Interview with Dr. Jeff Whelchel, Family Practice Doctor & Hormone Expert
Show notes & links from the video
In this video, I interview Jeff Whelchel. Dr. Jeff Whelchel is an MD practicing in Amarillo Texas. He is trained in Family Medicine where he practiced in conventional medicine for 21 and a half years.
He is now practicing functional medicine where he specializes in thyroid management and bioidentical hormone management with the use of BIOTE pellet therapies.
He's a good friend of mine and one of the few people I would trust to treat my own family members.
During our discussion, we talk about his own personal health journey and how that impacted his interest in practicing functional and integrative medicine. We talk about how he transitioned from focusing on conventional thyroid management with the TSH and levothyroxine to the functional medicine approach with the complete thyroid lab panel and other thyroid medications such as NDT, T3, and SR T3.
We also discuss the difficulties that conventional doctors face in treating thyroid patients with certain thyroid medications, how bioidentical hormones fit into thyroid management, how treating thyroid function can improve certain hormones, and when it's appropriate to use bio-identical hormones in thyroid patients.
- Dr. Whelchel's website
- Contact Dr. Whelchel
- How to find a good thyroid doctor - If you are a thyroid patient struggling to find a good doctor then see this resource which will provide you with tools to help you find one near you. You can also reach out to Dr. Whelchel to see if he will accept you as a patient.
- How to test for hormone imbalances - If you believe you may have hormone imbalances please see this article which outlines how to test your testosterone, estrogen, progesteron, and cortisol problems.
- How to test for thyroid problems - Use this article to see what a comprehensive thyroid lab panel looks like and how it differs from those provided by endocrinologists and family practice doctors.
- What are bioidentical hormones? - We discuss bioidentical hormones in this podcast quite a bit. If this topic is new to you, please see this article which explains what they are and why they are more effective and better tolerated compared to pharmaceutical versions.
- Pros and Cons of hormone pellet therapy - Dr. Whelchel talks a lot about hormone pellet therapy in this podcast. I haven't used pellet therapy much but some people do have great experience with it. You can see some of the pros and cons of this type of hormone management here.
Dr. Childs (00:00):
Hey guys, Dr. Childs here. Today, we have a really important and special guests and that is Dr. Jeff Whelchel. So Dr. Jeff Whelchel, is an MD practicing in Amarillo, Texas. He is trained in family medicine, where he practiced in conventional medicine for 21 and a half years. So he finally has seen the light and he is now practicing functional medicine, where he specializes in thyroid management, bio-identical hormone management, and he uses BioTE pellets as well. So Jeff is a good friend of mine, and probably one of the few people that I would trust to treat my family members, so I'm really glad to have him on the show. So Jeff, welcome.
Dr. Whelchel (00:33):
Thank you very much. It's good to be here.
Dr. Childs (00:35):
Awesome. Good. We're going to have a good conversation here. We'll be talking about thyroid, we'll be talking about your personal journey, we'll be talking about hormone management, and so on. What I'd like to do though, to get started is, if you could just sort of give us a little bit of background on you. Tell us a little bit about how you went from the conventional side of things, to functional medicine, because I imagine your own personal story, perhaps your own health journey kind of led you in that direction, so could you expand a little bit on that for us?
Dr. Whelchel (00:58):
Absolutely, and that's typically the case for most functional doctors, it seems like they have a personal health journey.
Dr. Childs (01:04):
Dr. Whelchel (01:04):
So, I grew up always wanted to be a doctor. It's been a dream of my life the whole time. I went to medical school. There was not one particular field that enamored me more than the others, and so I decided family practice, the Jack of all trades, master of none, so I chose that as my field of choice. And so I practiced in Amarillo, in a great practice for about 18 years. That was probably less than that, probably 10 years into it, I contracted a parasite. I assume from a patient. I still don't know where or how, but I got a Giardia infection in my gut, and took a round of antibiotics, got a little better, but not completely, took another round of antibiotics, got better for a while, then it flared up again.
