Jennifer (BHRT patient)
The Patient
Jennifer is a health conscious 47-year-old working mother of two. Her youngest child is a junior in high school. Over the past two years she has noticed worsening insomnia, hot flashes, moodiness, and irritability. She reports a significant drop in her energy level and is having trouble finishing her exercise routines.
When she was 35, Jennifer had a hysterectomy due to severe bleeding problems. She still has both of her ovaries.
Body and Mind
Always a healthy eater, Jennifer never had trouble maintaining a normal body weight. However, over the past two years she has put on 15 pounds and notices a major loss of muscle tone.
Jennifer prides herself on a sharp memory and attention to detail. Lately, she finds herself being forgetful. She gets upset with herself for making minor mistakes at work that are completely uncharacteristic. She is concerned about early onset dementia!
Sexual Health
Over the past two years, Jennifer has also noticed vaginal dryness and has seen her once normal sex drive almost completely disappear. She is still able to have an orgasm but, despite a loving relationship with her healthy husband, has no interest in sexual activity.
Try Something
After doing a significant amount of research, Jennifer decided to try over-the-counter progesterone cream and other natural remedies recommended to her by a homeopathic doctor. She saw no improvement of her symptoms.
Her family doctor recently ran routine bloodwork and did a thorough examination. Jennifer’s LDL-cholesterol is slightly high and she is a little overweight but otherwise her test results are normal. Her family practicioner gave her a trial of estrogen patches wich seemed to help her hot flashes quite a bit, but none of her other symptoms seemed to improve.
Bioidentical Pellets Make a Life Changing Difference
Jennifer comes to my office for information on bioidentical hormone replacement therapy. Bloodwork shows very low total and free testosterone, low estradiol, and normal DHEA. She receives bio-identical hormone pellets and within a few days her hot flashes have almost disappeared. She is sleeping better in her moods have improved. Within six weeks she no longer notices vaginal dryness. She has lost 5 pounds and her energy level is getting back to normal.
In the bedroom, Jennifer that her husband are both delighted that her sex drive, while not back to where it was when she was 35, has increased significantly.
Jennifer feels much better about herself and feels like her mental clarity and attention to detail are getting back to normal. Blood work done four weeks after her pellet insertion shows normal female premenopausal levels of estradiol and testosterone. She plans to come back every three to four months during this transition time for bioidentical hormone pellet therapy.
Vitamin D
With winter just around the corner it’s time to evaluate our vitamin D status. Most of us learned as children that vitamin D is essential in maintaining strong bones and teeth. But did you know that vitamin D is a prohormone that plays an important role in the health of our immune and endocrine systems that impact the overall health of every organ in our body? In fact, individuals with low vitamin D levels have higher rates of some types of cancer and are more susceptible to certain infectious diseases.
The Power of our Star
Vitamin D is produced in our skin as a result of exposure to the ultrviolet rays from sunlight. The average person with lightly pigmented skin requires at least 30 minutes of’s sun exposure to the face arms and legs three times a week to make an adequate amount of vitamin D. If you have darker pigment skin, you will require up to an hour of sun exposure three times a week to produce enough vitamin D.
Moo
Milk, soy milk, orange juice and other foods are often fortified with vitamin D.
Large amounts of vitamin D can be found in wild caught salmon, wild mushrooms, oysters, cod liver oil, shrimp, pasture raised chicken eggs and other food sources.
Supplement?
If you find that you’re not getting enough vitamin D through sunshine and your diet, you might consider supplementing with vitamin D3 gel caps. The usual recommended dose is between 1000 and 2000 international units a day. Since vitamin D3 is a fat soluble vitamin taking 5000 to 10,000 international units once a week is also a reasonable option.
Get Tested?
People with osteopenia and osteoporosis as well as those with gastrointestinal absorption problems, and other health problems should probably be tested for vitamin D deficiency. A simple blood test can be run by your primary care provider to determine if you have adequate stores of Vitamin D.