Eterna M.D. Age Management Program
It is important to remember that every individual is UNIQUE and we are all different. At our center, we will CUSTOMIZE your program. The following evaluation will take as follow:

1. A comprehensive history, specific questionnaires: Estimated time of completion 2 hours.
2. A comprehensive physical examination
3. Before the consultation containers for either 24 hour urine collection or saliva test will be sent to your domicile.
4. A comprehensive consultation with our Fitness Specialist: David Bartolotti. He will evaluate you and will design a specific plan for you based on your needs and goals. Specific measurements will be taken during the consultation. He will do your follow-ups every 4 weeks.
5. Then you will meet with the doctor who will design a specific therapy for you. Dr Carlos Mercado or Mara De La Vega, MD work very closely with the laboratory to assure clinical correlation. This is a very important issue when it comes to hormone replacement.
6. Follow-ups with the doctor are every 3 months or before if needed at no additional cost. You will be able to see the doctor or communicate via phone with previous appointment. You need to continue your medical care with your primary care physician.
7. It is important to know that FOLLOW-UPS are mandatory at least every 3 months. We do not recommend a single consultation since this is an ONGOING process. That is why we have design a YEARLY FLAT FEE to cover your needs. However SINGLE consultations are available as well.

What is Included ?
CONSULTATION + either URINE 24 hour or OVERNIGHT + or SALIVA TEST and BLOOD TESTS.
See below:

• Your first consultation with Dr Mercado or Dr De La Vega and our Fitness Specialist who is certified by the National Academy of Sports Medicine.
• Follow-ups with the doctor every 3 months are mandatory or PRN by appointment.
• Follow-ups with our Fitness Professional every 4 weeks or weekly if necessary

BLOOD TESTS covers the following:

• CBC
  • WBC
  • RBC
  • Hemoglobin
  • Hematocrit
  • MCV
  • MCH
  • MCHC
  • RDW
  • Platelet Count
  • MPV
  • Neutrophils
  • Lymphocytes
  • Monocytes
  • Eosinophils
  • Basophils
• Chemistry Panel
  • Glucose
  • BUN
  • Creatinine
  • BUN/Creatinine Ratio
  • Sodium
  • Potassium
  • Chloride
  • Magnesium
  • Phosphorus
  • Calcium
  • Uric Acid
  • Total Protein
  • Albumin
  • Bilirubin
  • Alkaline Phosphatase
  • SGOT
  • SGPT
• Lipids
  • Cholesterol
  • Triglycerides
  • HDL
  • LDL
• HbA1C
• C-reactive Protein, Cardio-Type
• LH (for males only) or FSH ( for females only)
• DHT ( Dihydrotestosterone) : Males only
• PSA and FREE PSA: Males only
• TSH
• Free T3 and Free T4
• Testosterone
• Estradiol
• Progesterone
• DNA Test
• IGF-1
• IGFPB-3

URINE TESTS either 24 hour collection or OVERNIGHT (urine collected during the night or first void) to measure the following:

SALIVA TESTS are offered if patient is not able to collect urine such as travelers or if it is clinically indicated. The following will be measured:

• MALES:
  • DHT
  • E2
  • DHEA
  • PROGESTERONE
  • TESTOSTERONE
• FEMALES:
  • E1
  • E2
  • E3
  • DHEA
  • PROGESTERONE
  • TESTOSTERONE

Complimentary newsletter via internet.

You will have access to fill out your medical history trough the internet at your convenience.

WHAT IS NOT COVERED:
We specialize in Age Management. Furthermore is like when you go to the cardiologist, your heart will be evaluated. However, we do a comprehensive assessment that includes hormones, preventive medicine, customized exercise program and nutrition. This three elements has to be synchronized in order to improve your well-being. You will need to continue your medical care with your medical providers. Example if you develop a cold or any emergency you need to call your primary care provider or call 911. Acute problems need to be managed by your primary care physician. However we are available to answer any questions you might have during your treatment.