Dr. Whelchel (01:53):
I tested positive again, took another round of antibiotics. Well, what that ended up doing is destroying my life as I knew it. And I know that sounds strange, but at the time I couldn't understand it. I went from a normal gut function person feeling good, to constantly nauseated, constantly cramping, going to the bathroom 20 to 30 times a day, including at night I would get up four or five times at night to go to the bathroom. And the only thing that I could eat that didn't upset my stomach was starches or simple carbs like crackers, and potatoes, and all of the things that now we know just cause you to put on weight. And so I gained about 40 pounds-
Dr. Childs (02:34):
Dr. Whelchel (02:36):
... and it was pretty miserable, had lots of anxiety, lots of depression type symptoms, but it's almost the story of putting the frog in the water, and then they slowly turn up the water, and the frog never jumps out, because he doesn't sense the temperature change until they boil to death. Well, that's kind of how it was with my gut. That's all that I knew at that point, so I didn't know what else to do. So I saw two different, very highly respected gastroenterologists, they scoped me everywhere. Did every test known to man, including capsule endoscopy, where they take a video of my gut, found a little bit of swelling and inflammation, but no ulcerations, anything like that.
Dr. Whelchel (03:15):
So they put me on several medicines that would help for a little while, but then my symptoms would return. And eventually one of them said, "Well, you probably have a type of crones disease, although it doesn't look like it on the biopsies." So they said, "This is your life." And well, around that time, I had a nurse that was very much in the functional integrative mindset, and she cornered me in my office, and said, "Okay, enough is enough. You need to go see this integrative doctor, a friend of mine, in a nearby city." And so I reluctantly agreed. So I went to that appointment with my wife and I fully expected him to twirl crystals over me, or poke me with voodoo dolls or something going on like that, but-
Dr. Childs (04:00):
Dr. Whelchel (04:01):
... it made total sense. This was just a good country boy, that very... rightly now, I understand said, "Look, you destroyed your gut bacteria, you had terrible gut dysbiosis, and your diet's making it worse." So he put me on several full good supplements, put me on a very strict keto-ish type diet. And in about 30 days, I was 50% better.
Dr. Childs (04:25):
Dr. Whelchel (04:26):
And then about three months, I was 90% better, and by six months I was 99% better.
Dr. Childs (04:32):
Dr. Whelchel (04:34):
Yeah, great story. No, I'm not well, don't get me wrong. I still cheat and flare myself up, but now I at least feel like I have control over my body, whereas before I was just at the mercy of my symptoms. And so that opened my eyes to where I'm going, "Wow, that really worked. And it makes sense to me. So what if there're other aspects of medicine, that the same is true to where I've just learned to do a pill for every ill and just prescribe prescription medicines without talking about diet, and supplements, and so many of these other things. And so that's when I started the journey, I went to a few conferences on functional and integrative medicine, and to be blunt, it blew my mind. I couldn't believe it may all sense finally, for the first time in my life. Rather than just learning menu-based medicine, where okay, if they have this symptom to treat them with this, I actually understood, okay, this is what's going on, and this is why we make these corrections. And so it's basically like I went to medical school all over again.
Dr. Childs (05:40):
Dr. Whelchel (05:42):
And read dozens of books, went to tons... every conference that I could afford or have time for, and basically had to relearn everything that I had known, for 10 or 15 years of medicine. That took about a five-year process from start to the end of that. And then I basically became the proverbial square peg in a round hole. I was still in volume medicine, still in a situation where patients, not just my partners, but the patients expected, they went in with an agenda of, "Look, I need these meds. This is what helps me."
Dr. Whelchel (06:17):
And I would sit there going, "Well, this is not the truth of what we need. We need to be talking about diet and lifestyle modifications, and stress management, all these other things." But I also realized I was trying to do that in a 10 or 15-minute time slot, which just was not practical. And so at that point, I loved the group I was with, but they were frustrated with me, I was frustrated with them and didn't like what I was doing. And so that's when I left to do more of the not traditional, but more of the functional or integrative medicine.
Dr. Childs (06:52):
Okay. So the functional medicine and that's kind of where you're at now. You use-
Dr. Whelchel (06:56):
Yeah. And through that, I've even gone more towards the hormonal side of things. For years, I would see particularly, and I'm being stereotypical here, but typically I would see a 40 to 55 year old woman that was absolutely miserable, that couldn't sleep, or acting depressed, hot flashes, night sweats, no libido, couldn't lose weight, all of these typical symptoms, and I knew something was wrong, but my conventional training told me, "Okay, check these few things, and they're normal. So they must be depressed, or they must have fibromyalgia or some other condition." But in fact, I told my wife, she reminded me just the other day that probably eight years ago in my practice, I'm going, "We're missing something. And if we ever figure it out, we're going to really start helping people."
