Come to grips with your health – Cheah Ui-Hoon ”Business Times, Executive Lifestyle”

This is a very interesting excerpt from a longer article published in ‘’The Business Times’’ in 2002.

In those days Singapore was supporting compounded hormones. Many people, male and female, have benefitted since then. Why is there now a witch hunt against them in Singapore?

Marion Gluck, who was spreading the word in Singapore at the time this article was published, has blazed the trail with bioidentical hormones and now works from her clinic in London. (See

Come to grips with your health

Cheah Ui-Hoon Business Times, Executive Lifestyle
Friday, 06 December 2002 Page: 18
Singapore Press Holdings Ltd.

. . .

THE recent Women’s Health Initiative (WHI) study on the dangers of hormone replacement therapy (HRT) in the United States has decisively dunked HRT as the miracle treatment for ageing and menopausal women. This might come as news to most, but not to holistic medical practitioners.

In fact, the findings made on synthetic hormones like Premarine Provera now throws the spotlight on natural, or bio-identical, remedies that have been around for 50 years, but which are less well-known.

Dr Marion Gluck, a women’s health specialist, points out that there is a safe, natural alternative for women, and men, who are suffering from symptoms of menopause and andropause such as hot flashes, night sweats, mood swings, and depression.

The German-trained doctor, currently based in an integrative medical centre in Australia, is spreading the word about Natural HRT (NHRT) in Singapore. She’s been to Singapore four times already, giving talks on NHRT at Shambhala Yoga School. ‘Women have been given a raw deal, because they’ve been exposed to synthetic hormones which have higher risks of side effects, not knowing that the safer alternative has been available,’ says Dr Gluck. Also, synthetic hormones have been given to women as a one-size-fits-all solution, and isn’t customised to individual needs.

‘It’s really important for doctors and patients to know that there’s an alternative on offer,’ says Dr Gluck. One of the reasons for this lack of information is that natural hormones – referring not to the source of hormone but to the actual hormonal structure – aren’t commercially viable for drug companies to produce since they can’t patent it.

Natural, also called bio-identical, hormones are derived from wild yam and soy, and unlike mass-produced hormones, they are custom-made to match the exact needs of the individual. The delivery systems are also safer and less taxing on the liver, as bio-identical hormones come in the form of creams and troches, which are like lozenges. In NHRT, the hormones estrogen, progesterone and testosterone have identical chemical structures of the hormones they replace, not being artificial or synthetic.

‘We would prescribe physiological doses, which are usually quite low, and that is effective enough,’ says Dr Gluck, who’s been in medical practice for 24 years. Practising integrative medicine, Dr Gluck would also prescribe or refer patients to other forms of treatment such as acupuncture or traditional chinese medicine if those are necessary or better-suited for the patient. ‘Instead of disease-based healthcare, as is now practised in the West, we have to turn around and concentrate more on prevention. It’s not just to keep a healthy constituency, but also to curb rising health costs,’ she says.

In the future, it’ll be easier for Singaporeans to get NHRT next year when a local company sets up the region’s first compounding pharmacy. Specialist Compounding Centre will operate from Camden Medical Centre, specifically for NHRT prescriptions.

Thomas Khoo, the head pharmacist, explains that a compounding pharmacy is basically like how the pharmacies of old used to be, compounding different formulas to meet individual needs.

One reason why the compounding pharmacy hasn’t existed here is because of lack of demand, but Mr Khoo thinks that it’s a matter of awareness. ‘We’re focusing first on NHRT prescriptions, and will venture into other areas once we’ve established the pharmacy,’ he says.

Dr Marion Gluck can be reached at Other NHRT practitioners include Shirin Jacob Clinic for Women, tel: 6733-7716 and Dr Ian Lee, tel: 6734-3831.

Why we must have foreign patients

Jeremy Lim, a partner in the Health & Life Sciences practice of Oliver Wyman, a management consulting firm.

A version of this article appeared in the print edition of The Straits Times on 22 July  2015.

Doctors need more patients to hone their skills, and Singapore patients benefit when a large pool of patients fuels biomedical innovation.

Medical tourism has been characterised as being about economic benefits and about attracting rich foreigners. Not any more – it’s not about them, it’s about us.

In 2003, then Acting Health Minister Khaw Boon Wan launched SingaporeMedicine, a national initiative to establish and enhance Singapore’s position as the medical hub of Asia. The ambitions were bold: one million foreign patients a year by 2012, the creation of 13,000 jobs and a contribution of $3 billion to the economy, or roughly 1 per cent of gross domestic product (GDP).

