Male Sexual Health Issues Presented by Dr. Paul E. Perito

Urological surgeon Dr. Paul E. Perito says that the male reproductive system may present unusual symptoms.

There are literally dozens of issues that can affect a man’s sexual well-being, says Dr. Paul E. Perito. Many are well known, like erectile dysfunction, but there are other issues, such as retrograde ejaculation, that aren’t in the spotlight as often. In this brief article, Dr. Paul E. Perito offers information on some lesser-known defects of the male reproductive system.

Hematospermia – This condition is associated with discolored ejaculatory fluid, reports Dr. Paul E. Perito. It is widely believed that the majority of cases come from irritation to the prostate or the seminal vessels. In itself, hematospermia is not considered life-threatening condition, although in rare cases, it can present as a symptom of prostate cancer and should be checked out by medical professional, cautions Dr. Paul E. Perito.

Gender Identity Disorder: While it is not considered a physical disorder, gender identity disorder can affect a man’s ability to have sex, due to the emotional strains of severe discomfort in his own body, says Dr. Paul E. Perito. GID is characterized predominantly by the individual’s disassociation with his or her own naturally assigned gender. Dr. Paul E. Perito reports that after prolonged and comprehensive care by a mental health professional, individuals may initiate transformation of their body into the opposite sex, via surgery or hormone treatments.

Micropenis: According to Dr. Paul E. Perito, micropenis is a condition characterized by an extremely small penile shaft. In order to diagnose micropenis a surgeon will take into account both the circumference and length of the penis. Hormonal abnormalities are often the cause of this condition, which is usually identified shortly after birth, reports Dr. Paul E. Perito.

Priapism: Priapism is described as a persistent erection that is not associated with arousal, cites Dr. Paul E. Perito. Left untreated, this condition can cause structural damage as well as loss of function of the penis. Risk factors for this condition include sickle cell disease and other hematologic disorders, says Dr. Paul E. Perito. Minimally invasive surgical techniques may be used to help blood from the penis drain naturally. Less commonly, reports Dr. Paul E. Perito, a surgeon will have to create a shunt so that the blood can drain back into the body.

Penoscrotal Web: This condition gives the appearance of a “Turkey Neck” on the underside of the penile shaft. The condition may be congenital – present at birth – or the effect of an overly aggressive circumcision, reports Dr. Paul E. Perito. Surgical correction of a penoscrotal web is an outpatient procedure that involves a re-creation of the natural penoscrotal angle or a Z-plasty, which redistributes skin and renders a natural look.

According to Dr. Paul E. Perito, this is not a comprehensive list of male sexual disorders and notes that there are many issues that science has yet to find a treatment for. He recommends consultation with either a primary care physician or urologist for issues regarding male sexual health.


Dr. Paul E. Perito graduated from the University Of Maryland School Of Medicine in 1988. His Coral Gables, Florida, urology center, Perito Urology, draws patients from around the globe for its innovative and updated Erectile Dysfunction treatments. Having successfully performed over 3,000 penile implants since 2005, Dr. Paul E. Perito is considered a leader in the field. His signature minimally invasive technique, The Perito Approach, has been taught to surgeons worldwide through travel and at Coral Gables Hospital, where he is Director of Urology. Dr. Paul E Perito has participated in countless medical studies in his quest to simplify the penile implant process and make the procedure safer for his patients.

Interview with Joe Aldeguer at the Los Angeles Premiere of “Nobody, Nobody But Juan”

Interviewer: Hey what’s up guys? In case you guys didn’t know, this film has people working from the back, and part of the cast, all in one. Great movie. I actually have one of the co-executive producers with Nobody, Nobody But Juan. I have to ask, how is it working with the comedy king?

Joe Aldeguer: You know, initially you’re definitely intimidated. It’s Dolphy—the king of comedy.  From the moment he says “hello” to you—he’s Dolphy. He treats you just like you’re one of his family. He’s absolutely unbelievably humble. That was really a surreal event. But immediately the surrealness just goes away.

Interviewer: Cool. You know what? I forgot to ask a lot of the people that I interviewed—. Give me a few names of the people in the cast.

