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Kathleen A. MacIsaac, MD, PLLC
INTEGRATIVE FUNCTIONAL MEDICINE
A Note About Insurance
The office does not participate in any insurance, Medicare, or Medicaid programs. Dr. MacIsaac is a provider out of network. The patient is responsible for payment in full at the time of service.
A superbill can be provided upon request, which one may submit personally for possible reimbursement.
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Why do people typically seek Bioidentical Hormone Therapy (BHRT)?The most common symptoms are fatigue, lack of mental clarity, hot flashes, night sweats, insomnia, weight increases, mood fluctuations and low libido. Aside from symptom relief, BHRT has been shown to be effective management for osteoporosis, prevention of dementia and overall decreased risk of stroke and heart attack.
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What hormones are examined or evaluated?Dr. MacIsaac evaluates key hormones, including sex hormones (estrogen, progesterone, testosterone), as well as insulin, cortisol, DHEA, thyroid hormones, and growth hormone.
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What is the difference between bioidentical hormones and synthetic hormones?As the name implies, the bioidentical hormones are identical in chemical structure to what the ovaries make in women and the testicles make in men. The conventional, synthetic hormones are a totally different chemical structure and are not naturally found in the body, which can lead to unwanted side effects.
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Are bioidentical hormones safe?Yes, bioidentical hormones are considered safe, especially when started soon after hormone decline. Recent studies show that bioidentical hormones can actually reduce the risk of heart disease, stroke, osteoporosis, and dementia when used appropriately.
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How long do I need to stay on hormone therapy? Are they safe to use long-term?Because the hormones are bioidentical and familiar to the body, they are safe and recommended indefinitely. The newest research recommends starting them soon after hormones start declining in menopause or andropause, so that the body has the protective features of the hormones ongoing.
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How often will I need to come in for treatment?All hormones are assessed by blood work and review of systems. Each case is individualized based on genetics, lifestyle and previous medical history that will be reviewed at the first visit. When you first start the hormones, you will have the first follow up in 4-6 weeks to check the clinical response. You should be feeling the effects by this point. First recheck of labs will be at 6-8 weeks. Sometimes things need to be slightly changed here and there. Remember, when you were creating your own hormones, the levels would change from day to day, always helping to provide the body with what it needed, moment to moment. In post-menopausal and andropause states, the dosing from the outside hormones is constant, so regulating them is a dynamic process. Once you’re doing well on them, you can come in less often.
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What are the benefits of BHRT?From a symptom standpoint, you can expect better sleep, mood, mental clarity, strength, endurance, libido and overall sense of wellbeing, and for women specifically, a decrease in night sweats and hot flashes.
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Do men need hormone replacement therapy? Do you treat men?Yes! In men, BHRT is most used to address the symptoms of andropause, an age-related decline in male hormone levels called testosterone deficiency. Although it has been compared to menopause in women, the decrease in hormones and onset of symptoms during andropause in men is slower and subtler than it is in women. However, low testosterone levels can occur for many reasons at any age, even as early as the teenage years. When a man’s hormone levels are low, hormone replacement therapy may help relieve a wide array of different symptoms, both physical and emotional.
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