Dr. Childs (07:49):
Yeah. No, that's really good. And I think that that's definitely true. When it comes to conventional medicine, which is really kind of the medicine that you're practicing previously, not now obviously, but that conventional sort of mindset really looks for big, big problems, but it misses this gray area that's in between. It's like-
Dr. Whelchel (08:06):
Dr. Childs (08:06):
... when you look at nutrient deficiencies, it's like, do you have a gross, super low vitamin B12 level that's causing all sorts of, potential or even life-threatening conditions. And if the answer is no, then your B12 is fine. That's their mindset. It's like-
Dr. Whelchel (08:18):
Dr. Childs (08:19):
... there is nothing in between. There are no shades of gray. So I totally respect that. But what I'd like to do Jeff is, have you talk about, your experience because I know you, and we're going to talk about your approach to treating thyroid patients and hormone management and so on. But I know you as somebody who is treating thyroid patients with T3 thyroid medication, natural desiccated thyroid, sustained-release T3, and so on. And so what I want to know though is because you lived in that world for so long, you probably have tons of friends, you probably had tons of acquaintances who probably looked at you... they watched you go through this transformation, and they're like, "What happened to this guy?" How were you received in that conventional community, as you changed your practicing style? How did that look like to you or for you I should say?
Dr. Whelchel (08:58):
For the most part, it didn't go well.
Dr. Childs (09:00):
I could imagine. Yeah.
Dr. Whelchel (09:02):
The way I would describe it as if you take 100 experts of anything, and you present to those 100 experts a completely new or different way of doing what they do, 90 to 95% are immediately going to discount it.
Dr. Childs (09:17):
Dr. Whelchel (09:17):
And that can be because, what they've done has always worked, and they don't see the point of that, or you're just crazy, or the other thing would be honestly, I've gone on to school and practice for this long, I don't want to have to learn a new way of doing something. And so, I would say at best people would be indifferent to me. And there were times is that I had endocrinologists in town, or even some primary care doctors that would be fairly antagonistic and even toxic towards me.
Dr. Whelchel (09:53):
When I would lay the facts down with them, that's [inaudible 00:09:56] ... then I couldn't disprove what I was saying. And one thing they never took into account, let's just take thyroid for example, or hormones are, what does the patient say? Do they feel better or not? And I had one endocrinologist, in particular, that told the patient that I was an idiot, for what I was doing, and then she said, "Well, the fact that I feel better in a month with what Dr. Whelchel has done, versus what I've done in 10 years with you, it tells me who the idiot is." And she stormed out of the room.
Dr. Childs (10:31):
Dr. Whelchel (10:33):
No, no, no, don't do that. My goal was not to make enemies or to make people choose sides. I mean, docs have a calling.
Dr. Childs (10:41):
Dr. Whelchel (10:41):
And they really, really want to help people. My argument and I think yours too, is not the doctors, it's more the medical system.
Dr. Childs (10:52):
Dr. Whelchel (10:52):
The studies have shown that by the time something is found in research, it takes an average of 17 years before it converts into common use. And that's what you and I are fighting. I mean, we're still seeing people that are managing things, but what was done in the 1970s, in the 1980s, and we just know so much more now.
Dr. Childs (11:12):
Yeah. No, that's definitely true. And it's frustrating though, from the perspective of the patient. Because the patient sees what we're talking about, and they hear a story like that. They hear a story about somebody who was struggling for 10 years and gets a slight change, a slight tweak to their medication, and feels a ton better. And so from their perspective, it's really frustrating. And I've seen from them, from some patients, and I want to bring this up and kind of get your thoughts on it. As I see this sort of mentality where certain patients, they kind of look to doctors because I kind of view them as the enemy.
Dr. Childs (11:42):
And they'll say things like, "The doctors are only prescribing levothyroxine because they're getting paid, or because they're doing it on behalf of the pharmaceutical company or whatever it is." And I really don't see that to be the case. And I'd like to hear your thoughts on that as well, but it doesn't appear to me that there's anything like that going on. In fact, I've never seen that, and it's a generic medication, so there's not much money to be made there anyway, but what do you see on your end? Like is your perspective that most doctors do really want to help their patients they're just going about it the wrong way. What do you think about that?
Dr. Whelchel (12:10):
No, I don't think that they have ulterior motives at all. I think they want their patients to feel better. They're doing what they were trained to do. And when that stops working, they don't really know what the next step should be. And let's be honest, most physicians, I myself, in my practice, I received a lot of my information on how I manage my practice through conferences, and pharmaceutical reps, and through those types of avenues. Very little of it was me going on a venture to find out, okay, then I'm going to figure out what's going on with thyroid and what new treatments are out there. I depended on most of that stuff to come to me directly. So no, docs don't make more money. There used to be a time to where yes, pharmaceutical companies could take you on trips, and do all these other things with the understanding that you would write more of their product, but that's not the case anymore.
