HRT FAQ | Questions About Hormone Therapy

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How Thrivelab Works Bioidentical Hormones Common concerns Your Medical Team Results Semaglutide Shipping Insurance

Questions about hormone therapy, answered

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How Thrivelab Works

How do I get started?

Complete the Thrivelab self-assessment and you will be prompted to schedule your $45 initial consult. Based on your self-assessment responses and medical history, we will develop your Hormone Balancing Plan, which will be discussed on your consult.

How to prepare for a telehealth consult?

You will receive a confirmation email with instructions for your telehealth consultation. We use Zoho Meetings as the platform and it is very easy to use. There are no software downloads required, but for privacy reasons you will be asked to enter a passcode to start the meeting. It may take a few minutes for the meeting to start. During the consult the doctor will review your self assessment, physical exam and lab results and answer any questions. Then the doctor will modify or approve your plan of care, which includes your prescriptions for bioidenticals.

In which states do you currently offer hormone rebalancing programs?

Thrivelab offers programs in the following states: AZ, AK, CA, CO, DC, DE, FL, IL, KS, KY, MA, MD, ME, MI, NC, NH, NV, NY, OH, OR, PA, SD, VT, TX, UT, VA, WA, ND, WY
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Thrivelab is currently adding more board-certified providers weekly and adding coverage areas, so please check back if your state of residence is not covered currently to see when services may be available in your area.

* Thrivelab providers do not prescribe testosterone in Georgia.

Can I stop my hormone optimization program?

Yes. Some patients simply need a "boost" to become balanced then your body can maintain the balance. Your doctor is the best resource you have to manage your therapy over time. Your commitment to hormone therapy should last as long as you want the results and for as long as you want to improve your quality of life.

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Bioidentical Hormones

What does BHRT stands for?

Bioidentical Hormone Replacement Therapy.

What are the bioidentical hormones made from?

Yam powder. Which is why your body can easily absorb it. IT's 100% natural.

Where does the medication come from?

Thrivelab has three compounding pharmacies - one in California, Texas and in Florida - which ship directly to your door wherever you live in the United States.

What does bioidentical mean?

The term "bioidentical" means the hormones in the product are chemically identical to those your body produces. At molecularly level, it means the hormone that you’re replacing is exactly the same as what your body produces naturally. The molecules of synthetic hormones are slightly different. There are hormone receptors all over your body. Think of these receptors as locks and hormone molecules as the keys. The synthetic molecules don’t fit into those locks quite right, which means they don’t work the same way in your body—often with detrimental consequences. You may be wondering…why do pharmaceutical companies make synthetic hormones with molecules that are slightly different? Because it’s the only way they can patent them. Bioidentical hormones can’t be patented.

Does BHRT really make a difference in managing symptoms and helping me regain my vitality?

Yes—if it’s done correctly, and under the supervision of an experienced doctor. Bioidentical hormone therapy is evidence-based and scientifically validated treatment. Chief Clinical Offericer, Dr. Nayan Patel has become an expert in regenerative and anti-aging medicine for more than 25 years, and he created our Hormone Optimization Program using sophisticated lab tests and treatment protocols he's been developing over many years to produce life-altering results.

Why don't your doctors prescribe hormone pellets as a delivery option for my hormone therapy?

Thrivelab medical practitioners do not prescribe pellets for 2 reasons. Pellets are inserted subcutaneously, and an assumption is made by the treating practitioner on the necessary dosage. This can lead to the dosage being too high, which requires additional drugs to mute the effects. Or, the dosage is too low, which can result in inferior results. Thrivelab's Hormone Optimization Program is designed just for you and the dosage is calibrated to find your optimal hormone level without these side-effects. Hormone pellets require a surgical procedure that comes with a one week healing time. We have found that patients can suffer from infection, discomfort and a reduced quality of life during this period. Additionally, it leaves a scar at the insertion point that can be unsightly.

Will BHRT interfere with other medications I am taking?

During your initial consult, your provider will review your current medical history to determine if any of your medications are contraindicated for BHRT or if a reaction could occur.

When should I start bioidentical therapy?

