Robert Whitfield MD explains why thyroid and sex-hormone testing matters before breast implant removal. Many perimenopausal patients have normal estrogen and FSH but low testosterone, and some have autoimmune thyroid disease or receptor problems that won't improve by just raising hormone doses. DNA testing can identify enzymatic pathway issues.
So when we're looking at hormone levels after we've established we're concerned about that thyroid function is important. Now, thyroid function can be affected by many situations and several of my clients have had autoimmune issues. So you can actually have antibodies causing you a hypothyroid situation called Hashimoto's. And that as well as other kind of situations with the thyroid are not simply corrected by adding more thyroid hormone to the situation. It's more about evaluating maybe the toxicity level that's going in and making the hormone receptors less responsive. So if the car needs more gas, is it more efficient to pour the gas all over the car or is it more efficient to put it in the gas tank so you can actually use the car more? So obviously we put gas in our gas tanks, we don't pour it all over the car. So if you keep giving more and more thyroid hormone to someone to establish a normal laboratory level, are you really helping them if in fact that hormone that you're giving them never gets inside the actual cells? It needs to. So the important part is to establish whether or not their hormone receptor is working properly and then if they need more thyroid, give the appropriate treatments for that. When it comes to estrogen, progesterone and testosterone. So I have the majority of my clients of the 9,000, they're between the ages of 35 and we'll say 55. So they're all pre and perimenopausal. And then a small amount of them are already postmenopausal. So, so the majority of them are peri. If you look at a bell shaped curve, and in a perimenopausal patient, they will have, on typical laboratory analysis, estrogens, that's lower but in the normal range. On laboratory analysis, they'll typically have fsh, that's normal. And then they'll have the testosterone will be typically in the lower 25%, the total testosterone, then the bioavailable testosterone and the free testosterone, those will all be really, really low. And so in this situation, like, what's the right answer? Is there a hormone receptivity issue? Is there a lack of hormone being produced? And in many of those situations it's the lack of hormone production. If we feel it's a receptor issue, we, we have a different supplementation profile for that based on how you enzymatically break down your estrogen and testosterone that's actually figured out through DNA testing. So if we think it's simply that you don't have enough based on those bioavailable free and total testosterone in conjunction with your estrogen. Then I do my own bioavailable hormone replacement using pellet therapy.