Dr. Whelchel (13:05):
They are very limited with what they can offer, physicians and so then it's just a matter of what they're hearing, and what they're learning from that, and if that's a primary source of their information on any treatments and that's what they stick with. And there's nobody that's representing zinc in the industry. So you're not going to have somebody come in and talk to you about the benefits of zinc, in fighting viruses. And that's just one example, or vitamin D or what have you. And so none of those are going to have the marketing behind them that these billion-dollar new pharmaceuticals have. And in defense of the companies, they're trying to make money, but they're trying to do it by helping people. I just think that we're going in the wrong direction and doing that. God kind of knows what he's doing, and he built a body that will normally repair itself. And if it's not, it's because it's either lacking something, or it has too much of something. And that's all we're trying to do, is find out what's out of balance, and get that back in balance, and let the body heal itself up.
Dr. Childs (14:03):
Yeah. Absolutely. And I think that that's sort of the ethos of functional medicine, right?
Dr. Whelchel (14:08):
Dr. Childs (14:09):
So what I want to do now is kind of talk a little bit about thyroid management because, I know you as somebody who now focuses a lot on thyroid management and hormone management and so on, so I'd like to know, how did you sort of get interested in treating thyroid patients? When did you reach out to me, and what was kind of going on in your life and your practice at that point, did you just see this group of patients as somebody who just really was suffering and needed help, or was there something else that drew you towards that population?
Dr. Whelchel (14:33):
I think a big part of it was, like I said before, these people coming in and they were miserable, in my training and my knowledge at that time would only help them to appoint. There was a percentage of people that fine you diagnose them with hypothyroidism, put them on levothyroxine and they good, but there was a large percentage of those people that would come in, and they're going, "Oh, I'm okay." But they didn't seem like they felt better. So I knew I was missing something. And so around that time, actually, how I got to know you, is a couple of my patients brought articles that you had written.
Dr. Childs (15:09):
Oh, that's funny.
Dr. Whelchel (15:10):
And I started reading some of those and I'm like, yes, that's what I'm talking about. And so it completely connected with what I was learning, and what I was believing, and you're a very gifted writer. And so that started me on that. And then BioTE, the hormone pellet therapy I was interested in, they are pretty accurate with how they manage thyroid disease. They don't go to the extent that you and I go on, on some cases, but sometimes just as simple as switching somebody from T4 only medicine, to natural desiccated thyroid, can change their world.
Dr. Childs (15:48):
Dr. Whelchel (15:48):
And that's one thing that BioTE recommends. And so you start seeing a few of those patients that greatly improved, and then that stimulated me to just want to learn more and keep figuring out what else I could do to improve things.
Dr. Childs (16:03):
Yeah. I mean, to your point that you mentioned previously, I think even changing just from levothyroxine to Tirosint, can have a huge impact on a number of people. So if we broke down this population of thyroid patients, we have a chunk of people that do well on T4, we got a chunk of people who could do well on T4 if they had cleaner inactive ingredients, we got some people who need natural desiccated thyroid, we have some people who need a combo of both, some people who need sustained-release T3 and T3. There are just these huge chunks in the population of people that need various different therapies. And it's sort of just about putting it all together and some, even an element of trial and error. And so it sounds like BioTE, I think has some sort of maybe formula, maybe that's not the right word, but some way-
Dr. Whelchel (16:39):
Yeah. They have a program that they recommend. That probably gets another segment of that group-
Dr. Childs (16:45):
Dr. Whelchel (16:45):
... you're talking about. And those people that do better with a little bit of T3 added to their T4, and that helped, but then there were still those other ones still that are going okay, they're a little bit better, but I'm still not getting these labs kind of in the optimal range, and they're still not feeling great. And I'm like, "What am I missing?" And so that's where I pursued then started doing more aggressive T3, or to be blunt, there's a percentage of people that just don't respond well, even to liothyronine or Cytomel, and It's like they get too much T3 all at once, and on those, doing it in a compounded form where it's slow-release, they can tolerate it so much better and feel better. So my frustration with the conventional training that I got, was it's very much a one-size-fits-all.
Dr. Childs (17:34):
Oh, yeah. For sure.
