Hypothyroidism 12 Common Symptoms. Is It Time To Call Your Doctor?


Hypothyroidism also known as an under active thyroid, presents with a variety of symptoms. These           symptoms arise because your thyroid is not making enough thyroid hormone. When this  occurs it causes a slowing down of all your bodies processes. Here are common symptoms that indicate you  may have hypothyroidism.

  • Fatigue: Hypothyroidism, one of the main symptoms, and often the first sign of hypothyroidism is fatigue. Without enough hormone your body slows down. You may have trouble getting up in the morning despite getting 8 or more hours of sleep each night..
  • Weight Gain: Hypothyroidism slows your metabolism down, which can make you gain weight, even though  you eat healthy and exercise.
  • Feeling Cold: Without adequate thyroid hormone to keep your metabolism active, you may feel like you are always cold no matter what the temperature is.
  • Depression: Hypothyroidism can also cause mood disorders like depression and or anxiety. It can also worsen symptoms in people who already have depression. If your mood is low, get your thyroid checked.
  • Memory Problems: Low thyroid hormones cause a slowing of all processes in your body including your brain. You may have difficulty focusing, problem concentrating, suffer from mental fatigue, and problem with short term memory. Although there are many causes, your thyroid could be the problem.
  • Muscle and Joint Pains: Hypothyroidism can cause your muscles and joints to hurt. The pain can be severe enough to interfere with your daily activities. Left untreated some people can develop muscle profound weakness. Again there are many causes of joint, and muscle pain but if you have persistent aches and pains its time to call your doctor.
  • Carpal Tunnel Syndrome: If you have been diagnosed with carpal tunnel syndrome, you should make sure to have your thyroid levels checked.Hypothyroidism is a common cause of carpal tunnel syndrome. Symptoms can include numbness, tingling and or pain in your hands.
  • Constipation: Hypothyroidism is associated with slowing down of your digestion system, resulting in constipation. The thyroid can make your whole digestive system “lazy”. The proper blood test may reveal its due to low thyroid hormone.
  • Change in Menstrual Cycle. You may develop lighter periods or even skip your menstrual cycle if you thyroid hormones are low. A change is your cycle may indicate thyroid disease.
  • Infertility: If your thyroid is underactive it can interfere with your fertility. Talk with your doctor about checking your thyroid if you are having fertility problems.
  • Elevated Cholesterol: If you have elevated cholesterol, your thyroid may be to blame.
  • Dry Hair and Skin: You can develop dry hair and skin. Some people also notice hair loss. A classic sign of hypothyroidism is the absence of hair on lateral one third of your eyebrows.

In addition if you have a family history of hypothyroidism you are at an increased risk of developing an underactive thyroid. If you have any of these symptoms, it’s important to discuss these with your doctor. Make sure to discuss any family history of thyroid or autoimmune diseases. When asking to have your thyroid checked, make sure they do a complete profile and not just check your TSH. You should have FreeT4, FreeT4, RFreeT3, Thyroid antibodies and also have your adrenal function tested. If your adrenal glands are not functioning properly, they can cause your thyroid to not produce enough thyroid hormone. Additional testing may be indicated depending on your symptoms.

If you think you may have an underactive thyroid, we can help!

To schedule a consult with Dr. Betty Keller call 201 485 7930

Optimal Wellness Center 172 Franklin Ave Suite 4A Ridgewood NJ 07450


Are Your Hormones Balanced?

bioidentical hormone replacement therapy helps restore your optimal health

Bioidentical Hormone Specialist in NJ Explains Symptoms of Hormone Imbalance

Hormones are responsible for making your body run properly. And for optimal health they need to be balanced.

Our hormones play a major role in our body’s health. Hormones effect how we look, feel, and function.

Why Hormones Impact Health So Many Ways

Hormones are the chemicals that make things happen within the systems of our body. These chemical messengers control our metabolic processes by stimulating the cells in our bodies.

Your hormone levels change throughout your lifetime. You may notice changes in mood, weight, body composition, energy, and physical strength. Hormone balance is extremely important to have optimal health.

The same hormones that keep you happy and healthy, when out of balance can cause emotional and physical distress. Hormones are the most finely tuned systems in our body. It is a delicate balance; each hormone is depended on the other hormones to work properly.

