TABLE OF CONTENTS

What does HerKare do?
What are hormones and what do they do?
What are symptoms of hormone imbalance?
What are some hormone replacement therapy options?
What are the benefits of hormone replacement therapy?
What are the pros and cons of the different hormone replacement therapy options?
What causes hormone imbalance?
Why should women be treated for hormone imbalance?
What are the signs of menopause?
Risks & Contraindications
What is the thyroid gland?
What are hypothyroidism symptoms?
What are hyperthyroidism symptoms?
How are thyroid problems diagnosed?
How are low estrogen levels diagnosed?
How do you treat low estrogen levels naturally?
What is folate used for in the body?
How is a folate deficiency diagnosed?
How is folate deficiency treated?
How do you test for low progesterone?
How do you treat progesterone deficiency?
How do you test for low testosterone levels in women?
How do you treat low testosterone levels?
How do you test for vitamin B12 deficiency?
How do you treat vitamin B12 deficiency?
How is vitamin D deficiency diagnosed and treated?

What does HerKare do?

HerKare was created to exclusively treat hormone imbalance in women. The physicians and treatment professionals at HerKare focus on improving the overall health and well-being of women through hormone replacement therapy.

Whether a patient is suffering from the effects of post pregnancy, a genetic deficiency, or stages of menopause, the physicians at HerKare will develop a customized treatment plan designed to support and improve common symptoms of hormone imbalance, including fatigue, depression, low libido, weight gain, hot flashes and/or muscle loss.

Hormone imbalance can be the cause of a variety of health issues, and some studies link hormone imbalance to the risk of more serious ailments such as heart disease, osteoporosis, stroke, memory loss, high cholesterol, depression and mood swings. Fortunately, imbalances are treatable. Treatment options could include modalities such as injections, prescriptions and/or supplements.

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What are hormones and what do they do?

Simply put, hormones are chemicals produced by various glands in the body to control and regulate various body functions. All hormones are shared by both men and women at different levels.

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What are symptoms of hormone imbalance?
Some of the symptoms may include:

  • Weight gain
  • Limited energy
  • Hair loss
  • Low libido
  • Depression
  • Mood swings
  • Sleeplessness
  • Loss of concentration
  • Memory loss
  • Fatigue
  • Hot flashes
  • Night sweats
  • Insomnia
  • Irritability

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What are some hormone replacement therapy options?

There are several modalities to replace various hormones which include pills, gels, creams, injections and pellets. Not all hormones are available in all forms or methods of administration. Replacement hormones are made in several different ways: synthetic, from plant sources, or from animal sources.

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What are the benefits of Hormone Replacement Therapy?
The benefits often include:

  • Improved energy levels
  • Improved mood
  • Reduction or elimination of night sweats and hot flashes
  • Improved memory and concentration
  • Improved sex drive
  • Prevention of vaginal thinning & dryness
  • Improved fat loss and muscle tone
  • Decreased skin wrinkles
  • Protection from osteoporosis
  • Reduced risks of heart disease

Of course, as any medical therapy, there are potential risks and side effects that must be carefully evaluated during the course of therapy. That is one of the reasons that the HerKare model fosters a professional relationship between physicians and patients, focusing on regular interaction and monitoring. With regular evaluation, the treatments professionals at HerKare can closely monitor the course of therapy and adjust as necessary to reach for clinically optimal outcomes.

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What are the pros and cons of the different hormone replacement therapy options?
Oral route: Convenient, but must be taken daily and not all hormones are available via this method. Also, absorption varies with food.
Cream/gel: Variable absorption and difficult to titrate or quantify. Must be applied daily to twice daily, can transfer to spouse, children and pets.
Pellets: Less frequent administration, but peaks at higher levels and cannot be removed if side effects occur.
Injections: Easily titrated or measured, less frequent administration. Best to be supervised by a healthcare professional for appropriate dosing.
Nasal sprays: Must be dosed up to 4x daily, which decreases compliance.
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What causes hormone imbalance?
Hormone imbalances can occur for a number of reasons:

  • Post pregnancy
  • Perimenopause (also known as pre-menopause)
  • Menopause
  • Post-menopause
  • Genetic deficiency
  • Birth control
  • Obesity

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Why should women be treated for hormone imbalance?

