Bioidentical Hormone Replacement Therapy

Invest in your health.  It’s a great place to put your money to work. We can’t turn back the hands of time, but we can help you rewind the clock! How do we do this? Correct nutrient and hormone deficiencies and imbalances and get the toxins out! *Note: This is for Educational Purposes Only* “The use of bio-identical hormone replacement therapies, nutritional supplements, peptide therapies, IV therapies, and the like, are only done within the context of the doctor/patient relationship”.  Harlan Bieley, MD, MS

What is the Purpose of Bio-Identical Hormones?

Bio-identical hormones or natural hormones have the same structures of hormones you were born with and perform the same hormonal functions.   Compounded bio-identical hormones used in Bioidentical Hormone Replacement Therapy (BHRT), also known as HRT (hormone replacement therapy), are typically made from plant-based materials (like yams, for example) from excellent compounding pharmacists. They are used to replenish hormones lost naturally through the aging process, or by certain medications. They can help protect against cardiovascular disease, weight gain, vasomotor symptoms such as hot flashes, and night sweats; but they can do far more than that when properly balanced. It’s all about the balance! Why? By creating hormonal harmony, ie, by balancing your hormones, your symptoms are improved and so does your quality of life. We offer a superb anti-aging, regenerative, and functional medicine practice serving all of South Florida. We offer personalized, customized care based on your unique needs. By measuring your current hormone levels, treating you, and then re-measuring your subsequent hormone levels, this is the safest method for bringing your hormones into balance. We resolve hormonal imbalance and put things into hormonal balance.  

Why Should You Consider BHRT?

Bioidentical hormone replacement therapy helps improve or eliminate hormonally created symptoms, such as PMS symptoms, the symptoms of Andropause (from low male hormones such as testosterone), and the symptoms of menopause misery (the hot flashes, vaginal dryness, night sweats, belly fat, dry skin, memory loss, and fatigue) to improve your energy, memory, mood, and sexual functioning. We can help you become more stress-resilient to avoid burnout. We can improve the function of your thyroid and can help you normalize TPO antibodies if you suffer from Hashimoto’s thyroiditis, replenish low testosterone, oestrogen, progesterone, DHEA, cortisol, pregnenolone, oxytocin, growth hormone, insulin, parathyroid hormone, and others. We use natural hormones to help create balance, which can protect you from the development of breast cancer or endometrial carcinoma. We also offer Estrogen Metabolism Gene Testing, which can indicate what abnormal genes you have in estrogen metabolism. Once we discover your vulnerabilities, we can offer you targeted supplements to help re-route estrogen down a healthy pathway, instead of one that predisposes you to developing breast or endometrial cancer. Gene testing, as we say, is the clarion call, the jarring gong of reality to let you know what your genetic vulnerabilities are, and what we can do about them. By undergoing gene testing, and taking proper action via targeted nutritional supplementation, we can lower the risk of breast cancer.  

Who Should Do Gene Testing?

All women have this option offered to them. It is especially important if there is a previous history of breast cancer, or a family history of breast cancer. Of course, if there is an interest, all patients can do this testing now. It’s not especially pricey. In addition, we not only offer gene testing for estrogen metabolism, but also for heart disease, stroke, and osteoporosis genes. If there is a family history of these conditions, patients are offered this kind of testing at the beginning, or anytime during their treatment. However, we often offer this before the start of bio-identical hormone replacement therapy. Once these abnormal genes are identified, we can impact their expression through a variety of ways — be it lifestyle modifications, or through supplemental vitamins and minerals that make these pathways work properly. In addition to these gene tests, we offer poly-pharmacy (multiple medicine) gene testing to see the likelihood of drug/drug interactions that will make the metabolism of the medicines slow down tremendously (consequently making you need less of it to treat your ailment) or speed up significantly (consequently requiring you to adjust your dosage to make them effective). If you have never felt well, or have bouts of depression throughout your life, we look at your hormones and also offer a total methylation panel gene testing. We may uncover some relevant yet previously unknown connections, and help empower you to overcome these seemingly unsurpassable circumstances. When we find abnormal genes, called snips (single nucleotide polymorphisms), we can give targeted nutrients that help these genes function better. Along with some proper lifestyle changes, you will have the opportunity to live the life you love.