What Throws Hormones Out of Balance?

Women with a healthy hormone balance enjoy long healthy and productive lives. Life stressors from working long hours, taking care of the family, commuting, poor sleep, unhealthy eating habits, environmental toxins and other forms of physical and emotional stress can disrupt our natural hormone balance.

Hormonal imbalance can make life challenging. Hormone imbalance can contribute to, common problems including, weight gain, mood disorders, PMS, perimenopausal, and menopausal symptoms. The following are some symptoms that can be caused by an imbalance in your hormones.

Symptoms of Hormone Imbalance

If you have any of the following symptoms, you may have a hormone imbalance.

  • Fatigue
  • Anxiety
  • Depression
  • Vaginal Dryness
  • Excess facial or body hair
  • Acne
  • Menstrual irregularities
  • Aches and pains
  • Thinning Hair
  • Dry Skin
  • Reduced Libido
  • Decreased Muscle Mass/Strength
  • Weight gain
  • Difficulty sleeping
  • Irritable/ Mood changes
  • Poor memory/concentration
  • Frequent/chronic infections
  • Headaches
  • Hot flashes and night sweats
  • Cravings for sweets/carbs
  • PMS

Bioidentical Hormone Therapy Treats Hormone Imbalance

Dr. Keller is a bioidentical hormone doctor, specializing in helping you look and feel your best.  Contact us about bioidentical hormone treatment at the Optimal Wellness Center, Ridgewood, NJ 201-485-7930.


Perimenopause and Menopause: New Hope for Difficult Symptoms

Treatment for difficult menopause symptoms

Experiencing difficult menopause symptoms? Some women seem to go through perimenopause and menopause without missing a beat. But others find themselves ‘dazed and confused’ by what is happening to the way they feel every day.

Many people think of menopause as the time when periods stop, and symptoms start. But most symptoms actually begin long before menopause. They start to appear during perimenopause — the time leading up to the end of menstruation. This is a longer period than most women realize — on average, four years before menopause, the time when a woman has had no period for a year.

Menopause Symptoms are Common but Intensity Varies

Some of the more common perimenopause and menopause symptoms are:

  • Hot flashes
  • Night sweats
  • Disrupted sleep patterns
  • Changes in emotional well-being

Unfortunately for some women, some symptoms become intense enough to throw them off keel. They experience:

  • Brain fog
  • Dizziness
  • Body aches
  • Panic attacks or intense emotional distress
  • Excessive fatigue

These symptoms can be too disruptive to ignore.

You may have tried to tell your friends what you’re going through but they don’t understand. All the other women your age may seem to be getting along and coping just fine. They might even tell you, however nicely, that you “get a grip” or “snap out of it” or just relax and have a glass of wine. They can’t sympathize; it’s a lonely place to be!

Unfortunately, doctors can also misunderstand that some women experience menopause differently. Maybe you’ve tried to get help from doctors, but felt like they saw you as ‘a complainer’ or with a weak tolerance for discomfort. Because it’s a normal phase of a woman’s life, some people may expect you to just take it in stride. The fact is, perimenopause is a very individual experience.

Your Experience Is What’s Normal for You

While perimenopause lasts an average of four years, your personal experience may vary. You are a unique individual, and average does not equal normal. For many women, perimenopause takes place for much longer than they expected. For some women, it lasts only two years, or takes as long as seven, 12, or 15 years.

It is possible for women to begin to notice menopause symptoms in their early forties. The average age of actual menopause is 51 years for women in the United States.

Each woman will experience symptoms in her own way. Your own symptoms may change in intensity over time. You may be surprised to know the number of women who experience severe perimenopause or menopause symptoms. Here are three groups of symptoms that may cause concern.

Sleep Problems

As many as 40-60% of women suffer from insomnia during perimenopause (says Medscape). Insomnia isn’t just a bad night’s rest. This is night after night of difficulty falling asleep, or of getting poor quality sleep. Insomnia often makes it hard for you to function during the day. It can be acute (noticed over days or weeks) or chronic (you’re wondering, after a month or more, if this will ever stop).

