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The Truth About Bio-identical Hormone Replacment Therapy

Integrative Medicine of Idaho
A family practice that integrates the best of science with the best of nature!

The Truth about Bio-identical
Hormone Replacement Therapy (BHRT)

by Mary K. Migliori, MD


We are so blessed to be living in the age where we can maintain our vitality long into our old age.

The definition of vitality is: the state of being strong, energetic and active. Vision, memory and mobility are key features of vitality.

When peri-menopause or andropause becomes a reality, it is because our hormone levels are rapidly falling and that state of vitality is noticeably changing. In fact, we may even start experiencing symptoms of fatigue, insomnia, weight gain, irritability, anxiety and depression.

Hormones are the messengers of life. They interact like a hormone symphony to create a beautiful melody. Every cell in our body has receptors for hormones to allow optimal communication.  Estrogen, progesterone, testosterone, DHEA, thyroid, cortisol, insulin and many more are like the instruments of our very own hormone symphony.

Estrogen, is a critical part of over 400 different functions in the human body.

Did you know that estrogen naturally breaks down into three basic metabolites, two of which are cancer promoting and one which is cancer protective?

Are you aware that the progesterone and estrogen balance is key to safe BHRT?

And that your thyroid hormone is the conductor of the hormone symphony?

We must not forget our beloved cortisol, without which we could not make energy.

How harmonious is your hormone symphony?

The truth is, there are three ways to test your hormones. They include blood, saliva or urine which, respectively, give you a one, two or three dimensional picture of your hormone symphony.

Specifically, blood tests are one dimensional in that they simply reveal the hormones floating in the blood, traveling to their destinations. It is the test of choice for some hormones including the thyroid levels but may not be as helpful for estrogen.

Saliva tests, on the other hand, are two dimensional in that they reveal the free working hormone concentration in the cells. The saliva test is valuable in that it reveals the progesterone to estrogen ratio which is an important safety marker.

Of the three testing procedures, many physicians agree that the most comprehensive, three dimensional picture of hormone harmony comes from urine levels of hormones and their metabolites. Knowing the metabolites enhances the safety of BHRT because certain nutrients help push metabolism toward the protective pathway.

Jonathan Wright, MD, pioneer of bioidentical hormone replacement therapy and director of the Tahoma Clinic in Washington, created the 24 hour urine hormone test in the 1980s. More recently, the DUTCH (Dried Urine Test Comprehensive Hormones) test was developed by Mark Newman in an effort to fill in the gaps. Dr. Mercola, well known health advocate, stated in an interview that his test of choice is the DUTCH because it gives the most information and is the easiest to do. I like it because it is not only easy but it measures oxidative stress in the body which is key to overall longevity and wellbeing.

Our hormone symphony determines the beauty of our music and how we maintain our vitality through optimal vision, memory and mobility.

At Integrative Medicine of Idaho, we attend the conferences and stay up to date in an effort to offer you the best choices to enhance your vitality. We are a member of Suzanne Somer's network of physicians called Forever Health and we're here for you.

If this makes sense to you, please call us and ask about our Summer Hormone Special. Will and Candice are happy to assist you in making an appointment.


Mary Migliori, MD
Director, Integrative Medicine of Idaho
Phone: 208-426-0052 Fax: 208-344-0136
2200 E. Warm Springs Ave. Ste 102, Boise, ID 83712