Frequently Asked Questions by New Patients

We recognize that every patient has different hormone levels & should be treated individually with BHRT. During the first assessment we will test a full blood lab panel of all hormones, + adrenal + thyroid levels. Each patient is evaluated via full assessment & tested before the being prescribed their individualized BHRT hormone treatment prescription.

Come visit our Clinic, fill out an intake form which includes current and past personal and family medical history. We will then talk with you to assist with any clarification needed. Blood Pressure, Height and Weight will be taken. From there, you will be given a blood-work requisition to have done at your earliest convenience. All hormones + adrenals + thyroid are tested (approx. 13 vials of blood for first assessment).

* blood tests in Ontario are covered by OHIP where applicable. Tests that are not covered include vitamin D, PSA & reverse t3. Only MDs & NPs can order blood tests under OHIP.

** blood test results take  approximately 10 business days

Because the plasma is made of your own platelets, there is usually no adverse reaction. There is a possibility of irritation, pain or bleeding related to the injection site but most people resume normal activities almost immediately after treatment.

Due to the natural variation in quality of Platelet Rich Plasma, results will vary between individuals.  Although you may see a change after the first treatments, you will likely require a series of 3-6 sessions to obtain optimal clinical results and desired outcomes

For optimal results:

* Skin and under eye area with 3 treatments completed 30 days apart.
* Alopecia (hair loss for men and women) 4 treatments 30 days apart
* Joint injections:  3 treatments in 2-4 week intervals (individualized)

There is no downtime or long recovery process.  You may take a warm shower the evening of the treatment.  It is advised that you avoid direct sunlight, hot saunas, make-up, harsh dyes or chemicals on your hair.

No, a single treatment doesn't take more than 30-45 mins.

Treatments vary based on your needs.  Initially, your HCP may recommend several treatments spaced one month apart.  After the initial treatments many HCP suggest maintenance treatments 2-3 times per year.

For optimal results:

* Skin and under eye area with 3 treatments completed 30 days apart.
* Alopecia (hair loss for men and women) 4 treatments 30 days apart
* Joint injections:  3 treatments in 2-4 week intervals (individualized)

Talk to your Health Care Provider (HCP) for a proper diagnosis and to create a treatment plan.

If you have any of the following conditions you may not be a good candidate

BHRT can help with:

• anxiety
• sleep issues
• thinning eyebrows
• hair loss
• cognitive concerns
• decline in general well-being
• decreased energy
• decreased mood
• depression
• fatigue
• excessive sweating
• nervousness
• weight gain (abdomen, buttocks, thighs)
• cold hands and/or feet
• increased fat around the abdomen
• irritability

BHRT can help with:

• aches, pains and stiffness
• anxiety
• cognitive concerns
• blood sugar control
• decline in general well-being
• decreased beard growth
• decreased energy
• decreased hair & nail growth
• decreased libido
• decreased mood
• depression
• erectile dysfunction
• excessive sweating
• fatigue
• higher cholesterol
• increased fat around the abdomen
• irritability
• joint pain and muscle achiness
• lack of skin elasticity
• loss of muscle
• loss of vitality
• metabolic syndrome
• nervousness
• osteoporosis
• poor exercise recovery
• sleep issues
• weight gain

BHRT can help with:

• wrinkling skin
• dry skin
• decreased bone density
• lowered sex drive
• nervous tension
• mood swings/confusion/irritability
• fine lines around mouth and eyes
• fatigue
• facial hair growth
• weight gain
• thinning hair or hair loss
• constipation
• increased incidence of cysts
• depression
• swelling
• osteoporosis
• sleep disturbances/insomnia
• rapid heartbeat
• shortness of breath
• backache
• urinary incontinence, discomfort, or changes in frequency
• loss of appetite
• dizzy spells
• bladder infection
• increased gas
• dry nose and mouth
• skin rash/irritation
• attention deficiencies, memory loss
• dry eyes
• headaches
• aching joints
• weakness
• diarrhea
• hot flashes/night sweats/cold sweats
• breast tenderness
• tingling in hands and feet
• lack of energy
• vaginal discharge/ vaginal dryness
• high cholesterol
• irritable bowel syndrome

Patients who benefit from BHRT are as young as 16 years old (severe issues with periods, depression & acne), right up to 90 years old. Our hormone levels drop 1 to 3% per year once we hit the age of 30 years old. It is wise to get tested sooner then later, so we can have a precursor of what your hormones were when you were young and youthful instead of waiting until your hormone levels are really low, when you feel awful. You can still start BHRT when you are over 50 and take advantage of the benefits.