Dr. Whelchel (17:35):
You check the TSH, maybe the T4, if the TSH is high, then you've got hypothyroidism, start them on levothyroxine. If it's low, oh, they must have graves' disease, send them to an endocrinologist. And so thyroid disease, when I first did my training, I thought, well, this is the easiest part of medicine [crosstalk 00:17:53] thinking to do, but then you start seeing these patients back and you realize, okay, a large percentage of them are not really any better.
Dr. Childs (18:01):
Yeah. That cookie-cutter approach is good for some people, but for the majority of them, it isn't. And you know what's frustrating is that when you look at conventional doctors, I remember being in the hospital, with internal medicine doctors, and specialists and so on, and I would look at, back in those days before I was really aware of functional medicine, some of the best doctors were the one that just had the most experience with different medications, because they would tweak them. They'd be like, let's give you a little bit of this and a little bit of that. And in this we'll stack these, calcium channel blockers with this, antihypertensive and now look, beautiful blood pressure. And I'd be like, "Oh my gosh, that guy knows what he's talking about." And what's crazy is, we're kind of doing that with thyroid medication. It's not that much different. It's like, "Okay, let's use this version of T4, oh wait, you can't help handle the feel, let's go to Tirosint. Okay. And let's now let's tweak up the T3 a little bit." It's just playing with the existing tools that are out there. It's nothing crazy. They're all-
Dr. Whelchel (18:49):
It's just using the art of medicine.
Dr. Childs (18:51):
Dr. Whelchel (18:52):
Not everybody is the same. And I get it all the time. Well, my best friend took this medicine, and did great.
Dr. Childs (18:57):
Dr. Whelchel (18:58):
Well, that doesn't mean anything. Even if it was your sister, you're going to be unique, and so that's why as a physician, you have to ask the questions, how are they feeling? Ask the pointed questions about symptoms, and then just get a good rapport with the patients, so that you'll hear them when they describe what's going on with them. And I can't tell you how many times that they're coming and going, "Yeah, I'm better." But then you bring up one or two things and like, "Well, how are you temperature-wise?" "Oh, I'm cold all the time." "Okay. Then you're not where do you need to be. That's not normal."
Dr. Childs (19:37):
Dr. Whelchel (19:37):
And they're getting... and sometimes that's in spite of what their labs show. Sometimes they will come in and their labs look like in the optimal ranges that you and I recommend for people to have, but if symptomatically or symptom-wise, if they're still struggling, then we're not at their good point yet.
Dr. Childs (19:53):
Dr. Whelchel (19:55):
One frustration that I have, and one thing that I had to get over myself is TSH is so pounded in us, through the end-all, do all tests, that it took me a few years to finally accept that a large percentage of people, you have to suppress their TSH, in order to get their free hormone levels up to where they need to be for them to feel good. And I was terrified everybody who's going to have atrial fibrillation and osteoporosis, if their TSH was 0.08 or something like that. But then I would get their T3 level and it's free T3 level and it's 2.5 and I'm going okay, then they're not where they need to be. They're not hyperthyroid.
Dr. Childs (20:36):
Right. Now that you brought that up, I do remember you sending emails, you're like, "Is this okay?" I think I remember seeing an email about that. [crosstalk 00:20:44]. No, I get it. Because you've been told for so long that it's atrial fibrillation, osteoporosis. And it's like, those are potentially a big deal, throwing a blood clot, or having a stroke and falling and breaking a hip. Those are things that you don't want to do. But then the funny thing is like you said, when you look at the person clinically, and you're like, "Is your heart rate elevated? Are you sweating a lot?" They have zero symptoms of hyperthyroidism and even then... It is a shift, and it's a big mind shift.
Dr. Childs (21:09):
And I do think that's important for people who... especially thyroid patients who are listening to this because they'll often ask like why don't doctors do this sort of thing? If this is right, why aren't they doing it? And it's not an easy answer. I think a lot of it is just due to, by the time a doctor gets out, they'd been in training for so long, and they've just have adopted the patterns and the recommendations from their superiors, and in their colleagues, and the people around them, and if you're that guy doing the one thing that's different, it kind of puts a target on your back in a way, for better or worse.
Dr. Whelchel (21:42):
It does. Yeah. When everybody that you work with believes what you're doing, and then you start doing something differently, then many of them feel threatened by it, and then there is a definite peer pressure there.
Dr. Childs (21:57):
Yeah. For sure.
Dr. Whelchel (21:58):
It's hard to overcome that. And so, it's going to be an uphill battle. I mean, I truly believe what we're doing is truth-
Dr. Childs (22:06):
Yeah, me too.