If our doctors at Eterna M.D. determine that you might need additional tests based on your clinical picture is then the responsibility of the patient to cover the costs.

Our facility does not accept insurance, nor perform paperwork for medical insurances such as superbills.

Your therapy or any medication is the patient's responsibility. We use bioidentical hormones. We will work with your compound pharmacy once we determine their quality and customer services satisfy our criteria. It is important that you choose the right compound pharmacy, paying close attention to their quality control as well as the type of ingredients used. Remember it is your health that is at risk.

Follow-up blood tests/Urine/Saliva are not covered in the yearly flat fee. The reason is that it would be difficult to estimate costs since we don't know what hormones or inflammation markers you will have. Again is the patient's responsibility to cover their blood tests either is covered or not by your health insurance. Again our package is very comprehensive and includes the initial consultation with BLOOD, URINE or SALIVA as mentioned above.

Our CONSULTATIONS might assist patients with the following medical conditions as some examples:

• Alzheimers
• Depression
• Fatigue
• Sexual dysfunction: males and females
• Indigestion
• Lactose Intolerance
• Memory Problems
• Arthritis
• Osteoporosis
• Premenstrual Syndrome
• Type II DM
• Hypertension
• Cardiac Health
• Nutritional deficiencies
• Gastrointestinal problems
• Male Hormonal evaluation
• Female hormonal evaluation

OUR 24 hour urine collection will take a look to:

• THYROID
• ADRENAL
• FEMALE HORMONES
• MALE HORMONES
• ANDROGENS
• CORTISOL
• MELATONIN
• METABOLITES OF HORMONES
• DNA Test

24 hour urine collection is the GOLD STANDARD. Blood test will give you a snapshot what is happening at the time of your blood is drawn and there are many fluctuations of the hormones during the day. It makes sense to quantify how your hormones fluctuate during a 24 hour period. The 24 hour urine collection will take a look to the metabolites of hormones, meaning how hormones are used by our body.

Some patients might object to have to collect urine for 24- hours. Even though we advocate it, we also offer an OVERNIGHT collection. This is the urine collected during the night time. There is a good correlation between these two.

Some patients might object to urine collection. We offer SALIVA tests as well.

We would rather check URINE or SALIVA rather than blood for hormone evaluation. However since this is a comprehensive program, we also need BLOOD tests to check for markers of inflammation such as HOMOCYSTEINE, C-REACTIVE PROTEIN, HbA1C, INSULIN levels.  For patients with cardiac disease or history of Heart attack we offered a very detailed lipid profile looking at all the sub-units of cholesterol.

Our prices are between 50-70% lower than other clinics. We offer financing as well. Our physicians have been trained trough CENEGENICS in the USA as well as in Europe. They bring a combination that is unique to Central Florida.

Call 407-771-0404 for more details. Also you will get to see our state of the art facility. A tour will be given to you and you will get to know our doctors and staff.

Current Medical Care System
America's current medical care system is based on the treatment of disease. See The Decline of Medical Care in America : What Can We Do About It? It is about having something negative happen, and then trying to fix it after the fact. If you assume you are healthy today, but then have a heart attack tomorrow, were you sick yesterday? There is a better way. We have the knowledge, technology, and expertise to prevent or delay degenerative disease and the signs and symptoms associated with aging. The starting place, of course, is a comprehensive evaluation to understand your unique needs. Today, each of us has the power to improve the quality of our lives by focusing on improving our health.

Expertise & Experience of AMM Physician
The most important element necessary for the success of any medical therapy is the expertise and experience of the physicians in whom you place your trust for your health care. Our physician CARLOS MERCADO, MD at Eterna M.D. is certified in Age Management Medicine and have a wealth of experience in hormone modulation therapies, nutritional strategies and exercise science. Our goal is to have you become comfortable with the science, the therapies, and our facility that provides AGE MANAGEMENT consultations.

