physician Training in Age Management Medicine, jointly sponsored by the Cenegenics Education and Research Foundation and the Foundation for Care Management. After receiving his medical degree from University of Iowa, Dr. Life completed his residency in family medicine and internal medicine at West Virginia University. He also attained a PhD in environmental sciences and health. Prior to joining Cenegenics, Dr. Life was a full-time family physician and a part-time assistant professor at Marywood University in Pennsylvania, teaching graduate courses in nutritional science and exercise physiology. He is completing a Masters of Science program in sports nutrition and exercise science, while working on an upcoming book. In 1998, after reaching a lifetime high in body weight, percentage of body fat and level of deconditioning, Dr. Life entered EAS National Bodyfor-LIFE Challenge, at age 60. He won the contest and became a Grand Champion, losing 35 pounds of body fat and gaining 15 pounds of muscle as a result of improving his nutrition and starting an exercise program. He continues to live a lifestyle promoting A p p e n d i x Beth A. Traylor, MD Institute Physician Dr. Traylor is a board-certified family physician, a Diplomate of the American Board of Family Medicine and a Fellow of the American Academy of Family Physicians. Dr. Traylor has completed the Physician Training in Age Management Medicine, jointly sponsored by the Cenegenics Education and Research Foundation and the Foundation for Care Management. Hailing from Chicago, Dr. Traylor earned an undergraduate degree in psychology from the University of Illinois. In 1984, she received a medical degree from the University of Health Sciences/Chicago Medical School. She completed her family medicine residency in 1987 at St. Joseph Hospital, a Northwestern University affiliate. From there, Dr. Traylor moved into private practice, enjoying her positions in both administrative and clinical capacities. She served as lead physician and branch medical officer for the San Jose Medical Group, as well as maintained a full clinical practice with a special area of interest in women’s health. In 2000, Dr. Traylor moved to Las Vegas, where her growing interest in WWW.CENEGENICS.COM 67 bioidentical hormone replacement led her to the Cenegenics® Medical Institute. She became an Institute physician for Cenegenics, decidedly focusing her medical work on age management medicine because it promotes wellness while opposing traditional medicine’s reactive approach. Throughout her career, Dr. Traylor was a Fellow of the American Academy of Family Physicians, received the American Medical Association Physician Recognition Award and was published for her work on behavioral factors and physical health. Dr. Traylor’s dedication, along with her strong commitment to the triad of nutrition, exercise and hormonal optimization, will help Cenegenics guide patients on a discovery toward maximized health and a higher quality of life. Now part of the Cenegenics team, Ms. Berry’s dedication to excellence is evident. Her ability to optimize human resources has proven invaluable. Additionally, Ms. Berry’s motivation, spirit, innate talents and willingness to broaden her knowledge have made a significant impact on daily operations. Not surprisingly, each department under her direction continues to successfully meet the needs and expectations of every patient. As Cenegenics COO, Ms. Berry stays focused on enhancing operating strategies, which support the demands of such an intricate, vital institution. Thanks to her good efforts and timely reporting, Cenegenics has received unqualified audit opinions every year since its inception. Similarly, our Dun & Bradstreet rating is at the highest possible level for privately held companies, under Ms. Sullivan’s leadership. Rosalind Sullivan, CPA Director of Accounting & Legal Annie Colbert, CPT Nutrition & Exercise Coordinator Ms. Sullivan is a Certified Public Accountant and a Seattle University summa cum laude graduate, holding a bachelor’s degree in accounting and business administration. Ms. Colbert earned her masters degree in nutrition through the University of Bridgeport, Connecticut, after graduating cum laude from Northern Arizona University with a bachelor of science in exercise physiology. Kristy Berry Chief Operating Officer Ms. Berry oversees all operations for Cenegenics Medical Institute, including its facilities in the United States and Asia. She also is global liaison for clinical sites, product distribution and finance for our U.S., Japan, Korea and Hong Kong facilities. Prior to joining Cenegenics, Ms. Berry began her career as a CNA (Certified Nursing Assistant) at a local senior care center. She went on to work in the administrative office of a chiropractic practice, before moving to Sunrise Hospital’s pediatric healthcare clinic. There, she applied her experience and skills to become office manager. 