Emotional Symptoms

Many women notice changes in their emotional outlook, or shifts in their sense of well being during menopause. Unfortunately, the term ‘mood swings’ tends to lump together a wide range of experiences. It doesn’t mean these emotional changes should be a simple walk in the park for you.

Emotional symptoms during perimenopause range from mild crankiness, to feelings of depression or panic that are very intense and very real. Some medical experts estimate that 20% of women will endure depression during menopause (reports Medscape).

Women may be ashamed to admit anxiety, depression or panic attacks during the transition to menopause. High anxiety during perimenopause may be more common than most people imagine. The symptoms may include feelings fearful for no clear reason, feeling tense or irritable, or feeling the heart pounding, racing or palpitating.

One study found, for women with low baseline anxiety before perimenopause, about 13% experienced anxiety symptoms for years, reaching a peak level of high anxiety late in perimenopause. The good news, the study found, was that anxiety levels decreased for these women later in postmenopausal years.

Emotional health is complex. A woman may have good reasons for depression or anxiety in addition to hormonal changes. So it is important to discuss your emotional health with appropriate, qualified healthcare professionals you trust.

Changes in the Ability to Enjoy Sex

With decreasing estrogen levels, the walls of the vagina become thinner, and the skin of the vagina becomes more dry. This is because the number of folds in the lining of the vagina decreases over time with lower estrogen levels.

During perimenopause, the vagina begins to secrete less lubrication. The skin of the vulva, around the opening of the vagina, may become drier and prone to irritation. The vagina can shape too — becoming shorter, narrower, and less elastic. These changes tend to occur especially for women who do not have regular sexual intercourse.

If a woman has not been sexually active during perimenopause, and then wants to have more sex, she may experience pain, even when using familiar lubricants. The discomfort can be so great that it interferes with a woman’s ability to enjoy sex or may dampen her level of sexual desire.

Fortunately, these symptoms usually respond well to low-level estrogen therapy. Vaginal estrogen with bioidentical hormones can help by providing estrogen directly where it’s needed, with minimal impact on the rest of the body.

Hormone Replacement and Bioidentical Hormones 

Hormone Replacement Therapy (HRT) is a reliable approach to treatment for menopausal symptoms. There are many new forms of HRT available: tablets, skin patches, vaginal lubricants, and lotions.

How do you know if HRT is safe for you? That is where talking to an informed doctor comes in. Not all hormones therapies are the same. In recent years, extensive studies show that the chemical makeup of the hormones plays a key role in their safety and effectiveness.

Bioidentical hormones are formulated to match the body’s own chemistry, that so that the body processes them safely, just as it would the natural human hormone. Bioidentical hormone therapy offers health benefits with lower health risks than the earlier generations of synthetic hormones used decades ago.

You can learn more about bioidentical hormone therapy. We’ve addressed many questions patients have in these articles:

We are Here to Listen and to Help You

I welcome your questions about how Bioidentical Hormone Therapy can help you.

If you live in or near Ridgewood, New Jersey, come to the Optimal Wellness Center and learn about our individual approach to your perimenopause or menopause symptoms. Hormone balancing is can help you if you are suffering from sleep disturbances, low libido, or emotional and memory changes with perimenopause. So can a doctor who listens carefully and understands that you have your own set of symptoms.

Contact Dr. Keller at the Optimal Wellness Center in Ridgewood New Jersey, at 201-485-7930 or request an appointment online.

We thank you for sharing this post to help others!

Bioidentical HRT: The Truth About Hormone Therapy for Menopausal Women

bioidentical hrt
Dr Betty Keller is a menopause specialist and bioidentical hormone doctor who helps you understand and care for your menopause symptoms.

Menopause is a normal stage of life, and some women have symptoms they can take in stride. But for others, mood changes, disturbed sleep, increased urinary issues, and discomfort during sex have too much impact on quality of life and well-being.

Many women have heard that bioidentical hormone replacement therapy (bioidentical HRT) can help. But there is a great deal of uncertainty and confusion about the safety of HRT medications. More women need access to updated information so they can learn about treatments without fear.

When Menopause Occurs

Menopause is an important health milestone in a woman’s life. A medical definition of menopause refers to the 12 months after a woman’s last period. However, changes in hormone levels occur for most women between the ages of 45 and 55.