How BHRT Helps Menopausal Women

Bioidentical hormone therapy for women: It’s not a fun experience to be visited by the ‘Seven dwarves of menopause’ Suzanne Somers wrote about: itchy, bitchy, sweaty, bloaty, sleepy, forgetful, and all dried up! All the menopause symptoms are really a result of Progesterone deficiency. Supplementation of progesterone will help alleviate these symptoms. We look at all of the sex hormones, in addition to thyroid and adrenals, and by looking and treating the totality of your situation, we have the best chance of obtaining hormonal harmony and balance, and you become yourself again, symptom-free! Menopausal symptom manifestation in post menopausal women is due to them typically having their ‘tank’ empty, and just flying on fumes. This means their hormone output is low, and they will benefit greatly by replenishing them through bio-identical estrogens (estradiol and estriol, to help alleviate vaginal dryness), bio-identical or natural progesterone therapy (creams or pills), and testosterone (yes, women need it too to help prevent loss of muscle and bone). It typically takes six to nine months, in general, for hormone replenishment to occur,  and we monitor hormone levels every three months unless there is a special need for earlier testing. The goal is not only to normalize lab results, but to have you feeling normal, like yourself, again. Remember, you are the patient, and we are treating you — you are not a lab test! Also, we do not use synthetic estrogens, only bio-identical hormones —  the hormones your body has made all through your life. We also never use oral estrogens, which can increase the risk of gallbladder issues, and they can alter your body lipids in an unfavorable direction. By sticking to topical application with estrogen creams, or by putting the cream in the vagina, we are able to bypass the liver and avoid these problems. We also, in the appropriate patient, treat with bioidentical hormones after breast cancer treatment. Although controversial, many women are desperate for symptom relief. In certain groups of women, we can administer them safely with regular monitoring at different times. Clinical trials have shown this can be done safely and effectively.  

Bioidentical Hormone Replacement Therapy for Men

Testosterone replacement and key nutrients help men avoid becoming the proverbial ‘grumpy old man.’ These men have a pervasive sense of fatigue and loss of mental and physical sharpness.   Therapy reverses this, and the effect is a better quality of life. There are multiple ways to increase testosterone in men. We pay particular attention to younger men, as the causes for low testosterone are variable. Treatments offered include Clomid stimulation testing  (Clomiphene) , HCG stimulation testing (human chorionic gonadotropin), and testosterone (creams, gels, injections), and peptide therapies such as Deep or Delta Sleep Inducing Peptide (known as DSIP) and also Kisspeptin. What is peptide therapy? This treatment sends signals to accelerate your body’s ability to heal, remember, have sexual desire, improve function, and more. For all men to achieve the beneficial effects of testosterone replacement therapy, their total testosterone levels need to be in the upper quartile of young men.  Being within a ‘normal range’ has not been shown to obtain the beneficial effects of testosterone replacement therapy. The benefits of testosterone therapy include: decrease in all-cause mortality, decrease in depression symptoms, and decrease in sexual dysfunction (that means good libido, sustainable erections, and orgasm).  

