Is Hormone Therapy safe?

2023-03-27T14:22:32+00:00March 23rd, 2023|Adults, Direct Primary Care, Family Medicine, Health Care, Uncategorized|

What’s the deal with Hormone Therapy? Is it safe?

After the Women’s Health Initiative study done in the early 2000s that demonstrated an increased risk of cardiac events, strokes, blood clots and breast cancer was terminated early, many believed HRT to have more risk than benefit. The number of women taking HRT dropped from 20% to 5% nationwide. One of the flaws in the study was that the women enrolled were over 60y old. For women 50-59years these risks are slightly increased but no where near as drastic as the original study.

The answer to safety is not an “all or none” proposition. HRT is not “good’ or “bad.” As with any treatment, the benefits and risks must be weighed for each individual woman. Remembering that menopause is a chapter in life and not forever helps. Discussing “how long” these symptoms will last or when and which ones warrant treatment is a conversation to have with your physician.

Hormone Replacement Therapy (HRT) is not a panacea for the changes that occur in menopause throughout the body. Often there are better medications to treat a lot of these specific changes. For example, it is not generally recommended to try to prevent osteoporosis with HRT. Additionally, we would not treat mood disorders that become unmasked during this transition period with HRT.

There are so many symptoms… which ones warrant consideration for HRT?

  • Severe vasomotor symptoms occurring every hour or two and disrupting daily life (not responsive to behavioral/lifestyle modification)
  • Vasomotor symptoms that are interfering with sleep
  • Vaginal atrophy or Urinary Dysfunction

Who might be a candidate for HRT?

  • In general, women who are less than 60 and less than 10 y from menopause.
  • Women without a history of heart disease, stroke, blood clots, or breast cancer.

Isn’t HRT just pills?

  • Not all HRT is created equally and there are numerous different modes of delivery for Estrogen.
  • Pills by mouth can decrease testerone affects on hair loss and acne, while patches have a lot less risk of blood clots and stroke than pills.
  • Vaginal symptoms alone are best treated with cream or rings that produces only local estrogen exposure.
  • All women with a uterus taking estrogen will need to get progesterone in pill form or as an IUD as well to decrease risk for endometrial cancer.

What about “bioidentical” hormones?

  • Bioidentical hormones just means they have the same molecular structure we produce naturally. Estrogen patches and prometrium are FDA approved bioidenticals that are prescription medications.
  • People often refer to compounded formulations as bioidentical hormones… with compounded formulations there is not a lot of safety data and no regulation.

At Roots Health DPC we use the NIH Breast Cancer Risk Assessment Tool (NCI) to assess risk for breast cancer. We assess for risk for cardiovascular disease as well when we discuss HRT treatment options so that patients can make informed decisions.

Not all HRT is equal and topical treatment options do not have the same systemic system side effects as pills and may be just as effective. A great resource for patients is NAMS (North American Menopause Society).

Are you looking for a physician who has time to discuss all your options with you? We are enrolling a limited number of new patients and would love to hear from you today.

Prediabetes Screening

2023-02-13T15:40:42+00:00February 13th, 2023|Adults, Diabetes, Direct Primary Care, Family Medicine, Health Care|

What is the best way to screen for Prediabetes and What Can I do if I have prediabetes?

Prediabetes is a diagnosis that gives us the opportunity to avoid developing diabetes and any of the complications that accompany it. I often refer to this as a warning sign… like the red “check-engine” light that comes on when your car needs servicing. Looking at the diagnosis as an opportunity to improve our health can dramatically shift our response to a new diagnosis and the actions we take.

Diagnosis

There are multiple available tests that are used to evaluate for prediabetes and diabetes. If a blood test shows that your blood sugar is higher than normal but not high enough to be called diabetes, it is called “pre-diabetes.” The most commonly used tests are:

  • One test measures glucose after fasting.
    • Impaired fasting glucose consistent with pre-diabetes is between 100-125 mg/dL.
    • Diabetes is diagnosed with a fasting glucose of 126 mg/dL or higher.
  • Another test, Hemoglobin A1C, measures how much glucose has attached to red blood cells and provides a view of your blood sugar levels over the past three months. This test does not require fasting.
    • An A1C value of 5.7 percent to 6.4 percent is classified as prediabetes.
    • An A1C value of 6.5 percent or higher is consistent with diabetes.