Since then, SingaporeMedicine has disappeared from policy discussions, becoming an agenda policymakers appear ready to excise from the collective memory. The SingaporeMedicine website has even been taken down, and once bold signage in at least one public hospital proclaiming “International Medical Services” has now quietly shortened to an ambiguous “IMS”.

What happened?

In launching SingaporeMedicine, Mr Khaw took pains to assert that “the dream of becoming a regional medical hub and containing healthcare costs are not mutually exclusive”, to allay fears that such moves would raise healthcare costs for all Singaporeans. He also pre-emptively explained using the analogy of Toyota Corollas, Lexus cars and Formula 1 racing that Singapore had to offer different types of healthcare to different target segments – Corolla-type care for the “bulk of our patients” with “maximum reliability, zero defects and lowest possible cost”, Lexus-type healthcare for those who can afford and want more, and Formula-1 cases to “show the world that we can hold our own against the best in the world and win”.

Fellow parliamentarians were not easily persuaded though. For example, Madam Halimah Yacob voiced concerns about distracting or diluting the public hospital core mission of serving Singaporeans. She said: “Foreign patients who come here do so because they want better and faster treatment and will have to be given priority… if we want to establish a reputation and continue attracting them. As it is, we are already suffering from a shortage of doctors, nurses and other allied professionals.”

By 2009, the Health Ministry’s tone had subtly shifted to arguing that SingaporeMedicine was only a secondary objective and that “our primary objective is to serve Singaporean patients, rendering good medical care at competitive prices”.

Despite the public concerns, Singapore has to soldier on. Foreign patients are vital to our healthcare system’s continued ability to provide quality healthcare for Singaporeans. In healthcare, high volumes deepen clinical acumen, sharpen surgical skills and enable higher quality for all patients, foreign and local.

I fear attracting foreign patients is no longer a “nice-to-have” but a “must-have”.

We may not have enough patient volumes in some specialities to even maintain competence and safety. Malaysia’s Institut Jantung Negara (National Heart Institute) aggressively markets itself internationally and performs almost 3,000 open-heart operations annually.

The National Heart Centre in Singapore? Fewer than 300 bypass operations in the last 12 months. What about the National University Hospital? Only 75 operations. “We have excellent outcomes despite the small numbers,” you might say. “How long more?” would be my response. Many of our heart surgeons cut their teeth in an era of plentiful patients and we continue reaping the fruits now.

Do we have enough patients today to train and build up the next generation of cardiac surgeons? Singapore has 43 cardiac surgeons island-wide: The latest numbers work out to only about a dozen operations per year per surgeon.

Is this enough?

The American Board of Thoracic Surgery stipulates that for surgeons in training, “operative experience requirements include an annual average of 125 major operations”.

Let’s be unequivocal – we need more patients.

The second reason we need more foreign patients is for biomedical innovation. For our biomedical research and innovation ambitions to be realised, Singapore needs medical scientists and clinicians to sub-specialise and focus on specific diseases or even sub-types of specific diseases.

And for this, we need patients, far more patients with certain selected diseases than Singapore’s modest domestic population could ever provide.

When I trained in Johns Hopkins Hospital, my supervisor was Dr Patrick Walsh, a world-renowned expert in prostate cancer. He had performed personally thousands of prostate cancer operations and this intimate knowledge of the disease had enabled him to pioneer innovative surgical techniques and contribute immensely to the foundational understanding of prostate diseases. His patients come from all over the world, not just America.

This call to reignite SingaporeMedicine is not a blunderbuss, clumsy and unbridled pursuit of all manner of foreign patients. Similar to labour policy, SingaporeMedicine needs a scalpel-like precision:

•Where are Singapore’s strategic priorities in healthcare and where are the gaps?

•Which types of foreign patients with diseases of interest and value to Singapore do we need to help plug these gaps?

• How do we encourage, for our own interests, foreign patients with these conditions to choose Singapore and help us maintain our pole position as a regional medical hub and as an increasingly successful biomedical powerhouse? Better coordination between public and private healthcare sectors? Special visa arrangements? Subsidies for expensive technologies?

I don’t have the answers, but I do know we need to have that conversation.

Forget the one about foreign patients crowding out locals; it’s a red herring and hurts Singaporeans.

Let’s discuss how some types of foreign patients can benefit from the excellent care Singapore is able to offer today, and help us to help ourselves.

