Hello, health enthusiasts, and welcome to Rev Up Health, your go-to podcast for all things wellness. I'm Dr. Mark Hechler, and I'm Tandi Hechler. Together we're here to fuel your health journey with the best of functional medicine and holistic well-being. Each episode, we'll dive deep into topics that matter to your health, bringing you the latest insights, research, and inspiring stories. Whether you're on a quest for vibrant health or just looking for daily health tips, we've got you covered. So let's embark on this journey together and transform the way you live. So, Tandi, what's on our wellness radar for today?
Hello, and welcome to the Rev Up Health Podcast. We are here in our office today, videoing for the first time, so bear with us as we learn to navigate this process a little differently. Today we're going to talk about bioidentical hormone replacement, which is part of what we do at Revelation Health.
What Are Hormones?
So what are hormones? There are a lot of theories, a lot of thoughts, a lot of things you see out there on social media. Essentially, bioidentical hormone replacement is what we do, and you can think of hormones as little chemical messengers that are produced by your tissues, organs, and glands. They travel through the bloodstream to directly affect our performance, our repairs, and our basic general body physiology and repair mechanisms. That's how hormones work, and it affects the way we feel and how metabolically healthy we are.
What do they do? They basically regulate our growth and development, our metabolism, even our appetite — there's a lot of talk about GLP-1s, and of course insulin is a hormone too. Hormones affect our mood, which is anxiety and depression, our sexual function, reproductive cycles, heart rate, glucose levels, general physiology, even your body temperature and sleep. All of that is affected.
Signs of Hormone Imbalance
What do you think of when you hear of somebody who has an imbalance in hormones? I think fatigue is one thing that comes up a lot — low energy, low mood, low libido, poor sexual satisfaction, sleep issues, weight gain, and a lack of muscle tone and muscle mass. You think of the person or a couple basically sitting around on the couch, not having any interest or motivation. Those individuals may just be having an imbalance in their hormones.
Why Doesn't My Primary Care Doctor Do This?
There are a lot of folks who provide and prescribe hormone therapy out there, but a lot of people will ask us, "Why doesn't my primary care?" That's one of those things where traditional doctors just aren't trained in it. There's been a lot of misinformation spread, back from the Women's Health Initiative trial, that really scared a lot of people off, and so a lot of doctors just decided, "Well, I'm not going to do that."
True. The other thing to talk about is that most Western medicine doctors are taught to treat disease, and aging is not considered a disease — which is a funny thing, because aging is the cause of all the other diseases that come after. So I think it's a transition in thought to see aging as a disease, and not only is it a disease, but it can be prevented and treated.
A lot of doctors may also simply get your hormone levels drawn and see them as being normal. But that's not optimal — okay, they may be normal, but why do I still feel this way, doctor? We hear that a lot from patients.
Normal vs. Optimal
What do we mean by normal versus optimal? You take the 93% of the population that are metabolically unhealthy and draw their blood, and of those individuals, that becomes your reference range. So now you're looking at a range of metabolically unhealthy people at all different levels. Do you want to be normal in this metabolically unhealthy group, or do you want to be optimal and feel better? If you're 70 years old, do you want to feel like you're 40? Do you want to perform like you're 40? That means you're going to have to have hormone levels that are optimal and functioning like you're 40.
Which Hormones Are We Talking About?
So which hormones are we talking about? We've got testosterone for men and women; estradiol for women, and sometimes for men; progesterone for women; thyroid for both men and women; and vitamin D — vitamin D is a hormone too.
Common Myths
Some people may be a little skeptical: what do hormones do, and why do we have these problems? I've always heard there are these issues with hormones. What are the common myths? One common myth is that they cause cancer — they don't. Hormones don't cause heart problems, they don't cause stroke, and they don't necessarily even cause blood clots when we're talking about bioidentical hormone replacement. That's the difference. They don't necessarily cause these things to occur, but those are common thoughts that people are worried about, and a lot of times people are asking questions about those types of things.