Knowledge gives you the power to advocate for your own health and well-being. Never miss another “Mondays with your MD.”

What can I do if I have pre-diabetes?

If you have pre-diabetes, you can make lifestyle changes to lower the chance of developing diabetes. Here’s what you can do to prevent Diabetes:

  • Eat a healthy diet – Try to eat a diet with lots of fruits, vegetables, and low-fat dairy products, but low in meats, sweets, and refined grains. Basic principles of healthy eating, portion control and counting carbohydrates will serve you well.

     

  • Weight Loss- If you are overweight, trying to get to a healthy body weight can help. Losing 5 to 10 percent of your body weight can lower your risk a lot. Your doctor can help you find healthy ways to do this.
  • Physical Activity: be active for 30 minutes a day – You don’t have to go to the gym or do heavy exercise to get a benefit. Activities like walking, gardening, and dancing can all help improve your health.
  • Quit smoking – If you smoke, talk to your doctor about how to quit. People are much more likely to succeed if they have help when quitting.
  • Consider medical interventions –You might try a medication to lower your chances of developing diabetes, especially if lifestyle changes aren’t helping enough. One drug that is often recommend in these cases for persons with prediabetes is metformin. You can discuss this option with your doctor.

Uncontrolled diabetes is a serious disease with complications that include kidney failure, limb and vision loss. The diagnosis of Prediabetes is an opportunity to change the trajectory of your health and wellness journey. Educate yourself and ensure you are working with a doctor you trust to answer all of your questions, all of the time.

Prediabetes – What is it exactly?

2023-02-11T03:11:19+00:00January 30th, 2023|Adults, Diabetes, Family Medicine, Family Practice, Health Care, Membership|

What is prediabetes? Who is at risk?
A look at the myths about diabetes.

Approximately 96 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 80% don’t know they have it. In fact, most people are not aware that they should be routinely screened.

So what is the harm in having prediabetes?

Prediabetes significantly increases the risk of developing type 2 diabetes, heart disease, and stroke. As with anything… knowledge is power.

The good news is that if you have prediabetes, which is easily detected on bloodwork, you can make lifestyle changes to prevent or delay type 2 diabetes and other serious health problems.

Is prediabetes more common than you thought?
Learn more about ways that you can maximize your wellness by setting up a FREE initial consultation with Dr Diaz to create a customized health plan based on your personal wellness goals.

Today we are going to dispel some common myths about Diabetes.

Myth: You’re not at risk for Diabetes if you’re a healthy weight

Being obese or overweight is associated with a number of health problems, and it increases your risk for type 2 diabetes. This does not mean that you are immune to the disease if you maintain a healthy weight, however. Even people at a healthy weight can have diabetes

Myth: No One in My Family Has Diabetes, so I Can’t Get It

Having a close family member with type 2 diabetes does put you at increased risk for developing the condition. But the risk of diabetes goes up with age. The risk is higher in people with heart disease, high blood pressure, and who have excess weight or obesity, regardless of family history. Although you might not be able to change your family history or age, you can practice a healthy lifestyle to cut your risk.

Myth: There’s Nothing That You Can Do to Prevent Diabetes

Even though genetics factor into your risk for type 2 diabetes, lifestyle choices play an important role in preventing diabetes. Maintaining a healthy weight, daily exercise and healthy diet modifications can help reduce your risk for diabetes. Smoking can make it difficult for your body to use insulin, so not smoking can help decrease your risk for diabetes, as well. Alcohol consumption can also play a role.

Myth: It’s Your Fault if you have Diabetes

Diabetes is a serious chronic disease, and people with diabetes are not to blame. There is no known way to prevent type 1 diabetes, and while lifestyle factors do contribute to your risk for type 2 diabetes, even type 2 diabetes is not entirely preventable.

Myth: Diabetes is Inconvenient but not Serious

Diabetes results in more deaths than breast cancer and AIDS put together. There are several risks and complications associated with diabetes, including heart disease, stroke, blindness, kidney failure, and lower limb amputation that impact the quality of life significantly.

Next week we will take a look at how you can figure out your risk for prediabetes and determine what type of screening is appropriate.
Knowledge is Power. Sign up to receive “Mondays with your MD” for FREE and take control of your health today.

Mondays with your MD – Breast Cancer Awareness Month!

