The use of bioidentical hormones got a lot of press after Suzanne Somers (Three’s Company cast member and promoter of the ThighMaster™) began touting them as an alternative to synthetic hormone replacement. I wholeheartedly agree that bioidentical hormones are preferable to synthetic hormone replacement therapy (HRT). Recall the large experiment on the female population known as the “Women’s Health Initiative Postmenopausal Hormone Therapy Trials”. If you aren’t familiar with the results of that study, here is a summary provided by the National Institutes of Health:
Compared with the placebo, estrogen plus progestin resulted in:
•Increased risk of heart attack
•Increased risk of stroke
•Increased risk of blood clots
•Increased risk of breast cancer
•Reduced risk of colorectal cancer
•Fewer fractures
•No protection against mild cognitive impairment and increased risk of dementia (study included only women 65 and older)
Compared with the placebo, estrogen alone resulted in:
•No difference in risk for heart attack
•Increased risk of stroke
•Increased risk of blood clots
•Uncertain effect for breast cancer
•No difference in risk for colorectal cancer
•Reduced risk of fracture
(Findings about memory and cognitive function are not yet available.)
Just because synthetic hormones come with proven risk, it seems that people have decided bioidentical hormones are totally fine to take. Bioidentical hormones are crafted to be the exact molecular structure of the hormone(s) your body produces. Synthetic hormones, on the other hand are not. Synthetic hormones are typically a bit different from the exact structure that your body makes because that way it can be patented by the manufacturer.
The purpose of this article is not necessarily to compare and contrast synthetic from bioidentical HRT; but to alert you as to how the body responds when bioidentical (and synthetic) hormones are taken. Well, really to alert you on the downside consequences of taking ANY hormones. The physiology is simple and logical. It can be more in depth, but I’ll focus on the basics. By the way, I’m referring to the pathways of the most commonly replaced hormones, steroid (e.g.: estrogen, testosterone, progesterone, cortisol, DHEA, etc.) and thyroid hormones.
Most hormones work in the body via a negative feedback loop. This means that as the level of a hormone rises, a signal is mediated that ceases that hormone’s production and release; in order to prevent the production of the hormone from getting out of control. Let’s begin with an example using thyroid hormone.
The three main glands involved in thyroid hormone production are the hypothalamus, pituitary and thyroid. The hypothalamus releases “thyroid releasing hormone” (TRH), which stimulates the pituitary gland to release “thyroid stimulating hormone” (TSH), which in turn stimulates the thyroid gland to manufacture and release thyroid hormones (thyroxine or T4 and triiodothyronine or T3). Once the thyroid hormone begins to do its job throughout the body, production begins to decline, so as not to produce too many hormones. So, as the level of thyroid hormone increases, the levels of TRH and TSH decrease. It’s called a negative feedback loop because the rise in hormone levels results in a decreased production; as opposed to a positive feedback loop where a rise in hormone levels would produce an even greater rise in the level of that same hormone. The only example of a hormone that works on a positive feedback loop that I can think of is oxytocin.
Because these hormones work this way, you may be able to guess what happens when you are exposed to (i.e.: ingest) exogenous hormones. Exogenous (as opposed to endogenous) refers to those taken in from outside the body, and can be any type of hormone. So, if you take a hormone, you can be sure that those negative feedback loops will still function as usual. The result…your body stops (or significantly slows) its own production of these hormones. What’s wrong with that? Eventually, you’ll be dependent on these hormones as your glands have “gone to sleep”, because “someone” else is doing their job. It’s simply not necessary for the glands to have to do anything.
So if you stop taking them, it may be extremely difficult to get your body’s own production back up to par. Now, considering people often take hormones because they’re not producing enough on their own in the first place, you can imagine how difficult it would be to begin the production process after taking exogenous hormones and suppressing your hormone production even further. Therefore, people usually become completely dependent on hormones, bioidentical or not. In general, as long as you’re okay with taking a hormone for the rest of your life, there is no need to worry. However, most (if not all) of my patients shun that idea.
The next issue is that of hormone receptor insensitivity. Generally speaking, each hormone docks into a receptor on it’s target cell. It’s as if the receptor is the lock and the hormone is the key. Once the cell “door” opens, the hormone goes on to carry out it’s function (usually turning on or off genes). The problem with bombarding the cells with large doses of a hormone is that eventually it’s as if the cell decides to change the lock on the door. The result is that it is harder and harder for the hormone to open the cell door, and therefore more and more of the hormone is needed each successive time you want to make an effect on the cell/genes. It’s almost as if you need enough hormone to knock the cell door down, because it doesn’t want to open. This is especially prevalent with the use of hormone creams (usu. progesterone). However, if you make no lifestyle changes it typically happens with any hormone. That’s why people on thyroid hormone often have to continue increasing the dose to get the same effect; the same goes for those who take insulin. Have you ever known of diabetic or person with hypothyroidism (except for autoimmune thyroid disease/Hashimoto’s) that had to decrease their dose, without making lifestyle changes? So, taking a hormone for the rest of your life may not even do the trick, especially insulin. You may be familiar with how well diabetics fare without changing their lifestyle, and continually increasing their doses of insulin. By the way, hormone receptor sites often “run out” of the vitamin and minerals that are necessary to allow them to function properly, due to the constant bombardment of hormones they are subject to in these cases.
This is not to say that no one should be on HRT, bioidentical or synthetic. There is a time and place for everything. And when these hormones are necessary, they can be miraculous. The big question is: When are they necessary? That’s a debatable issue and can certainly vary between individuals. So I am not absolutely against HRT, though I definitely prefer bioidentical over synthetic when possible.
The point I’m trying to get across is that I wouldn’t recommend anyone start with HRT, unless they are in a very unmanageable state. In these instances, one option may be to start with HRT to “prime the pump” and then eventually wean off them. Unfortunately, with all the books written about HRT and the attention it gets these days, many people (and doctors) go straight for hormones (with or without lab tests). Don’t get me wrong, chances are you’ll feel like a million bucks if you take hormones that you are deficient in, or insensitive to. But don’t forget to ask the million dollar question just because you feel like a million bucks: How long does that last? Well, there is no single answer to that question because everybody’s condition and lifestyle is a bit different. But, from what I’ve seen, it lasts about six months at best, before they have to adjust the dose upward. You may eventually find yourself always having to increase the dose to get the same effect. And finally, your cells just may not respond adequately, despite the dose. That’s not say there is no hope though.
I’m currently working with a patient who had low testosterone and used testosterone replacement therapy for over a year. Sure enough, he had to continually increase the dose, until it eventually stopped giving him the results he needed (i.e.: absence of musculoskeletal pain, strength, libido, and an erection). In this case (and others), I determine if the hypothalamus, pituitary, gonads (when it comes to testosterone), and/or cell receptors need support. Fortunately, in the above mentioned case, the patient got immediate results that according to him, showed via the number of plates he kept adding on the machines at the gym.
In some cases, it may not be easy to get everything back up and running like new. But with the proper nutritional support and lifestyle improvements, it certainly is an attainable goal. The willingness of the patient to change their lifestyle and the length of time the person has been on hormones are two very important factors that will help to determine the outcome. Fortunately, I haven’t seen a “lost cause” yet; but I sure have seen people feeling miserable after the hormones stop giving the desired effect. Remember, there’s no such thing as a free lunch!
Not to go into politics…but I’m a big advocate of being able to buy supplements over-the-counter. Although I truly believe that hormones should only be dispensed through licensed health care practitioners who know how to use them.
PS: There are more problems associated with HRT (bioidentical or not) than what I mentioned above. For example, many men who take testosterone can eventually wind up converting it into estrogen (just about the opposite effect they are looking for)…that’s enough on that for now.
PSS: I’m not saying that bioidentical hormones are never necessary. They certainly can be in some instances…just consider the potential side-effects and work with a licensed, competent, qualified health care professional who knows how to use them appropriately. They can be very useful to “prime the pump” when other lifestyle changes are implemented.
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology
I really enjoyed your information! It is wonderful to find like-minded practitioners out there.
I work for alternative doctors in the Houston TX area and we treat with bioidentical hormones. We find so many women in particular whose hormone production has been interfered with because of birth control pills, tubal ligation, hysterectomy or uterine ablation as well as the environmental factors that put estrogen into male and female bodies and throw them out of balance. We have found people of all ages by the tens of thousands with low hormone levels because either the glands were not functioning properly or had been altered.
Many people’s hormones, such as thyroid, have never been at adequate levels for them to be healthy.
The majority of women’s progesterone levels decline by age 35 because our ovaries have aged and this is the type imbalance that causes all female problems all the way to the cancers.
Just wondered about taking a break from bio-Identical compounded Progesterone and Vivelle dot. Been on both for almost two years. How do I wean off if that’s how to stop for awhile?
Hi Susan,
Weaning off hormones can be different everyone. Get your levels checked periodically and make sure all the basics are in order (blood sugar, etc.).
Good luck,
Dr. Rob D’Aquila
Dr. Rob, I just started bio-identical hormone replacement therapy about 3 months ago. I had blood test done and it showed that my Testosterone was basically at 0. I had low progesterone and normal estrogen. I was placed on pellet therapy for the testosterone and I take progesterone at night. I am 39 and have always had normal periods. I was told I would have to be on testosterone for the rest of my life. I was planning on staying on therapy for a year, and then I would like to have another baby so pausing therapy is what I am planning on doing. My questions are…
Should I pause therapy or stop it sooner to help my own production of hormones?
Will I really have to be on T forever? (I do feel great and am happy to have my sex drive back and depression gone.)
What can I do to naturally balance out my hormones?
I had my second daughter at 33 and gained a lot of weight with her and have been unable to lose it. Do you think this has to do with Testosterone and/or adrenal fatigue? (I was told my thyroid test came back within normal range.)
How can I fix adrenal fatigue?
Thanks
Hi Sonja,
Your questions are quite extensive and should be directed toward your prescribing physician.
I hope this work well,
Dr. Rob D’Aquila
Liza – I’m glad you enjoyed the article. And I agree, it is wonderful to find like-minded practitioners. We’re out here, they just need to find us! Thank you very much for your informative comment.
Hello, i had tubal ligation and also ablasion done, i am 45 yrs old and having hot flashes, sex drive low, vaginal dryness, what is an alternative for someone my age? i am not into vaginal creams, have tried over the counter esterven
You should have tests done to measure your hormone levels to see what’s going on with that first.
Hi Rob,
Excellent article. One question that comes up frequently is
Are Bio-Identical Hormones Safe?
The 2002 WHI study showed that synthetic, chemically altered hormones such as Provera cause cancer and heart disase. However, Bio-Identical hormones are safe and effective, and do not cause breast cancer, as shown in the French Cohort study published in Climacteric, Dec 2002. For more on the Safety Of Bio-Identical Hormones click here:
jeffrey dach md
Hi Jeffrey, thanks for your comment. As you can see, my concern with bio-identical hormones is not that they are unsafe, the way synthetic hormones are unsafe. My feeling regarding bio-identical hormones is that they are often overused and used as the first approach in addressing hormonal imbalances. Personally, I feel bio-identical hormones should only be used as a last resort. Patients’ lifestyle (i.e.: blood sugar balance, stress levels, etc.) should be balanced first in order to address the underlying cause of the hormonal imbalance. Otherwise, it’s synonymous to “painting over the rust”. So unless the patient is at a “point of no return”, I NEVER start with bio-identical hormones. I look to support the hypothalamus, pituitary, and end-organ(s) of hormones production. The patient whose testosterone levels plummeted after being testosterone replacement therapy for over a year (mentioned at the end of my article) recently reported to me that his testosterone levels were remeasured and are now “kick-ass high”. They were well below normal, between 100-150 ng/dl; and after supporting his system nutritionally (without hormones) they’ve rebounded back up to above 500 ng/dl. I see this frequently; that is, hormones ceasing to work after being on them for a prolonged period of time, only to leave the patient back where they started (if not worse off than where they started). Thanks again for your comment.
I am a 64 year old female with depleted hormones. I had a heart attack in 2003, but have been fine since. I have had hot flashes for the past 10 years and they continue and have seemed to be getting worse. My mother, now deceased, from heart disease, had them too until she died at age 68. At least twice daily, I soak my blouses thoroughtly and am miserable from the heat I generate in my own body. I also wake up at night hot and sweaty. I thought that by now, at the age of 64, this should be over with. However, it continues. I have never used HRT , but now am thinking that bio identical hormonr therapy may make my quality of life better and, believe me, I am miserable now. My regular gynecologist does not prescribe bioidentical hormones, so I guess I will have to leave her and find another doctor that does. I will do anything at this point to feel better.
Sorry this reply is so late in coming. (you wrote in 2010), but try dong quai, available at most health food stores, including Whole Foods. Start with small amounts. It’s what Asian women have used for centuries. . Taking less than a pill a day, I got rid of my hot flashes in less than 5 days.
I tried dong quai, black cohosh and every other herb known to MAYBE help with hormone embalance none of them worked for me. I used supplements and whatever else my alternative medicine doc wanted me to try nothing helped. I am finally on BHRt for about two years now and feel wonderful. No more hot flashes. I sleep like a baby almost every night. I am happy every morning, not dreading life. I wish I would have done this sooner. Life is not made to be lived feeling misearable and sick all of the time.
I am 57 years old and have been on bio-identical HRT for +- 4 years. I’ve never had a hormone test – is it necessary to have one before HRT is prescribed? My big concern is that I keep putting on weight even though I excersice and watch my diet. Before HRT I had hot flushes & feeling slightly depressed at times. Is it possible that HRT can cause weight gain? If this is the case and I want to stop HRT do I need to do it gradually or can I just stop using it? My doctor makes adjustments to the HRT everytime according to my symptoms. Sometimes I also have breast tenderness.
Linda, Are you on T-3. It keeps the weight off.
Hi Linda,
Whether or not it is necessary to have a hormone test before giving hormones might be a debatable topic. There may very well be some doctors that are extremely adept at using signs and symptoms in order to prescribe without actually measuring them. I personally would never do that, and also, I definitely consider some of my mentors “masters” when it comes to hormones; and all of them test – why go with signs and symptoms alone when there are so many great tests that can be run to give a true picture. A hormonal imbalance can certainly cause weight gain, whether it be estrogen, cortisol, insulin or thyroid hormone imbalances. So it’s hard to say whether or not the HRT was the reason for weight gain in your case, especially because I don’t know what your levels were before and after HRT. These are certainly questions you should be asking the prescribing doctor. You may simply need changes to the dose of what you are taking (again, hard to say in my position with the little information I have). I probably wouldn’t take someone off hormones cold-turkey, but then again, that depends on what they were on, and the dose. And don’t think that “female” hormones are everything, if you were my patient, I’d look into thyroid hormones, adrenal stress hormones (i.e.: cortisol), and the possibility of insulin resistance. These could all contribute to an ability to lose weight. Also realize that all hormones are interconnected and it may be a mistake to focus on just one or two. There is an intricate, dynamic balance that takes place in the endocrine system. I’d check you for other health markers (via blood), in addition to a thorough history and AK exam in the office. Hope this helps.
My best to you feeling better and reaching your goals,
Dr. Rob D’Aquila
In the case of the gentleman who was weaned off the bioidentical testosterone, what supplements etc. did you use to build his testosterone back up to high levels naturally? Thanks.
Gary
Hi Gary,
In the case of this gentleman, who is an individual as you know – meaning, this may not be the protocol that everyone needs who is looking to wean off bio-testosterone…
He took (very high-quality) tribulus – I say that because most tribulus on the market is “garbage”; support for his hypothalamus, pituitary, and gonads (“protomorphogen” glandulars), zinc, and a well-rounded blood sugar support supplement.
He was reluctant to take the blood sugar support supplement, presumably because of the cost. But my presumption was that his blood sugar was the original problem to begin with (he’s a vegetarian, and blood sugar issues seem to be very common in vegetarians). Sure enough, he came in a few months ago for a musculoskeletal complaint, and reported that his medical doctor wanted to put him on medication to regulate his blood sugar.
BTW – the reason blood sugar is key – or at least one reason – is because fluctuations in glucose and insulin will eventually result in an up-regulation of the enzyme aromatase, which will cause a male’s testosterone to be converted into estrogen.
Hope this helps,
Dr. Rob
Dr. I just started my bio-identical hormone therapy here in Austin ,Texas. I was on synthetic hormones for almost 2 yrs, but I was feeling so tired and my sex drive was gone, I wanted some relief and got on these hormones but now I have been breaking out with acne etc, also having some mentrual bleeding. Is it in your opinion better to get these hormone pellets inserted by a doctor that practices gynecology at the place where I went all they did was blood work and then started me on them, the doctor that does the pellet inserts is not a gynecologist. I am worried about my health and all the side effects that I wasn’t even told about when I got the process started. Please advice, I am having regrets and wondering if I did the right thing or should I look for another form of getting the bio-ientical hormones other than pellet inserts. Desperate for answers to my concerns. Thank you.
Please, What are the lifestyle changes you refer to in addition to the HRT? I was very hopeful about bio HRT but I just started taking bio HRT and the 1st night I had incredible breast pain and some muscle aches. There were no warnings or side effects on the Pharmacist which led me to your site. Are there any side effects that should be taken seriously?
I do have muscle flare ups (fibomyalgia) and high cholesterol levels, it was the cholesterol levels that made me start looking for alternative help other than statins which gave me horrible muscle joint flare ups. I am 51, work out 3 times a week, eat healthy, I had a complete hysterectomy 9 years ago, was on estrastest for a few years and decided to go off. I have been taking zoloft 50 mg and 5 mg ambien to sleep at night which has helped me for about 10 years now but my Dr is hopeful once we get the hormones balanced I can eventually go off those meds.
I own my own business which is very stressful and I have been having trouble handling the stress recently as well. There are times I feel like I am losing my mind but I have shared this with some woman friends and they are feeling the same, do I need Cortisol for the stress factor?
Thank you for answering my questions, God bless you
Kathleen, I know you may not respond to this since it’s been so long but I was wondering what you ended up doing? My story is almost exactly like yours on my own business, had a hysterectomy, I’ve just been introduced to bio identical hormones and I’m kind of leery of taking them… I just wondered what advice you had if any?
Hi Kathleen,
You should speak with the prescribing doctor about side effects and whether or not some of them are red flags. Hormones have very powerful effects on the body; the key is obviously getting the right balance.
When it comes to lifestyle changes – there usually needs to be an individual approach. However, in general, the lifestyle approach should always aim to lift as many (dis)stressors off the body as possible. That would include eating a healthy diet, with adequate amounts of protein – see this article for more on protein http://robdaquila.com/2010/10/08/dailyproteinrequirments/. Also, foods that cause sensitivities and/or allergies should be avoided. Other issues that should be dealt with are: gastrointestinal health, adrenal gland stress, toxic chemical and metal burdens, nutrient depletion, elimination/detoxification pathways, infections (protozoa, viral, bacterial and fungal) and general endocrine (gland) imbalances.
It’s difficult to prescribe a one-size fits all approach when it comes to health, because very often multiple people will have the same “problem”, signs, and/or symptoms with a totally different cause. But the basics for everyone would be covered well if the above mentioned issues were dealt with effectively.
As far as cortisol – I’ve never seen the need to use bio-identical cortisol, and would be very careful with it (as a doctor or a patient).
My best wishes,
Dr. Rob D’Aquila
Hello Monica, I am in a similar situation to you.
I am low Estrogen, Low Progesterone and LOw LH.
Normal FSH but 0.9 AMH!! low egg reserve .. I am 29!!
I am prescribed Bioidentical hormones which I am nervous to take. I have never experienced side effects like it.. burning in my stomach, insomnia, depression, etc…
I know my hormones went off balance when I was on fat burners and protein shakes with SOY!! and other toxins.. at the time I looked great so didn’t really see it!.. now I have had no periods for 3 years and we really want a baby.
Did you find a solution?.. I’m not sure what to do next..
I am 27 years old and am experiencing a number of symptoms. First, I’d like to tell you that I used to follow a very strict diet, cardio and weight training regiment consisting of a macro-nutrient breakdown of appropriate complex carbohydrates, fats and proteins. I have competed in several amature figure competitions so I have dropped significant amounts of weight and bodyfat, all the while building and maintaining lean muscle mass. Back in May I started intentionally putting on weight to gain muscle, I put on 30 lbs. A lot of this weight was unwanted but I knew it was part of “the game”… As I started to change my diet and training to lose the excess bodyfat I noticed that u was holding fat in my mid-section. I had not had a menstrual cycle in close to a year. I started retaining water throughout my entire body, gaining weight while still following a fairly strict diet. I noticed that if I would ingest larger than “normal” amounts of carbohydrates, especially refined sugar, processed foods, my entire body would swell. Since then, (September) I have been experiencing mild depression, more weight gain, (a total of about 35 lbs) lack of menstrual cycle, extreme food sensitivities, mood swings, excessive muscle swelling while weight training, intracellular water retention, difficulty concentrating, among others symptoms.
The research that ive done and some recent blood work indicate that I may be experiencing hormonal deficiencies; progesterone, thyroid, estrogen, etc. I would greatly appreciate any input that u may have. I am looking at seeing a specialist in BHRT.
Thank you for your time and consideration,
Monica
Hi Monica,
You may be experiencing the cumulative effects of “over-training syndrome”; which is essentially a culmination of metabolic effects that result in complete disarray of the endocrine system. Within the realm of the endocrine system, it sounds as if your adrenal glands have really suffered. They are usually the first to bear the brunt and then “all” the other glands follow in a downward spiral. The fact that you haven’t had a menstrual cycle in close to a year might be a big issue for you later in life – ammenorrhea for 1 year is a risk factor for developing osteoporosis. Find a very knowledgeable doctor… It’s hard to say if you absolutely need HRT (bio-id or not) based on what you said only. The tests and your symptoms would be the decision maker, so to speak. Recall that hormones measured through blood should be “free” – because it’s the free hormones that actually work at the cellular level – not the protein-bound hormones that are measured when a hormone is not prefixed with “free”. When you do a salivary hormone profile, it’s “automatically” free – that’s how they are in the saliva. It may be tough to get a good gauge on your “female” hormones because you’re not cycling, but regardless, they should be measured. Also, pituitary hormones are very important, in order to see how “far up” in the chain of command there is an issue.
I hope you find the care, attention, and treatment you need and deserve.
Best wishes,
Dr. Rob D’Aquila
Hi,
I just started on bio-identical progesterone replacement last week. I am pretty horrified, and looking for a better answer.
I’m almost 50 and hadn’t had a period in 10 months. Maybe a co-incidence, but last week I became terribly bloated, and started bleeding 4 days into the treatment. This is definately NOT the direction that I want to go!
To back up a little….I first saw my doctor starting about 4 months ago. He ordered blood tests and from those results put me on 2000 IU of D-3 and an iron supplement. He also started me on Cortrex and some adrenal support drops. At that time, I had only been about 6 months without a cycle, so he wanted to give it a few more months to make sure that I was truly in menopause.
I may need to back up a little more…I’ve been on about every anti-depressant that there is over the past 5 or 6 years, most recently Pristiq, with a Wellbutrin ‘kicker’. They keep me from being ‘over the top’, but mostly I have felt that they make me just not care as much – not a state that I want to spend the rest of my life in! Almost 2 years ago, I finished a 2-year time period on Depo-Provera as well. Two weeks ago – and a week before starting the progesterone cream – I decided enough was enough with the anti-depressants. (Got to be much too expensive, buying the Pristiq, plus the new Dr., and all the new supplements…) The doctor had wanted to take me off slowly…a better idea that what I did, I’m sure.
In the meantime, he gave me a saliva test kit, and the results from that showed that I was estrogen dominant and had low cortisol levels, and that brings me back to the beginning of this email…starting on the progesterone cream (30mg. – 1/2ml. two x per day) and increasing the adrenal support drops.
So I feel TERRIBLE (!!!) and went looking for an answer on the internet, and found you.
After reading your article, I know that I don’t want to go from being dependent on an anti-depressant, to being dependent on a hormone replacement, especially now, knowing that I will stop producing my own and stop getting results from the replacements!
What a nightmare – what can I do? Lifestyle changes? I give a lot of thought to my diet, I take good vitamins, get good excercise – nothing formal at a gym, but I take care of a farm-full of animals every day. I have gained a LOT of weight the past 2 years…from 135 to 170#, and I was hoping the HRT would help with that. Of course I’ve tried dieting…..it’s not something that I’ve been able to take care of that way.
Please help in any way that you can…nothing is working for me, and you can see that I’m not afraid to keep trying…
Thank you,
Deb
I started Bio- Equivalent Hormone Replacement over 1 year ago. I was in Menopause for over 5 yrs ( No Menstrual Cycle) but the hot flashes grew worse over the 5 years . I seen the commercial on TV for the HRC , all natural . So I thought that is for me! In days I was having pellets inserted. Only then after the inserted pellets did I learn that since I still have my uterus that I also needed to take progesterone. Hmmm really I thought , why wasn’t I told this before? Well you know now and we sell them here for $60.00 for 3 months supply. What will happen if I do not take it , I asked. You will bleed and might end up having a hysterectomy. Well good grief I sure don’t want that to happen.For 3 months I felt awesome. That ended after the 3 months , then I started to bleed , I called they said double up on the progesterone . OK , I did. The bleeding stoped for days then started again . It got heavy by each day that passed. They said something else is wrong with you. Hmmm Ok. I ended up in the Hospital to receive blood , because of so much bleeding . After many Doctors and test ( with no health insurance) I found out that I have Simple hyperplasia of endometrium , no atypia. This come from HRC. All the Doctors have told me this. I still after 8 months bleed . This has changed my life . I have lost my job, have a pile of Doctor & Hospital Bills and my state of mind is fragile .
I have changed my Diet to all organic Fresh Foods , NO Hormones in that. I have went totally Vegan . I really love it. This new diet has cleared up my sinus that I had suffered with for years , lowered my thyroid med.s to a mg that I have never seen in 12 years. Lost 15 pounds. The longer I’m on this Organic Vegan Diet the better I seem to feel . It has felt like the swelling has went down. I think that when I went through the change of life my body was make all the hormones that it then needed and, I was putting extra hormones in my body with the foods I was eating. With much research I have found out that all our meats our full of Growth Hormones .
Good luck with your journey .
Hi Deb,
Your bloating and bleeding for 4 days does not at all sound like a coincidence – but I can’t be sure. It sounds like you got your period. One problem with doctors using HRT (bio or not) is that they keep women menstruating “forever”, when that is not at all normal as you know. I’m not all saying that was the goal of your doctor, I’m just saying that it happens and it sounds like that happened to you.
Being on so many different anti-depressants etc. might indicate a (primarily) neurotransmitter-mediated issue. Neurotransmitters tend to take the lead in the hierarchy of biochemicals, as far as what is most important. I’d look into support for neurotransmitters based on your history.
Additionally, your issue of estrogen-dominance may be related to things other than a lack of progesterone. I won’t go into how to read a female hormone saliva profile, but it’s certainly possible that you have too much estrogen – period. That is, not too much in relation to progesterone, where simply giving progesterone “fixes” everything. Because it sounds like it didn’t. Very often, it’s not the body making too much estrogen, but a lack of clearing that estrogen from the system.
The weight gain could be a thyroid issue – but again, hard to say.
Lastly, it’s very difficult to tell you what to do without seeing the whole picture, etc.. Everyone has different needs, although there certainly are commonalities with many conditions or presentations. Information about blood sugar regulation can be found on my site, which is certainly something everyone needs to get in order if they want to be healthy and function well. You said you have a good diet, but it can still be an issue. Anyhow, I wish I could give you more things to do, but not knowing the whole picture is an issue.
I plan on writing more on ways people can balance hormones in general.
Good luck with everyone!
Dr. Rob D’Aquila
Fine article Dr. D’Aquila, thank you! I am an herbalist and am now in the “throws of menopause”. I stumbled upon Suzanne Somers book and read it and was still skeptical about bioidenticals and you have explained the body’s process in a very understandable way!
I want to urge people to trust in nature’s gifts of whole organic foods, and herbs, essential oils and homeopathic remedies, exercise, fresh air and laughter! It’s never too late to begin a healthy lifestyle.
Support sustainable living for yourself, your community and your earth!
Thank you for the informative article. I have had a total hysterectomy about 2 yrs ago. Initially, I was started on Climera Pro, a estrogen/progesterone patch. I used it for maybe about 6 months but stopped when I didn’t feel I was having much in the way of the traditional post menopause symptoms. Now I have noticed that I am very forgetful (enough to be concerned) and I am also very stiff and achy. What do you think the chances are these symptoms have to do with my hysterectomy and do you think bio identical will help? I am 44.
Thank you,
Cynthia
Hi Cynthia,
I’m glad you found the article informative. I’d say there is a 50/50 chance. But then again, I don’t know anything about your history other than what you told me. It’s even possible that 6 months of hormone replacement is the main contributor to your symptoms. If you were my patient; in addition to a full history, I’d run a full (blood) thyroid panel (and full blood chemistry), along with adrenal and “sex” hormone salivary profiles to see where your levels are. Loss of memory can be very thyroid specific, and being stiff and achy could be a calcium metabolism issue. If there is a calcium metabolism issue it could be related to many things, but certainly “female” hormones would play a role as estrogen plays a significant role in calcium metabolism.
My best to you,
Dr. Rob D’Aquila
Dr. Rob, Interesting article! I am 2+ yrs into menopause with only symptoms being night sweats a couple times a night and slight vaginal dryness. I otherwise feel great and make sure I strength train to protect bones. (I am a tad underweight) My question is: is there any reason for me to consider bioidenticals? My doctor prescribed vagi-fem but not sure if there are any side effects.
Hi Janet,
I’m glad you found my article interesting. It sounds as if you are doing better than most women in menopause. I don’t see why you’d consider bio-identicals with the way you describe your current health. If anything, you can get a work-up and have all your hormones measured along with other blood and perhaps bone-density tests. And as eluded to in the article, if you were my patient, I wouldn’t start with bio-identicals. They’d be a last resort, and again, especially because you don’t seem to be experiencing many symptoms. There are plenty of natural ways of going about it without bio-HRT – and considering the side effects that can come with it. Here’s a link to the side-effects of vagi-fem – http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000333/.
Take good care,
Dr. Rob D’Aquila
I am 53 years old and had a uterine ablations approximately 8 years ago. I have been having lots of mood swings, some heart palpitations, no libido whatsoever, vaginal dryness, dry skin and forgetfulness. I take thyroid medicine and have been doing so for many years. I have had complete blood work done and my testerone level was apparently bottomed out. My doctor recently started me on Estradiol and Testosterone injections every three weeks. I am a little afraid of taking these hormones and keep doubting whether to continue to do it or not. Can you give me some advice on this.
Hi Yvonne,
Sorry to hear about all that you’ve been through and continue to go through. I can’t give you “advice” about anything online because you’re not a patient, etc.. But some things to consider: a) the dose of your thyroid medication might need to be adjusted based on the symptoms of heart palpitations; b) there are many possible reasons that your testosterone level is low (e.g.: nutrient deficiencies, adrenal gland stress, hypothalamic/pituitary/gonadal axis dysfunction, liver dysfunction, etc.), and c) your thyroid may not be functioning optimally despite being on thyroid hormone.
Even if you were a patient in my office, I could not tell you to or not to take prescription medications (e.g.: injectable hormones) because my license as a DC does not allow me to. Although, I would be willing to consult with a patient’s prescribing physician about the matter – although in my experience that doesn’t go very far…
As you read in the article above, (bio-identical or synthetic) hormone replacement therapy can be appropriate in certain cases, but I never start with that. I start with diet and lifestyle; and then nutritional supplements to support systemic and metabolic health, in addition to in-office treatments.
In conclusion, it’s quite possible (and perhaps probable) that the original issue approximately 8 years ago was never dealt with to a degree that would lend to hormone balance. Ablation may be necessary for some women in certain situations. But if nothing was changed to correct the underlying imbalance that caused the “need” for ablation (excessive build-up or lack of shedding the uterine lining) in the first place, then the problems might continue to persist and show up as symptoms at a later date. And, it’s very possible that estrogen and testosterone imbalances were the original cause for the thyroid dysfunction.
I understand your fears about taking the hormone injections. There’s always the option of getting a second and even a third opinion.
My best to you,
Dr. Rob D’Aquila
Have you any experience with bio-identical hormones altering your ast level ?
Hi Teresa,
I have not in fact seen any direct relationship between the use of bio-identical hormones and serum AST levels. AST (also known as SGOT) is an enzyme that’s present in many tissues: heart, liver, muscle, kidney, brain, pancreas, spleen, lung. Damage or injury to any of those tissues may cause a rise in serum levels.
AST levels should also be looked at amongst “all” other blood markers to determine if there’s a pattern.
Best,
Dr. Rob D’Aquila
I am 64, and 5 1/2 yrs post breast cancer diagnosis. I had two positive biopsies in one breast and a positive lobular in situ in the other breast. I had taken prempro for 10 years. I have an oncologist that was aminiable to a wait and see situation, even tho two very good surgeons suggested a double mastectomy. I quit the prempro and started with a aromatase inhibitor (Arimidex) and six months later a MRI showed no more cancer and I have had a MRI every year since without any suspisous concerns. But this lack of estrogen has been very hard to deal with. I have hot flashes every couple of hours and all night long. I am very cautious about anything with estrogen, but the symptoms have all but finished my sex life, which I would like to have back. Will the bioidentical harmone treatment create a more likely reacurrance of the cancer, or do you think it is safe under my circumstances?
Hi Sue,
If bio-identical hormone replacement therapy (bHRT) is done properly and when “necessary” (which may be debatable); it shouldn’t cause harm. Also, recall that I consider bHRT to be a last resort and/or something to “prime the pump” temporarily while working to get the endocrine system functionally properly (via lifestyle and supplements). The way to get the endocrine system back on track will vary amongst individuals. Areas that need addressing might be: 1) adrenal gland function; 2) blood sugar balance; 3) liver (and possibly other organ) detoxification; 4) microbial balance in the digestive system; 5) thyroid function; 6) immune system regulation; and/or possibly more. You would obviously need to consult with your oncologist to determine if it’s right for you given the situation you are (or have been) in. Lastly, if a patient told me that an aromatase inhibitor “fixed” their problem; the first thing I would look at would be blood sugar and insulin balance, as insulin plays a major role in up-regulating the enzyme aromatase.
BTW – Sue, you are right in questioning whether or not estrogen replacement will cause issues with breast cancer. This is one scenario where you have to be extra careful. Again, your oncologist (or a second and third medical opinion) would be “best” to guide you. Without knowing all the details, what your tests say, and the fact that you are not a patient of mine says that I cannot intervene and give recommendations.