  • Hormone imbalance can be the cause of a variety of health issues, and some studies link hormone imbalance to the risk of more serious ailments such as:
  • Heart disease
  • Osteoporosis
  • Stroke
  • Memory loss
  • High cholesterol
  • Depression
  • Mood swings

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What are the signs of menopause?
Signs of menopause and related hormonal imbalance may include:

  • Weight gain
  • Hot flashes
  • Night sweats
  • Mood swings
  • Depression
  • Low libido
  • Insomnia
  • Fatigue
  • Memory loss
  • Fibroids

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Risks & Contraindications

Because HerKare does not focus on the delivery of a single hormone, potential side effects and contraindications will vary based on the individual and the therapeutic regimen prescribed by the physician. While each case is specific and must be determined by your treating physician, generally, the following conditions are contraindications for treatment:

  1. Undiagnosed abnormal genital bleeding.
  2. Known, suspected, or history of cancer of the breast.
  3. Known or suspected estrogen-dependent neoplasia.
  4. Active deep vein thrombosis, pulmonary embolism or a history of these conditions.
  5. Active or recent (e.g., within the past year) arterial thromboembolic disease (e.g., stroke, myocardial infarction).
  6. Liver dysfunction or disease.
  7. Known or suspected pregnancy.
  8. Current or past history of thrombophlebitis, thromboembolic disorders, or cerebral apoplexy.
  9. Patients with serious cardiac, hepatic or renal disease.

In some instances, your provider may recommend off-label use of certain drugs as part of your treatment regimen. “Off-label” means the medication is being used in a manner not specified in the FDA’s approved packaging label, or insert. Omission from the approved label does not mean that the FDA disapproves of an off-label use, it simply indicates that the agency has not reviewed that use. In some instances, a treating physician may determine that an off-label use may provide the best available intervention for a patient to achieve the anticipated therapeutic benefits of treatment. Only your physician can determine the proper course of therapy for you and you should discuss the risks and benefits of any treatment regimen with your provider. You can read more about off-label use of medications at on the FDA’s website located here: Click Here

Official FDA information regarding potential risks and side effects of each of the individual hormone replacement drugs utilized at HerKare is available here: Click Here

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THYROID TREATMENT QUESTIONS

What is the Thyroid Gland?

The thyroid is a gland that is located in the front of your neck. This gland is very important for the functioning of all organ systems. A poorly functioning thyroid can be responsible for a myriad of symptoms and organ dysfunction.

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What are Hypothyroidism Symptoms?

There are numerous clinical manifestations of hypothyroidism which include fatigue, reduced endurance, weight gain, cold intolerance, constipation, impaired concentration and short-term memory loss, skin and hair changes (loss of hair, dry skin), edema and cardiac dysfunction, mood changes, depression, lack of coordination, numbness and tingling in extremities, muscle cramps and aches, heavy menstruation, lack of menstruation and inability to achieve pregnancy.

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What are Hyperthyroidism Symptoms?

The manifestations of hyperthyroidism include nervousness, anxiety, increased heart rate, lack of menstruation, weight loss, muscle weakness and wasting, tremors, bulging of the eyes, edema, and diarrhea.

How are Thyroid Problems Diagnosed?

The evaluation of thyroid function is done through several blood tests that can be completed in about 30-45 minutes. True thyroid function or dysfunction can only be ascertained through complete evaluation of both the lab tests and the patient’s symptoms. At HerKare we look to optimize the thyroid function to provide the best possible outcome for quality of life and health. We use natural hormones when possible and synthetic hormones when it is indicated to achieve balance of thyroid function.

