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Mary Harvey, age 54, a yoga teacher and her husband Thomas, age 62, a businessman from Palo Alto, California, came to Dr. A J Peters, MD, because of symptoms attributed to aging - menopause and andropause. She had at least 6 to 7 episodes of hot flashes a day and frequent night sweats that caused insomnia and irritability. She was not a happy camper. Thomas had osteopenia diagnosed by a bone density scan four years earlier for which he was taking Fosamax. Usually a T score on densitometry scan of less than zero predisposes to a high risk of oeteoporosis and fractures. Thomas T score was -2. Their health goals and expectations from her therapy were to avoid the annoying menopausal symptoms and for him, further bone loss.

They wanted to remain active, teaching yoga, enjoying the outdoors and going on their frequent hikes in rugged terrain, and not being afraid of sustaining injuries or fractures. Thomas’s mother suffered a hip fracture at age 78 and he was at risk. He also did not like the side effects of the Fosamax. It was causing him epigastric pain despite all the precautions his primary doctor gave him upon prescribing the drug.

The Harveys did due diligence research on bioidentical hormone replacement to determine whether it would be helpful. Mary found menopausal symptoms can be relieved by estrogen and progesterone but wasn’t sure about her husband’s thinning bones. On consulting Dr Peters, she told them that, from her experience, there was a possibility that their health goals could be addressed provided they were candidates for therapy. After careful review of their medical history, Dr Peters did not have any concerns and thought that it would, in fact, be beneficial for both of them. Dr. Peters ordered comprehensive blood and saliva tests for hormone levels including thyroid hormones, insulin, cortisol to evaluate adrenal status; sex hormones estrogen, progesterone, testosterone, and DHEA; and growth hormone and Vitamin D.

Hormone levels that were subclinical were supplemented with bioidentical hormone therapy appropriate for them -estrogen, progesterone, testosterone, growth hormone and thyroid hormone. Vitamin D levels were also clinically low in the Harveys and added to their therapy. Mary was started on estrogen topical cream that contained estradiol and estriol; estradiol to alleviate the menopausal symptoms and a smaller dose of estriol to help restore skin tone and color and help avoid fine line and wrinkles. Progesterone was also started as a mood relaxant to aid better sleep and for its protective effects. In less than 2 weeks from start of therapy, Mary Harvey reported no more night sweats or hot flashes during the day. Her mood had improved; she felt in control of her life again.

Testosterone was prescribed at an appropriate dose for Thomas. Within 2 weeks he felt more assertive, energetic and confident than he had felt in years. He attributed his new-found attitude to testosterone and growth hormone that were added to target his bone loss. Dr. Peters states that growth hormone does wonders to increase bone density in men and women.  Because Dr. Peters practices evidence based medicine and looks at the scientific proof, she uses growth hormone to treat bone loss manifesting as osteopenia and osteoporosis in her clients.

"I would not have been convinced of the ability of growth hormone to restore bone loss had I not witnessed the visual improvement in bone density in before and after bone scans of male clients,” Dr Peters said.  After about 6 months of daily injections of a conservative dose of growth hormone, Thomas’s T score on his follow up bone scan was 1 and the actual difference could be seen. “There was considerable increased density of the femur and vertebra than previously demonstrated,” said Dr. Peters. The difference between his before bone scan and another following one year on Fosamax therapy pales in comparison to these results.

“I feel fantastic. My hot flashes are gone. I sleep through the night now plus I have more energy in the day for my classes,” describes Mary; and “On top of that my bones are stronger,” added Thomas. One medication Mary could not tolerate was Armour Thyroid. After attempts to alleviate her symptoms of cold hands she was taken off the conservative dosing of thyroid. Thomas continues on a dose of growth hormone and testosterone. They both take high-grade supplements of DIM, Fish oils, Vitamin C, Vitamin E and vitamin D and Thomas has saw palmetto added to his regimen. They are both quite content and happy with their results and continue with routine testing to maintain their hormone levels.