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What We Treat

Hormones

HormonesDigestive IssuesSkin IssuesThyroid / Endocrine SystemMusculoskeletalTick-Borne Illness/Fatigue SyndromesMetabolic Dysfunction & Weight GainHealth OptimizationEnvironmental ToxinsNeurologicalFatigue Syndromes & Multisystem Illnesses

Menopause & Perimenopause

The imbalance of hormones that occur during menopause or perimenopause can have a very dramatic impact on a person's ability to manage even the smallest tasks. Hormone imbalance affects a person's ability to function normally, making them feel inadequate to handle the demands within day to day tasks and sometimes even causing depression. In trying to diagnose menopause or perimenopause, a patient may be asked to track your symptoms and record when they occur. Your doctor will order a complete blood workup to assess your hormone levels and may also check for any other contributing factors, such as adrenal dysfunction or thyroid issues. Bioidentical hormone replacement therapy (BHRT) has been found to be a safe and effective treatment for symptoms associated with perimenopause and menopause. These hormones, which are derived from plants, are structurally identical to the hormones produced by the human body. Long term BHRT treatment is highly encouraged due to its exceptional results in maintaining bone density, decreasing incidences of breast or uterine cancers, lowering the incidence of heart disease (stroke), and prevention of dementia.

The imbalance of hormones that occur during menopause or perimenopause can have a very dramatic impact on a person's ability to manage even the smallest tasks. Hormone imbalance affects a person's ability to function normally, making them feel inadequate to handle the demands within day to day tasks and sometimes even causing depression. In trying to diagnose menopause or perimenopause, a patient may be asked to track your symptoms and record when they occur. Your doctor will order a complete blood workup to assess your hormone levels and may also check for any other contributing factors, such as adrenal dysfunction or thyroid issues. Bioidentical hormone replacement therapy (BHRT) has been found to be a safe and effective treatment for symptoms associated with perimenopause and menopause.

These hormones, which are derived from plants, are structurally identical to the hormones produced by the human body. Long term BHRT treatment is highly encouraged due to its exceptional results in maintaining bone density, decreasing incidences of breast or uterine cancers, lowering the incidence of heart disease (stroke), and prevention of dementia.

Premenstrual Syndrome

PMS

Premenstrual Syndrome (PMS) affects up to 80% of women, causing a variety of physical and psychological symptoms. The majority of women affected are in their childbearing years, with 20% to 30% of these women entering menopause. Symptoms appear just after ovulation and may last for two weeks, ending when menstruation occurs. The average length of PMS is approximately six days. Symptoms of PMS range from mild to severe. Severe symptoms may interfere with a person's ability to navigate daily activities. Hormone imbalance is directly linked to PMS symptoms, as observed in a study performed of pregnant and menopausal women. Women experienced relief of PMS symptoms during these stages, lending to hormonal imbalance as the source of PMS. Thyroid dysfunction can also be a huge contributing factor in premenstrual symptoms and should be evaluated. Low thyroid can decrease your body temperature, creating symptoms that mimic the same symptoms found in PMS. Low serotonin levels or un-diagnosed depression has also been known to influence PMS symptoms.

Premenstrual Syndrome (PMS) affects up to 80% of women, causing a variety of physical and psychological symptoms. The majority of women affected are in their childbearing years, with 20% to 30% of these women entering menopause. Symptoms appear just after ovulation and may last for two weeks, ending when menstruation occurs. The average length of PMS is approximately six days. Symptoms of PMS range from mild to severe. Severe symptoms may interfere with a person's ability to navigate daily activities. Hormone imbalance is directly linked to PMS symptoms, as observed in a study performed of pregnant and menopausal women. Women experienced relief of PMS symptoms during these stages, lending to hormonal imbalance as the source of PMS. Thyroid dysfunction can also be a huge contributing factor in premenstrual symptoms and should be evaluated.

Low thyroid can decrease your body temperature, creating symptoms that mimic the same symptoms found in PMS. Low serotonin levels or un-diagnosed depression has also been known to influence PMS symptoms.

