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See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog I often see patients at the office who come back to get BBH Pellets after a hiatus of months to years, that they tell me waiting was the biggest mistake they ever made. They were feeling so good after their hormones were replaced that they forgot how bad they felt before their treatment. Stopping their hormones brought back their symptoms, and they realize how much their pellets are doing for them! This is human nature, and often happens because when we feel better, we forget quickly how we felt before treatment. The problem with starting and stopping pellet hormone replacement is that slowly all the symptoms come roaring back and then my patient wonders why they don’t feel well. Until they remember that the pellets made such a difference and come back. Stopping Hormone Pellets for No Apparent Reason Hormone Treatment with Pellets Is different than other medications because when a person stops therapy, pellets continue to dissolve slowly, so they continue to make our patients feel good before the pellet hormones wear out which can be 6 months for women and 12 months for men. Because blood levels of testosterone and estradiol from pellets are slow to increase and slow to run out, patients don’t notice an abrupt change. Generally, months after an insertion was supposed to be repeated, the symptoms of hormone deficiency are evident but patients may not put it together with not getting their pellets on time. Other medications make it easier to recognize the cause and effect, because if you don’t take a medication such as a diuretic or an ADD medication, you get the symptoms you are taking the drug for back in 24 hours. Even oral, transdermal and suppository hormones have a half-life that is less than hours long, so if a patient is taking oral estrogen for hot flashes, then discontinuing treatment would bring an obvious return of hot flashes and dry vagina right away. That makes it easier to the return of symptoms with the stoppage of the oral hormones. Short acting hormones or drugs make it more obvious to a patient that they need to take their medication or get they will get their symptoms back. I have to ask my patients to consider their pellet treatment as a lifelong therapy like taking thyroid or blood pressure medicine. The result of stopping pellets is that a patient feels well for a while and then slowly goes back to their symptoms before pellets, and they don’t put it together and look for other causes and other diseases without results, until they remember they didn’t get their pellets inserted. This causes patients to delay feeling well and they don’t get the benefits of symptom relief or prevention of the diseases of aging during the time without pellets. For those patients who put realize what is going on and comeback “late”, it takes months to years to get their hormones replaced and balanced again. Stopping Supplements Has a Delayed Response Too Let’s look at another treatment that patients often stop and then don’t know why they don’t feel well. That is treatment with supplements. Supplements slowly improve specific symptoms by either treating genetic deficiencies or deficiencies in your diet that take a month to 6 weeks to have an effect and that same amount of time to wear off. Let me tell you a story that is an example of this very thing. I was at dinner with one of my friends who is also my patient. He had a knee replacement a month before. His doctor asked him to hold the supplements that would cause bleeding at surgery 2 weeks before his surgery. My friend is a type A guy who believes that a little is good and a lot is better, so he stopped all of his supplements. Then 4 weeks after surgery and 6 weeks after stopping all of his supplements, he sat at dinner with us and looked “deflated”…he complained that he just didn’t feel good, and this was occurring more and more since his surgery. He left dinner early because he just didn’t feel well and that his symptoms had been getting worse over the last 2-3 weeks. I did my usual casual questioning with a purpose—asked about his knee, pain meds, how long since his pellets, etc. All his answers didn’t give me a clue. I went home and looked at his last labs and meds and supplements. I then talked to him and asked if her had gone back on the supplements his surgeon told him not to take? He said, “I stopped taking everything two weeks before surgery! I never restarted them.” This “aha” moment hit at the same time for both of us…he needed his supplements both to heal and to replace the nutrients he didn’t get in his diet. Supplements for patients who have no genetic deficiencies, who eat a perfect diet, who exercise daily and who have no bad habits or take drugs that would use up their nutrients, don’t need supplements. I haven’t seen a person who qualifies as too healthy for supplements including me and my husband. If there were a perfectly healthy patient who eats a perfectly balanced diet with enough fruit and vegetables, healthy protein, from home cooked meals without chemicals or preservatives, who eats no junk food or sugar containing food, and who doesn’t drink alcohol or any medication. BioBalance Health uses supplements to make up for deficiencies in diet, or instead of medications for health issues. We make a plan based on a patient’s risk factors obtained from their history and blood tests, and we explain why patients should take these supplements. Lastly sometimes medications use up your enzymes and vitamins. For example, when a patient who was on a statin had fatigue and muscle aches, I prescribed CoQ10 because that important nutrient would be used up by the statin would be taken off the CoQ10 when they stop the statin. Patients who can’t or won’t add foods to balance their diet then we recommend the supplements that are needed to take instead of eating foods