HCS: And don’t let’s drive away the foreign patients who come here for bioidentical hormone replacement therapy by making it unavailable in Singapore.

New Study Reveals Why 1 in 6 Hypothyroid Patients Still Feels Bad on Levothyroxine

Joe Graedon The People’s Pharmacy, January 15, 2015

The comments which follow this article echo much of our own experience and need for Natural Desiccated Thyroid. Why is it that we cannot all be heard?

Doctors often treat an underactive thyroid (hypothyroidism) with levothyroxine (T4). New research is revealing that many people also need T3 to feel good.

One of the most controversial and contentious issues in endocrinology has to do with the best treatment for hypothyroidism. Most doctors insist that standard treatment with levothyroxine (L-T4, Levothroid, Levoxyl, Synthroid, Tirosint, Unithroid) is the answer to a sluggish or inactive thyroid gland. They reject natural thyroid or supplementation with T3 (Cytomel or compounded slow-release products) as unnecessary or unreliable.

Why Levothyroxine Alone Might Not Be Adequate

Many people with hypothyroidism (estimates range from 12 to 15% of patients or higher) complain of symptoms when they are treated with standard levothyroxine. Even when blood tests (TSH & TH) suggest that thyroid function is normalized, these individuals feel like crap. They complain of fatigue, impaired cognition or “foggy brain,” weight gain, and general malaise.

Until now, many endocrinologists were inclined to chalk up such complaints as psychosomatic, ie, all in the head. They did not wish to contemplate a problem with the standard treatment regimen.

Here is just one example from a visitor to our website:

“I have been on Synthroid for 40 years. I definitely have problems that have grown over the years. I go for my TSH blood test and it comes back within the normal range. So the doctor prescribes my usual .125 mg Synthroid and sends me on my way.

“When I show him my swollen feet and legs and the stasis dermatitis now forming on my lower legs, he says, “You have venous insufficiency. Wear compression stockings and elevate your legs as much as possible.”

“When I had two separate incidents of depression and anxiety, I was prescribed the antidepressant Paxil. I took myself off that after one year when my legs swelled up even more than usual.

“I suffer from constipation, lack of energy and lower back pain and have not been able to lose weight for years. My muscles ache all the time and my feet hurt constantly when I walk very far.

“I ‘ll be 66 years old in a few weeks and I feel like I am 80. I read all the articles and am very aware of the foods I should and should not eat. All my doctor cares about is the TSH test, and as long as the result comes back within the normal range he is happy and assumes all is well with my thyroid.” K.H.

How Do We Get from T4 to T3?

To understand the complexity of thyroid supplementation, we need to take a quick detour into some basic biology. Don’t panic! We will do our best to make this understandable.

The thyroid gland makes a few hormones but we are only going to focus on two, T4 (thyroxine) and T3 (triiodothyronine). The numbers T4 and T3 represent the number of iodine atoms ( 4 and 3 respectively) attached to the basic hormone structure.

Thyroxine (T4) is a prohormone and is relatively inactive. It has to be converted to T3 by the body. An enzyme removes one of the iodine atoms to accomplish this. As much as 80% of T4 is converted to T3. T3 is three to five times more potent than T4. So the efficient conversion of T4 to T3 is critical, and levels of circulating “free” T3 are essential to well being.

The New Discovery

Okay, before your eyes glaze over, let’s get to the new and exciting research. A team of investigators led by endocrinologists at Rush University Medical Center (in Chicago, IL) has just published studies in the Journal of Clinical Investigation (online, Jan 2, 2015) and the Journal of Clinical Endocrinology & Metabolism (online, Jan. 8, 2015).

Their animal research involved removing rat thyroid glands. When the scientists tried to normalize hormone levels with just levothyroxine (L-T4) they were unsuccessful. The animals demonstrated signs of hypothyroidism, especially within the brain, which might account for why some humans complain of cognitive dysfunction on T4 alone. The investigators were able to normalize circulating T3 levels and improve symptoms by supplementing T4 with extra T3.

Their human study uncovered genetic variability in patients suffering from hypothyroidism. They estimate that the mutation exists in 12% to 36% of the population. It makes it harder to convert T4 to T3. The scientists detected negative brain changes in patients that have difficulty making the T4 to T3 conversion. Such patients generally prefer a treatment regimen that involves both levothyroxine together with T3 supplementation (Journal of Clinical Endocrinology and Metabolism (May, 2009).