Joe Aldeguer: Well, there is of course Eric Quizon who plays his son and my brother in the movie. He’s also the director of the film. There’s G. Toengi. There’s Pokwang. There’s Willie Revillame. He does a special appearance and a guest on there. There’s Heart Evangelista. There’s of course Eddie Garcia, Gloria Romero. The cast is a long cast.

Interviewer: It sounds like a star-studded cast.

Joe Aldeguer: Yeah. There’s also Epi Quizon, and also Vandolph.

Interviewer: So you have, like, the Quizon is president of the movie. I have to ask, what is the fondest moment you have with making the movie?

Joe Aldeguer: Well, the fondness is obviously, you know, coming from the United States—this was my first project in the Philippines. The vastness of the movie. There’s a lot of moving parts in the film—a lot of film crew, there’s truck loads, and the entourage that comes with the Dolphy name.

Interviewer: Would you say it’s like culture shock of having films independently made here to films being made over there?

Joe Aldeguer:Well, yes, because there are so many more people involved there because, of course, you know, it’s easier to make a movie in the Philippines but it’s more fun.  Being Filipino-American you feel home right away. It was my first time in the Philippines as an adult. But as soon as you walked off the plane you feel like you were home. You know what I’m talking about?

Interviewer: Cool. I know with the scripts and whatnot is it exactly what you guys envisioned it out to be?

Joe Aldeguer: Reading the script it comes out so differently than what you actually see in the film. There’s a lot that goes into the film. The scenes are definitely a lot more vivid than real life, of course. And also the script changes a lot. Of course working with Dolphy who is the king of impromptu –he absolutely ad libs everything. But he ad libs it to make more of it, to involve more people, to have more fun with the film.

Interviewer: I hear he makes everybody so comfortable on the set trying to work with him. So everybody is not nervous around him.

Joe Aldeguer: Not at all. Again, it’s a big family affair. Really the whole cast becomes Dolphy’s family—the whole thing becomes like a big extended Dolphy family.

Interviewer: It sounds really great. You guys make sure to check out Nobody, Nobody But Juan. Let’s go ahead and invite our viewers out there.

Joe Aldeguer: Well, real quickly. This is going to be the first Filipino film that is going to hit AMC Theaters or mainstream theaters in the United States. The first film. And who better to represent our culture or our films than Dolphy, Dolphy himself. Sixty-five years is the anniversary this year. In the L.A. area it’s going to be in Covina and also Long Beach. AMC. And that’s February 26 through March 4.  For more information go to for other cities. It will be playing nationwide in different selected cities.

Interviewer: And this will be in AMC theaters?

Joe Vincent Aldeguer: AMC theaters—we are so excited to work with them. Not only, if it does well, which we think it will, it gets our foot in the door. Most Filipinos, as we get our foot in the door, we work very hard. We think it could be a step to bigger, bigger films in the future.

Interviewer: Great! You guys heard it straight from one of the producers of the movie and a part of the cast. Come by your nearest AMC theaters. It’s going to be out in Covina, Long Beach. So check it out. Nobody, Nobody but Juan. And the website again?

Joe Vincent Aldeguer:

Interviewer: Alright guys. That’s it for now. Thanks.

Dr. Paul Perito Presents Patient Testimonials about the Titan OTR Penile Prosthesis

Alfredo is a 59 year old Hispanic and patient of Dr. Paul Perito.

How did you find out about Dr. Paul Perito?

What I did was I went online and found  I wanted to find out who this doctor everyone was talking about in South Florida was. So I went online and I learned that Dr. Paul Perito is a leader in his field. I like the way he does the surgery. His success rate, where he went to school, etc. So I learned a lot about the man and then I went on to, which is the manufacturer of the implant and I learned about how the implant was produced in all of the wonderful things that the implant and Dr. Paul Perito are doing for men all over the world.

How did you decide to get the Titan implant?

Dr. Paul Perito explained that Titan has a unique valve. I think it’s called the lock itself. And what brought my attention was that that valve prevents the implant from activating itself in any given situation. So you really have to activate the implant yourself. If you sit or cross your legs, the implant will not activate itself and that’s good to know.