All the best,
Dr. Rob D’Aquila
My wife and I are looking for answers. Lynn was on Fenhrt for 4 years, she had a stroke Feb 15th. They can not find any reason for the stroke!. I have read about Femhrt and an increase of 41% of strokes in a study that was stopped.
She came out fine as her boss caught the symptoms and called 911. Major stroke but no side effects except she is tired by early afternoon.
Can you suggest anyone in the Des Moines Iowa area to see.
She has night sweats, mood change, anxiety, headache, and worrys about everything.
Medical or natural meds?
Hi Ken,
It’s terrible to hear about the scenario your wife (and you) have been through. Typically, when I refer and am not familiar with a doctor in the area where one is needed – I point people to the ICAK website – as that is my specialty. Although, no matter what specialty a person is in, it never guarantees any competence for any particular issue. Here’s the link – http://www.icakusa.com/.
Wish I could be of more help,
Dr. Rob D’Aquila
PS: If you find someone, I can let you know if I know or have heard of them
Dear Dr. D’Aquila,
I am on three years of hormone replacment. Right now
I have excessive bleeding and going in tomorrow for a
pelvic scan, I really want off these hormones. I have gained
close to 18 pounds. What is the best way to get off hormones. I did have the hormone test I am low on progesterone 2.5.
I would appreciate your input.
Yvonne
I have enjoyed reading your site, please keep me informed.
Thanks,
Eddwina
Hi Yvonne,
The best way to get off hormones is going to be different for everyone. It depends on so many factors, and the first place to begin is by measuring hormone levels. And hormone levels should generally be measured through saliva.
You’ll most likely need to work with a (competent) health care practitioner who is knowledgeable is this area.
Things that typically need addressing are:
1) hormone receptor site re-sensitization
2) liver detoxification
3) hypothalamic/pituitary/gonadal axis support
4) digestive support
5) adrenal support
6) thyroid support
Numbers 4-6 will usually vary the most between what type of support individuals need.
There certainly can be other outliers, but that’s a good place for most to start.
Good luck and I wish you the best,
Dr. Rob D’Aquila
After two years, I am over all the side effects of the hormone therapy I have done the liver detoxification,TMG, Beta amd so, still no help with the weight.
How long is this process befpre I can start losing the weight. Maybe I gave up too soon.
Hi Yvonne,
Great job with getting over all the side effects of your HRT. You may want/have to look into other areas for weight loss. Hidden sources of inflammation like blood sugar imbalances and stress hormones might be playing a role; or you may have a sluggish thyroid. I’d look into these things first and go from there.
Best,
Dr. Rob D’Aquila
I’m going to my local gp on Monday.
I am 69. The weight gain , hot flushes , memory lapses , and loss of sexual intrest , has me finally going for help. I am not takeing any medication . I have had a hystorectomy years ago ( at 41 ) . They found cancer cells on the uturus after the hystorectomy.
My question is ,,,what kind of test’s do I request from my gp?
Hi Brigitte,
(the long explanation…)
My second thought to your comment was” “How can I answer this question and be politically correct?”.
My guess is that if you asked anyone who knows me even remotely well; if I was arrogant; they’d say “No”.
As you know I am a chiropractor who practices natural, functional “medicine”. And many (definitely not all) of my patients also see medical doctors and get blood work ordered through their MD’s.
I’ll give you two recent examples that come to mind when I asked patients to bring me a copy of their blood work.
1) The original tests of a gentleman showed a significant gallbladder problem – that is, his bilirubin test was out of the reference range based on the standard tests. I immediately said, (not necessarily exactly, though I’ll use quotes): “You need to get another blood test which measures “direct” and “indirect” bilirubin to see where the problem may be stemming from”. He went back, got more blood work and still the tests were not ordered, just the same ones. I then saw another standard marker on the new test which was normal on the first, “alkaline phosphatase”, which was extremely high (the problem had gotten worse). The patient informed me that his doctor was still not concerned. After urging the patient to get imaging studies done on his gallbladder, because I suspected that at any moment he may have a “gallbladder attack” and need to be rushed to the emergency department where they’d routinely take out his gallbladder, he did so and got the imaging study. Sure enough, there were many gallstones, and he then went forward with a type of surgery known as an ERCP, which essentially finely slices the gallbladder to relieve the pressure of the bile/stones. Much better than having the gallbladder removed, but possibly avoidable had action been taken sooner. This patient is from out of town (Michigan), and so I only see him when he’s in NYC, I had very limited one-on-one contact with him throughout.
2) A woman brought in her tests that showed elevated TPO-antibodies which indicates that she had “Hashimoto’s Thyroiditis”. I said: (something like) “OK, so you know you have autoimmune disease” and she looked at me with horror saying: “NO!, what do you mean!”. I said: “Your tests clearly indicate that you have autoimmune thyroid disease; your doctor didn’t tell you that?”. She said “No!”
I can give you many more examples but don’t want to go overboard. Based on extensive experiences like this, I have very little faith in “average” GPs (or other “specialists”), and their ability to spot or prevent a problem (even when it’s in “black and white”).
In conclusion, because your symptoms seem to be one of a functional nature, I doubt that your “local gp” would order the presumably necessary tests to determine where to begin. What I see with patients is that their MD’s are only concerned about pathology (which is how they’re trained) – so I can’t “blame” them.
If you were my patient, I may or may not order more than standard blood tests, but I certainly would not rely on the interpretation of a “local gp”. Again, that’s simply my experience.
You may or may not need functional tests (e.g.: salivary hormones, functional stool tests, etc. etc. etc.). Most times I ask a patient to have certain tests run through their MD’s, they come back saying their MD’s didn’t think it was necessary. I now order my own lab tests for patients; and they prefer that.
You can start with FREE “sex” hormones run through blood, but even if those tests are out of range, it doesn’t necessarily point to where the true cause of imbalance lies.
“At then end of the day” – The problem essentially lies in your question: “What kind of tests do I request from my gp?”. You should not have to ask your health care practitioner what tests he/she should order. They should know. If you request tests based on my recommendation, what are the chances they’d be able to interpret them anyway.
BTW – if you had cancerous cells on your uterus 28 years ago, I might first look for malignancies in other areas of the body… not that I suspect them based on your symptoms.
Best wishes,
Dr. Rob D’Aquila
I just came across your site looking for information regarding Bio-identical hormone replacement therapy. As I began reading along I thought I would tell you ‘my story’.
I am 47. Had my first son at 35, second son one month shy of my 40th bday. While pregnant with my first son, I began experiencing heart palpitations. A few years after the birth of my second son I was diagnosed with Wolfe Parkinson White Syndrome. I am still menstruating although my cycle has changed – shorter in duration, more intense cramps and bleeding, stops completely in 2-3 days. A few months ago I began getting what seems like some sort of hormone blast (I had one of these a few days after the birth of my second son – my OB said it was my hormones readjusting)…heart races, sometimes WPW kicks in, hot flash, dry mouth, then after my heart starts to beat normal my body begins to shake uncontrollably – I feel cold to freezing. I have had all blood work done. Everything is normal. Thyroid, hormones, glucose levels, iron, etc. My doc thought perhaps I was hypoglycemic because if I am stressed and have not eaten enough the episode will occur – sugar test was normal. By mid day I am completely exhausted – to the point where I NEED to lay down. I am stressed out. I’m a stay at home mother who home schools my sons, 10 and 7. The tiredness is so severe at times that I feel as though I have NO reserve and laying down sometimes does not help right away. I also experience peri-menopause symptons – heart palps, night sweats, mood swings (mostly crying), weight gain. I have just been to a doctor who specializes in peri and meno – pause. She said everything I’m experiencing is peri at this time and suggested HRT. My primary doc says NO because of my WPW. I do take 1/2 – 1 tablet 25mg of atenolol when I have the heart racing episodes. Today I laid down, later afternoon, felt kind of funny after about an hour, went to get up and my heart began racing, then went to fast normal beats, then the body shakes – like shivering cold. The episode lasts anywhere from 15 to 45 min.
I should also tell you that this past winter (Dec. thru Mar.) I have not eaten well, nor exercised much. Typically I walk 30 minutes a day outdoors and do free weights.I have begun exercising again. 30 minute workout 5X a week. Started to eat healthier, more greens, lean protein, fresh fruits. Limit sugar. No caffeine. No alcohol. Sleep the best I can. Try to get 8 hours. I take a Women’s daily supplement, 1T of chlorophyl daily, began 1000mg of Vit D – one drop daily, and sublingual B12.
The fatigue is nearly debilitating. And I am experiencing depression now. Also, I live in the upstate New York – dark and long winter this year. Are there any flags as you read that my docs and myself may have overlooked. Would you suggest seeing a endocrinologist?
I appreciate any suggestions. Thank you,
Kolein
I’m glad I read your article. My doctor uses bioidentical hormones, and recommended them to me, for my borderline low testosterone. After reading your informative article, I know I won’t proceed with it. My question: Are you familiar with any studies done on the use of “Tongkat Ali extract” to raise testosterone levels? From the articles I’ve read about this herb, it seems to have a positive feedback loop. It increases the body’s own testosterone production by stimilating the secretion of luteinzing hormones, which in turn, stimulate the leydig cells of your testicules to produce testosterone.
Hi Kolein,
There’s obviously something “wrong”. Typically, when I see a woman “in trouble” experiencing symptoms of peri- or menopause, the adrenal glands are the culprit. And “you” can’t fix the adrenals, unless you fix blood sugar handling, and you can’t fix blood sugar if you don’t fix the diet (and often, but not always, include exercise). And you said your diet hasn’t been great recently. When a women goes into normal peri- and menopausal changes, her ovaries essentially “go to sleep” (which is normal); the other main reserves for “sex” hormones are the adrenals. So when they are stressed, women will often experience all the typical peri- and menopausal symptoms.
I basically never start with bioidenticals, though in some cases it may be necessary to “prime the pump”.
Your symptoms sound related to blood sugar, adrenal, and thyroid hormone imbalances. I can’t imagine that all your tests are “normal”, especially if functional (i.e.: not pathological) blood reference ranges are used for assessment. Also, it’s not always easy to pick up a blood sugar imbalance if only glucose is measured. HbA1c would be a better test to determine long-term blood sugar handling, along with an adrenal hormone analysis. And again, your symptoms sound like there certainly are blood sugar issues; in addition to possibly bouncing in and out of hyper and hypo- thyroid/adrenal hormone balance.
I can’t determine what type of practitioner (e.g.: endocrinologist) will be best for you. But I can say that a competent physician who understands functional medicine and endocrinology is what I’d be looking for. And a practitioner doesn’t have to be a medical doctor or medical specialist to understand functional endocrinology. They just need to study it well and know their “stuff”. And that very often includes chiropractors and naturopaths these days.
Good luck with your path to better health, and I wish I could offer more; but not being a patient of mine, and not examining and reading your lab tests is certainly an obstacle to determining what you most need.
Take good care,
Dr. Rob D’Aquila
Hi David,
Glad you enjoyed the article. I’m not at all familiar with “Tongkat Ali extract”. It’s not that I’m not interested in learning about new products and compounds. There’s just so many products that already exist and work quite well. I suppose if I find myself in a rut, I’ll branch out to new and “obscure” herbs, etc..
As far as the positive feedback loop effect – I don’t see how that’s possible. The endocrine system is “hard-wired” with negative feedback loops. That is, if more testosterone (etc.) is in the bloodstream, the hypothalamus and pituitary will stop producing hormones that stimulate the production of even more testosterone. If it were possible for a compound to override the negative feedback loops, I imagine the system would go completely “out of whack” and who knows what the end result would be.
The only hormone that I’m aware of that has a normally existing positive feedback loop mechanism is oxytocin.
Good luck with everything!
Dr. Rob D’Aquila
I’m 53 years old No major health problems execpt peri-osteo in which i was taking fosomax, but stopped taking it a couple years ago, because i didnt want to take it anymore. I’ve been diagnosed as hormonal, and my symptons are: trouble falling asleep and staying asleep, weight gain, light mood swings, and low sex-drive. I found alot of positive information on bioidentical hormone replacement, but after reading your article, I too would rather this be my last resort. I do exercise and try to eat healthy, but keep gaining weight anyways. Before I stopped my period about a year ago, I weighed 109 – 111, now I weigh 118-120. (5’2″) Is there any other way to get my hormones balanced naturally? Will eating the right diet do this? where do I find the right diet? Should I take Bhrt? Please help~~This is all so new to me.
I am doing great with Biest.8:2Prog/5?200 and 1oMg of testosrogen. The problem and i do mean problem is that after having absolutely no libido I cannot stop thinking about sex I am going to the doctor to cut the test, in half. I look great for 54 most people think I am 38 and I have not gained weight. I sleep great, have 0 hot flashes and of cousre am more muscular.
PS, Don’t tell anyone mt age as I lie…..
Hi Debbie,
There certainly are ways to get hormones balanced other than using bioidentical hormones. In some cases they may be necessary, but in the patients I see, they are the exception. Eating well is definitely necessary to balance hormones, but usually diet alone is not sufficient to fix the entire problem. The right diet is somewhat individual in regards to what foods NOT to eat. However, it can be generalized that sugar and processed foods need to be avoided for (typically) all people trying to regain health, or even maintain health.
I don’t know enough about you to say whether or not you “should” take Bio-HRT; and I certainly couldn’t make specific recommendations without examining you and seeing test results. And again, I almost, if not always try a more conservative approach before starting with hormones.
Being that this is all new to you, I’d say you need to find a licensed, competent health care practitioner that you trust. Perhaps a referral is where to begin.
Good luck with everything,
Dr. Rob D’Aquila
hi im 50 years old i started bio identical hormones its been about 4 months i have pellet put in i also get a b-12 shot when i go back in june im not sure if that was the right thing to do .i was feeling better at first im feeling like im haveing the same sign again which is mood swings lots of weight gain very tired doing the day very depress i do take anti-depression pill which is zolft wellbrtuin in abmien to help with sleep.just dont feel like my self dont know what to do .can you gave me some advice
Hi Teresa,
I cannot give advice to anyone who is not a patient and signs a consent form, along with a HIPPA form.
Also, I don’t have much information to go on and speak generally about your symptoms. But obviously it sounds as if your treatment is not going the way you’d like it to.
If it were me, I’d speak to the prescribing physician and if I still didn’t get what I thought was a competent response or change in treatment, I’d seek another (competent) practitioner.
Wish I could be of more help.
Good luck with everything,
Dr. Rob D’Aquila
Hi Esmi,
It is my opinion that a person go to a doctor who is competent in using bio-identical hormones, endocrine physiology, and the best methods of testing and interpreting those tests. I can’t see why it would matter who gives you the hormones, assuming it is in their scope of practice to do so the way you are describing.
Personally, I’d use a sub-lingual route. But again, no matter what the route, it needs to be done properly. Creams are almost always a problem and the worst route.
Best of luck,
Dr. Rob D’Aquila
I am interested to know if its possible to balance hormones by using nutrition, homeopathy, herbal remedies, and practicing, Tai Chi or Qi Gong during/post the menopause? There is no hormonal imbalance, at present.
Same question for my mother who had a full hysterectomy, including the ovaries.
Many thanks
Hi Rainbow,
I/my patients do it “all” the time. I presume “nutrition” refers to diet and nutritional supplements. It may be more difficult for someone who has had a total hysterectomy. Although, she may also be far enough past menopause that the ovaries are less important for producing hormones than the adrenal glands.
Best wishes to you and your mother,
Dr. Rob D’Aquila
Hi Dr Rob
I have been using bHRT for about 6 months. I started taking it out of desperation. I wasn’t sleeping, had constant brain fuzz, couldn’t concentrate – basically, I was unable to function. I run my own business so I had to do something.
Mind this hasn’t been without problems and I have ended up with some serious breast cysts – had a couple of FNA’s but am not confident they won’t come back.
I find the information that I am receiving from the Drs a little confusing and perhaps quite conflicting.
However, your comments reminded me of my intial concerns. When do I stop? The Drs assure me that the doses I am taking will not keep my cycle going. I don’t want to be taking these things long term. My initial plan was to take it to help me over a hump – how do I know when the hump has passed?
Over the period that have been taking them, I have stopped on serveral occasions and the symptoms began to return. The first symptom that comes back when I stop and disappears when I start is waking up with a headache.
thanks
Jenny
I am about to have a hysterectomy one week from Monday, i am hearing all sorts of “stories” about my hormones going out of wack immeadiately following the procedure and all the different ways to replace these hormones – what would you suggest is the safest route to go…medication, bioidentical or herbs (natural – if this option is available).
Please help, becoming very nervous!!!!
Hi Meg,
It’s impossible to say what would be the best route for you at this juncture. We don’t even know how you’ll respond to the procedure; and won’t until the procedure is finished. If it were me, I’d get several opinions from competent practitioners who are familiar with and use different approaches – including lifestyle. I’d also try stress reduction techniques to calm the nervousness.
Good luck,
Dr. Rob D’Aquila
Hi Jenny,
Your concern of when and how to finish treatment is an important one. Some doctors don’t take this into consideration when beginning treatment. So in essence, sometimes there is no treatment “plan”. Does your doctor have one? Shouldn’t you be asking the question you posted to him/her?
Regarding the “hump” you speak of, there are really only two options. A) you surpass the “hump” or B) or you don’t. It’s hard to say how long a person will take to respond to treatment. And if a person is not on the right hormones, “delivery system” for those hormones, and/or doses – the treatment won’t work well. Lab tests can help determine progress, but your signs and symptoms obviously need to be taken into consideration; especially because the tests can all look normal, while the patient still has symptoms.
Here’s how I see it. If you never addressed the underlying problems that first caused the symptoms to appear – you may never get over it, and if you do get over it with hormones, that “hump” may reappear after you stop taking them.
Good luck,
Dr. Rob D’Aquila
What is your opinion on Bio identical Hormone therapy in pellet form? Have consultation next week and am very confused
Hi Maria,
I prefer sub-lingual pellets or sub-lingual liquids. It’s the creams that I wouldn’t touch with a 10-foot pole!
Good luck with the consult – always ask questions. Always get a prognosis and treatment plan. And of course, periodic re-evaluations.
Best,
Dr. Rob D’Aquila
I’ve never heard of sub-lingual pellets, and I thought I’d heard of every imaginable HRT available since my complete hysterectomy nearly 18 years ago ( and have tried all of them!). I am now 50, and have recently (3 months ago) been going to a new practitioner who has given me Nature-Throid, 32.5 mg., for my hypothyroid symptoms, with a TSH level of 3.5. I began to feel much better about a week on this. She also gave me the bioidentical HR cream of Test/Est/Proges, which seemed to work great for the first several weeks, but now I am experiencing hot flashes worse than I’ve ever had before, along with night sweats! I’m also getting acne on my face, which I haven’t had in over 20 years. All these symptoms just started about 3 weeks ago. I have an appointment in one month from now, at which time I will have another complete adrenal and hormone blood tests drawn. She also put me on a preservative-free daily multi-vit., B-6 complex, and DHEA. I take St. Johns’ Wort 1 or 2 times daily (started this as an alternative to prescription anti-depressants which I never did take because of the feared side-effects). I eat healthy, and excercise about 3 times a week. I am not overweight, as I have lost 20 pounds in the past 3 and 1/2 years – mostly due to stress at the time, then I got braces on my teeth, and have had some stomach issues related to the stress (no ulcers found with scope). About 2 months ago I began going wheat/gluten free, as suggested by my doctor, because of some of my tummy issues. This seems to have cleared up a lot of the stomach problems I had been having. But the biggest problem now is the severe – almost constant – hot flashes, and night sweats.
I’ve been reading a book called “Balance Your Hormones, Balance Your Life”, by Dr. Claudia Welch, MSOM, in which she talks of warm oils massages which many claim alleviate hot flashes. Is this something you’ve heard of or would recommend? If I remember correctly it seems it is suppose to “heal” your adrenal glands. I’m about ready to try this. Anything that will help.
Back to the hormone thing and my age: of course I’ve been experiencing the low libido, vaginal dryness, and lack of response during sexual relations, and my doctor has also given me vaginal suppositories for this. She then prescribed an Oxytocin sublingual “melt” for me to use an hour before relations (which is sometimes difficult to pinpoint).
Also, for about the past 3 weeks, my hair is beginning to come out profusely again (something that was a real problem for months before starting on the Nature-Throid, but slowed down significantly after starting it), and I’ve noticed my fingernails are becoming more brittle again. Also some increased hoarseness, and more fatigue during the day. I believe I read in one of your answers to someone that you have to keep increasing the dose to maintain the same level of symptom relief, if I understood correctly. I suppose I will find out when I have more blood work done in a month.
Any suggestions? I’m open to almost anything!
Thanks, Edith
Hi Edith,
You certainly are on a lot of hormones – thyroid, estrogen, progesterone, testosterone and oxytocin. I don’t know your full history with lab results and haven’t done an exam, but my question is: “Why isn’t your body able to make what’s necessary?”; and “If your body is making what’s necessary, why do you still have so many symptoms?”. Of course, there are cases where bHRT is warranted…
As far as the TSH, 3.5 is within normal limits based on the labs I see and use. A good range for TSH is 1.8-3.0, but regardless, prescribing thyroid hormone based on symptoms and a TSH of 3.5 is a bit much in my opinion. It doesn’t sound like the cause of your thyroid imbalance has been determined.
That said, has the cause(s) of any of your imbalances been determined? Have you simply been prescribed hormones because of your gender, age symptoms, and hormone lab values? I understand that hormones can help and be necessary and get people out of a crisis… That said, I’m not saying the wrong treatment was given, I don’t know the whole story.
I’m not familiar with using massage oil for hot flashes or adrenal fatigue. And even if they do provide some help, the cause of your hot flashes and/or adrenal fatigue is certainly not a lack of being massaged with a particular oil. Again, it’s great if it helps, but it really sounds as if you need to figure out what’s causing the issues that are surfacing.
As far needing to increase the dose to maintain symptom relief – I’ve seen that be the case, but it won’t always work in the long run. I’ve seen it mostly with thyroid, testosterone and progesterone replacement. However, one can’t simply increase these doses forever. Somewhere along the line the person reaches a tipping point and increasing the dose doesn’t help. The reason for this is because the underlying issues were never dealt with.
In cases similar to yours, I’d be searching for some causes to these symptoms and wouldn’t be comfortable with a physician prescribing (many) hormones simply because the levels are low (and/or because of age, gender, and symptoms).
I hope this helps,
Dr. Rob D’Aquila
Why wouldn’t you touch creams with a ten foot pole? I have had nothing but great results. I am off the coach. I have a sex drive again. I no longer have night sweats. I am in great shape. I really wnat to know why my experience is so positive yet all these posts are of concern. What am I not getting? I am living proof as are friends on the creams and T3/T4 that this treatment works.I have to agree with Suzanne Summers and look at her.
Hi Sheila,
Please see this article for my take on creams – http://robdaquila.com/2012/05/21/complications-associated-with-bioidentical-hormone-creams/
Best,
Dr. Rob D’Aquila
I have read your article but before I took the BIO Creme I could not get off te couch, had no energy, no libido, etc. I think that is probably harder on my heart then taking a small amount of estrogen, progeterone and testosterone.I now work our have energy, a sex life and my life back. Are you saying I am in danger?
I have low blood pressure, don’t eat hardly any carbs no meet.
I use a well respected compounding company in Calif. I still don’t get your concerns.
Sheila,
I am not at all saying you are in danger. I expressed my concerns, thoughts and experiences with people taking hormone creams in the article I previously linked to.
You should speak with the prescribing physician if you have any concerns.
Thanks,
Dr. Rob D’Aquila
I’m interested in knowing why you wouldn’t touch the bio id creams with a 10 foot pole? I just started them and am looking for answers on side effects. I am having a little ovarian tenderness and slight cramping. I’ve had 6 years of wild hot flashes, took the genetic test to find out I don’t have the breast cancer gene and started the bio id cream.
Kristi
You will have tendeness in your nipples. I have been on bio indentical hormones for 3 months and have my life back.I am off the coach., having sex again, losing weight and no longer depressed as i could not get off the couch due to exhaustion.I take estrogen, proestregen and testogerone. I had spotting at first while I was getting used to them but am really happy and look great. I am going to lower the testrogen as I am too horny.LOL
Hi Kristi,
When it comes to creams – the typical response I see is overdose of the hormone. Once the person gets tested (appropriately), their levels show extremely elevated. Obviously, the amount of time that the person has been taking the cream will play a role as to how overdosed they actually become. Additionally, it’s said that the hormones tend to build up in the subcutaneous fat and the hormone gets released at random.
The problems with overdosing are basic imbalances of the hormone of itself, that hormone in relation to other hormones (proper ratios are thrown off – which will affect the way other hormones work), receptor site down-regulation of that hormone (which affects that hormone and can also affect the way other hormones work because some hormone’s action(s) are dependent on others), and then there is dealing with clearance or detox of the overdosed hormone.
Hope this helps,
Dr. Rob D’Aquila
Hello Dr D’Aquila,
I’m stunned that you have taken time to respond to so many posts. How incredibly compassionate of you! I know NYC well and can picture where your office is precisely. If I lived there, I’d be your patient! As it is, I live in LA and know Susanne’s doctors quite well. They both take the bio-identicals and have urged me to do the same. I’m terrified, as I’ve seen personality changes in both of them.
That said, I am suddenly in peri-menopause. I cry/rage/bloat/sweat/mood swings, etc. I went to my long-time Chinese herbalist and whatever he gave me seemed to work for the month I had the herbs, but one must return for a whole new customized prescription every month and that’s expensive and may be solely the placebo effect. I’m wondering about your opinion?
A New York doctor prescribed me diethylpropion and hydrochlorothiazide years ago for weight gain and I can easily wrangle another prescription – it works like a charm on the middle aged weight gain. But the heart palpitations are overwhelmingly terrifying (and apparently permanent) and the withdrawal symptoms are literally life-threatening, so I’d LOVE to find something that helps me lose the chub AND stabilizes my hormones. My cycle has always been just 24 days like clockwork – still is – although now it lasts for 9-10 days!!! this means I’m almost always in hormonal flux.
What do you recommend in general? I am an active woman (4 hours crew rowing per week), I eat right except for 5-6 days per month when I am so emotional I will drive past Whole Foods to buy cheap candy or cookies – and thus I never lose the spare 18 lb. I’m afraid to try HRT because I’m sure my ego will get addicted instantly. The alternative seems to be liposuction and then locking myself in a padded cell until this passes! Your perspective would be SO appreciated. Thank you for helping all of us.
Hi Susan,
I apologize for the time it’s taken me to respond to your comments and inquiries. It just so happens I’m traveling in LA right now.
If you’re ever in NYC, stop by! I’m two doors down from Carnegie Deli.
I have no idea who Suzanne Somers’ doctors are, and can’t comment as to there competence or individual recommendations.
As far as the Chinese herbal recommendations, it’s hard to say if they were appropriate, though it sounds like they helped you. Do keep in mind that it’s common to need more than one month of treatment in order to get everything balanced out; and the time-frame would also depend on the extent of the imbalances. Also, if it were me, I really wouldn’t care if it were a placebo effect or not, as long as I felt better. Then again, it would be nice to know that things are on the right track.
In general, I recommend the following:
1 – drink enough pure, clean water
2 – keep blood sugar metabolism optimal
3 – make sure digestion is optimal – i.e.: eliminating an overgrowth of any yeast, bacteria, viruses, and certainly parasites; eliminating food sensitivities; having a proper amount of HCl and enzymes; and making sure “leaky gut” is not an issue
4 – get liver and gallbladder function up to par
5 – eat adequate amounts of protein
6 – get stress hormones under control and balanced (whether too high or low)
7 – exercise if you’re lifestyle does not include enough activity
8 – make sure thyroid function is optimal
9 – get and keep the structure of the lower extremities and pelvis “in order”
10 – work out any underlying emotional issues (conscious or not) that may be causing physical symptoms.
11 – make sure the immune system is balanced
Many times all of these points don’t need to be addressed individually, however it may be necessary.
I hope this helps – and as you know, it’s hard to be specific with a person’s needs when I don’t have the full picture (e.g.: lab tests, exam, etc..). And I can’t offer specific recommendations to anyone who is not a patient.
Good luck Susan!
Dr. Rob D’Aquila
You say “change of lifestyle’, what would that change be? I understand a healthy lifestyle, that has not changed my low hormone levels. I do not eat sweets. I eat sprouted wheat bread, lots of fruit and greens, still have the outrages weight gain after going to the gym two or three times a week and having an active life with friends and small child still at home???
Dr. Rob,
I found a Dr. in California who finally gave me something for liver detoxification, I will continue to seek him out. You give very sound advise, I wish I had listened to you a veyr long time ago. Things got worse for me. I am in search of someone local that can help me. Thank you again.
Yvonne
Hi Yvonne
Thanks for your comment. I truly hope you find the help you need.
Take care,
Dr. Rob D’Aquila
Hi Yvonne,
The change of lifestyle would depend on what the person needs. Nothing is cookie-cutter, at least from what I see. Everyone needs healthy blood sugar regulation, and fruit can be a problem for some. Wheat, whether sprouted or not, can definitely be a problem. And that’s whether or not a standard blood test finds true celiac disease. Everyone needs adequate protein and healthy fats. An active life is great, a healthy diet is great, but keep in mind that there can be an existing functional (i.e.: not technically a disease process) issue that needs to be dealt with – whether in the liver, the adrenals, the thyroid, the female endocrine system, the gut, etc..
Best,
Dr. Rob D’Aquila
I did the bio Identical Hormone replacement therapy for 1 year. My last pellet implant was in June. Back in April my husband noticed that I was hunching in my sleep. I was getting estrogen and testosterone and B12 shots. Are these possible side effects?
Dear Dr. Rob,
Your information is interesting, but I miss the most essential information: The dosage of BHRT applied.
As far as I know most, if not all, problems related to hormone replacement therapy are caused by application of (too) high doses.
For instance suppression of your own hormone production does not occur if low doses of BHRT are used. The same holds true for hormone receptor insensitivity. You also mention that yourself as you write ‘when bombarded with large doses of a hormone’.
So the answer needs not be to totally avoid using BHRT, but to make sure that doses are low enough to be safe to make sure that dependency does not occur.
For instance, what dose of testosterone does the patient you describe in your article use. And what kind. Without that essential information what you write is not of much use for the reader.
I use BHRT in low doses prescribed by a world-famous hormone specialist and anti-aging doctor called Dr. Thierry Hertoghe from Brussels in Belgium and trust his very extensive expertise and experience in this field.
I think it is good to not use hormone therapy if there are alternatives that work. I respect that approach, but as far as I know BHRT are safe when applied at appropriately low doses.
Best regards,
Jeroen Buis
Hi Jeroen,
Thank you for your excellent, very informative comment! You make great points, and I am very appreciative.
For the case I mentioned, it was a testosterone cream, and therefore “you” can be sure that it was overdosed, as that’s what happens when most if not all creams are used.
I certainly didn’t go into every possible scenario that could happen. As you know, I’d have to write an entire book on the subject, as others have.
The reason I focused on the downsides is because that’s the usual scenario I see with people. Additionally, this article is THE MOST read on my website, pointing more towards the extent of the problem.
I did qualify that there are certain times and applications when BHRT is helpful. I’m not at all against it. The problems arise when people don’t make the necessary lifestyle changes needed to fully help support their endocrine system and then begin BHRT expecting to “fix” all their problems. What I see is people looking for a magic bullet, not changing their lifestyle, going on BHRT and then falling apart. They suffer partly because of the dose, but also because they are perpetuating the problems with not changing their habits (mainly dietary and stress), and also using creams.
I totally agree that BHRT can be safe and is often necessary, especially if there is an antibody reaction by the immune system to the glands that produce the hormones that are needed. Additionally, synthetic HRT can be fine too, but I’ve only seen that with thyroid hormone.
Thanks so much again for your great comment and bringing more clarity to the issue. Hopefully all my readers see your comment.
Take good care,
Dr. Rob D’Aquila
Dear Dr. Rob,
I see that I posted my last comment two years ago. That was in the beginning of the BHRT and when I did notice the positive effects. Over time my doctor kept prescribing me the hormones and despite rising hormone levels (DHEA, testosterone) the dose prescribed stayed the same or even increased.
That’s when I started to wonder. I started BHRT to stay healthy, not to keep the hormone level of a 30-year old. Even though that seems part of the anti-aging idea. And I was certainly not planning to keep taking hormones till the end of my life.
While in the beginning the hormones gave me more energy, about 6 months ago I became more and more stressed. Very agitated and shaky and I started to sleep worse rather than better. Then my acupuncturist questioned my hormone use. I then used 1 g of testosterone (cream), 20 mg of cortisol, 25 mg of DHEA and 0.2 mg of sublingual melatonine a day.
I googled the internet and found people with my symptoms blaming DHEA. I stopped using DHEA and started to feel much better. My acupunturist advised me to stop all hormones. Over some time I brought down my cortisol intake to 5-10 mg a day, testosterone to 0.5 g a day and melatonine to 0.1 mg a day.
I’ve been taking this for 3 months now and generally feel good. But I still don’t like the idea of being dependent on 3 different hormones.
Would you advise to further decrease the dose or stop (certain) hormones? What hormones would you most advise me to stop using because you think are most easy to get dependent on or have most effect on slowing down the bodies own production?
I’d be most concerned about stopping melatonine. I’ve never been a great sleeper and it does help me to sleep. Actually, if it is healthy, I wouldn’t mind taking this one for the rest of my life. Also because the cost is low (at my current use some 50 euros a year).
I can also imagine using hormones at certain times. For instance cortisol at stressful times or testosterone when doing lots of sports. What would you advise and what lifestyle changes I could make to stop needing these hormones?
Your reply is greatly appreciated. Kind regards,
Jeroen Buis
______________________________________________________________________________________________________
Hi Jeroen,
Sorry to hear about what you’re going through, albeit not surprisingly…
You’re definitely right about the idea that a person shouldn’t try to maintain hormone levels of a 30-year-old when they “age”. The healthiest outcome for anti-aging regarding menstruation and hormones would be a woman who naturally regains her menstrual cycle after having lost it “early”. I stress “naturally” without the use of hormones.
I certainly can’t make any recommendations to you specifically because I haven’t examined you, don’t have a big enough “picture”, and most importantly, you’re not a patient of mine. I’ll continue with generalities.