Everyone ages differently. Everyone goes through hormonal changes differently. However, there are broad guidelines that can help you decide if and when bioidentical hormone replacement therapy (BHRT) is right for you. Knowing when to start BHRT can help you maximize its impact while minimizing any risks. By strategically considering the timing of treatment, you may not only prevent unnecessary suffering, but protect your health for years to come. So when should you start hormone therapy? In part, it depends on your symptoms, regardless of age. For many men and women, andropause and perimenopause symptoms —which can begin in your late 30s or early 40s—can be uncomfortable and distressing. Symptoms for women can include irregular periods, mood disturbances, sleep disturbances, increased anxiety, and vasomotor symptoms like hot flashes. For men, symptoms can include weight gain, loss of lean muscle, hair loss, anxiety, decreased sex drive, fatigue and loss of stamina. All of the above, for both men and women, can benefit from BHRT treatment. However, some patients worry that their symptoms are not severe enough to warrant hormone therapy, particularly if they are relatively young. Others erroneously believe that they are too young for BHRT even while experiencing severe perimenopause symptoms. The idea that we can manage the aging process is gaining momentum. Whether you want to head off the aging process early, or you’re just beginning to experience symptoms, or your symptoms are severe and you’ve had them for a long time, we can design a treatment program to address your unique needs.

At what age should you stop taking bioidentical hormones?

If you are healthy, most experts agree that BHRT is safe to use at the lowest dose that helps for the shortest time needed.

How long can you stay on bioidentical hormones?

Most women continue treatment for 2-3 years to decrease symptoms of menopause or other hormonal changes. However, there is no limit on how long you can continue treatment if you are happy with the results.

Are there any side effects from taking bioidentical hormones?

Generally speaking, there are less side effects compared to synthetic derivatives. For most, the positive benefits far out-weigh any negative symptoms. However, dose related symptoms may occur. It is a matter of modifying the particular hormone dose to achieve the desired results. Thrivelab provides patients with a continuum of care that makes feeling better easy. When hormones and other treatments are administered correctly—and correctly is the only way we do things—there should be no side effects.

Why would I need to take bioidentical hormones?

When we are young, our hormone production is in a more balanced state. Both males and females produce testosterone, estrogen and progesterone, just in different ratios depending on sex. As our hormone production decreases, we may develop a host of systemic conditions. For females, this period of life is called Menopause. There is also a Perimenopausal period where women first start to notice issues. During this phase of life female symptoms may include: hot flashes, night sweats, weight gain, decreased libido, headaches, vaginal dryness, joint pain, nerve pain, anxiety and insomnia, just to name a few.For males, this period is called Andropause. Symptoms can start in the mid-thirties and may include: weight gain, erectile dysfunction, decreased libido, loss of muscle and strength, brain fog, fatigue and decreased motivation. Our sex hormones are very powerful substances that regulate many different bodily systems. When hormones start declining, the simple fact is that we noticeably begin to age (interiorly and exteriorly). Replenishing with bioidentical hormones is part of the science of Anti-Aging. This treatment is known as Bioidentical Hormone Replacement Therapy or BHRT.

What are bioidentical hormones?

Bioidentical Hormones are manufactured in a compounding pharmacy lab from plant sources that identically match the molecular structure of the hormones that our own bodies produce. This is what separates Bioidentical from synthetic hormones. The Bioidentical hormones fit perfectly into all the receptor sites on the cells to provide the cell with specific instructions whether it’s a bone cell or heart cell. And, yes, we need the sex hormones in every cell of the body for optimal functioning. For example, progesterone and testosterone are the primary fat burners in our cells. When we become deficient in progesterone and testosterone as we age, we tend to gain weight. The synthetic hormones do not fit correctly onto the cell receptor sites, which may give the cell “different” instructions which may cause hormone imbalance. Examples of synthetic hormones include the birth control pill, progestin and conjugated estrogen.

How are bioidentical hormones made?

Bioidentical hormones are not formed in nature but are made, or synthesized, from a plant chemical extracted from yams and soy. Bioidentical estrogens are 17 beta-estradiol, estrone, and estriol.

Who needs bioidentical hormone replacement therapy?

Bioidentical hormone replacement therapy benefits men and women of various ages suffering from hormonal imbalances. Each treatment plan is uniquely tailored to the individual. To select the right therapy, you must understand all the available options for therapy and exactly how bioidentical hormone therapy can enhance your life and wellbeing.

How do you know if your hormone levels are unbalanced?

