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BioIdentical Hormone Replacement Therapy

MacDonald Healthcare

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Bioidentical Hormone Replacement Therapy

Hormones are chemical messengers that coordinate different functions in your body. Several glands, organs and tissues in the body make and release hormones, many of which make up your endocrine system. These chemical messages tell your body what to do and when to do it. Hormones are essential for life and your health. As hormone levels deplete in your body from aging, disease, stress, and illness your health begins to show the symptoms. 


Women have seven primary hormones that can be replaced; estrogen, progesterone, testosterone, thyroid, DHEA, Pregnenolone and melatonin.  

Men have five hormones that can be replaced; testosterone, DHEA, thyroid, Pregnenolone, and melatonin. 

The optimal ranges of these hormones vary for men and women as each body will utilize the hormones in different ways. 

Read more about hormones, and the vitamins and genetic variants that affect hormones, below.

  • The thyroid is a small gland located in the lower part of the neck. It is one of the largest endocrine glands in the body and plays a major role in energy and metabolism through the production of thyroid hormones.

    The principle thyroid hormones, triiodothyronine (T3) and thyroxine (T4) are produced by the thyroid gland when stimulated by thyroid-stimulating hormone (TSH) (a pituitary hormone). The thyroid hormone plays a major role in metabolism and energy. The thyroid does this by controlling the speed of energy utilization, protein production, and hormone sensitivity for all of the hormones in the body.

    Thyroid imbalance occurs when the thyroid gland produces too little (hypothyroidism) or too much thyroid hormone (hyperthyroidism). Both of these conditions cause many unpleasant symptoms. Thyroid imbalance also causes an imbalance of other hormones, which adds to these unpleasant symptoms. Thyroid imbalance increases the risk of developing medical conditions such as heart disease, obesity, and osteoporosis.

    There are hundreds of symptoms of thyroid imbalance. Some of the most common symptoms include fatigue, low body temperature, greater susceptibility to colds and viruses (low immunity), depression, anxiety and mood swings, weight gain, dry skin, brittle nails, hair loss, headaches, high cholesterol.  Thyroid helps to protect our body from cardiovascular disease, improves cerebral metabolism, and prevents cognitive impairment. 

    An additional component of thyroid imbalance may be an autoimmune condition called Hashimoto's thyroiditis. It is imperative to treat this condition as early as it can be detected. While not curable, this condition and the effect and control on your health can be well managed by an educated provider. The term “Thyroiditis” refers to “inflammation of the thyroid gland”. There are many possible causes of thyroiditis. Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis, is the most common cause of hypothyroidism in the United States. It is an autoimmune disorder involving chronic inflammation of the thyroid. 


    This condition tends to run in families. Over time, the ability of the thyroid gland to produce thyroid hormones often becomes impaired and leads to a gradual decline in function and eventually an underactive thyroid (hypothyroidism). Hashimoto’s thyroiditis occurs most commonly in middle aged women, but can be seen at any age, and can also affect men and children.

    There are no signs or symptoms that are unique to Hashimoto’s thyroiditis.

    Because the condition usually progresses very slowly over many years, people with Hashimoto’s thyroiditis may not have any symptoms early on, even when the characteristic thyroid peroxidase (TPO) antibodies are detected in blood tests. TPO is an enzyme that plays a role in the production of thyroid hormones. If Hashimoto’s thyroiditis causes cell damage leading to low thyroid hormone levels, patients will eventually develop symptoms of hypothyroidism. Hypothyroid symptoms may include fatigue, weight gain, constipation, increased sensitivity to cold, dry skin, depression, muscle aches and reduced exercise tolerance, and irregular or heavy menses. In some cases, the inflammation causes the thyroid to become enlarged (goiter), which rarely may cause neck discomfort or difficulty swallowing.

    I have been extensively educated to treat and manage thyroid imbalances including the condition of hashimoto's. 

  • The hormone estrogen comprises a group of compounds that includes estrone, estradiol, and estriol. Estrogen is the main sex hormone in women and is essential to the menstrual cycle. Although estrogen also exists in men, it is found in higher amounts in women, especially women of reproductive age who still have their ovaries.

    Estrogen contributes to the development of secondary sex characteristics. In women, these characteristics include breasts, a widened pelvis, and increased amounts of body fat in the buttock, thigh, and hip region. Estrogen also contributes to the fact that women have less facial hair and smoother skin than men.

    Estrogen is an essential part of a woman’s reproductive process. It regulates the menstrual cycle and prepares the uterus for pregnancy by enriching and thickening the endometrium. Two hormones, luteinizing hormone (LH) and the follicle-stimulating hormone (FSH), help control how the body produces estrogen in women who ovulate.

    Estrogen is manufactured mostly in the ovaries by developing egg follicles. In addition, estrogen is produced by the corpus luteum in the ovary, as well as by the placenta. The liver, breasts, and adrenal glands may also contribute to estrogen production, although in smaller quantities.

