Dr. Herdman offers wide range of approaches, from botanical formulas to customized prescriptions, depending upon the patient’s choices and health needs. We begin with a careful history, listening for potential endocrine symptoms including fatigue, sleepiness after meals, sleep patterns, bowel function, skin and hair health, feeling overheated or chilly, anxiety or low mood, and weight gain or loss. Thorough laboratory testing may include adrenal function with morning and afternoon cortisol levels and the hormone aldosterone; thyroid hormones free T4 and T3, and the highly sensitive TSH; thyroid antibodies including TPO. We may also screen for fasting glucose and HbA1c, a longer-term marker for blood sugar levels, and check insulin, cholesterol and fat levels, as these may be affected by the health of the pancreas and adrenal and thyroid glands. A detailed physical examination looks at blood pressure, pulse rate, eye health and reflexes, nervous system function, and thyroid gland size and texture.

Adrenal depletion and borderline-low thyroid can benefit greatly from herbal formulas. Depending on the patient’s needs Dr. Herdman may mix a custom botanical tincture of herbal concentrates to gently restore adrenal or thyroid function. Or she may recommend a capsule blend of herbs with vitamins B5 and C which are necessary for the adrenals to make their stress-balancing hormones. Many of our patients diagnosed years ago with sluggish thyroid function have maintained better energy, weight balance, skin and hair health, increased vitality, and improved blood test results with botanical treatments over the long term.

If botanical approaches are ineffective for thyroid support, or if blood values show thyroid function may be too low to respond to gentle herbal encouragement, we offer prescriptions with customized blends of T3 and T4 thyroid hormones. These are biologically-identical, replacing hormones naturally made in the body. We may have these prescriptions made to order by an expert pharmacy specializing exclusively in customized blends: These ‘compounded’ medicines are usually inexpensive, and they allow Dr. Herdman to specify exact doses matched precisely for each patient’s needs. Or patients may receive carefully chosen doses of thyroxine or Synthroid, with T3 or Cytomel. New prescriptions are introduced in small steps, with feedback from the patient and careful tracking with lab testing. We occasionally use ‘natural’ thyroid tablets, which are extracts of pig thyroid, but they tend to have too much T3 hormone and proportions of T4 and T3 that don’t ideally match human needs.

Dr. Herdman works with type 2 diabetes, pre-diabetes, elevated blood sugar, and metabolic syndrome. Healthy eating programs are an essential part of the care, along with a stable plan for moderate exercise four or more times per week. Nutrients and botanicals including chromium picolinate, vanadium, gymnema, bitter melon, cinnamon concentrate, and berberine can each play a key role for maintaining healthy blood sugar.