First, my take on hormone replacement creams – see here – http://robdaquila.com/2012/05/21/complications-associated-with-bioidentical-hormone-creams/
Secondly, I would NEVER supplement someone with cortisol. There are too many known detrimental side effects, especially bone loss. OK, never say never, but regardless, if it was supposedly “indicated” due to extremely low levels, there are probably other things to address, and other compounds to give to raise it without supplemental cortisol.
As far as melatonin goes, there is usually an inverse relationship between cortisol and melatonin in healthy individuals. I may have suggested melatonin twice in my career. I think it’s best saved for traveling between time zones, or just temporarily to get someone “back on track”, while working on the main issues which should naturally restore melatonin levels. That said, it’s probably one of the more benign hormones to supplement with.
With DHEA, again, it may be indicated in extreme cases, but the reasons for its decline should be addressed simultaneously with the goal of getting off it completely. It can have profound initial beneficial effects. But again, in my opinion, the goal should be to eventually eliminate it.
Lastly, I’d run all hormone levels again, and hope for finding a practitioner competent in addressing the root causes of the imbalances – although with someone who has been on HRT, the hormone levels will obviously be skewed… Even though, looking at signs, symptoms, and all lab tests should be useful in recommending necessary lifestyle changes to balance hormone levels.
Best of luck!
Dr. Rob D’Aquila
Hi Kim,
I’ve never heard of “hunching in my sleep” as a side effect of hormone use. But anything is possible. One motto I practice with is: “anything can cause anything”. Good luck, and you should seek the help of a competent, licensed health care practitioner.
Dr. Rob D’Aquila
Hi Dr Rob, I have recently started Bio Identical Hormone Therapy (not widely re commended in Australia it seems) due to being post menopausal and having absolutely NO libido – I am only 47. All my hormone levels (measured via blood test) were way below the minimum normal level, and my testosterone was so low it was not measurable.
My GP was skeptical so I found a Dr who was pro BHT. 8 weeks in I have developed a very “sensitive” vagina and it seems larger or puffier. Is this normal? Right now I don’t want my husband to go near me which kind of negates the reason for starting the therapy in the first place!! Is this something that will balance itself out or is my prescription out of balance?
I appreciate your time and look forward to your feedback.
Hi Jo,
If your blood tests were “way below the minimum normal level”, then you can be sure there is a problem.
Your symptoms don’t sound as if they are “normal”. And as you said, it’s certainly not helping the reason you started BHRT.
I can’t make specific recommendations as far as treatment. However, if you were my patient, I’d take a thorough history and do a thorough exam along with more tests to try to determine a mechanism for why the levels are so low to begin with. There can be many and in any patient, they should always be addressed whether or not BHRT is working.
Hope this helps.
My best,
Dr. Rob D’Aquila
Hi Dr Rob
What constitutes a low dose? I have gone of the BHRT because I had side effects. The practicioners response was to increase the dose, which made things worse.
I am guessing that low dose is a dose to which there are no side effects.
Regards
Jenny
Hi Jenny,
It’s hard to say what a low dose is. It’s an issue of biochemical individuality. Testing hormone levels is certainly necessary to help determine the dose.
Side effects can be for many reasons. One of which can be fillers in the supplement, although that’s much more common in thyroid hormones.
If I saw side effects with a dose, I can’t imagine I’d increase, but then again, I don’t know your case history and presentation.
If I was taking them personally, I would start at the bare minimum and increase the dose until the desired effect was reached. But that’s with me. I can’t say with you. Additionally, I’d get all lifestyle changes in place first. Those would include diet and stress. And as mentioned, I prefer not to start with BHRT. But that also depends on how symptomatic the patient is, and how awry their physiology is to begin with.
Good luck,
Dr. Rob D’Aquila
Dr Rob,
So grateful to happen onto your site…was on the verge of spending 400 dollars to have hormone levels tested, then even more for the bioi hr. Like so many others, was desperate for a full nights sleep, return of libido, etc.
History: 58 years old, on climara patch 3 years, slowly weaned off as of feb.2011. have been administering low dose progesterone creme (over the counter, from health food store), and trying valarean root and D3 & lemon balm sleep formula. I guess my first step is off the cream? what can i do to support my system during this process? I strive to maintain a healthy lifestyle, ie healthy diet, exercise, yoga, prayer. Your input would be greatly appreciated. Deb G orange,CA
Dr. Rob,
I live in a small town, but within a 90 minute drive of three large cities in Middle Tennessee. My problem is in finding a competent practitioner that can assess all of these issues and guide me along the path to wellness. I have struggled with depression for most of my life, and have found very little help in traditional medicine. I am currently on cymbalta, but am so tired and foggy all of the time. I have tried several anti depressants as well as ADD medications. I have an appointment to see a doc about BHRT this week, as I am open to trying anything, but am very apprehensive about throwing more chemicals into my very sensitive system.
Ideally, I would like to find someone like yourself who looks at the whole body and how all the systems work together. I read about Dr.’s like yourself and others, but don’t know how to find one that is in my area. What types of questions do I ask? What should I be looking for?
Thanks so much for your time and commitment to health.
Sincerely,
Mandi
Hi Mandi,
Finding a competent practitioner to walk you through everything is important. So indeed, it is a problem if you can’t find one.
If I were looking for a practitioner, I’d ask them to describe the mechanisms and physiological processes that justify the recommendations. Also, I’d be VERY careful if no lifestyle recommendations are suggested.
I’d also ask what the plan is, and why/how it will work.
Your symptoms of being “foggy” and a history of being on psychotropic medications suggest neurological/neurotransmitter involvement in the brain. The brain is a commonly overlooked area that needs attention.
Lastly, a competent practitioner should be aware of how all the different systems in the body work together and affect one another.
Good luck and I hope you get help,
Dr. Rob
Hi Deb,
Glad you enjoy the site!
It’s always best to work with a competent practitioner. And it may not be a bad idea to have your levels measured to see what’s going on with your system. I often see liver clearance issues after people have been on creams or synthetics. And remember, sometimes bio hormones are OK. I just prefer to get the system up and functioning well first. That is: eliminate sources of inflammation (could be infections, toxins, foods etc.), get the digestive system working optimally (microbes, enzymes, gut repair, probiotics), make sure the liver, adrenals and thyroid are working well, and of course get blood sugar stable.
If the system isn’t up to par first – the hormones often work initially, but then the person slips further into ill health and it can be tough to recover.
Hope this helps,
Dr. Rob
Dr. Rob-
Thank you for your reply. I still wonder what type of practitioner I should be looking for. Chiropractic? Naturopathic? D.O.?
Thanks,
Mandi
Hi Mandi,
You’re welcome. Frankly, I don’t think the initials after the name matter. What matters is whether the practitioner is competent or not. He or she should understand functional endocrinology and its interactions with other systems (e.g.: neurological and immune) of the body.
Best of luck,
Dr. Rob
when a woman has a “radical hysterectomy” at age 23, gets off the synthetic hormone/estrogen replacement prescribed by the surgeon a year later (1974) and now at age 60 w/no ovaries in 37 years and no hrt ~ would she be a candidate for bio-identical hormone replacement therapy? the dr i have in mind is a specialist in it ~ does full blood panel work and states that statistically women who have a complete hysterectomy before age 45 “don’t live” as long as their normal life span would be. Hence the question: properly administered, after full blood work is done and competently analyzed, can bio identical hormone replacement therapy help stave off a premature demise for a woman who’s been without ovaries or hormone replacement for 37 years?
Thank you for your opinion on the matter.
Hi Sylvia,
She may in fact be a candidate. And she also would have been a candidate since the hysterectomy.
I personally would check hormone status via saliva, not blood. Free hormone levels are what work at the cellular level, and they’re much cheaper to be run via saliva.
There may already be a considerable amount of “damage” that has taken place if her hormones were very low since the hysterectomy. Those hormones affect many areas of the body.
Another area to consider supporting is the adrenal glands, as they produce “sex” hormones, and are especially important for peri- and menopausal women when hormone levels begin to drop off. The adrenals prevent the rapid decline in hormone levels, which is usually what causes all the symptoms and ill effects.
Hope this helps,
Dr. Rob D’Aquila
Dr. Rob,
I am a 30 year old woman and after being on birth control pills for several years I have completely lost my sex drive. My doctor told me that if I stopped the pills that things would go back to normal. No luck. I stopped my birth control in January and my libido is non existent. I have also developed bad acne since stopping the pills. I do not want to go back on birth control as I am worried about some of the long term effects associated with the pill. I have been looking into bio-identical HRT to get my libido functioning and eliminate my acne. Are there other, more safe options? It seems when I go to doctors they all promote the current “hot” treatment. I want to get back to normal but want to do it in a safe way. What are my options?
Thank you,
Jessy
Hi Jessy,
It’s not uncommon for people to have issues while on and after stopping birth control. It’s hard to say what the options are. The first thing to do is find the mechanism causing the issues. Low libido is often a result of low testosterone. The question is where and why is the problem there. No matter what type of treatment a patient goes with, diet and lifestyle should always be addressed in my experience. If those issues are not dealt with, the treatment usually won’t work or simply won’t last; and it’s possible that the main symptoms even go away, but others pop up. It’s always important to do lab tests, a good exam, history, and symptom survey to help identify what’s driving the problem.
Lastly, it’s not uncommon for the glands in the brain (hypothalamus and pituitary) to down-regulate after taking exogenous hormones.
Best of luck,
Dr. Rob
Hi!
I started BHRT in march 2011 with 1.25 Biest and 100mg progesterone and 10 mg DHEA orally once daily.
i did well for 4 months and then i started getting hotflashes, nodular acne on my face and anxiety and insomnia.
I started 2ml estradiol and 30 mg progesterone once daily at night time.
It has been 11 days and I still feel heart palpitations and anxiety during the day and early morning when i wake up.
how long does it take to get settled with the new regimen?
Would my acne get better?
When would my body get adjusted to one regimen?
How long can I take the estradiol?
What are the side effects of estradiol and what is considered a high dose?
I would appreciate your feedback.
tks.
Hi Femina,
You are asking very specific questions that are difficult to answer without seeing the entire picture: age, lab tests, history, exam, and symptom survey.
It sounds like it’s time for the prescribing doctor to run more tests and adjust your treatment protocol.
It’s also worth considering other issues that may be contributing to your symptoms, like thyroid and adrenal gland function.
Your age will also be a factor in determining treatment, and additionally, diet and lifestyle must be addressed.
The fact that you did well for 4 months, but are not anymore says to me that more tests may need to be run and you should ask your doctor about what to do; and if he/she feels it’s the right protocol even though you don’t feel good.
Have you done that?
There can be many side effects of estradiol which can be easily be found by searching the internet.
Best of luck,
Dr. Rob
Hi Dr. Wow, you blog is very informative. I flew to Nevada to get tested, hair analysis, saliva testing and blood tests all totalling about $1500. I am almost 63, total hysterectomy 2 years ago, Type II diabetic taking Glucophage (hate the stuff) and taking 150mg Avapro for BP. I recently started taking CoQ10 and my BP dropped about 40 points… yeah:)
After all the tests came back, I was told, Immune, thyroid and most everything was normal EXCEPT, I was almost non-existant on the Human Growth Hormone. I am heavy so I have an abundance of “bypass estrogen. This Doctor is the one who treated Suzane Summers. He started me on Progesterone and Testosterone creams to balance out the Estrogen and give me more energy. I have not yet started the injections of HGH. I am so sensitive to so many things I wanted to do one thing at a time.
I started with DHEA, the first dose about killed me. My heart pounded for so long I swear I would never sleep or relax again. Didn’t take another one. Next, the Testosterone and Progesterone Creams. By the second day, I had very bad bloating, indigestion, very jittery almost panicky feeling. There are terrible heart palpatations and pounding, shortness of breath or more like labored breathing. I am very very achey all over like when my Fibromyalgia acts up. I have been waking up with headaches. I gained 6 pounds in 7 days. I am already overweight and can’t afford any more weight.
My Chiro is concerned. His adjustments help some but I can’t seem to get this to STOP?? Am I reacting to the creams? I am very nervous about starting the VERY EXPENSIVE HGH injections and will that be worse side effects? What’s a girl to do??
Terri
I am asking for your professional opinion on these issues. I just don’t want to go down a road and not be able to get back.
Hi Terri,
You sound as if you are going through a lot and willing to do anything to help yourself, which I admire.
I can only give treatment advice to patients. However, if you read some of the comments of mine and others above, you’ll see my take on creams. Also, with all due respect, I personally would have very little faith in a doctor who is prescribing hormone creams if I had your condition. I don’t claim to know everything, this is what I’ve learned and seen with patients. Local applications for certain body parts may be appropriate, but again, I feel and see they are not appropriate for a systemic condition.
I also find that thyroid conditions are almost always “missed”. One of the main reasons is because Hashimoto’s thyroid disorder is overlooked. Hashimoto’s is ab autoimmune condition, which means it’s really an immune system “gone awry”. In these cases, the cause of immune dysregulation needs to be addressed. And thyroid hormone replacement therapy is sometimes necessary, although that alone won’t necessarily address the root cause. A patient will often have to address their general health, even if thyroid hormone replacement works well at the start of treatment. I have no idea if you have Hashimoto’s, and I certainly AM NOT diagnosing you. I am simply stating facts. Regarding Hashimoto’s, one test that shows negative antibodies does NOT rule out Hashimoto’s, because the antibodies are not always present. In cases where Hashimoto’s is suspected but antibodies are not found positive, a re-test should be run, even several times.
Autoimmune conditions are on the rise and when a person has an autoimmune disorder where the immune system has been identified as attacking a certain tissue, it’s always a good idea to check for antibodies to other tissues that the immune system may be attacking.
I hope you get the help and recovery you need,
My best to you,
Dr. Rob D’Aquila
Thank you for your reply regarding the hormone creams. I am inclined to agree with you 100% and have stopped as of today. The intense itching has slowed down some but the skip beat and pounding pulse are still present to a degree. I have only been on them for 5 days. I was also prescribed Human Growth Hormone injections as the saliva and blood tests show I basically am void of them. I am suppose to take one 50cc injection at bedtime. This is suppose to help with fighting my type II diabetes. Although, since my intense reactions to the creams, the HGH is sitting in my refridgerator. I just didn’t want to compound the matter.
I would value your opinion of the natural HGH. I got the creams and the HGH from a compound pharmacy in Nebraska…. suppose to be the best and naturally the purest. If I am void of HGH, is there any way I can get it back? Do you feel the injections are temporary… as you say to “prime the pump”. This is all very new and very scarey for me. I a such a “tender muffin” and really leary of so much stuff and “snake oils” I have friends that have gone to this clinic and the rave about it….. still skeptical me.
As for the Hashimotos and thyroid, I had Blood, urine, Hair analysis and saliva testing done and the thyroid was fine on all levels. I did the very high protien Atkins diet about 10 years ago and lost about 200 pounds. The trade off was massive kidney stones that required lithotripsy and type II diabetes. I would LOVE to eat primarily Vegan but all the Doctors swear I need all this protien. I honestly think all that protien is what gave me Diabetes.
At almost 63 and diabetic…. I am just looking for a CURE not a bandaide. I have been told I need to balance the hormones and the rest will fall into place. I ride my chopper 3 wheel bike at least a mile at night and walk on other nights. I eat primarily only grass fed poultry, fish and all organic veggie, eggs and raw milk cheese and almond milk. Great food, good exercise and still heavy with diabetes. I was so sure the hormones were the answer. I welcome any advise or suggestions you may want to toss my way. Thank you for being here to help others.
D’Aquila
Sir, I just came across your site looking for information regarding Bio-identical hormone replacement therapy; and I have enjoyed reading your site.
please keep me informed.
Thanks,
V/r
Amparo
Hello Dr Rob –
Just came across your website in search of BHRT info. After months of sleepless nights, mood swings and all the wonderful symptoms of menopause, I decided to take my MD’s advice and agreed to an appt with a menopause “specialist”. He took no tests, claiming that hormone levels change throughout the day, and any tests results would be based on the level of hormones at the time of the test and would likely not provide an accurate reading. He tried to talk me into conventional HRT, but having read so much about the risks, I refused to go that route. He then prescribed 180 ML Bi-Est 2.5 mg (7:3) with 6% Progesterone In EOC (whatever all that means) in a cream form. I took my first “dose” last night, and my second this morning. I now have a dull headache and am so cold, I can’t warm up. I also feel very jittery. Don’t know if this is related to the therapy. My concern is that he didn’t do any tests whatsoever, prescribed BHRT, but has no idea what specifically my needs are. I am 54 years old and just want to sleep. I really feel I could deal with the got flashes and moodiness far easier if I wasn’t so sleep deprived. I don’t want to take sleeping pills Even though I’m only 2 doses in- I’m seriously considering stopping. I’ve heard that accupunture can be really helpful for reducing symtoms. Is there any insight you could provide me with regards to this kind of treatment, and in your opinion, should I be seeking a new more thorough doctor? Also, does the BHRT formula prescribed make sense from your perspective? Thanks so much in advance for any help or guideance you can provide.
Hi Karen,
Well, first off, I have not found that testing changes to such a degree that would not make it useful. I am referring to saliva testing to be clear. Follow-up testing with changes that correlate (hopefully resolved) symptoms and hormone levels is enough for me to suggest they be run. This doctor may be quite skilled without testing, I am not ruling that out.
One thing I don’t like is when BHRT is administered through creams. They almost always overdose the patient, eventually leading to receptor site down-regulation and liver stress. This can clearly be seen on hormone testing. I will say though, just last week I had a patient who was on a hormone cream and her levels did not show overdose. It’s possible that creams are getting better but I don’t bother with them.
In some respect, I’d like to think that some sort of test(s) would be done to any patient. I can’t say there is no doctor out there who would be able to diagnose and prescribe successfully without ANY KIND of testing. Although I can say, if tests are available, why not use them. And let’s say hormone testing is invalid, one can still run blood tests for other basic markers.
This leads me to my next point. When a woman’s hormone levels naturally “drop-off” at peri/menopause and she experiences devastating symptoms, simply replacing them (bio or not) is typically not the answer from what I see. As I tell patient’s with PMS or peri/menopause symptoms, just because “everyone” experiences them – that doesn’t make it “normal”. I don’t feel females were inherently “designed” to suffer devastating symptoms once a month or later on in life. Then again, I didn’t “design” females.
What’s most often overlooked are the issues involving other organ/glands. This includes the GI tract, liver/gallbladder, immune system, thyroid, and certainly adrenals. All areas of the body need to be addressed, not just outright hormone levels. Doctors need to start asking the question “Why?”. Without asking this question, doctors can’t see the forest for the trees.
If I were in your shoes, I’d take up these issues with the prescribing doctor. I can’t say if you should see another doctor or not. I don’t know the person and their competence level. Additionally, I can’t say whether or not it’s the right prescription, because I don’t know enough about your case – i.e.: what your hormone levels are, and what other health issues originally caused you to “need” BHRT.
Good luck with your health – I hope you find some solutions,
Dr. Rob D’Aquila
Thank you so much for all the valuable information. It’s obvious that you truly care for what you do and for those who look to you for guidance. You take time to thoughfully respond to us who come with sincere issues, looking for a second opinion or your knowledgable perspective on what ails us. And you do it here for no self gain.
Thanks again. The world could use a few more like you.
Dr Dr Rob,
I’m 52. Very fit and healthy, but I suffer from migraines for 25 years. I take no medicines except for migraines, as needed. I can endure hot flashes, and mood swings, but there was a marked increase in my migraines which I considered hormonal. I sought a solution with bioidentical hormones. I’ve been taking bioidentical progesterone for 2 yrs now and now since my estradiol measures < 5, and testosterone 6; I have started the estrogen and testosterone this week. Meanwhile, my medical doctor has resolved my migraines with a preventive medicine. Your article concerns me. Three questions/advice, please:
1. I don't want to be on ANY medicine for a lifetime. HRT was not a last resort for me. I don't want to screw up my normal system functions. Should I get out now?
2. Is <5 Estradiol a problem that needs to be addressed?
3. Did the progesterone have a decreasing affect on the estrogen level?
Thank you, Maria
Hi Maria,
1) I don’t know enough about your case (history, symptoms, lab results, goals) to say whether or not you should continue with the treatment you’re on. And, I’m obviously not the prescribing doctor, nor am I your doctor, so it would be completely inappropriate for me to suggest a course of action.
2) Nothing can be taken out of context. I don’t know where you are regarding menstruation/peri-menopause/menopause so it’s hard to say. Additionally, no hormone should be singled out. All the hormones should be in balance with one another; and therefore ratios can be helpful in determining where the problem lies, if in fact there is one.
3) It is possible that (too much) progesterone could have an impact on estrogen levels. Although that’s hard to say considering I don’t know where you levels were to begin with.
Good luck,
Dr. Rob D’Aquila
Hi Dr. Rob. Your website is an absolute blessing. At age 61 and having my last period, almost hemorrhaging, at age 31 (I was under incredible stress at that time) I finally started on BHRT . I’ve been on it for about two weeks now. Changes have included breast tenderness and menstrual bleeding for about five days. My hormone levels for both prog. and estrog. were in the negative, lower than my doctor has ever seen. I had a tubal ligation back in 1979. I actually do feel more balanced after having depression for many years and no libido. I am overweight and do not exercise which I am working on now to change. After reading all of your information I am hoping I’ve made the right decision to be on BHRT. It is monitored by my doctor. This past May, after no previous history, I had to have a pacemaker put it. My doctor is closely monitoring me, starting me off on very low BHRT doses, including a very mild thyroid pill since I’ve not been able to loose weight. My cortisol levels are fine. My recent mammogram was good. What to you suggest?
Hi Donna,
Thank you for the nice comment about my website.
It sounds as if you went on bHRT because of the test results alone. Did you have other symptoms? What was the purpose? These are questions you should ask the prescribing physician.
Additionally, I don’t feel anyone should be put on thyroid hormone until all the appropriate lab work is done. There can be many reasons for an inability to lose weight.
Cortisol is best measured through a 4-sample saliva test – not through blood.
I suggest you monitor your menstrual bleeding considering how long it’s been since you’ve had your last period.
Also, it would be wise to check salivary cortisol and run a battery of thyroid tests to see if your thyroid is malfunctioning and if it is, find out why, through those tests.
Good luck,
Dr. Rob D’Aquila
Dear Rob,
Again I would like to thank you for your great generosity in responding to questions. I am a 56 year old woman with insulin resistance which is managed with 1500mg metformin daily. My periods have been erratic for 2 years and the last was in June this year. Due to the IR I have struggled with weight gain but for some years now it had been stable. I eat well and exercise moderately (hill walking for up to 8 hours per week). Since the beginning of the year I have had severe hot flushes (up to 15 a night) leading to severe sleep disturbance and exhaustion. My GP cautioned against HRT because of a history of bladder cancer. However I commenced bio-identical HRT a month ago (.25mg estrogen, 150mg progesterone – sub-lingual) and had almost instant relief from the hot flushes. However I have gained over 4kg in weight in that period (with no significant changes to diet or exercise), am experiencing sugar cravings for the first time in my life, my libido is parked in a freezer somewhere and I am even more exhausted than I was waking due to the hot flushes! I’m thinking that I need to consult an endocrinologist – would you agree?
Many thanks.
Hi Anne,
I’m glad to help in the capacity I can. Thank you for expressing your gratitude.
I would definitely agree that consulting an endocrinologist would be a good idea. And, don’t necessarily stop at just one. You can also consider a competent “functional medicine” doctor.
Additionally, I find it extremely rare that anyone’s symptoms (whatever they may be) get resolved without stabilizing their blood sugar. And considering that a peri/menopausal female needs strong adrenal glands to “take over” the job of the ovaries in hormone production; blood sugar definitely needs to be stabilized. I say this because you can’t “fix” the adrenals if you don’t “fix” the blood sugar. Focusing only on certain organs/glands can cause one to “miss the forest for the trees”.
I wish you well in your search for health and happiness!
Dr. Rob D’Aquila
Dear Dr. Rob,
I have learned so much from your website. Thanks for taking the time respond to those of us in bewildered states of life. I am 56 and had a complete hysterectomy at age 45 due to advanced endometriosis. They started me off on the patch after surgery, due to reactions to the adhesives, I was switched to estrogen pills. After experiencing no libido, testosterone pills were added. I took this regimen for years, then suddenly hot flashes plagued me and I was given monthly injections for years, never receiving progesterone. While on the shots I developed severe pelvic floor weakness and at times needed to be in bed. Physical therapy only made it worse until I found one who helped me learn to relax pelvic muscles instead of tightening them with Kegels. This helped a lot, still I was unable to carry anything and occasionally bedridden. 2 years ago the shots no longer worked for me, I developed a continual hot flash and my hormone blood work up showed zero, In addition I thought I was going crazy and began to hear the strangest things. My GYN advised me to start bio-identical hormones. I was interviewed by a specialized pharmacist who asked about pelvic floor weakness and if I was going crazy, with out me introducing the topics. I was started on Estradiol/ Progest cream 2x/day and testosterone/estradiol vaginal cream, which I take every other day. Within a week my physical therapist was ecstatic concerning pelvic floor muscle tone and I was relieved with the disappearance of strange noises. Occasionally I would have a hot flash. I take test. vaginal cream once every 2 days or it causes sexual nightmares and dark upper lip hair.
6 months ago blood work showed I had very low progesterone, so that was increased in my cream.
Now 2 years after starting BHRT I have a lot of hot flashes and unable to sleep. I do not sweat with mine, but develop what I call chimneys which are areas on the head, shoulders and back where an extreme amount of heat tries to escape. Also my hair is getting really thin and I am quite anxious, although thankfully not hearing things! I am thinking I’d better get in for a hormone test, sounds like I should ask for the saliva one instead of the blood draw.
My Questions:
1. Why do you not prefer the cream and what alternative is there?
2. It is frightening to think that my receptors may be closing their doors to BHRT, is there any other alternative besides increasing the dosage?
3. My GYN-PA says I’ll have to always be on BHRT to avoid the “crazy” part. What is your opinion? I am quite afraid of this aspect reoccurring.
4. I am concerned about transference to others. After applying the cream to arms or thigh, how long before it is no longer able to be absorbed by others?
5. And what about transference vaginally? Is it necessary to douche or something before intercourse? I don’t want my husband to be affected.
6. Why is the saliva test best?
I thank you again for making your wisdom available and very much appreciate your time with my questions!
Sincerely, Kathy
Hi Kathy,
I’m glad you learned so much from my site! Thanks for the comment. It sounds like you’ve certainly been “going through it”. As far as your questions:
1) Creams can build up in the subcutaneous fat and then cause the hormone to be dispersed at random. Additionally, almost every time a person takes a cream, they wind up overdosing on that hormone, which can easily be seen via saliva testing. So basically, it’s very hard to give specific doses with creams. Sublingual liquids or pellets are a preferred alternative.
2) Receptor down-regulation can be helped. There are certain nutrients that receptors require to function and they can “run out” if the receptor has been “working overtime”. The key however is to figure out what systems need balancing, and why there is a hormone imbalance to begin with. If that’s done well, hormones are not always necessary.
3) I’d like to think your GYN is wrong about “always” needing bHRT to control your mood. Very often, neurotransmitter support is necessary in mental/emotional symptoms. Also, emotional therapies may be warranted.
4) That’s a very good question, and was the topic of a “House” episode I recently watched. Although the gentleman wasn’t using bHRT cream in the episode…
I really do not know the answer to that question. Another drawback to using creams?
5) Again, I do not know the answer to that question.
6) Saliva is preferred because it measures “free” hormone levels. Free hormones are not bound to a protein, and the free hormone is what works on the cellular level, because it fits into the receptor. You can run free hormone levels via blood, but it’s quite expensive comparatively, and most physicians do not order “free” hormone levels in blood. They simply measure the protein-bound hormone which doesn’t tell enough of the story.
Good luck with everything!
Dr. Rob D’Aquila
Hello Dr.Rob,
I am 53 and a very intense athlete..I have been doing bioidentical creams for over five years now, and now have NO libido..It is really hurting my relationship with my husband , as you can imagine..I’m afraid that because I’ve been on bioidenticals for so long that my body won’t produce it’s own hormones any more.I don’t know what to do ..I really want my libido back.
Thank you ,
Renee
Hi Renee,
It’s very possible that your body is having trouble making its own hormones after five years of being on creams. Creams usually cause an overdose of the hormone as well. Libido typically has to do with testosterone. If you were my patient, I’d have your levels checked via saliva and see how to proceed from there.
My best,
Dr. Rob D’Aquila
Can you explain how HRT can be used to “prime the pump” when as you have explained due to negative feedback mechanisms providing exogenous hormones reduces the body’s ability to produce its own hormones?
Also, since starting on HRT (bioidentical) I have had terrible headaches. Any suggestions?? I am taking it to help with osteoporosis as well as menopausal symptoms. Do you know of any other “natural” treatments for osteoporosis other than obviously taking the relevant nutritional supplements.
Hi Janie,
I see hormones as being a good idea when levels are extremely low and/or nothing else is making a dent in the patient’s function. It’s almost as if you’re priming the target tissues to again become responsive to the message of the hormone(s).
It doesn’t sound like you have right balance considering the “terrible headaches” and also, liver function may be worth looking into. It’s possible that there is a form of estrogen dominance taking place.
Finding the right balance with estrogen should certainly help with bone density and quality.
Thyroid hormone levels also need to be considered.
Obviously vitamin D and K need to be considered along with the other important minerals. It’s also important not to overdose on the D however, as people often load up on it these days.
Elevated cortisol levels will certainly cause decreased bone density and that should be considered as well.
Hope this helps – good luck,
Dr. Rob D’Aquila
Hello there Dr.! I’m 47, I have hypothyroidism and went looking for help 3 years ago and was put on Progesterone (80 mg 2xday). I believe most of my symptoms were because I was over dosed on Armour Thyroid, I had many symptoms of that, but the docs just left it alone. I sure wish I hadn’t gone on the progesterone so quickly. Anyway, now I’m on a lower Armour dose and labs look good, (FT3, FT4 & TsH) but I’m having blurry vision,, fatigue, and temperatures too high. I went of Progesterone 6 months ago to test off of it and see how I was, and my levels were normal. But, my bladder freaked out, chronic spasms. Now I’ve tried going off of it again and am wondering if I need to “wean” off of it. Any suggestions?
Hi Marie,
It could definitely be a shock to your body if you simply stop taking a hormone; and that’s essentially what causes many problems for women going through peri/menopause – i.e.: a sudden drop in hormone levels.
Additionally, the symptoms of blurry vision, fatigue, and high temperatures would certainly indicate to me that the thyroid should be checked. Blurry vision can be the result of myxedema, or swelling due to increased deposition of tissue behind the eye. Fatigue is an obvious symptom of hypothyroidism, and high temperatures could also point to an overactive thyroid, or an excessive amount of thyroid hormone replacement.
Blurry vision can also be caused by blood sugar problems, and a high temperature can also indicate an infection.
You may want to get checked for Hashimoto’s Thyroiditis, as that’s the most common form of hypothyroidism in the US. Hashimoto’s often causes symptoms of both hypo and hyperthyroidism. There are many causes of thyroid dysfunction, and simply checking the levels of TSH is not enough to see the whole picture.
I hope this helps – good luck,
Dr. Rob D’Aquila
Hi Dr. Rob,
Thank you so much for your reply – almost a year ago now. It prompted me to seek a different doctor and I feel like I’m on a much better path now. So I wanted to follow up and let you know how it’s going.
You were absolutely correct in saying (concerning estrogen dominance) that it’s not the body making too much estrogen, but a lack of clearing that estrogen from the system that was my problem.
My new doctor has recognized this and I took a supplement (Meta I-3-C) for several months to clear the estrogen, along with supplements for thyroid, adrenal, and digestive support, and most recently, he’s added black cohosh.
He’s also done other testing including a blood test that confirmed that I’m truly (recently) in menopause now and also meridian testing that confirmed problems in the areas he’s already aware of, plus an Epstein-Barr virus that he is treating with a homeopathic therapy. He also had me do a great 28-day detox and I was able to lose15 pounds.
I do not have the energy or strength that I hope to recover yet, and my weight is still an issue, but overall, I’m in a much better place than I was last year at this time.
Thank you so much for your very generous help and suggestions. It meant a lot to me, and changed my course to something that’s working a lot better.
Hi Debra,
I’m so glad you’ve been so well! And thank you so much for sharing it with me and the other readers. I hope your story motivates others to see that there is light at the end of the tunnel if you put the time and effort in. It also helps to have a good doctor though.
Take care and feel free to comment and/or ask more questions.
Keep up the great work!
Dr. Rob D’Aquila
I have a question about stopping bioidentical HRT. I am 28 and had testosterone pellets and progesterone pills ( day 14-28) for a year to year and a half. I stopped a few months ago and it seems my hormones have hit bottom. I am more emotional than usual ( swings) and I have never had these symptoms. Along with the emotions I had my first anxiety attack this week and it seems my level of anxiousness has increased. Is there a link with these symtoms and coming off bioidentical HRT? How can I naturally balance this in addition to diet and exercise? Thank you!!
Hi Julie,
There is definitely a link between stopping hormones having (new) symptoms occur. Your feedback loops are probably dysfunctional due to being on hormones for so long, based on what you’re describing. The only way to be certain would be to test your levels.
In addition to diet and exercise I’d personally give herbs and nutritional supplements to help the body get back on track. In addition, I’d probably look into emotions and how they are affecting you physically, and use flower essences and/or homeopathy in addition to in-office emotional release techniques.
And even though everyone has some emotional component to their situation, it’s possible that simply balancing your hormones will help with those symptoms.
Hope this helps,
Dr. Rob D’Aquila
Hi Dr. Rob
I am going to a anti aging doctor tomorrow. I was on bio identical creams 3 years ago but stopped after a few months because I sa no improvement. But I also made no lifestyle changes so that could have been a problem. My question is the options offered in administering BHRT. I know your take on creams but what is your opinion on troches and pellets? Thanks for this blog!!
Diana
Hi Diana,
Lifestyle changes are something that I always recommend…
Sublingual pellets or liquids are what I find to be the best delivery method. I haven’t considered creams in over 7 years.
I hope you have a great experience with your doctor tomorrow.
