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A Note from Neal on Hormones and Beyond / Part IV for 2018

July 03, 2018 10:54 AM | Christiaan Killian (Administrator)

Dear Colleagues,

It is now time to start to prepare the lectures for Part V, which I start organizing a year in advance.  It is also time for everyone to block out October 5-7 on their calendar, so you can attend this year’s WLM symposium. My interest/focus this year will be the brain, breasts, prostate, and mitochondria. And I’m pleased to announce this conference as our 20-year anniversary event.  Dana has worked long and hard to make this reunion special. And so have I by organizing a review of the most recent profound literature that we should all be aware of. It is my annual update of literature that I can’t cram into the courses but that we should have command of to better treat our patients.

During my toxicology fellowship we were taught that the best treatment for a poisoning was to prevent the poisoning in the first place.  The same concept applies to dementia and Alzheimer’s disease. After 30 years of failure by the pharmaceutical industry to develop a cure for Alzheimer’s disease, we still have no treatment after billions of dollars in research.  However, the best treatment still is to prevent the disease in the first place.  There is an amazing plethora of data proving loss of hormones is culpable and replacement is protective.  Our ignorance is embarrassing when it comes the research showing benefit.  “Yea but…the WHI showed…” I hope that I can cram all the articles that I want to show you into 3 hours of lecture demonstrating many different hormones affect the brain.  UCLA is one of the outstanding universities that has a special section devoted to treating dementia, with Dr. Bredesen heading that endeavor.  Unfortunately, he will not be presenting but Dr. Sharlin will review UCLA’s protocols as well as functional medicine treatments that have been shown to provide reversal of cognitive decline and improvement in symptoms.  SPECT scans demonstrate plaque reversal with BHRT but not so with SHRT.  It’s impressive. Patients can now go to you for treatment/prevention without having to travel to UCLA.

As you know I used to run at the front of the pack.  In the last 10 years I have moved to the back of the pack, choosing not to fight the fight I used to fight, allowing the naïve specialists to have the upper hand.  The pendulum has now swung back in the opposite direction.  Patients should not have to suffer the inadequacies of their specialists nor should we have to play second fiddle.  I’m tired of dealing with physicians that don’t understand why we do what we do or ignore the literature that supports it.  It’s time to show and prove to the specialists that which they should know but don’t. Yes, I do pity them because there is no venue for them to learn this information other than WLM.  Unfortunately, it is the patient that suffers the consequences of the physician’s lack of knowledge. Thus, I’ve taken on the role of being the patient’s advocate, empowering them to understand an alternative treatment or prevention that is all evidenced based, but that which is going to be rejected by their PMD’s.  I now provide articles to patients supporting the important benefits of testosterone in prostate cancer patients, progesterone and testosterone in breast cancer patients, and the safety and efficacy in prevention and treatment of these diseases.  I will provide and review all the studies that you should have in your quiver to present to patients and their physicians that reject what we do because the physicians have not a clue.  I’m tired of letting the patients endure the consequences of physician ignorance. All new and recent evidence will be presented. Please utilize these studies to provide direction and support to your colleagues and patients.

The diagnosis and treatment of prostate cancer continues to evolve yet remains controversial.  Dr. Bernadette Greenberg from Desert Medical Imaging will present the update in diagnosis and treatment as well as the use of genomics to predict outcomes. This will be the most captivating lecture you will ever hear as I have never experienced any lecturer as dynamic as this lady. Be prepared to be blown away by her knowledge and presentation.

We at WLM are pleased to now have a 2-hour presentation before Part I to help attendees “figure me out.”  This is presented by Dr. David Kern who has the same sarcasm and insight as I do.  He will be presenting all the data on how glucose affects the brain, dysglycemia, and protein glycation.

A new addition to WLM is a separate course on PRP, injection techniques, and the latest literature by Dr. Nacouzi.  Unfortunately, the PRP course sells out due to the popularity of this new and easy treatment.  We’ll learn why it is so popular and how to incorporate this procedure into your practice.

We have tried to introduce new and promising concepts that we can incorporate into our practices. I know nothing about genetic testing, epigenetics, when to test, and what to do with the results. What I have read in JAMA is confusing and perhaps political. Dr. Stickler will enlighten us as to what, when, and why to test and then what to do with the results.

I also know little about cannabis, cannabinoids, CBD, etc.  Are they a safe and effective alternative to opiates now that we suffer from opiate paranoia?  I have had many patients request it with excellent results.  Now that it is legal in California and other states, pot shop owners know more about cannabis than physicians. So, we have chosen Dr. Felice to enlighten us about what we should know about this alternative for pain and sleep management.

Our resident attorney and business consultant that teaches the WLM business course will provide an update on practice management, compliance, and how to avoid hassles with insurance and regulatory agencies. As far as hormones are concerned I have focused in this course primarily on breast cancer, prostate cancer, and mitochondrial dysfunction. 

I would like to focus on the recent literature as it pertains to my personal situation and how HRT has helped me in this regard as well as the medical literature as it pertains to pain. After 30 joint surgeries, joint sepsis, 5 back surgeries, and over 20 IV antibiotics that have played havoc with my gut that resulted in significant inflammation, I’m an expert in pain management and gut dysbiosis.  Pain can affect our psyche and sleep cycles.  I’ll review the recent literature as it pertains to opiates effects on hormones. Concurrently, hormones have been shown to have a significant impact on multiple nociceptive pathways that result in significant pain improvement.  Unfortunately, do to my snips, opiates and cannabis don’t work for me but I’ll present literature and as to what does work and why.

Lastly, and most disturbingly, is a topic that I must address but with grave reservation and frustration, and that is our legal environment.  It is a complete system failure, from the process of medical board complaints, to medical board handling of complaints, to reliance on completely inappropriate endocrine guidelines as if they were case law.  I will review all the cases (with fake names, case scenarios, and circumstances of course) that I have had to deal with so that history doesn’t repeat itself. More importantly, I will discuss my solution to the issues and how everyone can help.  This will be an audience participation time, Q & A, discussion by Dr. Kadambi (esteemed endocrinologist that totally gets it), and how we can all help each other through this process.  Number one on my current bucket list is to educate the medical boards to the literature as well as stop using worthless and outdated guidelines to sanction physicians that only make their patients better. WLM attendees should be the experts that review these cases, not a specialty that has no understanding of the literature and current studies. I will enlist everyone’s assistance in doing so.  We will spend an entire evening addressing these issues and concerns.

Last year’s Beyond Hormones conference at the Lied Lodge will be hard to beat.  However, we are going to try to make this anniversary celebration better than last year with great food and entertainment at a fabulous resort in Tucson.  I’m looking forward to a great reunion this October and hope to see everyone there. 

Kindest regards, Neal


Neal Rouzier, M.D.
Faculty Chairman

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