Polycystic Ovary Syndrome

PCOS

PCOS affects 5 to 10% of all women, with less than 50% diagnosed or treated, and is the most common cause of infertility today. Studies have determined that patients diagnosed with PCOS were three times more likely to develop autoimmune thyroid disease and are at greater risk for developing coronary heart disease. Another condition that seems to be associated with PCOS is insulin resistance, leading to the development of Type 2 diabetes by the age of 40. After evaluating symptoms and performing a physical exam, a doctor may order blood tests to check for hormone imbalances. Additional blood tests such as a fasting cholesterol/triglyceride levels or a glucose tolerance test will check for signs of insulin resistance. A physical exam, including a pelvic exam, can be done to manually inspect the patient's reproductive organs for any signs of a mass or growth. A Transvaginal Ultrasound of the uterus and ovaries can show the thickness of the uterine lining and the appearance of the ovaries. Any abnormalities can be seen visibly with this method of diagnosis.

PCOS affects 5 to 10% of all women, with less than 50% diagnosed or treated, and is the most common cause of infertility today. Studies have determined that patients diagnosed with PCOS were three times more likely to develop autoimmune thyroid disease and are at greater risk for developing coronary heart disease. Another condition that seems to be associated with PCOS is insulin resistance, leading to the development of Type 2 diabetes by the age of 40. After evaluating symptoms and performing a physical exam, a doctor may order blood tests to check for hormone imbalances. Additional blood tests such as a fasting cholesterol/triglyceride levels or a glucose tolerance test will check for signs of insulin resistance. A physical exam, including a pelvic exam, can be done to manually inspect the patient's reproductive organs for any signs of a mass or growth. A Transvaginal Ultrasound of the uterus and ovaries can show the thickness of the uterine lining and the appearance of the ovaries. Any abnormalities can be seen visibly with this method of diagnosis.

Testosterone Replacement

In the largest study of its kind, researchers in Massachusetts measured testosterone levels in 1,532 men ages 45-79, between 1987 and 2004. Their findings, published in The Journal of Clinical Endocrinology and Metabolism, showed that at any given age, average testosterone levels are significantly lower than they were 10 years ago and even lower than 20 years ago. Thus, even if a doctor says that a testosterone level is “normal for your age,” it may still be the cause of a loss of sense-of-well-being and quality of life. In other studies, those with higher levels of the hormone were 60 percent less likely to get heart disease and had better memory and overall mental function. Even sub-optimal testosterone levels that are still in the so-called “normal range” can be deadly. At the Holtorf Medical Group, our doctors are experts in the field of hormone replacement and will determine the best way to get patients back to the way they once felt.

In the largest study of its kind, researchers in Massachusetts measured testosterone levels in 1,532 men ages 45-79, between 1987 and 2004. Their findings, published in The Journal of Clinical Endocrinology and Metabolism, showed that at any given age, average testosterone levels are significantly lower than they were 10 years ago and even lower than 20 years ago. Thus, even if a doctor says that a testosterone level is “normal for your age,” it may still be the cause of a loss of sense-of-well-being and quality of life. In other studies, those with higher levels of the hormone were 60 percent less likely to get heart disease and had better memory and overall mental function. Even sub-optimal testosterone levels that are still in the so-called “normal range” can be deadly. At the Holtorf Medical Group, our doctors are experts in the field of hormone replacement and will determine the best way to get patients back to the way they once felt.

Hormone-Resistance Syndromes

Thyroid Resistance Syndromes are diagnosed based on abnormal lab work completed on the thyroid hormone. In patients with thyroid resistance, their blood levels of the thyroid hormone are elevated because the pituitary gland is not responding to the thyroid hormone. Overproduction of the thyroid hormone may lead to goiter or enlargement of the thyroid gland. These conditions are the result of a patient's body not responding normally to the thyroid hormones thyroxine and triiodothyronine. Unfortunately, patients may be misdiagnosed if a primary care physician is unfamiliar with the condition.

Thyroid Resistance Syndromes are diagnosed based on abnormal lab work completed on the thyroid hormone. In patients with thyroid resistance, their blood levels of the thyroid hormone are elevated because the pituitary gland is not responding to the thyroid hormone. Overproduction of the thyroid hormone may lead to goiter or enlargement of the thyroid gland. These conditions are the result of a patient's body not responding normally to the thyroid hormones thyroxine and triiodothyronine. Unfortunately, patients may be misdiagnosed if a primary care physician is unfamiliar with the condition.