My best,
Dr. Rob D’Aquila
Dr. Rob,
My name is Karen. I am 55 and have been really run down for years. My blood test and saliva that I am rock bottom and making NO hormones really to speak of. Five days ago I started on troches given by a PA who specializes in Bio ID hormones. Estro- testost combo in AM and Progesterone at night. I am SO tired I cannot see straight. Like walking through mud all day, a bit depressed too. Is this something that will work itself out in time? She says it’s a low dose and I am not supposed to see her for another month! I will call on Monday but what do you think? Thanks Karen
Hi Karen,
It’s hard to say if it will work itself out in time – if what you were prescribed is what you need, then it should work itself out. You may need a higher dose, but it’s impossible for me to say for sure. Also, your adrenals and thyroid may be playing a role in the fatigue and depression. Typically patients see a change in symptoms within a week or two. Of course, lifestyle issues always need to be addressed.
Good luck,
Dr. Rob D’Aquila
Dear Dr. Rob, I am a 52 yr old female and I started the bi identical hormones approx 8 months ago. I had extensive blood work done and saliva tests and the doctor prescribed 30mg armour, 5mg melatonin, 0.5mg/ml test, hrt, 5mg dhea, 50mg/ml prog.hrt. The prog I admin as cream 6 days a week, the test cream 7 days. I went for a followup and he had to increase the progest cream and all seemed pretty good except the last 2 weeks I wake up every 2 hours with hot flashes. I was so desperate yesterday I went to the store and bought an over the counter black cohosh menopause pill. I’m very concerned now using the creams by what you’ve said. I went to a specialist I found from the Suzanne Sommers book that specializes in the bi identical hormones. Am I doing more harm to my body then good. I feel good otherwise except the sleep disruptions.
Hi Lori,
It’s difficult to say if you’re doing more harm than good. Although, from what I’ve seen, people get worse as they continue taking creams. I suppose it’s possible that creams have improved in the past 7-8 years since I’ve shunned them, but I really don’t know and don’t bother with creams.
It sounds like your only symptom was sleep issues, which could be caused by a number of things – usually adrenal and blood sugar, or an excessive histamine response. It sounds like the hot flashes were helped with the black cohosh…
Again, I can’t say right now if it’s causing more harm, but you know my stance on creams. Also, it doesn’t sound like this protocol helped your symptoms at all.
Lastly, I am very much against the approach of simply measuring levels of hormones and then prescribing based on the lab results. That may be appropriate if the patient has severe symptoms or signs, but it doesn’t at all get to the root of the problem causing the low levels to begin with. There isn’t much doctoring involved in that approach – I prefer to get to the root of problem.
Good luck,
Dr. Rob D’Aquila
Synthetic hormones are clearly the greatest crime perpetrated in this country. How many people have to die before we realize pharmaceutical corporations only make synthetics because they can’t profit from natural substances (we are unable to patent a natural substance).
However, if bio-identical are not the solution (I support your position, on how these interrupt your own ability to produce and “utilize”) then,
what is the solution to our modern messed up hormones, menopause symptoms and unbalanced biology?
Simply live a healthy lifestyle and correct any imbalances that are currently present. It’s individual to some degree, but it’s also fairly general. “Fix” the diet, blood sugar, GI tract, adrenals, detox, etc..
Hello Dr. Rob,
Thank you for the wonderful information, I am so glad I found your website!
For awhile I thought I was the only one that felt this way. I am 52 and have recently tested “borderline” positive for menopause. My Dr. had me on bithcontrol pills for the past 3 years to control the heavy bleeding I was experiencing for my fibroid. She has taken me off the BC pills and started me on the Bio Identicle Hormone Replacement therpy…. Testosterione cream, Biest Cream and Progesterone pills at bed time. I have been on them for 3 months now and actually feel worse than before, gained 15 lb and the bleeding has increased from once a month to twice a month. I have also been tested for cancer and the results were negative.
I exercise 3-4 times weekly and eat well. I have just recently gone off of all the hormones a few days ago, they don’t work for me!
Can you recommend another option perhaps diet and supplements plan to help me go through this naturally?
I just recently started taking adrenal support supplements, incorporated soy and flaxseed to my diet along with my other vitamin supplement program.
Thank you!
Linda Brechtel
Hi Linda,
It’s hard to say what need because I don’t what your levels are, and I also don’t know what the goals of the treatment are. I’d look into exactly what’s going on with adrenal function (4-sample cortisol and DHEA saliva test), as they are the glands that need to be ready to help with hormone production as the ovaries begin to slow their production in menopause.
Please check comments above for my stance on hormone creams.
It’s hard to say exactly why you had the reaction you did – but obviously something was wrong.
If you were my patient, I’d use in-office testing to see if soy was suitable for you – and even if it is OK, it should only be fermented soy (miso, tempeh, natto).
If your blood sugar isn’t well-balanced you’d want to consider fish oil instead of flax oil – click here – for my article on the difference.
I hope this helps,
Dr. Rob D’Aquila
Hi Dr. Rob,
I am an athlete and have been one for most of my life. By this I mean hardcore swimmer, runner , as well as lift weight. i also have had four children in 7 years and breast-fed each one for a year. So my hormones have definitely been through a roller-coaster.
However, I have taken as good of care as I could and have been able to “get my body back” after each child. I have been told that my body fat was too low at one point and tried to ease up on my running. Anyway, I feel as though i have always had to starve myself or eat very little in order to maintain weight.
My belief is that I have always had a sluggish thyroid and have recently been told by my regular doctor that I have hypothroidism and should start taking synthroid. Of course, being who I am I want to fix this as naturally as I can.
Something else I should mention is I am 31 and started taking DHEA as a supplement. I didnt really know as much about it as I should when I did this. I took this for about two months and noticed acne, irritalbilty, and emotional highs and lows, as well as shorter menstrual cycles (which I have never had).
So I stopped taking it. Then as a routine exam at the doctor, they took blood and found a high red blood cell count, high hemglobin, and high hemotacrit level which made them nervous. My TSH level was a 4.5, so they retested me again a week later. My hemogloblin and hemotacrit were still high normal but RBC were normal, but my TSH was 5.9. Anyway, as I have been a pretty healthy person all this has made me nervous.
I am definitely experiencing headaches and blurry vision as well as fatigue and no ambition to do anything, I still go to the gym everyday and have started myself on a regimen of kelp, selenium, B complex vitamin, as well as a thyroid complex that I got at the vitamin shoppe,
I believe that I messed myself up by taking the DHEA and that my levels of estrogen may either be high or I am not able to rid myself of it.
I guess my question to you is what type of doctor should I be searching for, a DO?? as well as how do you suggest a person detox estrogen or other hormones from their body?
Thank you for all your information. It has been very helpful.
Jessica
Hi Jessica,
I don’t know how high your RBC’s and other markers were, but sometimes that’s dehydration, which causes an increased concentration of the cells in the blood sample.
I was thinking thyroid as you wrote, and a TSH of 5.9 (and even 4.5) is definitely a sign of hypothyroidism. You need to get checked to see if you have Hashimoto’s Thyroiditis which is the most common form of hypothyroidism in the US. It’s an autoimmune condition and needs to be treated accordingly – although alternative and mainstream approaches are different, but sometimes they need to be combined. If it is Hashimoto’s, you seriously need to reconsider taking iodine, based on a lot of research.
I can’t say what type of doctor you need, as it really has to do with the individual’s competence and experience and not simply their credentials. Many people have a driver’s license and aren’t very good at driving.
With symptoms of headaches, blurry vision, fatigue, and lack of ambition, you should get this sorted out sooner that later. The blurry vision is most alarming to me.
Lastly, even though the DHEA caused problems, I doubt it would be enough to cause the symptoms you are experiencing, though anything is possible.
I offer phone consultations if you’re interested.
Take care,
Dr. Rob D’Aquila
Dr Rob I’m a 42 year old male who has been diagnosed with graves disease, what do you think of bioidentical hormones for that?
Hi Mark,
I wouldn’t think much of bioidenticals for that. I’d look into what’s causing the immune system dysfunction.
Take care,
Dr. Rob D’Aquila
Hello Dr. Rob,
I’ve just read your informative comments and also the questions from other women. Your answers are very accurate in promoting good lifestyle and serious consideration for any choices for hormone replacements.
As a 65 year old woman, I have had a horrendous gynaecological history necessitating many surgeries. With a hysterectomy at 27 for a 2 1/2 lb. (yes, that heavy and 10 cm. in size, leiomyosarcoma), I survived and within 12 years developed endometriosis that resulted in 2 separate oophorectomies 5 years apart. Naturally, these surgeries, plus an ovarian remnant hemorrhage necessitating yet another abdominal operation between the oophorectomies, resulted in surgical menopause and changes in my hormone levels from a young age. I’m a very healthy, active person who values so much this miracle of surviving my original cancer.
From 1992 until 2003, I used patch estrogen only hormone replacement therapy and discontinued their use due to the study that indicated one should not have long term therapy. By 2007, I was feeling many symptoms linked to hormone deficits, such as continued night sweats, insomnia, some anxiety with repeated thought patterns and also a sense of lacking a ‘female’ identity and definitely zero libido. I am single, so that latter symptom isn’t too much of a problem without a partner.
In 2007, I found a US Board Certified Anti-Aging Canadian GP who is specializing with female patients and prescribing Bio-Identical Hormones. I was tested with saliva analysis and was found to have zero levels of both estrogen and progesterone. With my prior surgeries, I was expecting this result. I began on both estradiol/ester and progesterone cremes and am at the lowest dose. Over about 4 months, I gradually noticed that the symptoms disappeared, much to my delight. Now, after 4 years of use, I am being pressured by both my regular GP and gynaecologist (who monitors my Calcium levels and bone density levels, which the latter having increased over the past two years!) to quit using these hormone cremes.
I keep asking them why would I given how horrid I felt after four years off the therapy and that I know that I’ll return to feeling that way again. If I feel so well, why put myself at risk for insomnia, night sweats, feeling ‘lost’ again and having some anxiety? I am being told this may not happen ‘this time’ as I am older. I was ‘older’ when it happened when I quit the therapy in 2003!
Honestly, I don’t believe them and think that what will instead happen is that they then will start prescribing other FDA approved medications such as sleeping pills and anti-anxiety meds for the symptoms that I am certain will arise. I am not a person who likes taking medications at all and because I feel so very well at my age, with no current health issues, it doesn’t make sense to me to quit these bio-identical hormones.
Also, I just realized that on my hormone cremes, I have not had another migraine headache! They used to be debilitating, and I am relieve that I they are not a problem anymore.
So, my dilemma is what to do. And if I am pressured enough by the doctors to quit the therapy, how should I wean myself off the HRT?
Sorry this is so lengthy, but as you can appreciate, I’ve given this much thought. Also, I was an RN by career, now retired.
Thank you for any suggestions.
Wendy
Hi Wendy,
I’m sorry to hear about all that you’ve been through – but happy to hear that you are currently feeling fine!
The main thing I don’t like about your scenario is that you don’t seem to trust your doctors. In my opinion, it’s extremely important to feel your doctors are trustworthy. You said “I don’t believe them” – that to me is a big problem.
If they want to take you off the hormones, they should have protocols in place to do this.
If I were weaning someone off hormones, it would depend on that individual patient’s situation. And I don’t know that I would in your case. I’d have to have a better idea of your health status including lab tests. I would do your best to get more information out of your current doctors, and I would also get a second and perhaps third opinion because of the trust issues that exist.
Good luck,
Dr. Rob D’Aquila
I am a 52y/o Insulin Dependent Diabetic of 32 years. I have no complications. I have a healthy lifestyle. I started hot flashes this past summer and noticed weight gain at my waist. I read about Bioidentical hormones and decided to start therapy under the direction of an MD. After 10 months of not menstruating I began having a period 13 days ago.(after taking the hormones for 3 weeks) I was told to double my progesterone. I took once double dose and felt sleepy and depressed. I went back to a regular dose. I kept bleeding so I was advised again to double the dose. I became nauseated, depressed, and fatigued. I was also placed on testosterone, DHEA, and armour thyroid when I began progesterone. I stopped all hormones 3 days ago. I am concerned that stopping abruptly could be unhealthy but I am afraid to take anymore. I continue feeling nauseated with ringing in my ears, dizziness and menstruating. Any advise.?
Thank you.
Mari
Hi Mari,
I’m not sure what your hormone levels were before starting the treatment, but it sounds as if you were about to enter menopause and the hormones pulled you out of it.
I would suggest getting a very good work-up with having your hormone levels checked appropriately through a doctor that is not going to prescribe based on symptoms alone. It sounds like a typical scenario where the patient gets the “kitchen sink” thrown at them without proper testing, and not figuring out the root cause of the problem.
Good luck,
Dr. Rob D’Aquila
Hello again, Dr. Rob,
I greatly appreciate your thoughtful reply to my comments above concerning my history and current status. Your comment about not trusting what I am being told by my general GP, as opposed to my anti-aging specialist, who was a well reputed GP, is absolutely correct. I will definitely make sure I am not pressured into a drastic change that will result in my feeling unwell. These days, quite honestly, I feel like I’m in my 40’s and often go out running for over an hour and biking for over 4 hours. As I work very diligently at my own health standards, I find it interesting that given I am well, the general GP and my gynaecologist keep trying to convince me that I don’t need to feel this way but rather feel like an older woman ‘should’ without any hormones at all. Isn’t hormone influence that which influences our sense of being feminine or masculine? After all, transgendered folks prove that hormone therapy can indeed alter how one feels about one’s sexuality. I just do not want to feel like a non-sex, which was one way that I did feel off my HRT for four years.
It’s difficult to find someone in the medical profession that isn’t opinionated either one way or the other, it seems there is no grey area with this topic of treatment or not. Also I do resent the fear based approach of comments like, “If you continue with HRT there is a strong link to cancer!” I am not supplied with any statistics or recent data about this with this strong statement. More confusion for the patient, I feel.
Any further comments would be appreciated again.
Wendy
Hi Wendy,
It’s great that you feel like you’re in your 40’s and are so active. And yes, hormones do affect our sense of gender. As far as cancer – there is a strong link to synthetic hormones and cancer. It is assumed that bioidenticals don’t pose that same risk, and it would make logical sense that they wouldn’t. However, no one really knows at this stage of the game…
Thanks for your comments and take care,
Dr. Rob D’Aquila
Hi, Dr. Rob,
My granddaughter is being diagnosed with Autism. She just turned 2. I have been researching bioidenticals and wonder if you have an opinion about using them in children? She has had bloodwork showing her thyroid to be low. She had an EEG and is scheduled for an MRI later this month.
thanks very much
Barbara
Hi Barbara,
That’s a tricky one. Personally, if I had an autistic child, I’d load him/her up on brain-supportive nutrients and herbs and see what results that brings first. Her thyroid being “low” doesn’t say much at all, because it gives no indication of why. There are over 20 reasons why someone might be hypothyroid, and giving hormone may or may not be appropriate.
Take care,
Dr. Rob D’Aquila
Hi, Dr. Rob…Thanks for responding to my question. We are wondering what brain-supportive nutrients and herbs you would recommend for our granddaughter’s Autism…
Thanks so much,
Barbara
Hi Dr. Rob
I am 30 years old and noticing that every month my periods get worse. Not worse in Menstrual flow, but fatigue, cramps, headaches, and mood swings. I can cry at the drop of a hat and 10 minutes later want out of my own skin. The feeling is horrible and wondering if BHRT would help? Hope you have some input.
Thanks so much
Debbie
Hi Debbie,
Please read all the comments above for my input. I recommend people find out the cause of their hormone imbalance before simply taking BHRT; esp. at age 30.
Good luck,
Dr. Rob D’Aquila
Hi Dr. Rob First off I enjoyed reading your article above and hope you can help me. I am 57 years old. About a year ago my Testosterone was under 200 . I went to a Dr for healthy living who did a very extensive blood panel(13 vials) and put me on bioidentical gel ..To use it 5 days on then 2 days off. my level rose to 600 then 3 months later to 750 then it dropped to 200 . I was told that the gel was not absorbing so he switched me to a cream. My level went back up to 600 but i get alot of fatigue and irritability and do not really like that. When my level was low I had fatigue and working out in the gym seemed like a chore The T helped with the working out that got easier but the fatigue seem to come and go but come more often. I was never an irritable person and can control it but dont like it. Is this a side effect?. Also when i ejaculate now its very little compared to before i started the testosterone. its seems the only thing that is better is that I get more erections. I sometimes just do not feel like my self and think maybe I should stop but if I stop what alternatives do I have. The long term effects you described above scare me. I am 5.5 weigh 124 eat very healthy do not eat gluten or wheat. Walk 5 k 4 times a week ride a bike 10 k 3x a week and work out in the gym 3x a week but had to stop weights as i strained a deltoid. One more thing I have also lately been getting stomach pains. Anything you can do to help would be greatly appreciated.
Jeff
Hi Jeff,
It’s very hard to be able to help you without knowing the entire story. After 13 vials of blood, I would expect some tests to be out of range – at least out of a functional range. If testosterone was the only treatment offered, I think it’s an incomplete treatment at best, and unnecessary at worst. Again, it’s hard to say without knowing the whole story.
Another thing I don’t understand is why your body suddenly stopped absorbing the gel after it had been working fine previously- that makes little sense to me…I don’t think your levels dropped because you weren’t absorbing it.
The irritability can definitely be a result of the treatment, esp. because you make it sound as if it was never a problem before – and the same goes for the volume of your ejaculate.
The alternatives to your treatment depend on exactly why you had the low testosterone to begin with.
I would have to evaluate all your tests and take your complete history to guide you better.
I offer phone consultations if you’re interested.
Take care,
Dr. Rob D’Aquila
I enjoyed reading this article , especially after reading countless others which promote hrt so easily. Even the endo I went to see suggested hrt a bit too easily .
I would like to know more about the patient mentioned above who was treated for low testosterone as I think I maybe am going through the same as him.
Hi Shaun,
I’m glad you enjoyed reading the article. Yes, in many cases endocrinologist’s and alternative practitioners prescribe HRT too quickly, and without other types of support.
The patient I mentioned mostly had blood sugar problems contributing to his low testosterone. The blood sugar issues were very much caused by being a vegetarian for years. Obviously he had receptor site down-regulation from the HRT as well.
Thanks for reading,
Dr. Rob D’Aquila
D
DrRob D’Aquila
My name is Annie, and I’m a 59 yr old who had a hystorectomy about 12 or so years ago. I saw an ad on tv about bio-identical hormone replacement therapy. I went in, they did blood work and said I was very low in the areas of testosterone and progesterone. I just have decided not to continue with the bio-identical program I’m currently on, due to the fact that when I started this program almost 4 months ago I had a reaction to the testosterone pellet. I felt like I was having an anxiety attack on the 2nd day after it was inserted. When I called them to ask about it, it seemed to me that it wasn’t an issue according to them.
I’m coming up on my next pellet insert, and I’m feeling very uncomfortable with the propect of going in for it. If there is a way to get my body up to speed with a good diet, PLEASE help me.
Hi Annie,
I’m sure the anxiety attack was just a coincidence after receiving the bio-identical treatment. (please realize I’m being facetious) To be fair, anything is possible…perhaps it was a coincidence or related to a fear you may have had about the treatment. Although, I wouldn’t at all be surprised if it was a result of the treatment.
For help on diet, click the “sugar” tag on the right of this site. Also, read the “Weight Loss and Detox” articles I recently posted.
Being that you had a hysterectomy, bHRT may very well be appropriate for you. But it is also important to eat properly and live in a way that avoids unwanted inflammatory reactions in the body. AND, it’s important to get the proper hormones replaced in the proper dosage.
Good luck,
Dr. Rob D’Aquila
HI Dr. Rob,
I read with interest your article on the side effects of BHRT.
I am a 55 yr old female and have been on BHRT for at least 6 years with great results. I had was thrown into Menopause 10 years ago after a hysterectomy and oophorectomy. I struggled the first years after with extreme depression, mood swings, not to mention the hot flashes. I was put on HRT and this seemed to aggravate my symptoms. I found my way, after research, to BHRT.
While at times I have been symptomatic ( hot flashes and tired) I have used these with great success. The last couple of years I have been able to actually decrease my dose to 1/2 the recommended dosage. This I feel is due to cleaning up my diet and becoming very mindful of making healthy food choices. I eat a primal diet and exercise regularly including olympic weight lifting. I am very conscience of my food choices eating grass-fed, pastured meats and buy most of my food locally. I supplement with Fermented CLO, Krill Oil, Vit C, Vit B complex, Vit E, Vit D3 and Co-Q10. I try to supplement with Whole Food complexes rather than synthetic. I also supplement with a grass fed whey after my workouts. I am a firm believer that the body can heal itself if given the correct fuel (food). Currently I feel fantastic and am told I look younger than my years. My question: I would like to come off of BHRT and allow my body to take over. I want to make sure my adrenals, thyroid and endocrine system as a whole is healthy as I continue to age and I feel that continuing on BHRT is not in my best interests. The only endocrine issue I have is thyroid cysts. They are benign and all my blood levels are fine. ( there were 10 different levels checked) Is there anything I should supplement to beginto come off of the BHRT. Do you have any other suggestions as how best to do this. Thank you for your help and advice!
Hi Martha,
I’m glad you like the article. And good for you and your health over the years. As you can see, most people who find this article are really struggling.
As far as getting off of hormones, it sounds as if you’re on the right track with diet and exercise.
It’s good that you got so many thyroid tests done. Hopefully all the values were within the functional normal range. The reference range for normal on lab tests is often way too wide. For example, the range for TSH (thyroid-stimulating hormone) is often 0.45-4.5. That’s a whopping 10-fold difference, which implies that it would be normal if one person had 10 times the hormone level of another.
I would also look into adrenal gland function via salivary hormone levels, as well as “sex” hormones via saliva.
Obviously weening off would be better than going cold turkey…
You should monitor yourself regularly, via blood and saliva tests, as relying on symptoms may not be the best route. And of course, bone density and quality needs to be assessed.
Lastly, I would certainly recommend you do everything under the supervision of a competent, licensed healthcare practitioner.
Keep up the good work,
Dr. Rob D’Aquila
I’M 69 YEARS OLD AND LIFT WEIGHT ALL MY LIFE. I NOW FILL TIRED AND NO SEX DRIVE AT ALL. BUT LOOK HEALTH. CAN YOU GIVE ME A IDEA WHAT TO DO….
Hi Charles,
I would start with reading the articles that are categorized under the “sugar” tag on the right side of this website.
Take care,
Dr. Rob D’Aquila
Dr. Rob,
I absolutely loved this article! I can attest for almost anyone (women) having issues with hormones (due to menopause) that HRT is not the way to go! I found this out the hard way.
I don’t want to write a book, but I think it’s essential that I share my story so others in the same position can avoid bad mistakes.
I was diagnosed with uterine cancer at the age of 18 (I am 43 now). I was pregnant at the time and shortly after my daughter was born, my doctor did a hysterectomy. He left my ovaries behind because of my age, but feared I would have problems later (which I did). Both of my ovaries were removed at age 23. None of my doctors discussed HRT with me (which was great, I wish noone ever did!) I had no symptoms for 5 years until one day, I noticed that my sex drive was becoming less and less. In fact, I didn’t think about sex, and could care less if I ever had it again. This was not good for my relationship, so I went searching for help from my GYN. She prescribed me a soy based estrogen pill (very low mg). I did not notice any improvement with sex drive for 3 years, but kept taking it. I didn’t have any adverse reactions for 3 years and pretty much felt the same. When I told the doc that I felt nothing, she then changed me to a product called Estrotest. Little did I know that very day would change my life forever!
I noticed within 3 weeks of taking this drug that I was irritated, crying, and swelling. When I say swelling, I mean my face, eyes, hands, feet were swollen to 3x the size. I felt like a monster. I wouldn’t leave the house. I went to the doc and she lessened the dosage. Thinking that she knew what was good, I continued to take these pills for 6 months. I became worse and worse. Finally, I stopped taking them, but…this is very important…somehow, (maybe because of meds? not sure), I was convinced that I should be taking something! In reality, I should have stopped everything! The doc then put me on a patch (not sure what kind) and I had to stop in 2 weeks because my skin bubbled from the patch glue. She started me on something else, I think Premerine (spelling?) and I continued on that for another year…with horrible symptoms..but was convinced that it was “helping” my bones. I started to develop boils on my legs. Painful huge boils that were infected and red lines leading to my heart. My doc’s answer? Antibiotic therapy! Never once did she think about the hormones. She felt I was just sensitive and needed this therapy. For 1 year, I took 500mg of Amoxicillin every day! Needless to say, my immune system was destroyed and I became allergic to every food, dust particle and AIR! I stopped all drugs at once! Started doing some research and found out it was the hormones that did this to me.
What took 4-5 years to destroy, it took my body triple that time to heal “a little”. I lived on boiled chicken (no spices) and white rice (plain) for 1 year. Ate it every day twice a day. Was able to introduce beef and some veggies (mainly peas and green beans) and ate that twice a day for the next 4 years. Was still highly allergic to wheat, nuts, corn, etc. (btw, I wasn’t allergic to anything my entire life up to this point)
It wasn’t until 3 years ago (like I said, I’m 43) that I am able to eat almost anything (except strawberries and soy) without a reaction. I still cannot take antibiotics without having a reaction.
That being said, ladies, this doc knows what he’s talking about. HRT should be very last resort.
How do I cope? I am still going through menopause after all these years, but my hot flashes are better if I don’t eat sugar. Sugar suppresses the immune system and makes you feel bad. I eat local meat (no hormones) and always get frozen veggies (organic). I do cheat sometimes, but when I do, I feel crappy . Take liquid or chewable multi-vitamins and cleanse your liver often (lots of liver cleanse products at health food stores). Take at least 1000mg of calcium (soft capsules) and take a chewable probiotic. As for the sex drive…I still don’t have an overwhelming desire, but I can say that the “mind” is the major sex organ. Once you have your mind in “that area of thought or visual stimulation” the body follows…trust me. Thanks for reading my story and I hope I’ve helped someone out there.
Hi Kelly,
Thanks for sharing your story with everyone.
I wish you the best,
Dr. Rob D’Aquila
Dr. D’Aquila,
Thank you so much for sharing your wealth of knowledge with all of us who are in search of answers.
I am 48 and underwent a total hysterectomy/cholecystectomy last Dec. ( Ovaries were kept intact) due to fibroids and severe anemia. Unortunately, most Dr.’s don’t tell you the consequences of having a vital organ removed even when you ask them specifically if your body will change. After discovering my body will never be the same again, I am desperate to be as healthy as possible and preserve what I have left. I have always exercised and eaten for the most part a healthy diet. I take several supplements such as CoQ10, Vit C, D3, Valarian root( for sleep aid), Magnesium, Fish oil, Vit E, Horse Chestnut and Biotin.
I notice you keep mentioning in the above comments about the vital role the adrenal glands play in the body. Are there supplements or certain exercises you can do to promote healthier adrenal glands? I understand detoxing the body is essential but what form of exercise would be best? Yoga comes to my mind but I would appreciate your opinion and any suggestions on exercise, supplements and diet.
Thank you for taking the time to address my email.
Jeannie
Hi Jeannie,
When it comes to the adrenals, you have to look at what is causing adrenal hormone imbalance. Stressors to the adrenal glands would include (mainly) – blood sugar imbalances, insufficient detoxification, infections, food sensitivities, over-exercising, and/or major emotional/mental stress.
If you’re that concerned with adrenal gland imbalance, it’s best to have a salivary hormone test run and see where along the spectrum of adrenal stress you lie. And also work with someone to figure out what the major stressors causing the issue are.
As far as exercise, I usually recommend 30 minutes 4 times a week. It really depends on the person and the health status as to how intense or what type. Typically though, my patients already have exercise routines that are fine for them, or at least not interfering with the results we are looking for. My patients typically need more help with diet-related issues.
As far as supplements, that is also going to vary from individual to individual based on their needs.
I treat people as individuals and never use a cookie-cutter approach where I recommend the same thing to everyone – that simply doesn’t work.
I hope this helps,
Dr. Rob D’Aquila
doctor iam writing this because iam a 52 year old women that had a period for 29 days never had abnormal one before. i finally went to the doctor and found out my blood was 6.1 had every test done was all clear. but found out levels where tanked. in order to keep my periods normal iam on biodentical hormone cream. what do u do in a case like that what other options are there for me iam desperate thanks melissa
Hi Melissa,
I’m not exactly sure of what you’re saying and don’t have enough information to be able to make any suggestions. Additionally, I can’t give out specific nutritional advice to anyone that is not a patient.
Best,
Dr. Rob D’Aquila
Hi Dr. Rob,
I am interested in finding out if you could recommend a doctor that specializes in BHRT or natural alternatives in Hampton, Virginia. The only medical center that I am aware of is in Virginia Beach, Virgina called the HRC Medical Center. If you can help, I definitely need that information. I have a consultation at the HRC center, however, I’d rather not use bio-hrt. I’ve been having severe night sweats, sleeplessness, very low libido, weight gain that I can’t get rid of around my belly. I work out, just about every day and lift light weights, but still this belly just won’t leave. HELP!!!!
Thanks,
JLW
Hi JLW,
I wish I could help but I don’t know of anyone in or around Virginia Beach. The only thing I can offer is a phone consult. And by the way, unfortunately, the belly fat can certainly be the most stubborn. Many people wish it was easier to get rid of.
Take care,
Dr. Rob D’Aquila
Hi Dr. Rob. Iam 47 years old. I have endometriosis, fibroma and some cyst. I had surgery before for the endormetriosis. I do weight training and cardio. I eat, for sure not perfect, but not red meat, sal, sugar, etc. Howerver, I am always tired. If fact, I feel extremally tired. Specially on the morning. My blood test are perfect. Therefore, the doctor doesn’t what it is happening to me. Since my 40, I had had several joints problems. I had overcome all of them, but had take me almost a year for some of them. I also have other sytoms, wich I believe biodentical hormones can help. Today I found your article, and my question to you is what do you think I should do? Thanks,
Hi Vanidad,
You need to figure out what’s wrong before you simply start taking hormones. There’s a god chance you have thyroid and adrenal imbalances as well. And, there’s a good chance that your blood tests would be out of range using functional reference ranges. If you’re interested in a phone consult you can email me to set up an appointment. I do not know what you should do at this point and without any information.
Take care,
Dr. Rob D’Aquila
Thanks for all the valuable information on your website. I am considering taking BHRT. I am 52 years old had a hysterectomy one year ago and have been experiencing hot flashes and sluggish memory. I eat healthy and exercise and cannot lose any weight. What type of doctor do you recommend I consult……gynecologist or endocrinologist?
JulieAF
Hi Julie,
You’re welcome. It’s not so much the type of doctor that I’m concerned with. The question is whether they are competent. Many doctors aren’t well-versed in functional medicine and have very few (sometimes dangerous) tools to help their patients. And many doctors aren’t very good at assessing a patient’s overall health. Seeing low hormones on a test and then giving hormones as the treatment isn’t always the best way to go, and isn’t really doctoring in my opinion – a 10-year old could do that. Of course, there are situations where low hormone values on a test indicate the need for hormones. However, very often there is a better option for treatment that gets to the actual cause of the problem.
To answer your question though, both a gynecologist and an endocrinologist should (key word) be well-versed in basic (another key word) hormone physiology.
I hope this makes sense,
Dr. Rob D’Aquila
Hi Dr. Rob,
I have been on BHRT since October 2011. I have only had two implants done. After the first implant my testosterone went to 400, so I was told I had to wait for 1 month and have another blood test, it was still High over 200, finally in January I had my second implant done. I have had some break through bleeding, but light, so my progesterone was increased to 200mg for two weeks, the bleeding stopped and I went back to 100mg again. But after about 3 weeks after my second implant I was not sleeping as well and was irritable. I was told to increase my progesterone to 150mg, only a few days after doing that I started having panic attacks, so they went to 200mg the panic attacks were still occuring. I am now back to 100mg of progesterone, though I am still not sleeping well, my panic attacks have subsided. But I am having mild hot flashes at night again. Before starting BHRT I was postmenopausal for about 7 years. I am not really sure if I want to continue on BHRT, I don’t want to have to depend on them for the rest of my life and I know the longer I stay on them the harder it will be to stop. Since I have only had two implants and Have been on the progesterone since October how hard would it be to stop or ween off of them. My worry is the panic attacks.
Hi Joan,
It certainly sounds like the proportions or amounts of hormones are not correct. It’s not at all normal to have bleeding when you’ve been postmenopausal for 7 years. And obviously the other symptoms aren’t normal either.
The question is, why did you start to begin with?
It’s really difficult to say how you’ll respond to weening off the hormones. It depends on your system’s sensitivity and you may just have to dive in and see what happens.
And as always – try to have your adrenals strong – if they’re not functioning well, you’ll have to figure out why that is as well. Simply taking supplements like B-vitamins and adrenal glandulars will probably not be enough, it depends on the cause for adrenal stress, if that is going on.
Good luck,
Dr. Rob D’Aquila
Hi Dr.Rob,
I am 52 years old and recently started a very strenuous workout program. Five weeks into the program, I am still just as exhausted and have difficulty building up any endurance. I also have not been able to lose any weight even though I added cardio on the in-between days.
Back in the Fall, I had hormone testing done, but was not able to follow up with the provider at that time, and since, have not been able to reach them for a follow up appt now. The only lab that appeared to possibly be abnormal was my cortisol levels. They were as follows:
Cortisol#1- 0.859, #2 – 0.158, #3 – 0.131 & the last one done in the evening was 0.039. Are these low and could this possibly be the reason for my lack of engery? Should these levels be follow-up with by a specialist?
Thank you so much for your column.
Hi Tammy,
Different labs use different units of measurement – I’m not quite sure I understand the numbers you’ve posted (especially with the decimal points). The actual report with the numbers and graph should tell you right away if these values are too low. Usually I see values that are above 1, so it’s strange to see the decimal points.
It absolutely could be the issue with your fatigue.
In my experience, specialists – I’m assuming you mean an endocrinologist – only deal with adrenal hormones when there is pathology like a tumor or autoimmune situation. I have yet to see one consider “functional” adrenal imbalances as an issue. And my guess is that with your symptoms, they’d run thyroid tests and then if they were out of range, possibly prescribe thyroid hormone, which may or may not be appropriate.
You can always get several opinions. And you may want to consult with someone who is skilled in functional endocrinology.
Hope this helps,
Dr. Rob D’Aquila
Dear Dr. Rob,
I just sat and read all these comments. I have one to add as feel. I started bio identical hormone replacement therapy in August 2011 and STOPPED TODAY!!! My primary physician suggested I start taking them due to severe knee pain (arthritis). Against my better judgement, I did 2 sets of blood tests and the saliva tests. I am 55 yrs old, went through menopause @ age 48, eat organic only, exercise 4 times a week, had minimal hot flashes and slept daily well. After 7 months of BHRT, I have gained 5 lbs (doesn’t seem like much, but I have weighed 115 since the age of 16), am not sleeping well, suffer from breast tenderness and feel like I am going out of my mind!!! Your sight confirmed what I knew all along, only wish I found it 7 months ago. I just hope I can get my body and mind back (I don’t care about the hundreds of dollars I spent)!! You can’t put a price on your health!!
