HORMONAL MODULATION AND ANTI-AGING MEDICINE

2. HORMONAL MODULATIONANDANTI-AGING MEDICINE Dr Odilza Vital M.D. Endocrinologist Geriatrician

3. ANTI-AGING MEDICINE IS THE PRESENT AND FUTURE!

4. THE ERA OF PREVENTION !

5. THE HORMONAL MODULATION TO BALANCE PHYSICAL, MENTAL AND EMMOTIONAL STATUS !

6. LIFE EXPECTANCY REQUIRES HORMONAL MODULATION THERAPYWHY IS THAT?

7. QUALITY OF LIFE!

8. HORMONAL MODULATION =HORMONAL BALANCE • HORMONES ACT SYNERGISTICALY • ONE AFFECTS THE OTHERS FUNCTION • PRODUCTION • RESPONSE • CELL RECEPTORS SENSITIVITY

9. MY EXPERIENCE WITH ANTI-AGINGAND BLUE TENT MY EXPERIENCE WITH ANTI-AGINGAND BLUE TENT

10. WHAT TO DO IN HORMONAL MODULATION? CORRECTION OF HORMONAL DEFICIENCY CORRECTION OF HORMONAL OVERPRODUCTION

11. HORMONAL MODULATION • AGING PROCESS IS ASSOCIATED WITH DECREASE OF MOST OF HORMONES LIKE: SEXUAL HORMONES, DHEA, HGH, T4? MELATONIN • AGING PROCESS IS ASSOCIATED WITH INCREASE OF SOME HORMONES LIKE: INSULIN, CORTISOL, PTH

12. ENDOCRINE SYSTEM…  BIG ORCHESTRA

13. HORMONE DEFICIENCY AND OVERPRODUCTION PROMOTE DISEASES ASSOCIATED WITH THE AGING PROCESS

14. HGHHUMAN GROWTH HORMONE

15. HGHSTIMULATES PROTEIN SYNTHESIS, CELL MULTIPLICATION

16. BENEFITS OF THE USE OF HGH IN ADULTS WITH DEFICIENCYSUPPORT THE SHARP DECLINE IN THE ELDERLY 20 y 60 y

17. HGH • THE HGH RESTORES MUSCLE MASS AND STRENGTH OF THE ADULT WITH DEFICIENCY

18. HGH • IT ACCELERATES THE HEALING OF SURGICAL WOUNDS • AN IMPORTANT ROLE IN THE IMMUNE SYSTEM • USED TO PREVENT AND REVERSE CACHEXIA IN HIV PATIENTS

19. HGH • SECRETION IN PULSES • THE HGH IS A SINGLE CHAIN OF 191 AMINO ACIDS 75% • 22 KD PROTEIN, 20 KD • NO GLYCOGEN • HAS TWO BRIDGES S = S

20. HGH • VALUES RANGE FROM UNDETECTABLE TO 40MCG/DL • THE SECRETION IS AFFECTED BY FOOD • DECREASED IN HYPERGLYCEMIA • INCREASED BY AMINO ACIDS AND HYPOGLYCEMIA

21. FACTORS THAT INCREASE SECRETION OF HGH • SOMATOTROPIN: GH-RH(HYPOTHALAMUS) • HYPOGLYCEMIA • AMINO ACIDS • ACUTE STRESS

22. FACTORS THAT REDUCE THE SECRETION OF HGH  • IGFs= SOMATOMEDIN C (NEGATIVE FEED-BACK) • HYPERGLYCEMIA • CHRONIC STRESS • AGING PROCESS

23. HGH • HOW TO EVALUATE HGH DEFICIENCY IN AGING PROCESS?

24. IGFsInsulin Growth Factor-s(Mediate HGH action)

25. HGH • IGF SMALL MOLECULE PRODUCED BY MOST TISSUES, ESPECIALLY LIVER • FREE : IGF • LINKED TO PROTEIN: IGF-BP 1,2,3,4,5

26. HGH • THE IGF-1 MEDIATE THE PHYSIOLOGICAL ACTIONS OF HGH • THE IGF-BPs MODULATE THE ACTIONS OF IGFs IN THE TARGET CELLS • IGF-BPs CHANGE BIOAVAILABILITY OF IGFs TO THE TISSUES

27. DIAGNOSIS HGH DEFICIENCY • IGFs: SECRETION REFLECTS THE OVERALL PRODUCTION IN THE LAST 24 HOURS • USED IN ADULTS WITH DEFICIENCY

