Bioidentical hormones: Who should I see for these?

I just had the pleasure of speaking at a medical conference on bioidentical hormones sponsored by the International Hormone Society at the San Diego Harbor Marriott. My subject was testosterone deficiency and replacement, with an emphasis on testosterone pellet implantation.

I was struck by some of the questions the attending doctors asked me after the presentation. One included: “Why is it that some of my female patients still don’t have much libido despite being on testosterone?” I immediately knew that this dilemma related to elevated cortisol due to adrenal stress, among other causes, and I asked her how her patient’s adrenals were. She said she hadn’t checked them. I gently asked her what training she had in using bioidentical hormones. She said that she had attended only weekend seminars in the past. Rather than tell her how to work up and treat a woman with persistent low libido I told her she owed it to herself and her patients by taking at least one of the more than 10 available modules that are part of fellowship training given by the American Board of Anti-aging and Regenerative Medicine. The first module is 25 hours on hormones. I suggested starting with that,

After the flurry of questions from doctors practicing all over the country I thought about how many of the physicians in attendance actually had the knowledge base to prescribe bioidentical hormones in an optimal fashion. This means: maintaining adequate levels if each hormone, balancing hormones with others that interact with each other, addressing inflammation, immune status, diet, GI and liver health and optimally managing cancer and heart disease risk factors.

I immediately knew which 25 of the 300 doctors in attendance were able to claim to have this knowledge base. The BodyLogicMD doctors, who had completed fellowship training. I knew here were other fellowship trained physicians in the audience. But I also knew he majority of doctors were relative neophytes in this emerging branch of medicine

I earnestly hope that all physicians who wish to offer their patients bioidentical hormones take more advanced training leading to fellowship certification.

For now I encourage interested patients to seek out a doctor who has been fellowship trained. This will be listed on the physician’s web site.

Once in the doctor’a office for your initial visit you can expect to hear from your chosen physician about how your hormones are balanced, along with whether or not they are high or low Your initial testing will always include adrenal testing, using 4 saliva samples collected over the course of the day. It will always include measurements of the sex hormones and the free fractions of the thyroid hormones. The hormone vitamin D, (not a vitamin) will be measured Markers of inflammation will be examined. Heart disease and diabetes risk factor assessment will be done. After a thorough history and review of symptoms and goals for wellness is completed, a comprehensive treatment plan is then agreed upon and hormones and appropriate supplements are ordered. Followup labs and visits are scheduled. The doctor’s staff then reminds you when it is time to do the labs and be seen to optimize your compliance and ultimately your outcome.

If you are not getting this kind of personalized attention you deserve to. You can find board certified, fellowship trained bioidentical hormone doctors in your area by going to www.bodylogicmd.com