Hormone Replacement Therapy Doctor Dov Rand

1. How many male patients do you estimate that you have treated with testosterone therapy?

A. In the past 3 years, I have treated over 250 male patients with testosterone replacement therapy.

2 What are your preferred delivery methods for prescription testosterone?

My primary delivery method for testosterone replacement is with a compounded bio-identical cream in a highly absorbable Lipodermal base. This non greasy, odorless cream is applied to the inner thigh or forearms, 1 to 2 times per day. The results for most male patients has been highly effective. The cream also allows the dose to be adjusted and is much more concentrated than the commercially available cream.

For those men who do not respond to cream, I use an injectable form of testosterone that is administered 1 to 2 times per week. The preferred testosterone is the Cypionate ester. Occasionally, a blend is required to achieve a more balanced level.

I do not use pellet therapy as this is a minor surgical procedure with risk of infection. Also, the dose cannot be adjusted as needed.

Occasionally, I also introduce a testosterone troche for more rapid absorption.

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3. Doctors sometimes develop different areas of expertise. Do you feel that HRT (Hormone Replacement Therapy) is one of these areas for you and your office?

I have been studying and practicing BHRT for over 5 years, and the population of people looking for trained BHRT physicians is increasing. I am a Fellow of the A4M as well as a member of the Age Management Group. I presently attend a conference every six weeks around the country. Functional and Regenerative medicine including BHRT has become a huge part of my practice.

4. What do you monitor on a routine basis when a man goes on HRT?

There are a variety of factors that are monitored when a male patient is on hormone replacement.

Free and total testosterone levels, DHEA, and thyroid markers are measured in the blood approximately every 3 months to optimize levels. Estradiol and DHT are also monitored to make sure that testosterone is not converting to one of these hormones that can result in unwanted side effects. Typically if one is aromatizing (converting) to one of these metabolic end products I introduce other medications to lower these metabolites.

Liver enzymes, lipid profiles, and PSA are also checked every 6 months.

5. How do you handle men who clearly could benefit from HRT but do not have insurance? What options are available through your office? Do most insurance plans cover standard treatments in your office? (Feel free to explain some of the exceptions.)

Healthy Aging Medical Centers is not an insurance based center. Optimizing and monitoring various hormone levels along with caring for the patients overall health is a time consuming process, which often is not recognized by insurance companies. Prior to our office consult a detailed history is completed on our web site. This is then reviewed by myself and a customized lab order is created based on the patient’s history. Our initial consult usually lasts over an hour, and consist of a body composition analysis as well as a comprehensive review of the patients labs as well as subjective complaints. A detailed and customized treatment plan is then provided for the patient. The consultation fee as well as the treatment plan is reasonably priced and we offer payment plans through annual programs.

Our practice is very unique in that we have patients visit us all over the United States. Our program fees our extremely affordable and payment plan programs are offered. Most insurance companies do pay for the blood panel. If the patient does not have insurance, we draw the blood in our office for a marked discount rate as we have negotiated discounts with several labs. An average cost for a comprehensive panel is 500 dollars.

6. How do you monitor prostate issues and screening for men on HRT? Or do you let other physicians handle that?

Prostrate health is important to evaluate when male patients seek BHRT. If a man has been diagnosed with prostate cancer in the last 5 years, he is not a candidate for testosterone replacement. The PSA level is obtained on the initial blood test, and monitored every 6 months, along with patient symptoms. If the PSA is high, the patient is referred to a urologist for evaluation. It is a common misconception that testosterone replacement causes prostate cancer. IT DOES NOT. The latest studies, as well as the work of Dr Morgantaler demonstrate no correlation between testosterone and cancer. Intersetingly, some studies show testosterone replacement may be a future treatment for prostrate CA.

7. How does your office go beyond simple subscribing of PDE5 Inhibitor for Erectile Dysfunction? Do you have any other treatment strategies for men who are experiencing a loss of erectile strength?

My experience with men who suffer with various degrees of ED is that the problem is usually hormonal. Testosterone, DHEA, thyroid hormone, Growth hormone as well as Vitamin D deficiencies have all been documented in the literature as having a direct effect on libido, desire, and erectile function. Elevated levels of Insulin, estradiol, DHT, cortsol as well can negatively impact erectile function.

In most men, when these hormones are optimized, and estrogen and DHT are kept at normal levels, erectile strength improves dramatically. Therefore PDES inhibitors are not needed in most cases. BHRT also increase the man’s desire for sexual relation, which the PDES inhibitors do not. In cases of advanced diabetes and other vascular diseases, drugs like Viagra may be needed. In addition, to the conventional delivery methods we offer troche’s which have higher and quicker rate of absorption as the delivery is via the buccal (cheek) mucosa.

Often patients do need supplements as well do help address issues associated with decreased Nitric Oxide. I have found that L-Arginine as well as alpha-lipoic acid as well as other anti-oxidants are very useful.

8. Are there aspects of your practice or treatment strategies that you’d like to share that feel may make your practice “stand out from the crowd?”

There are several reasons why my practice “stands out from the crowd”. Firstly, we offer an online registration form to initiate your consult. This process prevents any delays in initiating treatment and allows me to focus on the comprehensive issues. It is imperative that at the time of your initial consult, blood work is reviewed. A customized prescription for blood work is emailed to the patient. I don’t have to ask the patient to present a second time in two weeks to review the labs. Our patients often are excited to leave the office after the initial consult with a solution as well as treatment plan.

Secondly, I think our practice stands out because of the one on one time and compassion our staff provides to our patients. Standard medical care has failed most patients. Most doctors are not empathetic to these issues nor do they understand the intricate and delicate balance that hormones, nutrition and exercise play. When patients complain that they don’t feel vital or lost their vigor, they are told that they are depressed, stressed out, and anxious. They are told that it’s part of aging and offered anti-depressant drugs. This is quite a typical response of conventional medicine. Patients are amazed how they feel when their hormone levels start to rise. They are so thankful that their youth and vitality have been restored. I also personally do make sure that if they have a partner, that perhaps they should be treated together to enjoy the benefits of hormone optimization. Many of the side effects related to hormonal optimization includes normalization of blood sugar, body composition and weight loss.

9. Can you give a brief description of your medical certifications and licensing?

I am a Licensed Medical Doctor in the State of NJ. I have been practicing medicine for 20 years. I am presently a Fellow of the A4M and preparing to take my Boards in Anti-aging Medicine, Regenerative as well as Functional Medicine.

10. Can you please list any contact information for men interested in reaching your office?

• We can be reached at:
• Healthy Aging Medical Centers
• 667 Eagle Rock Ave.
• West Orange, NJ 07052
• 973-325-6400
• http://www.Healthyagingmedicalcenters.com