Hone’s Clinical Stance on Treating Hormone Deficiency
Written by:
Dr. Jack Jeng, Chief Medical Officer of Hone
Dr. Jim Staheli, Medical Director of Broad Health
Hone’s mission is to help men understand that age doesn’t have to have any limits, and that you can get better in your 30s, 40s, 50s and beyond. Our initial offering is an easy-to-use telemedicine solution for men with low testosterone and hormone imbalances. We pride ourselves on creating one of the safest hormone optimization clinics in the country, with physicians that deeply know how to treat low testosterone. The longer-term goal is to become an anti-aging and optimization service that helps people live longer.
How do physicians balance hormones and fix low testosterone?
Hormone optimization is the science of measuring your hormones and, if deficient, integrating treatment that includes using lifestyle changes, supplements and/or pharmaceuticals to get or return your hormone levels back to an optimal, healthy range. Everyone’s body is unique and an optimal range is different for each person. Licensed medical professionals, who have years of experience in diagnosing and treating patients can help you find the right course of treatment and optimal range for you. Some clinics might treat patients who are already in the optimal range; however, licensed physicians Hone works with only prescribe to men who are hypogonadal, or have clinically low testosterone levels and are symptomatic.
Does Hone promote any particular type of treatment?
No. Licensed physicians affiliated with Hone personally review your medical and family history, symptoms, fertility goals, labs, age, vitals, etc., before making a diagnosis or establishing any treatment plan, if any.
Once a patient assessment has been conducted, a thorough treatment plan will be established by the physician for the patient. The plan can include lifestyle guidance and education (for example, changes in diet, exercise, stress, sleep, etc.), use of supplements and/or pharmaceuticals.
Physicians will provide education and guidance around lifestyle modifications at each consultation to make sure patients know how to incorporate them into their lives. Every patient is different and it’s up to the physician to decide the best treatment plan, or if any treatment plan, is appropriate.
Our patient base ranges from 25 to 80 years of age, and it is up to licensed physicians to determine the most appropriate treatment.
Are there ways that I can naturally optimize my hormones?
Before you take any medication, there are a number of important lifestyle changes you should consider, since they could improve your hormone imbalance or low testosterone levels. You should:
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Get 7-8 hours of sleep
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Exercise regularly
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Reduce or stop your consumption of alcohol
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Eat a balanced diet
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Try supplements
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Get enough sunlight daily
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Practice stress reduction techniques
If you want additional advice on how to incorporate these changes into your life, we’ll be publishing a free course soon to help you. If you’ve tried these and are still experiencing symptoms, then consulting with a licensed physician who understands hormones may be the right next step for you.
Each patients’ situation is unique (biology, environment, psychology) and it is up to the physician to determine if and when a patient should try medication in addition to lifestyle modifications.
Will a licensed physician working with Hone prescribe testosterone to anyone?
No. Prescribing testosterone must be deemed medically appropriate as evaluated by a licensed physician who follows evidence-based clinical protocols and requires the following before any prescription is issued:
1. Clinical diagnosis of hypogonadism, supported by medical history, patient symptoms, lab evaluation, questionnaires such as qADAM and a one-on-one audio/video consult.
2. Lab testing that includes tests for testosterone, free testosterone, SHBG, albumin, LH, estradiol, ALT, AST, HCT, PSA and others.
3. Two (2) separate testosterone readings and other tests that help physicians evaluate need and safety, and validate results.
4. Review of your fertility goals.
5. A review of the risks and benefits of hormone optimization, and your willingness to move forward with treatment.
6. Your willingness to complete follow-up testing and physician consultations every 90 days.
7. Your willingness to make lifestyle adjustments.
There are many cases where patients have low testosterone, but a licensed physician will not prescribe testosterone or other medications due to factors such as age, and an unwillingness to make lifestyle adjustments such as weight loss, reducing smoking and alcohol consumption, and inadequate sleep, among many other reasons.
Are physicians incentivized to provide any particular treatment?
No. Licensed physicians work for an independent, physician-owned medical group, and they are not compensated based on any treatment decisions. They are compensated based solely on completing a consult and their compensation does not vary based on patient diagnoses or if a prescription is issued. The independent, physician-owned medical group is responsible for all decisions related to physicians and medical care.
Do physicians review the risks and benefits of any medication?
Yes, physicians have sufficient knowledge of the risks and benefits associated with the medicines they subscribe to patients. Physicians spend time explaining these during the consultation, and patients are required to consent to these risks before medication is provided.
Can I have children if I go on hormone optimization?
Your physician will speak to you about the risks and benefits of taking each one of your medications. If having children is one of your goals, testosterone may not be your initial choice for optimization treatment as it could reduce your chances of fertility in the future.
However, there are other medications that may be used for treatment optimization that help increase testosterone while preserving sperm production. Your physician will share these options with you prior to establishing your treatment plan. Additionally, if you and your physician decide to take testosterone there may be ways to restart your body’s natural production of sperm.
If I decide to go on treatment do I have to be on treatment forever?
It depends on several factors: your age, health, medications, lifestyle practices, and desired outcomes.
The need for testosterone therapy is due to a deficiency and may be caused by several factors. Depending on the cause, one may be on testosterone therapy long term (similar to taking medications for chronic conditions like hypertension, diabetes, arthritis etc) or short term.
If you decide to take testosterone it may reduce your natural testosterone production over the long term. If at some point you decide to stop the use of testosterone, our physicians may taper your testosterone dose over time and may add an additional medication to try and stimulate the production of your natural testosterone – this may take several months. This is very important and you’ll be required to consent when you begin this particular kind of therapy.
Some of our patients have been on hormone optimization for years, while others have successfully transitioned off.
What do we have coming?
Hone’s vision is very large and doesn’t stop at hormone optimization. We are huge believers in holistic health and know that hormones are one small piece of a much larger puzzle. We’ll move into new therapeutic categories, behavior modification around diet and exercise, and mental and emotional mindset in the future. Hone will become the optimization platform for your life.
Dr. Jack Jeng
Chief Medical Officer of Hone
Dr. Jack Jeng is the Chief Medical Officer at Hone. Dr. Jeng received his medical degree from the Mayo Clinic and completed his residency training at the University of California San Francisco. Prior to joining Hone, Dr. Jeng was the Chief Medical Officer at Scanwell Health, which was acquired by Becton Dickinson, and an attending anesthesiologist at UCSF. He is passionate about leveraging technology to improve the value of healthcare for patients, as well as improving healthspan and lifespan through lifestyle interventions and therapeutics.
Dr. Jim Staheli
Medical Director of Broad Health
Dr. James R. Staheli is the Medical Director for Broad Health and a family medicine doctor in Atlanta, Georgia. He received his medical degree from the University of Osteopathic Medicine and Health Science in Des Moines, Iowa, and has been in practice for more than 20 years. Following medical school, he completed an Allopathic Family Practice Residency at Broadlawns Medical Center and then a one-year fellowship in OB/GYN at the University of Nebraska Medical Center. An advocate for preventive health and nutrition with a focus on the prevention and reversal of the reversal of disease, Dr. Staheli is a current fellow on metabolic and nutritional medicine, anti-aging, metabolic and functional medicine. He is actively pursuing additional training through the A4M as well as the IFM.
