Archive for the ‘Andropause’ Category

What Would it Take For You to be Healthier in 2012?

Sunday, December 25th, 2011

As we celebrate the holidays and wind down 2011, it is common practice to start thinking of things large and small that we would like to change in the new year.

Many of these changes are health changes.  Perhaps the most common wish or resolution for the new year is to lose weight or “get healthier”.   In my opinion, this is very worthwhile.   I have been a doctor long enough to know that it is unlikely to happen without a plan.  I’m talking about a plan that breaks a good plan down into small, strategic, doable action items.

I am a master at helping people lose weight.  One reason is that I recognize that being overweight is way more than eating too much and exercising too little. Those are often important factors,  but usually there is more to it than that.

Did you know that food sensitivities can cause you to hold on to fat?   One of my favorite patients lost 60 pounds within 4 months after stopping eating gluten once I diagnosed her with a sensitivity to gluten!

Thyroid issues are a frequent contributor to weight issues.  Before I did my extra training in functional medicine and looking for and treating the root causes of my patients’ health problems, I was taught to just look at TSH.  Now I spend much of my day reviewing with patients their complete thyroid lab results.  Did you know that Free T3 accounts for about 85% of thyroid activity?   How about that Reverse T3 has no activity and increases if a patient is stressed or is taking a synthetic T4 like synthroid or levothyroid?

Just not getting enough sleep can even make you fat.  If you get less than 7 hours of good quality sleep, then you actually mess up your hormones than tell you when you are hungry and when you are full, and affect fat storage.

Being stressed causes you to pump out constant cortisol, which is a fat storage hormone.  It is one of the common causes of belly fat.

Eating a high glycemic diet, and having unstable erratic blood sugars cause you to spike your blood sugar over and over during the day, which causes you to spike your insulin over and over again.  Insulin is another fat storage hormone.

Having a toxin load of heavy metals or other toxins can cause you to hold onto many extra pounds of fat and water, too.

There are other causes, too!

So, what to do about it?  I recommend a personalized approach, with labs and a detailed history to identify any easily fixable causes or contributors to the excess fat.  I have many approaches to actually helping my patients to lose their excess quickly and painlessly.  Most of all, it is always my plan to help a patient to get healthy and to have the weight loss be a side effect of that.  There is no joy in helping patients to lose the same 30 pounds over and over.

I am thankful for the opportunity to practice my craft of optimal health functional medicine and to serve my patients.  I am a lucky doctor!

I am accepting new patients, so if you or a loved one could use a new doctor, call or email to make your appointment now at 512-537-8859 or drliesa@drliesa.com. Come see me in my new office at 1524 South IH-35, Suite 140, Austin, TX  78704 between Riverside and Woodland.

To your health!

Liesa Harte, M.D.

Management of Low Testosterone Levels

Saturday, August 20th, 2011
low testosterone

low testosterone

One way to help maintain (if not actually increase) testosterone levels is by reducing excess body fat. Weight training is another way to raise testosterone levels in both males and females. Additional lifestyle changes include avoiding excess alcohol and high-fat diets, increasing intake of soy products, taking caution with drugs that impair liver function, and managing stress. Avoid over-the-counter agents promising to improve  testosterone levels, such as androstenedione. Testosterone replacement therapy, prescribed by a physician, can dramatically augment the benefits of these lifestyle changes.

In general, natural testosterone replenishment for andropausal  men has the potential to prolong the quality-of-life by decreasing many diseases of aging. Testosterone protects against cardiovascular disease; it can raise HDL cholesterol, and lower LDL cholesterol levels. It can decrease blood pressure, excess body fat, and symptoms of arthritis. Testosterone is a memory enhancer for many men. It stimulates the cardiovascular system, the neurologic system, muscles, bones and the vascular system. It prevents tendon and joint degeneration and osteoporosis.