Thank you,
SAM
Hi Sam,
Thanks for your comment! I’m sure others will appreciate it too.
Take care,
Dr. Rob D’Aquila
Hi Dr Rob,
I was wondering if you could please give me some advice? I have suspected endo ( having laparoscopy on Friday), and to try and ease the pain and endo growth I was put on depo provera. My first injection was on oct 19 th last year. By dec I was extremely ill with weakness, fatigue, serious depression, muscle spasms, nausea, anxiety, ibs, headaches, confusion and the list goes on. I didn’t know there was a link to depo with all these symptoms and the doctors said it had nothing to do with it, so unfortunately I had another injection jan 12 this year, and have got worse. I feel this injection has ruined my life and I am scared I will never feel the Same again. I am 9 weeks into the second jab and have been bleeding red blood for 3 weeks now. I know that the gyni can sort out the endo problem if they can find it during the lap, but I am Not sure how I can help ease the side effects from the depo injection? I have a fuzzy foggy head all day and can’t keep my eyes open, but am restless the whole time. My muscles seem to cease up a lot and I cry all the time. My estradiol is 7.12 pg/ml, my progesterone is 0.41ng/ml, my cortisol was low but has now gone up to normal again. Vit d is normal, as is fsh. My ACTH is on the low side of normal at 13.2, blood count normal. Will bioidentical hormones help me feel more normal, as I am struggling to function, and worried these side effects will never go? Thank you for any advice. Ella
Hi Ella,
I’m very sorry to hear about what you’re going through.
Endo(metriosis) I’m presuming can be very devastating. Although it sounds like the hormone treatment was more so for you. I can’t see how the doctors would say that your symptoms had nothing to do with the shot – I’d love to hear the explanation of your symptoms, not that they gave you one…
Taking a one sample blood (or saliva) test is not very useful in a menstruating woman because they have a “28” day cycle. You can’t see the full picture. A salivary female hormone test that runs hormone levels throughout the cycle is best to determine where the problem is. Your cortisol may have gone up due to a stress response, which at least shows that they’re responding. But if levels were low in the past, they obviously weren’t functioning great beforehand.
With all of the bleeding, you need to consider anemia and make sure to get that taken care of ASAP – a blood test is ideal for that.
Given that it’s been so long that you’ve had these symptoms, it may be worth it to go ahead get your hormone levels properly checked. I know your cycle is abnormal right now, so maybe consider a one day test and try to work out a multi-sample test as best you can. Taking bioidenticals to balance yourself out and get over this rut may be a good idea. You don’t necessarily have to stay on them forever.
Lastly, remember to get all the basics in check: balancing blood sugar, gut function, liver detox, food sensitivities, adrenal function, and of course anything else supplement-wise to combat inflammation.
You should work with a practitioner who is well-versed with balancing (hormone) physiology.
I wish you the best,
Dr. Rob D’Aquila
I signed up for bio identical hormone replacement.I was very excited because I have every symptom imaginable,am really feeling bad. Two days before implant I was told that there is a danger of blood clots (I have a 3 year old stent in my RCA).Now ,should I proceed?They didn’t tell me this when I signed up! I’m scared to go ahead but I was hoping this pellet insertion would improve my quality of life and now,I’m very depressed.I don’t know what to do! Is there danger of blood clotting as in synthetic hormones?
Hi Barbara,
You need to take this matter up with the prescribing physician, and also consider speaking to the doctors that put in the stent.
It’s said that the risks of bioidentical hormones are not the same as synthetic, and it makes sense that they would be safer; although I’m not sure if there’s enough research on it considering there probably isn’t enough money behind it.
Additionally, hormones will cause strong effects in your body whether they are bioidentical or not. As you can read above, many people (at least commenters on this site) have had negative experiences; although not necessarily with the problems you are referring to.
It may be pertinent to get blood levels of clotting markers checked periodically. And again, you need to take this issue up with the prescribing physicians.
Take care,
Dr. Rob D’Aquila
I have been on several different forms of HRT for the past 8 years. I am 55 and had a partial hysterectomy about 15 years ago. I was on Estratest for about six years and then started having hot flashes again. I then began using the Viville Dot patch for about a year until the hot flashes started again. (I should probably tell you I lost 15 lbs on the HCG diet protocal about 6 mos ago and after I finished the hot flashes started) Then two weeks ago I switched to the bioidenticals after my Dr. ordered a saliva test. I stopped the patches the same day I started the bioidentical cream. I have begun experiencing terrible hot flashes again as well as a feeling of being very overwhelmed and anxious.
My question is, does it take time for the cream to start working?
I am going to do everything I can to change my lifestyle including my diet, exercise habits and stress level, however, after reading your article I’m concerned I will never be able to get off of HRTs.
Twice over the years I’ve tried quitting HRTs cold turkey but both times after about 6 months I was so miserable I had to go back on.
Also, if I’m always using some form of HRTS how will I ever know when the hot flashes are gone. Maybe I should just go through it.
I should mention that based on my saliva test the pharmisist also recommended the following supplements which I started taking the same day I started the bioidenticals: Theanine, Isocort and Energy Multi-Plex Adrenal Support Formula. Thes supplements cost me a small fortune but I’m willing to continue them if they are going to get my system functioning properly.
Hi Jeri,
I am not a fan of hormone creams at all. They tend to overdose people and then cause further imbalances. I find it a huge problem and a horrible way to deliver hormones.
It’s very important that you change your lifestyle and avoid any foods you may be sensitive to, eliminate any infections, balance blood sugar and get digestion and detoxification in order.
Cold turkey may not be the best way to go for you. Check with your physician about weening off and possibly avoiding having to “go through it”.
Lastly, I am totally against the use of Isocort as a supplement. I’ve never seen an adrenal problem not be able to be resolved when my patients have followed their instructions. From what I see, cortisol can be regulated without using bioidentical cortisol. Again, I am strongly opposed to supplemental cortisol.
I’m familiar with Theanine, but not the Multi-Plex Adrenal supplement.
My best,
Dr. Rob D’Aquila
Dr. Rob,
I am an RN (28 years old) and understand all too well that general MD’s often overlook so many things. I am struggling with issues related to my birth control and no sex drive, fatigue, migraines ,fibromyalgia type symptoms, lack of lean muscle mass (Despite exercise) among other things. If I lived in New York I would see you in a flash. My question is, Do you know, or could you recommend anyone that practices as you do in Oshawa/Toronto (canada) area? I am very intrigued, and at the end of my rope here. I have tried to do some research ‘functional medicine’ wise, and I have come up with nothing. I would greatly appreciate any help. Thank you so much,
Melissa
Hi Melissa,
I’m sorry to hear about all you’re going through.
I can’t say that I know anyone who practices the way I do in Toronto. You can check the following link for a doctor who uses Professional Applied Kinesiology, that is my specialty.
http://icakcanada.ca/
Take care,
Dr. Rob D’Aquila
I am 55 years old and have been taking bio-identical hormones (troches in mouth) for five to six years. I do believe they have helped to calm my anxiety in that time, night sweats and hot flushes.
Several weeks ago I was diagnosed with an aneurysm in the carotic artery in the brain. I have to undergo a stent in a month and my neurosurgeon has told me to stop taking the troches. I stopped outright and am experiencing sharp, short pains in all areas of the head. My neurosurgeon does not think these have anything to do with the aneurysm.
I have contacted my doctor who has explained how to wean myself off the troches, so I have started taking them again. From your experience in this subject, do you think these pains are as a result of stopping the troches? What other side effects could I experience?
Thank you.
Hi Kathy,
I haven’t ever seen the complaints you’re experiencing with patients using bHRT. You should speak with your medical doctors about your symptoms and possibly seek a second or third opinion if you’re not convinced of your current doctor’s advice and recommendations.
Best,
Dr. Rob D’Aquila
Hello Dr. D’Aquila,
In January, I posted two comments and appreciated your replies.
Since 2007, at age 60, I began using Bio-identical creams with a break from 1992-2003 of using patch HRT. (I had surgical menopause after a last oophorectomy when just 46. I haven’t had any problems and indeed feel better since 2007, under the care of an Anti-aging Specialist in West Vancouver, Canada.
In March, I became aware that my container of estradiol was going to run out a little earlier than 4 days before the end of the month. My progesterone supply was fine until my usual four days of ‘rest’ from using the creams at the end of March. So, instead of getting the prescription filled right away, meaning I’d run out of the estradiol cream again at the end of 3 more months, I spoke to the pharmacist who compounds the creams about this situation before I completely ran out, estimating it would be perhaps 8 days without the estradiol instead of four. He said I should be okay with that longer break.
Also, I had one week prior to this happening spent an hour with the Anti-aging specialist, with whom I have a great rapport and respect her opinion on my care with HRT for my q2 year’s appointment. She was very pleased how I have been doing. I mentioned to her that I’d realized after 2007, that the migraine headaches that were an infrequent problem since I’d been 27, that they had completely stopped after beginning the Bio-identical creams. Even behaviours that used to trigger the migraines, like lower blood sugars or a little dehydration (with my sports, if I didn’t really hydrate enough) did not cause any more migraines.
On day 7 of not having the Estriadol cream and on day 2 of my four days of not using creams, so no Progesterone cream for 2 days, I developed my familiar and consistent symptoms of a migraine, despite no triggers at all. The symptoms were milder but definitely progressed as they used to with right eye involvement of pain and right sided pounding of my head. The migraines always lasted nearly exactly 72 hours and this one did also even though milder in the pain level. My treatment in the past had been Advil and Maxeran. This time, I just took Tylenol two extra strength on day 2 and 3 of the headache and tried to ignore it. It was tolerable and I didn’t want to take Advil and my Maxeran had expired.
I recommenced both creams on April 1st and have had no further headaches or migraine symptoms.
This reinforces my conviction that I benefit in many ways from these Bio-identical hormones, despite my regular GP feeling that I shouldn’t be using them. My gynaecologist on an annual visit in March, who previously felt the same as my GP, this visit stated that he now feels that there is a protective and positive cardiac effect from Bio-identical hormones. He also told me that the carcinogenic influences and concerns are minimal on a general scale. So, it was interesting his 360 change in attitude to my remaining on HRT.
Again, I find that there are many conflicting opinions.
I did look up some articles on migraine and Bio-identical creams and if there is a correlation. Apparently there can be a decrease or be eliminated (As in my case) with these creams. So, even a break of 7 or 8 days, in this case I’ve described made that much difference in triggering a migraine, my first in 4 1/2 years.
Hence, another good reason for me to remain on these Bio-identical hormones.
Sorry this is so lengthy, but it does reinforce a reason not to ever stop these creams cold turkey if quitting, but taper off with physician guidance.
Your comments and opinion about the last statement would be appreciated.
Hi Wendy,
It’s usually not a good idea to stop any bHRT cold turkey; though in certain instances it can be done. And of course, a physician’s guidance is of utmost importance.
The main problem for most peri-menopausal women is a sudden drop in estrogen, which triggers many symptoms.
As far as creams, I’m not a fan. There hasn’t yet been an instance where I DIDN’T see a person get overdosed from taking hormone creams. When the tests are run, I always see levels that are anywhere from double to ten times the level that the hormone(s) should be. This in itself tends to pose a problem, sooner or later.
Take care and thanks for sharing,
Dr. Rob D’Aquila
Hello Dr Rob – How do you feel about accupunture for treating menopause. I’m reluctantly on bioidentical cream and want to slowly wean with the help of accupunture. Any opinions on that?
Thanks,
Hi Karen,
If you find an acupuncturist that is good, it certainly may help. However, I don’t believe that would be enough. When it comes to creams, the case is usually one of overdosing on that hormone. And when that happens, I usually recommend supplements and lifestyle changes that enhance liver clearance of those hormones.
Hope this helps,
Dr. Rob D’Aquila
Oh boy…I was just put on bHRT a few days ago. This morning after applying the cream instantly felt loopy in the brain and tired. Exactly what I have NOT been wanting and what I initially went in for. (adrnal fatigue issues or is it) Now am wanting to just take myself back off since so early in the bHRT game. This is a nightmare! Symptoms for too many years (17 plus) with feeling like being pulled this way and that with docs treating symptoms and not getting down to the root cause. I am afraid for my very life. What is a woman to do?
Hi Jean,
Simply giving someone hormones is definitely only treating symptoms. And, unfortunately in your case, those symptoms didn’t get resolved. Most people have some degree of adrenal fatigue, but it’s hard for me to say how much that is a factor with you…
You need to find a good practitioner to work with. I offer consultations if you’re interested.
Take care,
Dr. Rob D’Aquila
Hello Rob,
I am 47 years old and had begun experiencing night sweats, flashes, sleep interruption, irritability, depression, fatigue and lethargy along with many more symptoms. (Night sweats were apparent approx 1.5 years ago, other symptoms had increased over the years)
I found a doctor who prescribes bio-identical hormones, in order to have my hormone levels checked. When I explained the history of my symptoms, she recommended I try a low dose of bio-identical hormones; 15mg/.025ml in a versa base topi-click, from day 10 to menses.
I began taking the suggested progesterone on January 23rd, 2012. Unfortunately I misunderstood how much each dosage was and took less than was prescribed. This was corrected in March.
To add, I have a rare chronic skin disease known as HS or Hidradenitis Suppurativa. (Hidradenitis suppurativa is a skin disease that most commonly affects areas bearing apocrine sweat glands or sebaceous glands, such as the underarms, breasts, inner thighs, groin and buttocks) I have done extensive research on this disease as I have suffered with it for about 30 years. On January 27th, just after I began the progesterone, lesions occurred rapidly at a stage 3. I underwent surgery and had one drained and packed. I understand according the Mayo clinic and other records and pilot studies on HS that there is suspicion that the occurrence of these extremely painful and scarring lesions may linked to hormone imbalance. Having said that, no has been able to determine the cause of these initial blockages.
I realize this is a loaded question but have you any knowledge on how hormone levels could affect these occurrences and in your expert opinion, could the introduction of these bio-identical hormone replacement cause more imbalances?
Any feedback is much appreciated.
Painfully yours,
Margaret
Hi Margaret,
It sounds like your doctor prescribed based on symptoms alone. I see no reason to do that considering there are great ways to get very accurate measurements of hormones, esp. via saliva.
I am not at all familiar with the skin disease you are speaking of. However, based on what you said occurred, it certainly sounds like imbalanced hormones can affect your condition – I can’t say how specifically. Again, I’d get your levels measured properly and then perhaps you won’t have any issues.
Good luck,
Dr. Rob D’Aquila
Dr. D’Aquila
I am 40 years old and had a complete hysterectomy three years ago after going through 13 surgery’s for endodemetriosis. After the hysterectomy I was sent home with no hormones due to still having some endo. After 5 weeks I felt like i was losing my mind. My GYN put me on the V-dot patch and Wellbutrin. This helped for a period of time. Soon the insomnia, hot flashes, weight gain, headaches, lack of sex, mood swings began to become imbearable. In Oct 2011 I received my first HRC inserts as well as oral progesterone. Within a month of the inserts I began to sleep very well. However, I became very bloated feeling, much swelling and felt preg. I spoke with the Dr. about this and she decreased my next insert. By my third insert in Feb 2012 I expressed to the Dr. that my sypmtoms were very bothersome, swelling of my legs, feet, hands, face, weight gain in the middle stomach area. The dr then put me on a high dose of dieturtic for two weeks. This helped some, however, I have some kidney function issues so this was not a long term solution. I feel worse now then before with all the swelling. What could be the cause of all this swelling?
Thanks
Jenny
Hi Jenny,
Have you been tested for your hormonal imbalances? My guess is that you haven’t. Too often doctor’s prescribe on symptoms alone and it causes many problems. I would personally want a saliva test done to see where the levels are. There’s no use in speculating.
Also, your adrenal hormones could be contributing to swelling.
Good luck,
Dr. Rob D’Aquila
Hello again Dr. Rob. Thank you so much for your response on my previous question. Just to clarify, my Doctor did send me for bloodwork to test hormone levels prior to suggesting the low dose of bio-identical hormones. It was my understanding that the levels were not so bad however based on the symptoms, as you also suggested, my Dr. prescribed the hormone replacement in an effort to alleviate the various common symptoms of peri-menopause. I have just had more hormone level bloodwork done and am awaiting results. Is it your opinion that saliva testing is more accurate? It seems many woman, including myself are looking for answers to balancing their hormone levels to lead a more pleasurable life. What is your opinion on naturopathic remedies, as an alternative? It’s become very difficult to know who’s guidance is the most accurate. If taking a hormone replacement whether synthetic or bio-identical, is prone to cause more problems, what other option is there that is safe and natural and do you recommend one in particular over the other?
Kindest regards,
Margaret
Hi Margaret,
It’s nice to hear that your doctor didn’t go on symptoms alone, which is rather common.
As far as the difference between blood and saliva testing – they can both be accurate, however, saliva measures the “free” form of the hormone, which is what actually impacts the cells and produces an effect. It is possible to measure “free” hormones in blood, it is just very rarely done because of the expense. As a result, blood usu. measures the protein bound hormone levels and that only reflects the potential of the hormone to work. That’s because the hormone cannot enter the cell and have its effect when bound to its transport protein.
Also, reference ranges vary quite widely when it comes to blood results. I definitely prefer saliva tests.
I’m a big supporter of supplements and herbs. However, lifestyle changes need to be in place first. The reason many women suffer through peri-menopause is because of adrenal fatigue and inflammation. Simply adding hormones to the mix (although sometimes appropriate) doesn’t actually fix the problem. It’s totally normal for a woman’s reproductive organs to cease producing hormones; and for them to feel normal through peri-menopause and after menopause.
Good luck with everything,
Dr. Rob D’Aquila
Hi Dr. Rob!
I’m 46 and I have a micro prolactinoma, which is since few months treated with some ayurvedic herbs and rosemary essential oil, because I couldn’t tolerate the side effects of Cabergoline anymore. My prolactin level is now only slightly increased. I also have a hypothyroidism, I’m taking 25 mg L-thyroxin. Since last summer I have strong peri menopausal symptoms and my period is very irregular, with skipped cycles and extremely strong PMS. I have no libido anymore, which is causing problems in my marriage,also the problems with the bladder after intercourse, which is totally new symptom for me. I have insomnia, strong mood swings, fatigue and sometimes anxiety plus depressive moods. I can’t recognized myself anymore. I’m already visiting a therapist, but it don’t really help me.
So I’m considering some form of (B)HRT to get some life quality back again. I’m vegetarian since 25 years, I drink no alcohol and no caffein, I’m slim, I have rather low blood pressure, I’m meditating, practicing yoga, trying to avoid sugar and processed food. I have varicose veins, but not bad.
Regarding to my endo as long I have my periods I don’t need any estrogen or progesterone. But my symptoms are making my life so very difficult at the moment, that I can’t just wait till I’m menopausal…
It’s in my case ( prolactinoma) a HRT recommended? I don’t know what I should change in my life style to get some improvement. In my country the BHRT is still not very known, but I would definitely prefer bio identical hormones. I took the birth control pill only as a young woman, for 3 months and I didn’t feel well on it.
What would you suggest me?
Thank you!
Diana
Hi Diana,
I can’t say that HRT is recommended because of the prolactinoma. Also, it sounds as if you have that under control by saying that the levels are only slightly increased.
Generally speaking I would agree with your endo in saying that you are not automatically a candidate for HRT simply because you are experiencing peri-menopausal symptoms.
My assumption, without seeing the entire picture (including labwork) would be that you need to get your general health in order. Those with weak adrenals tend to get the worst symptoms going into menopause. Based on your saying that you have “rather low blood pressure” and have been a vegetarian for 25 years leads me to believe that your adrenals aren’t up to par.
Also, I very rarely see vegetarians that don’t have adrenal stress. This is usually due to blood sugar imbalances caused by a lack of protein. I can’t say for sure, but that is what it sounds like.
If you were my patient, I’d have all your hormone levels (including adrenal) measured via a saliva test, in addition to extensive blood work and take it from there.
My best,
Dr. Rob D’Aquila
Dear Dr. Rob,
thank you for your reply! I already asked my endo about possible adrenal fatigue, but he said there is no such diagnosis, only Morbus Addison which I don’t have, so I should do more sport and maybe take an anti depressant… He is supposed to be one of the best endos, but isn’ really helpful… My blood levels of cortisol and ACTH are in the norm range, ( he don’t see any need for saliva tests) but in the lower area. My ferritin is 55 ( 10-150) which is supposed to be o.k.
Would you suggest me to eat more protein like soy, tofu and cheese? I have to say that I had regularly problems with low blood sugar and hypoglycemia through my childhood in my youth, when I eat a lot of meat. Now as a vegetarian my blood sugar is actually better, although sometimes ( mostly before the period) I feel like having low sugar. I’m taking Ashwagandha and Royal Jelly for the adrenals, on my own.
Thank you!
Diana
Hi Diana,
You’re welcome.
Your endo is clearly focused on pathology and not functional medicine, as so many endos and MDs are in general.
And your endo recommended an anti-depressant??? On what grounds? Have he measured that you’re low in serotonin or norepinephrine? I wonder why that’s suitable without a diagnosis of clinical depression (and presumably no lab testing) however functional adrenal fatigue is not. Adrenal fatigue can at least be measured via saliva – although there probably isn’t a standard diagnosis code for the insurance companies and medical profession, and so it is ignored. The questions above are rhetorical…
Blood levels of cortisol (especially one sample) is about as useful as a screen door in a submarine – UNLESS there is pathology. Again, saliva is the way to go when it comes to functional adrenal issues (4 samples throughout one day). He probably doesn’t see any need for saliva because he is not familiar with it and doesn’t know how to interpret it. Bear in mind that I am in no way mocking your endo. I’m sure he’s smarter and more experienced than me. It’s just that we do two different things – function vs. pathology.
Ferritin at 55 is OK – TIBC and other RBC markers should be evaluated as well, however. If you are anemic in anyway, you can’t expect to get very well, because that would mean that your cells are deprived of “the most” important “nutrient” – oxygen.
I don’t recommend that anyone eat soy or gluten. Dairy is OK on a case by case basis in my opinion. However, when it comes to protein, I recommend meat, i.e. beef, fish, chicken, turkey, pork, lamb, eggs, etc.. Again, I can’t ever recall seeing a vegetarian with balanced blood sugar and healthy adrenals. And every time I see a patient in that state begin eating meat, they get better and never go back to being vegetarian because they feel so much better. I know it’s tricky with morals and just the thought of eating animals for some people. I’m just going with what I see and basing it on physiology.
I can’t say why you’ve had problems as a child despite eating meat. There are many reasons for blood sugar imbalances. And I’m certainly not suggesting that eating meat “fixes” blood sugar imbalances. I see plenty of people with blood sugar imbalances that eat meat – probably more, because I see more people who eat meat. However, I still rarely or never see people who don’t eat meat (or at least an adequate amount of protein) with healthy blood sugar. And what I’m saying is that from what I see, people that don’t eat meat don’t get enough protein – often because carbs are substituted for protein.
For all I know, you’re better off without meat. It could be something else driving your blood sugar issues, and low blood pressure issues (and presumed adrenal issues). Infections, nutrient deficiencies, emotional stress, and food sensitivities are just a few other issues that can adversely affect blood sugar. It’s very difficult for me to know what’s going on without seeing labwork and going by comments alone. I’m sure you understand.
I hope this helped at least somewhat.
Good luck with everything,
Dr. Rob D’Aquila
Thank you for your answer! I have only one more question- my hemoglobin is always about 12, ( norm range 12-16), or 11, although my ferritin was few months ago 55. I wonder why the hemoglobin is always so low and if this levels can actually already make me feel anemic? Last two periods were very strong and I have lost a lot of blood. So now I feel even more fatigued. But all doctors always say my iron and ferritin are o.k.. They said this even when my ferritin was 11 few years ago. ( was still in the norm 10-150…) Which ferritin and hemoglobin levels you recommend to your patients as optimal?
Thank you once again!
Diana
Hi Diana,
I like to see ferritin above 40 and hemoglobin from 13.5-14.5.
Also – I use 250-350 for TIBC, total iron binding capacity; which is an important marker to look at.
Hope this helps,
Dr. Rob D’Aquila
Hi there,
I have been lost and confused about what to do about peri-menopause symptons, the worse being overly emotional and basically crying for 3-4 days for no real reason.
I thought I would try NHRT and since starting it 10 days ago I have been totally exhausted, mainly because I just can not get to sleep. I am not a good sleeper but this is not normal for me.
Does NHRT do this as I thought progesterone helped with sleep.
Now I feel flattened and not sure where to turn.
Thanks
Jude
Hi Jude,
HRT should not be disrupting your sleep. It sounds like you need to dig a little deeper and also get your hormone levels checked.
Also, sometimes the thyroid is the culprit with being overly emotional and crying for no apparent reason.
Take care,
Dr. Rob D’Aquila
Dr. Rob D’Aquila
I started seeing a natural doctor, Dr. Cushing. He is great and has opened my eyes to alternatives. I am 45 years young and its been challenging to lose weight for a long time. I was diagnosed with PCOS around 18 years old or so… Anyway, I have been trying to lose weight for about a year now and I lost around 25 but I keep gaining 10 or so back. I cut down on the “bad” carbs (white rice, pasta etc). I have not eaten red meat since 85 and just stopped eating chicken 2 months ago (I was just tired of it).
I met with Dr. Cushing and he said that based on our conversations he feels that my hormones have something to do with it so he ordered a saliva test. Now, I am anxious because I dont want to take any type of synthetic or bio-identical hormones. His choice is neither of those by the way. Im assuming he will treat whatever it is naturally. I just dont know what that may be…how or what he will do. Im just frustrated….
Any ideas or suggestions?
Hi Kim,
First, you should wait and see what the results show and then decide if you’re comfortable and able to implement his treatment plan.
Issues with weight loss could be related to cortisol or thyroid hormones. Also, with the history of PCOS, you may elevated testosterone and blood sugar imbalances.
See my most recent article on this topic by clicking here: http://robdaquila.com/2012/04/23/blood-sugar-imbalances-can-alter-estrogen-and-testosterone-levels/
Good luck,
Dr. Rob D’Aquila
Hello,
I am is a predicament, I am 49 years old, and have chosen a really healthy lifestyle. I eat an organic, hormone free, 100% all natural diet. I exercise everyday (just ran a half marathon 2 weeks ago) and I have a great Immune system. I am experiencing full blown menapause symptoms, The worst is the NO sleep cycle. I have bloated weight gain across my upper body and during intercourse. I took a spit test and it showed extreme lows on across the board on ALL the hormones. I sought a doctor and we did a major blood panel yesterday and she ordered bio Identical hormones that will be delivered today based on the results of the spit test.
Question: should I take them? or wait to get the results of the full blood panel? The blood panel includes all hormones, thyroid, adrenal cortisol,ect.
I am tired, and have not slept more than 3 hours straight in months.
Hi Shari,
I can’t tell you to or not to take any supplements or hormones because you’re not my patient and obviously don’t have a full history, exam, or lab results.
Personally, I would wait until ALL the results are in before moving forward. I would wonder why a test was ordered if its results weren’t going to be considered for treatment.
I offer phone consults if you’re interested.
My best,
Dr. Rob D’Aquila
Sleep is my biggest issue as well. I felt that if only I could sleep, I could handle all the other symptoms with ease. No sleep has such huge impact on our lives, and our ability to function normally. After trying many things, I finally relented and went on low-dose bio identicials with much success. I don’t sleep perfectly, but I sleep. I recently began acupunture and am slowly weaning myself off the hormones. I am surprised by the acupunture’s effectiveness. Anyway, good luck. Had to write, as I know so well, how you’re feeling. Take care.
Dear Dr. D’Aquila,
I found your article and the discussion most useful and informative. I have found your website because I was looking up information on bioidentical hormones, which I was considering taking because of my overall state.
I am 37 years old and about two years ago, I have had a sudden onset of allergies that I have never had before – hives, swollen eyelids and face, intestinal cramps and bloating. After a long, frustrating and painful search, I finally narrowed down the allergies to caffeine and dairy.
I must say, however, that I liked sweets since childhood and have eaten these quiet regularly. One of my favourites was dark chocolate which I eventually got to consume everyday. In rest my diet was healthy – strictly organic unprocessed, natural foods. I have also done severe 6-months candida cleansing regimes (I did not have any classical symptoms, I just thought it might help to break the vicious cycle of dependency on sweets) three times in the last 15 years as well as liver cleansings.
After my brother died 16 years ago, I had a severe hormonal imbalance and was eventually put on natural (wild yam) progesterone (Prometrium) for one and a half years to bring my body back into balance. By that time, when I started on Progesterone, I have not had my period for 6 months. Prometrium seemed to have done the job, so I have gone off it.
Now, with the onset of these allergies, I have also felt a decrease of libido (down to nonexistent now) and a feeling of constant tiredness and brain fog. My hair also seems to reflect these undesirable changes – it is listless and bit finer.
I knew that there is a link between hormones and allergies and went to an endocrinologist and asked to be prescribed only testosterone (for the libido) because I thought I was too young for HRT. Was I ever surprised when she told me that I was peri-menopausal! I thought: I AM TOO YOUNG for this. I follow now a diet that is fully organic, stripped of everything except protein (no dairy except raw milk org. butter), vegetables and fruits, seeds and nuts, raw veg. oils and occasionally some non-gluten crisps. So, almost no carbs.
The testosterone she prescribed for me – Testim – is a synthetic one, if I am not mistaken. I have applied the gel for a month before I stopped it because it did nothing for libido and added some other effects (over sensitivity).
I know that my adrenal glands are probably the culprit of all my problems. While I was eating all this sugar, I had extreme mood swings, crying fits, depression and feeling of hopelessness. I never, however, took anything else to alleviate these problems. Now that I changed my diet, I am a different person, calm and content if it would not be for these symptoms that interfere with my ability to do research and write my PhD.
I would gladly come to you to be treated if I was not in Belgium and I was wondering what tests and treatment should I request the endocrinologist in order to treat these problems – food and makeup allergies, brain fog, tiredness, lack of libido and listless hair?
I am most grateful to you for this help.
Kindly,
Kassandra
Hi Kassandra,
At this point I would continue eating well, and avoiding food sensitivities you know of.
As far as tests, you may as well go all in and have everything checked. Adrenal hormones are best checked via a 4-sample saliva test, and hopefully your endo will be willing to do that and know how to interpret it. Additionally, I would again, check everything – all the basics inc. anemia markers, blood sugar, immune system, liver, thyroid, pituitary and all sex hormones via saliva as well.
Lastly, don’t rule out the emotional impacts on your life. It sounded like everything began with the death of your brother. I would guess that that began a major disruption in your neuro-endocrine-immune axis which has never been fully resolved. For a situation like that there is a technique called Neuro-Emotional Technique, amongst many others like EFT, and the list goes on. Additionally, I find homeopathic remedies and flower essences to be helpful in that realm.
Good luck and I hope you find the relief you are looking for,
Dr. Rob D’Aquila
Dear Dr. Rob D’Aquila
I am a 43 yr. old female.I started on bioidentical progesterone last year due to hot flashes, spotting every day for 3 months and was very anemic as a result and basically felt like out of control PMS emotionally ( with weight gain) for approx. the previous 6 months. In the last year I have lost 12 lbs, slept each night through, had no hot flashes and felt the emotional balance that I’m used to return. It felt miraculous because all these symptoms went away almost immediately. However, I am now losing my hair. Can progesterone cream ( bioidentical) be causing this? I don’t want to stop the cream as it has helped me so much, but if it is causing hair loss, then of course I will need to. I really appreciated your article on how hormones work and I’m now realizing I’ll need to ween off this cream, but I’m a afraid to just stop it.
Hi June,
I hope you took care of the anemia as that is critical! It’s difficult for anything to improve well and permanently with anemia. Cells need oxygen to function to properly…
I would check ALL thyroid markers to determine if that’s a culprit in the hair loss.
Also, weening off the cream may be necessary, but other measures should be in place if necessary.
Good luck,
Dr. Rob D’Aquila
I’m 44 and I’ve been taking bioidentical hormones for at least 2.5 yrs now… The reason I started on them was because Ive always had horrible mood swings that NO Dr. Has ever related to. It’s disruptive to my daily life and I needed a natural solution. Every Dr I’ve ever seen just wanted to label my symptoms as PMD and throw some antidepressants at it, which are a ridiculous solution. My breasts are more tender than they have ever been and my periods are more frequent, migraines are more stubborn and progressive and laty I’m dizzy all the time. Oh, and I have a lump that wont go away (it was cleared ok, by the surgeon). I think I wanna go off the bio identical progesterone, but I worried I could cause more problems… Any thoughts??
Hi Heather,
I would get all your levels checked via saliva. You can do a test that measures and charts the entire cycle by taking samples throughout the month.
It could be a build-up of progesterone in the system (which will affect the balance between estrogen and progesterone) and/or a dropping of estrogen if you are going through peri-menopause.
Best regards,
Dr. Rob D’Aquila
Thank you. Where would I get saliva tests and who would perform the lab results? Again, thank you for your time and advice.
Heather
You’re welcome.
I use a lab called Neuroscience b/c it’s the only one that operates in NY. You should see the care of a practitioner who is proficient in analyzing the results of the test. They would be the one to order it as well.
I started bio-dentical hormone replacement a month ago after 3 sleepless years and more recently a complete lack of sex drive. I immediately started feeling agitated and itchy. After 3-4 weeks i am sleeping better but am still “testy” and itchy. I also started taking thyroid pills. My doctor has broken down the creams separately so I can try to figure out what is causing the side effects. He seems to be at a loss. Any thoughts or suggestions?
Hi Melissa,
There are a lot of possibilities here and it may just be best to test everything out as you’ve been suggested to do. Hopefully it’s a response that is easily reversible so you can figure it out. And hopefully you don’t get other changes by going off the hormones causing more confusion. Also, read my latest article on the home page about using bioidentical hormone creams and their risk factors.
Good luck,
Dr. Rob D’Aquila
Hi, Im 30 years old and have had absolutely NO sex drive for almost 2 years. No arousal at all. Ive heard that bioidentical hormones can help with sex drive. I havent been tested. But do people as young as 30 get on hormones for sex drive? Am I too young to be on hormones?