Dr. Whelchel (22:07):
... and the way that it should be. And I think it will get there, I just don't want it to be 17 years down the road, before we get to that point.
Dr. Childs (22:15):
Yeah. I'm thinking... my estimates, maybe five to 10 years, I think we'll start seeing shifts and improvement in how thyroid patients are treated. But if you're a thyroid patient, that can't come soon enough. I'm not the one-
Dr. Whelchel (22:25):
And I equate it to things like a bone density. At first, bone densities were work pushed by the integrative or functional medicine, to check [inaudible 00:22:35] in the conventional world kind of [inaudible 00:22:39] the same way as vitamin D. I can remember even 10 years ago, if you talked about checking vitamin D levels, people would say, "So you just one of those vitamin doctors?" And I'm like, "No."
Dr. Childs (22:50):
Dr. Whelchel (22:51):
But vitamin D has to do with so many functions in the body. And then if you're low in it, nothing else is going to work right. I don't know why that's controversial, but-
Dr. Whelchel (23:02):
... I think the worst thing we could do would be to get defined about it, and combative is if the truth will rise to the top and as more studies come out, and if I can just get some of my conventional colleagues to try some of the therapies that I do, when they see the success, that alone is the testimony that we need.
Dr. Childs (23:22):
Yeah. And I agree with you, I think the patients and their outcomes, because like we're saying, if the doctor really wants to help, and I do think most do, when they do see improvement in their patients, I think that will be the sign. And that's kind of the case for you. You saw yourself get better.
Dr. Whelchel (23:37):
Dr. Childs (23:37):
And pretty much like you said at the beginning, I think most doctors, conventional minded doctors, who ended up going into functional medicine, they have a similar story. And that was similar for me, and I think it's similar for most people. What I want to do though, is to kind of shift into hormone imbalances. So you and I both know that, and probably the people who are listening to this, they know that the thyroid helps to control and regulate many different hormone systems in the body, including estrogen, progesterone, leptin, insulin, cortisol even, and I know that you tend to focus a lot in addition to thyroid management, you also help with these other hormone imbalances. So can you kind of tell me a little bit about what you're seeing among thyroid patients in terms of these other hormones? Is it always the case that somebody who has a thyroid problem has these other hormone imbalances, that sort of thing? What do you think about that?
Dr. Whelchel (24:20):
Well, the vast majority of the time there is something else going on with the different hormone systems.
Dr. Childs (24:25):
Dr. Whelchel (24:26):
Probably the most common one that I see, would be an issue to do with the adrenal system, because just the stress of Hashimoto's, or hypothyroidism, or graves' disease, is going to stress the adrenal system and cause cortisol imbalances, which then triggers insulin resistance, and leptin issues, and those things. So what I typically do in my practice, is I typically focus on adrenal thyroid insulin resistance first, and unless they're just absolutely miserable, if they're 60 years old and post-menopausal, and in desperate need of testosterone and estrogen progesterone, I don't necessarily jump to those first. I try to get the cortisol system balanced, and the thyroid system balanced. And don't get me wrong I will still do pellets on some of those people, but not at the exclusion of the others. So very, very, very important to address all of them.
Dr. Childs (25:19):
So are you thinking... and I think that's sort of the way that I look at it too, is that because the thyroid regulates these hormone systems downstream, like estrogen and progesterone. If you can level out that one first, then you can see improvement in these ones downstream, and then you can determine, well now do I need to add in, these additional bio-identical hormones and whatnot?
Dr. Whelchel (25:37):
You hate to commit anybody to a lifetime treatment. And typically, sometimes you know of cases and I do too, that you can get the thyroid repaired and oftentimes you can get people to reduce their meds, but that's not as much the case with testosterone and estrogen and progesterone. So once the ovaries, or the testicles have stopped producing enough, typically you've got to replace them. And so what I try to do is yeah, get the system in balance, and oftentimes their innate systems will kick in at least to some degree. And even if it means delaying some of those treatments for a year, or two, or a few, then to me that's an advantage and worth doing, rather than just starting them on all of these different treatments at once.
Dr. Childs (26:20):
Yeah. And I think that's a wise way to approach it. And I agree with that approach actually. So let's talk a little bit about the BioTE pellets. So will you kind of give me a little bit of information? When I used to see patients, I would tend to use gels, and even liquids in bases and things like that. So give us a little bit of insight into the BioTE pellets and why you prefer to use those over other methods? So-
Dr. Whelchel (26:39):
Dr. Childs (26:40):
... kind of fill us in there.