Basic methods to raise testosterone levels
-Exercise, especially vigorous resistance training, 30-90 minutes three times per week
-Lose excess body fat to reduce aromatization and reduce insulin resistance
-Nutritional Supplements
Acetyl-L-Carnitine 3 gm/d may increase male libido
-Zinc (a natural aromatase inhibitor) – 50-1000 mg BID orally (take with piperine 5-10 mg, to improve absorption). transdermal chrysin often requires only 1/10th the oral dose.
-Nettle 120 mg twice daily – binds with SHBG, freeing up testosterone, it inhibits the binding of DHT to prostate receptors, and inhibits 5-alpha reductase
-L-Arginine up to 6 gm BID on an empty stomach may augment erectile potency
-Beta sitosterol (extract of saw palmetto) 300 mg/d for DHT management
-Grapeseed or red wine extract (inhibits aromatization) or 4 oz. red wine

Many substances may speed up the liver P450 system, decreasing estrogen levels. By decreasing estrogen levels the testosterone: estrogen ratio may improve, and may also result in increased percent of free testosterone by way of lower SHBG levels.
-Vitamins
-High-dose vitamin C (also increases testosterone production) 1-2 gm/d
-Vitamin K up to 1 mg daily
-Niacin 250-1000 mg BID with meals
-Foods
-Soy products containing genistein and isoflavones, which displace estrogen from estrogen receptors, or
-Soy isoflavone supplementation 110 mg daily
-Vegetarian diet
-Cruciferous vegetables (broccoli, cauliflower) stimulate excretion of estrogen
-Shellfish (oysters)
-Resveratrol (grape skin compound)

 

We treat men of all ages who are experiencing symptoms that might be related to hormonal imbalances or deficiencies. If you would like to be checked, then make your appointment today with either me (Dr. Liesa Harte, M.D. or my nurse practitioner Andrea Armstrong, FNP-C) by going to my website www.DrLiesa.com and click on the link to make your appointment online, or email us at drliesa@drliesa.com, or call us at 512-537-8859.  See my website for more information about my practice: www.DrLiesa.com .

Effects of Low Testosterone on Health

Saturday, August 20th, 2011
Testosterone Deficiency Effect on Men's Health

Testosterone Deficiency Effect on Men's Health

 

Testosterone and Prostate Cancer Risk

 

-The preponderance of the evidence indicates that testosterone does not cause prostate cancer

-Testosterone has been shown to protect prostate size and function. The prostate grows in low testosterone levels

-Medline search of studies

-75% found testosterone is not a risk factor

-25% indicated higher testosterone levels have a greater incidence of prostate cancer

-Low testosterone levels are associated with higher Gleason scores in men with prostate cancer

-Men with prostate cancer cannot take testosterone-boosting therapies because it stimulates the proliferation of existing prostate cancer cells

 

Testosterone and Depression

 

-Low testosterone correlates with symptoms of depression and other psychological disorders

-Testosterone replacement in men has been shown to significantly reduce

-depression scores

-Fatigue

-Libido

-Prescription antidepressants have a common side effect of loss of libido

-Testosterone replacement enhances libido

 

 

 

 

Testosterone and Mental Decline

-Low levels of testosterone

-Are found in men with Alzheimer’s disease compared to controls, independent of confounding factors

-May contribute to memory impairment and increase brain vulnerability to Alzheimer’s and related disorders

-Testosterone

-Exerts neuroprotective benefits from the effects of beta-amyloid

-Decreases beta-amyloid protein formation

-Increases secretion of the non-amyloidogenic APP fragment, sbetaAPPalpha

-May be beneficial in the treatment of Alzheimer’s

 

Testosterone and Obesity

-Obese men have low testosterone and high estrogen levels

-Fat cells, especially in the abdomen, convert testosterone to estrogen

-Central or visceral obesity is a risk factor for

-Cardiovascular disease

-Type-II diabetes

-High-fat foods may reduce free testosterone levels

-Testosterone plays a regulatory role in counteracting visceral fat accumulation

-Boosting testosterone levels can

-Decrease abdominal fat

-Reverse glucose intolerance

-Reduce lipoprotein abnormalities

 

Testosterone and Osteoperosis

-An important risk factor for osteoperosis and fractures in men

-Testosterone stimulates osteoblasts and therefore new bone formation

-Men with testosterone deficiency have significant decreases in bone density

-In men older than 65 years of age, the incidence of hip fractures is nearly 5 per 1000

-Approximately 30% of all hip fractures occur in men

-Testosterone deficiency has been reported in more than 50% of men with a history of hip fracture

 

Testosterone and Inflammation

-Cytokines impair synthesis and release of testosterone

-Androgens, including testosterone, downregulate pro-inflammatory cytokines

such as TNF-alpha, and IL-1b, and Upregulate anti-inflammatory IL-10

-Autoimmune disorders (e.g., MS, RA, SLE) improve with testosterone replacement

 

We treat men of all ages who are experiencing symptoms that might be related to hormonal imbalances or deficiencies. If you would like to be checked, then make your appointment today with either me (Dr. Liesa Harte, M.D. or my nurse practitioner Andrea Armstrong, FNP-C) by going to my website www.DrLiesa.com and click on the link to make your appointment online, or email us at drliesa@drliesa.com, or call us at 512-537-8859.  See my website for more information about my practice: www.DrLiesa.com .