How is your life after the implant?

My life turned around 180°. Just like I told Dr. Paul Perito, I’m not depressed anymore. I don’t suffer from anxiety. I look at life in a different way, I’m having the greatest time with my wife, she’s happy…I’m happy.

What are the main concerns about getting the implant?

I think the main concern is the feeling. Is it different than before? And I tell them no, it’s actually better. Because before you have to worry should I slow down, should I go faster, if I have an orgasm… That’s the end of it. With the implant, you don’t have to worry about that.

Are your orgasms different now that you have the Titan implant?

They are much better. They’re more intense because I have the peace of mind that I’m not going to reach orgasm and go flaccid. Before this implant, “my friend” would go up and down when he wanted. Now he goes up and down when I want him to, with no side effects. I was worried that after my surgery with Dr. Paul Perito that I would lose some sensation. I have not.

Is there anything you wish you would have done differently?

I would’ve done this 10 years ago. Instead of going through all of the injections, the Viagra, the hassles…if I would’ve known about Dr. Paul Perito and the Titan OTR, I would’ve done it at least 10 years ago.

What do you want men to know about getting an implant?

I would advise them to go and see Dr. Paul Perito, because he is the top doctor in his field. And he will help you. He is very frank – he will tell it like it is.

What advice would you give a man suffering with erectile dysfunction?

I would tell him not to be afraid of the unknown. This implant is the best thing – go and do it. Go and meet with Dr. Paul Perito. Because the other methods, yes they work but they are only temporary. And to think, now, that for whatever number of years I’ve got left on this Earth, I can live a happy sexual life. All thanks to Dr. Paul Perito and the Titan OTR implant.

For more information about Dr. Paul Perito or schedule an appointment, please contact the office at 305-444-2920.


Dr. Paul Perito is a 1988 graduate of the University Of Maryland School Of Medicine. His practice, Perito Urology, is considered one of the foremost Erectile Dysfunction treatments centers in the world. Since 2005, Dr. Paul Perito has successfully performed more than 3,000 penile implants, establishing him as a leader in the field. He has streamlined the procedure, making it not only more efficient, but safer, by the development and actualization of a minimally invasive approach. Aside from contributing extensively to medical publication libraries, Dr. Paul Perito heads the training center at Perito Urology where his technique is taught to an audience of surgeons from across the globe.

The information contained in this article is provided by Dr. Paul Perito for educational purposes only. It is not intended to treat or diagnose any condition.

The Balancing Act on Lifetime with Dr. Leslie Zebel

The following segment aired on The Balancing Act on Lifetime Television. Joining the show was licensed mental-health counselor, Dr. Leslie Zebel, to discuss what is needed for healthy relationships and what is needed to be left behind in past relationships.

The Balancing Act Lifetime Host Beth Troutman:  We’re always welcoming relationship advice that we can all benefit from whether we’re in one or we’re looking for one. Dr. Leslie Zebel is a licensed mental-health counselor and is joining us on The Balancing Act to talk about the things that you need in order to have a healthy relationship. Leslie, what are we looking for when it comes to a healthy relationship? What should we strive for in order for the relationship to succeed?

Leslie: The first thing I would think about is, what is your attitude about relationships? Most people just think that they’re one destructive disaster after another and they get upset because they don’t turn into marriage or they don’t turn into an engagement.  You should look at relationships like a learning experience and use that to learn, grow and have fun.

The Balancing Act on Lifetime Television: If someone seems to be having the same type or failed relationship, what would your advice to them be? Is it about them or the person that they are choosing? Please tell The Balancing Act viewers what the real issue tends to be.

Leslie: It is about them and there is a reason why they are choosing the people they are with.  A lot of times all of us will repeat emotional patterns. If you’re doing that then the same feelings are going to carry over to the next relationship and you have to look at why you keep doing that to yourself.

The Balancing Act on Lifetime Television: It seems that the emotional pattern is what really has to change. If we don’t change the type of person we choose then we have no hope of finding a healthier relationship than the last.  I know that a lot of this pattern is unconscious and we have to understand that as well.