Patient Stories

My daughter has had hypothyroidism since she was 12. She is now 28 and took Synthroid up until 2 years ago. She felt lousy and was tired and her hair fell out and she had dry skin, even though they said her levels were fine! Well she started to take Armour Thyroid two years ago and there was a huge difference!

“She feels better and was also able to lose 60 lbs over the past 2 years. She couldn’t lose any before, as hard as she worked at it. I highly recommend Armour instead of the Synthroid!” J.F.

I have struggled with thyroid problems since I was 8. At age 57, I’ve had thyroid cancer twice, 2 surgeries & now high dose radiation/ablation. My last surgery was 18 months ago & I have gained 18 pounds since then.

“I have no energy & struggle to stay awake. My hair & nails are falling off. I’ve been getting weekly iron IV infusions yet my red blood cell & ferritin levels as well as thyroid levels remain low.”

“For years I took Armour Thyroid & was happy & healthy. Now I’m told I MUST take Synthroid even though I feel it’s ruining my life. I’m in my doctor’s waiting room now; I plan to show him these articles & ask for Armour. It’s hard to imagine the damage levothyroxine has done to my life unless you have lived it. I urge all people taking Synthroid but feeling poorly to tell their doctor & give Armour a try.” Shasha

“I have taken Armour Thyroid, Synthroid and Levothroid at various times. The ONLY one of the 3 that did not give me major side effects has been the Armour Thyroid. I have much more energy, no headaches and no fatigue like I have with the synthetic products.” Diane

We are not beating the drum for Armour Thyroid or any particular brand of natural or synthetic thyroid hormone. Some doctors prescribe levothyroxine and supplement it with Cytomel (T3) or with a special timed-release T3 formulation that compounding pharmacists can make. This creates more balanced T4 and T3 levels circulating within the body.

If you are intrigued by this thyroid discussion we think you will find our newly revised 25-page Guide to Thyroid Hormones of great interest. Not only does it go into much greater depth regarding treatment options, it provides information about thyroid testing that you may not find anyplace else.

Thyroid hormones are essential for normal body functioning. Getting the balance adjusted is a little like Goldilocks and the porridge; not too hot, not too cold, not too much and not too little. We want you to get it just right. Here is a link to our new guide.

Please share this information with anyone you think would be interested. Comment below in the “Add My Thoughts” section and please vote on this article at the top of the page. We appreciate the feedback.

Why you should not avoid hormone replacement therapy

Estrogen Could Have Prevented Almost 50,000 Deaths

Dr Mercola

8 August 2013

This long and informative article contains these two paragraphs of particular interest to HCS:

Ideally use Bioidentical Hormones

Premarin (the most popular estrogen replacement) comes from horse estrogens and is not bioidentical. While it may sound “natural,” I recommend avoiding animal estrogens for hormone replacement, as there are excellent human bioidentical estrogen hormones easily available through any compounding pharmacist. Your body recognizes these as “normal” and virtually identical to the hormones produced in your body, which makes them far safer than synthetic prescription versions.

There are three types of estrogens commonly used in bioidentical hormone replacement therapy: estrone, estradiol, and estriol. A common mixed formulation known as Tri-est includes 80 percent estriol with 10 percent each of estrone and estradiol.

Estradiol is the primary human female hormone found in all premenopausal women, whereas estriol is produced in significant amounts during pregnancy. Estriol is considered the safest of the three and is the most commonly prescribed. It has been used safely for decades, and I believe it’s particularly useful when you’ve had a hysterectomy.

Unfortunately, there is still much unnecessary concern about bioidentical estrogen supplementation. What the FDA, most doctors, and patients do not realize is that bioidentical hormone supplements can actually optimize your health. That said, your hormone levels should ideally be monitored by either blood, urine, or saliva, to ensure they reach a target level that corresponds to the reference ranges for healthy young women. I also believe that menopausal hot flashes that do not resolve with phytoestrogens such as black cohosh, are another valid indication for short-term estrogen use. However, if estrogen is used, it is nearly always wise to use it in conjunction with natural progesterone.

The Best Way to Administer Bioidentical Hormones

Keep in mind that when it comes to administering bioidentical hormones, some delivery methods are clearly superior to others. Oral supplementation is perhaps your worst option, as your liver processes everything in your digestive tract first, before it enters your bloodstream, which will metabolize most of the swallowed hormones to inactive and potentially harmful derivatives. Any method that bypasses your liver will therefore be more effective.

