Patients Medical Treatment Approach

Patients Medical Treatment Approach

How the Patients Medical Holistic Approach Differs from Conventional Hormone Treatment

by Rashmi Gulati, MD

Dr. Rashmi Gulati

In the traditional hormone replacement approach, synthetic and pharmaceutical hormones are administered to rectify any deficiencies using set dosages and protocols. Since the chemical composition of conventional hormones is different from the hormones produced naturally in the human body, they remain structurally foreign to the human body. This can be the major source of several undesirable side effects.

Premarin is a non-bioidentical hormone product comprised of multiple conjugated equine estrogens (CEE), some of which are obtained from the urine of pregnant horses. Provera is an example of synthetic progestin hormone known as medroxyprogesterone acetate (MPA).

Some Terms Simplified
  • Estrone (E1), estradiol (E2) and estriol (E3) are the three estrogenic hormones secreted primarily by the ovaries.
  • Progesterone is secreted by the gonads, adrenal glands, brain and, in time of pregnancy, the placenta.
  • Testosterone is secreted mainly from the testes of males and ovaries of females.
  • Dehydroepiandrosterone (DHEA) is a natural steroid prohormone produced from cholesterol principally by the adrenal glands and gonads.
  • Pregnenolone is another prohormone.
  • A prohormone, or protohormone, is a precursor molecule to a more active hormone form.
  • L-thyroxine is actually a prohormone that serves as a reservoir of triiodothyronine.
  • Triiodothyronine is the most powerful thyroid hormone affecting almost all bodily mechanisms.
  • Vitamin D is another prohormone converted in the body into various forms that activate receptors throughout the body’s tissues
  • Neurotransmitters are molecules that relay, amplify, and modulate signals between nerve cells and other types of cells. Many of our hormones function as neurotransmitters.

The product that combines these two, called Prempro, has been marked with a black-box warning for causing serious health risks. The basis for this step was supported by the reports of the Women's Health Initiative (WHI) as well, a trial in which these particular synthetic hormone forms were administered.

Our Bioidentical Hormone Treatment Methods

Patients Medical provides bioidentical hormone treatment based on five dimensions:

  • Unique Individual–Each patient is given separate focus and tailor-made treatment for comprehensive care.
  • Mind-Body-Spirit Whole–Hormones affect all aspects of life. Thus, the treatment must be extended to and coordinated with the complete physiology and psychology of the individual.
  • Empowerment and Partnership–The patient is empowered with the confidence to heal herself or himself, and in the process he or she becomes the partner of the practitioner.
  • Safety and Choice–As long as the processes are acceptable to the patient, they are offered a spectrum of methods to select the approach with which they are most comfortable. Upon further observation, the practitioners may recommend further modifications.
  • Best Practices and Practitioners–The practitioners at Patients Medical are highly experienced and rated experts in their respective fields.

On basis of these five dimensions, Patients Medical provides a safe, integrative, holistic medical practice.

Supplements We Use in Treatment

When appropriate, Patients Medical may recommend a complementary set of supplements and other therapeutic interventions to be used concomitantly with bioidentical hormone treatment. These supplements draw from a wide range of traditions, including Eastern and Western botanical medicine traditions, such as Ayurveda, Traditional Oriental Medicine, Native American herbal medicine, and homeopathy, as well as individualized men's and women's health formulae, targeted antioxidant and phytonutrient formulae, blood sugar support, stress management formulae, cardiovascular formulae, and vitamin and mineral supplementation.

