Bio-identical Hormone Balancing and Hormone testing

Bioidentical Hormone Balancing

Cynthia Furnberg, NP featured in Southbay Magazine November, 2015Cynthia Furnberg, NP featured in Southbay Magazine November, 2015Hormones may become out of balance during our adult life causing certain signs and symptoms. Our hormones also decline as we age. Bioidentical hormones are hormones that have the same chemical structure as the hormones that your body secretes. Cynthia only prescribes bio-identical hormones. Some of the hormones that can be tested and supplemented are as follows:

Vivelle DotEstradiol

Women: Before menopause this needs to be tested during the latter portion of a woman's cycle (day 21) along with progesterone to analyze the ratio amongst the two hormones. After menopause, this may be tested on any day of the month. High estradiol (estrogen) can cause a woman to be estrogen dominant causing premenstrual symptoms such as breast tenderness, bloating, mood changes, and more. Low estrogen menopause can cause hot flashes, night sweats, insomnia, mood changes, osteoporosis and slight weight gain, as just a few of the symptoms. Estradiol can be supplemented using FDA approved bio-identical hormones, such as patches shown to the right, creams, gels, topical sprays, vaginal rings, and compounded creams.

Men: As men gain central body fat, their estradiol can increase. Increased estradiol can increase sex binding hormone globulin, which can decrease the man's testosterone levels. Excess levels of estradiol can contribute to causing prostate cancer.


This is an estrogen that increases with increased central body fat, and becomes the main estrogen secreted after menopause.


prometriumThis is a hormone that is secreted after ovulation in women, and is tested to determine whether it is at a proper level to properly oppose the estrogen so as to prevent symptoms. This hormone can be supplemented using FDA approved bio-identical progesterone in a gelcap, or topical creams.


AndrogelAids in maintaining proper libido, strength, weight, bone density, drive, and mood. High testosterone can cause acne, unwanted hair growth in women, oily hair and skin, and irritable attitude. As men age, their testosterone levels decline causing symptoms. Testosterone can be supplemented in men using FDA approved bio-identical topical gel called AndroGel, or compounded creams. For women, creams can be compounded or levels might be raised by using DHEA or by using herbal supplements.

DHEA (dehydroepiandrosterone)

Helps to boost the immune system, and is a precursor to estrogen and testosterone. When women are supplemented with this hormone, it generally will convert to testosterone. Therefore, it can be a nice method to raise testosterone levels in women that have low levels. Although, this hormone can be anti-cortisol, so cortisol levels must be tested, also. When men are supplemented with this hormone, it is generally converted it to estradiol, so follow up testing is needed to determine if this is occurring. If so, herbs may be given to block the conversion.


This hormone causes unwanted hair growth on men and women. It can also cause hair loss on the top portion of the head. In men, excess levels can contribute to causing prostate cancer.


Aids with providing energy, controlling proper blood sugar levels, and controlling proper immune function. If cortisol is too high, the patient will experience weight gain and muscle loss. Low cortisol levels from chronic stress will cause fatigue, poor immune function, allergies, intolerance to cold temperatures, low coping skills, cravings for salt, sugar, and caffeine, suspicious thinking, low blood sugar, and low blood pressure. For low cortisol levels, adrenal supplements may be used to help support the adrenal glands.


Aids in mental function, appreciation of art, and is the mother hormone that helps to supply all of the above hormones. Pregnenolone can be converted to into progesterone and cortisol when they are low, which can then cause low levels of pregnenolone. This hormone can be taken as a supplement.

Thyroid hormone

When this hormone is low, the patient can be fatigued, have cold hands and feet, high cholesterol, weight gain, constipation, poor mental focus, hair loss, brittle nails, and loss of outer third of eyebrows. If this hormone is borderline low, thyroid supplements can help improve thyroid panel blood levels.


There are many other blood tests that are used for assessment of optimal aging at standard lab companies. We also have very specialized testing from cutting-edge lab companies. Click here for more information about specialized lab testing.


Rates: The initial office visit is $275.00 for one hour. Follow-up visits are $175.00. Insurance is not accepted for office visits, but they can be covered by your HAS or FSA account. Insurance may be used for lab costs, It is best to find out what your policy covers for lab testing, or if they have a deductible that must be met, before having blood drawn.

10 Most Asked Questions

1. How are hormones balanced?
Lab tests and symptoms are reviewed, and then bioidentical hormones (hormones that have the same chemical structure as the human body) or supplements are prescribed to treat imbalances or deficiencies. Follow up testing is also done to evaluate the therapy.
2. Will hormones or supplements help with fatigue?
Yes, if there are deficiencies in thyroid hormones, cortisol, estrogen, testosterone, growth hormone, minerals, vitamins or protein levels.
3. Will hormones or supplements help to prevent weight gain?
Yes, maintaining optimal levels of hormones, vitamins, minerals and protein, and preventing toxic levels of heavy metals, will help to prevent weight gain when eating appropriately, to allow for proper function of your metabolism.
4. Will hormones or supplements help with PMS?
Yes, if you have a deficiency in progesterone or certain nutrients.
5. Will hormones or supplements help with my hot flashes?
Yes, if you are low in estrogen, cortisol, serotonin, or GABA.
6. Will hormones or supplements help with anxiety or insomnia?
Yes. Your neurotransmitters can be tested, and natural supplements can be used to support deficiencies in the calming neurotransmitters, such as serotonin and GABA. Progesterone can also aid with sleeping.
7. Do men need to replace hormones?
Testosterone declines for men starting around their forties. As time goes on, it often declines to half of what it was in one's twenties, which can cause weight gain, irritability, low libido and reduced confidence.
8. What about Human Growth Hormone (HGH)?
Growth hormone cannot be legally prescribed unless a patient is deficient based on their lab results. This is uncommon as the "normal range" on lab reports gets lower and lower based on the age of the patient. Although, supplements can be used to increase levels.
9. Will hormones or supplements help prevent wrinkles?
There are receptor sites for hormones in the skin that can increase collagen along with certain amino acids, vitamins and minerals. Correcting deficiencies along with avoiding sun exposure, and having a good skin care regimen covers all the bases.
10. Do you take insurance?
You can use your insurance for your lab testing and prescriptions. You can use your FSA or HSA to cover your visits. You will receive a superbill that you can submit to your insurance to use toward your deductible or to obtain partial reimbursement, if you have a PPO.
Hormone Balancing/Functional Medicine for Women:
The most common issues that women seek hormone balancing for is PMS, fatigue, anxiety, insomnia, food allergies/sensitivities, testing of nutrient or heavy metal levels, and menopause.
Hormone Balancing/Functional Medicine for Men:
Men are usually interested in replacing testosterone when the levels become deficient, or they are interested in testing of vitamin, mineral, amino acid, fatty acid or heavy metal (mercury) levels.

Cynthia Furnberg is a board certified nurse practitioner who is a credentialed menopausal practitioner who has her Master of Science degree in nutrition, and is certified as a nutrition specialist. She has been practicing hormone balancing and functional medicine for men and women since 2005.

For more information on Functional Medicine, click here.