Ultimately, the fact is that hormones aren't only healthy, they're vital to living a long, healthy, disease-free life. There are zero well-done studies out there that show adverse negative effects for those risks. I think it's key to point out that there are a lot of studies done that are not well-done studies, so you have to make sure that they're peer-reviewed, and look for the different things that make a good study. There are a lot of insurance- and pharmaceutical-based reports and programs and studies that basically say what they want to say and tell you what they want you to know, so they may not necessarily be the most accurate. But the studies are out there — you just have to look for them, and that's the hard part.
What Hormones Can Do for You
There are a lot of studies that show an improvement in general well-being, as well as helping with age management. Hormones are going to make you feel better, happier, stronger, younger, sexier — that's the intent. When you're younger, you have all these things, and as we age, our hormone levels continue to decline. As a result, we start having disease processes show up, or mood changes, thinning hair and nails, lack of libido and drive, loss of muscle strength and performance — it all gets affected as we get older.
Real quick, just to talk a little about this natural decline in hormones: it's also from the environmental toxins we're exposed to. Our mitochondria just aren't functioning like they used to, and our cells aren't taking up the hormones like they used to, so that also plays a part.
Who doesn't want to feel better? There are too many people who are okay feeling bad. So, sign me up — we all want to feel better and live our best life. Bioidentical hormone replacement therapy will help with preventing cancers, macular degeneration, anxiety, depression, insulin resistance, improvement in your dyslipidemias, and erectile dysfunction. And women have a significant improvement too. The female is a very complicated hormonal situation — I've said so many times that men are nothing compared to women in how that works — everything from fertility to vaginal health and UTIs.
Chronic fatigue is a common issue for a lot of people, and there are a lot of causes for it, but hormone optimization will help improve that. And there are a lot of autoimmune disorders that are pretty directly associated with hormone imbalance.
The Bottom Line: Safety and Individualized Care
So what's the bottom line? It's exceptionally safe. Bioidentical hormone replacement is a very safe thing, and it's going to improve many of the causes of age-related diseases and chronic inflammatory diseases — it's going to improve your quality of life. When we're performing our testing and evaluations, we like to take into consideration each person, each patient. Each patient has their own goals for what they want to do if they're seeking or have an interest in hormone replacement. That's the important thing — identifying what the patient wants to get out of their hormone replacement, and that helps drive our treatment plans. Our goal is not to get you to normal; our goal is to get you to optimum.
We pride ourselves on treating the patient and what they're wanting and seeking, and not necessarily just what a blood test says, whether it's normal or optimal. We need to figure out what makes you feel better — that's the goal.
Thyroid: A Misunderstood Hormone
What about thyroid? Thyroid is a really common hormone that's misunderstood a lot. There's so much variation in how thyroid labs are interpreted and how thyroid function can be optimized for patients. We're going to be looking at a lot of things, and one thing that's typically overlooked is T3 levels — totals and frees. Those free T3s are very important to how you're going to feel and how well you're going to be optimized.
Some of the synthetic medications for thyroid hormone replacement out there don't quite bring people back to where they need to be, and that's because it's a conversion issue. A lot of the synthetic stuff is essentially just T4, which is not the active form of thyroid hormone — T3 is the active form. So if we can give you the micronized, more bioidentical form of thyroid that has a combination of T4 and T3, then you're going to feel better quicker, and it's going to feed the cells that need to take that thyroid up for you to get energy.
Essentially, hypothyroidism is not the only indication for treating someone with thyroid hormone — we want you to be optimized. There are a lot of things that will optimize it. Yes, we can give you the perfect bioidentical thyroid hormone replacement, but there are things we need to optimize in you so your cells can take up that thyroid. A lot of toxins, environmental influences, and gut health make a huge difference for individuals and how their thyroid will function, and even sleep, obviously.
Low thyroid or suboptimal thyroid function is going to affect everything from head to toe — from your mood to your energy levels to muscle weakness and joints in general. There are a lot of things it affects, even the menstrual cycle — it's a big component of that.