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ESTROGEN DEFICIENCY TREATMENT QUESTIONS
How are low estrogen levels diagnosed?

At HerKare, your blood will be drawn and analyzed to determine whether you have a
decreased estrogen level.

How do you treat low estrogen levels naturally?

The medical providers at HerKare will complete an assessment, evaluate your lab results,
and discuss available treatment options that are designed to meet your specific needs. If estrogen replacement therapy is appropriate, we use plant-derived estrogen replacement therapy (as compared with synthetic, or animal-derived) as we believe it to be the most effective.

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FOLATE AND FOLATE DEFICIENCY QUESTIONS

What is folate used for in the body?

Folate is a B12 vitamin that plays a vital role in cell division, DNA and RNA synthesis and helps prevent cancer.

How is a Folate deficiency diagnosed?

At HerKare, Folate deficiency is diagnosed with our initial blood tests.

How is Folate deficiency treated?

After an evaluation and a review of your lab results, the medical providers at HerKare
will determine whether a Folate deficiency exists and customize a treatment regimen
specific to your needs. Several different formulations are used for replacement. These are based upon absorption characteristics.

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PROGESTERONE DEFICIENCY AND TREATMENT QUESTIONS

How do you test for low progesterone?

At HerKare, the providers test for progesterone deficiency on your initial visit by
taking a sample of your blood and running a serum progesterone test.

How do you treat progesterone deficiency?

The medical providers at HerKare will review your lab results, and determine whether a progesterone deficiency exists. After an assessment and discussion with you, they will customize a treatment regime specific to your needs. HerKare’s most common method of delivering the therapy is oral, plant-derived progesterone, however we will prescribe the treatment modality that is appropriate for your needs.

You can learn more about the role of hormone therapy for women through the
FDA’s Office of Women’s Health, and the drugs used in connection with women’s
hormone replacement therapy at: http://www.fda.gov/downloads/forconsumers/
byaudience/forwomen/ucm383348.pdf.

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LOW TESTOSTERONE IN WOMEN QUESTIONS

How do you test for low testosterone levels in women?

At HerKare, our medical providers will draw and analyze your blood in our in-house lab while you wait. We will determine the level of serum testosterone in your blood and discuss whether treatment with testosterone could be beneficial for you.

The medical community has established levels of testosterone for women based on taking levels from “normal” women in the population and creating an age-based “normal range”. At HerKare, we optimize your testosterone levels and bring your level into the normal range to improve symptoms that are caused by less than optimal levels.

The use of testosterone in women, although done frequently, is not FDA approved, and is
therefore considered an “off-label” use of an otherwise FDA approved drug. Learn more at
www.herkare.com/fda

How do you treat low testosterone levels?

If the physicians and medical providers at HerKare determine that your serum testosterone level is below the normal range, they will discuss testosterone treatment with you to determine if treatment is appropriate. Our most common method for delivering testosterone therapy is by injection. We believe that injection therapy allows for the most precise and controlled dosage of testosterone, thereby optimizing your results.

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VITAMIN B12 DEFICIENCY QUESTIONS

How do you test for Vitamin B12 deficiency?
At HerKare, we test for Vitamin B12 deficiency on your initial visit by taking a sample of your
blood and often have an answer as to whether you need supplementation at your first visit.

How do you treat Vitamin B12 deficiency?

Once your assessment is complete and your lab results have been evaluated, the medical
providers at HerKare will discuss your options and customize a treatment regimen to treat your
specific needs. At Herkare, the preferred treatment options are vitamin B12 shots/injections and orally.

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VITAMIN D DEFICIENCY QUESTIONS

How is Vitamin D deficiency diagnosed and treated?

At HerKare, your blood will be drawn and analyzed to determine whether a Vitamin D
deficiency exists. After an assessment and evaluation of your lab results, the medical providers
at HerKare will tailor a regimen customized to meet your specific needs. Vitamin D deficiency can be replaced orally.

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