LOCAL DUE DILIGENCE
If you are considering a local physician to manage your hormonal modulation program, I encourage you to perform your own due diligence. Ask your local physicians whether they practice Age Management Medicine full-time or part-time, how many patients they have, and whether they have documented or published their clinical outcomes. Then compare their experience to the Cenegenics Medical Institute. DR CARLOS MERCADO, MD is certified in AGE MANAGEMENT and affiliate of CENEGENICS. He also has been in training fellowship in ANTIAGING in EUROPE with one of the top leaders in the field ( Dr Thiery Hertoghe, MD). If you needed open-heart surgery, would you have it done by a physician who performs one per month, or would you find an internationally recognized cardiac surgeon who specializes in open-heart surgery and performs one per day on patients from around the world. The New England Journal of Medicine published an outcomes study in April 2002 that concluded that clinical success and lack of complications are directly related to experience. The more experience a physician has with specialized therapies the better the patient results. It is important to understand the difference between a local physician's excellent intentions and his or her limitations due to lack of full-time experience.

Upper 33% of Normal Range
Age Management Medicine is defined as preventive medicine focused on regaining and maintaining optimal health and vigor. This medical specialty incorporates well-known and accepted markers of disease-risk into proactive patient management and uses hormone modulation for the endocrinologically normal by identifying hormone levels that yield superior health outcomes. For most hormones, this is simply the upper 33% of the normal range for a patient's age. The exceptions are insulin and cortisol that should be modulated to the lower 33% of the normal range, and human growth hormone which is only prescribed to deficient adults.

Age Management Medicine recognizes that successful therapies necessitate healthy lifestyle including optimal low glycemic index nutrition, appropriate nutrient supplementation, and the absolute need for physical exercise. Age Management Medicine focuses on the synergy of all of these elements in order to enhance vitality and extend our health span. While we may or may not be able to increase longevity, we are able to prevent premature disability and death and enhance quality of life.

WHAT IS ANDROPAUSE?
Andropause/Male Menopause is real. We lose critical hormones at the rate of 2%-3% per year beginning at age 30. Most men in their late 30's or early 40's understand that life is not as it should be or could be. An individualized program based on the results of a comprehensive evaluation can have tremendous beneficial effects for the short-term, and create a better opportunity to live well longer. A poorly designed program can have significant negative effects, both in the short-term and long-term.

Your Andropause Evaluation establishes your hormonal and metabolic baseline and provides your Physician at Eterna M.D. with the medical information necessary to design a program to increase your energy level including sexual energy, reduce body fat, increase lean muscle, improve cognitive function, lower cholesterol, enhance mood, improve ability to handle stress, and strengthen the immune system so as to remain as disease free as possible.

WHAT ARE THE SYMPTOMS OF ANDROPAUSE?
Upon reaching his 40's or 50's, the average man will start to notice subtle changes in his body, attitude and vitality. One day you wake up and think that the dry cleaners have shrunk your shirts and pants - or did they? They must have, your weight, eating habits and exercise routine have not changed since you were in college. For you, these changes may begin with something as simple as irritating an old football injury, or sleeping wrong and waking up with back, hip, neck or joint pain. You will make excuses for it but in the back of your mind you are thinking all I did was go to sleep and I woke up with debilitating pain, what is wrong with me? You may be starting to experience Andropause, a natural decline in your male hormones (testosterone and DHEA). As a man enters andropause, he may start to slow down and mature - some may say you have finally grown up. You may experience a reduced sex drive or feel that you have lost your edge. You may notice a decrease in muscle mass, skin tightness and strength, all which may be replaced by a wider girth, enlarged breasts and an overall blasé feeling (your get up and go has got up and went and you don't even care).

How Will the Doctor Treat and Evaluate me for Andropause?
Our experienced professionals at Eterna M.D. will discuss the rationale and provide solid physiology for each recommendation they make. Recommended changes may include: diet, exercise, smoking cessation, alcohol ingestion reduction, stress management, and nutraceutical supplementation.