2022-10-17T23:16:13+00:00October 16th, 2022|Adults, Direct Primary Care, Family Medicine, Health Care, Public Health|

October is Breast Cancer Awareness Month

Many of us have been touched by breast cancer- perhaps through a personal diagnosis- or by a family member, friend, or colleague diagnosed with this disease. Breast cancer, after all, is the most frequently diagnosed cancer and leading cause of cancer death in women. Please join me over the next few Mondays to discuss prevention, screening, and warning signs.

Education is Key for Prevention

Do you know the risk factors associated with an INCREASED risk for breast cancer?

  • Hormonal factors can influence your risk for breast cancer. Higher levels of endogenous estrogen and hormonal combined estrogen/progesterone replacement has been associated with increased risk of developing breast cancer.
  • Reproductive factors associated with a higher breast cancer risk include earlier onset of menstruation, not giving birth or having first child later in life, and a late menopause.
  • Family history and genetic mutations. The risk of breast cancer is affected by the number of first-degree female relatives diagnosed with breast cancer and the age at which they were diagnosed.
  • The highest breast cancer risk occurs among White women (although it remains he most common cancer among women of every major ethnic/racial group).
  • Alcohol consumption is associated with a higher risk of breast cancer.
  • A higher BMI in postmenopausal women is associated with increased risk for breast cancer. 

Do you know how to DECREASE your risk for breast cancer?

  • Breastfeeding. For every 12 months of breastfeeding there is an approximate 4% reduction in the relative risk of breast cancer.
  • Increased physical activity at all ages lowers risk.
  • Dietary factors may modify breast cancer risk although data is limited. Eating a low-fat high fiber diet with plenty of fruits and vegetables is recommended.

This is part ONE of a THREE part series on Breast Cancer Awareness. STAY TUNED. Next week we will review breast cancer screening options and recommendations.

 

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Mondays with your MD – 5 tips to prevent eczema flares

2022-10-10T21:29:01+00:00October 7th, 2022|Adults, Family Medicine, Health Care|

Winter is coming… 5 tips to prevent eczema flares!

Did you know that your skin is the largest organ of your body? Your skin works as a barrier to prevent infection. When your skin barrier is weakened you experience dryness, irritation, and inflammation. These are all signs that your skin needs attention. Follow these 5 tips to avoid flare-ups….

Keep Skin Moisturized

Moisturizing is key and it must be fragrance free! Slather on gentle, fragrance-free moisturizer several times a day, especially right after bath/shower. Highly recommended brands include CeraVe and Aquaphor.

Avoid Irritants

Highly sensitive skin is prone to irritation with perfumes, dyes, and chemicals found in everyday household products. The trick is to use hypoallergenic and fragrance-free products. Minimize flare-ups and itching by using fragrance-free soaps, shampoos, and detergents.

Be Temperature Aware

Pay attention to temperature and humidity. Take shorter baths with luke-warm temperature water. Avoid exposure to extreme heat/cold and wear 100% cotton allowing skin to breath. This helps with overheating and excessive sweating which can trigger a flare-up.

Supplement with Vitamin D

Vitamin D supplementation and direct sun exposure can lessen the severity of eczema symptoms and support your skin barrier and immune system. Vitamin D supplementation is a safe and tolerable therapy.

Partner with your physician

With eczema-friendly skin care and trigger management most people can control eczema. Your physician can create custom-tailored treatment plans that can include topical medications, specialized dressings, oral medications, or UV light therapy each of which has unique risks/benefits.

At Roots Health DPC, we partner board-certified physician services with patients who prioritize their own health and wellness. If you are interested in joining our practice please schedule a free meet and greet with Dr Diaz today.

Mondays with your MD – Getting to the root of your healthcare concerns

2022-10-08T18:48:36+00:00October 3rd, 2022|Community, Family Medicine, Family Practice, Health Care, Membership|

Are you frustrated with the existing health care system? Is your doctor treating your individual symptoms but not helping you find the root cause for the constellation of symptoms you have? Are you wondering if your health care needs might require an integrative approach?

Roots Health DPC provides a patient-centered approach that engages the whole person; nourishes the mind, body, and spirit; and encourages the conscious creation of personal health and wellness. Patients have constant direct access to board-certified medical care with ample time to fully evaluate and treat the root cause of symptoms.

Did you know that the average length of time spent in an office visit to cover patient concerns and circumstances is 7 minutes in the traditional insurance-based health care model? That’s right… 7 minutes! It is no small wonder that the typical health care experience feels piecemeal and rushed. You would not expect your mechanic to diagnose, let alone treat, your car problem in 7 minutes…. so why do we accept this substandard care for our own health and well-being?