Dr. Whelchel (26:41):
And I'm not opposed to the gels, especially if someone's having relatively early or mild symptoms, then the gels could be helpful. What I have found in my experience is they're not as potent as the pellet therapy. And so if you have somebody... it's kind of an all-or-nothing thing with the gels. And there was even one study that showed topical absorption is impaired and up to 30% of patients. And so it's hard to detect those people. And so if they're afraid of appellate therapy, which is a procedure, then I will do creams. And then if they feel great, then fine, we stay on it. If that's not enough, then we'll switch to the pellets. The pellets are not a new treatment. People think that this is something that's just come out in the last decade or so, but the hormone pellet therapy was developed in the 1930s.
Dr. Childs (27:30):
It's been around.
Dr. Whelchel (27:31):
And it was very popular at that time, and then pharmaceuticals developed Premarin and some other hormone therapies. Well, all of the money in the marketing went to that, so it fell off of popularity, the same way it had another revival in the 70s, and then Prempro was developed. And so that popularity fell out again. So the founder is Dr. Donovitz, and he is an OB-GYN in the Dallas area. And he kind of had the same issue that I had that I talked about earlier, to where he was seeing all of these patients that were miserable, and his conventional training was only helping them to a certain point, and he's like, "Okay, we're missing something." And so, that's where that developed. And then the women's health initiative study came out in 2002. I don't know if everyone's heard of that, but that was the study that showed there was an increase heart attack, stroke, and breast cancer risk with hormone replacement therapy.
Dr. Whelchel (28:23):
So lawyers got involved, all the docs became terrified, and we started pulling everybody off of their hormone therapy. Well, the problem with that study, there's a lot of flaws with it. For one thing, everyone was treated with synthetic hormones in the study, and I think as we'll talk here in a minute, there is a difference between bioidentical and hormone studies. And in fact, I think if you break down the data from that study, the majority of the breast cancer risk comes in the synthetic progesterone, what we call the progestins are the ones that I think medroxyprogesterone acetate, the Provera, those types of medicines are the ones that I think the study shows there's an increased breast cancer risk. Now, with that in mind, keep that in mind, we're also still talking an increase, but not as much as what the press made it out to be. For example, stroke, they said there's a 41% increased risk of stroke with hormone replacement therapy.
Dr. Whelchel (29:18):
Well, they went from 29, or excuse me, 21 cases of strokes out of 10,000 patients up to 29 patients out of 10,000. So really there were eight more out of 10,000 people. So I'm not minimizing those eight people, but it's not like it went from 21 to 500, out of 10,000. So it was still a relatively small increase. And the other thing that that study didn't take into account is, patient preference. How do they feel?
Dr. Childs (29:47):
Dr. Whelchel (29:48):
They didn't ask them at all. And I know I've had some patients that have said, "Look, I don't care if this increases my risk substantially or not, I want to take this medicine because my quality of life has improved." And so, that was kind of my stance early on before I found BioTE and some of the functional medicine. Well, now that the bioidentical, they're made from yam or soy plants, and it's identical to the hormones that our body makes. And so it's just cleaner. There's fewer side effects. And I think there have been some studies come out that have shown that there is a decreased incidence of some of these things [inaudible 00:30:27] definitely lower side effects. Dr. Donovitz himself just published a study that they studied, I believe over 6,000 women, and there were a 35.5% decrease in incidence in breast cancer in women that had subcutaneous testosterone, versus the control group. So, not only did they not cause these things, I think there's data to show that it reduces the risk of some of these things.
Dr. Childs (30:51):
Yeah. And that's been my experience as well when I look at the data. I actually think that they do tend to be protective against a lot of these things. Especially Alzheimer's, I would say heart disease is one of those things. I would say, a reduction in and breaking bones and things like that because of increased muscle mass, and increased bone density. I mean, you've got a lot of potential benefits, but I think what ends up happening is you have a lot of confusion among patients, because they see these headlines and like you said before, they'll attach like this label that hormones are dangerous. And then it's like, okay. But then they compile in there, the progestins the progestogen the actual progesterone USP.