Common Symptoms of Menopause

Many women are satisfied that the issues of pregnancy and monthly periods are over. But for some women, these hormonal changes have a major negative impact on their well being:

  • Negative Changes in Mood: Changes in levels of estrogen and progesterone can affect mood. As the body adjusts, some women find it difficult to concentrate or keep from becoming irritable.
  • Painful Intercourse: Lower levels of these hormones make the skin around the vagina thinner and less lubricated. This can make sex painful or uncomfortable.
  • Hot Flashes and Night Sweats: Hot flashes are symptoms of menopause that cause sensations of sudden heat in your upper body, neck and face, and may trigger increased perspiration. And when a hot flash is over, you may feel a damp chill. Night sweats (hot flashes that occur during bedtime) can disturb sleep for months at a time for some women.
  • Bladder Control Problems: During menopause, changes in vaginal tissue can impact bladder function. As these tissues become thinner, less elastic, and lose strength, some women find that normal coughing, sneezing or lifting causes uncontrollable leaks. It may be hard to sleep through the night without having to get up and use the bathroom. Some women get painful urinary tract infections more often.
  • Bone Health: If menopause is premature or early, some women may be concerned about bone health.

Women who want to improve their quality of life during menopause have good questions, but may also have doubts about the safety of hormone replacement therapy. The level of distrust and misinformation around HRT is unfortunate.

It is important to inform women about bioidentical HRT, especially those who do not know the benefit of new forms of these hormones.

The Checkered History of HRT

Hormone replacement therapy began to be widely prescribed for menopausal women during the 1980’s and 1990s. HRT usually came in the form of oral tablets called Premarin and Prempro. But many stopped in 2002 with the public reports of health risks by the Women’s Health Initiative (WHI).

The media widely reported the finding that combinations of hormones used at the time were linked to increased risk of heart disease and cancer. Women were suddenly told to discontinue taking their medications, and there was widespread alarm about unwanted health risks.

What these studies could not show, because of their design, was the role of the synthetic forms of estrogen and progesterone used.

Premarin, for example, was processed from the urine of pregnant mares (as the name Premarin reflects). These drugs had adverse affects because the hormones extracted and synthesized in the lab had a different chemical structure than the body’s own forms. As the body processed the synthetic forms, they released harmful byproducts.

What is Bioidentical HRT?

Bioidentical hormone therapy uses hormones that match those made by the human body. In other words, the chemistry of these hormones matches the body’s own estrogen, and the body processes them the same way.

Bioidentical hormones are sometimes called “natural” hormones, which can be very confusing. Many HRT products can claim a “natural” origin, be it plant or animal. The important difference is that bioidentical HRT medications are formulated to act just like the body’s own hormones. The FDA has approved many bioidentical HRT medications for use in treating women with concerns about menopausal symptoms.

More Recent Findings

Research after the WHI study identified important factors that impact the safety and outcome of HRT, such as how soon it begins after menopause, and whether it is taken orally or in other forms. Unfortunately, the news of these findings is much less widespread.

Follow up studies found that the way a treatment delivers hormones also plays a part in how safely the body can use them. Some hormones in pill form carry different risks than those taken through the skin as a cream or gel, for example.

If you were to try to get information on the Internet, it is difficult to know who to believe. Some medical sites continue to share findings of older studies, and some focus on some of the newer studies without making clear what the full range of risks and benefits are.

Talk with a Doctor Who Is Informed about Bioidentical HRT

If you are concerned about symptoms and the safety of HRT, the best step for your health is to become better informed by talking with a knowledgeable doctor you trust.

HRT safety and effectiveness depends on when it starts, how long treatments last, what preparations are used, whether hormones are combined, and how the hormones themselves are formulated.

The benefits of any treatment must certainly outweigh the risks. And you deserve the opportunity to work with a doctor who will carefully assess and diagnose your symptoms and talk with you about the safest, most effective therapy for you.

Bioidentical HRT in Ridgewood, New Jersey

If you are in the Ridgewood, New Jersey area, and want to see bioidentical HRT can help, speak to Dr. Keller at 201-485-7930 or request an appointment online.

Thank you for sharing

When you share, you help friends only YOU can reach! Thank you for liking and sharing this update.