Cardiac Effects of Low Testosterone

Saturday, August 20th, 2011

Andropause and Heart Disease

 

Negative Effects of Low Testosterone on Cardiovascular Disease

 

-Cholesterol, fibrinogen, triglycerides, and insulin levels increase

-Coronary artery elasticity diminishes

-Blood pressure rises

-Upregulates i-NO, an inflammatory type of nitrous oxide

-Human growth hormone (HGH) declines, weakening the heart muscle

-Abdominal fat increases, increasing the risk of heart attack

 

Testosterone and Heart Disease

 

-Low testosterone correlates with heart disease more reliably than does high cholesterol

-Testosterone slows the rate of vascular smooth muscle proliferation and apoptosis

-Testosterone may maintain the fibrous cap of atherosclerotic plaque by smooth muscle stability

-Testosterone strengthens the heart muscle

-There are more testosterone receptors in the heart than in any other muscle

-Testosterone lowers LDL and total cholesterol (synthetic testosterone, on the other hand, raises cholesterol and lowers HDL)

-Transdermal testosterone raises HDL cholesterol

-Testosterone raises apolipoprotein A

-Testosterone can improve or eliminate arrythmia

-Testosterone improves symptoms of angina, probably through vasodilation of coronary arteries

-Testosterone prevents blood clots

 

Testosterone and Stroke Risk

 

-Men with low testosterone have greater progression of carotid intima-media thickening

-Low free testosterone levels are related to intima-media thickening of the common carotid artery in elderly men independently of cardiovascular risk factors

 

 

Testosterone and Chronic Heart Failure

 

-Low testosterone is a common characteristic in men suffering from heart failure

-Testosterone

-increases anabolic function

-improves arterial dilation

-augments cardiac output

-has anti-inflammatory activities

-Trend toward improved mood scores with testosterone replacement

-Men with chronic heart failure have high rates of depression

 

 

 

Testosterone and Ejection Fraction

 

-Ejection Fraction

-Tends to be lower in men with low testosterone levels

-Men with the lowest ejection fractions average only 28% of the free testosterone level of men with higher ejection fractions

-Men with proven CAD have about 50% less total and free testosterone

-Testosterone Replacement

-Increases cardiac output via reduction of left ventricular after-load

-May be of benefit to men with heart disease

Recent Animal Studies with Testosterone replacement

-Relaxes coronary arteries in rabbits, suggesting that humans suffering angina could benefit

-Significantly improves recovery from global cardiac ischemia. For humans this means that having adequate testosterone levels may enhance the chances of being revived following a heart attack

 

We treat men of all ages who are experiencing symptoms that might be related to hormonal imbalances or deficiencies. If you would like to be checked, then make your appointment today with either me (Dr. Liesa Harte, M.D. or my nurse practitioner Andrea Armstrong, FNP-C) by going to my website www.DrLiesa.com and click on the link to make your appointment online, or email us at drliesa@drliesa.com, or call us at 512-537-8859.  See my website for more information about my practice: www.DrLiesa.com .

Andropause

Saturday, August 20th, 2011

Andropause, also known as male androgen deficiency syndrome, is the male equivalent of female menopause. It results from diminished levels of testosterone in the body along with a relative increase in estrogen, and exhibits a similar symptom complex to female menopause.

The enzyme system called aromatase (found mainly in fat cells) converts a portion of testosterone into estrogen. Because the drop in testosterone is more gradual, the symptoms of andropause appear over a longer period of time as compared to the female menopause.

Symptoms present slowly, with a loss of overall energy, thinning bones and muscles, increased body fat, depression, and impaired sexual function.

