1.  A Neuroendocrine Model for Healthy Aging Speaker: Sharon Norling, MD, MBA December 13, 2013 Booth - 3046

2. Surgery Medicine

3. Prevalence of Mood Disorders  26.2% 18 and older – about 1 in 4 adults.  57.7 million people  45% meet criteria for 2 or more disorders  Comorbidity 1. Kessler RC, Archives of General Psychiatry, 62(6) (January 2005): 617-27. 2. U.S. Census Bureau Population Estimates by Demographic Characteristics.

6. CLIA High Complexity Clinical Testing Laboratory CLIA: 34D1054007

7. NeuroLab™

8. Inhibitory Neurotransmitters  Serotonin  GABA

9. Excitatory Neurotransmitters  Dopamine  Nor-epinephrine  Epinephrine  Glutamate

10. Adrenal Hormones  DHEA-s – (2-point)  Cortisol – (4-point)

11. Neurotransmitters Anxious? Depressed? Mood swings? Difficulty sleeping? Experiencing pain? Lacking motivation? Low libido?

13. Pharmaceutical Drugs  Mood-altering drugs are considered affective if it reduces depression 50%  SSRI’s help 30-50 % of the time but have side effects 86% of the time  Turner looked at 74 clinical trials and found the drug worked 51% and the placebo 49% Erick H Turner MD, et al. “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy,” NEJM (January 17, 2008); 358: 252-60.

14. Evolution of Model Mood Disorders  Middle Ages: Demons within-exorcism is therapy of choice  1917: Freud explains that those demons are really our mothers  1988: Eli Lilly releases our mothers from 80 years of victimization, explaining that depression is really a Prozac deficiency Dr. Hedaya, Clinical Professor of Psychiatry Georgetown University.

15. Disease Management & the Organization of Physician Practice “There is a large gap between what physicians do for patients with chronic diseases and what should be done.” Disease Management and the Organization of Physician Practice Lawrence P. Casalino, MD, PhD JAMA. 2005;293(4):485-488.

17. Causes of Neurotransmitter Imbalance  Life  Gluten  Lack of nutrition and blood sugar  Hormone imbalance  Low thyroid  Adrenal fatigue  Toxins  Infections  Lack of sleep

18. LIFE

19. Causes of Neurotransmitter Imbalance  Life  Gluten  Lack of nutrition and blood sugar  Hormone imbalance  Low thyroid  Adrenal fatigue  Toxins  Infections  Lack of sleep

20. Gluten Sensitivity  Depression in 52%  Injured GI lining decreases the effectiveness of absorbing essential nutrients to keep the brain healthy.  Zinc, tryptophan, and B Vitamins  “second brain” produces 80-90 percent of serotonin

21. Causes of Neurotransmitter Imbalance  Life  Gluten  Lack of nutrition and blood sugar  Hormone imbalance  Low thyroid  Adrenal fatigue  Toxins  Infections  Lack of sleep

22. Vitamin D  Low levels contribute to depression and chronic fatigue  Adequate Vitamin D needed by the adrenal gland for the production of dopamine, epinephrine, and norepinephrine  Several months of supplementation

23. High Blood Sugar “when your blood sugar rises there is an immediate depletion of the neurotransmitters serotonin, epinephrine, norepinephrine, GABA, and dopamine. B-complex, which is needed to make neurotransmitters, gets used up.” David Perlmutter, MD, Grain Brain (New York, Boston, London: Little, Brown and Company, 2013).

25. High Blood Sugar “ The most powerful tool you have to change your body and your health is your fork.” Mark Hyman, MD

26. Causes of Neurotransmitter Imbalance  Life  Gluten  Lack of nutrition and blood sugar  Hormone imbalance  Low thyroid  Adrenal fatigue  Toxins  Infections  Lack of sleep

27. Hormone Imbalance: Statins “If you deprive the brain of cholesterol, then you directly affect the machinery that triggers the release of neurotransmitters. Cholesterol changes the shape of the proteins to stimulate thinking and memory.” David Perlmutter, MD, Grain Brain (New York, Boston, London: Little, Brown and Company, 2013).

