Why do I need hormones?

Hormones are natural chemicals that regulate the functions of the body and maintain balance within the body in men and women. As you age, certain hormones such as estrogen (females), progesterone (females), and testosterone (males and females) begin to decrease and the balance is disrupted. This imbalance can cause you to experience a variety of bothersome symptoms as well as put you at increased risk for osteoporosis, high cholesterol, and other medical conditions. Fortunately, your body’s imbalance can be corrected by replacing the hormones that have been lost. One way of doing this is with bio-identical hormone pellets.

Common Symptoms of Hormonal Imbalance in Men

• Fatigue
• Decreased Libido
• Irritability
• Decreased Muscle Mass
• Depressed Mood
• Erectile Dysfunction
• Weight Gain
• Foggy Thinking/Difficulty Remembering Things

Common Symptoms of Hormonal Imbalance in Women

• Hot Flashes/Night Sweats
• Fatigue
• Vaginal Dryness
• Decreased Libido
• Weight Gain
• Mood Swings
• Foggy Thinking/Difficulty Remembering Things
• Urinary Incontinence

What are bio-identical hormone pellets?

Bio-identical hormones are compounds that are chemically the same as your body’s natural hormones. The hormones are made in a powder form and then compressed to form pellets that are about the size of a tic-tac or smaller. The pellets are placed under the skin in the buttock region via a minor in-office procedure with local anesthetic. Your body absorbs the hormones slowly over time creating a steady level of hormones in your blood stream. The pellets are placed every 3-5 months in women and every 5-6 months in men.

 What are the benefits of  bio-identical hormone pellets?

• Contain bio-identical hormones
• Do not require you to apply cream or take oral tablets on a daily basis
• Provide support for internal health- bones, cholesterol, etc
• Allow the body to continually have the amount of hormones that it needs to function
• Treat symptoms without increased risk for cancer
• Improve your quality of life

How do I get started?

Contact our office to set up an appointment with one of our providers. During your initial appointment, you will discuss your symptoms and have your hormone blood levels checked. The results of your blood work along with your symptoms will allow the provider to customize the dose of the hormone pellets to your needs.

What type of person do you think of when you hear BMI of 24, 15% body fat, runs 10 miles per day? Sounds like someone who is fit and healthy, right? So I imagine when you hear high cholesterol, arterial plaque, and heart attack that you picture someone who is overweight, eats unhealthy, and never exercises. But, what if I told you these two scenarios could be describing the same person? Jim Fixx popularized running in the 70’s and was the ultimate example of being physically fit, but he died of a heart attack at age 52.  He had a strong family history of cardiovascular disease so no matter how in shape he was his genetics put him at increased risk for cardiovascular disease. Unfortunately, he did not see a healthcare provider on a regular basis so he had not undergone the recommended cardiovascular screening tests which might have helped prevent his heart attack.

Cardiovascular disease is known as the “silent killer” because plaque can build up for years before any symptoms occur. Fortunately, there are tests that screen for plaque in the arteries and tell us your risk for plaque formation. If plaque or the potential for plaque formation can be identified early on, the risk of heart attack and other adverse events can be decreased. In depth cholesterol testing allows us to look beyond LDL and HDL, “good” and “bad” cholesterol, and evaluate things like Apo B and Lp(a) which are cholesterol particles that have a high potential for causing plaque formation. The

Lp-PLA2 test allows us to detect inflammation of the lining of the arteries which can occur prior to plaque formation. We can further evaluate the arteries by doing a Carotid IMT, an ultrasound of the carotid arteries that can be done in a doctor’s office and is a noninvasive way to estimate the age of your arteries and identify the presence of soft arterial plaque. It is a great way to assess your cardiovascular risk and can be followed over time to monitor the effectiveness of cholesterol therapy. A Carotid IMT test is usually covered by insurance and is less expensive and more informative than other tests such as a Heart Scan (Coronary Calcium CT Scan).

Once we know that you have high cholesterol and inflammation and/or plaque in your arteries we need to decide how we are going manage these things. There are so many medications and supplements that are available so how do we decide where to start? It turns out that genetics also play a role in managing cardiovascular disease. The Apo E genetic test is a blood test that tells us what works best for management of your cholesterol based on your genotype. This allows us to create a treatment plan that is tailored to fit your needs and genetic make-up.

Are your genetics putting you at risk for cardiovascular disease? Don’t wait until you have symptoms to find out. Make an appointment to see one of our providers so you can have an in depth cardiovascular assessment and have the opportunity to decrease your cardiovascular risk and prevent adverse events due to cardiovascular disease.

Commercial Topical Testosterone

General Information
There are various commercial topical testosterone creams/gels. All of these products contain bio-identical testosterone and are applied once daily to the skin. The application site varies from product to product (see table below).