Leslie: It’s very unconscious and I am sure some of The Balancing Act viewers are aware of this unconscious emotional pattern.

The Balancing Act on Lifetime Television: There’s an underlying issue that needs to be brought to the surface and dealt with. People seem to carry their issues from one relationship to the other, so how do we change those patterns?

Leslie: People do carry their emotional baggage with them and they also find that they’re communicating in similar ways in these new relationships. They find themselves in similar destructive patterns that they’re finding themselves either being criticized or they’re feeling like a victim in relationships, they’re feeling judged and losing themselves. When that starts to happen, its lack of skills on their part and their partner’s part.  Both partners need to have very good, healthy communication skills that are kind and caring which makes each person feel good about themselves.

The Balancing Act on Lifetime Television: What else should we be striving for? How do we work toward getting to that place? What are the things that we should focus on?

Leslie: I think that you need to focus on getting yourself as healthy as possible. If you go into a relationship depressed, you’re just going to have a depressed relationship. If you work on being the best you can be, sharpening your communication skills and your conflict resolution skills, then you will learn how to feel good about yourself.  Then you are going to have better relationships and you are going to choose people who have those similar parts in themselves.

The Balancing Act on Lifetime Television: How big of an issue is forgiveness and how do we know when to forgive and when to walk away?

Leslie: Forgiveness is learned and a lot of times we do exactly what we saw our parents do.  Forgiveness is a day-to-day thing that involved the little things and the big things in life.  To forgive is to make the choice that you want to and it is a process.  Working through the sadness and disappointment and being able to put it behind you and not bring it up in another relationship and clobber your partner with it.

The Balancing Act Lifetime Television: Thank you so much for sharing so much important information with The Balancing Act viewers and family.

The Balancing Act on Lifetime Television is the only morning show in America produced by women specifically for women. Every morning, The Balancing Act on Lifetime hosts Danielle Knox and Kristy Villa tackle the issues that face today’s woman. Popular show segments include Live weather updates with Mark Mancuso, surprise celebrity visitors, and news about the latest trends affecting your life, home, career and family. The Balancing Act on Lifetime Television airs daily on Lifetime at 7 a.m. ET/PT. For more information, visit The Balancing Act on Lifetime Television’s website at

BrandStar Entertainment’s The Balancing Act with Lisa Dorfman and Chef Ozzie

The following segment originally aired on the January 26th, 2011 show on BrandStar Entertainment’s morning TV show, The Balancing Act on Lifetime Television.  The featured guests were Nutritionist Lisa Dorfman and Chef Ozzie from Heartland Sweeteners.

BrandStar Entertainment – The Balancing Act on Lifetime: It’s the New Year and that means that you get a “clean slate.”  You can start all over and maybe do thing a little differently in 2011.  One thing that many of us in this country need to change is our eating habits.  Putting the right foods in our bodies and cutting out the wrong stuff with not only help us look great for the New Year, but it will also make us FEEL great.

BrandStar Entertainment – The Balancing Act on Lifetime: BrandStar Entertainment’s popular “New Year- New You” series on The Balancing Act on Lifetime is going to help clear up any confusing details about our food with Nutritionist, Lisa Dorfman and we’ll get some fabulous recipes to get us on track to staying healthy in the New Year from Chef Ozzie from Heartland Sweeteners.

BrandStar Entertainment – The Balancing Act on Lifetime: Lisa, there’s so much info out there when it comes to some of the bad things we could put into our bodies.  Fats confuse everybody, so let’s start with the bad fats.

Lisa: The bad fats as we know them are the hard fats at room temperature.  Things like butter and lard not only put on pounds, but also can clog our arteries and increase our blood pressure.  They’re just not generally good for our health.

BrandStar Entertainment – The Balancing Act on Lifetime: What about the bad fat category called—trans fats?

Lisa: I call the trans fats the Frankenstein of fats because they were created in a lab a couple of decades ago when companies wanted to pull out the cholesterol and the animal fats from their products.  What happened was they put in some oils, but the oils didn’t hold at room temperature.  So, they added back and made them more saturated again—creating these trans fats.  These trans fats are worse than any of the saturated fats on the market.  At a very quick rate, they build up cholesterol in our bloodstream, bring up our blood pressure and cause all kinds of metabolic and health problems for everyone—young and old.