they don’t like, but need. All patients on a weight loss diet require a multivitamin, protein supplements to increase the amount of protein eaten daily to more than ½ of the patient’s weight in grams of protein. Some medications use up a normal supply of a certain vitamin. An example is that the medication Metformin uses up B12 stores in the body so the patients taking metformin should be on B12 in a multivitamin, monthly shot, or a separate supplement to make up for the B12 the metformin uses up. The lack of B12 shows up as generalized pain, muscle pain, neurologic numbness or lower extremity neurological abnormalities. Alcohol consumption is also another habit that uses up B12. All patients who drink alcohol more than occasionally should be on plenty of B12. B12 cannot be overdosed because after you use what you need, you urinate the rest out through the kidneys. Another example of what happens when you stop taking supplements that are indicated by a patient’s symptoms it takes weeks and months to feel the difference, or to get the original symptoms back. A long-time pellet patient who would not go without her pellets, asked me if she could stop her supplements…she was just tired of taking them. In fact, she had stopped them months before and she had a “new list” of symptoms. I did some lab to see what her blood levels were, and she had a low Vitamin D level, B12 level, her estrone was elevated (stopped taking DIM) and she was gaining belly fat and blaming pellets. After a consultation, she decided to start taking her supplements again, and a month later she felt great and lost some belly fat! Recommending supplements is part of our treatment that we provide with our preventive medical therapy for our Pellet patients. Supplements are not required but recommended to make up for the modern lifestyle, diet, alcohol, lack of sun exposure and exercise. The fact that the effects of supplements might be silent, causes patients to doubt their activity, and usefulness. When all supplements are stopped we can often see a subtle decrease in a patient’s symptom relief and overall well-being. Sometimes understanding why we as humans are apt to do things that make us less healthy or sicker sometimes makes it easier to follow recommendations of our doctors. I see the benefits of vitamins, minerals and supplements that my patients take every day in their blood work and their symptoms. Sadly the medical community, funded by the drug companies don’t want us to take supplements….the medical studies they do on supplements always say they don’t work…however they create a study that will result in no improvement by lowering the dose too low, shortening the period of taking a supplement or they choose their subjects so that NO drug or supplement will work. You can make a study say almost anything you want it to… Don’t stop your thyroid medicine! I live in the “Goiter Belt” in the middle of the US, so many of my patients need thyroid replacement, which resolves their low thyroid symptoms, and makes their lab look normal. It is unfortunate that some doctors are so poorly trained in thyroid treatment that they look at a person’s lab while they are on thyroid medicine and say, “See, your lab is normal so now you can stop taking your thyroid!”. The thyroid gland does not regenerate, start working again or heal unless you have the rare kind that occurs after childbirth and then resolves after 12 months. Otherwise, taking thyroid is for life, and unlike pellets and supplements, you will feel the symptoms come back right away. Taking a hypothyroid patient off their thyroid replacement medicine leaves them severely hypothyroid and unable to stay awake, with chronic swelling, low heart rate, low BP, weight gain, severe fatigue and hair loss, and feeling cold all the time. The doctors who do what I describe above and take patients off their medicine should go back to medical school physiology. “Figures often lie, but liars always figure!” –my husband is a lawyer, and he uses this phrase all the time in his arguments. It is true that a medical study can be manipulated to conclude anything you want it to. A researcher trying to prove something can manipulate the structure of the study, or choice of participants in the study, or just title the article so that it implies something that is the opposite of the true findings, like the NIH did with the Womens Healthcare Initiative in 2002. When I see different results in my office than what the studies tell me, I trust what works for my patients, and double the veracity of the study. Later I am usually happily surprised that the study was deemed inaccurate because it was done wrong, the population was one not in my patient population (like all patients are Asian, and I have very few Asians in my population) or the assumptions of the results were inaccurate. Using the information that patients give them and determining the best treatment for that individual is the job of a doctor…to read studies critically and compare them to the results seen in their own patient populations, then use what they see with her own eyes to treat their patients. I hope I have encouraged patients who wonder what their pellets or supplements are doing for them after years of successful treatment who might think they will stop because they are “cured”, to think again. Menopause, Testosterone deficiency and hypothyroidism don’t just go away! They are something that must be treated to bring you back to a quality of life, you will have to treat these deficiencies until you die, or have a medical reason you have to stop treatment. Sadly, pellet therapy and nutritional supplementation are not curative if you don’t take them, you go back to how you felt before treatment! You might lose years of joy and health by stopping the treatments that make your health and quality of life better. Think it through and talk to your doctor or NP before you make any changes.