The symptom profile for Andropause is multi-factorial and we will address each aspect of it, from medications you are on that may be reducing your vitality, to exercises you may want to participate in to increase your strength and stamina. During your consultation, we may recommend a 24 hour-URINE collection or OVERNIGHT collection or saliva test to check for imbalances between your male and female hormones. If we find that you have an imbalance, we will work with you to help restore you to optimal health and wellness. Our experienced professionals at Eterna M.D. will discuss the rationale and provide solid physiology for each recommendation they make. Recommended changes may include: diet, exercise, smoking cessation, alcohol ingestion reduction, stress management, and nutraceutical supplementation. We will provide you with the necessary information and designed program in order to increase your energy level- including sexual energy, reduce body fat, increase lean muscle mass, improve cognitive function, lower cholesterol, enhance mood, improve ability to handle stress, and strengthen the immune system so as to remain as disease free as possible.

Testosterone
Testosterone is one of the two main Androgens (male sex hormones) produced in the testes and by the adrenal cortex. Testosterone is responsible for libido, sexual vitality, male sex characteristics, increased muscle mass and strength, and distribution of fat. If a man is low in this hormone, he may experience many of the following symptoms:

At Eterna M.D. our MEDICAL DOCTORS will work with you and your healthcare practitioner to create a hormone regimen designed to meet your needs and to try to help restore your youthful vitality. We will work to assist you in combining the wisdom of your experience with the vitality of youth.

DHEA
DHEA is the second of the two main androgens. It is recognized for its ability to reduce the incidence of osteoporosis, increase libido, alter fat distribution (decreases deposition of fat in the abdominal area), improve the body's and brain's ability to relax and develop regular sleep patterns, as well as being supportive of the immune system.

Bioidentical Hormone Replacement Therapy

General - Menopause

NIH Study - Estrogen Alone Study Update
Unfortunately inaccurate information often receives unwarranted media attention. The Women's Health Initiative Study is another example of a highly publicized flawed study that continues to produce a great deal of misunderstanding. The National Institute of Health (NIH) reversed its position on the harmful effects of estrogen on March 2, 2004 with the following statement: Estrogen alone had no effect, good or bad, on heart disease [and] didn't increase the risk of breast-cancer. The NIH will need to continue retracting previously published information because the study itself was poorly designed and executed.

Recently, an article titled, The Women?s Health Initiative 2004 Review and Critique, by J.A. Goldman, MD and published by Medscape Ob/Gyn & Women's Health, 6(3), 2004, addresses the details of The Women's Health Initiative of 2002. This was an extremely flawed study of which we have been critical from its beginning go to HRT Scare Study Flawed, clearly explains the details of the study and further substantiates the use of bioidentical hormones

Interest in Menopause & Goal is Credible Information
I have included information to address your interest in menopause. Our first goal is to provide credible evidenced-based medical information to help you make well-informed decisions so that you can improve your overall health and prevent disease. The benefits of hormone supplementation for menopause and age management have been clearly documented by medical literature from The American Journal of Medicine, The Journal of the American Medical Association (JAMA), and other prestigious institutions and publications. Recent articles and books on bioidentical hormone replacement therapy are highlighted in the following references: The Sexy Years- Book Description; Hormone Replacement Therapy Increases Bone Mineral Density In Frail Elderly Women; and Testosterone: Sexual elixir and Estrogen Booster.

Interest in Menopause/Testosterone is Justified
Your interest in testosterone, estrogen, and progesterone supplementation for menopause is justified; however these hormones are only a few of several hormones that should be evaluated and possibly modulated as part of a comprehensive program. Age Management Medicine is defined as preventive medicine focused on regaining and maintaining optimal health and vigor. This medical specialty incorporates well-known and accepted markers of disease-risk into proactive patient management and uses hormone modulation for the individuals with sub-optimal levels of key hormones. For most hormones, this is simply the upper 33% of the normal range for a patient?s age. The exceptions are insulin and cortisol that should be modulated to the lower 33% of the normal range.