28. Hormones & Neurotransmitters  Strong interaction E2 and serotonin  Progesterone and GABA  Testosterone and DHEA

29. Causes of Neurotransmitter Imbalance  Life  Gluten  Lack of nutrition and blood sugar  Hormone imbalance  Low thyroid  Adrenal fatigue  Toxins  Infections  Lack of sleep

30. Symptoms of Low Thyroid Production  Depression  Anxiety  Decreased memory  Inability to concentrate  Migraine headaches  Muscle and joint pain  Menopausal symptoms and PMS  Insomnia  Fatigue  Low libido

31. Causes of Neurotransmitter Imbalance  Life  Gluten  Lack of nutrition and blood sugar  Hormone imbalance  Low thyroid  Adrenal fatigue  Toxins  Infections  Lack of sleep

32. Adrenal Hormones  DHEA-s  Cortisol

33. Dancing Hormones AdrenalineGABA CortisolThyroid InsulinSerotonin Estrogen Glutamate Progesterone DHEA DopamineTestosterone

34. NeuroLab™  Leading specialist in the technology, analysis, and research of the biomarkers relating to HPA-T axis function.  Leaders in the clinical application of urinary HPLC/MS testing.  Certified by CLIA as High Complexity Clinical Laboratory  Participates in College of American Pathology & BIORAD proficiency testing for salivary samples.

35. Amino acids “We have found that if a drug can be found to do the job of medical healing, a nutrient can be found to do the same job. We now know that if we give the amino acids the body will synthesize neurotransmitters, thereby achieving the same effect as drugs. The challenge of the future is to replace drugs with these natural healers.” Dr. Carl Pfeiffer, a pioneer amino-acid researcher.

36. Step 1: Assessment Assess the patients’ neurotransmitter and adrenal hormone biomarkers with a non-invasive laboratory test Establishes a baseline on first test, looking for imbalances affecting HPA-T axis function. Important tool for monitoring and adjusting therapy to meet the patient’s individual biochemical needs

37. Step 2: Correlation Personalized laboratory results to patient specific symptoms and, current treatments, and lifestyle factors Comprehensive review of patient’s neuroendocrine system

38. Step 3: Correction  Sanesco’s exclusive line of TNT products are natural, non-drug formulas balanced with specific low dose amino acid precursors and nutrient cofactors designed to support neurotransmitter and hormone pathways showing imbalances affecting HPA-T axis function.

39. Targeted Nutritional Therapy- safe & clinically effective  Prolent™ (inhibitory support)  Lentra™ (GABA receptor support)  Procite-D™ (dopamine support)  Contegra™ (catecholamine formula)  MethyMax™ (methylation support)  Adaptacin™ (adrenal support)

40. Effective Clinical Tool 1. Symptomatic patient does a test 2. Test reveals a number 3. Intervention is made 4. Test is repeated 5. Number improves

41.  Neurotransmitt ers Gluten Sensitivity Hormones Anxiety Depression Insomnia Fatigue Joint Pain Memory Loss Poor Concentration Low Libido Carb Cravings Muscle stiffness Anxiety Depression Insomnia Fatigue Joint Pain Memory Loss Poor Concentration Low Libido Carb Cravings Muscle stiffness Anxiety Depression Insomnia Fatigue Joint Pain Memory Loss Poor Concentration Low Libido Carb Cravings Muscle stiffness Neurotransmitters Hormones Anxiety Anxiety Depression Depression Insomnia Insomnia Fatigue Fatigue Joint Pain Joint Pain Memory Loss Memory Loss Poor Concentration Poor Concentration Low Libido Low Libido Carb Cravings Carb Cravings Muscle stiffness Muscle stiffness Gluten Sensitivity

42. Summary  Assess patients for mood disorders  Remove known causes of imbalances  Test using NeuroLab, leading specialty laboratory in the technology, analysis, and research of HPA-T axis function  Balance neurotransmitters with Sanesco’s specific amino acid targeted nutrient therapy for safe effective clinical results

44. Neurotransmitters Anxious? Depressed? Mood swings? Difficulty sleeping? Experiencing pain? Lacking motivation? Low libido?

46. Question Is there SEX before or after menopause ?

47. Sexual Frequency Across the Life Cycle Age Frequency  30-40 Tri - weekly  40-50Try weekly  50-60Try weakly  60-70Try  70-80Try something else

48. Remember Laughter is the BEST Medicine

49.  A Neuroendocrine Model for Healthy Aging Dr. Sharon Norling 5655 Lindero Canyon Rd Westlake Village, CA Your Doctor is Wrong www.drsharonnorling.com Come by booth 3046 for an opportunity to meet Sharon Norling MD, MBA and receive a signed copy of the her book.

50.  Continue the Conversation with Us Booth - 3046