Pre-Pregnancy Optimization

When you start planning a pregnancy, the first step on the right path is to consult a physician specializing in women’s reproductive health to ask any and all questions you may have. Make sure you find a physician you trust to help you along the way, through pre-pregnancy, and each trimester until the birth of your child. You want what’s best for yourself, and for your family. You want to take all the necessary steps to starting a healthy, happy family. There are many ways you can optimize your lifestyle for your plans to start a pregnancy. Many people think of prenatal health as just your health during pregnancy, but maintaining excellent health prior to becoming pregnant is crucial, as well. There are many guidelines to follow to live your healthiest lifestyle and protect your fertility. As it becomes more difficult for women over the age of 35 years to carry a pregnancy, you should also talk to a physician if you are planning on delaying having children until later in your life. Ask a specialist at Holtorf Medical Group to learn more about the steps you can take towards a healthier, and happier, pregnancy.

When you start planning a pregnancy, the first step on the right path is to consult a physician specializing in women’s reproductive health to ask any and all questions you may have. Make sure you find a physician you trust to help you along the way, through pre-pregnancy, and each trimester until the birth of your child. You want what’s best for yourself, and for your family. You want to take all the necessary steps to starting a healthy, happy family. There are many ways you can optimize your lifestyle for your plans to start a pregnancy. Many people think of prenatal health as just your health during pregnancy, but maintaining excellent health prior to becoming pregnant is crucial, as well. There are many guidelines to follow to live your healthiest lifestyle and protect your fertility.

As it becomes more difficult for women over the age of 35 years to carry a pregnancy, you should also talk to a physician if you are planning on delaying having children until later in your life. Ask a specialist at Holtorf Medical Group to learn more about the steps you can take towards a healthier, and happier, pregnancy.

Low Libido

A study in the Journal of the American Medical Association showed that 31% of men and 43% of women suffer from sexual inadequacy at some point in their lives. Low libido does cause a lack of sexual desire, however, it can also affect your life in other ways. Libido is the life energy that fuels motivation and provides a sense of well-being. Low libido may also be an indication of a more serious condition such as thyroid dysfunction, diabetes, cancer, heart problems, or kidney disease. It is the libido that is commonly used to measure one’s state of health. Symptoms of low libido may include a lack of the desire to engage in any form of sexual activity, lack of sexual fantasies, and low energy, or lack of motivation. Low libido can be the result of different physiological, emotional, or lifestyle factors. A lack of testosterone is a very common cause of low libido in both men and women. Women also possess the testosterone hormone, which creates a sexual desire in both sexes. In diagnosing low libido, blood tests will be performed to check hormone levels, thyroid imbalance, diabetes or to screen for high cholesterol. Once the cause that is creating low libido is determined, safe and effective treatments can be implemented.

A study in the Journal of the American Medical Association showed that 31% of men and 43% of women suffer from sexual inadequacy at some point in their lives. Low libido does cause a lack of sexual desire, however, it can also affect your life in other ways. Libido is the life energy that fuels motivation and provides a sense of well-being. Low libido may also be an indication of a more serious condition such as thyroid dysfunction, diabetes, cancer, heart problems, or kidney disease. It is the libido that is commonly used to measure one’s state of health. Symptoms of low libido may include a lack of the desire to engage in any form of sexual activity, lack of sexual fantasies, and low energy, or lack of motivation. Low libido can be the result of different physiological, emotional, or lifestyle factors. A lack of testosterone is a very common cause of low libido in both men and women. Women also possess the testosterone hormone, which creates a sexual desire in both sexes. In diagnosing low libido, blood tests will be performed to check hormone levels, thyroid imbalance, diabetes or to screen for high cholesterol. Once the cause that is creating low libido is determined, safe and effective treatments can be implemented.