If you are considering bioidentical hormone replacement therapy (BHRT), you may be experiencing symptoms that may be keeping you from feeling like yourself. Those symptoms may be the earliest signs of aging, such as foggy thinking, sleeplessness, muscle loss, or low energy. Furthermore, conditions of aging like menopause in women can cause hot flashes, mood swings, and weight gain while even post-menopausal women experience symptoms including but not limited to hair loss and low libido. Aging also has an effect on men known as andropause, which is caused by fluctuation of testosterone levels.

How do you test hormone levels?

In order to be truly bioidentical, we check your hormone levels by blood test to evaluate progress and your hormonal response to BHRT. Frequency and types of lab panels are personalized by the provider for the patient, however a full panel serum blood test will often be required after six weeks of treatment. Your provider will use this information to optimize your medication as needed. If necessary, we will perform additional tests after three months to monitor progress. All patients will require annual lab work. Most insurance companies will typically pay for labs, but check with your individual insurance provider and plan to be sure.

Watch: Learn about lab work for HRT & TRT

Can BHRT help with aging skin?

Indeed. Testosterone therapy in particular has been shown to improve skin elasticity, thickness, and moisture when compared to control groups. This effect is greatest on the skin when taken preventatively during aging process, but improvement has been seen in people of all ages where hormone therapy was indicated.

How long do I need to be / have-to-be on these hormones?

Our goal is to achieve long-term symptom relief for our patients. As long as these medications are safe and the patient wishes to continue to reap the benefit of HRT, therapy will be available. We will continue to scour the medical literature as more research is completed to provide the best care possible patient care.

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Common Concerns

Does BHRT cause cancer?

Overall, recent clinical studies show that the absolute risk is exceedingly low for cancer caused by HRT. In general, the benefits of HRT appear to outweigh risks for most standard risk women under 60 or less than 10 years from menopause. For men, there is an absence of significant evidence linking TRT to prostate cancer. However, PSA levels should be monitored at least annually to maximize patient safety. Your personal risk for cancer depends on your age group, type of cancer, whether you have had HRT before, and your overall health and lifestyle. At Thrivelab, we encourage our patients to be diligent about cancer screening protocols, such as mammograms and PAP exams for women, prostate exams for men, and colonoscopies.

Most of all, at Thrivelab we work to potentially lower your risk by personalizing your HRT plan and starting with a low dose of your hormone prescription based on your specific symptoms. Your Thrivelab provider will monitor you regularly and may adjust dosage to further minimize risks or side effects.

Will your treatment effect my kidneys?

Hormone replacement therapy is not associated with causing or worsening kidney disease. Those with severe kidney disease must avoid certain subtypes of injectable hormones, but several equitable replacement strategies are available that are safe and effective in achieving symptom relief. All cases will be evaluated and monitored by a licensed healthcare provider who will discuss individual concerns with the patient before prescribing.

Is BHRT safe if I’ve previously had a heart attack?

Great question. In men, both low testosterone and testosterone abuse were associated with increased risk of a first heart attack. For men who have had a heart attack already, we typically avoid testosterone supplementation unless we obtain cooperative approval from your cardiologist. Patient safety is our #1 concern. However, patients may still qualify for other hormone optimization strategies including thyroid and DHEA treatments.

In women with existing coronary heart disease, the balance of the evidence suggests that estrogen/progesterone replacement therapy has an elevated risk to benefit ratio and unfortunately, we cannot offer that therapy to that patient group at this time. However, estrogen therapy alone is a possibility for some women with heart disease if they have had a hysterectomy and thyroid management is still an option for those with coronary heart disease.

Can I take Thrivelab prescriptions along with my other medications prescribed by my doctor?

In general, yes. Our providers check for specific medication interactions to make sure your treatment plan is safe and effective for you. Rarely, there are medications and supplements that patients are taking prior to beginning our program, which may reduce the efficiency of hormone therapy. In such cases, we may make recommendations for alternatives that can be discussed with your primary care provider.

Are bioidentical hormones safe for everyone?

Certain women should not undergo hormone replacement therapy of any type until detailed studies on safety have been performed. You are not considered for bioidentical therapy if you have a personal history of breast cancer or stroke, or if you have a blood clot.

Are bioidentical hormones safer than standard hormones?

There are no studies to prove that bioidentical hormones are safer than standard hormone replacement pills; however, hundreds of thousands of women have been treated successfully and with fewer side effects.

Is bioidentical hormone replacement therapy approved by the FDA?