Bioidentical Hormone Therapies for Psychological and Psychiatric Issues

For Sleep disorders, Burn-out Syndrome, Sexual Arousal, Depression, slowed progression of Alzheimer’s disease, Irritability & Anxiety, Chronic tendency to Social Withdrawal, Bipolar disorder, and Schizophrenia, the judicious use  bio-identical hormones, coupled with targeted nutrient therapy, can be quite helpful. For women, the benefits of bio-identical hormone therapy include:
  • better energy
  • better memory
  • better mood
  • improved sleep
  • prevention of frailty
  • improved muscles
  • improved bones
  • better heart health
  • improved libido and orgasms
  • better immune function
  • reduced PMS symptoms
  • reduced symptoms of menopause
  • … and more!
For men, if your hormones are out of balance, you may have some or all of the following hormone imbalance symptoms:
  1.    A pervasive sense of fatigue – you feel tired all day!
  2.    Losing mental and/or physical ‘edge’
  3.    ‘Couch potato’ after 5 pm
  4.    Workouts do not produce the results of the past
  5.    Aches and pains (particularly in the neck and shoulders)
  6.    Sexual functioning decreased- unable to obtain or maintain erections, less ejaculate, etc…
  7.    Loss of self-confidence
  8.    Poor sleep
  9.    Less focused thinking
  10. Depression
These symptoms can be reversed with bio-identical hormone replacement therapy. For example, testosterone replacement can sharpen a man’s focus and mental clarity, improve self-esteem and self-confidence, help prevent heart disease by decreasing inflammation, improve blood sugars, helps build bone, helps build muscle, workouts are more productive, and improves sexual functioning. By combining the work of hormone replacement with nutritional assessments, environmental toxins evaluations, and gene testing for methylation issues and more, we offer you the best chance of becoming well and functioning at your best. We also offer toxic heavy metals testing and treatment, assessment of environmental toxins, such as mold mycotoxins, and offer modern therapy to remove the offending substance, be it a metal or a mycotoxin. Once diagnosed, chelation therapy based on the binding coefficient of the metals is offered. If mold mycotoxins are discovered to be present, we offer comprehensive therapy to kill the mold, boost your immune system, boost your overall nutritional status, and decrease the Herxheimer reaction symptoms that often accompany the die-off from the treatment. These symptoms are usually headache, profound fatigue, stomach discomfort. We further offer brain fitness to quicken your thought processes, and improve your memory. We can add this for men and women as a regular component of their consults. There are many nutrients, hormones, and other substances that improve  brain processing speed and we routinely take advantage of them, in the course of our consultation with our patients, should they request help in this domain. The expression “You are only as strong as your weakest part” is demonstrated on a regular basis, so we attempt to address these issues so you can lead a better life. You have to prime the pump with mild to moderate exercise and high-end nutrition if you want to get the best results with hormones. That means:
  • whey protein or protein with branched-chain amino acids (BCCAs — particularly the amino acid Leucine) in protein shakes with dietary choline of some form to balance the sympathetic vs. parasympathetic nervous system
  • beet crystals to increase nitric oxide to relax the endothelium and lower blood pressure
  • minerals such as magnesium and potassium to get optimal results.
We use functional needs testing and nutritional testing, which include organic acids testing, fatty acids testing, amino acids testing and the functional need for B-vitamins and oxidative stress markets. This kind of testing best predicts what your functional needs requirements are for different nutrients (vitamins and minerals and antioxidants).   As you can see, bio-identical hormone replacement therapy does not stand alone. It is bolstered by:
  • great nutrition
  • gene testing with supplementation
  • removal of environmental toxins including overbearing stress (we do a thorough evaluation of your adrenals, with questionnaires, and saliva testing)
  • other hormone testing
  • lifestyle modification, which includes getting proper sleep totally necessary for weight loss goals
  • peptide therapies, which is the regenerative part of medicine
Peptide therapies can bolster the effects of hormones and getting well physically, emotionally, and sexually.   Getting healthy takes work on your part and on the part of the physician, who is really just a guide in the proper direction as you embark on this journey.   It requires the  investment of your entire being, a certain amount of discipline, your money, and your time. But the achievement of these health goals can propel you onward and upward to the achievement of a sharper brain, good energy, good mood, and a life worth living — plus having a body that is responsive to the demands placed upon it, no matter the chronological age. Invest in you. Invest in your health.  It’s a great place to put your money to work for you.

Bioidentical Hormones for Psychological and Psychiatric Issues

Mental Health is really Brain Health. We address brain health with a combination of nutritional supplements that support brain health, bio-identical hormones, mental exercise/ mediatation/neurofeedback training/’Holosync technology’, and mild physical exercise along with removal of environmental toxins.

Bio-identical hormone replacement therapy can improve many psychological and psychiatric issues such as: Autism Spectral Disorder, Sleep disorders, Burn-out Syndome, improved Sexual Arousal, Depression, Slow the progression of Alzheimer’s disease, Irritability, Anxiety, Hypochondria,  Social Withdrawl, Bipolar disorders, and Schizophrenia.

Bio-identical hormone replacement therapy can also play an important role in the treatment of those affected by traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD). Head trauma leading to neurobehavioral changes occurs due to inflammation, free radicals and hormone deficiencies.  See video  By first quenching the free radicals, decreasing oxidative stress, and decreasing the inflammatory cytokines creates a conducive environment for the brain to heal (a neuropermissive environment). Then, by replenishing and balancing bio-identical hormones such as DHEA, Pregnenolone, Human Growth Hormone (which after age 18 is really a repair hormone), Testosterone, Estradiol, Progesterone, Thyroid hormone and Cortisol, people have a good chance to recover and reclaim their lives. Finally, loss of consciousness is not a pre-requisite for  brain injury. Even if you never lost consciouness, brain injury can occur which can affect your pituitary and hypothalamus and the production and release of numerous hormones. 

Testosterone and depression. View here

Acetyl L-Carnitine in Major Depressive Disorder. View here

Vitamin D3 is a seco-steroid and along with other Micronutrients (Vitamins and Minerals) and Antioxidants (like Vitamin C) and judicious use of particular Fats (after RBC Membrane Fatty Acid testing done through Kennedy Kreiger Peroxisomal Lab at Johns Hopkins Medical Center) can ameliorate neurpsychiatric conditions.