One thing to note is that the type of hormone replacement therapy we're talking about here is an off-label use of thyroid. Most insurances aren't going to look at this as an approved treatment, but there are lots of studies that show improvements in a multitude of symptoms with this type of treatment.
It Still Takes Ongoing Monitoring
Even after we get your hormones optimized with replacement therapy, it still takes somebody in your corner to help optimize where you're going and continue to monitor what you need or don't need. Maybe you're starting to feel better and we need to back off your thyroid or other hormones. So it's not saying you need to be on hormone replacement forever — there are things you can do to help yourself along where you may not need it, potentially. But once you start down that road and start to feel so much better, you understand what's really going on, and that's kind of a motivator to drive you to be more health-conscious.
Bioidentical vs. Synthetic Hormones
We've had a lot of folks ask us questions about hormone replacement. One frequently asked question is: what's the difference between traditional hormones and bioidentical hormones? What I can tell you in a nutshell is that synthetically derived hormone therapy is not an optimal thing — you don't have the benefits of what's called bioidentical hormone replacement. If you're going to take something, you'd rather it be molecule for molecule, atom for atom, specifically similar to what your own body makes — and that's what bioidentical hormone replacement is. Those individuals will tend to have the best results. It helps with preventing your osteoporosis and with bone health, brain health, cardiovascular improvements, and neurodegenerative improvements and stabilizing. There are a lot of ways of taking bioidentical hormone replacement too, so there are a lot of variables with that.
Why We Don't Use Insurance
Another question that comes up quite frequently is about insurance and why we don't use insurance when we're dealing with this. I mentioned it already, as far as the off-label use of thyroid. Also, the testing we do — a lot of times insurance won't pay for those tests until there's an indication of a problem. For instance, we had a patient who tried to use insurance for a vitamin D level and got a huge bill from the lab company, because there wasn't an indication to draw a vitamin D — even though most people are deficient in vitamin D, and she was having fatigue and a multitude of other symptoms. Once insurance gets involved, it's a rather difficult conversation to get that covered. So we can deal with the off-label cash price for it, and it brings on very minimal amounts for the replacements, so it's very affordable.
The lab testing we do — we work with a company that provides testing for self-pay patients. This actually happened to us: we put in orders using our insurance, and our labs cost over $1,200 apiece. Or we can draw the same labs out of pocket for a cash price, and it's under $300. So it's not hard to figure out, and you can have it drawn as many times as you want. If you want to monitor the levels and see where you're at, you can get it done — you don't have to have the insurance company's approval to try to find the right code to get that done.
Wrapping Up
A lot of folks have had a more recent interest in hormone replacement, and it's truly something that's safe. With the quality you get from the different pharmaceutical companies and compounding pharmacies, they're very safe and very effective. There are some places where the hormone replacements may be cheaper, but you may not be getting the product you need to get the results you want — and the benefits from being on the right stuff are certainly out there.
Thanks so much for joining us. If you have a question, feel free to leave a comment, send us a message via our website, or DM us on Instagram — we'd love to hear from you and answer your questions. Get connected with us at revelationhealthandwellbeing.com. Have a great, healthy day.
Thank you for tuning in to another episode of Rev Up Health. We hope you're leaving with some valuable insights to supercharge your health journey. Don't forget to follow or subscribe to Rev Up Health wherever you listen to your podcasts, and if you enjoyed today's episode, please leave us a rating and review. Have a topic you want us to explore? Reach out to us on our social media channels — we love hearing from our wellness community. Until next time, keep thriving, and remember: your journey to health is a journey to a better you. Stay well, and we'll connect with you again soon. This is Tandi, and this is Dr. Mark, signing off from Rev Up Health. Take care.
The information provided in this podcast is for educational purposes only and is not intended as medical advice. The content is designed to support, not replace, the relationship that exists between a patient and their healthcare provider. Always consult with a qualified healthcare professional before making any changes to your healthcare regimen, including diet, exercise, or treatment plans. The views and opinions expressed in this podcast are those of the hosts and guests and do not necessarily reflect the official policy or position of Revelation Health and Wellbeing.