Symptoms associated with Low Testosterone Levels:
-Decrease in spontaneous early morning erections
-Decreased libido
-Decrease in fullness of erections
-Decrease in volume of ejaculate or strength of climax
-Difficulty starting or maintaining an erection
-Lack of focus or mental sharpness
-Fatigue
-Forgetfulness
-Mood swings
-Unexplained depression
-Increased body aches and stiffness
-Flabbiness and muscular weakness
-Decreased energy and stamina
-Arthritis and osteoporosis
-Rise in blood pressure or blood sugar level
-Weight gain
-Loss of lean body mass
-Changes in sleep patterns
-Hot flashes

Testosterone deficiency has also been linked to hypertension, obesity and increased risk of heart disease. men with heart attacks often have lower levels of testosterone and higher levels of estrogen. Low free testosterone is an independent predictor of the degree of coronary artery disease in men. Low testosterone is also a common characteristic in men suffering from heart failure. Testosterone replacement increases cardiac output in men with congestive heart failure.

When testosterone levels decline (especially with a diminished testosterone to estrogen ratio), a man’s prostate gland will enlarge. An enlarged prostate gland has been associated with a greater risk for cancer of the prostate. Many doctors still believe that testosterone augmentation causes prostate cancer. The preponderance of evidence indicates otherwise.

Testosterone has been shown to protect prostate size and function. It is possible, however, that it can accelerate existing prostate cancer and cancer-screening tests are necessary prior to replacement therapy. If prostate cancer is present  and has spread outside the prostate then testosterone can accelerate its growth. testosterone replacement therapy is therefore contraindicated in men with known prostate cancer.

We treat men of all ages who are experiencing symptoms that might be related to hormonal imbalances or deficiencies. If you would like to be checked, then make your appointment today with either me (Dr. Liesa Harte, M.D. or my nurse practitioner Andrea Armstrong, FNP-C) by going to my website www.DrLiesa.com and click on the link to make your appointment online, or email us at drliesa@drliesa.com, or call us at 512-537-8859.  See my website for more information about my practice: www.DrLiesa.com .

What is T? (Testosterone)

Monday, August 15th, 2011

Testosterone Declines With Age

Testosterone is a hormone secreted by the ovaries, adrenal glands and testes. Testosterone is the primary male sex hormone, responsible for male sexual development and critical in maintaining erectile function, libido, normal energy levels, and mood, and building muscles and burning fat. It is responsible for supporting immune function, bone density, and skin tone. It also controls a whole range of other physiological functions throughout the body in both males and females.

Testosterone levels decline with age. The decline begins when a man is in his mid to late thirties, and by the age of 80, is only 20% of what it was in youth. While the total testosterone does not drop drastically the free testosterone, which is the biologically active form, does decline dramatically with age.

Free testosterone makes up about 2-3% of the total amount secreted. Increased estrogen levels and insulin resistance in men can also cause a drop in the free testosterone levels. It has been found that diabetic men with elevated hemogoblin A1C levels have lower levels of testosterone and this association is independent of obesity and body fat distribution.

The number of men in the U.S., between the ages of 45 and 70 years, is expected to increase from 46 million in 1990 to 81 million in 2020. Currently more than 5 million men in the united states suffer from the effects of hypogonadism or low testosterone levels.

 

We treat men of all ages who are experiencing symptoms that might be related to hormonal imbalances or deficiencies. If you would like to be checked, then make your appointment today with either me (Dr. Liesa Harte, M.D. or my nurse practitioner Andrea Armstrong, FNP-C) by going to my website www.DrLiesa.com and click on the link to make your appointment online, or email us at drliesa@drliesa.com, or call us at 512-537-8859.

Rediscovering Desire-Unlocking the Erotic Potential of Menopause

Sunday, August 14th, 2011

 

Sex is Important at All Adult Ages

Many of you currently experiencing symptoms of menopause or perimenopause may remember a time in your life, say your teens or early twenties, when sex or the possibility of sex seemed exciting and carefree.  Perhaps, you came of age during the sexual revolution, when women were encouraged to take charge of and love their bodies. Desiring sex was easier when we felt desirable and sexy.

Maybe you never felt this way, or maybe as you move towards and through you fifties, you have lost the feelings of confidence and freedom that nourished your libido. Many women are alarmed at the changes in their bodies as they age and feel devalued by a society that celebrates youth.  You may also be confused and discouraged by the cultural message that having a vital, active sex life after menopause is somehow inappropriate, and that it’s not really important anyway.  But trust me, there is hope.

A less active sex life may not be a problem for some women, and in fact may be a relief for some. For others though, it may contribute to anxiety, depression, feelings of loneliness and isolation and result in  decreased emotional and physical intimacy with their partner.  An active and satisfying sex life contributes to both your emotional and physical well-being.  With a little effort, and the appropriate support from your healthcare provider, you can experience the best sex of your life after menopause!

