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Hormone Replacement Therapy- What To Expect At An Initial Visit With A Licensed Naturopathic Doctor Versus A Conventional MD
By Dr. Patti Haebe, NMD
October 4, 2018
Hormone replacement therapy, while around for years, has been growing in popularity due to accessibility and efficacy and it’s not just for women anymore! Hormone replacement therapy has grown enormously in importance for males starting as young as 35 years old. Naturopathic Doctors are known for detailed medical intakes lasting 45-90 minutes in duration that include in-depth medical history while a visit with a conventional medical doctor spans a quick 10-20 minutes.
Your first visit with either provider will include a personal history, blood work as well as a physical examination. Lab tests that should be routinely run for males by a Naturopathic Physician include:
Your MD/DO may order all the above labs or a slimmed down list usually including Total Testosterone, PSA, CBC, and CMP.
Your physician will also be listening for symptoms of hormonal imbalances from low testosterone or DHEA that you may be experiencing such as:
After receiving lab results, values on the low end of the range may warrant either testosterone and/or DHEA supplementation. Naturopathic Doctors may sometimes utilize herbs such as maca, tribulus or supplement oral DHEA to jump start sex hormone synthesis. However, significant deficiencies may require a prescription for testosterone. If a testosterone prescription is warranted, it is a controlled substance and the provider will do a search with the local board of pharmacy to ensure the patient does not have a history of controlled substance abuse and/or is not obtaining multiple testosterone prescriptions through other doctors.
Testosterone prescriptions are available in many different forms, the most commonly prescribed by conventional docs seems to be Androgel due to the ease of application under the armpits and is readily available in most commercial pharmacies. Just like in any profession, each Naturopathic Doctor prescribes slightly differently, there is no consensus on any one specific treatment methodology.
Because Naturopathic Doctors often run additional lab work, as mentioned above, additional hormonal imbalances may be identified and must be addressed. The most common being low progesterone or high estrogen. Elevated estrogen levels are common with the over conversion of testosterone to estrogen, these levels are even higher in men who have recently lost or are losing weight as estrogens can be sequestered within fat cells and released with the fat loss. A natural aromatase inhibitor that prevents this is called chrysin, a natural compound that has proven to be quite effective at dropping estrogen levels and increasing the physiologic effects of present testosterone.
This leads to more complex prescribing by NMDs that includes custom-compounded creams that may include Testosterone, DHEA, Progesterone and sometimes chrysin. Injectable testosterone cypionate is another alternative, injected abdominally or in the thighs once or twice weekly. These prescriptions are made specifically for each patient at a compounding pharmacy and may or may not be covered by insurance.
Lab testing should be repeated 4-6 weeks after starting a hormone replacement therapy regimen to make sure that your prescriptions are the correct strength. Everyone responds slightly differently to hormone replacement so expect a little bit of fine-tuning!
MDs, DOs, and NMDs all practice with the patients healing in mind, the goal is always to reestablish homeostasis and do no harm. As you can see, the deeper you look into hormonal pathways, the more targeted you can be in your approach which is why seeing a licensed naturopathic doctor with a hormonal specialty can be advantageous, especially if previous hormone replacement has only been marginally effective. Treating the root cause is essential and ensuring hormones are well balanced and playing together create the best patient outcomes.
If you are suffering from the symptoms listed above, consider seeking out care from your primary care physician or a licensed Naturopathic Doctor. Advocate for yourself and make sure all of your concerns are being addressed adequately.
Dr.Patti Haebe is a licensed naturopathic doctor in the state of Arizona. She sees patients via a telemedicine based practice called Ocotillo Integrative medicine and specializes in hormone optimization, pre-conception planning and general wellness.