Dr. Childs (31:26):
And then it gets really confusing because they kind of obfuscate what they're actually talking about intentionally. Because they can't really make money off of the bioidentical hormones. So they try to tweak them and alter them a little bit so that they can patent them and then make some money off them. But it just ends up being confusing for the patients. So I do tend to agree with you on the benefits that they provide otherwise, I would. But let's say that even there was a small risk, like let's say one or 2% risk of any of these things. The impact that they have on quality of life is so massive that I would say you should have, like you mentioned, a good discussion with your doctor and say, "Is it worth it in my case?" Because it might be. It might-
Dr. Whelchel (32:02):
Dr. Childs (32:02):
... be worth it to have your life back, to be able to exercise again, or play with your kids or whatever it is that you enjoy, go golfing, I don't know, whatever it is. And so in that case, it's probably worth it. But what I do want to talk about is switching into... we'll stay on this topic, but what type of improvement do you see in women who use the BioTE pellets? What type of symptoms, resolutions are they receiving? That sort of thing, what has been your experience there?
Dr. Whelchel (32:24):
Well, there's a spectrum. At the very lowest end of the spectrum, people come in and go on, "Oh, I'm sleeping better. I feel better. I'm not having hot flashes. I'm not having night sweats." All the way to the other extreme to where they're going, "This changed my life. I feel 20 younger than what I did." And I'm not guaranteeing anybody that they're going to be there.
Dr. Childs (32:42):
Dr. Whelchel (32:44):
That's what we love to see. But yeah, as far as sleep is improved, sweating at night goes away, hot flashes during the day typically go away, energy, one description that I have patients say is, before they would get home from work and they just sat in their chair and were done the rest of the night. They had no energy to do anything else. And then also they feel like doing other things. And then there're other benefits that are obviously libido improvement helps with testosterone in particular, but just the sleep and the energy overwhelming or the number one things.
Dr. Whelchel (33:19):
And by the way, if we're talking about side effects of these, yes, I've had some patients that have had bad outcomes with BioTE. And in my experience, it's because the provider that was doing it, is not checking their labs and not following them. And so if I'm trying to get someone's, say a woman's testosterone level to 100 to 200 as an example, and they are 150, when I tell them I'm great, so we'll see in a few months, whenever these pellets run out. Well, it's never going to drop down to the 10 or the 15 level that they were when he started, it's going to be 70 or 80 and they start having symptoms again. So they come back in and appellate them. Well, then it may go up to 175 that time and the next time, 200. So typically you have to be anticipating that, and checking the labs at least a couple of times a year, or else you'd get what we call a stacking effect.
Dr. Whelchel (34:08):
And I've seen some of those that come in and go on. I love how I feel on this, but I'm losing the hair up here, I'm growing hair here, I am angry, and then I check their testosterone and they're at 500. And I'm like, well, no wonder. And so typically, as long as it's monitored and we're keeping the level down in the optimal ranges, and anticipating that, then in my experience side effects are pretty minimal. Some people you'll get some peach fuzz, prominence, testosterone grows hair, but that's usually that's a small price to pay. But as far as the other things, unless someone is just very unusual in their side effects, most people tolerate them very, very, very well. And statistically, 97% of people that get the hormone pellets come back again.
Dr. Childs (34:51):
Oh, that's good.
Dr. Whelchel (34:53):
That's a pretty high statistic.
Dr. Childs (34:53):
That's very high. Yeah. I didn't know that it was that high. That's actually good to know. I appreciate you educating me on this because I didn't really use a lot of pellets. And so it's good to sort of hear this, but we are getting towards the end here, but so what I'd like to do, Dr. Whelchel is kind of, as we wrap up, if people want to get in contact with you, or they're interested in being treated by you, where can they find you? Where can they get in contact with you?
Dr. Whelchel (35:15):
Well, the easiest way is to go to my website. It's www.healthyhormones.us and I've got further contact information on there. I am open for... I primarily do thyroid management and then the BioTE hormone management, I don't do general functional medicine anymore. I'm pretty much focused on the hormone side of things, but we would be happy to help them. There are also some issues with state to state. I've had some people call from other states, and if I'm not licensed in their state, I probably can't manage them long term. Although someone's willing to come to MRL and see me in my office, then I can do that. But it gets a little dicey as far as the telemedicine with certain states. But even if we can't help, we'd be happy to at least point them in the direction of someone in their area that might be of benefit to them.
Dr. Childs (36:06):
Awesome. And I appreciate that. What I'll do for anyone listening to here is I'll put the link to that website below the healthy hormones. And so you can get in contact with Dr. Whelchel there, if you'd like. And Jeff, we're definitely going to have you on again, because we didn't even get to hardly any of the things that I wanted to talk about.
Dr. Whelchel (36:21):
That's amazing, we do have a lot to talk about.
Dr. Childs (36:23):
We have a ton to talk about. So anyway, thank you so much for coming and that's all I have for you guys, and otherwise, we'll see you in the next one.