Although it may seem natural for a woman’s sex drive to decrease as hormone levels drop and fertility wanes during menopause and perimenopause, this is not inevitable. Certainly the physiological changes that occur with the hormonal shifts of menopause can undermine your enjoyment, therefore, your desire for sex. Vaginal dryness and atrophy can make sex uncomfortable, and hot flashes, night sweats, and insomnia can lead to fatigue, another libido killer. The good news is that all of these physical discomforts can be easily diagnosed and treated.

A program that includes restoring the balance of the major sex hormones as well as any other endocrine imbalances, addressing nutritional deficits along with dietary and lifestyle guidance can get you started down the road to reclaiming your sexual self. Learning to want sex and delight in your sexuality is about taking better care of yourself and learning to listen to your body’s requests for support.

At Elite Care we are always happy to welcome new patients to our clinic in Austin, Tx. Please visit our website at http://www.drliesa.com/elite.html  for more information, or to schedule an appointment online, email us at drliesa@drliesa.com, or give us a call at 512-537-8859 and let us help you start your journey to a better sex life today.

Andrea Armstrong RN, FNP-C

Potential Effects of DHEA

Saturday, August 13th, 2011

DHEA may have any of the following potential effects:

 

  • Improved sense of well-being
  • Improved energy levels
  • Lowers LDL cholesterol levels modestly (one study, however, has shown DHEA replacement may reduce HDL cholesterol levels in females, and HDL is desirable)
  • Lowers insulin modestly, helping to stabalize blood sugar levels
  • Enhances immune system response by stimulating the thymus gland and by affecting the PPAR receptor lymphocytes, which decrease the production of free radicals by monocytes, resulting in a possible decreased risk of infections, malignant tumors or cancers
  • Decreases levels of inflammatory cytokines IL-6 and Tumor Necrosis Factor (TNF)
  • Decreases synthesis of thromboxane A-II in platelets (with doses of 100-300 mg DHEA daily)
  • Playsa role in conversion of fat to lean muscle
  • Reduces platelet aggregation
  • Decreases plasma plasminogen activator antigen (with doses of 100-300 mg DHEA daily)
  • Modest decrease in cardiac risk for men
  • Better outcomes have been reported for DHEA replacement following insertion of cardiac stents
  • It binds to GABA and NMDA receptors, possibly resulting in a positive impact upon depression, memory and cognition, by opening calcium channels.
  • Assists in improving symptoms associated with some learning disabilities, obesity and auto-immune diseases such as chronic fatigue syndrome, arthritis, lupus, Epstein-Barr, and adrenal insufficiency
  • May play a role in treating or preventing osteoporosis
  • An estrogen-like effect on the brain, by increasing beta-endorphin levels after initial therapy
  • DHEA exerts its effects upon the central nervous system by binding to the GABA receptor
  • In some animal studies, DHEA has slowed the aging process
  • Reduces subjective vasomotor symptoms as well as psychological symptoms in menopausal females
  • Increases IGF-1 levels (With doses of 100-300 mg of DHEA daily)

I encourage you to make an appointment at www.drliesa.com and make yourself an appointment to have your hormones tested and rebalanced.  Insurance usually pays for blood tests for hormones.  The results are back within about a week, and we can start treatment immedicately.  The sooner you balance your hormones, then sooner you will feel like your old self again, and often better!

Come see me or my nurse practitioner Andrea Armstrong, FNP-C  at my office at 1132 South Lamar, Austin, TX  78704 inside the Lamar Plaza Drug Store!   512-537-8859, drliesa@drliesa.com, or make an appointment by going to my website www.DrLiesa.com and clicking on the link to make an appointment.

DHEA (What is DHEA and what causes low levels)

Saturday, August 13th, 2011

DHEA (Dehydroepiandrosterone) is a steroid hormone produced from pregnenolone in the adrenal cortex, gonads, nervous system and brain.   About 90% is produced in the adrenal glands located just above the kidneys.   Cholesterol is the precursor to DHEA.   More than 150 hormones are made by the adrenal glands. However, the most abundant hormone made by the adrenal glands is DHEA and its metabolite DHEA-sulfate.   The ratio of DHEA-S to DHEA is approximately 400:1, and the concentration of the DHEA-S in serum is approximately 20 times higher than any other steroid hormone.