Menopause Info & Understanding Your Hormone System
Most women over thirty-five years of age need some form of hormone supplementation, which can include testosterone, thyroid, and possibly others. This applies to women that have reached menopause as well as premenopausal women. Menopause is clearly a hormone deficiency condition. Articles documenting ongoing research supporting hormone supplementation for menopause are provided in the following reference titled Bioidentical Hormone Replacement Therapy for Women.

Restoring Hormone Levels for Menopausal Women
At Eterna M.D. we believe in hormone restoration in men and women as we age. Women lose the majority of their female hormones over a very short, two-year period, once they enter menopause. These hormonal losses can severely compromise a woman?s quality of life and frequently lead to weight gain, mood disorders, and relationship problems.

We at Eterna M.D., believe it is absolutely crucial to the health and well being of every woman to replace these lost hormones with natural bioidentical hormones in order to maintain quality of life and prevent unnecessary suffering. We have aggressively discouraged the use of synthetic, non-bioidentical hormones even though they have been traditionally used in medical practices throughout America.

Menopause is no longer a stage in life that needs to be dreaded. Restoring and balancing hormones to premenopausal levels with bioidentical hormones is the key to great health, vitality, and youthfulness. Replacing and balancing hormones lost in the aging process will someday become the standard of care.

Unlike any other time in history, today's woman, is under an extreme amount of stress. Women are unable to maintain proper nutrition through food intake as our soil is depleted, the food supply is tainted with hormones and women are missing many enzymes to process our food.

With these issues and others, women are starting to experience life changes earlier and more severely than previous generations. Many women are starting into peri-menopause in their late 30's to early 40's. Peri-menopause can last for 10-15 years. In the United States, the average age of natural menopause is currently 48-52 years old and the average age of hysterectomy (causing surgical menopause) is 35 years old. Considering the fact that women are experiencing waning or absent hormones earlier, coupled with increased longevity, the average woman is living one-third to one-half of her life with a hormone imbalance.

Women are very complex and hormonal imbalances may start before a pattern or cycle has been established. PMS, infertility, peri-menopause, menopause, and post menopause are some of the hormonal imbalances seen by women today. Women have to find balance between the 3 estrogens (estrone, estradiol and estriol), as well as progesterone, testosterone, DHEA, cortisol (the stress hormone), and thyroid.

Approach to Hormone Balance
We live in an instant gratification society and many are looking for a 'quick fix' or a 'magic pill.' Many times, the first step in achieving balance is to change the way we live, and to implement changes that will allow us to recreate the balance we once enjoyed. There are many ways to achieve balance: stress reduction through exercise, prayer, meditation and relaxation training. Life approaches must include weight management, a natural diet, proper vitamins, herbs and nutrient supplementation in addition to hormone balance.

Hormone Imbalance: At Eterna M.D., our team of professionals will assist you in your journey to put the balance back in your life. We will address many areas of potential imbalance: nutrition, sedentary lifestyle, stress, insulin resistance, infertility, PMS, fibroids, endometriosis, breast pain, perimenopause, menopause, osteoporosis, breast, uterine and ovarian cancer, all which may stem from or be the cause of hormone imbalance.

Estrogens
Many women believe that estrogen is the name of one of the female hormones in their body; however, estrogen is actually the name of a group of hormones. There are 3 main estrogens in the human body: estrone (E1), estradiol (E2), and estriol (E3). This family of estrogens is responsible for growth of endometrial tissue, growth of follicle into an egg, growth of breast tissue, support of vaginal tissue, development of secondary sex characteristics in females, fat storage and increasing thyroid binding globulin. Correcting imbalances may help reduce the symptoms of menopause which may include: hot flashes, night sweats, weight gain, depression, fibrocystic and/or tender breasts, irregular bleeding, irritability/anxiety, water retention, low thyroid symptoms (feeling cold, thinning hair, fatigue, etc.), vaginal atrophy and sexual dysfunction. If you are deficient in estrogen, you may have an increased risk of bone disease, heart disease, colorectal cancer, sleep disturbance, mood disorder and loss of memory and cognitive function. Estrogen lowers blood sugar in women; therefore low estrogen may lead to increased insulin and may increase the risk of diabetes. Estrogen influences 400 actions in the body including vision, hearing, osteopenia/osteoporosis, mobility, memory, vasodilatation and other signs of aging. It also exerts a stimulating effect on breast, uterus and brain tissue and prevents bone loss by osteoclasts. It is also responsible for promotion of fat storage at the hips and maintains the integrity of the urogenital tract.

