I have the privilege of working with a unique company, Total Rejuvenation. They are a nationwide service for men and women who are sensing a change in their life with aging – whether it be emotional, physical or sexual dysfunction – and are looking for help. Many of these life changes can be due to a decrease in hormone levels. Total Rejuvenation provides lab testing to consumers and depending on their hormone levels, bio-identical hormones can be prescribed to return hormones back to normal levels. After seeing several patients in conjunction with Total Rejuvenation, I’ve noticed something very interesting.
More on that in a second. Before Total Rejuvenation can prescribe hormone replacement, they want to be sure their patients don’t have any other underlying issues. Therefore, they require their nationwide database of patients to see a physician to perform a physical exam and review their lab work annually. That’s where I come in. I receive the patients history and lab results from Total Rejuvenation prior to my seeing the patient. This gives me the opportunity to determine how “off” their hormone levels are due to aging. Since Total Rejuvenation also reviews the hormone abnormalities and makes recommendations regarding hormone replacement based on those abnormalities, I tend to focus more on the other lab values such as cholesterol, hemoglobin A1C and prostate specific antigen (PSA).
The first two (cholesterol and hemoglobin A1C) can provide information regarding the risk of heart disease. High bad cholesterol and low good cholesterol can translate into plaques forming along the walls of the blood vessels supplying the heart, leading to a heart attack. Hemoglobin A1C reveals the amount of sugar binding to the proteins in the blood, suggestive of diabetes and also contributing to vascular (blood vessel) disease. Lastly, I focus on the PSA to see if they have evidence of prostate disease.
Here’s what I’ve noticed. Many of these patients are so focused on their hormone replacement and their return to a more youthful feeling, that they sometimes forget to see their primary care doctor and address other medical issues besides anti-aging. For example, they may feel great on testosterone but there is a known risk of heart disease and stroke with testosterone. That doesn’t mean testosterone is bad. Just like anything, there are risks and benefits and moderation is key. If patients have “low T” (low testosterone) and are not feeling like themselves, they should consider testosterone replacement. Patients have to recognize that while there are benefits to testosterone, they must continue to focus on their risks for heart disease. This includes checking their cholesterol and hemoglobin A1C levels.
This is why every patient I see from Total Rejuvenation is reminded to consider their total health, not just anti-aging. In this capacity, I’m able to “triage” the patient and direct them to their primary care doctor, cardiologist or urologist for definitive treatment of any underlying medical issues.