BrandStar Entertainment – The Balancing Act on Lifetime: That’s what we don’t want—but we do need some GOOD fats in our system, right?

Lisa: Yes.  We do need fats in our diet.  Fats help us to absorb the fat-soluble vitamins “A” and “D.”   “E” and “K” help us to prevent inflammation.  The good fats, known as the Omega-3s and the Omega-6s are essential fats that are found in vegetable oils and olive oils, are good for our health so we do want to include them in our diet.  We have some commercially prepared products now that contain a lot of those good fats.

BrandStar Entertainment – The Balancing Act on Lifetime: So, keep a smart balance but don’t overdo it?

Lisa: There is definitely too much.  On a 2-thousand calorie diet, most people don’t realize they only need between 44 and 66 grams of fat a day.  Like, when you go to those restaurants and you’re dipping away with the bread and oil—each tablespoon of olive oil has 14-grams of fat so that adds up very quickly.

BrandStar Entertainment – The Balancing Act on Lifetime: Let’s talk about Fat-Free.  Is that something that’s still important?

Lisa: Ok, if low fat is good for you—then let’s take out all the fat.  But, what happens is then there’s no taste.  So, what companies started doing was adding in a lot of sugar and other ingredients as well as processing.  It’s these things that created a lot more health problems and cravings.  You know, people don’t eat one cookie these days.  They eat a BOX!  So, it’s a huge problem.

BrandStar Entertainment – The Balancing Act on Lifetime: Chef Ozzie, you’re the guy who knows how to replace the sugar in these things.  So, let’s talk about Ideal No-Calorie Sweetener!

Chef Ozzie: Ideal is the best no-calorie sweetener on the market.  It’s made from Xylitol, which has added health benefits.  What’s unique about it is that you can bake and cook with it.  It’s wonderful and your guest would never know that you did NOT use real sugar.  In independent taste tests, consumer actually picked it over sugar!

BrandStar Entertainment – The Balancing Act on Lifetime: You’ve brought some great tasting things along with you.  Let’s talk about what you’ve replaced to make yummy pumpkin bread.

Chef Ozzie: This pumpkin bread is absolutely most and flavorful.  You put this on a table and no one would ever know that it’s actually GOOD for you and made WITHOUT sugar!  I made it with Ideal and I’ve also taken out the eggs and used egg substitute—so we’ve gotten rid of some of those fats.

Chef Ozzie: We’re also using alternative spreads.  You can use a 50/50 blend, or you can use a straight commercially prepared.  These new spreads out there are fabulous and you don’t even know they’re in the mix.  So, you can save not only the sugars and the calories from the sugars—but you’re saving all the extra fats too that you don’t need.  This pumpkin bread saves you 25-grams of sugar and 70-calories per slice.

BrandStar Entertainment – The Balancing Act on Lifetime: So, you’re not sacrificing any flavor, sweetness or ANY taste at all! Now let’s move on to that delicious looking chocolate cake!

Chef Ozzie: This is a no-dairy chocolate cake.  When I say, “No Dairy,” it’s actually healthy, moist and decadent!  In this cake we’re saving 44-grams of sugar and 100-calories.  Per slice!  We’re taking the fats out.  There’s no dairy in the cake, so there’s no eggs or butter.  I’m using other ingredients in there.

Chef Ozzie: All these recipes are in my cookbook and I personally like to use a lot of these different alternatives.  A butter alternative instead of butter—or you can do a 50/50.

Chef Ozzie: I like to use olive oil but NOT the extra virgin because of the very strong flavor.  I use just plain olive oils in the recipes, like canola and vegetable oils in lieu of some of the fats in there.  For example these muffins have a low-fat yogurt, a butter substitute, Ideal sweetener and oils.  So, I’m taking the fats out.

Chef Ozzie: In the cookbook I’ve really taken the sugar out of all the recipes, but these are all great tips that you’re not going to sacrifice a lot of the flavor.