68 WWW.CENEGENICS.COM her previous extensive experience in financial analysis and reporting, tax preparation, compliance reporting, financial operations, general accounting and auditing. She carries out her multifaceted position with great professionalism, determination and accuracy. Her vast experience in health clubs and rehabilitation settings—assessing fitness levels and individualizing exercise programs—has proven a tremendous advantage in helping Cenegenics patients achieve their personal health goals. Having served as senior accountant for a large accounting firm in Seattle, Ms. Sullivan broadened her experience, leading to an appointment as assistant controller of Merrill Lynch/Howard Johnson & Company. While there, she supervised the financial reporting and coordinated the due diligence and audit of a $40M subsidiary acquisition. Ms. Sullivan joined the Cenegenics Medical Institute as director of Accounting and Legal, drawing upon A p p e n d i x A certified Jazzercise instructor for over ten years, she teaches all formats (balls, tubes and weights) and includes all modalities of fitness: cardiovascular, resistance training, balance, coordination, flexibility and core stabilization. Additionally, Ms. Colbert oversees the diet and nutrition component of the Executive Health Evaluation, as well as training physician affiliates on the related details to be addressed during the evaluation process. Certified as a personal trainer with the prestigious National Academy of Sports Medicine, Ms. Colbert is known for her keen ability to motivate people toward making healthy lifestyle changes. Her knowledge and encouragement help Cenegenics Medical Institute create a program, where each patient’s nutritional and exercise goals can be realized. The Cenegenics Teams Cenegenics is about and for its patients. That as our goal, we established four integral teams to meet daily demands. These teams work in synergy, focused on patient care, expectations, quality, effectiveness and high performance. The dedication of each team member has helped Cenegenics gain international recognition and provide the utmost in patient satisfaction. Patient Services Team. When you embark on your health journey with Cenegenics, you will be in constant dialogue with our Patient Services Team. They handle patient care and calls, finances, scheduling and coordination, medical documentation, recommendations, monthly fulfillment (of pharmaceutical products). The Patient Services Team also functions as a back office staff for our physician affiliates. Clinical Team. Our Clinical Team delivers an unprecedented five-star clinical care service. A nurse manager, nutritionist and several administrative team members support our doctors. Their primary focus is managing a patient’s medical experience, from start to finish. That includes diagnostics, consultations and making certain every expectation is met. Practice Development Team. Solid communication is critical to our success and our patients’. The Cenegenics Practice Development Team proves the vital link between all potential, new and existing patients and our physicians. This support team handles questions, concerns and registrations, relating to patient goals and needs—and provides the research, history and evidence-based scientific literature to individuals wanting to learn more about Cenegenics. Their diligent assistance to the medical team also includes transcribing practice development and medical dictations, tracking inventory as well as producing and distributing mailers. 60 Minutes and 48 Hours, NBC’s Today Show, CNBC and an HBO documentary. Cenegenics has been featured in major newspapers around the world, such as the Las Vegas Review Journal, The New York Times, Chicago Tribune, The Washington Post, Los Angeles Times, The Wall Street Journal, London Times, London Express and The Toronto Star. Accounting Team. The team handles financial needs, tracks Internet strategies, creates agreements and manages contracts with related facilities and our university affiliates. Press Room Cenegenics Medical Institute has made a significant, worldwide impression on the health and medical community, as well as consumers, through extensive media exposure. Not only has Cenegenics become the largest and most-experienced agemanagement medicine practice in the world, but we are viewed as leading experts in the field by American and international journalists. As a result, our medical institute has received considerable media coverage. Media coverage. Cenegenics Medical Institute’s TV exposure includes appearances on NBC, CBS, ABC, CNN, PBS, FOX News, ESPN and many local and regional television programs. We have earned glowing coverage from ABC’s 20/20, CBS’s A p p e n d i x Periodicals featuring Cenegenics Medical Institute include GQ, Esquire, Total Health Magazine, Medical Economics, Hippocrates, Penthouse, Health, Physician and Healthcare, Modern Maturity and Men’s Health. A number of regional magazines have also featured articles about our age management approach. Cenegenics is frequently featured on national and regional radio shows, including Art Bell’s widely heard Coast-to-Coast AM. Visit us on the Web for a detailed list of current and archived media coverage: www.cenegenics.com. WWW.CENEGENICS.COM 69 70 WWW.CENEGENICS.COM A p p e n d i x Cenegenics ® Medical Institute . . . It just makes sense. A p p e n d i x WWW.CENEGENICS.COM 71 72 WWW.CENEGENICS.COM A p p e n d i x $14.95