LGB Trans HRT ~ New Program, Fresh Vision, New You

imagesWIDJJQD2The flame of Trans* Health has been burning steadily brighter in my life over the past 3 years. I was keen on the practice while still living and working in Toronto, ON but without a scope of prescribing hormones, my work with the Trans* community was peripheral medicine – acupuncture, restoration of transman fertility, anxiety support etc. I continued to take trainings in the hormone and lab protocols to better understand the medical aspects of transition, without the vision of guiding transition myself.

Once I moved to Maine in 2011, my scope of practice as a ND changed. Naturopathic Doctors have different abilities to prescribe and order diagnostic lab work in each state and province. Most of the west coast states plus British Columbia have full prescribing rights, can do IV therapies, and can act like primary care docs for their patients. In the more conservative middle North America and east coast, Vermont and New Hampshire are the only states/provinces with a full scope of practice. However, for me, from Ontario, the ability to prescribe most hormones and antibiotics was a big change of pace!

I mentored and practice with Dr. Michael Bedecs, an Osteopathic Doctor specializing in hormone therapies for the past  3 years. Under his guidance (plus several conferences on trans health, anti-aging and hormone optimization) I have come to better understand the intricacies of the endocrine system, and how they interrelate through reproductive, thyroid, adrenal, pancreatic and pituitary pathways. All this time, my brain has been making subtle connections in Trans* health, drawing pathways to hormonal optimization the bridges the cultural and gender fluidity required with treating the LGBT community with medical advancements in metabolism, subclinical hypothyroidism, fertility, adrenal exhaustion, cortisol excess, insulin resistance and more.

Dr. Bedecs and I have created a new program called LBGT HRT that includes the dynamic possibilities of gender and hormone variation, bioidentical hormone replacement, transsexual transition and transgender health. We will be offering this through our concierge style practice at Age Management Center in Portland, Maine.

Age Management Center is a cash based practice. We do not accept any insurance plans for visits, medication or laboratory services. Some patients are able to pay for our services through Health Savings Accounts, or get third party reimbursement. Working outside of insurance allows us to provide a standard of care far above  the norm. We offer blood work here in our clinic, at physician pricing. Because we are not limited by the current scope of insurance, we are able to test for and evaluate metabolic parameters that are essential to our complete understanding of hormonal health and wellness.  We spend an average of 90 minutes for first visits, and offer a free 30 minute consult before any commitment is required. Furthermore, within our framework of concierge medicine, each visit is not priced and ticketed; rather, the ongoing support of our doctors, nurses and medical staff is included in the program, allowing you unlimited access for questions, concerns, and follow up until your program is fine tuned and ship shape.

We know this style of medicine is not accessible for all members of the LGB and Trans community. Therefore, I created a monthly sliding scale clinic at Justice in The Body the first Monday of each month from 9am – 12pm to meet the needs of the lower income members of the gender queer and Trans* community here in Portland, Maine, and beyond. This clinic is limited in that a prescribing MD, NP or DO is still required to Rx the Testosterone for FTM and Spironolactone or Cyproterone for MTF; however, I am able to order lab work through insurance in Maine and can work with your prescriber to optimize current hormone protocols and work on supporting the Integrative aspects of general health and wellness that come with transitioning. Many of my patients at the Trans* Health Clinic have been fully transitioned, and we are working on other aspects of preventative medicine and optimized health through the lens of Trans* medicine. I am currently working on expanding the scope of the JITB Trans * Health Clinic by finding a prescriber to work directly with us in house. Stay Tuned!

Follow me on Twitter for Trans* Health @LGBTHRT

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Note: Trans* is a new-ish term. The asterisk denotes that the term is encompassing the entire transgender, transsexual and gender fluid spectrum of individuals without having to write all of that every time.

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5 Steps for Fertility Preservation Over 35

1Rope_Cross. CoQ10 preserves the quality of the eggs mitochondria  – essential for replication and good “egg energy” aka ATP for cell division. 100-400 mg daily prevention, 400 mg twice daily during a stimulation cycle.  ( The use of mitochondrial nutrients to improve the outcome of infertility treatment in older patients. Fertility and Sterility 2010; 93:272-5. )

2. DHEA is a lipid antioxidant and youth-reviving hormone precursor. I suggest 10 mg daily for prevention,  25 mg daily 6 weeks before stimulation cycle. Up to 75mg daily is evidenced to improve egg and embryo quality and enhance spontaneous conception. (Addition of Dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Hum Reprod.  2010; 25(10): 2496-500 Accessed September 13 2013)

3. This is your individualized medicine step – what do you need to tonify your specific reproductive patterns and enhance the chances of conception?

4. Fertility Massage is key for addressing muscular and ligament stress lodged deep in the pelvis that could mechanically impair the ability to maintain pregnancy. Concomitant castor oil packs clear debris from the ovaries and fallopian tubes, flushing lymphatic channels for a more balanced local immune response. The self massage/ hands on aspect maintains a connection between the cerebral, medicalized experience of ART and the physical sensations of the lower belly while reducing emotional stress. http://natural-fertility-info.com/fertility-massage.

5. Optimize your nutritional status with: extra leafy greens on a regular basis; superfoods especially in smoothies;daily  fresh vegetables; and choosing clean meat and dairy whenever possible. Reduce or eliminate sugar during high intensity hormone treatments including birth control pills.

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