Ocotillo Integrative Medicine
Ocotillointegrativemedicine.com
@Dr.Patti_Haebe
By Dr. Patti Haebe, NMD
October 4, 2018
Hormone replacement therapy, while around for years, has been growing in popularity due to accessibility and efficacy and it’s not just for women anymore! Hormone replacement therapy has grown enormously in importance for males starting as young as 35 years old. Naturopathic Doctors are known for detailed medical intakes lasting 45-90 minutes in duration that include in-depth medical history while a visit with a conventional medical doctor spans a quick 10-20 minutes.
Your first visit with either provider will include a personal history, blood work as well as a physical examination. Lab tests that should be routinely run for males by a Naturopathic Physician include:
- CBC
- CMP
- Total Testosterone
- Free Testosterone
- DHEA-S
- SHBG
- Estradiol
- Progesterone
- DHT
- PSA
Your MD/DO may order all the above labs or a slimmed down list usually including Total Testosterone, PSA, CBC, and CMP.
Your physician will also be listening for symptoms of hormonal imbalances from low testosterone or DHEA that you may be experiencing such as:
- Poor stress response
- Poor memory
- Low Libido
- Brain Fog
- Fatigue
- Depression
- Diminished Motivation
- Inability to Climax
- Muscle Weakness
- Increased abdominal fat
After receiving lab results, values on the low end of the range may warrant either testosterone and/or DHEA supplementation. Naturopathic Doctors may sometimes utilize herbs such as maca, tribulus or supplement oral DHEA to jump start sex hormone synthesis. However, significant deficiencies may require a prescription for testosterone. If a testosterone prescription is warranted, it is a controlled substance and the provider will do a search with the local board of pharmacy to ensure the patient does not have a history of controlled substance abuse and/or is not obtaining multiple testosterone prescriptions through other doctors.
Testosterone prescriptions are available in many different forms, the most commonly prescribed by conventional docs seems to be Androgel due to the ease of application under the armpits and is readily available in most commercial pharmacies. Just like in any profession, each Naturopathic Doctor prescribes slightly differently, there is no consensus on any one specific treatment methodology.
Because Naturopathic Doctors often run additional lab work, as mentioned above, additional hormonal imbalances may be identified and must be addressed. The most common being low progesterone or high estrogen. Elevated estrogen levels are common with the over conversion of testosterone to estrogen, these levels are even higher in men who have recently lost or are losing weight as estrogens can be sequestered within fat cells and released with the fat loss. A natural aromatase inhibitor that prevents this is called chrysin, a natural compound that has proven to be quite effective at dropping estrogen levels and increasing the physiologic effects of present testosterone.
This leads to more complex prescribing by NMDs that includes custom-compounded creams that may include Testosterone, DHEA, Progesterone and sometimes chrysin. Injectable testosterone cypionate is another alternative, injected abdominally or in the thighs once or twice weekly. These prescriptions are made specifically for each patient at a compounding pharmacy and may or may not be covered by insurance.
Lab testing should be repeated 4-6 weeks after starting a hormone replacement therapy regimen to make sure that your prescriptions are the correct strength. Everyone responds slightly differently to hormone replacement so expect a little bit of fine-tuning!
MDs, DOs, and NMDs all practice with the patients healing in mind, the goal is always to reestablish homeostasis and do no harm. As you can see, the deeper you look into hormonal pathways, the more targeted you can be in your approach which is why seeing a licensed naturopathic doctor with a hormonal specialty can be advantageous, especially if previous hormone replacement has only been marginally effective. Treating the root cause is essential and ensuring hormones are well balanced and playing together create the best patient outcomes.
If you are suffering from the symptoms listed above, consider seeking out care from your primary care physician or a licensed Naturopathic Doctor. Advocate for yourself and make sure all of your concerns are being addressed adequately.
Dr.Patti Haebe is a licensed naturopathic doctor in the state of Arizona. She sees patients via a telemedicine based practice called Ocotillo Integrative medicine and specializes in hormone optimization, pre-conception planning and general wellness.
Ocotillo Integrative Medicine
Ocotillointegrativemedicine.com
@Dr.Patti_Haebe