This therapy is not a new approach to hormone replacement; it has been used since the 1930’s. Bioidentical hormones are legal to prescribe and use in the US, although the FDA has not given its specific approval. The lack of FDA approval is because there are no official placebo-controlled studies to prove whether bioidentical hormones are safer than standard hormone replacement therapy.

What if I experience unwanted side effects from this therapy?

You should always discuss any side effects or unusual changes with your team doctor. Your medical team is available to you any time. Simply contact your medical team leader and set up an appointment to speak to them directly about what's going on?

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Your Medical Team

Who are the medical team?

Your Thrivelab medical team is comprised of a patient advocate, nurse practitioner, medical director and chief medical officer who all work together to help you have a successful hormone therapy journey. Thrivelab is unique in that we have one of the world’s foremost authorities on hormone health working with us, who has five decades of experience. Our Chief Scientific Officer, Dr. Nayan Patel has treated over 250,000 patients.

Are your provider's licensed?

Yes, our nurse practitioners and doctors are licensed by the medical board in their state and completed their training for hormone optimization under our Chief Scientific Officer, Dr. Nayan Patel.

Why does Thrivelab use nurse practitioners for some of the visits?

Our nurse practitioners are licensed and trained by Chief Scientific Officer, Dr. Nayan Patel. Nurse practitioners provide the same quality of care as doctors, but are able to spend twice the amount of time with you, making sure all your questions are answered. Nurse practitioners have a collaborating physician that provides support and regulatory compliance.

What is the difference between a nurse practitioner and a regular nurse?

Licensed nurse practitioners are legally able to prescribe medications and have greater flexibility in diagnosing and treating illnesses. Registered nurses cannot prescribe medications and often work under the direction of a physician when it comes to determining patient care and follow-up. All thrivelab nurse practitioners are specialists in hormone optimization and have undergone extensive training under our Chief Scientific Offericer, Dr. Nayan Patel an expert in hormone health.

What training do your providers have in hormone optimization?

In addition to their clinical experience in hormone optimization and regenerative medicine all providers at Thrivelab undergo training in Hormonal Bioidentity with our Chief Scientific Officer, Dr. Nayan Patel.

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Results

How long until I feel better?

It is not unusual for patients to report feeling improvements in many symptoms within the first week or two. However, our goal is long-term symptom relief and improved quality of life for each patient. This requires a cautious, evidence-based, and patient centered treatment strategy with a primary focus on patient input. Most patients stabilize within the first couple of months, but our personalized approach enables adjustment any time.

What results can I expect over the next six months of therapy?

Every person is unique, so your experience with hormone replacement therapy may be different from someone else’s. Generally, you will see changes physically, mentally, emotionally, and sexually when starting BHRT. You may even feel more confident along the way! While the results will differ from person to person, and depending on which hormone you take and your dosage, you can expect to start noticing changes within the first couple weeks or months. For some patients on bioidentical progesterone or estrogen treatments, results can be noticed in as little as 2 weeks. You’ll likely see relief in frustrating symptoms of menopause. Women have reported improved sleep, less joint pain, better mood, and recovered concentration. Additionally, they have more energy, fewer hot flashes, and reversal in the changes around their vagina related to dryness and discomfort during sex.

Watch: What to expect on HRT: the timeline

As a man what can I expect from testosterone therapy?

For men, there is much more extensive research available on testosterone therapy’s effectiveness and when you can start to see results: 3 weeks: After the first few weeks, you’ll notice a dramatic increase in sexual interest. This typically plateaus around 6 weeks. You will also notice an improvement in quality of life. 6 weeks: Symptoms of depression will start to dissipate starting at the six-week point and will continue to improve. You may experience less joint pain and better blood work, as inflammation will start to decrease. 3 months: Blood circulation will improve, which leads to better erections. Changes in fat mass, lean body, mass, and muscle strength will become noticeable. These will continue to improve for years. If you have diabetes, you may notice an improvement in glycemic control around this time. 6 months: Your bones will begin to strengthen. This will continue for 3 years and beyond!

Will I lose weight on bioidentical hormones?

BHRT can have a major impact on how you feel and function. Most men and women notice not only a significant improvement in energy and mood but also an increase in lean body mass and reduction in fat, for a healthier body composition.

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Semaglutide

Who is eligible for semaglutide?

Thrivelab currently only prescribes semaglutide to individuals who have a BMI that is over 30, or people with a BMI of 27 with metabolic conditions such as diabetes, pre-diabetes, high cholesterol, high blood pressure, cardiovascular disease, or non-alcoholic fatty liver disease. To find out if semaglutide is right for you, schedule a consultation and one of our trusted team of board-certified providers will assess your concerns and eligibility.