HI Katie,
I’ve heard of people as young as 30 taking hormones, although it’s certainly not commonplace. And personally, I feel every other option should be explored before using hormones; unless there are dire circumstances at play.
Typically women aged 30 will be put on oral birth control pills for hormone regulation, as you know, however, I haven’t seen it for libido.
A lack of libido is often related to low testosterone. And of course, the reasons for that should be determined. Emotional/circumstantial issues should also be considered.
You should get evaluated by a qualified, competent, licensed health care practitioner.
Take care,
Dr. Rob D’Aquila
I am 56 years old and have not been sleeping well, gaining weight in the midsection, always tired, foggy memory, mild occasional dizziness, etc for several years, last period six years ago. My doctor ordered blood work which showed very low levels for progesterone and estrogen and wants to prescribe HRT. What is your opinion…..
Hi Rachelle,
You’re certainly experiencing some serious symptoms, as are many women…
My opinion is that it bHRT may be helpful to get things moving in the right direction, but you must consider the other factors at play. It sounds like you have insulin and cortisol issues to deal with as well. They’re often the culprit in weight around the midsection, and dizziness also sounds blood sugar related. The fatigue and memory could have to do with thyroid imbalances. And lastly, the brain may need to be addressed.
As always, I highly recommend getting the basics in order before taking hormones to see if they’re really needed. And of course getting the basics in order even if a person is taking hormones is recommended – i.e.: diet/lifestyle
Lastly, I prefer the lowest possible dose and the least length of time when it comes to adding bHRT.
Read the comments above to see what I mean about that. They may seem like a miracle at first, but that may be fleeting if primary issues are not addressed.
Good luck,
Dr. Rob D’Aquila
Dr. I got a saliva test that showed my cortisol levels low my estrogen, progesterone and testosterone are all low. I have energy I get regular periods, however I crave sweets from time to time and have panic attacks. my health practitioner said I had adrenal fatigue. I have a special diet take probiotics and vitamins. He told me to take sublingual DHEA pregnetelone and progest For 12weeks but never told me when to start them. Should I just go to my regular OB and see what he says. Can I have a regular cycle and have such low hormone??
Hi Marie,
Well, you said you have “regular periods” and therefore I suppose you can with low hormone levels.
You may very well have adrenal fatigue and that probably somewhat explains or is related to your sweet cravings and panic attacks.
As far as female hormones though – a cycling woman should do a “female cycle map” in which saliva samples are taken throughout your cycle in order to see how your hormones measure throughout your entire cycle as opposed to just one day of your cycle.
Personally, I prefer to get hormones balanced without taking hormones and use supplemental hormones as a last resort only, especially if you’re young and far from peri-menopause.
Good luck,
Dr. Rob D’Aquila
I have been on pellets and progestren pills for about 6 months. It took away the need for anti-depresant within three months. I have had trouble sleeping for years after a tramatic event and although not 100%, I am sleeping better (still have to take an anxiety med) . Now tho I am having cramps that feel like when I used to have a regular period. Should I consider this my jump start and try something else. Also what does the salavia test indicate? I had gone to a herbal dr. and he told me my salavia test was not good. I also notice my tounge stays white coated and I had a round with thrush? I want to feel better with no meds. I am 51 and never had a weight issue until last 5 years.
Hi Lee,
A saliva test will show you the levels of your hormones. That can be important when dealing with someone who is experiencing “hormonal” symptoms.
I can’t say if it’s time for you to stop taking hormones, but I can say that it isn’t normal to get your period back if you’ve already went through menopause naturally.
Lastly, it sounds as if the “traumatic event” led to a primary adrenal issue which may need to be addressed in order to get you fully healthy and symptom-free. Also, if you have or had thrush, you may want to consider yeast overgrowth lower down in the digestive tract that may be affecting your health adversely.
Good luck,
Dr. Rob D’Aquila
Ok Dr. Rob want to tell ladies beware. Yes, on the beginnig I was feeling better. I am 5 weeks into last pellett. Right after last pellet isert my period gets heavier now bleeding everyday. My testastrone level was 260 three weeks ago, my Dr. Said it would not peak until 6 weeks. So no telling what my level is now. They increased my progestern to 200 and I am still having period. Feel bad, sleep not good,headache. My Dr. Has finally scheduled a ultra-sound. I forgot to mention my estrogen is still low. An RN friend of mine says she thinks I am estrongen low due totestastrone dominance. What do you think Dr. Rob. They say cannot remove pellet, ladies be careful.
Hi Lee,
Your situation is complicated and I can’t be sure exactly what’s going on based on this information. You need to be monitored well and frequently. Also, check anemia with the excessive blood loss.
Take care,
Dr. Rob D’Aquila
Okay, I’m confused, just picked up my prescription from the pharmacy, progesterone 30mg troche and estrace vaginal cream 42.5gm. The first thing I read is on the literature is that estradiol is a synthetic hormone, I was emphatic about only wanting bioidentical hormones, have I been duped???
Hi Rachelle,
It may be called “synthetic” because it was “synthesized”. However, to my knowledge it is estradiol which is the hormone made in the human body.
Speak with the pharmacist or prescribing physician.
Take care,
Dr. Rob D’Aquila
Can you make any recommendations for doctors in the Dallas/Ft. Worth area who are on the same wave-length as you?
thanks!
Hi Glory,
I don’t know anyone personally in the Dallas area – but it may be worth going to the Professional Applied Kinesiology website and finding a practitioner there.
Here’s a link – http://www.icakusa.com/
Good luck,
Dr. Rob D’Aquila
Good article. I’m a Naturopathic Doctor and always straighten out patients hormones using herbs, diet and lifestyle before jumping to the bioidenticals.
One issue most people, even Doctors don’t seem to understand is that the biofeedback can turn off or slow down other hormones in addition to the one being targeted.
Hi Barry,
Thanks for the comment. Yes, you’re absolutely right. The endocrine system is completely intertwined and an imbalance in one will cause an imbalance in another.
Take care,
Dr. Rob D’Aquila
I meant negative feedback, not biofeedback. 🙂
Hi Dr. Rob,
I thought maybe you can answer my question: since one year I’m taking 25 mg of synthetic thyroid hormone for my hypothyroidism ( TSH was over 3, free hormones in the lowest norm level). Since I’m taking the pills I have all the time anxiety, which was even worse when I increased the meds on 50 mg- I had fast heart beat, severe nervousness and panic attacks. When I went back on 25 mg I feel little bit better, but I’m still very anxious and nervous. My TSH is now 1.7 and the free T3 and T4 are still in the lower norm range. Could the thyroid meds cause anxiety? Is there some natural remedy for the hypothyroidism? I don’t have Hashimoto, I have increased prolactin levels,(48) but I don’t want to take Bromocriptine, my cycle is still more or less regularly, estrogen quite low. I’m 47.
Thank you!
Hi Barbara,
Thyroid meds can certainly cause anxiety, nervousness, panic attacks and an increased heart rate. You may need to switch the type of thyroid hormone replacement or monitor the dose better. Blood tests are ideal for that.
Also, you need to get to the bottom of why your thyroid hormone levels are imbalanced in the first place. There are many possible causes.
Good luck,
Dr. Rob D’Aquila
Dear Dr. D’Aquila,
I am 55 and just started going through menopause. I started doing bio-identical Estrogen/testosterone pellets and progesterone pills.
I have had a medical problem for several years where my legs become weightless and I have no sense of where they are in space. It is like I am on a boat and can’t get off. I believe it might be a form of dizziness, however it is felt in my legs mostly. During these episodes I will either fall or grab hold of something and sit down. The episodes usually last for 1 to 2 hours.
Besides my legs feeling weightless I usually have a slight headache, feel very tired and lethargic (mostly in my brain), sometimes my right eye twitches and my legs feel weak.
When I am not having an episode I feel generally off-balance. My balance and gait is not good.
I have seen several doctors, but all tests come back clean except I have nystagmus in both eyes and my blood pressure is extremely low (usually 87/56). It has gone as low as 97/40.
Since I went on Bio-identical hormones my symptoms have become worse. I have had 6 episodes in 4 weeks. I usually have 1 episode every 3 months.
Do you think there is any connection between my symptoms getting worse and the bio-identical hormones?
Have you ever heard of these symptoms and can you shed any light on what direction I should go?
Thanks so much for your help!
Deborah
Hi Deborah,
It certainly sounds as if the hormones exacerbated your symptoms. I would have a brain MRI done and also lumbar MRI’s to rule of a spinal cord issue because of the symptoms in your legs.
Lastly, I’d seek out a chiropractic neurologist if I was you.
Good luck,
Dr. Rob D’Aquila
Thank you Dr. D’Aquila for replying to my email and for your expertise. I had a brain, neck and spinal MRI, as well as a lumbar puncture, but so far it is a mystery as to what is causing my balance issues. Thanks again.
You’re welcome Deborah,
If it were me I’d look into a qualified chiropractor skilled in the studies of the Carrick Institute in addition to blood sugar and other endocrine issues (e.g.: thyroid and sex hormones).
Best,
Dr. Rob D’Aquila
Thank you for your caring attention to people’s questions. I am in California, 58 years old and the blood work showed very low levels of estrogen, progesterine and testosterone. I am seeing a Naturopath and she prescribed the estradial, progesterine and testosterine creams which I have been taking for about three months. I seem to be sleeping better and feel pretty good. My weight is 146 pounds (down from 151 pounds when I started HRT) which is too much for my height of 5:1″. I believe that I eat pretty healthfully and I do an intense Zumba workout four times a week. My Thyroid level was 2.5 so the doctor put me on Armour. I thought the heart palpilations were from the Armour so I stopped that after a couple of weeks. However, I seem to still get heart palipations. So my questions are this: 1. Can estradial, progesterine or testosterine creams cause heart palpilations? 2. Would you recommend that I wean off of the hormones so I don’t get the negative loop cycle as you mentioned in your article? 3. Should I take another form of HRT instead of the creams (which you wouldn’t touch with a ten foot pole)?
Thank you very much.
Enid Sterling
Hi Enid,
I understand your concerns. As far as the thyroid level, I’m not sure which actual marker you’re referring to. There could be more than one that register with that number.
I stand by what I’ve written about creams (except intravaginal). And I also stand-by where I would (generally) start with a patient.
The questions you’re asking me are very specific and would I’d basically be managing your case if I answered them. For one, you’re not my patient, so I can’t manage your case, and two, I don’t have enough information to answer those questions.
I hope you understand. And if you’re not confident with your practitioner you should seek another.
Take care,
Dr. Rob D’Aquila
Dr. Rob-
So glad to have found your site. I am a 46yo and just had saliva testing done because of perimenopausal symptoms (mood swings, lack of concentration, decreased libido). Results showed decreased progesterone, but estrogen and testosterone were well within normal limits. DHEA was borderline. I was prescribed 100mg progesterone capsules to take day-21 to menses. I’m scheduled to start taking them next week. My questions are: Is it typical for these symptoms to be caused by low progesterone alone?What is your view on compounded capsules vs sublingual liquid or pellets?
Hi Stacey,
I like sublingual liquid or pellets. I’d also look into the adrenal glands, and why they might be stressed if that is the case. A 4-sample cortisol test is useful, and then further investigations if there’s an issue with that test.
Good luck,
Dr. Rob D’Aquila
Dear Dr.,
I am currently on Bio Identical HR. Recently my hair has been falling out and thinning. The doctor says my testosterone may be too high..She says next time she will lower it. In the mean time what do I do for the hair loss? All my hormone levels were rock bottom she told me before starting the pellets. I am really worried about this. Have been on the internet all day looking for answers. So many products on the market for this. What do you buy> How can you know which ones work and which ones don’t. I know you can’t give me an diagnosis but can you steer me in the right direction? I don’t even know if the pellets are causing the hair loss.
Hi Pinky1252,
It could be excessive testosterone. And it could also be a thyroid issue due to many possible things, one being estrogen imbalances (excess).
It’s too difficult to say what to do about your hair loss without enough information.
Good luck,
Dr. Rob D’Aquila
Hi, I’m so glad to find you. I’m a mess right now and need some direction. I am 60 years old, post menopausal, and have Hashimoto’s. I have been on Synthroid 75 mcg for 3 years and all labs now fall into “normal” ranges. But I have no energy, muscle fatigue, generally not feeling well. My doc says I’m ok. Clearly I am not.
About a month ago, I went to an anti-aging/wellness center. I had lab work done that showed I barely had enough estrogen, progesterone, testosterone to even measure. The dr immediately changed me to Armour 90 for my thyroid (he said he doesn’t want me to take anything synthetic), started me on Progesterone 200 mg, DHEA, Biest cream 60:40, B-12 shots weekly, and I’ve had 1 testosterone shots.
Additionally, he told me to cut out all carbs, especially gluten, which I have done. I have discontinued diet coke and drink water with an occasional glass do unsweetened iced tea.
I started having severe hyperthyroid symptoms after 2 weeks on Armour so he told me to stop for three days and resume Armour 60. About a week later is developed hyper symptoms again (those symptoms went away on my three day hiatus).
Last week I had labs repeated (haven’t gotten results yet) and I was told to stop Armour, start taking Synthroid again, and they would be in touch about switching me to Nature-thyroid.
I feel horrible! I do have more energy but also shake like a leaf most of the time. I feel anxious and my blood pressure is bottoming out on me. Sometimes my heart rate is 100+.
I’m scared to stop taking the hormones and I’m scared to take them. I want to be fair to the doctor to give him a chance to sort things out but I can’t keep going like this.
What would you suggest?
PS. My adrenal function looked ok on my labs, the doc said, but my cortisol levels were high. And he said I do not have metabolic syndrome.
Thank you so much for any insight.
Barbara
Hi Barbara,
It’s possible that your immune system quelled it’s attack on the thyroid gland causing you to need less thyroid hormone. But it’s also possible your immune system mounted an attack on your thyroid gland leading to a leakage of more thyroid hormone in the blood stream and causing the hyper-symptoms. I’d look to get the Hashimoto’s under control ASAP. Lifestyle is key. And I’d keep measuring as many thyroid levels as possible, in addition to getting the cortisol under control.
Good luck,
Dr. Rob D’Aquila
I started Hrt last Nov.I had to do something,I felt exhausted, could not sleep, has no sex drive what so ever.I was in full blown menopause.I feel like a total different person now.I have energy, I’ve had 1 cold ,a year ago I think I was sick all the time.My sex drive is better than I ever remember it being.And I have started to lose the menopause wt I had put on.They do check my labs before dosing wth the pellets.Im glad I decided to go this route and so is my husband 😉 !
Hi LuAnne,
Thanks for your comment. I’m glad you found the help you need, and with what sounds like a good practitioner. This forum has been in need of some comments that shed a nicer light on bHRT. Good for you!
Take care,
Dr. Rob D’Aquila
HI Dr. D’Aquila,
I am a 41 year old female. I have been in excellent shape for my age for as long as I can remember as exercise has always been a part of my life even as a young child. I eat mostly a grain-free, dairy free diet that includes mostly non-starchy vegetables and lean/clean protein. I’ve done this for years. I am a healthy weight of 115 for my 5’1″ frame.
After being on the birth control pill non-stop for about 17 years, I went off it 5 years ago. I also had a very stressful marriage and got divorced after being together for 16 years. I was worried about what the BCP might be doing to my system. That’s when I went super clean with my eating as well (very little processed foods, mostly organic, non-hormone, non-GMO, etc.). Just after that, my thyroid plummeted. I was exhausted and gained about 15 lbs in a month. I was still exercising a lot and eating this same diet. I had my thyroid checked and found my TSH to be close to 4. I saw an endocrinologist and went on Synthroid. But, because of my views on BigPharma, I didn’t feel comfortable taking that so I went to an integrated clinic that focused on hormone balancing via bio-identical hormones. I started taking a T3/T4 combo. Then, about 2 years later, I was feeling weepy, sad, and low energy (even though my thyroid was fine). And, even though I felt the happiest I had in years. I found out my progesterone was low. So, I started taking bio-identical progesterone (in a slow-release tablet). It is a tablet that bypasses the liver (http://belmarpharmacy.com/belmar_apart.htm). I started to feel good again.
Well, just recently, I noticed hot flashes that wake me up at night and keep me up. And, I have been very moody and weepy again. Although I haven’t had any weight gain. I recently had my blood work for a complete hormone panel and my thyroid was back down to 4.05 (when it had been close to 1 (when I was feeling good). My Estradiol is now super low at 24, My Testosterone is below the low end of normal at 7 out of a range of 8-48.
My doctor prescribed an increase to my bio-identical thyroid medication (almost double the dose). Then, she changed my progesterone to include DHEA and pregnenolone.
After reading your page with the risks of being “addicted” to hormone therapy, I am a bit freaked out that I might do my body more harm than good. But, I am also exhausted and have felt the feelings of not being a “woman” or losing my femininity and sex drive.
What else could have caused such a drastic drop in all of these hormones? Is there another test you would recommend?
I am scared and would love your opinion.
Thank you,
-Ali
Hi Ali,
Birth control pills tend to increase the amount of Thyroid Binding Globulin, the transport protein that carries thyroid hormone around the body. When the hormone is bound, it can’t work at the cellular level. It’s possible that when you went off birth control, your TBG levels dropped, causing an excess of free hormones leading to thyroid resistance and the eventual down regulation of the thyroid gland.
Once you said you were feeling weepy, sad and low energy, it was (mostly) obvious that your thyroid wasn’t fine. TSH is not the only thyroid marker that should be looked at in my experience.
I’d look into your adrenal glands and possibly neurotransmitter and brain function to determine why the levels are low at this point. It’s hard to say if your system is down-regulating, but it’s quite possible. It sounds like your adrenals are an issue based on the recent Rx of DHEA.
I would run all blood and saliva hormone tests I could, and also look to other stressors like infections, blood sugar, GI function, liver function, and even emotional factors as well.
Good luck and I hope you find what you want,
Dr. Rob D’Aquila
Thank you so much for responding. Amazing how much the BCP can mess up the system. I definitely suspect that and the emotional stress.
She did run a T3 and T4. Is there a specific test for the adrenals, neurotransmitter and brain function that you’d recommend? I do have gall bladder issues and several cysts on my ovaries. I have tried dietary changes with eating little sugar/grains/fructose. What about a complete nutritional panel too? I am a firm believer in trying to getting to the root of the problem.
Any further information would be helpful.
Thanks,
-Ali
Also the Biodentical Hormones seem to be giving me heart racing mainly at night. I’m hoping this is not stress but I did find some time ago that vitamins make my heart race.
You’re welcome.
I would use a saliva panel for adrenal function. Brain neurotransmitter levels can’t be measured accurately other than through questionnaires.
Good luck,
Dr. Rob D’Aquila
Lisa,
A racing heart is obviously not normal.
I’d consider stress hormones/neurotransmitters and Hashimoto’s Disease.
Good luck,
Dr. Rob D’Aquila
Hi Dr. Rob,
I have been reading your posts and it has been so educating for me, thank you for the information. After reading all of the other ladies posts I must say I am quite embarrassed to tell my measly story as it does not compare to what some of these ladies are experiencing. I wish them all the best 🙂
I am 44 yrs old and I consider myself healthy. I have 2 sons, that I had very young in life, I was 16 and 18 yrs of age at their births. I am never sick, I exercise, eat right, no fast food and I am a runner, play lots of singles tennis. However, I have always had extreme PMS but only in the way of my mood swings, very weepy, insecure feelings usually a week before my period. My cycle is every 26 days on the money and my period from start to finish is 7 day, (the 2nd and 3rd day heavy bleeding).
In the last year I have not been sleeping (waking up in the night), right before my period I sweat in the night (not horribly, just wake up with sweaty breast, bizarre,) forgetfulness, brain fog, but the mood swings are horrible and worse!! I have a pretty stress free life and have never been a worrier but with these horrible mood swings and anxiety, to the point where I feel like everything in my life are bad. My husband is looking at me through all this thinking, “What is going on, where is my wife.” I feel like my sex drive is pretty good, especially right before my period is to start.
So I know a couple of ladies who have done the bio-identical hormones so I thought I will go check it out. I did some research and went to a Dr. here in Atlanta that is pretty reputable. Before my appt. I was sent for blood work (day 19 of my cycle). When I went for my appt. I sat down for the consultation and he was talking to me about what happens to women during peri-menopause and something to do with serotonin in the brain. It is all kind of fog to me now (imagine that, can’t remember) but here were my labs
TSH 3.24uIU/mL, T4, Free (Direct) 0.96 ng/dL, T3 82 ng/dL, Testosterone, Serum 17 ng/dL, Free Testosterone 0.2 pg/mL, FSH 2.8 mIU/mL, Estradiol 251.4 pg/mL
So he tells me he is not ready to prescribe me Estrogen yet b/c of my mother sister having breast cancer and that Testosterone would help even everything out (this is where he talked about the serotonin) and that the ratio to help even out the mood swings and sleeping and I am going to feel great. So I go ahead get the Testo pellet inserted. I decide when I get home that I am going to do some more research.
Now I am scared to death. My estrogen level (from all my research) seem a little high and correct me if I’m wrong but I definitely am not in peri-menopause with a estrogen level like that, my testosterone is a little low. Now I am scared about these testosterone pellets inserted in me. Does it sound right that testo will help my mood swings and sleep. Oh, the other thing was he told me to go to the Compound Pharmacy to buy DIM 100mg and take twice a day. Does any of this make sense to you Dr. Rob or am I over-reacting?
Dr. Rob, By the way he never mentioned Progesterone to me and I’m reading about it everywhere and it seems to go hand in hand with Estrogen. I don’t even see the result for progesterone in my labs.
Hi Susan,
When a woman is cycling I prefer to use a salivary female hormone map which measures levels throughout the days of the cycle and then graphs the results. This way, you can really see what’s going on and when. I don’t use blood tests for female hormones.
And yes, I would have looked at progesterone too, but again, via saliva.
It’s hard to say how much testosterone will affect you (negative or positive), but as you probably know, I’d never start a patient on bHRT unless it seemed absolutely necessary.
I agree about serotonin possibly being an issue, and thyroid function is also something to consider.
You may need a lot of support for your brain, considering your symptoms.
I hope things are working out well for you,
Dr. Rob D’Aquila
Thank you Doctor for your article. I am very distressed. I have been on the bioidentical HRT since June (about 2 1/2 months now) and am on my 3rd time with bad cramps and heavy bleeding. The gynecologist connected to Woman To Woman took me down to 1 pill at night instead of 2 per day but nothing has changed. She put me on it originally because of hot flashes, weight gain, low sex drive and moodiness. Before that I hadn’t had a period for 6 mo. Now she wants to start me on a different hormone. Any thoughts? This is the pits. Thank you Doctor. Roxanne
Hi Roxanne,
You should have your hormone levels measured and also consider other reasons for amenorrhea. I don’t know how old you are, so I’m not sure if you should be menstruating or not.
Best,
Dr. Rob D’Aquila
Hi,
I enjoyed reading your article. I have what
I believe is a rectocel. I have been to the dr.
and they have recommended a mesh patch to hold things up when really I am not sure if they know what is falling down. I take Biodentical Hormones and they seem to hold things up
to a degree. I still feel things are falling. If I get off of the hormones I feel pain almost unbearable. Would love to get off of the hormone and I could deal with the hot flashes but not the pain of things falling. Not sure what recommendations you would have for this type of problem if any but would be appreciated.
Thank you!
Hi Lisa,
You may want to consider a consult with a colorectal surgeon, or a gynecologist to find out exactly what the problem is first.
If estrogen replacement helps, it’s possible that it causing tissue proliferation that is helping support the structures in the area.
I’d get a confirmed diagnosis.
Take care,
Dr. Rob D’Aquila
Enjoyed reading this incredibly long thread, although I didn’t find an answer to my problems. I’ve been on BHRT for a year now, and have estrogen and testosterone pellets injected every 4-5 months. After the first insertion, I felt incredible…my long dead sex drive returned, and I almost wore my husband out. (Sorry, if that’s tmi). I had energy, felt good for the first time in quite a while, the only downside was hair thinning and I was prescribed a medication primarily for men with prostate problems to rectify the hair loss. I must say I’m a bit nervous about taking the pill, but I do. Long story short…I just had the pellets refreshed on July 31 and I can no longer tell any difference. No sex drive, am on prescribed med for depression, gaining weight, and for personal physician says he isn’t surprised since the body acclimates to the pellets and unless you continually increase them, they tend to be euphoric. I’m considering not having them refreshed and wanted to know if you forsee any problems with that. The doctor who does the pellets always requires a complete blood work up prior to my visit, so I have faith in his abilities. The BHRT just doesn’t seem to be working for me anymore. Oh…and I’m 66 and had a complete hysterectomy and took synthetic hormones for years.
Ginger
Hi Ginger,
It’s very possible that you are getting receptor-site down-regulation as mentioned in the article. Your doctor is alluding to this.
It’s very hard to say how much of a problem getting off the hormones will pose. I do have female patients who’ve had hysterectomies and are doing fine without hormones, but they obviously have a unique physiology without everything you’re describing.
You said you have faith in your doctor’s abilities. You should consult with him/her.
Good luck,
Dr. Rob D’Aquila
Hi Dr.,
My case is a little different in that I am preparing for sudden menopause. I have an ovarian tumor in my remaining ovary (other ovary remove 4 years ago due to same cause). I am dreading it, but feel that I would rather be educated than surprised. I’m 31 years old and it seems that I’m going to have to deal with this for the rest of my life. My question is: Can the body produce hormones without ovaries? Am I the special circumstance that will need to take HRT?
Thanks,
Valerie
Hi Valerie,
Yes and no. Going into perimenopause, the adrenals should be able to keep up with “sex” hormone production that the ovaries used to take care of.
At 31 years old, your major source of estrogen and progesterone is going to be your ovaries, so my guess is that yes, you’ll need HRT. Obviously, you’ll be under the care of a doctor, so get their opinion.
Also, you probably don’t need to be concerned with the side effects mentioned in this article, because you’ll be taking doses that should normally be in your bloodstream if you were to have ovaries.
Good luck,
Dr. Rob D’Aquila
I was given a testosterone and estadiol pellet in May. Since then my Tsh has slowly increased and is now 3.86. One yr ago it was 1. At the start of therapy it was 2.07.Should I be concerned?
Hi Julie,
You should take this issue up with the prescribing doctor. It’s possible that the estradiol is interfering with thyroid hormone activity due to its ability to increase TBG and not allow for enough free thyroid hormone to be available.
Best,
Dr. Rob D’Aquila
Wow! What a great article! So glad i found it.
I have been trying to heal myself naturally for several years now and just read suzanne somers books and was blown away by her book Knockout and the experience she had in the hospital. I have low thyroid but have done a lot by changing drastically lifestyle and eating Garden of life raw super greens with Donna Gates raw fermented Spirulina and carrot celery cucumber juice daily. I was wondering a lot about BHRT and you answered my question
So well. I do NOT want to take anything that i have to be on forwvever and u explained it so well. I am on armor thyroid and would love to get off that! I learned that doung cleanses like Dr Natura ( easiest) and Arise and Shine ( hardest) with Colonics (slow soak method as Donna Gates explains ) can get TONS OF TONS IF TOXINS OUT OF THE BODY!!! It has been nothing less than miraculous for me!!! Then adfing fermented spirulina and raw greens and oprebiotics probiotics and Genesis today fusion 4 juice and Seabuckthorn juice … I am rid of severe asthma psorriases and stomach problems and ALL ALLERGIES. I have come so far but still have trouble sleeping and losing last
Lbs of weight ! Thank you for a great article and please keep informing us!
Isn’t the Armor Thyroid heavy duty stiuff? I heard it is from a pig and being a vegatarian the thought of taking that turns me off. I do have a friend who went on it for weight loss and lost a lot of weight. I am on t-3 and t-4 and Biest
(8:2) Est/prog. I was on 10Mg og test and had to lower it as I was way to horny(Sorrry for being so bold but I was and i am single) and I lowered it to 7.
Ladies, I feel incredible. i am early 50′, look and act much younger. Do not have any night sweats, depression or weight gain. I have stop eating bread and most of the junk that makes us gain weight as we get older. I am still addicted to sugar and need chocolate every day but I working on that, thanks.
Thank you for your informative article. About 8 years ago I had a hysterectomy because of endometrosis. Please excuse my spelling. As the years went by I started to put weight on and I at times would be weepy. My doctor at that time told me that I shouldn’t take hormone replacement because it caused cancer. Now, 8yrs later, and a different Doctor, she had me do blood tests to check my thyroid and my hormone levels. She said my thyroid is low, and my hormone levels are almost non existent. She wants to have me take natural hormones. After reading your article, I’m really nervous about taking anything.
Why live and be miserable? I am of the mind set to try something and if I have any reaction get off of it. It took me about 2 weeks t adjust to the BIHormones but I am no longer suffering and listless. I could not get off the couch before the Hormones and T3/T4. I don’t think men realize how much we suffer. Take it from me girl, your life will change if you want it to. I would really like to hear more poitive experiences on this board. Ok, gotta go do my daily run and workout.
Hello Dr. D’Aquila
Happened upon your website by accident and loved reading all the questions submitted by your readers and your answers to same.
I have a question for you. I am 76 years old, had a complete hysterectomy at 31 years old, took premerin for a year or so, then stopped due to bad press. Now for the past several years I have hot flashes. Not so much at night but during the day. I can walk a block and I am a sweaty mess. All my friends refer to me as the “hot one”. I can’t go anywhere that I’m not thinking about how miserable and sweaty I will end up.
After a complete hysterectomy does a person have any hormones left? I am in good health. People think I look sixty, not seventy six and I have a lively personality. I’m considering checking into bio hormones. Would they be of any use for a women my age?
Thanks and keep up the great blog
Jeannie B
PS I live in Honolulu with warm weather but my friends don’t experience my symptoms.
Hi Jeannie,
Yes, hormones are still produced in the liver, adrenals, breasts, and fat tissue after a complete hysterectomy.
If you have a hormonal imbalance, bioidenticals can certainly be of use. I prefer to use them as a last resort however.
Good luck,
Dr. Rob D’Aquila
Dr. D’Aquila
Thank you for your response. I will check into some viable options and see what else is out there.
Mahalo Jeannie
Dear Dr. Rob,
I have written to you before when I started having problems with the bioidentical hormones,since then I have had months of clotting and excessive bleeding, Have seen numerous doctors, spent alot of money on test, exams and also in holistic therapy. Being on those hormones was the worst experience of my adult life. I have nothing but regrets and only sorry I did not find you sooner and listen to your warnings. I would be glad to share my nightmare with anyone that might have an interest or a question.
Hi Yvonne,
Thank you for sharing and feel free to express what you’d like here.
Best,
Dr. Rob D’Aquila
No longer up-to-date
I would advise that you look at the 2011 report of the Million Women Study for evidence of HRT and breast cancer risk. It is wrong to make claims that the high risk remains.
http://www.medscape.com/viewarticle/761287?src=mp&spon=38
Julie,
I am not making claims because of a personal issue with HRT. I am simply stating what research has shown, via the Women’s Health Initiative outcome(s).
And regarding the Million Women Study, I’m not sure what you read but the website you provided clearly states: “Results from the Million Women Study published in 2003 showed that women currently using HRT are more likely to develop breast cancer than those who are not using HRT.”
Best,
Dr. Rob D’Aquila
Dear Doc D’Aquilla,
I’m 47 and due to my very low estrogen ( it was less then 20 og/ml) plus peri menopausal symptoms I decided to try with bio identical hormones. I still have periods, but irregular, my FSH is 8.
Since 8 weeks I’m using estrogel,1-2 pumps and progesterone 100 mg. During the first week after I have started with one half estrogel, my non existent libido returned and my estrogen levels were after 2 weeks 124 pg/ml. I started to feel great again! Then, after 2 more weeks my estrogen levels again decreased and are now 40, despite 2 pumps of estrogel. My libido is lost again and I still have some peri menopause symptoms. I will see my gyno in 2 weeks, till then I’m looking for answers- how it is possible that first my estrogen levels increased so fast and then they fell down, despite the estrogel? Should I maybe increase the estrogel?
During the last year I was trying a lot- homeopathy, TCM, ayurveda, phytoestrogens, but nothing really helped me to increase estrogen and with my symptoms, so that’s why I decided to try the hormones.
Thank you and greetings from Germany,
Barbara
Hi Barbara,
It’s difficult to say why the estrogen level dropped despite taking the estrogel. And it’s possible that the estrogen receptor sites have been downregulated, leading to your symptoms returning as mentioned in this article. Seek guidance from your prescribing physician regarding changes in your regimen.
Best,
Dr. Rob D’Aquila
I am at a loss as to what to do regarding missed HRT doses. My wife takes a low dose of estrogen twice a day 12 hours apart. She delays taking her evening dose to reduce hot flashes during the night but sometimes she forgets completely. After an hour or so of missing this dose she begins to get nasty and confrontational. Usually I recognize what’s happening but her mind set makes it impossible to mention that she may have forgotten her meds. I have tried to resist being bated into an argument. However every once in a while it sneaks up on me and I get sucked into a nasty confrontation … like I did tonight. Let me say now that I’m am a VERY large 3XL man, over 6’4″ and built like a defensive tackle. My wife is only about 5′ 2″/3″. However this size differential is no protection against the verbal, in your face, diatribe of insults and provocation. Unlike my petite Irish wife I have NEVER gotten physically abusive. I have been beat about the face and head, scratched, and had various items thrown at me. After being backed into the proverbial corner my only weapon is to finally insult her by calling her the mother of all insults to an American women, (which is a very popular British slang word) Even though I know that by using “The Word” it’s akin to throwing gasoline on a fire. HELP !!! How can I defuse this situation w/o getting my head and testicles ripped off? I apologize if this is not the proper venue for this question, BUT I can’t or won’t believe that I am the only man caught in this “no win” scenario. Sincerely from the couch, Paul
Hi Paul,
No need for an apology and I’m sorry to hear what you (and your wife) are going through. As you mentioned, this is not exactly the forum for questions like that, however it’s good to show others how spouses can be affected as well. It sounds like the two of you may need some behavioral therapy, and it may be best to approach your wife while she is feeling good and even-keeled. Perhaps a system to remind her may be a good start as well.