Erectile Dysfunction

Erectile Dysfunction can be caused by a host of health concerns, including, but not limited to, heart disease, atherosclerosis (clogged arteries), high cholesterol, diabetes, obesity, and hormone abnormalities. The study and use of hormones have long been the domains of endocrinology, which is primarily focused on the pathologic phenomena encountered in the human body as they relate to hormones. No specific field in medicine has been designated to study and analyze the effects of hormones on wellness and disease prevention. Androgen deficiency includes but is not limited to symptoms of decreased body hair, reduction in muscle mass and strength, increase in fat mass, decreased hematocrit, decreased libido, erectile dysfunction, infertility, osteoporosis, depression, and mood changes. Androgen deficiency may occur secondary to testicular or pelvic trauma or surgical removal, hypogonadotropic hypogonadism, or with normal aging. Studies show that optimum levels of testosterone can not only restore energy, drive, and sexual health but also extend life. At Holtorf Medical Group we have the most highly trained physicians in this field and are the doctors that other doctors turn to for treatment, training, and help with their most difficult patients. Your health is your most important asset, why not come to the best?

Erectile Dysfunction can be caused by a host of health concerns, including, but not limited to, heart disease, atherosclerosis (clogged arteries), high cholesterol, diabetes, obesity, and hormone abnormalities. The study and use of hormones have long been the domains of endocrinology, which is primarily focused on the pathologic phenomena encountered in the human body as they relate to hormones. No specific field in medicine has been designated to study and analyze the effects of hormones on wellness and disease prevention. Androgen deficiency includes but is not limited to symptoms of decreased body hair, reduction in muscle mass and strength, increase in fat mass, decreased hematocrit, decreased libido, erectile dysfunction, infertility, osteoporosis, depression, and mood changes. Androgen deficiency may occur secondary to testicular or pelvic trauma or surgical removal, hypogonadotropic hypogonadism, or with normal aging. Studies show that optimum levels of testosterone can not only restore energy, drive, and sexual health but also extend life.

At Holtorf Medical Group we have the most highly trained physicians in this field and are the doctors that other doctors turn to for treatment, training, and help with their most difficult patients. Your health is your most important asset, why not come to the best?

Adrenal Dysfunction

Adrenal Fatigue

Many health experts believe approximately 80% of the population suffers from some level of adrenal insufficiency, yet are only diagnosed when an extreme deficiency (Addison’s disease) or overproduction (Cushing’s disease) of the adrenal hormones are found in routine blood work. This means that many people are trying to manage their lives and daily activities with malfunctioning adrenal glands, which goes undetected, not meeting the level of severity to diagnose disease. When adrenal glands are stressed, an autoimmune inflammatory response can occur throughout the entire body. Often times adrenal malfunctions cannot be addressed with just a healthy diet and exercise. And while exercise is a very important part of maintaining a healthy lifestyle, if not done properly for your level of health, exercise can trigger an adrenal crash. Common causes and triggers of adrenal dysfunction include acute life stressors, surgeries, prolonged emotional stress, ongoing bacterial infections, insufficient amount of sleep, and more. In diagnosing adrenal dysfunction, a provider will perform the ACTH stimulation test which measures the levels of cortisol in blood and urine. A normal response after an ACTH injection would be a rise in blood and urine cortisol levels. Abnormal response of this test is indicated by very little or no increase in the cortisol levels.

Many health experts believe approximately 80% of the population suffers from some level of adrenal insufficiency, yet are only diagnosed when an extreme deficiency (Addison’s disease) or overproduction (Cushing’s disease) of the adrenal hormones are found in routine blood work. This means that many people are trying to manage their lives and daily activities with malfunctioning adrenal glands, which goes undetected, not meeting the level of severity to diagnose disease. When adrenal glands are stressed, an autoimmune inflammatory response can occur throughout the entire body. Often times adrenal malfunctions cannot be addressed with just a healthy diet and exercise. And while exercise is a very important part of maintaining a healthy lifestyle, if not done properly for your level of health, exercise can trigger an adrenal crash. Common causes and triggers of adrenal dysfunction include acute life stressors, surgeries, prolonged emotional stress, ongoing bacterial infections, insufficient amount of sleep, and more. In diagnosing adrenal dysfunction, a provider will perform the ACTH stimulation test which measures the levels of cortisol in blood and urine. A normal response after an ACTH injection would be a rise in blood and urine cortisol levels. Abnormal response of this test is indicated by very little or no increase in the cortisol levels.