Fed up with Hot Flashes and Nights Sweats? Tips to Manage them Naturally

manage hot flashes naturally

Discover natural ways to ease night sweats and dietary supplements that help. For night sweats bioidentical hormones may also help you get the rest and relief you need.

Hot flashes and night sweats can be very disruptive, even if you expect them as part of menopause. Sometimes their severity can come as a surprise. Symptoms may be so intense they wake you up at night.

Night sweats are related to daytime hot flashes, and are usually associated with menopause. However, both hot flashes and night sweats can happen in younger women, pregnant women, and those with an underlying medical condition, or high levels of stress.

What Causes Night Sweats

Night sweats occur when blood vessels open in the skin to release heat. You can perspire enough to soak your nightclothes and be awakened by cold wet sleepwear and damp sheets.

Night sweats happen when the body-temperature control system in the brain — the hypothalamus — triggers your body’s cooling system. The hypothalamus also controls stress hormones, sex hormones, and is sensitive to hormonal changes, including changes in estrogen levels. It can trigger the body to rapidly cool down in response to lower levels of estrogen.

Natural Ways to Manage Symptoms

The foods you eat and the way you manage stress can have a big impact on night sweats and hot flashes. You can reduce and manage the symptoms by knowing how to manage stress, take care of your body, and by learning which foods to avoid and why.

For example, excess sugar in the diet triggers a stress response in the body – including an increase in blood pressure, and heart rate, which can elevate body temperature. The hypothalamus is already hypersensitive to signals of overheating, and is can contribute to hot flashes and night sweats.

What other foods can you avoid to help you minimize night sweats? Here are a few to avoid:

  • Hot foods (served at a high cooking temperature)
  • Spicy foods
  • Alcohol
  • Caffeine or other stimulants

Here are some simple lifestyle changes that can help you calm your temperature regulation system:

  • Practice meditation to decrease adrenal hormones
  • Dress is loose clothing – for easier temperature regulation
  • Keep room temperature lower especially at night (ideal sleeping temperature is 65 degrees)
  • Exercise daily – do aerobics to get your heart rate up; and sweat will help decrease stress hormones
  • Eat a low glycemic whole food diet
  • Get 8 hours of sleep

These Dietary Supplements Can Help

Dietary supplements and herbs can be beneficial but should be taken under the guidance of your physician.

I recommend these 4 essential supplements for optimal health (Four Essential Supplements):

  • A good multivitamin
  • Fish oil
  • Probiotic (“good bacteria” in yogurt, sourdough bread and also capsule form)
  • Vitamin D

Two additional supplements have been shown to reduce night sweats. The first is Estrovera by Metagenics, a tablet formulated using the extract of Siberian rhubarb, which has been clinically proven to reduce symptoms. I have found it to be especially  helpful in reducing night sweats.

I also find many of my patients find Kavinace Flash-Ease by Neuroscience to be effective in reducing hot flashes, night sweats and helping them get and stay asleep. It contains black cohosh in addition to ashwagandha (a restorative herb which helps balance stress hormones). A naturally occurring amino acid known as 5-HTP which helps increase serotonin levels (the feel-good hormone).

It is important to discuss your options fully with your doctor. If you plan to take herbs or supplements, it is important to do so under the guidance of your physician. Just because a preparation is ‘natural,’ does not mean it’s free of side effects or possible interactions with other treatments you are taking. Herbs and supplements can have an impact on each other, or interact with prescription medication or over-the-counter medications.

Night Sweats and Bioidentical Hormones

I find that for many patients, a personalized treatment plan that combines, lifestyle changes, diet changes, exercise, stress reductions, and supplements helps provide relief from night sweats. But for other patients, these changes may not provide enough relief or control over symptoms. In these cases, low dose bioidentical hormones may provide the relief you are looking for.

Find many of the supplements we recommend at:

http://drkeller.metagenics.com. Use code: drkeller

Estrogen Dominance

Hormone specialist NJ Dr. Betty Keller identifies insomnia, weight gain, and anxiety among symptoms of estrogen dominance.  Discover Dr. Keller’s holistic treatment approach to restore hormone balance.