Estrogen Dominance
Excess estrogen may cause any of the following symptoms:

Estrone (E1)
Estrone is the primary estrogen of menopause; it is aromatized (made) in abdominal fat. In excessive amounts, metabolites (4-hydroxyestrone, estrone sulphate) have been linked to cancer. Do not take estrone unless you need it, and only in low doses. If it is necessary for you to take estrone, topical administration is recommended as it avoids "first pass metabolism" by the liver.
**Conjugated Equine Estrogens (Synthetic Estrogens) are 50% Estrone**

Estradiol (E2)
Estradiol is made by the ovary and is the most potent estrogen with the greatest effects. Estradiol may be converted into the other 2 estrogens (estrone and estriol) and helps to maintain the 400 effects of estrogen.

Estriol (E3)
Estriol is highest in pregnancy and it is an end metabolite/product of the other estrogens. Estriol can generally be utilized with confidence as there are not 'downstream' metabolites. Estriol has mild estrogenic effects and is much weaker than Estradiol. Estriol restores vaginal integrity and may be effective in reducing the number of recurrent urinary tract infections (UTI).

Progesterone
Progesterone is not the same as Progestin (a synthetic form of progesterone). Progestin's (also known as Medroxyprogesterone Acetate) are not biologically identical to natural progesterone due to their chemical alteration. Because they are not the same drug, synthetic progestins do not share the positive actions of natural Progesterone. Similarly, natural Progesterone does not share the negative side effects of synthetic progestins.

Progesterone is a potent intracellular metabolite
Progesterone is a neurological relaxant that may help reduce the frequency and intensity of migraines. Progesterone is needed by GABA receptors in the brain and to balance the effects of estrogen. Short term exposure to progesterone stimulates tissue and prolonged exposure causes cells to mature and differentiate. There are also numerous benefits for the cardiovascular system. If progesterone is not balanced with estrogen, it may raise blood sugar and put one at risk for diabetes. Balance is the key in hormone therapy.

High Progesterone
Excess progesterone may cause any of the following symptoms:

Testosterone in WOMEN
Testosterone may help to increase bone mineral density, libido and improve quality of life. It is an anabolic hormone that may build and strengthen the tissues of the bones, urogenital tract, and muscle. All sex hormones decline with age; it is important to maintain proper testosterone levels as it may have positive effects on estrogen balance, cortisol balance, sex drive, intensity and response and as a vasodilator.

Testosterone Excess in WOMEN
The following are some of the symptoms of testosterone excess:

DHEA
DHEA is a hormone made by the adrenal glands. Small amounts are also made in the brain and skin. DHEA opposes cortisol, therefore it may be important in stress regulation. DHEA production declines with age, starting in the late 20's. By age 70, the body may only make one-fourth of the amount it did earlier in life. DHEA may be converted into estrogen, progesterone and testosterone. In post menopausal women, DHEA may promote bone growth, brain function, and sense of well being.

Possible Functions of DHEA
The following are some of the possible functions of DHEA:

Note that high DHEA (along with high triglycerides) may be a sign of insulin resistance.

Thyroid
Thyroid hormone affects muscle metabolism, determines metabolic rate, and energy utilization by tissue. If thyroid is low, you may not be able to build muscle and may feel tired or sluggish. Decreased T3 production may raise low-density lipoprotein (LDL) levels. Research is pointing to a link between fibromyalgia and hypothyroidism. Thyroid hormones decrease Cortisol, so make sure your cortisol level is within acceptable limits prior to taking thyroid medication.

