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Graduate Course Proposal Form Submission Detail - GMS6449
Tracking Number - 3145

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Current Status: SCNS Liaison Notified of Graduate Council Approval - 2013-10-11
Campus: Tampa
Submission Type: New
Course Change Information (for course changes only):
Comments: to GC 5/6/13 for MSMS Program. Approved. Cleared Syst Concurrence 7/31/13. to SCNS 8/5/13 (Note - needs new proposed number. 6444 is already taken) - used 6449

Detail Information

  1. Date & Time Submitted: 2013-03-30
  2. Department: Deans Office
  3. College: MD
  4. Budget Account Number: 6108-000
  5. Contact Person: Michael J. Barber, D.Phil.
  6. Phone: 9749908
  7. Email:
  8. Prefix: GMS
  9. Number: 6449
  10. Full Title: Advanced Endocrinology
  11. Credit Hours: 3
  12. Section Type: C - Class Lecture (Primarily)
  13. Is the course title variable?: N
  14. Is a permit required for registration?: Y
  15. Are the credit hours variable?: N
  16. Is this course repeatable?: Y
  17. If repeatable, how many times?: 1
  18. Abbreviated Title (30 characters maximum): Advanced Endocrinology
  19. Course Online?: C - Face-to-face (0% online)
  20. Percentage Online: 0
  21. Grading Option: R - Regular
  22. Prerequisites: None
  23. Corequisites: None
  24. Course Description: This course is designed to provide a detailed understanding of current advances in the field of endocrinology and places particular emphasis on advanced hormonal prescribing and difficult hormonal therapy cases.

  25. Please briefly explain why it is necessary and/or desirable to add this course: Replacing Selected Topics with Permanent number; already listed in program
  26. What is the need or demand for this course? (Indicate if this course is part of a required sequence in the major.) What other programs would this course service? Metabolic Nutritional Medicine represents a new and evolving discipline in the medical sciences that deals with an integrative and functional medicine approach to healthcare and disease prevention The discipline combines evidence based medicine with new approaches to therapeutics and patient wellness. Nutrition and metabolism represent a critical approaches to understanding and controlling obesity The Metabolic Nutritional Medicine concentration currently has 110 registered students and approx 32 registered for the first course offering.
  27. Has this course been offered as Selected Topics/Experimental Topics course? If yes, how many times? Yes, 1 time
  28. What qualifications for training and/or experience are necessary to teach this course? (List minimum qualifications for the instructor.) All the instructors in the course are M.D., D.O. or Ph.D. or equivalent trained faculty.
  29. Objectives: The course has the following objectives:

    •Providing a basic overview of steroid hormone physiology

    •Discussing the structural and hormonal components of HPA axis

    •Discussing the gut-immune-brain connection

    •Explaining the gastrointestinal consequences of HPA axis dysfunction on the immune system

    •Discussing the role menopausal hormone imbalance plays in both hypocortisolism, CFS and fibromyalgia

    •Discussing the evolution of glycemic dysregulation consequent to HPA axis dysfunction

    •Comparing and contrasting various treatment options for HPA axis dysfunction

    Examining various patient case studies as examples of diagnosis and therapy

  30. Learning Outcomes: At the completion of this course, the students will be able to:

    •Explain that the dose of hormone given is only a small component or hormone exposure

    •Discuss the physiological factors that contribute to hormone production

    •Explain the complexity of hormone production and exposure

    •Discuss how Phase 1 and Phase 2 detoxification affect hormone metabolism

    •Discuss how cortisol, the GI system, diet, and method of hormone testing effect hormone exposure

    •Describe the current dogma concerning the initiation and promotion of breast cancer and discuss the success and failures of adhering to this dogma

    •Explain the function of the cellular matrix

    •Discuss the effect of inflammation on the cellular matrix and cell behavior

    •Explain how controlling inflammation can have an effect on cancer cell behavior

    •Discuss the importance estrogen metabolism plays in bio-identical hormone replacement therapy

    •Assess and improve methylation status in a patient

    •Explain the role methylation plays in the metabolism of hormones

    •Identify single nucleotide polymorphisms (SNP’s) in both phase 1 and phase 2 of the metabolism pathways and how these may contribute to a patient’s cancer risk

    •Identify specific potential strategies to improve phase 1 and phase 2 metabolism

    •Identify the role xenoestrogens and other toxins play in the metabolism of hormones

    •Discuss the complex biology of calcium and phosphorus regulation and the role of PTH, vitamin D, calcitonin

    •Discuss the subtle diagnostic clues to primary hyperparathyroidism

    •Discuss the medical literature on the risks of elevated PTH

    •Discuss the expanding indications for surgical treatment of primary hyperparathyroidism

    •Discuss the functional medicine aspects of parathyroid hormone optimization including nutrition, inflammation and stress response

    •Identify the signs and symptoms of hyperthyroidism

    •Review the kinds of thyroiditis that may predispose the patient to hyperthyroidism

    •Examine precipitating factors that may lead to hyperthyroidism such as stress, infection, iodine supplementation, and pregnancy

    •Recognize thyroid storm

    •Understand that the signs and symptoms of hyperthyroidism may change with age

    •Discuss how to diagnosis hyperthyroidism

    •Compare and contrast conventional therapies for hyperthyroidism

    •Discuss nutritional and conventional treatment modalities for hyperthyroidism

    •Review the medical literature and case histories on hyperthyroidism

    •Provide a basic overview of steroid hormone physiology

    •Review the structural and hormonal components of HPA axis

    •Discuss the relationship between the adrenal gland hormones and other major hormones

    •Review factors affecting cortisol release patterns

    •Discuss the gut-immune-brain connection

    •Review the gastrointestinal consequences of HPA axis dysfunction on the immune system