28. DIAGNOSIS • IN PATHOLOGICAL DEFICIENCY - DYNAMIC TESTIN CHILDREN ONLY: CLONIDINE, INSULIN, L-DOPA, PROPANOLOL, GLUCAGON : TEST : HGH • IN AGING PROCESS : TEST :IGFs

29. ADMINISTRATION: PARENTERAL

30. THE FIRST EVIDENCE OF BENEFICIAL USE OF HGH IN ADULTS WITH DEFICIENCY 1962

31. HGHKEY FEATURES OF THE SYNDROME OF GH DEFICIENCY IN ADULTS

32. SYMPTOMS LOSS OF PSYCHOLOGICAL WELL-BEING • REDUCED VITALITY AND ENERGY • DECREASED PHYSICAL ACTIVITY • DEPRESSED MOOD • EMOTIONAL LABILITY • ANXIETY • DISORDERS OF SEXUAL FUNCTION • SOCIAL ISOLATION 

33. SIGNS CHANGES IN BODY COMPOSITION • REDUCTION OF LEAN BODY MASS • INCREASED FAT • INCREASED VISCERAL FAT • REDUCTION OF BODY WATER • REDUCTION OF BONE DENSITY

34. SIGNSDECREASED MUSCLE STRENGTH DECREASED ABILITY TO EXERCISE INCREASED BODY MASS INDEX (BMI) INCREASED WAIST / HIP RATIO

35. ABNORMAL LIPID PROFILE • INCREASE IN TOTAL CHOLESTEROL • INCREASED LDL • REDUCTION OF HDL

36. INCREASED RISK OF CVD • INCREASED PAI-1 (PLASMINOGEN ACTIVATION INHIBITOR) • INCREASED OF FIBRINOGEN

37. HGH DOSESBY THE BODY WEIGHT ?

38. CURRENT CONCEPTS THE GROWTH HORMONE RESEARCH SOCIETY SUGGESTS: INCREASING DOSES OF GH, NOT BASED ON WEIGHT 

39. DOSESPATIENTS SHOULD START TREATMENT WITH LOW DOSES(0.15 TO 0.3 MG / DAY OR 0.45 TO 0.9 IU / DAY);(RARELY EXCEEDS 1 MG / DAY: 3 IU / DAY)

40. MONITORING THE DOSE GRADUALLY ACCORDING TO CLINICAL AND BIOCHEMICAL RESPONSESWOMEN REQUIRE HIGHER DOSES, THE ELDERLY REQUIRE LOWER DOSES

41. THE ADMINISTRATION SHOULD BE DAILY, AT NIGHT, SUBCUTANEOUSLY.

42. CONTRAINDICATIONS FOR USE OF HGH:  • NON COMPENSATED DIABETES MELLITUS • HEART FAILURE • SMOKING • MALIGNANT TUMORS OF ANY ORIGIN IN ACTIVITY

43. DIABETES;HYPERTENSION;CARDIOVASCULAR DISEASE; IATROGENIC ACROMEGALY;CANCER??? SIDE EFFFECTS OF GH ABUSE

44. FEMALE SEXUAL HORMONES

45. CLIMACTERIC SYNDROMEPRE-MENOPAUSE • HORMONAL CHANGES : LOSS OF CYCLE 2nd phase • CLINICAL MANIFESTATIONS • SIGNS AND SYMPTOMS • LABORATORY : LOW PROGESTERONE

46. MENOPAUSE • DEFINITION: AMENORRHEA • HORMONAL CHANGES • CLINICAL MANIFESTATIONS • SIGNS AND SYMPTOMS • LABORATORY

47. EFFECTS OF FEMALE SEXUAL HORMONES • ESTROGENS ARE PRODUCED IN FOLICULAR CELL: STIMULATES CELL PROLIFERATION • PROGESTERONE IS PRODUCED BY CORPUS LUTEUM: MATURE CELLS STIMULATED BY ESTROGENS

48. TESTOSTERONE • LIBIDO • BONE DENSITY • MUSCLE STRENGTH • MOOD

49. CLINICAL CHANGES OF PROGESTERONE DEFICIENCY • ENDOMETRIAL HYPERPLASIA • EXACERBATION OF PMS • MENSTRUAL IRREGULARITIES • BREAST CANCER?

50. CHANGES OF CLINICAL ESTROGEN DEFICIENCY  • VASOMOTOR SYMPTOMS • BONE LOSS • ATHEROSCLEROSIS AND CVD • INSOMNIA • EMOTIONAL LABILITY • UROGENITAL ATROPHY • DEMENTIA