Over the years, several studies have shown that TRT improves multiple measures of men's vitality, especially related to cardio-metabolic health. Bio-identical testosterone does not cause prostate cancer. The precipitous decline of men's testosterone levels over the years is evitable. Unless aging men replace their diminishing testosterone, they could succumb to any of the numerous health problems linked to low testosterone levels including fragility, muscle loss, weight gain, impaired cognitive function, fatigue, depression, decline in bone health, increased risk of type ii diabetes, stroke, and cardiovascular disease. TRT can restore your testosterone to a physiologically optimal level so you can take control of your quality of life and reclaim your competitive edge.

BHRT will help you feel like yourself again, even through the ups and downs of hormonal change. BHRT also helps with disease prevention and offers you a better quality of life as you get older. Low hormone levels cause cancer, bladder infections, dementia and Alzheimer's disease.

• For women benefits of BHRT - helps increase libido, better memory, boosts energy and will help with your hot flashes, night sweats, anxiety and weight gain.
• For men - benefits of BHRT/testosterone therapy helps increase libido, lower muscle mass, more energy to work out faster recovery time, sharper memory and more stamina and energy.
• With accurate testing we can track your hormone levels and optimize them.

Patients will pay the custom compounding pharmacy directly and the pharmacy will ship your prescription directly via express post with signature. Patient(s) can submit their own receipts to their insurance. Coverage depends on your insurance plan.

Note: patients can keep all receipts and claim tests, consultations and rx/prescriptions on their taxes.

OHIP will cover the majority of the lab tests, there are a few that are not covered which we will discuss and you'll have the option to choose whether you'd like to do these. Consultations are not covered at this time.

Saliva testing measure "free" hormones (2-5% of the hormones in a person's body), which are the hormones that are available to go to work for you - stimulating receptor cells and carrying out the tasks they are designed to perform.

In contrast, serum testing generally measures the "total" hormones, which includes those hormones already bound to protein and unavailable for your cells to use. Thyroid testing is done via blood panels.

Your follow up consults are approximately 30 minutes each and are done at 4, 8, and 12 months plus lab tests (these are usually done about 2 weeks before each consultation). The lab tests are not a full panel for follow ups but rather selected based on your goals/needs. During these follow ups we go over your results and your prescriptions as needed.

Your first full assessment is approximately 60 minutes and is done either in-clinic or via telemedicine = skype/phone/facetime, if preferred. We will go over your medical history, hormone issues, hormone symptoms, thyroid & adrenal issues etc. We will then also review your blood work results which will allow us to manage your symptoms and any prescriptions effectively.

* Please note, only an MD and an NP have full prescription rights for hormones & controlled substances in Ontario.

Platelet-rich fibrin can have multiple benefits for osteoarthritis of the knee. Along with improving growth in arthritic cartilage, PRF for osteoarthritis can:

• Reduce pain and inflammation caused by osteoarthritis: The PRF injection knee treatment can help reduce pain and inflammation that is caused by osteoarthritis and other bone issues by lessening the overall stress on your joints.

• Activate stem cells and increase growth and repair of damaged tissue: PRF injection treatments have been shown to activate stem cells and increase growth and repair of damaged tissue. The PRF procedure involves the use of concentrated platelets, which have been known to improve overall functions and processes in the body.

• Slow progression of osteoarthritis while improving current discomfort: PRF can also improve discomfort caused by osteoarthritis. 

A study conducted by the Hospital for Special Surgery in New York also showed that PRP injection knee treatments improved overall pain and knee function in up to 73% of patients and slowed the progression of osteoarthritis. RP has some very promising results however more research studies are needed to back up the clinical results.

The risks of PRF are minimal. There is always a small risk of infection with any injection and some patients may experience some pain and/or inflammation at the injection site. 

The number of injections varies depending upon the site being injected. Usually patients being treated for OA of the knee will receive 2-3 injections done 2-4 weeks apart.

Stop all anti-inflammatory medications for 2 weeks prior to injections (e.g. Advil, ASA, Aleve, Naprosyn, Voltaren, Arthrotec, and Celebrex.) 

Patients MUST INFORM THE NP if:

1. You are on anti-coagulation therapy such as Coumadin, Plavix, Pradax, Low molecular weight heparin 

2. You are Pregnant

3. You have an active infection at the injection site

4. You have a local tumour at the site of injection

5. You have metastatic disease (cancer).

It is generally a good idea to avoid any strenuous activities for a few days after the PRF. Only resume sporting activities if you are pain free with activities of daily living. Individuals taking anti-inflammatories should wait 1 week after their complete course of PRP treatments before resuming.

Most people start experiencing a response 2-3 weeks after the final injection.

PRF can be done a 2-3 injections a couple of times a year for OA of a joint. For an acute injury one treatment should be all that is indicated.