    •Discuss the gastrointestinal immune system and factors, including adrenal dysfunction, that can lead to compromise in gastrointestinal integrity

    •Review the effects of sex and stress hormones on the immune system and how imbalances can lead to susceptibility to autoimmune disease development

    •Define and discuss hypocortisolism (low cortisol states)

    •Discuss the role menopausal hormone imbalance plays in both hypocortisolism, CFS, and fibromyalgia

    •Review etiologies of FMS and CFS and the role hypocortisolism plays in these conditions

    •Provide a multidimensional approach to testing and treatment of menopausal hormone imbalances, abnormal cortisol release patterns, CFS and fibromyalgia

    •Discuss effects of sleep disturbances on the stress response system and cortisol release patterns and review treatment options

    •Discuss the evolution of glycemic dysregulation consequent to HPA axis dysfunction and various treatment options

    •Discuss the evolution of cardiometabolic disease consequent to HPA axis dysregulation

    •Discuss a multidimensional approach to testing and treatment of androgen deficiency therapy within the context of HPA axis and adrenal dysfunction

    •Discuss the multiple etiologies of female sexual dysfunction (FSD)

    •Recognize FSD in clinical practice

    •Perform diagnostic evaluations on patients with FSD

    •Explain effective treatments of patients with female sexual dysfunction

    •Explain vaginal atrophy and the problems associated with it

    •Discuss the various OTC and prescription therapies available to treat issues with female sexual health

    •Discuss compounding opportunities to treat female sexual health issues and why they work

    •Review the basic physiology of hormone synthesis and metabolism

    •Discuss the key roles of stress, inflammation, and nutrition in modifying steroid hormone metabolism

    •Introduce and familiarize participants with diagnostic testing with urinary hormones that will enable them to customize their approach to the perimenopausal, menopausal and andropausal patient

    •Discuss the basis of steroid synthesis and the role of stress in shifting hormonal production

    •Explain the role of hormonal therapy, as well as nutrients, in rebalancing hormone metabolism

    •Discuss the urine monitoring of hormone levels and metabolites and share specific algorithms used in clinical practice

  31. Major Topics: Major course topics include:

    Female Sexual Health

    Urinary Hormones & Steroid Metabolism

    A Metabolic Approach to Hyperthyroidism

    Case Studies in Hyperthyroidism

    Case Studies in Hyperparathyroidism

    Personalizing your BHRT Protocol

    Inflammation & Breast Cancer

    Hormone Production & Metabolism

    Female Sexual Health

    Parathyroid Hormone

    Advanced Topics in Adrenal Pituitary Dysfunction

    Adrenal Dysfunction: Chronic Pain & Mood Disorders

    Adrenal Dysfunction: Sleep Disturbances & Cardiometabolic Syndrome

    Adrenal Dysfunction: Immune System & Gastrointestinal Dysfunction

    Case Studies in Adrenal Dysfunction

  32. Textbooks: The course features a single required text:

    Edwards, L., “Adrenalogics.” Cypress, TX: The Ultimate Publishing House, 2011.

    In addition, several recommended textbooks that provide additional reference material include:

    Greenspan, F.S. & Gardner, D.G., “Basic and Clinical Endocrinology”, 8th Ed. McGraw-Hill Prof. Publ., 2007.

    Morley, J.E. & van den Berg, L. eds., “Endocrinology of Aging”. Humana Press, 1999.

  33. Course Readings, Online Resources, and Other Purchases: Additional and appropriate readings will be identified and posted on Blackboard or Canvas.
  34. Student Expectations/Requirements and Grading Policy: The course requires the completion of 3 case study research papers 15% each 45% of grade. Comprehensive midterm exam 23% of grade. Comprehensive final exam 23% of grade. 5 webcasts 9% of grade.
  35. Assignments, Exams and Tests: The course requires completion of 4 unit self-assessment quizzes, 3 case studies research papers, a comprehensive midterm exam, a comprehensive final exam and 5 webcasts.
  36. Attendance Policy: Course Attendance at First Class Meeting – Policy for Graduate Students: For structured courses, 6000 and above, the College/Campus Dean will set the first-day class attendance requirement. Check with the College for specific information. This policy is not applicable to courses in the following categories: Educational Outreach, Open University (TV), FEEDS Program, Community Experiential Learning (CEL), Cooperative Education Training, and courses that do not have regularly scheduled meeting days/times (such as, directed reading/research or study, individual research, thesis, dissertation, internship, practica, etc.). Students are responsible for dropping undesired courses in these categories by the 5th day of classes to avoid fee liability and academic penalty. (See USF Regulation – Registration - 4.0101,

    Attendance Policy for the Observance of Religious Days by Students: In accordance with Sections 1006.53 and 1001.74(10)(g) Florida Statutes and Board of Governors Regulation 6C-6.0115, the University of South Florida (University/USF) has established the following policy regarding religious observances: (

    In the event of an emergency, it may be necessary for USF to suspend normal operations. During this time, USF may opt to continue delivery of instruction through methods that include but are not limited to: Blackboard, Elluminate, Skype, and email messaging and/or an alternate schedule. It’s the responsibility of the student to monitor Blackboard site for each class for course specific communication, and the main USF, College, and department websites, emails, and MoBull messages for important general information.

  37. Policy on Make-up Work: For documented student absences or emergencies, such as for illness, students will be allowed to make up any missing case reports or exams. Students will be required to abide by USF policy on academic integrity as described in course syllabus.
  38. Program This Course Supports: M.S in Medical Sciences- Metabolic & Nutritional Medicine concentration.
  39. Course Concurrence Information: None

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