 

DHEA is one of the most abundant hormones in the body and is precursor to the sex hormones androstenediol, androstenedione, testosterone, estrone, estradiol, and progesterone.   In females, DHEA is the precursor for approximately 50% of the androgens, 75% of active estrogens in premonopause and 100% of estrogens in postmenopause.   DHEA has weak androgenic activity.   Other reported actions include anti-inflamatory, anti-cancer, anti-obesity, anti-diabetogenic and anti-aging.

 

For the first few years of life, the adrenals make very little DHEA.   Around age six or seven, they begin production in increasing quanities until the mid-twenties.  DHEA levels decrease progressively from a peak at age 25, and then begin to decrease after age 30, so the average 70 year-old has only 20% of the DHEA in circulation than he/she had 50 years earlier.

 

At all ages, men tend to have higher DHEA levels than women.  Many people over the age of forty produce inadequate levels of DHEA.   Levels are typically low in those with chronic  diseases such as obesity, diabetes, immune deficiencies, cancer, high blod pressure, heart disease, adrenal insufficiency, AIDS, and in the critically ill.

 

Many factors can contribute to low DHEA levels. Elevated insulin levels decrease DHEA levels; one reason why hyperinsulinemia increases vascular disease. DHEA levels may also be depleted by a number of drugs, including corticosteroids, opiates, birth control pills, and danazol. Moreover, low DHEA may be resulting from menopause o andropause, decreased DHEA production, excess alcohol consumption, hypothyroidism, lack of exercise, aging and smoking.

 

I encourage you to make an appointment at www.drliesa.com and make yourself an appointment to have your hormones tested and rebalanced.  Insurance usually pays for blood tests for hormones.  The results are back within about a week, and we can start treatment immedicately.  The sooner you balance your hormones, then sooner you will feel like your old self again, and often better!

Come see me or my nurse practitioner Andrea Armstrong, FNP-C  at my office at 1132 South Lamar, Austin, TX  78704 inside the Lamar Plaza Drug Store!   512-537-8859 ,  drliesa@drliesa.com , or make appointment online by clicking on the link on my website at www.DrLiesa.com .

Biologically Identical Hormone Replenishment Therapy (Synthetic Non-biodentical vs. Bioidentical Hormones, Synergy of Different Hormones Working Together is Necessary)

Saturday, August 13th, 2011
healthy couple jumping for joy

Healthy Couple Jumping for Joy

Biologically identical hormones, often referred to as bio-identical, or ‘natural’ hormones, are identical in molecular structure to the hormones the body makes. When a bio-identical hormone circulates through your system and binds with a receptor, the fit is the same as if your body had produced that hormone.

Synthetic hormones may be foreign to the body and are often treated by the body as toxins. They may not have the same molecular structure as human hormones. When one of these binds with a receptor, the fit is not exact, sometimes resulting in side effects.

Biologically identical hormones generally provide advantages over synthetic hormones when metabolized. Metabolism is performed by enzymes whose work is to break down (metabolize) hormones – the enzymes won’t metabolize hormones they don’t recognize, which can cause over-stimulation of the receptors and possible side effects. Additionally, to be effective hormones need to communicate with other hormones. Synthetics don’t always do this effectively or correctly. The goal is to improve cellular communication, restore balance and optimize function. The optimal approach replenishes all suboptimal and deficient hormones at one time.

Why replenish multiple hormones, rather than one at a time? The answer is relatively simple: we are not one hormone creatures. Hormones do not work in isolation from one another; they work in harmony, like individual instruments in a symphony. Hormones have synergistic and overlapping effects on the body. By improving the system with one, you may need less of another to make further improvements. In addition, chances of side effects are reduced when you replace less of each hormone. No matter how many hormones you replace, patience and getting in touch with your body’s responses to hormone replacement are the keys to success.

The third order of priority for hormone balance, bioidentical hormone replenishment therapy, should always avoid use of unnecessary hormones and unnecessarily high doses of hormones.

We treat men and women of all ages who are experiencing symptoms that might be related to hormonal imbalances or deficiencies. If you would like to be checked, then make your appointment today with either me (Dr. Liesa Harte, M.D. or my nurse practitioner Andrea Armstrong, FNP-C) by going to my website www.DrLiesa.com and click on the link to make your appointment online, or email us at drliesa@drliesa.com, or call us at 512-537-8859.