Atlanta doctor filter: help me find the right doc

May 4, 2009 7:42 AM

Good Bioidentical doctor in Atlanta? I want to give this a try. Several relatives have had good success with using these for various solutions. I do not want to go to a doctor to "look younger."

Not that I would mind looking younger....but it seems that some are pitching just that aspect.
Short story is I went through menapause in my early 30's, was on HRT for 15 years and have been off for 7 years. Yes I am older than dirt.
I have been to several endocrynologists and they all seem to think I have hormonal problems when they take my history but never find anything after testing. I would like to get some baselines and see if something can be done for a few lingering symptoms. But I do not want to go to some hack who is looking to make big bucks by promising me the moon.
Can anyone recommend a legit doc in Atlanta who is good with bioidenticals?

posted by shaarog to health & fitness (5 comments total)

You've had multiple opinions from specialists, and it seems that none of whom feel that hormone therapy is indicated in your case. Why are you trying to shop around for one that will? It seems like finding a provider who will take your money and tell you what you want is the very definition of a hack.

Also, I'd be wary of this fad in general. See the FDA's page on Bio-Identicals: Sorting Myths from Facts.
posted by grouse at 8:30 AM on May 4

As grouse says, finding a doctor who will simply do what you want is the opposite of finding a good doctor.

If you just want someone to do what you ask, keep their opinions to themselves and damn the consequences, go to India or China. Cheaper, too.
posted by rokusan at 9:40 AM on May 4

Oh man, hormones are so complicated. You don't mention what these "few lingering symptoms" are, but have you mentioned them explicitly to your doctors? If they don't find an underlying hormonal abnormality, there may be a simple course of treatment to address these particular symptoms without messing with the enormously complex feedback loops of the endocrine system.
posted by ladypants at 10:27 AM on May 4

I have been to several endocrynologists and they all seem to think I have hormonal problems when they take my history but never find anything after testing.

The endocrinologists are responding to your description of the problems from your history. So, if you say you are tired, have put on weight, seem sluggish or depressed, for example, it might indicate a thyroid problem.

Their tests, however, are not backing this up. Yet. This could change.

I understand where you are coming from, feeling frustrated, but you are better off staying with these specialists and tracking your hormone levels over a period of time instead of seeking out bio-identicals and taking matters into your own hands.

Your idea of getting some baseline measurements is not a bad one. You could be falling within what is considered a "normal" range, but just barely, for example. You may be on the borderline. In two weeks or a month you might slip far enough above/below the range that you require treatment. Keeping track of all of this and being persistent should that shift happen is a pro-active step and a way to take charge of your health.

But shopping for a doctor that tells you want you want to hear, so that you can adjust your hormone levels with bio-identicals that are not medially indicated, is just asking for trouble.
posted by misha at 8:47 PM on May 4

I know it's not what you want to hear, and I'm largely repeating what the folks above have already said, but the whole "bio-identical" push is woo to the extreme and entirely not grounded in an appropriately informed assessment of the science to date regarding hormone replacement, its risks and its benefits. Bio-identicals may be helpful with respect to controlling perimenopausal symptoms, but to the extent that they may be helpful in this regard, there is no reason what-so-ever to believe that those benefits come without the long-term risk already identified and attributed to conventional hormone replacement. The simple fact that these agents have not been studied does not absolve them of risk. If anything, it makes the risk of harm attributable to these agents more poorly defined, and given the lack of regulation regarding compounding, one might even expect even more problems with bioidenticals.

Anyone who claims to be a practitioner of this sort of therapy is at best either unqualified to interpret the science to date and practicing under false and potentially dangerous assumptions, or at worst well-aware of these issues and pushing them anyway.

Again, on a per-person basis, none of this excludes the potential for significant benefit from bio-identical hormones (the same being true for conventional HRT), but the prescription of these drugs and being a "legit doc" are to a large extent mutually exclusive. If you really want to explore this option, you are going to be limited to the anecdotal reports of your relatives and referrals from local friends/online forums that you trust. If anyone is both prescribing and selling this stuff, or operating under a cash-only or fee-for-service model, my advice would be to go running in the opposite direction.
posted by drpynchon at 9:56 AM on May 5 [1 favorite has favorites]