At Roots Health DPC, we know that your health is the most important thing. It is the foundation for living life on your terms.

Why should you consider direct primary care for your health care?

Quality time
Quality time to understand your health care needs with your physician and create an individualized health care plan. We focus on the whole patient as a unique individual –taking into account each element of a person’s health, environment, and lifestyle.

Communication
Communication with your board-certified physician that is easy and ongoing making it simple to adjust the plan as necessary to meet your health care needs. Unlimited physician access and visits… in office and virtual

No Waiting. No Copays. Ever.

Affordable Transparent Pricing.

A low monthly membership fee provides unlimited direct access to your physician to work with you as a team to obtain and maintain your optimal health and well-being. Steep discounts on labs, medications, supplements, and imaging.

If you are looking for a board-certified physician that you trust to look at the whole picture and get to the root of your health concerns and help you build a healthier life…. consider joining us at Roots Health DPC. Schedule a Free Meet and Greet with Dr Diaz today.


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    Mondays with your MD – HPV: What you should know

    2022-08-15T21:41:16+00:00August 15th, 2022|Adults, Family Medicine, Health Care, Public Health|

    Human Papilomaviurs, or HPV, is the most common sexually transmitted infection (STI) in the United States.

    70- 80% of women will get at least one type of HPV at some point in their lifetime. HPV can cause cervical cancer.

    The following questions and answers address what you need to know about HPV and screening for cervical cancer:

    What is human papillomavirus (HPV)?

    HPV is a group of viruses that can be passed through sexual contact. The types that infect the genital area are called genital HPV.

    Who gets HPV?

    Genital HPV is the most common STI in the United States. It is so common that 70-80% of women will get at least one type of HPV at some point in their lifetime.

    What are the symptoms of HPV?

    Most people with HPV do not have any symptoms which is why women need regular Pap tests starting at age 21. The Pap test can find changes on the cervix caused by HPV. If you are a woman between ages 30 and 65, you can also do a DNA test for HPV strains of the virus that cause cervical changes.
    HPV infections can sometimes cause genital warts. Genital warts usually appear as a small bump or group of bumps in the genital area and     physicians can usually diagnose warts by looking at the genital area.

    What health problems can HPV cause?

    HPV usually goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems including: cervical cancer and genital warts most commonly.

    Do I need to get tested for HPV?

    • If you are 21 to 29 years old, your doctor might suggest the HPV test if you have had an unclear Pap test result. Most women younger than 30 do not need the HPV test, because the immune system fights off HPV in the vast majority.
    • If you are 30 years or older, you may choose to have the HPV test and Pap test to screen for cervical cancer. If both tests are normal, the chance of getting cervical cancer in the next few years is very low and often you can wait up to five years for your next HPV screening.

    How can I prevent HPV?

    There are two ways to prevent HPV. One way is get an HPV vaccine. The other way to prevent HPV or any STI is to avoid sexual contact with another person.

     

    If you do have sex, lower your risk of getting an STI with the following steps:

    • Use condoms. Condoms are the best way to prevent STIs when you have sex.
    • Limit your number of sex partners. Your risk of getting STIs goes up with the number
      of partners you have.

    If I get the HPV vaccine, do I still need to use a condom?

    Yes. The vaccine does not replace or decrease the need to wear condoms. Using condoms lowers your risk of getting other types of HPV and other STIs.

    Do I still need a Pap test if I got the HPV vaccine?

    Yes. There are three reasons why:

    • Although the HPV vaccine protects against many of the HPV types that cause cervical cancer, it does not prevent all HPV types that cause cervical cancer.
    • You might not be fully protected if you did not get all the vaccine doses (or at the recommended ages).
    • You might not fully benefit from the vaccine if you were vaccinated after getting one or more types of HPV before vaccination.

    Talk to your doctor today about HPV screening

    Mondays with your MD: Formula Shortage

    2022-06-25T21:22:11+00:00June 25th, 2022|Families, Family Medicine, Public Health|

    Formula Shortage

    Recently I had a patient reach out to let me know she was unable to locate the formula she routinely provided to her baby. She let me know she was considering feeding her baby with breastmilk from a friend and was concerned about allergens in some of the other formula products.