What is semaglutide?

Semaglutide is a weekly injectable with dosages that increase each week. Semaglutide is a class of medications called incretin mimetics which work by helping the pancreas release the right amount of insulin, slow the movement of food through the body, and move sugar from the blood into other bodily tissues where it is used for energy.

What can you expect from semaglutide?

A patient can lose 5%-15% of their body weight over the course of the first 90 days. Although uncommon in most cases, side effects are possible. Nausea, vomiting, and diarrhea may occur but these symptoms usually subside after a few weeks of using the medication.

What does semaglutide do?

Medications like semaglutide, coupled with healthy lifestyle changes can take control of risks of high blood sugar and diabetes by increasing insulin secretion, suppress hunger and increase the feeling of fullness to regulate body weight.

Is semaglutide safe?

Semaglutide is an FDA-approved medication, and is clinically-tested, stimulant-free, and non-habit forming. Side effects are extremely rare, and most individuals who take semaglutide do not experience any. For those who do, nausea is the most common, and this typically resolves over the first few weeks of being on the medication. In the most recent clinical trials, less than 5% of people discontinued medication because of side effects.

Does semaglutide get rid of belly fat?

Semaglutide has been shown to dramatically improve body composition by reducing excess body fat and increasing lean body mass. A recent trial testing 1,961 obese adults discovered that patients who injected semaglutide lost close to 15% of their body weight, on average over the placebo. Although these results prove the medication’s effectiveness in assisting with weight loss goals, it’s important to note that diabetes and obesity should also be met with holistic lifestyle solutions. Semaglutide will often be prescribed in conjunction with doctor-approved exercise, diet plans and behavioral adjustments.

What diet is best with semaglutide?

Technically, there are no foods that are off-limits, but depending on your health goals and provider’s recommendations, there may be some foods that you’ll want to avoid.Fried, greasy, and sweet foods should generally be avoided due to their inflammatory and gastronomical side effects. Healthy, natural foods that are light and bland are always encouraged, not only from the standpoint of interactions with semaglutide, but also for whole body wellness.

Does semaglutide give you energy?

Since semaglutide suppresses hunger and increases the feeling of fullness and satiety to regulate body weight, individuals will consume less food. Controlling eating habits will ultimately lower the preference for fatty, energy-dense foods. Instead, supplementing energy loss by food intake with other forms of energy, such as regular exercise and healthy sleeping habits will accelerate the positive effects of semaglutide for weight loss.

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Shipping

How do I track my package?

You will receive an email when your package ships to you with your tracking number.

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Insurance with Thrively

What is Thrively?

Thrively is our insurance program covering clinical costs: proactive symptom tracking, plan optimization, patient care and lab work. The cost of Thrively is $99 per quarter ($33 monthly) Insurance does not cover compound medications. Your insurance provider may require a copay, coinsurance or deductible. If you have coinsurance you will be charged $45 and once a final determination of benefits is received you will receive a statement. If there is a difference you will be notified and either credited or charged the difference. Our team will complete verification of benefits promptly after receiving your insurance information.

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Learn more about Thrively here.

How do reimbursements + copays work?

You were charged $45 for your Initial Telehealth Consultation. Once we complete a verification of benefits, if your copay is lower than $45, we will credit the difference on your next invoice. If the copay is higher, you will be notified of the difference and billed accordingly on your next invoice.

Why doesn’t insurance cover the cost of prescriptions?

Most insurance companies will not cover bioidentical hormones from compounding pharmacies or over-the-counter medications due to certain restrictions. The compounded prescriptions at Thrivelab are customized for each patient and therefore can't be approved or viewed as a single entity.

How do I submit my insurance information?

For existing patients, you can submit your insurance information via the Patient Portal and we will reach out to set up your Thrively plan. For new patients, your provider will discuss Thrively as an available option on your Initial Telehealth Consultation.

What if I'm not covered?

If you have an HMO plan without a referral, or do not have access to health insurance, then you will be covered by Thrively at $99 paid quarterly + $45 per telehealth visit with your provider.

Can a HSA or FSA card be used for payments to Thrivelab?

Yes - we accept both HSA and FSA cards. It is important to note that we always recommend that our patients reach out to these entities directly, as guidelines vary.