BrandStar Entertainment – The Balancing Act on Lifetime: It’s time to move on to the muffins!  They look like raspberry?

Chef Ozzie: These are lemon-raspberry muffins.  We’re using fresh raspberries and fresh lemon.  I just like to use all fresh ingredients, even fresh pumpkin seeds on the pumpkin bread.

BrandStar Entertainment – The Balancing Act on Lifetime: What about these cookies?

Chef Ozzie: These are oatmeal raisin.  I once again used the spread and great raisins.  These are traditional favorites—people love them.  A lot of kids love chocolate chip, but I really like these.  It’s good and healthy.  You have the oats and you’re using the spread instead of butter.  It’s a really good cookie and you’re not sacrificing flavor or sweetness with our product—Ideal.

BrandStar Entertainment – The Balancing Act on Lifetime: Chef Ozzie, you’re getting people ready for the New Year because you can still have delicious food and you’re saving yourself so many calories and sugar– a perfect way to get on track for the New Year!

BrandStar Entertainment – The Balancing Act on Lifetime: If you would like more information on Ideal No-Calorie Sweetener, visit  To check out more tasty and sugar-free recipes, check out Chef Ozzie’s Cookbook, “Sweet Revolution.”

The award-winning television production team at BrandStar Entertainment is one of the industry’s leaders.  BrandStar Entertainment features a full array of creative services that include distribution, sound stages and production/post production facilities. BrandStar Entertainment is known for producing content driven shows like The Balancing Act on Lifetime Television, the only morning show in America produced by women specifically for women. BrandStar proudly carries a WomenCertified® Seal, demonstrating leadership in women friendly programming. BrandStar Entertainment’s The Balancing Act airs daily on Lifetime at 7 a.m. ET/PT. For more information, visit BrandStar Entertainment’s website for The Balancing Act at

A Vision is Born: How Madison Pharmacy Associates Revolutionized the Field of Women’s Health

Madison Pharmacy Associates’ founder Marla Ahlgrimm saw the need to start a pharmacy specializing in women’s health when she realized her own boss was unsupportive of the work she and her associates were doing to help women manage the symptoms of PMS. “Women are all neurotic anyway and should be on tranquilizers,” Madison Pharmacy Associates’ Marla Ahlgrimm recalls the manager saying.

Still, starting a new business isn’t easy. When she and a colleague decided to found Madison Pharmacy Associates, a Madison, Wisconsin based business focused on women’s health, she found almost everyone tried to talk her out of it. Financial institutions balked at the idea and the Madison Pharmacy Associates founders learned they’d have to interpret state and federal regulations to meet their own business’ specialized focus.

According to Madison Pharmacy Associates’ Ahlgrimm, most Americans had never heard the term premenstrual syndrome or PMS, although research had been done in Europe on the syndrome. Madison Pharmacy Associates focused on developing unique treatments for women dealing with irritability, mood swings, depression, headaches and other moderate to severe symptoms each month.

Because PMS was a new field, Madison Pharmacy Associates had to develop all of the educational materials. The staff at Madison Pharmacy Associates introduced customized natural hormone prescription compounding which is now provided from pharmacies through out the country.

Madison Pharmacy Associates’ Marla Ahlgrimm, R.Ph. recalls the challenges of starting a new business. “Gearing up to start a small business means confronting questions about financing,” states the co-founder of Madison Pharmacy Associates.  “How will I know how to do everything from bookkeeping to managing employees? What if I make a wrong decision?  Will I have the energy to make the business grow?”

Over time, Madison Pharmacy Associates worked through all of these issues and more, becoming one of the country’s foremost leaders in the field of women’s hormonal health. Beginning small—in the early days, Madison Pharmacy Associates was only 700 square feet—Madison Pharmacy Associates gradually added experienced pharmacists, nurses, and health educators who added to Marla Ahlgrimm’s vision.

“In contemplating starting a business, the most important challenge lies in evaluating and following your personal values which, while tangible and immeasurable, not only define your path to success, they insure it,” Marla Ahlgrimm, co-founder of Madison Pharmacy Associates, concludes.