Take care,
Dr. Rob D’Aquila
Dr Rob,
I don’t know who to trust, or how to find a “qualified” professional to help. I’m 53, still having very heavy periods, debilitating really. Went to FNP who said bio progesterone and consider ablation. Cream bio progesterone slowed the bleeding. Saw two obgyn, both against cream bio progesterone. Both suggest ablation. Bio cream is $61mo, hard for me to afford. Obgyn says not much difference and prescribed Rx progesterone round tablet. Insurance covers for my copay $10 mo. I DON’T WANT TO TAKE ANYTHING AND I DON’T WANT SURGERY! Tried to stop taking and feel I will bleed to death! I eat lots of healthy food, very little sugar, work hard with a trainer 2x week, exercise + 3-4 days week. I feel good other than this bleeding, and I don’t understand why my body isn’t going through a natural change on its own! I can’t afford to “dr shop”. Suggestions?
Hi Debbie,
Obviously expenses can be an issue when trying to resolve any type of health issue. And unfortunately the only suggestion I have is to seek a qualified, competent, licensed practitioner in order to help you get back to the health you want.
Good luck,
Dr. Rob D’Aquila
Hi Dr. Rob,
Thanks for the very useful information. I am 25 years old and have been on and off birth control for the last 4 years. The reason I initially went on BCP was for an outbreak of acne I developed at 20. I now believe that come on due to very poor diet and lifestyle although the acne has never been severe it has always been persistant. So on and off birth control switching packets and brands over the last 4 years was fine, when I decided my skin was clear and I wanted to come off cold turkey in 2010 the acne came back 6 months after stopping which scared me back on the pill. After the doctor put me skin cleared up great on Dianne 35 which I was on for 9 months around 8 months I started having the most horrific side effects hair started falling out, anxiety, weight gain, loss of sex drive. So with the help of my naturopath over the last 6 months I have changed my diet and lifestyle completley. I haven’t touched any kind of sugars, breads, fried foods, dairy, coffee for the last 5 months I eat as natural and organic as possible.
I have also had a hormone test (saliva) which stated I was high in testosterone and not producing enough good estrogen. So we have been working on rising my progesterone. I take a heap of vitamins – Zinc, enzymes, probiotics, progestralift, B12, Lymphatox. I feel so much better emotionally and physically.
However the acne has started to come back which is concerning. I am just wondering is this something I am going to have to ride out for a long time?
I don’t want to scare and get back on the BCP! But I just want to know that there will be some relif with all of this hard work I have been doing to avoid the break outs. Any suggestions as to what I could do to help?
Hi Rebecca,
High testosterone in a female is almost always due to blood sugar imbalances and possibly insulin resistance. I’d look to tackle any reasons your blood sugar may be imbalanced. Getting an HbA1c blood test should help to determine your sugar levels as well. It may be a good baseline.
Good luck,
Dr. Rob D’Aquila
I have been searching for a Dr. to listen to my Low Energy, No Motivation, No libido, Foggyheaded, Concentration problems for years. My GP & GYN 7yrs ago tested me and said my Testosterone was Below the lowest of the range then, but that it was not the problem. It went up slightly after I discontinued B.C. (which I was on for 15yr to suppress ovarian cysts) After my first son @33yrs, I was found to have Hashimotos/Hypo. and have been on T4 since. I assumed that this would fix all my problems once balanced. It did not. Any time I would ask my GP about what else could be the problem I was told to go on Anti-Depressents. This was NOT the answer I was looking for but eventully did try out of desperation. Tried 3 differnet types which only made my symptoms worse. The 1st month of BRAND Wellbutrin was the best month I had in years, but was never attained again. I stopped all use to become pregnant with my 2nd @36. Timing all my supplements for Iron,Vit. D,Pre-Natals,T4,ect. got cumbersome and my T4 usage became sporatic. 6mo post-partum my TSH was 15 and I went back on T4 reguarly. I recently went to an Integrative MD and with blood work and full history was allowed to switch to natural T3/T4 and was also put on 20mg Testosterone cream (applied to genitals)/10mg DHEA/Biotin, along with the Pre-Natals I still take due to Breastfeeding my 2nd child (now 10mo) All my other results were “in Range”. The Dr. was also aware of my family history of Breast Cancer. (Mom, sister, aunt, g.aunt)
I am now wondering if this course of action, laid out by the Dr., (which includes adding exercise, more protien, more H2O) is the best choice. Especially, since I am nursing my son- in the evenings & mornings now- and with the Cancer history.
I’m just desperate to feel better going into my 37th birthday next month…
Hi Stephanie,
If you were my patient I would look very closely at all possible thyroid tests and immune function tests, among the basic blood tests. It sounds like the main driver of your symptoms could be due to thyroid imbalances, possibly secondary to your immune system.
Best,
Dr. Rob D’Aquila
Dr. Rob,
I had the bio-identical pellet for several years. They tested my hormones once but never again. If I mentioned I was tired, they just bumped the testosterone. I began to grow facial hair. I had to have a stent placed in my LAD artery and was advised to stop doing the pellets. My testosterone levels were three times what they should be, I had too much cortisol. Instead of balanced, my hormones were extremely unbalanced. When the pellet stopped producing hormones, at least when it should have, I began to feel ill. I then had another stent. A few days after that, I started to get very ill. I kept going to doctors but no one knew what was wrong with me. I ended up going to Mayo Clinic. By the time I went there, I couldn’t fly because I couldn’t sit up long enough. My husband made me a bed in the back of our SUV and drove me from Illinois to Phoenix where they have a Mayo and we have a house. My cholesterol was out of control. My triglycerides were 1357. Thyroid extremely low. I couldn’t eat so when they scoped my stomach is was filled with bial. Iron saturation, 100%, iron level was 697, copper was too high. My blood work was all crazy, I was diagnosed with diabetes and NASH. I was there for a month. They really didn’t do anything for me. I spontaneously began to get better. One month after I left Mayo, I had blood work done and my cholesterol was down to 234 and my triglycerides were 90, blood sugar normal. When I went back to Mayo for followup MRI, my liver was fine…everything good. Except the tumor in my kidney was still there but unchanged and about the size of a pea. They never knew what was wrong with me exactly. I thought I was allergic to the nickel in the stent. After reading your article, I wonder if my body had no hormones at all when I stopped the stent. Could that have made me that ill?
Hi Linda,
I’d have to see a full work-up on you along with a more thorough history. But, yes, a lack of hormones can certainly cause the issues you are describing. The good thing is that it sounds like you’re back to normal now.
Take care,
Dr. Rob D’Aquila
Hi Dr. D’Aquila, I have a series of questions and some background info that if you have the time to read over and answer them I’d be very appreciative.
I have tried to follow a basic metabolic typing/Weston A Price way of eating for the past several years. The problem for me seems to be past mistakes compounding into current problems and I’m trying to find a way out.
I recently started bio-identical HRT. My progesterone was 0.3, Testosterone 24, and Estrogen 50.6 at initial testing. Non-fasting glucose serum was 92 (pretty good to be drinking a latte at the time of testing I think). The T3, T4, TSH, reverse T3, etc. came back perfectly normal, even leaning toward the ‘hyper’ spectrum which really surprised me. I worked a desk job 12-14 hours a day, 5-6 days a week, under extreme stress from 2002-2008. I stopped smoking, drinking sodas of any kind (including diet), dropped sugar, and transitioned into a mostly organic, low grain diet in 2006. I was out of work for about 8 months when we moved out of state, then found another high stress job just like the previous one. During that 8 months out of work, our income was tiny so our diet accordingly became poor. A lot of cheap starches, inexpensive meat, frozen bagged veg, etc. Then when I started working again I had no time to cook or eat anything good so we started eating fast food again. Now my sugar/starch addiction is back because of that 2 year period off the wagon and I haven’t been able to kick it. I don’t know HOW I did it before. Eating a raw vegetable dish makes me want to throw up now when I used to love it. Fortunately I don’t have that problem with eggs or grass fed meat! I’m even considering an HCG diet just because it’s supposed to help reset your tastebuds, as it were, and kick sugar cravings. I have 3 children, a husband who works nights, and about $700 to spend on food a month. I’m trying to get my circadian rhythm back in order and get away from the junky foods again because I KNOW better. I definitely do NOT want to be on HRT my whole life so I plan to wean off hopefully when I’ve gotten other factors under control. I go to the gym and walk or do strength training as often as I can. But I’ve hit the 400 pound mark and I feel like I’m spiraling out of control right now. My stress is still high because I homeschool (one of them is going into his teen years…), I have total brain fog all the time. So far, I don’t have diabetes or any symptoms of it. Blood pressure is normal. I’d like to initiate testing for food allergies when I have the money to do so. But I just can’t seem to find an answer to how to fix myself so I can keep my family going on the straight and narrow. I like to try to lead by example and I’m a BAD example of health right now. I’m an intermediate herbalist student and I’ve worked for a CHEK practitioner before so I’m open to suggestions of just about any nature. Thank you and God bless!
Hi Mrs. Yoder,
Well, I think a new set of blood and other tests is in order to see where your system is imbalanced. I’d thoroughly check your thyroid in addition to basic and advanced blood work. I’d check Hashimoto’s due to seeing hyperactivity in your thyroid in the past. But as you know, until you get your diet in order, it’s not very easy to achieve health and well-being.
Good luck,
Dr. Rob D’Aquila
Hello – I am 54 years old. My dr. wants me to take progesterone cream and test/dhea cream – all bio identical. She also wants me to take estrdiol patch- that I can’t take – servere cramps in stomach and legs. My thyroid number is 3.3. She wants it at 1 or lower. My legs feel as though they are swollen alot and they burn and tingle. She thinks this is my thyroid. I thought 3.3 was normal. I will be taking another test next week for my thyroid. I do not sleep very well at all. I had a complete hysterectomy at the age of 39. She seems to think the bio-identical hormones will help with everything. Personally I do not want to take any hormone at all !!! I with you only as a very last resort. My blood sugar tests were normal. I believe I am totally stressed out – thought I was having a nervous breakdown – My mother was is hospital for pace-maker and my brother in the hospital for back surgery on his back – It seems all my problems began shortly after all of this. That was over 1 year ago. I still have panic attacks once in a while. The main problem is my legs and lack of sleep.
My chloesterol is noraml except for trygl – 150 -. What do you think the problem is with my legs. Could this be from adrenal stress or thyroid or both.
Thank you so much for reading and answering these comments. It seems these days no one really listens. Thank you again.
Hi Rebecca,
Sorry to hear about your issues. It sounds like your adrenals are probably an issue due to the fact that your symptoms were worse after stress. Also, adrenal imbalances can lead to thyroid imbalances.
I generally use a TSH of 1.8-3.0 as normal. So 3.3 is not very far off balance, however, a simple TSH test is not at all enough to fully evaluate thyroid function. I like to see triglycerides at 75-100. They usually go high when there’s too much sugar (or blood sugar imbalances due to anything), alcohol, or caffeine in the diet.
Bio-HRT may be in order as well because of the complete hysterectomy.
Good luck,
Dr. Rob D’Aquila
Hi Dr. Rob D’Aqila. First I want to thank you for your site. I have an appointment with my GYN on 12/7 to have the pellet inserted. I have been doing a research on the side effects of this and all said none until I read your site. I have a co worker who loves it. And of course the nurses at the GYN office states it is the best thing since slice bread. I am suffering badley with hair loss, weight gain, saddness, low sex drive, tired, no motivation memory fading, anxiety, hot flashes and night sweats. It has gotten so bad with the hot flashes and night sweats that my husband caught a very bad cold due me turning the air on when I am hot and off when I am cold. Out of all of the symptoms the hair loss and weight gain is the most devastating to me. I have tried every vitamin there is. I am currently taking phentermine for weight loss prescribed by a weight loss Dr., I take biotin, hair vitamins, and Prozac for anxiety ( I work in a prison). Oh yeah I am 53 years old. I am now nervous about going. I was so excited about getting releif until I read your site. Now I know you cannot give out treatment advice because you do not know my history in detail or my blood work results ( I do not know either I will be told on my visit) But you mention supplements and natural ways to help. What are they? Also, I live in Florida (near Orlando). Do you know of any Dr. such as yourself that can help me? Of course I want to follow your advice of using BHRT as a last resort but the hair loss, weight gain is bothering so so much. Not to mention the embarrassment of sitting in meeting with sweat pouring down my face. How do I get an appointment with you without having to come back twice for blood work needed for treatment. I have spent so much money on shampoos, vitamins, and doctors fees and do not have that much more left. Do you accept blue cross? I would love to fly up there NYC is my home town. Please let me know.
Hi Yolandal,
I would evaluate your thyroid as well. Weight gain (or inability to lose weight) and hair loss can definitely be a symptom of low thyroid function.
you can check icakusa.com for doctors certified in Applied Kinesiology, which is my specialty. I can’t think of anyone off hand.
I am out-of-network, so if you have out-of-network chiropractic benefits with your plan, you’d be covered based on your plan’s details if you came in the office and had a musculoskeletal complaint that needed examination and treatment.
Best of luck,
Dr. Rob D’Aquila
Dr. D’Aquila,
I was reading about your male patient on switching from testosterone “ht” to tribulus therapy. You state that market products are junk, does this mean it’s available through my “GP” doctor or my naturopathist? Also, is it pill, which I do not want to stress my kidneys, or injectable? What is the duration or was he weaned off after a period of time. I had testosterone tests done that reported, I was on the low end of normal, I am 41. My searches are finding a lot of junk and opinions. Please help
Hi Carl,
Yes, they are herbal tablets available through licensed healthcare practitioners. A medical doctor can get them, but they are not prescription. The duration for him was about 2 months, but that can vary between individuals.
Good luck,
Dr. Rob D’Aquila
I have been on synthetic HRT for about 5-7 yrs, lowest dosage, recently started to have periods every 2 wks n heavy period with cramps, sore breast. My dr double on estrogen did not work. Had ultra sound n biopsy no cancer so Dr told me to stop. As of now my period also stopped but here is the thing. All symptoms r back 10 fold, hot flashes, night sweats, headache, low sex drive, irrability n discontent… My back is to the wall not knowing what other options I have. My quality of life has dropped, seems I’m back like I was 5-7 yrs ago… Any suggestion… I’m open to try new ways…
Hi Karen,
My suggestion is that you work with a competent licensed healthcare practitioner in order to get the root of some of these symptoms. Simply “painting over the rust” with hormones is not my preferred approach. Stick with the basics of health – blood sugar regulation, digestive function, etc.
Good luck,
Dr. Rob D’Aquila
I have been using bioidenticals for 5 years! I am feeling that they aren’t working as well as they used to. After two years of working on reducing my weight through diet and exercise, I was running 10Ks and feeling terrific! In January of this year I don’t know what happened…I fell off the ‘wagon’. I have gained about 30 of my 50 lbs. back! I am trying to exercise again but my energy level is low. I can’t seem to jump start myself. I have noticed the hormones are not working as well. Is there hope for me to reduce my hormones as I continue my exercise (I am hoping to be running again soon.) and watch my diet again? I had no clue my body would stop producing on it’s own. I know that I can’t miss a day or I feel awful. Please help!!!!
Hi Julie,
It’s very possible your system became down-regulated as discussed in the article above.
You should work with someone who can accurately measure your hormone levels and put you on a program to get things back on track. It doesn’t sound like this will be easy to do without help, though it’s certainly possible.
Good luck,
Dr. Rob D’Aquila
Julie,
I was on the pellets for over a year, and suddenly had the same thing happen to me. All that new found energy, sex drive and lost weight became things of the past. I started gaining weight, feeling exhausted, depressed, and having symptoms of all the things I was told the pellets would prevent. My doctor advised me to discontinue them, explaining that once we go through menopause, the pellet injections are a euphoric feeling that is temporary. Once the system adjusts to having hormones again, well…you see what happens. I agree. Both my husband and I experienced the same. He is continuing to get pellets, but his insurance pays for them because he’s a man and they consider Low-T a medical issue, but we women….well, let’s just say it won’t matter once Obamacare determines we’re too old to salvage anyhow. *smile*
Hi, I have been on a triest..80-10-10…..and a oral progestin…..Not really working…Thinking of asking dr. about about 25-50-25 or 60-20-20… what are your thoughts? What do you think about using a topical progesterone vs an oral?
Hi Pam,
See this article here on my thoughts about progesterone applications: http://robdaquila.com/2012/05/21/complications-associated-with-bioidentical-hormone-creams/.
I think you should have your hormone levels measured by a lab.
Take care,
Dr. Rob D’Aquila
Hi Dr. Rob, I am so glad to find this site. As a 44 year old I have experienced loss of sleep, mood swings, heavy and irregular periods (longest lasting 21 days) breast tenderness, breast cysts, uterine fibroids, headaches, weight gain and no sex drive. I am also on Zoloft for severe anxiety which causes heart palpitations. I have also been diagnosed with Celiac Disease which I am now gluten free. My Dr. recently put me on Bio-Identical Progesterone cream…after my saliva test came back low in progesterone (35 on scale of 100-500).My thyroid is constantly swollen, yet my thyroid levels have all been normal. My question for you is; since my mother died of breast cancer at age of 48, is there a higher risk for me being on the progesterone? I am only on my second month of progesterone cream and have noticed most of my symptoms have gotten better. Except loss of sleep. I am relatively healthy, but could exercise a little more. I was hoping to kick start my system and backing off the cream. Can you give me some advice? Thanks so much.
Hi Jamie,
You should speak with the prescribing doctor about the potential risks of treatment. In fact, he/she should have already discussed them with you by now. And you should also discuss your wanting to get off the treatment he/she is prescribing if that’s what you want. I can’t say what you need/should do specifically given the little information provided and the fact that you’re not a patient Also, I do believe you should have your thyroid evaluated more thoroughly than the simple routine TSH, T4, T3 tests if it is constantly swollen.
Good luck,
Dr. Rob D’Aquila
Hi Dr. Rob, thanks so much for the great information. My problems started in 2006 (age 36) with sudden onset of IBS symptoms including chronic constipation and rapid weight gain. I went from a size 8 to 12 in just a few months and then continued to gain more over time to size 16. I tried every trick in the book for constipation and nothing helped. I did not eat right or exercise previously but changed to a much better diet/exercise program since the problems began, However, I could barely maintain much less lose weight no matter what. I saw my family physician, gyn, & 2 gastro doctors. They ran every test imaginable and said all was normal. Starting digestive enzymes and probiotics did help my IBS-C symptoms some but not back to normal.
Then I also started having hot flashes, hair loss, dry skin, irregular periods, and severe chronic fatigue. I tried a few remedies from the health food store, but, progesterone creams, black cohash, maca, & herbal thyroid all broke me out. I tend to be sensitive to taking anything anyway; no surprise. I did find a supplement called I-Cool that I can take and it helped the flashes some and made the fatigue completely better. It is well worth the cost just for that.
So, recently I tried BHRT hoping it was going to be the miracle I was praying for. My gyn did a long list of blood tests and based on the results put me on estragen, DHEA, progesterone, & Armour thyroid 3/4. While on this treatment the hot flashes, constipation, dry skin, hair loss was all relieved. I was like my old self again finally. I was also able to lose 15lbs going from size 16 to size 14. However, I had scaly flaking areas of skin on my body and a lot of deep cystual type acne on my face that would not clear up. Also, my irregular periods got a lot worse having 2x per month. So, after 3 months of treatment I didn’t renew the prescriptions except the Armour thyroid which I’m still taking.
Before long the hot flashes came back with a vengence (14 a day) and brought their cousins night sweats with them. I haven’t had a monthly since stopping BHRT; October, November, or December now. The hair loss and dry skin are still okay but the weight is trying to creep back up it’s a struggle just to maintain. Even worse, the constipation is back as bad as ever causing a lack of circulation feeling in my left leg that is very bothersome. I had this same issue with the chronic constipation before. I drink plenty of water and fiber makes it worse; none of the common remedies help. I did start taking apple cider vinegar caps and that helped my hot flashes; having somewhat fewer of less intensity.
I’m not sure what to try next. I’ve been off processed foods and most sugar for quite a while now. Switched to better oils; olive, coconut, & flax; take flax & chia seeds. I do buy a lot of things organic but not all foods.
I don’t know if you might be able to make any suggestions from this information or not. Or, if you know of another doctor in my area of Crestview, FL or Destin, FL who treats similar to the way you do, I would be willing to see him/her…
Thanks so much for your time and assistance.
Hi Jimmie,
It certainly sounds like you’ve been through it! As have many others…
It seemed exceedingly obvious that you most likely had a thyroid problem as you had/have all the textbook symptoms, glad someone picked it up…
If you were my patient, I’d start with a 3-6 week detox and take it from there based on lab tests and in-office findings through muscle testing.
You can check this site: http://www.icakusa.com/ for doctor’s that are certified in Applied Kinesiology, which is my specialty. Although, simply being certified doesn’t guarantee competence in the areas you’re looking for help with.
Good luck,
Dr. Rob D’Aquila
Hello Dr. Rob D’Aquila. Thank you and all the people who contributed comments in helping me learn bounds about HRT. I was just diagnosed (blood work by my Primary Physician) with low Testosterone levels. I am a 44-year old female with tubal ligation and was also diagnosed with osteopenia last year. I live a healthy life with a balanced diet and lots of exercise. I have two questions for you
1. I need to find a specialist who can perform additional tests and help me decide on the pros/cons of potential testosterone therapy. What type of ‘specialist’ do I need to look for? Do you have any recommendations for the Dallas, TX area?
2. although it has been a struggle to keep my weight at normal levels in recent months, I am mostly concerned about the potential osteoporosis prospect; in a case like mine, would you recommend testosterone replacement therapy given the drawbacks you mentioned in your article?
thanks, Laura
Hi Laura,
You’re very welcome.
1) I don’t think there is any specialist per se that you need to find. A licensed healthcare practitioner competent in functional biochemistry/nutrition/medicine/endocrinology should be able to help, whether they’re a DC, ND, MD, DO, etc..
Unfortunately, I don’t know of anyone in the Dallas area.
2) I prefer not to begin with hormone replacement. I’d work with balancing your system and looking for culprits in every possible area first, if you were my patient.
And osteopenia/osteoporosis can be caused by many factors, low testosterone being a contributor for sure. I recently posted articles on osteoporosis that you may find helpful.
http://robdaquila.com/2012/10/15/managing-and-preventing-osteoporosis-naturally/
http://robdaquila.com/2012/10/18/the-dpd-test-a-great-way-to-help-measure-bone-health/
Good luck,
Dr. Rob D’Aquila
Hello Dr. Rob D’ Aquila,
Fantastic and informative Forum, thank you for your time.
40 yr old male and have been on Hormone therapy for over two years now. I was diagnosed with Low T at that time. I live a healthy lifestyle, 6’1. 205 lbs active and diet aware.
I had approached my GP, as my symptoms were fatigue and erectile dysfunction two years ago.
He was quick to approve a product called Testim cream. Very little blood work done and away I went. What a roller coaster. I started with one 5g tube and within 30 days gained 15 lbs, libido was through the roof, erections were great, finally. After three months I completely crashed. Experiencing all time lows in every dept. Had blood work done on only T as suggested and was lower then when I originally started. A story you’ve heard countless times I’m sure. So I proceed to increase dosages. Fast forward two years later, I’m now at two tubes. Libido is poor, erections poor and have very sensitive nipples. I reduced to 1.5 tubes to try to stop this.
At this time( two weeks ago ) I went to a private clinic, a GP who has “branched” into Hormone therapy working within a local pharmacy, who suggested several new tests, siliva etc and determined I had crashed in my progesterone and my total T and free T was very high, estrodial high as well he figured although my test showed I was within range. He prescribed me an in-house made new T cream and a progesterone cream as well and has me on 25mg of DHEA daily. I’m feeling horrible this last week having changed creams and onto this new program. In short Dr, I’m beyond frustrated, not sure where to turn, both Dr’s will not refer me to an endocrinologist and are quickly offended when asked. I feel I’m missing something. Why did I feel so great in the beginning, then crashed, then great again when dosage increased, then crashed, it’s a roller Coaster. Do I infact have ED as my erections when first on therapy actually worked well but then disappeared? The other worry is this New Dr suggested I have bad gynecomastia at the moment, perhaps as a result of the larger doses I was accustomed too. Should I be taking something for that as well. Ugh so frustrated, I would love to get off everything…but what issues will I be faced with in doing so, will my body respond and come back to reasonable levels again? I feel let down and misinformed by all involved.
I sincerely appreciate any input from you, be it good or bad.
Tks very much.
Hi Devon,
You sound like the poster-boy for down-regulation of the hormonal system after beginning bHRT. I can’t be sure, but that would be my first impression. If you were my patient, I’d start from square one with a detox, etc. and go from there. Also, your blood sugar may be imbalanced, causing your testosterone to be converted into estrogen. See this article on that: http://robdaquila.com/2012/04/23/blood-sugar-imbalances-can-alter-estrogen-and-testosterone-levels/
I’d like to think it’s possible to turn things around – it usually is, even though it may be very demanding on your lifestyle; diet, supplements, etc…
Good luck and keep your head up – and find a different practitioner if you feel they’re missing something.
Take care,
Dr. Rob D’Aquila
Dr. Rob, Thank you for your very informative article and comments. Much appreciated! I am 64 years old and started bio-identical hormone therapy 4 months ago. I had blood work and symptoms that definitely warranted it. I had been working with a Naturopath for about 2-3 years, but had only modest improvement, so I decided to go see an integrative MD who specializes in Chronic Fatigue, Thyroid and Hormonal issues. He prescribed bio-identical thyroid, aldosterone and testosterone (25 mg troche). But since seeing him I have not felt that much better and my sinus issues were getting worse. My most recent blood work, though, showed that my thyroid levels were within range now and my testosterone levels had significantly improved to just about normal levels and my aldosterone had gone up. As well, my PSA was low and so, too, my estradiol. But I still felt lousy. BTW, besides having thyroid levels out of range when first went to see him, I was also found to have Hashimotto’s.
Recently I came across a certified holistic nutritionist and licensed acupuncturist who I started to see 3 weeks ago. He uses blood work and Oriental diagnosis to get a sense for what is happening and suggests numerous herbal supplements as well as treats you with acupuncture. He does not encourage the use of bio-identicals and has suggested I go off of them. Actually, I was getting really hyper from the thyroid medication (17.5mg daily) and just stopped it and the hyperness subsided. As well, I went off the aldosterone, but kept doing the testosterone. I had my wife muscle test me for the testosterone and it tested as being good for me. The thryoid and aldosterone bio-identicals tested weak.
Anyhow, three days ago, I decided to go off of the testosterone. Actually for the past 4 or five days I have been feeling pretty good and even my sinuses have, to some degree, been improving. But this morning I woke up totally exhausted and am wondering whether going off the testosterone “cold turkey” could be the reason? I see the acupuncturist tomorrow and the MD in 2 weeks.
I eat a Paleo diet basically and have taken nutritional supplements most of my life. As well, up until a year or so ago, I would exercise regularly. But my energies really started waning then, so now I just do some stretching and when the weather permits a two-mile walk.
So, I guess my question is: What can I expect to experience since I have gone off the testosterone “cold turkey?” Is this exhaustion and spaciness part of what happens?
My goal is to regain my strength and stamina totally as naturally as possible.
Hello Yanni,
It’s possible that stopping the testosterone “cold turkey” is the culprit. However, I’d dig really deep into the Hashimoto’s if you were my patient. It could very well be thyroid imbalances that are causing your symptoms. And I’d look into everyone avenue that may be affecting your thyroid. The basics being blood sugar regulation, adrenal imbalances, GI function, liver stress, immune system imbalances, infections, and food intolerances to start. Without a healthy thyroid, it’s tough for everything else to work properly because the thyroid controls the rate of metabolism of every cell in the body. But, you need to find out the root of the thyroid imbalance, as it’s usually coming from another imbalance in the body.
Or perhaps you simply need adrenal and gonadal support for testosterone issues. It sounds like you’re close to becoming balanced again shortly, although it’s possible that it may be a long road, hard to say for sure.
Good luck,
Dr. Rob D’Aquila
Thank you, Dr. Rob,
I am working big-time with the acupuncturist/nutritionist on my gut and am seeing real improvement. As well,I am getting a Thermogram to determine whether an old root canal I had might be the source of my chronic sinusitis. As well, I will run your list of suggestions by my MD and acupuncturist to see if we are covering all bases.
Wish you were closer to me.
All the best!
Yanni
You’re welcome Yanni,
I find that sinus issues are GI and/or liver-related 90% of the time. Sounds like you’re on your way to feeling great!
All the best to you as well!
Dr. Rob D’Aquila
Dr. Rob, I. am 41 and have been using a bio identical cream for just over 1 month. Can’t tell much difference yet, doc wants to start me out slowly. (Actually, my appetite is increasing and I seem swolen and bloated all of the time.) My initial blood work came back showing extremely low estrogen and the lowest testosterone he`s seen in a woman. My prgesterone was also very low, but not quite as bad as the others. This testing was done 1 week before my cycle was to start. I`ve been on birth control pills since I was 17, with the exception of my 2 pregnancies. Is the pill wreaking havoc on my hormones? I should be starting my pill pack tonight, but I have decided not to continue them. I guess my question is, am I doing the right thing? Can you even answer a question like that? I just want to feel good again. It is impossible to lose weight, tired all the time, NO libido, the list could go on. By the way, my thyroid came back fine. I believe the t3 and t4 were checked. Husband is getting a vasectomy, so that`s all good. Will I have to be on hormones forever? If I do, and it`s safe, I`m alright with that. Thanks for your time.
Elaine
Hi Elaine,
Unfortunately, no, I can’t answer your questions without having a full history, exam and lab tests.
It certainly is possible that the pill is wreaking havoc. But if you don’t want to get pregnant, I understand why you’re taking it.
Hopefully the doctor you went to can help.
Here’s an article I wrote on hormone creams that may help as well. http://robdaquila.com/2012/05/21/complications-associated-with-bioidentical-hormone-creams/.
Good luck,
Dr. Rob D’Aquila
Next month will be two years since I had a complete hysterectomy. I tried estrogen gels, lotions, patches and pills. All of which never helped me. Night sweats, hot flashes and the worst of all was a flat lined emotional state all in my first year of marriage. It’s been horrible.
In December i went to Sottopelle and received my first pellet treatment. pre pellet my levels were Estradiol <5, FHS 72.4, Testosterone <12. After they were Estradiol 43, FHS 34.9 and testosterone 172. So with that being said, procedure went fine and i noticed my memory was better, stamina better, smiled more but still nowhere feeling like my presurgery self and still never got my sexuality back.
Then yesterday I went for my second treatment. Injection was extremely painful then after the pellets were inserted i got very dizzy and shook all over. The nurse had me lay down in a room and i went into full on convulsions. My chest hurt, pain in my shoulder going around my shoulder blade to elbow. I went pale, my lips went blue and my pupils kept changing in size according to the nurse. This lasted for almost 2 hours til they called for an ambulance. I might also mention that my doctor left during my distress and never came back to check on me! I spent thousands of dollars in the ER with xrays, bloodwork, ekg's, urine test along with medications to help with my symptoms. My face swelled and turned bright red also. I was simply told all my tests were fine and they have no clue what caused it.
Now i am feeling very frustrated and ignored by my doctor. He had no information yesterday other than he may have hit a vein with the pellets and that was it. I guess I'm trying to find some answers as to possible reasons i went into convulsions. Is this something that happens with this treatment? I also wanted to know if i have any other options to get my life back if i choose to stop with the pellets. This seemed like my last hope.
Looking for hope,
Stacey D.
Hi Stacey,
I’ve never heard of a reaction like that to HRT. I really don’t have an explanation either.
In some of the comments above, I’ve outlined what needs to be taken care of in order for people’s hormones to function optimally. Essentially, blood sugar regulation, liver detox, optimal GI function, etc..
Good luck in finding your answers.
There’s always hope and it sounds like you were on your way to doing better.
Take care,
Dr. Rob D’Aquila
Hello Dr. Rob,
At age 36 I had a tubal ligation. A year later I had emergency surgery from endometrosis as tissue had attached itself to one of my ovaries and caused it to burst. Come to find out I also had an etopic pregnancy on the same side at the same time and I was bleeding internally for over a week. It was a close call actually. They took one ovary and one f. tube. My doctor put me on low dose birth control. A year later I could not stop bleeding so was in for a DNC. I got off BC and until age 46 was fine. I went perimenopausal and had severe hot flashes, night sweats and depression. I knew I didn’t want synthetic hormones so I began researching natural alternatives. I got on the lowest dose Vivelle and Prometrium. It worked fine for a few years. I finally found someone who could prescribe BHRT and I began using progesterone cream and Bi-Estrogen cream. I was up and down in terms of symptoms for 5 years or so. I am 61 now and am still on these 2 hormones, plus 75 mcg thyroid meds. I feel great. I am afraid to mess with this balance but wonder if I should wean off the progesterone and estrogen now. I am not really sure how long I have been on them. I am going to say 11 years.
Thank you,
Kathie
Hi Kathie,
Well, it sounds like you’re doing well now. It’s hard to say what route you should take from here. I’d find a competent licensed healthcare practitioner knowledgeable in this area and have some tests done. Also, you should probably get more than one opinion.
Best,
Dr. Rob D’Aquila
Appreciating the hard work you put into your blog and in depth information you offer.
It’s nice to come across a blog every once in a while that isn’t the
same old rehashed material. Excellent read! I’ve bookmarked your site and I’m including your RSS feeds to my Google
account.
Hi Dr Rob,
I’ve been on taking bioidentical hormones for almost 2 years now. I am 46 years old and had my uterus removed when I was 27 years old (ovaries still there). I had no troubles till my late 30s when I started having some night sweats. I started BHRT because I was having brain fog, night sweats and trouble sleeping. Also, I had been a single mom for 8 years and was about to get married. The low sex drive was perfect for my single years but I knew I needed a little help in that area too.
We have had a wonderful first year of marriage and I have loved how I felt on the bioidentical hormones but it seems like they are not as effective as they were at the beginning.
I have regular blood tests which show that my ovaries are still producing a bit (6 months ago they showed me to be perimenopausal) but really low on testosterone even after 2 years of BHRT. Right now my troches have .625mg 50/50 Estrogen/ 3mg Testosterone which I take 2x daily under my tongue. So I’m getting lots of testosterone but moving my blood levels very little.
I just wonder if there is a way to take bioidenticals without shutting down my own body’s somewhat sporadic production? What if I took breaks from hormones? How can I get my testosterone up? Should I even be on BHRT? and have I messed up my own production by taking it? I do feel about 80% better.
Thanks so much for your amazingly helpful blog.
Doreen
Hi Doreen,
All things considered, 80% better sounds a lot better than most. At least from those commenting above and from what I see in the office.