Hypothyroidism: Low Thyroid
There are many things to consider with a diagnosis of hypothyroidism. If a patient is receiving estrogen supplementation, she should monitor her levels, as a high estradiol or estriol level may decrease thyroid function. Thyroid hormone directly interacts with cortisol, progesterone and the estrogens, therefore all levels must be monitored. The following are some of the symptoms of hypothyroidism (low thyroid):

Iodine and Iodide
Iodine and Iodide directly affect the body's ability to make thyroid hormone. It is best to supplement with both since different tissues concentrate different forms of iodine. One third of the patients being treated for hypothyroidism will need to lower their dose of thyroid hormone once an iodine deficiency is corrected.

Cortisol
Cortisol is made in the adrenal glands and is considered a catabolic hormone. This means that it breaks down tissue as part of the normal cycle of remodeling. It is considered the 'stress hormone' and may modulate immune function, raise blood glucose, and store fat for energy.
Cortisol may also displace progesterone from its receptor site and cause symptoms of estrogen dominance. Cortisol suppresses production of testosterone by competing with it at the DNA level.

Cortisol Excess: "Wired but Tired"
In excess, Cortisol may complicate or cause the following:

Stress
Stress has been linked to all the leading causes of death: cardiovascular disease (CVD), cancer, lung ailments, accidents, cirrhosis of the liver and suicide. 43% of all adults suffer stress-related adverse health effects and 75-90% of all visits to primary care physicians are for stress-related complaints or disorders. An estimated 1 million workers are absent each day with stress related complaints, resulting in more than 25 billion workdays lost annually because of absenteeism.

Effects of Stress
Stress may increase blood pressure, heart rate, heart contraction, blood flow to active muscles, muscular strength, mental activity and metabolic rate. At the same time stress may decrease blood flow to areas not needed for rapid activity, such as the kidneys and intestines. It may dilate pupils and bronchial tubes, release glucose from the liver, shunt blood from the gastrointestinal (GI) system and decrease the function of the immune system.

Mental Effects of Prolonged Stress
Stress directly affects our mental health. Prolonged stress may lead to metal fatigue and a loss of spontaneity and creativity, as well as confusion, including forgetfulness and difficulty making decisions. Stress also may cause anxiety including feelings of panic, tension, frustration, irritability, anger, resentment, depression, decreased feelings of self worth, decreased intellectual functioning and boredom.

Social Ramifications of Prolonged Stress
The social implications of stress may include loss of health, love, position, and security. Prolonged stress may lead to procrastination (avoiding responsibilities at work and home), lack of concern for others (which may result in deterioration of relationships), reduced effectiveness in communication (including an inability to listen to others), emotional hypersensitivity with a tendency to overreact to others, or feelings of isolation and alienation with a tendency toward suppression of feelings resulting in withdrawal. You may feel as though you have lost control, be quick to anger and aggressive; many people become involved in high risk behaviors such as gambling, drug use and alcohol abuse.

Stress Related Illnesses:

How are my hormones tested in urine?
A 24 hour urine collection will reveal how your body is metabolizing and using your hormone. We will be able to detect what happens to your hormones in a 24 hour compared to blood, which is just a snapshot of what occurs in your body at that time when the blood is drawn. In other circumstances, we might choose to use overnight urine collection (urine collected during the night or first void in the morning). The 24-hour and the overnight correlate well. We work very closely with the laboratory to assure accuracy in order to obtain adequate interpretation. In other circumstances we do choose to do saliva testing. We might choose to use both blood and urine in order to help out for interpretation. Medicine is an art and not a cookbook recipe and every individual is different and unique.

Conclusion:
At Eterna M.D., our medical doctors will customize your plan based on your needs. Our evaluation is comprehensive and is 50-70% lower in cost compared to other clinics around the country