The information in this article has been previously published and is provided as a reference resource by Marla Ahlgrimm, R.Ph. Madison Pharmacy Associates was sold in 2011. Marla Ahlgrimm is also the co-founder and President of Cyclin Pharmaceuticals, Inc. The company sells proprietary products for the women’s health market as well as ProCycle PMS and ProCycle Gold products. For more information, go online to

Pharmacist Marla Ahlgrimm Explains the Process of Screening for Thyroid Problems


As a woman gets older, she may dismiss symptoms like fatigue, weight gain, and painful joints as a natural part of the aging process. But Marla Ahlgrimm, founder of Women’s Health America, regularly sees patients suffering from these very symptoms and, in some cases, hormone therapy can return a woman to a happy, healthy life. Marla Ahlgrimm reports that, according to the National Thyroid Institute,

millions of women have been diagnosed with hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) and many more remain undiagnosed. A pioneer in the field of women’s health, Marla Ahlgrimm explains that thyroid related symptoms can mimic some symptoms of PMS and menopause making treatment frustrating if symptoms don’t improve. Several tests are available to identify thyroid problems early and begin treatment, Marla Ahlgrimm says.

The better way to test, Marla Ahlgrimm explains, is to use the sensitive serum TSH test combined with a “free T4 and free T3” test. This is the most thorough and accurate test, and according to Marla Ahlgrimm, it’s sensitive enough to identify thyroid disease even in its earlier stages. “TSH is thyroid stimulating hormone, produced by the pituitary gland,” pharmacist Marla Ahlgrimm, co-founder of Madison Pharmacy Associates, states. “TSH stimulates the thyroid gland to produce triiodothyronine (T3) and thyroxine (T4), which regulate the metabolism of fat, protein, and sugar.” Hypothyroidism happens when the TSH level is high, T4 level is too low, or when the T4 level is normal and T3 level is low.

The thyroid testing test can be expensive, but Marla Ahlgrimm points out that the price has decreased over the years. The test involves a blood sample which must be analyzed by a laboratory and most clinic laboratories perform this test. The test should always be done in women of menopausal age, Marla Ahlgrimm recommends, and three main factors should be taken into consideration before undergoing the sensitive serum TSH test: family history, presence of an autoimmune disease, or enlarged thyroid or goiter.

According to Marla Ahlgrimm, co-founder of Madison Pharmacy Associates, additional tests are available, such as a “free T4 and free T3” test. But this test measures the amount of T4 and T3 that is “free” or available to act in the thyroid receptors as compared to total T3 and Total T4 where much of the thyroid hormone is bound to protein and unavailable.

Hypothyroidism: Underactive Thyroid

Hypothyroidism has two forms, says Marla Ahlgrimm, primary and secondary. In primary hypothyroidism, the thyroid itself malfunctions, producing too little T4 and causing symptoms such as fatigue, weight gain, and depression, explains Marla Ahlgrimm. Primary hypothyroidism can be caused by disease or an autoimmune condition, according to Dr. Marla Ahlgrimm. Secondary hypothyroidism has several causes. One can be that the pituitary gland isn’t producing enough TSH. Unlike primary hypothyroidism, the pituitary gland is malfunctioning instead of the thyroid, Marla Ahlgrimm says. While the causes may be different, the results are similar—you may feel lethargic and depressed, among other symptoms. The thyroid test can detect both primary and secondary hypothyroidism, signaling your doctor to do further tests, adds Marla Ahlgrimm.

Probably the most common cause of thyroid deficiency symptoms in aging women is due to subclinical hypothyroidism when TSH is slightly elevated and T4 and T3 are low.

Prescription Options

Pharmacist Marla Ahlgrimm says many doctors will prescribe Synthroid, which is a synthetic form of T4 but many others prefer natural thyroid or desiccated thyroid.  One brand is called Armour Thyroid which contains T3 and T4 as well as other thyroid hormone derivatives naturally found in the thyroid gland. Your doctor also can prescribe a customized thyroid hormone prescription prepared by a pharmacist for you. Available both in a prescription tablet and capsule form, thyroid must also be closely monitored, cautions Marla Ahlgrimm.

For more information, contact Marla Ahlgrimm at