Bioidentical Hormones—A Partial List

DHEA (Bioidentical)

Dehydroepiandrosterone, or DHEA, is a steroid hormone produced by the adrenal glands, as well as the testes in men or ovaries in women, and the brain. In both men and women, the body's production of DHEA increases dramatically before puberty. DHEA levels usually peak when we're in our mid-20s, then decrease with age. Physiologic levels of DHEA are approximately 200–400 micrograms per deciliter (mcg/dL) in women, and 500–700 mcg/dL in men. By the time we hit our 40th birthday, most of us have DHEA levels below 200 mcg/dL

DHEA is a natural antioxidant that may:

  • Restore immunity
  • Improve memory
  • Improve energy levels
  • Slow the aging process
  • Positively affect depression and anxiety
  • Improve psychological and physical aspects of sexuality

ESTROGEN (Bioidentical)

Estrogens are hormones produced primarily by the ovaries. There are three basic forms of estrogen: Estradiol (10-20%), estrone (05-20%), and estriol (60-80%). Of the three, estradiol is the most physiologically and biologically active. Bioidentical estrogen replacement is often comprised of either two (Bi-est), estradiol and estriol, or all three estrogens (Tri-est), using a bioidentical formula that your body recognizes as it would its own. Topical estriol face cream (0.6%–1.5%) may be used to treat hirsutism, excess facial hair around lip, jaw, and neck in women.

Studies show bioidentical estrogens may be protective against:

MELATONIN (Bioidentical)

This hormone, produced in the structure of the brain known as the pineal gland, helps to set your "biological" clock for wake–sleep cycles. Melatonin is a natural hormone that helps to regulate both the rhythm of sleep as well as its stages. Rhythmic melatonin production allows you to sleep more soundly and improves the function of your immune system.

Melatonin can:

  • Improve quality of sleep
  • Assist in regulating body temperature
  • Support kidney function
  • Boost immune function
  • Slow the aging process

PREGNENOLONE (Bioidentical)

Pregnenolone is a hormone that keeps our brains working at peak capacity. Research has shown that pregnenolone assists with memory, mental function, concentration and overall well-being. At Patients Medical, pregnenolone is prescribed in a sustained-release micronized form to assure adequate absorption. This form also assures a pure-grade supplementation devoid of contaminants.

Pregnenolone is a precursor to other hormones and serves to:

  • Improve cellular repair
  • Enhance memory and learning
  • Reduce PMS symptoms
  • Boost immune function
  • Protect cerebral function
  • Protect against neuronal injury
  • Treat autoimmune disorders

PROGESTERONE (Bioidentical)

This hormone is secreted primarily by the ovaries, is of equal importance to women as estrogen, and by nature counterbalances the effects of estrogen. Natural progesterone has a soothing effect that allows women to feel significantly better than they do on any of the synthetic progestins. It is also far less likely to be associated with unwanted side effects of synthetic products such as bloating, swelling, breast tenderness, bleeding, headaches, irritability and depression.

Studies show micronized bioidentical progesterone may be protective against:


This hormone is typically considered the male hormone, but its presence in the body is important to both males and females. As testosterone levels decline with age, there are health and appearance concerns that may accompany this loss. Bioidentical testosterone is available in micronized form, and may be prescribed in a topical or oral formulation.

Studies report men may experience:

  • Increased bone density, formation, and mineralization
  • Increased energy levels
  • Improvement in sexual function
  • Decreased body fat
  • Increased muscle strength
  • Decreased markers for heart disease


Healthy women naturally produce small amounts of testosterone in the ovaries. This molecule helps regulate a women's libido, and may also enhance the functions of estrogen.

Studies report women adding prescription-strength testosterone may experience:

  • Enhancement of sexual drive
  • Relief of menopausal symptoms
  • Restoration of energy
  • Strengthening of bone
  • Prevention of osteoporosis
  • Improvement in overall sense of well being
  • Fewer wrinkles, increased collagen and elastin

Begin Your Journey to Wellness with Patients Medical

Our job at Patients Medical is to listen, to connect the dots between a patient's medical history, symptoms, and their underlying causes. Patients Medical is a superb place for women and men to secure integrative and holistic health care from providers who give personalized care, partner with the patient to focus on the root cause of their illness, support their recovery, and help them maintain good health.

To make an appointment with one of our physicians, please call us at 1-212-794-8800. We look forward to hearing from you.

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