Estrogen Dominance:What Every Woman Needs to Know

hormone specialist nj

Estrogen dominance affects about fifty percent of the women in the United States. It describes an imbalance of estrogen the “stimulating hormone,” relative to progesterone the “calming hormone.”

Estrogen and progesterone work with each other to create a balance. Estrogen is a stimulant.  It can induce anxiety, insomnia, and cellular proliferation of breast and uterine tissue. Progesterone is the “calming hormone.” Progesterone helps with anxiety, sleep, mood and inhibits cell proliferation in breast and uterine tissue.

What Is Estrogen Dominance?

Estrogen dominance is a condition in which women can have deficient, normal, or excessive levels of estrogen, but too little progesterone to balance the estrogen level. It is the balance between the two that matters. Women can have low estrogen but relatively lower progesterone and have symptoms of estrogen dominance.

Common symptoms of estrogen dominance can include:

  • Anxiety
  • Irritability
  • Anger
  • Agitation
  • Heavy periods
  • Bloating
  • Weight gain
  • Breast tenderness
  • Fibrocystic disease
  • Mood swings
  • Depression
  • Weepiness
  • Headaches
  • Migraines
  • Food cravings
  • Sweet cravings
  • Muscle pains
  • Joint pains
  • Acne
  • Foggy thinking
  • Memory difficulties
  • Cold hands and feet
  • Insulin resistance
  • Decreased libido
  • Infertility
  • Insomnia
  • Endometriosis
  • Polycystic ovaries
  • Fibroids
  • Allergic tendencies
  • Autoimmune disorders
  • Breast, uterine, cervical and ovarian cancers

Adrenal Fatigue and Estrogen Dominance

Estrogen dominance is often seen in combination with adrenal fatigue. Adrenal fatigue and estrogen dominance share many of the same symptoms.

Adrenal fatigue occurs when your body is exposed to sustained stress.  We often experience stress due to our modern lifestyle. Chronic stress eventually overwhelms our adrenals and they cannot keep up with the increased demand for cortisol, a stress-response hormone. Eventually stress hormone levels decrease and fatigue sets in.

Estrogen dominance and adrenal fatigue frequently occur together. Progesterone produces cortisol. Since most estrogen dominance is due to low progesterone, you will also have low cortisol. Most adrenal fatigue results when the adrenal glands are not able to answer the body’s demand for cortisol. So when the adrenals are overtaxed, they rob the body of progesterone to make more cortisol. As more progesterone is shunted to cortisol, you have less progesterone available to balance estrogen. So, it is important to correct not only the hormone imbalance between estrogen and progesterone.  We must also correct the adrenal imbalance.

Restoring Hormone Balance with a Holistic Treatment Plan

At the Optimal Wellness Center, we take a holistic approach to estrogen dominance and adrenal fatigue. Often we prescribe appropriate medications including Bioidentical hormones. In addition, we also prescribe medical foods, vitamins, and supplements.

We also address the many lifestyle issues that can affect hormone levels. We work with our patients to develop individualized wellness plans that include diet, exercise and stress management. As our patient, we help you find your own unique balance.

Contact Dr. Betty Keller, Hormone specialist NJ

Talk with Dr. Keller to understand your symptoms or for a consultation for your optimal wellness plan. Contact Dr. Betty Keller at 201 485 7930.

Hormones 101

The U.S. Census reports that there are over 50 million women in the U.S. who are over age 50. If you’re one of them, you may be experiencing the transition to menopause. You may have symptoms such as the following.

  • Hot flashes and night sweats.
  • Difficulty sleeping.
  • Mood swings.
  • Vaginal dryness.
  • Pain during intercourse.
  • Irregular periods.
  • More vaginal and urinary tract infections.
  • Less interest in sex.

These symptoms are the result of changes in your body’s levels of hormones, or natural chemical messengers. Menopause may be the best-recognized condition characterized by hormonal imbalance, but it isn’t the only one. An over-active or under-active thyroid can also disrupt your balance and cause symptoms.

Here some of the well-known and lesser known hormones that your body needs to be in balance, and why they are important.

