Watch the replay of Dr. McConnell’s BioTe webinar or read about the benefits of hormone therapy below.

Signs & Symptoms of Low Thyroid Production

• Poor circulation
• Elbow keratosis
• Slow speech
• Nails that are easily broken
• Anxiety/panic attacks
• Decreased memory
• Inability to concentrate
• Muscle and joint pain

Appropriate replacement hormones can help us feel better, think better and act better. In many areas of our life, there are some symptoms that can occur with waning hormone levels. Fatigue is probably the most common reason that doctors see. There’s also a mood shift. Hormone such as thyroid can help with these symptoms. Another benefit of hormone replacement therapy is that it can help with dysthymia. For example, a woman in her thirties has difficulties coping up with a stressful job, taking care of her family and staying up with her husband. A lot of these women are usually out on SSRI or anti-depressants. However, with these types of medicine, the sex drive is often decreased. What we usually do is give a woman in this situation a little bit of testosterone to help in the areas that will give her more energy, a better sex life and helps with focus and brain fog.

Benefits of Hormone Therapy

 Everybody on hormones, whether male or female, is on a product called Diindolylmethane. Diindolylmethane are the detoxifiers of hormones. It creates a level of safety to the hormones and it decreases any kind of risk for unwanted side effects from hormones. For example, 20% of  men who are andropause and are over 50 have low levels of testosterone. When a man has 450 for his level of testosterone, physicians might think that his levels are pretty good. The normal levels for the population at large, without testosterone, in this age group is probably somewhere between 300 and 1100. Let’s say he’s middle of the line, 450 or 500, but his free testosterone was 50. So if you look at what the lab can say as normal for the testosterone, it’s 50 to 250. What we do is give that patient a bio-identical testosterone in the form of pellets or injections or a cream or lozenges. That’s how we get that free testosterone up to 200. 

With diabetes, what diabetic patients need to do is put on muscle, because that’s going to reverse diabetes. Most patients with type 2 diabetes can keep it at the door. Most patients don’t have to be affected by diabetes with diet and exercise and proper hormone replacement therapy.

Another benefit of hormone replacement therapy is it can protect the person from heart disease. We are protected against heart disease with hormone replacement therapy. And so a lot of these men are underdiagnosed with falling to sleep where they have the common symptom of sleeping easily when set in a chair. They also have excessive, daytime sleepiness and sleep apnea is another cause of that. 

Another benefit of testosterone for men and women is that it helps build strong bones. It protects our brain against dementia and even breast cancer. 

Post-menopausal women are at increased risk of heart disease for this reason, we like to get that perimenopausal women on testosterone. Estrogen, of course, is higher in women, but it is also very important in men. Low estrogen in a man makes him pissy, irritable, and too high up in testosterone and he’s crying at the Gladiator movie. So there’s a balance to everything. 

BioTe did some study on the bone strength and with pellet therapy. There’s of course, other ways to increase our bone mass besides pellet therapy, but 8% per year is the effects of estrogen and testosterone on bone health. So, we are actually routinely taking women from an osteoporotic or an osteogenic, which is basically pre-osteoporosis and getting them into normal ranges for bone density. One of the things that the bisphosphonates do is our body has a way to tear down bone and build bone up osteoclastic activity. What the bisphosphonates do is they stop the osteoclastic activity.

What happens then is these bisphosphonates continue to pack bone in and patients end up with not that big of a decrease in bone density. There is a great increase in bone density with those bisphosphonates, but there’s no significant decrease in fractures.

How Hormones are Administered

We want to avoid pills and the estrogen in the form of pills, whenever possible. Pills are obviously easier to take, right? But there’s a thing called a first pass effect when you take pills. It means that our livers might just see that and it’s going to change it. So estrogen taken by mouth, birth control pills Premarin, they all cause increased amounts of clots in your legs, deep vein thrombosis and pulmonary emboli. So, we want to avoid that if at all possible. Experts stopped it in 2002 and said that there was an increase in strokes and heart attacks. For the next 10 years, mainstream medicine was putting the kibosh on and not replacing it that many women died unnecessarily. They did come out in about 2012 and said that they have made a mistake. 