Pros

• Bio- identical testosterone
• Provides support for bone health
• Once daily application

Cons

• Risk of transference:
  
  Because the testosterone is applied topically, there is a risk for transferring it to other people or pets that come in contact with uncovered skin where the testosterone has been applied. This can be avoided by covering areas where testosterone has been applied and showering before having skin to skin contact.

Cost

• Can be covered by insurance
  
  Coverage for these products varies based on insurance plan, but usually depends on your plan’s preferred product and your testosterone levels

Wiley Protocol

General Information
The Wiley Protocol was developed by T.S. Wiley, who has worked with numerous doctors to develop this unique method for hormonal replacement therapy. The idea behind the Wiley Protocol is to mimic your body’s natural production of hormones by using topical bio-identical testosterone and DHEA in a cyclic fashion.

Pros

• Uses bio-identical hormones
• Mimics your body’s natural hormonal rhythm
• Provides support for bone health

Cons

• Time consuming- requires twice daily application
• Can be expensive

Cost

• $100- $135 per month

Pellets

General Information
Pellet hormonal therapy consists of bio-identical testosterone pellets that are inserted under the skin. Insertion of the pellets involves a minor in-office surgical procedure. After the pellets are placed, they are slowly absorbed by the body and produce a steady level of hormones in the blood stream for 5-6 months.

Pros

• Uses bio-identical hormones
• Provides support for bone health
• Convenient
  • NO creams to worry about on a daily basis
  • Pellets last for 5-6 months

Cons

• Requires minor surgical procedure
• More difficult to adjust the dose compared to other HRT options
• Non-cyclical dosing so will not provide all of the internal health benefits that the Wiley Protocol does

Cost

• Initial placement- $600-700 (depending on dose of testosterone needed)
• Options:
1. If you sign up for our automatic monthly payment plan, the cost will be $100 per month
   OR
2. If you choose not to sign up for the monthly payment plan, the cost will continue to be $600-$700 every 5-6 months.

Testosterone Injections

General Information
Depo-Testosterone (testosterone cypionate) is a synthetic testosterone solution that is given via a weekly intramuscular injection (IM). Men or their partners can be trained to give the injections at home or men can come into the office on a weekly basis for the injections.

Pros

• Once weekly dosing
• Provides better absorption in men who do not absorb topical testosterone well
• Provides support for bone health

Cons

• Synthetic Testosterone (not bio-identical)
• Requires giving yourself a weekly IM injection
• Increased potential for testicular atrophy compared to other forms of TRT
• Increased potential for elevation of hematocrit level:
• A high hematocrit level causes an increase in the viscosity (thickness) of the blood and can require donation of blood to return the hematocrit to a normal range and prevent adverse side effects.

Cost

• Can be covered by insurance
• Coverage varies based on insurance plan, but usually depends on your plan’s preferred product and your testosterone levels

Tesosterone Patch

General Information
Androderm is a transdermal patch applied to your back, stomach, upper arms, or thighs once daily. The patch contains bio-identical testosterone that is absorbed through the skin. Because the testosterone is contained within the patch, there is less risk for transference of the testosterone.

Pros

• Bio- identical testosterone
• Provides support for bone health
• Once daily dosing
• Decreased risk for transference compared to topical creams
• Do not have to shower before having skin to skin contact with other people or pets as is required with topical creams

Cons

• Large amounts of body hair can prevent patch from adhering to the skin
• Less convenient than pellets or injections

Cost

• Can be covered by insurance
• Coverage varies based on insurance plan, but usually depends on your plan’s preferred product and your testosterone levels
]]> http://www.docmallory.com/testosterone-replacement-therapy-options-for-men/feed/ 0 http://www.docmallory.com/the-power-of-vitamin-d/?utm_source=rss&utm_medium=rss&utm_campaign=the-power-of-vitamin-d http://www.docmallory.com/the-power-of-vitamin-d/#comments Mon, 09 Jan 2012 18:50:18 +0000 devtech http://www.docmallory.com/?p=279 Winter has arrived! As we know this means plenty of snow, skiing, hot beverages, and unfortunately, colds and the flu. Did you know that having an optimal vitamin D level is the second best (The flu shot being the first of course) defense against influenza? Vitamin D is important for growth and development, but it also supports the immune system and metabolism and has been shown to play a role in cardiovascular disease and cancer. There is a small amount of vitamin D in dairy products and fish, but the body mainly relies on vitamin D being made in the skin which requires exposure to sunlight. Because we spend so much time inside and focus on preventing skin cancer by wearing sunscreen when we are outside, it should not be surprising that recent research estimates that around 50% of the population is deficient in vitamin D. Fortunately, we can screen for vitamin D deficiency with a simple blood test, and we recommend that all of our patients, children and adults, be screened since vitamin D plays such a vital role in so many systems in the body. If you are tired of always getting sick and feeling run down, ask about having your vitamin D level checked.
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