Bioidentical Hormone Replacement

Hormonal imbalances ― no matter what is causing them ― can be corrected with the right type of treatment: bioidentical hormone replacement therapy, or BHRT, available by prescription. The word “bioidentical” means that a substance is biologically identical to one made by your body. For example, the molecules that make up bioidentical progesterone are shaped exactly like your own progesterone. In contrast, the progesterone in birth control pills is similar to, but not exactly like your own hormone. ### Bioidentical Hormone Replacement for Men - We have a built-in biological clock, but today’s toxic environment full of plastics, pollutants and pesticides, coupled with poor nutrition are speeding it up. Even men in their 30s can start feeling “old,” and hormone depletion is often the root of the problem. For example, during the past few decades, average levels of testosterone, the hormone responsible for your “maleness,” have been declining at a substantially faster rate than aging alone can explain. Testosterone is abundant in young healthy men, and when levels drop below this youthful healthy range, it can result in fatigue, weight gain, inability to gain or keep lean muscle, poor libido and sexual satisfaction, loss of endurance, stamina or motivation and/or poor mood or depression. Because the testosterone levels decline over years, the symptoms are often dismissed as part of aging or due to lack of exercise, poor nutrition or excess weight, missing the underlying common denominator. ### Bioidentical Hormone Replacement for Women - Are you debilitated at a certain time of the month? Do you eat less and less but keep gaining weight? Does it seem like menopause is arriving ahead of schedule? These are all signs of hormonal imbalance, a growing problem that most doctors are not equipped to solve. Birth control pills are one common trigger, even if it’s been years since you’ve taken them. Environmental pollutants are others, from chemicals in skin care products and plastics to fire retardants in furniture and pesticides in food. And a poor diet intensifies all these effects. Without such triggers, the natural hormonal changes during a woman’s life aren’t likely to cause severe symptoms. But today, it’s virtually impossible to avoid disrupting toxins.

Hormonal imbalances ― no matter what is causing them ― can be corrected with the right type of treatment: bioidentical hormone replacement therapy, or BHRT, available by prescription. The word “bioidentical” means that a substance is biologically identical to one made by your body. For example, the molecules that make up bioidentical progesterone are shaped exactly like your own progesterone. In contrast, the progesterone in birth control pills is similar to, but not exactly like your own hormone.

Bioidentical Hormone Replacement for Men -

We have a built-in biological clock, but today’s toxic environment full of plastics, pollutants and pesticides, coupled with poor nutrition are speeding it up. Even men in their 30s can start feeling “old,” and hormone depletion is often the root of the problem. For example, during the past few decades, average levels of testosterone, the hormone responsible for your “maleness,” have been declining at a substantially faster rate than aging alone can explain. Testosterone is abundant in young healthy men, and when levels drop below this youthful healthy range, it can result in fatigue, weight gain, inability to gain or keep lean muscle, poor libido and sexual satisfaction, loss of endurance, stamina or motivation and/or poor mood or depression. Because the testosterone levels decline over years, the symptoms are often dismissed as part of aging or due to lack of exercise, poor nutrition or excess weight, missing the underlying common denominator.

Bioidentical Hormone Replacement for Women -

Are you debilitated at a certain time of the month? Do you eat less and less but keep gaining weight? Does it seem like menopause is arriving ahead of schedule? These are all signs of hormonal imbalance, a growing problem that most doctors are not equipped to solve.

Birth control pills are one common trigger, even if it’s been years since you’ve taken them. Environmental pollutants are others, from chemicals in skin care products and plastics to fire retardants in furniture and pesticides in food. And a poor diet intensifies all these effects. Without such triggers, the natural hormonal changes during a woman’s life aren’t likely to cause severe symptoms. But today, it’s virtually impossible to avoid disrupting toxins.

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When is payment due?

Payment is expected at the time services are rendered and your office may require a $100 non-refundable deposit to schedule your first appointment. We accept most major credit cards, cash, or check. We will provide you with a complete billing statement that you may submit to your insurance company for possible partial reimbursement to PPO insurance. We are an out of network provider.

Does Holtorf Medical Group participate in Medicare?

Our offices have opted out of the Medicare system. This means that our services cannot be filed with Medicare and therefore are not reimbursable. Patients have the option to get their labs done through their primary care physician.

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