    Estrogen supports bone density and reduces the risk of osteoporosis in men and women.

    Female levels of estrogen and progesterone drop drastically after menopause.  It comes as no surprise that, after menopause, heart disease in women skyrockets, surpassing the male population.  It is the leading cause of death in postmenopausal women in the United States, more than twice as many as all cancer deaths combined. 


    Estrogen has been prescribed for decades to women in menopause for relief from sweating, fatigue, hot flashes, vaginal dryness, depression and decreased sex drive.  Replacing estrogen increases muscle quality, mental outlook, and skin as well as decreases the risk of heart disease and osteoporosis. 

  • Progesterone is a female hormone that stimulates and regulates various functions, including maintaining pregnancy. Progesterone is produced in the ovaries, the placenta (during pregnancy), and the adrenal glands. It helps prepare your body for conception and pregnancy and regulates your monthly menstrual cycle. It also plays a role in sexual desire.

    One of progesterone’s most important functions is to cause the endometrium to secrete special proteins during the second half of the menstrual cycle, preparing it to receive and nourish an implanted fertilized egg. If implantation does not occur, estrogen and progesterone levels drop, the endometrium breaks down, and menstruation occurs.

    High progesterone levels are believed to be partly responsible for symptoms of premenstrual syndrome (PMS), such as breast tenderness, feeling bloated, and mood swings. When you skip a period, it could be because of failure to ovulate and subsequent low progesterone levels.

    At menopause, a woman’s estrogen level may drop by 40-60%. This will stop the menstrual cycles. Progesterone levels, however, may drop close to zero in some women. After menopause the adrenal glands and other organs take over the manufacture of hormones, particularly testosterone and estrogen, and some progesterone. However, in cases of adrenal exhaustion and other health problems, the body often cannot compensate adequately, thus causing further hormonal havoc.

    Progesterone is a building block for many other steroid hormones, such as cortisol, testosterone, and estrogen. Because it is a modulator, its use can greatly enhance overall hormonal balance. Progesterone therapy stimulates bone building and helps protect against osteoporosis. For women who suffer hormonal imbalance but are not necessarily menopausal, progesterone is equally important. Even young women in their 20's and, on occasion, teenagers may need progesterone if they are not ovulating regularly and have an array of estrogen-dominant symptoms.

  • Testosterone is the primary male sex hormone, and is responsible for the normal growth and development of the male sex organs and for the maintenance of other sexual characteristics. In men, testosterone is produced in the testes, the reproductive glands that also produce sperm. The amount of testosterone produced by the testes is regulated by the hypothalamus and the pituitary gland.


    Some functions of testosterone in men include:

    • Ability to have and maintain erectile function 

    • Sex drive

    • Growth and maturation of prostate and other male sex organs

    • Development of male hair distribution such as facial hair

    • Changes in body muscle mass and strength and fat distribution

    • Mood and energy level

    • Bone strength

    In women, the ovaries produce both testosterone and estrogen. Relatively small quantities of testosterone are released into a woman’s bloodstream by the ovaries, adrenal glands, and fat tissue. Both sex hormones are involved in the growth, maintenance, and repair of reproductive tissues.

  • Dehydroepiandrosterone (DHEA) is a steroid hormone produced by the adrenal glands. The body converts DHEA into other sex hormones such as estrogen and testosterone. DHEA levels typically peak in your 20s and decline with age, which is why there has been considerable interest in DHEA and its role in aging. Low levels of DHEA have been detected in some people with type 2 diabetes, breast cancer, heart disease, osteoporosis, and kidney disease. Certain medications may also deplete DHEA, including corticosteroids and insulin.

    DHEA is often taken to slow or reverse the aging process, enhance exercise performance, prevent Alzheimer’s disease, improve libido, fight fatigue, enhance health in people with HIV/AIDS, soothe menopausal symptoms, treat erectile dysfunction, and stimulate the immune system.

  • Melatonin is produced by the pineal gland.  Levels are higher at night and are suppressed by bright light during the day. Melatonin levels decline as we age. Melatonin manages our natural circadian rhythms and helps to control our sleep/wake cycle which allows quality rest at night and optimal function during the day. 


    Some of the benefits of melatonin: 

    • Influences stage IV sleep and REM sleep. 

    • Improves sleep pattern, as well as depth and quality of sleep. 

    • Energizer and mood enhancer. 

    • Increases natural killer cells and modulates immune function.

    • Lowers blood pressure.

    • Decreases migraines and cluster headaches.  

    • Reduces nocturia by increasing stage IV sleep.  

    • Possesses potent antioxidative effects. Scavenger of the most reactive and destructive free radical–the hydroxyl radical. 

    • Multiple studies demonstrate benefit in preventing and treating cancer.