Hormone creams are one common alternative that achieves this. However, since hormones are fat-soluble, they can build up in your fatty tissues and lead to having too much in your body. This in turn can disrupt other hormones. It’s also near impossible to accurately determine the dose when using a cream. Sublingual drops can be a good option, as it enters your blood stream directly and will not build up in your tissues like the cream can. It’s also much easier to determine the dose you’re taking, as each drop is about one milligram.

In the 90s, I prescribed transdermal progesterone cream based on the now deceased Dr. John Lee. That worked well for most of the women but after 3-6 months most started to lose the benefits. However, I now believe the ideal delivery method is via trans mucosal administration. For more information about this, please listen to my interview with Dr. Wright. Administration methods are discussed toward the end of this interview.

Read the whole article at:

The surprising cause of falls and how to avoid broken bones

Exerpt from Dr Frank Shallenberger’s Second Opinion Health Alert Volume 12, Issue 92,  3 August 2015  Email communication (Bolding by HCS)

. . .

In essence, the bad thing about falling is not the falling itself, but the possible fracture that might happen and the inability to get up again. Most of us have had a fall at some point in our lives. But as long as we didn’t break anything and could get up and keep going, it just isn’t that big of a problem. So here are two additional things you can do that will make the biggest difference of all.

One, make sure you are taking a combination of bio-identical hormone therapy and a supplement to strengthen your bones and prevent a fracture. There is nothing anywhere close to the efficacy of bio-identical hormone therapy and the right nutritional supplements to keep your bones strong as you age. To do this, you will need a doctor versed in bio-identical hormone replacement. Fortunately, more and more doctors are getting trained in this incredibly important therapy.

. . .

How frustrating that “this incredibly important therapy” is under threat in Singapore . . .

Lavish trips laid on by drugs firms to ‘sway’ NHS staff

This article in The Telegraph, 22 July 2015, explores how “health service officials earn thousands organising and attending extravagant events where companies promote their products.

. . .

There have been concerns for a number of years. In 2013, the Association of the British Pharmaceutical Industry claimed that both NHS and private staff were paid £40 million for consultancies and sponsorships and other interactions with drug businesses.”

Does this only happen in the UK?

Read the article at:


Of course if a product such as compounded bioidentical hormones cannot be patented, it will not be included in such marketing drives and of course it does not make money for drug companies . . .

New Attack on BioIdentical Hormones by Drug Industry

Jeffrey Dach MD

Just when things have calmed down, the drug industry opens a new salvo in its war against bioidentical hormones, perceived as stealing market share from their women’s hormone pill, Prempro, currently in litigation for causing cancer and heart disease.

The attack article appeared in the Huffington Post by Phyllis Greenberger, CEO of Society for Women’s Health Research (SWHR), an industry-sponsored mouthpiece that funnels money from the drug industry to doctors for research grants, speaking engagements, meetings and even gala celebrations.

Hot Flash and Cold Cash by Alicia Mundy

A 2003 expose by Alicia Mundy in the Washington Monthly discloses SWHR-industry ties to Eli Lilly, Johnson & Johnson, Merck, Pfizer, and Wyeth, companies sitting on the SWHR advisory board.

Serving Your Corporate Master

Apparently, having the drug industry as one’s corporate master requires regurgitation of old marketing propaganda, even if it doesn’t make sense. Even to the most casual observer, this Huffington Post piece is a blatant attempt to discredit bioidentical hormones using fallacies, innuendo, and misinformation. Much of this material was covered in my free book, Bioidentical Hormones 101.

Let’s Take A Look At the Huff Post Article

The author, Phyllis Greenberger M.S.W., states, “Bioidentical hormones are not FDA approved.”

This is blatantly incorrect. There are twenty or so FDA-approved bioidentical-hormone preparations widely available at corner drug stores. Here are a few examples: Vivelle-Dot, Estrace, Climara, Prometrium, Androgel, etc.

The author Phyllis Greenberger states: “Bioidentical hormones made by compounding pharmacies are non-FDA approved.

This is misleading and deceptive. Compounding pharmacies are regulated at the state level, and do not fall under FDA jurisdiction. So, of course compounding is not FDA approved. No FDA approval is required or even desired. Your local hospital pharmacy is a compounding pharmacy that makes up life-saving medication such as IV antibiotics with no FDA oversight or approval. The FDA-approval process is designed for manufacturer capsules and tablets, and is impractical and unnecessary for compounded medications prepared to order by hand. Are we going to reject IV antibiotics from the hospital pharmacy because these are non-FDA approved compounded medication? Of course not. Compounding is here to stay.