Dehydroepiandrosterone (DHEA)

The most abundant steroid hormone in your body, DHEA helps the body manage stress, acts somewhat as a sex hormone, and has a role in the immune system. It promotes fat breakdown and protein synthesis. This hormone is also used to in the making of other hormones, including androgenic and estrogenic sex hormones. Your adrenal glands, skin, and brain produce and secrete DHEA. A low level of DHEA is a risk factor for heart disease, poor blood sugar regulation, depression, and nervousness.


Estrogen is present in both women and men. Women have much higher levels of estrogen than men do. It reduces a woman’s risk of heart disease, osteoporosis, Alzheimer’s disease, and urinary incontinence. The ovaries secret the most estrogen.Estrogen levels drop and cause well know symptoms during the transition to menopause. Low estrogen can also lead to lethargy, depression, and breakdown of collagen in the skin, leading to wrinkles.

Human Growth Hormone (HGH)

This hormone comes from the pituitary gland and supports tissue repair, bone health, muscle strength, and fat metabolism. Levels tend to decrease with age, and are associated with a greater risk for heart disease, reduced bone strength, greater fat mass, and trouble sleeping.


Melatonin is an antioxidant and it regulates your body’s circadian rhythm, or natural cycle of sleeping and waking. Deep sleep improves your energy levels and immune system’s strength. Melatonin comes from the pineal gland, and inadequate levels are associated with insomnia and jet lag.


This hormone comes from the ovaries, corpus luteum, and adrenal glands, as well as the placenta in pregnant women. It is lowers the risk for certain cancers, osteoporosis, and ovarian cysts.

Thyroid Hormone

Thyroid hormone is involved in nearly all of your body’s functions, including metabolism, regulation of body temperature and cholesterol levels, and body weight. It is produced by the thyroid gland in your neck, and the active form contains iodine molecules. Hypothyroid leads to low body temperature, fatigue, and weight gain, while hyperthyroid leads to nervousness, trouble sleeping, and unintentional weight loss.

How Can You Tell if You have A Hormone Imbalance?

Having symptoms is not necessarily a sign of hormone imbalance. If you have been unsuccessful finding relief or finding a doctor who can diagnose the cause of your symptoms, you may need to talk with a doctor who has updated information about hormone imbalance. You and your doctor will need to gather a detailed history and plan careful testing to determine whether hormone imbalance is a likely cause of your symptoms. Talk to Dr. Betty Keller about whether hormone replacement therapy can safely give you the relief and results you want for better health.

Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Get answers to your question in a professional consultation.  Contact Dr. Betty Keller.
Request an appointment

Is Hormone Rebalancing right for you?

Want to feel your best? Wonder how integrative medicine can help?
Get the Latest Information on Hormones and Your Health FREE

Bioidentical Hormone Replacement Therapy: Are you a Candidate?

New Jersey bioidentical hormone doctor answers questions about hormone replacement therapy.

For some women, menopause symptoms can be hard to adjust to. Women experience menopause usually between 45 and 55. Changing hormones bring on hot flashes, pain with intercourse, irregular moods, and low libido. Some women also experience trouble sleeping, restless leg syndrome, and some develop depression.

As we age, the body’s usual balance of hormones changes. These hormone include estrogen, progesterone, and testosterone.  You may notice a clear difference in your quality of life. And you may decide to do something about it.

There is no one-size-fits-all solution.  But by working with a qualified bioidentical hormone doctor, rebalancing hormones can help restore your best health and wellness.

Alternatives to HRT

You might get all the relief you need with beneficial herbs, better nutrition (cutting out sugar is a big help), nutritional supplements, and exercise.

Or you may decide to learn about bioidentical hormone treatment.  Is it right for you?

Age and HRT

Age and time since the onset of menopause are two factors you will want to consider.

Researchers have studied whether hormone therapy affects the risk of heart attack, stroke, breast cancer and other health concerns. If you start HRT within 10 years of menopause, you face no increased heart attack risk, according to extensive research. Starting treatment between the ages of 50 and 59 also shows no increased risk to health.

However, women over 60, or who have at least 10 years of menopause are advised to not to begin hormone therapy.

Your Health History is An Important Deciding Factor

Women with certain health histories may be advised to avoid hormone replacement therapy.