    Nothing is as important to families as the health and safety of their babies. The formula shortage has left many anxious about how to feed them. My guess is that many are thinking about a similar solution. I thought I would share a few recommendations from the American Academy of Pediatrics.

    RECOMMENDATIONS

    • Consider trying a brand new formula
    • Consider trying a formula made in another country
    • Talk to your physician about substitutes for hypoallergenic or specialty forumulas (as was the case in the above example)

    OPTIONS for HOW to FEED YOUR BABY SAFELY

    • Consider discussing using whole cow’s milk if baby is over 6mo
    • If baby is close to one year discuss with physician options for toddler drinks
    • Consider using local milk bank

    AVOID these options

    DO NOT share breast milk with friends or purchase on the internet. There are significant infectious disease and storage safety risks

    DO NOT water down formula

    DO NOT make it at home

    DO NOT use expired formula

    If you are having difficulty finding formula and solutions please reach out to your physician.

    Mondays with Your MD: Skin Cancer Awareness Month

    2025-08-04T17:32:26+00:00May 15th, 2022|Community, Families, Family Medicine, Special Offer|

    Summer is almost here…. and with it comes lots of outdoor activities. Protecting your skin from the sun is imperative. Did you know that skin cancer is the most common type of cancer?

    skin-cancer-prevention-facts

    The good news is that skin cancer can be prevented and it can almost always be cured… when it’s found and treated early.

    Simple Skin Cancer Prevention Tips:

    -Seek the shade between 10am-4pm
    -Do NOT get a sunburn
    -Use broad spectrum sunscreen SPF 30 or higher and reapply after 2hours
    -Examine your skin once a month

     

    Subscribe to our newsletter to learn more and get FREE SKIN CANCER SCREENING

    The Pandemic. Deferred wellness. Navigating health today.

    2025-08-04T17:32:17+00:00May 8th, 2021|Community, Copays, Deductibles, Direct Primary Care, Family Medicine, Membership, Pandemic, Telemedicine, Urgent Care|

    As we pass one year since the pandemic started, it is time to take stock of our overall health and what it means to us as individuals.  It’s important to note the collateral effects that the COVID-19 pandemic has had on our individual health as well as the overall wellness of our community.  Many avoided or delayed care (both urgent and routine) to lower the risk of acquiring COVID-19.   We now have evidence that this shift has led to delayed diagnosis and treatment which results in poor outcomes.

    While we can celebrate some success as the number of vaccinated individuals increases in the United States, we still struggle with effects of social isolation and the surge of mental health problems that accompany it.

    Prior to the pandemic, it was common for patients to avoid the “hassle” of the traditional health care system. Patients disliked the “big production” around getting an appointment and waiting to be seen as well as the amount of time and energy spent to engage with the insurance-based model of care. Often patients delayed care because the cost was not transparent and surprise billing was never popular.  Between copays, deductibles and out-of-pocket maximums most people have no idea what costs to expect when they seek the care that is recommended.

    The pandemic has accentuated the difficulties of getting care… we have witnessed that our health care system is beyond broken.  It does not serve patients and the time for change is past due.

    What if getting care was as easy as scheduling online and speaking directly to your doctor via phone text or email whenever needed?  What if there was no “hassle” to get an appointment and no wait to see your doctor?  The Direct Primary Care (DPC) model has made this a reality.  Your physician is easily accessible with time to address all your health concerns.  DPC is the future of health care and is championed by physicians around the country dedicated to doing what is best for their patients.  DPC takes away the “pain” of seeing the doctor.  It emphasizes the value of the patient-physician relationship and creates space for shared decision-making around health and wellness.  DPC provides excellent care, transparent pricing, and unparalleled accessibility.

    During the pandemic, DPC patients had unlimited access to their physician.  They were engaged in healthcare prevention and maintenance conversations with their physicians.  They received superior care by having direct communication with their physician.  There were no “surprise” bills because DPC membership fees are transparent and extremely affordable.

    As with anything difficult, we can always find a silver-lining… and we must if we want to continue to grow and improve. The pandemic has made the case for DPC.  We all deserve better health care. The foundation for improved health outcomes lies in the rebuilding of a solid physician-patient relationship.  How we get through it all… will always depend on… who we get through it all with.

    >>LEARN MORE ABOUT ROOTS HEALTH DPC<<

    >>Click here to call ROOTS now 708-613-7916<<

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