Preventing Endometrial Cancer 

The author, Phyllis Greenberger, brings up a 2007 report of three cases of endometrial cancer in women on bioidentical hormones, implying that synthetic PremPro prevents endometrial cancer whereas biodentical hormones do not. This is a blatant lie.

Prempro contains a synthetic progestin that reduces the incidence of endometrial cancer. However, this is not reduced to zero. The author conveniently neglected to mention the 66 cases of endometrial cancer in Prempro-treated women as reported by Dr. Chlebowski. Examining the Women’s Health Initiative data after 13.2 years of follow-up, there were 66 endometrial cancers among women given synthetic PremPro (premarin and medroxyprogesterone).

Another fact conveniently omitted by the article: The bioidentical hormone, progesterone, has been studied and is FDA approved for prevention of endometrial hyperplasia. Preventing endometrial hyperplasia is the best way to prevent endometrial cancer, and a major reason why progesterone is always included in a bioidentical-hormone program.

A “Bad Drug” in Litigation?

One easy way to determine if you are dealing with a “bad drug” is to ask the question: Is this a drug in litigation? For Prempro and synthetic “FDA-approved” women’s hormones, the answer is yes; Prempro has been in litigation for years now. Pfizer, the company that bought Wyeth, has paid almost a billion dollars to settle 6,000 lawsuits by women who claimed the drug caused their breast cancer. This information should have been included, yet was conveniently omitted from the Huffington Post article by Phyllis Greenberger.

A Quote from June 19, 2012 Bloomberg News:

“June 19 (Bloomberg) by Jef Feeley: Pfizer Inc. has paid $896 million to resolve about 60 percent of the cases alleging its menopause drugs caused cancer in women. Pfizer has now settled about 6,000 lawsuits that claim Prempro and other hormone-replacement drugs caused breast cancer, and it has set aside an additional $330 million to resolve the remaining 4,000 suits, according to a filing with the U.S. Securities and Exchange Commission.”

Abandoning Synthetic Hormones

The Women’s Health Initiative (WHI) study was terminated early in 2002, because of increased risk of breast cancer and heart disease in the synthetic-hormone PremPro-treated group. This revelation prompted intelligent women to abandon synthetic hormones. Instead they switched to bioidentical hormones, same as the estrogen and progesterone produced by the ovary. The massive switch to bioidentical hormones produced an immediate decline in breast cancer rates of about nine per cent.(9,10)

Wake up From the Synthetic-Hormone Nightmare

It is time to awaken from the nightmare of synthetic hormones, known for decades to cause cancer and heart disease. The drug industry can spin and deceive us with misinformation and propaganda; however, the truth is clearly seen. Synthetic hormones remain monsters that should be avoided. Sadly, nowhere in this Huffington Post article was this important message stated.

For link to original article with references: click here.




Getting to the root of female pattern baldness

Using T3 and/or compounded bioidentical hormone cream

Extracted from an email communication from Dr. Glenn S. Rothfeld, M.D.

21 July 2014 (Bolding by HCS)

When looking for the reasons behind female hair loss, there are many different factors you have to consider. Hair loss can be triggered by harsh and toxic products that women often use in their hair that can cause thinning and follicle damage over time.

And certainly there are plenty of prescription drugs that have been linked to hair loss and thinning. The short list includes antibiotics, antidepressants, statins, proton pump inhibitors, immunosuppressant drugs and medicines to prevent blood clots. When I’m treating a female patient with hair loss, I always take a look at which medications she may be taking.

But, of course, the most common cause of hair loss among menopausal women is the hormone changes they experience. Estrogen plays a vital role in keeping hair full and strong. But as estrogen levels decrease during menopause — and hormones like testosterone become more dominant — you can experience hair loss.

And keep in mind that hair loss may just be the most visible sign of how hormonal changes are affecting your body. Low estrogen levels can weaken your bones and even affect your mood.

Thyroid is another hormone to look at when there is female pattern baldness. In many cases, I give a small dose of T3, the active form of thyroid, to help boost the metabolism of the hair follicles.

In some cases, I have a compounding pharmacist make up a penetrating cream with progesterone and T3 (the active form of thyroid hormone) and have that rubbed into the scalp nightly.

When dealing with something as serious as hormone replacement, it’s important to copy nature as closely as possible. That’s why I use bio-identical hormone replacement therapy, which uses hormones that have an identical molecular structure to what you produce in your own body.

Thanks for all the great questions I’ve been receiving. Remember, you can e-mail me your question directly at

To Your Health,

Dr. Glenn S. Rothfeld, M.D.