  • Pregnenolone is an adrenal hormone that is sometimes called the “master hormone” because it is the first step in the synthesis of other sex hormones such as testosterone, DHEA, and estrogen. It is manufactured directly from cholesterol. A pregnenolone deficiency can cause (or reveal) deficiencies in other hormones.

    Aside from helping to synthesize other hormones, pregnenolone helps maintain cognitive health and brain function, thanks to its role in helping to synthesize neurohormones in the brain. Low levels of pregnenolone have been linked to cognitive issues, difficulty with memory and recall, low energy and feeling tired, depressed mood, and worse-than-usual symptoms of menstruation in women.

  • Scientists continue to discover profound benefits of adequate vitamin D levels, while also uncovering an epidemic of vitamin D deficiency. Vitamin D is manufactured in the skin in response to sunlight. However, since more people are avoiding direct sunlight and using sunscreen many people are not making enough vitamin D.

    This is especially unfortunate because low vitamin D has been associated with an increased risk of heart disease, multiple types of cancer, diabetes, autoimmune diseases, multiple sclerosis, mood disorders including anxiety and depression, Alzheimer’s disease, and bone disorders including osteoporosis.

  • While vitamin B12 is not a hormone, having adequate levels of B12 is vital to proper hormone balance.


    Vitamin B12 is an important nutrient that helps your body keep your nerve cells and blood cells healthy. It also helps your body make DNA, the genetic material in all of your cells. Your body does not make vitamin B12 on its own, so you have to consume food and drinks that have vitamin B12 in order to maintain proper levels in your body. Vitamin B12 is found in animal products you may eat and drink such as meat, dairy and eggs. It can also be found in fortified foods (foods that have certain vitamins and nutrients added to them) such as certain cereals, bread and nutritional yeast.

    Vitamin B12 deficiency can cause physical, neurological and psychological symptoms. The symptoms of vitamin B12 deficiency can develop slowly and can get worse over time. Some people may have no symptoms despite having a low level of vitamin B12 in their bodies, while others with vitamin B12 deficiency can have neurological symptoms and/or damage without anemia (lack of red blood cells).

    General physical symptoms of vitamin B12 deficiency can include:

    • Feeling very tired or weak

    • Experiencing nausea, vomiting or diarrhea

    • Not feeling as hungry as usual

    • Weight loss

    • Having a sore mouth or tongue

    • Having yellowish skin

    Neurological symptoms of vitamin B12 deficiency can include:

    • Numbness or tingling in your hands and feet

    • Vision problems

    • Having a hard time remembering things or getting confused easily

    • Having a difficult time walking or speaking like you usually do

    If neurological problems develop from vitamin B12 deficiency, they may not be reversible

    Psychological symptoms of vitamin B12 deficiency can include:

    • Feeling depressed

    • Feeling irritable

    • Experiencing a change in the way you feel and behave

  • Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that breaks down the amino acid homocysteine. The MTHFR gene that codes for this enzyme can mutate, which can interfere with the enzyme’s ability to function normally or completely inactivate it.

    There are two common types, or variants, of MTHFR mutations: C677T and A1298C.

    These gene mutations are relatively common. In fact, in the United States, around 25% of people of Hispanic descent and 10–15% of people of Caucasian descent have two copies of C677T.

    The mutations can lead to high levels of homocysteine in the blood, which may contribute to several health conditions, including:

    Mutations in the MTHFR gene can affect the body’s ability to process amino acids like homocysteine, which can lead to some adverse health outcomes.

    Conditions associated with MTHFR gene mutations include:

    • homocysteinemia, which is the term for abnormally high levels of homocysteine in the blood or urine

    • ataxia, which is a neurological condition that affects coordination

    • peripheral neuropathy, which is a neurological condition that damages the nerves

    • microcephaly, which is a condition present at birth in which the head is smaller than usual

    • scoliosis, which refers to an abnormal curvature of the spine

    • anemia, which means that there is a lack of healthy red blood cells in the body

    • cardiovascular diseases, such as blood clotsstroke, and heart attack

    • mental health conditions, such as depression

    • behavior disorders, such as attention deficit hyperactivity disorder

    Symptoms of a folate or vitamin B12 deficiency, which may include:

    • fatigue

    • shortness of breath

    • constipation

    • a loss of appetite or unintentional weight loss

    • muscle weakness

    • numbness, tingling, or pain in the hands or feet

    • dizziness or a loss of balance

    • mouth sores

    • mood changes

    Also associated may be symptoms of anemia, which may include:

    • fatigue

    • weakness

    • shortness of breath

    • dizziness

    • headaches

    • an irregular heartbeat

    MTHFR genetic variants are identified by a blood test and the variants that you have will determine the approach to treating you. These variants are hereditary. Each person has two copies of the MTHFR gene: one from their mother and one from their father. If a parent has a known variant it important to identify the variant of their offspring. 

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