Physiology says that your body will “under-produce” hormones if you take exogenous ones, because of the negative feedback loop. A break might be good, although you may go through some serious ups and downs in different symptoms. There’s only one way to find out… I’d do it under the care of the prescribing physician.
As far as testosterone, I would personally try precursor nutrients and some herbs that are known to help low T if they’re not contraindicated for you.
Lastly, I can’t say whether or not you’ve “messed up” your own production, or if you should be on them at all.
And do keep in mind that everything else should be taken care of, i.e.: balancing blood sugar, stress hormones, detoxification, food sensitivities, GI function, etc.. before expecting hormones to “fix” everything.
Good luck,
Dr. Rob D’Aquila
Dr Rob,
Just a continuation of the last message. I forgot to say that I’m also taking 100mg Progesterone at night and a recent test said that I was low on my DHEA so I’ve been taking 25mg of that daily for the last 3 months.
Thanks again,
Doreen
Hi Dr. rob,
I’m so glad I found this page by chance. I’m 40 yrs old and have a 19 month old son. Eat pretty well and am somewhat active. I found out I had hypothyroidism during pregnancy and was put on synthroid. I finally got off it las Timothy and am taking dessicated thyroid. I feel much better but not 100%. I’m getting my blood work down tomorrow but now am nervous about starting this therapy with what I’ve read. I had terrible anxiety and mood swings from the synthroid but now my period is late since starting the dessicated thyroid….
Thank you,
Hi Catalina,
Sometimes thyroid hormone is necessary. I can’t say either with your situation.
Best of health,
Dr. Rob D’Aquila
Hi there,
My question is does bio identical therapy help for hypothyroidism or is it just when one is pre menopausal or menopausal?
Thank you
Hi again – bioidentical hormone replacement therapy should “help” when prescribed appropriately at any age.
Great. Thank you. I’m so impressed that you take the time to answer all of us.
All my best,
Catalina
Hi Dr D’Aquila,
I am a happy mother of 3 beautiful children. I do home-school 2 of them.
I recently started a bio-idential hormone treatment, -2 moths- I started because I was feeling extremely tired, and low libido, with no apparent reason.I do not suffer of hot flashes, I feel fortunate, after talking with some of my friends who do suffer from them.
I started pre-menopause at 38 years old, it was when my 3rd child was born.
I enter full menopause stage almost 3 years ago, at age 46, I am now 49. Just as a reference, I started my first menstrual period when I was almost 16 years old. So I guess I was always low in hormones?
The blood test my doctor order, showed very low levels of hormones. The reason I am contacting you is because, together with the, estradiol(pill form),progesterone (pill form) testosterone(cream form) he also prescribed to me thyroid extract also in the form of a pill. I take this pill first thing in the morning, before meals. I asked my doctor, if I would have to take this thyroid extract for life, he told me we will see in the next blood test. My concern is that I do not want to be on thyroid pills for life, my mother takes them, she is diabetic, and she needs to take them for the rest of her life.
I have a healthy life style, do not smoke,drink, and not red meat. We cook from scratch almost every thing, but we have not switched yet to completely organic meals.
This is my only concern, I do know that the thyroid glad is key in our organism, so this is something I do not want to alter. Like I said before, I asked my doctor about this, thyroid pill and he said we will see on the next blood test. The pill is made by Anazao Health Corporation. They use only natural ingredients that do not form addiction.
Are you familiar with this corporation? is there any other natural treatment you could recommend that is natural to regulate my thyroid glad?
Thank you very much,
Norma
Hi Norma,
The appropriate natural approach to helping your thyroid function better would be based on what the cause of the dysfunction is in the first place. There can be many different reasons…
I am not familiar with that company.
Additionally, I don’t understand the comment by your doctor, saying that he would determine if you need thyroid hormone for life based on your next blood test. Typically, people don’t get off thyroid hormones once they begin them.
Best,
Dr. Rob D’Aquila
I read your article and some of the questions and answers that you have provided to some of your readers. I would appreciate your help, thank you.
I was using Testosterone cream for almost a year and Progesterone pills. It was working until I switched pharmacies and the cream seem to stop working. My hot flashes came back I started to have sleeping problems , headaches and I was always tired.
So about a month ago I had the Pellet done and it did take my headaches away. I am not so tired any more plus my sex drive is way up. I noticed that the last two times after sex I felt head pressure. I am not sure why but it felt like my head wanted to explode it was a really bad headache. It went away but not till a long while passed. I wanted to know if this is a side effect from having the Pellet done.
Estel
Hi Estel,
It would best to have your hormone levels measured to see what’s really going on.
As far as the headaches, you should rule out other possible concerns through imaging techniques like MRI’s and/or MRA’s of the head and/or neck. You should speak to your doctor about this.
The headaches could possibly be from hormonal imbalances, but it’s hard to say what’s out of balance without actually having them tested.
Good luck,
Dr. Rob D’Aquila
Thank you, I will speak with my OBG-YN and have my hormones checked again. The pain in my neck and behind my ear only happens during and after sex. Sometimes it feels like a headache but not sure. This just started three weeks ago. Thank you. Estel
Hi Estel,
It’s important that “free” hormones are done via blood – otherwise (and preferably) salivary hormones should be measured.
Definitely rule out “worst-case scenarios” for the headaches. Although, I currently have a patient who has similar symptoms, although the headaches can be at other times – and it seems to be hormonal for her…
Best,
Dr. Rob D’Aquila
Hi there. I am hoping you can help me. I am 49 yrs old. I had a partial hysterectomy at age 35 leaving my ovaries. I never took HRT due to not having any significant symptoms. I took Vagifem for vaginal dryness but never had much in the way of hot flashes. My sex drive is lower than I would like though. Anyway, I was just diagnosed with Osteoporosis and now my doctor wants me on 1/2 patch of .025 Vivelle. The problem is I don’t seem to be tolerating it well. I started with 1/4 patch for 6 weeks and adjusted to that. Now I’ve been on 1/2 patch for 6 weeks and I am bloating, my breasts are huge and tender, I’m not sleeping and my memory is suffering. What is your opinion on taking ERT for OP? I’m trying to tough this out to help my bones. Any advice would be appreciated.
Hi Patti,
Estrogen replacement therapy may help halt bone loss a bit, IF it’s taken soon enough before estrogen drops during menopause. When estrogen drops rapidly in menopause (usually due to impaired adrenal gland estrogen output, that should take up the slack), inflammation sets in and bone breakdown is one of the signs. You see, bone breakdown after menopause is really an issue of inflammation, as opposed to calcium intake (which is much more helpful in the pre-menopausal years). See this article for more about that – http://robdaquila.com/2012/10/15/managing-and-preventing-osteoporosis-naturally/.
And as far as hormone replacement goes, it’s always best to have your hormone levels measured to be sure you’re taking the right hormone(s) at the right dose.
Best,
Dr. Rob D’Aquila
I’m a 54-year-old female in menopause since Feb. 2011, thin, have always had low blood pressure and follow a vegan diet. My TSH crept up from 2.98 in 2010 to 5.17 in June of 2012, and my LDL jumped from 69 to 99 too! About 8 months ago I started feeling weak and short of breath when exercising, especially in the morning when going up steep hills where I live. I’ve always exercised daily. I had my T-3 and T-4 levels checked in November 2012 and they were normal, as they were when I checked again in February 2013, but my TSH had jumped to 6.19. My LDL is now 88 and total cholesterol is 164. I had a coronary calcium scan that came out with 0% calcium in arteries, so my arteries are not blocked at all (I’ve followed a vegan diet for almost 10 years now) but my symptoms remain – they are hit and miss. I can go almost 2 weeks feeling pretty good – no weakness or shortness of breath – and then it’s there again with a vengeance so that I literally have to stop to “recover.” I have an appointment with my gynecologist next month and she has mentioned putting me on bioidentical thyroid hormones – I told her I wouldn’t even consider anything synthetic. She also wants a stress test to rule out any other cardiac problems and possibly a lung xray if needed. I don’t want to be on medication/hormones the rest of my life, but I also am VERY frustrated that I often am unable to exercise like I used to and feel like I’m 80 when trying to walk up hills or do any kind of real exercise. Any advice would be VERY much appreciated!
Hi Valerie,
Sorry to hear about your symptoms. If you were my patient, the first thing I’d do would be to check for thyroid hormone antibodies – “anti-TPO” and “anti-TGB” antibodies. It’s possible that you are going “in and out” of thyroid tissue destruction from an autoimmune reaction, causing hyperthyroid symptoms at times, and hypothyroid symptoms at other times. This happens because when thyroid tissue gets damaged, the hormones leak into the blood stream at an excessive rate. The result is high levels of thyroid hormones during breakdown of the gland. This high level can then lead to thyroid hormone “resistance” because the receptors down-regulate from the excess hormone during thyroid breakdown. Thyroid resistance can lead to symptoms of hypothyroidism because even though the hormone is in the bloodstream, the cells are resistant to using them.
I’d also have a prescription for blood work on hand, and go to the lab when the symptoms arise to catch anything that may be “hiding” otherwise.
Don’t take this idea as gospel though. You’re situation sounds more complicated than I can guess about without further testing and examination.
Best of luck in a full resolution,
Dr. Rob D’Aquila
Sue
I have been on BHRT for 2 years for menopause symptoms I could no longer deal with. I DID NOT want to go on them, but my Naturapathic doc recommended them along with supplements. The symptoms have subsided and so I am gradually trying to decrease the dosage. My question is, does hormone replacement therapy and/or Armour Thyroid (which he’s also now prescribed) cause hair loss. I was experiencing hair loss before I started BHRT, but it seems to be worse now. What do you recommend to reverse hair loss?.
Hi Sue,
Hair loss can be due to a number of causes. In your case it could be estrogen and/or thyroid hormone “deficiency” – I put the word in quotes because a person may have normal levels, but if they don’t work at the cellular level, it may as well be considered a deficiency. It sounds like you’ve missed to cause of the hair loss from the start.
Perhaps you should have looked into a second and third opinion if you DID NOT want to go on them.
I wouldn’t say that hormone replacement “causes” hair loss. If it did, my guess is that no one would use them, and of course, not everyone who takes HRT gets hair loss. And if you “get it right”, it may even help with hair loss. There are many factors that are possible, including hormone receptor site resistance, as outline in the article.
Best of luck to you,
Dr. Rob D’Aquila
I am taking est/prog bio identical because I am so low via bloodwork. That capsual is making me nauseous and given me a headache. Should this b happening? How long will it last?
Speak with the prescribing physician, there are many possibilities. There could even be a filler that you are sensitive to.
Dr. Rob,
Thank you for responding to so many cries got help. I have read many of the inquiries and responses listed above.
So now for my question. I have recently had the bio identical hormone therapy pellets implanted. (Two weeks ago). Since having the implant, I have been having the following symptoms and wonder, is this a normal response or am I allergic reaction to the pellets. 1) Low heart rate and blood pressure 2) burning under my skin throughout my entire body including ears, mouth, tongue 3) sharp stabbing pains in my muscles 4) no energy, worse than before the pellets 5) nausea, vomited for more than 24 hours 3 days after having the pellets were implanted and nausea continues 6)light headed and dizzy
I had hoped and prayed the pellets would be an answer to my health problems. In addition to my health concerns, I seem to be unable to lose weight. I consume on average 800 calories a day and walk 4-5 miles a day 5 days a week. I have been doing that for four months with no weight loss, seems kind of strange to me.
Thank you in advance for your response.
Tina
Hi Tina,
Well, you can be sure that’s not a “normal response” – although it could be argued that’s “normal” if it’s the completely wrong dosage and/or prescription, which it sure sounds like it is. You really, really need to speak with the prescribing physician about this and if I were you, I’d seek multiple opinions and treatment options before moving forward.
Lastly, you may want to have your thyroid THOROUGHLY checked regarding the inability to lose weight.
Best of luck,
Dr. Rob D’Aquila
I love your knowledge and wisdom. This is the best website for getting to the root of symptoms. I had my first and last hormone pellet put in July 2013. Estrogen and testosterone. I had hysterectomy when I was 39 keeping my ovaries. I am 57 years old and didn’t start menopause until I was 54. I had always done a small amount of cream or shot every month. After the hype my doc gave me about bio pellets I wanted to try mainly for convenience. I am a fit woman with no health issues. I teach trapeze and Pilates and have my doctorate in natural medicine…….I had no issues until 7 weeks after pellets. I got aggressive, enlarged clitoris, voice change and extreme thinning of hair. So much change in hair it doesn’t have same texture or density. It is now October and with all the supplements I believe would help have showed no help. I thought the testosterone would be leaving my body by now. I have a very high metabolism and think my body must have absorbed all testosterone at once. I still had hot flashes so assumed the estrogen didn’t absorb. My doc gave me spirolactin to block dht. Hair really never fell out just totally changed in everyway. Almost like it has quit growing and thin as cotton candy. I fear it won’t change back and has totally affected my self esteem and caused depression. Is this going to change or is this irreversible? I am desperate to get my hair back. I have all the vitamins, minoxidil and liquid supplements, niacin and amino acids. My hair usually grows a lot to hardly anything now and shrunk hair size and wispy strings. Any suggestions?
Hi Gale,
Thanks for your nice comments about my site.
It definitely sounds like testosterone is the culprit here, although all the hormones “dance” with one another thus affecting one another.
If you were my patient, I might start with a “heavy duty” detox to clear out the hormones that you took. It can be a wild ride because of fluctuations and “abnormal” levels that occurred because of the bioidenticals.
And after it’s all cleared, you’ll probably still need to do some things to achieve better balance because of the imbalances that were created.
Best of luck,
Dr. Rob D’Aquila
I used the pellets as well. I believe looking back that they threw my body off. But the real injury came 5 years ago when a doctor changed my bioidentical cream to the oral form. My life changed for the WORST and I have not been the same since. I have gone from doctor to doctor and gone through $30,000 of my savings trying to get my body back on track and am still suffering.
I stayed on the pill for 4 weeks then went off. As a result of taking this pill:
1) I became pre-diabetic
2) my immune system was weakened
3) I have nocturnal hypoglycemia . The BS drops every 3 hours making it impossible for me to sleep through the night. I must pack food and get up every 3 hours (sometimes 2 hours) to eat. Then I go back to bed and repeat this process all night !
4) I am allergic to many foods. I can eat only 4 vegetables and some meats.
5) I cannot take entire supplements like one pill. My body is so sensitive that I can only take a “sprinkle” of a supplement and build up over several months. Otherwise I have an “allergic reaction.”
Not a pretty picture. I wish that I could go back and undo everything.
Everything that I have read about undermethylation and genetic mutations makes sense. I am awaiting my test results at this time.
I just wanted to share with people out there that not all forms of bioidentical hormones are good for us and some of us don’t have the make up to handle them. When the doctor told me that she was taking me off the cream and putting me on the oral form I told her that I didn’t think that my liver and kidneys were strong enough, but she pooh poohed me. She said that there was nothing in my lab work to indicate that there was a problem. Well, there WAS A PROBLEM !!! Clearly, I knew my body better than she did. I look back now and think of how I excited I was when I read Suzanne Sommers books. What a mistake.
Hi Suzanne,
I’m sorry to hear about all that you’ve been through, and thank you for sharing your story with the rest of the readers on this site.
My best,
Dr. Rob D’Aquila
Hello Dr. D:
Finally, a practitioner who alerts people to the potential negative effects of biolidentical hormones.
As I read about the methylation process and DNA genetic mutation tests like those by Dr. Amy Yasko or 23andme, I was wondering if “under-methylation” might have to do with the negative effects. Some people simply cannot methylate as they should.
I look forward to hearing from you.
Hi Suzanne,
Yes, everyone thinks bioidenticals are the key to anti-aging. “Anti-aging” is actually an oxymoron in my opinion. How about “healthful aging”. The last time I checked, I couldn’t stop the clock from ticking.
You bring up a very interesting and technical point.
Methylation is one of the most important biochemical processes that takes place in the body, not the least of which has to do with hormone balance. If methylation is faulty, you won’t metabolize hormones properly which can affect cell receptors, and you also may have issues with detox which will also alter hormone levels. It’s quite a topic and not within the scope of a comment. But again, you are right that methylation can dramatically affect hormone balance. Fortunately, there are easy blood tests that can be run to check if methylation is functioning adequately.
Thanks for your comment,
Dr. Rob D’Aquila
Thanks for the interesting dialogue, Dr. D’Aquila. I started on Biest about 3 months and and bioidentical progesterone about 5 months ago. My reason for wanting this was to stay healthy and vibrant into middle and old age; I really wasn’t having severe menopause symptoms, except sleep issues and some moodiness.
In the three months that I’ve taken biest, I’ve gained almost 10 lbs, and am experiencing water retention, bloating and breast tenderness. I am beginning to feel like the “cure” is worse than the “condition”…and am not even sure I can call menopause a condition, except that mine is a bit earlier than I would have liked. I am an otherwise healthy, fit person (and I also would not like to buy a new wardrobe due to weight gain!). I tried to blame the weight gain on other things, and I just can’t find anything more logical to blame it on, other than the biest. Years ago, I tried taking birth control pills, thankfully for just a few months total, and the symptoms I am having now are almost exactly what I got from birth control pills, go figure.
I am thinking of going “cold turkey” and just not taking them. I am not going to my NP until December, but will try to get in touch with her for at least a 3 minute conversation over the phone. I think I will try to address the aging process through means other than replacement hormones. If you or someone else happens to have the time to post a response to my comment, I would be interested to hear what you/they have to say.
Again, thanks for the dialogue on this topic. I have not found much related information online in my searches.
One other interesting thing to note about my situation. I just got my 23andMe genetic results back a couple of months ago. I have increased genetic risks for venous thromboembolism, including the compound heterozygous MTHFR mutation (supposed to increase one’s risks for DVT, heart disease, etc.). Again, I am a very healthy person. Maybe I don’t want to mess with my good health searching for the fountain of youth in BHRT??
I hope you can find a competent practitioner to work with you.
Hi Mariell,
Sorry to hear about the “cure” being worse than the “condition”. You’re not alone as you can see above…
And I agree, menopause shouldn’t be a diagnosable medical condition as if it’s not normal. Of course, symptoms other than erratic period timing is an issue, but still shouldn’t be lumped into “menopause” as it so often is.
It sounds as if your thyroid may have been “thrown off” (for lack of getting into the particulars) by the estrogen you took.
Cold turkey is one way to go – and if you choose that, you may have to grin and bear the fluctuations that will probably come with it.
Best of luck with balance,
Dr. Rob D’Aquila
I was on Bio-Identical Hormones for about a year. I stopped suddenly because I just didn’t think they were doing much.
In the last 4 or 5 weeks, since stopping, I have had three yeast infections. This was never a problem before for me. I am 57 years old. Is there anything I can do? Is it likely the infections a result of stopping the BIHT?
Hi Linda,
It certainly doesn’t sounds like a coincidence. Hormones will affect many systems of the body, including the digestive system, “microbial system”, and nervous system.
You will probably need dietary and lifestyle interventions to help with your current situation. Ideally, find a qualified, licensed practitioner to work with you through this.
Best,
Dr. Rob D’Aquila
Dr. Rob
Thanks for the article. I am 52 and just starting to investigate the Bio identical. I had my thyroid removed completely when I was 21, am hypoglycemic (I control with eating right) and had an ablation about 10 years ago. Through it all I managed to keep my weight decent for my frame but over the last 4 years it has crept up and nothing I do has any effect. I have gained 40 lbs I rarely eat any grain or sugar due to the blood sugar issues. My consentration is shot and sleeping is a challenge. I havent seen anywhere that talks about a hair growth side effect. This has also been a huge issue for me throughout my lifetime and after thousands in laser treatments I would not relish that battle again. It is not completely gone but nothing like it was. do you have any thoughts on this?
Hi Tracy,
I’d look further into your thyroid. And also go ahead and have others hormones tested. There’s no reason to speculate when these things can be measured.
Best,
Dr. Rob D’Aquila
Wow. I can’t believe you are continuing to answer questions on this post, that’s amazing.
I found this post looking for an answer regarding the Minivelle patch (0.0375mg) twice a week and the oral progesterone (50 mg) at bedtime.
I’m 56 and have been without a cycle for just about a year.
I have had symptoms of what I thought was low thyroid, but it turns out my thyroid levels are fine, my doc took a full panel, anti-bodies and all. My adrenals, testosterone, DHEA, are at good levels. My progesterone and estrogen are basically non existent according to my doc. The progesterone was 0.06, I don’t recall my estrogen level, but is was below what is considered low.
After reading your post I’m not sure I want to start taking what my doc has prescribed. I was going to start it this evening.
My symptoms are various including, joint pain, hair texture has changed and some loss, major weight gain, fatigue, lack of stamina, hot flashes, few night sweats, gum issues, silent reflux, and other symptoms. I have gone into a fib a couple of times when vomiting due to the vagus nerve. I eat a real whole foods diet, wheat free, low grains and organic. I’m not on any other medications.
As far as bioidenticals go, is the Minivelle patch and oral progesterone good to use?
What would be some alternatives to bioidenticals that would get my progesterone and estrogen levels up?
I am ready for some relief and would love to lose some weight, I’ve never had a weight issue before this time in my life.
I would appreciate any thoughts.
Thank you.
Hi Libby,
Yes, still answering questions…
I might look into other areas that may be causing issues. For instance, low grade infections, toxic metals and chemicals, food sensitivities, etc.. If those issues don’t exist, you may be clear to “prime the pump” with bioidenticals. Obviously you should work with a qualified, competent, licensed healthcare practitioner.
Generally speaking, I prefer pregnenolone and progesterone (not necessarily together), not estrogen.
Good luck,
Dr. Rob D’Aquila
Hi, I am a 54 year old woman who was feeling great but wanted to try BIOHRT because my OBGYN told me that it would protect my heart, bones and dementia. I took estrogen and progesterone for 6 weeks 1/2 cc everyday. After 6.5 weeks I started getting migraines with aura I only got a migraine once a year before I started taking these. For 3 weeks every day I got auras with headache, auras with no headache and just a background headache everyday. I went to talk to my obgyn and he said, “Well,you need to be taking 1 cc instead of 1/2. So I took one dose of 1 cc and thought I was going to die. I was terribly dizzy both laying down and standing up and I shook all over even though I was not cold. Needless to say, I stopped taking them and still have the migraines with aura. I even went to a neurologist and he said it was hormone related and it will take 30 days to completely come out of my system. I will never take these again.
Although I was wondering if the Bio Identical hormones could have helped my atypical face pain? I have two blood vessels near the trigeminal nerve and with each heart beat, it irritates the nerve. I have constant pain lower jaw and inside my mouth and left side of my face. It seems to me that they may have helped the pain some. Do you think?
Hi Jamison,
Sorry to hear about all you’ve been through. It’s very difficult to say about your face pain, but at least it’s better and perhaps the hormones didn’t only do harm…
Best,
Dr. Rob D’Aquila
Hi Dr Rob,
I came from Bangkok, Thailand. I came across your article and reading lots of comment and feel very interesting. I am 46 years old with 2 kids. In late January this year, I feel fatigue and dizziness because of my hard work and I had blood and saliva test. My estradiol was 112, Progesterone 9.7 and Testosterone was 0.2. Doctor said my AM cortisol is below Mean and she gave me DHEA and lots of other vitamins such as Vitamin D, Magnesium . I took it for 8 months and gained 3 kilos and felt lots of breast tenderness before the period so I stop taking that. My DHEAs on OCt 9 , was 156 T4 7.3 FT4 1.18 TSH 1.33 FT 3 2.3 . After stop taking DHEA, my period was on Oct 10 and then on OCT 29, my period came very little . Usually it comes around 7 days and every 25-28 days cycle before taking DHEA ( when I was young, it was 30 days cycle) . Just before I stopped DHEA, period longer to 31-33 days
After my last little period on Oct 29, my period has not yet come. I feel much better now , not much dizziness ( after treat on sinus ) but a bit less libidos . But my Estridol on Nov 29 drop to 7.4 and FSH was 42.3. The Doctor said I am menopause which make me lots of worried . I don’t have any sign of menopause before . And now after I try to stop caffeine taking such as coffee, I sleep much better. I had period at 14 years which is very late among friends and my mom went to menopause at 50 years up so I have not expect that this soon.
I wonder if DHEA hormone is the cause of that and what should I do. Will the cycle become normal by itself ? Doctor want me to take bio hormone cream but after reading your article, I afraid that may affect my body hormone in long run
Do you have any opinion on this ? Is my period affected by DHEA ? If so, How long it should be adjusted after stop taking DHEA ? Or I am really menopause .
I wonder if I should go to acupuncture first . Will that also affect my other hormone ? Thank you very much
LIly
Hi Lily,
Thanks for the comment. It’s obviously a little difficult for me to know exactly what’s going on without examining you and seeing more lab work.
However, I would find it hard to believe that your menopause came on naturally after taking the DHEA. It just doesn’t seem like a coincidence to me – especially because your menstrual cycle also changed.
It’s hard to say how things will progress. If you go off the hormones, it’s possible you’ll balance out in 3 months or so, but that’s impossible to know beforehand.
As far as acupuncture – it’s not a panacea, but should be helpful IF it’s done by someone “correctly”. I have had patients who’ve gotten worse from acupuncture, but that’s obviously because the practitioner wasn’t very skilled…
Good luck,
Dr. Rob D’Aquila
Great article. I want to get off BHRT but I am wondering what to do to address:
1) hormone receptor site re-sensitization(major concern, I want my hormones to be able to get “high” again)
2) liver detoxification
3) hypothalamic/pituitary/gonadal axis support
4) digestive support
5) adrenal support
6) thyroid support
Thanks Jasmine,
That information is best found out via diagnostic tests – blood, saliva, etc..
Best,
Dr. Rob
I hope you are still answering questions on here anyways, maybe not because this article is years old! Anyway, my anti-aging medicine doctor uses blood tests for hormones. Does that mean he’s not up to date with the best diagnostic tools? Should I ask for saliva tests instead?
Thank you so much!
Hi Jasmine,
Yes, still answering questions…
Thyroid hormones are best tested in blood. As far as “all” the others, I prefer saliva tests. I’d ask him why he chooses blood if it were me. You can measure hormones via blood, but if you measure “free” hormone levels, it can get very expensive, and is rarely if ever done based on what I’ve seen. Also, in a cycling female, measuring one day’s hormone levels probably won’t yield enough information to really see what’s going on.
Best,
Dr. Rob D’Aquila
I was intrigued in reading your info on hormones. I thought I might write you to ask your opinion in my recent chNge of meds. I have hypothyroidism and currently take amour 90mg also take northindrone tabs 0.5/0.1 mg have been on this for couple of years. Recently tests came back testosterone is 32/ tsh is 1.26/ estriol is 0.15/ Dhea sulfate is 66/ progesterone is 0.5/ estradiol is 40 I was put on testosterone lozenges2x daily 10 mg , c-biest 2mg 2x daily and progesterone 100mg 1at night I am concerned of any side affects I have noticed hair thinning from my hypothyroidism already and worried if all this meds will trigger any unwanted results am I in the wrong direction ? I am 55 in good health have some brain fog and memory issues but overall have felt ok your advice please ??
Thank you theresa
Hi Theresa,
It’s hard to say why your hair is thinning. There are so many possible mechanisms that cause thyroid dysfunction; and simply taking (more) thyroid hormone isn’t always the best way to correct it… It could be from too much estrogen affecting thyroid hormone function. And it could even be from estrogen deficiency. I’d speak with the prescribing physician.
Good luck,
Dr. Rob D’Aquila
Do you recommend a person stop the progesterone, if continual bleeding is occurring? I have been on the insertion pellets for3 months, started bleeding and the Dr. up the progesterone from 100 mg to 200 mg. The bleeding stopped for 2 days and started back up. I am do want to stop this crazy roller coaster I am on.
Thank you, Tina
Hi Tina,
I can’t make any recommendations to you because you’re not a patient of mine. Based on my knowledge, “continual bleeding” doesn’t sound like a desirable effect. You really should speak to the prescribing physician. Have you?? I sure hope so…
Best,
Dr. Rob D’Aquila
Dr. D’Aquila
I am a male 63 years old and have been on BHRT for about 4 years, but only testosterone and DHEA. Lately I have had insomnia and even though my blood tests show that my DHEA and testosterone are in the mid normal ranges, I feel that maybe the DHEA is contributing to my insomnia. My sex drive is not consistent either. My doctor keeps giving me higher dosages of testosterone because my blood tests reveal that I don’t have high levels of “free” testosterone.
I would like to get off the BHRT all together, but would you agree that stopping cold turkey is not a good idea? I’ve been using the cream every morning, but I was thinking that maybe I could go to every other day and use a natural testosterone supplement on the days I don’t use the cream such as “T-Male”. I think I need a strategy for getting off the BHRT and any recommendations would be appreciated.
Hi Robert,
I can’t make any recommendations because you’re not a patient. I’d speak with the prescribing physician.
It sounds like you have too much sex hormone binding globulin. That’s the testosterone transporter, and too much of that would result in too little free hormone. I usually see that as a result of elevated cortisol levels (which can have many causes).
As far as cold turkey…that could be rough, but varies individually from what I’ve seen – and seems highly related to length of time the person has been taking exogenous hormone. If you were my patient, I’d check LH to see if the pituitary is still sending a signal to the testes to produce its own testosterone first. That may be a good indicator of how you’ll do if you go cold turkey.
Best of luck,
Dr. Rob D’Aquila
Thanks for finally writing about >Unwanted side effects of
(bioidentical) hormone replacement therapy | Dr. Rob D’Aquila <Loved it!
The only side effect I have, is that I feel normal. Oh yeah, also I’m willing to have sex with my husband.
That’s fantastic Darla! Unfortunately that’s not the case with most commentators on this article…
I have been scouring the internet and cant find any info. I was a chronic pain patient on oxycodone for 8 years, which i suspect caused androgen deficiency. One day I stopped having firm erections. After much fretting and losing my mind I spent all my tax money to go to a testosterone clinic that costed me about 700 dollars. I have no medical insurance. I just wanted to see if it worked. Well it didnt. I felt better. they said my test was 298 and started me on 100 mg injection once a week. I did this for about a month or two. I recently quit taking painkillers and i want to make it permanent. but i NEED my sex drive to come back. I need a female in my life spiritually and psychologically. I have no doctor. I have no money. I been off the Test since april 25 and I been off oxycodone for 3 days. and I will continue to stay off. Getting my old self back would be ideal. Please give me some feedback and I will appreciate it greatly. I cant afford to go back to a clinic, i have no medical insurance. I know it was stupid. whats my chances without anything. as i am broke. my sex drive is gone.
Hi Dr. Rob,
I was wondering the BIEST 50/50 could possibly help with weight loss? I have had the full work-up between blood and saliva. As it turns out, I have Adrenal Hypofunction. I put on 60 lbs in a little under a year. Even though I work out daily and have a personal trainer. Also no matter how little I eat, I cannot lose. I am gluten intolerant and I do not eat carbs in the form of crap. I eat a good amount of veggies and rarely to never eat junk foods. I have asked if this BIEST would help me in losing weight, but I always tend to get a vague answer. Also, this BIEST is basically a last resort for me. I have tried multiple hormone treatments without success. This to me, seems to be my last hope. Thank God too, I have a personal trainer who refuses to give up on me, he seems to think he can help kick start my adrenals again…if it’s even possible. I work out an hour each morning, I use a vibration plate (1150 w) once or twice a day, I walk each day no less than 2 to 4 miles. I am active and do not like sitting still though now that school is out I plan to de-stress and have some time to sit and read a good book. I have a HIGHLY stressful job as a teacher of nearly 100 K-12 students that are split between 9 different schools. So I know or rather feel certain the high stress of this job has also helped to shut down my adrenals. I just want to lose the weight I have gained in my abdomen, butt and thigh areas. How in God’s name, besides having it sucked out, how can I get rid of this fat? Is this possible since it’s all 100% pure cellulite? Will this BIEST help me?
Thank you so much for your time,
Teresa
Hi Teresa,
Unfortunately, I do not know the best route you should take. It’s too complicated and issue. You should seek the guidance of a licensed, competent healthcare practitioner knowledgeable in this area of health.
Good luck,
Dr. Rob D’Aquila
Hi Damien,
I’m sorry to hear about your situation. Unfortunately I don’t know your chances. If it were me in your situation, I’d do everything I could to stay healthy by keeping blood sugar balanced, eliminating any infections that may exist, detoxing if need be, avoiding food sensitivities and allergies, exercising appropriately, etc.. More importantly perhaps, I’d do my best to find a licensed, competent healthcare practitioner to work with, who is knowledgeable with that type of condition.
Best of luck,
Dr. Rob D’Aquila
Hi Dr Rob
I started BHRT, estradiol and progesterone troches, 4 months ago aged 52. I had a hx of severe endometriosis diagnosed finally at 49 and went thru menopause at 50. Feeling constantly hot and sweating, insomnia and irratibility were making life less pleasant. After 2 months on the troches I developed abdo pain reminiscent of the endo’ so they lowered estradiol and increased progesterone. But for the last 2 months at the new compound I’ve had shortness of breath, chest tightness and dry cough. ECG CXR all normal and definitely not Asthma. Dr couldn’t explain but thought stress, though I don’t feel this. I think it’s the dose I’m on. Have you seen anyone else with the respiratory symptoms related to HRT? BTW, the BHRT has been great for insomnia, libido and flashes/sweats, wish I could breath normally however.
Hi Tracy,
I haven’t seen respiratory effects from bHRT. Glad everything else was helped.
Best,
Dr. Rob D’Aquila
Hello Dr D’Aquila:
Just a week or so ago I started on a bio-identical HRT cream. I’m in menopause, but I really don’t have the negative symptoms. Just more anxiety than anything, but I started the HRT, cause everyone seems to think it is the miracle cream for everything that ails you, which there is a lot in the big Meno.
After 1 day I had horrible cramping & big mood swings from agitated about tiny things to super relaxed (almost catatonic). I was told by my Dr & pharmacist(who both have good reps) to cut the dosage. I did that with no change so I went the hell off!
Since I really don’t have the menopause symptoms (hot flashes, low libido, dryness, super moody etc), I’m deciding to go other routes, like herbs/extracts/yoga/diet or the Ayurveda way or maybe American Indian way.
Do you have any suggestions Doctor? If so, I would appreciate any input you could give me.
PS: I’m starting meditation classes for my anxiety next week.
Thank you,
Dyan
Hi Dyan,
I hope going the “other routes” helps a lot. With a competent physician, it sounds like you’ll do great.
Best,
Dr. Rob D’Aquila