Patches are an option for some people and creams are another very popular way to give hormones. It is something that needs to be done every day. We would want to be careful that rubbing up against either others like grandchildren or children or pets, cause they can transfer this to other individuals

The injectable testosterone is probably the most cost-effective way of testosterone replacement for the male, 200 milligrams per male. You can be given the shot perhaps once a week. However, if your hemoglobin is going up to 18 or 19, that’s just too thick of blood and that could be a limiting factor. 

When talking about pellets, they’re derived from net natural compounds which is the same molecular structure as the human hormones for a female. They last somewhere between three and four months. Men have a little longer period of time of healing for that side because we’re putting in potentially an area, with up to 10 to 12 hormones, depending on their age and levels. 

There is a stronger delivery of the hormones that we get better, quicker bone density, which the bones move slowly. The maximum benefit for bones after you start HRT is at three years. So it’s the slowest tissue as of course, the most dense and the deepest tissue in our body. It takes a while to change those. However, it does not introduce increased breast cancer risk. It does not stimulate breast tissue. And testosterone is actually protective because we’re not giving them in a pill form. We don’t see any increase in blood clots, heart attack or strokes.

Hormone Replacement Therapy Effectivity

The breast cancer recurrence was 17 per 1000 person who used HRT. There has been a fourfold increase in bone density over oral estrogen which is 2.5 times greater than patches. So, as we’ve said earlier, if a woman is osteoporotic we will encourage her to consider pellet therapy because there’s 8.3% bone growth per year which is pretty remarkable about half of that for patches and less so for oral.

 If you think about all these receptors in our body, you know, in the skin, in the brain and in the heart, it makes sense that we’re going to have them in our joints, too, right? So, people on hormone replacement therapy are actually protected with arthritis and arthritis pain. We can now live longer, happier and more robust lives. 

Alzheimer’s is another disease that HRT helps to avoid. Women get it more often. If someone is on HRT, she has 50% less chance of getting it. Men who are also with low testosterone were likely to get Alzheimer’s. 

Bioidentical estrogen also has positive effects on body fat. It helps decrease total cholesterol, LDL, HDL and triglycerides. The addition of testosterone does not negate the favorable effects of estrogen on the LDL cholesterol. Hormone replacement therapy also helps lower our fat mass and increase muscle. Lots of studies have shown a beneficial effect on testosterone from the heart.

Hormone Replacement Therapy Risks

Fluid retention is one of the risks of HRT. This is pretty common and it’s transient. We can see a little bit of transient swelling at those times. We tell patients that they need to cut their salt intake. If there’s breast sensitivity, we tell women to take some evening Primrose oil that will mitigate breast tenderness. Usually, a transient sign of spotting or bleeding is probably what we deal with the most because if they’re out of menopause, like less than five years or so, there’s a good chance they might spot. This is due to the uterine lining that builds up. Increasing the progesterone helps and we can often stabilize it either to 200 to 300 milligrams at night or even 400 milligrams. 

What we usually do is to keep the levels every 12 hours and the system. We do not take this lightly. If we feel like we need to obtain an ultrasound to evaluate what’s going on in that uterus, then we will do that. The trans vantage is the best way to go to look at the uterine lining. If the uterine lining is more than 0.4 centimeters or four millimeters, then we would consider a referral to a gynecologist because it’s not like for example, hormone replacement therapy will just show what’s already there. If there was a fibroid there, or if there’s a cancer there, it may be somewhat quiescent. Usually, when we give the hormone, it brings it to life. So it’s really kind of exposing what that woman has in her uterus already and it does not cause cancer.  

Pellet extrusion is an issue we have yet to have in a single female that we have treated. After the pellets are put in, especially on males, we tell them to ice the part at least once a day. After the first week, they’re usually not as tender. We just want them to avoid big leg workouts, but they can definitely walk and do normal activities. After two weeks, they’re usually stable  but with a subtle facial breakout. That’s another limiting factor potentially with testosterone replacement and of course, shrinking of the testes that is expected and a reduction in sperm count.

We can have low hormones at any age. And it’s not a one size fits all. Everybody is different but HRT can be beneficial for men and women especially with the many good effects that it provides to the body.