HRT is not recommended for women with :

  • a history of breast cancer
  • a medical history of heart disease
  • a health history of a heart attack, stroke or blood clots
  • high risk of any of these health concerns

Your HRT Plan Will Change With Time

You may find relief almost immediately, especially if you work with a doctor who is skilled in finding the right re-balancing treatment for you.  But, what works in the beginning may not be right later on. You will probably re-evaluate your hormone treatment annually.  You and your doctor will plan how to taper off HRT when you no longer need it.

During the transition to menopause, your body’s production of estrogen decreases more than 90 percent. It’s no wonder that women experience disruptive and at times exhausting symptoms for along time.

New treatments to re-balance the body’s hormones can be very effective to relieve menopause symptoms. But not every doctor has the most up-to-date medical information.  Dr. Betty Keller uses the latest findings to develop your unique plan for optimal health.
Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Get answers to your question in a no-cost consultation:
Request an appointment

Is Hormone Rebalancing right for you?

Talk to New Jersey biomedical hormone doctor, Dr. Betty Keller, at the Optimal Wellness Center in Ridgewood, NJ.

Want to feel your best? Wonder how integrative medicine can help?
Get the Latest Information on Hormones and Your Health FREE

Women and Hormone Imbalance – Signs that You Are Experiencing Hormone Imbalance and What You Can do About it

Hormones regulate every function in our bodies throughout our lives. Estrogen, progesterone and testosterone levels rise and fall from a woman’s childbearing years through menopause. But women experience pronounced, normal hormonal changes through their 40s and 50s.

During menopause the production of estrogen may fluctuate. Higher levels of estrogen can cause uncomfortably tender breasts. You may feel bloated and have heavier than normal periods.

Eventually, the body will make only 1/10th of the estrogen it produces during peak years. As levels decrease, you may experience hot flashes, night sweats, trouble sleeping, and increased feelings of anxiety or depression. The body stops making progesterone when there is no ovulation (during pregnancy) and during menopause. Periods can last longer and become more irregular with a lack of progesterone.Testosterone, though known as a ‘male’ hormone, is also present in women and an important contributor to health. Testosterone peaks around age 20 and declines as a woman ages.

You may notice these common, and less well-known signs that you are experiencing hormone imbalance:

Hot flashes and night sweats.

Hot flashes and night sweats are often the first sign of hormonal change. They affect 2/3rds of North American women, and the exact cause is not known. You probably can’t avoid hot flashes during menopause, but you can help minimize them by avoiding these triggers:

  • Stress
  • Caffeine
  • Alcohol
  • Spicy foods
  • Tight clothing
  • Heat
  • Cigarette smoke

Foods rich in phytoestrogens — compounds that act like estrogen found in certain plants – can help women have fewer symptoms. Studies have observed fewer menopause symptoms among women in countries where the diet includes phytoestrogen-rich foods such as tofu and soybeans. Other sources or supplements to consider include ginseng, fenugreek, licorice, gotu kola, dong quai, black cohosh and evening primrose (according to the North American Menopause Society’s Menopause Guidebook.)

Diminished or low libido.

One of the most noticeable indications of a hormonal imbalance is a diminished or lowered sex drive. Sleep disturbances and lack of quality sleep, also caused by hormonal imbalance, can cause a reduction in the production of the sex hormones.

Persistent weight gain.

Although weight gain is often tied to diet and lack of physical activity, undetected hormonal imbalances can make it very difficult to remain at a desired healthy weight.

Digestive problems.

Slow digestion, cramps, gas and bloating can have a number causes. They can be made worse by hormonal imbalance. The stress hormone cortisol often increases during menopause. Cortisol has a dampening effect on digestion, slowing down the release of stomach acid, and the rate of digestion.


Insulin resistance, adrenal fatigue and other hormonal imbalances are a common cause for cravings and overindulgence. Minimizing or eliminating sugars, alcohol, dairy and wheat from your diet can help control cravings and improve many of difficulties with digestion as well.

Insomnia and inadequate sleep patterns.

Lack of proper sleep can result from hormonal imbalance. It can also make other symptoms worse, as fatigue can begin a cycle of physical stress on the body, which increases cortisol levels.

Fatigue and low energy.

If you experience daily mid-morning or mid-afternoon fatigue, you may wonder what is going on with your body. Feeling scattered, overly tired or mentally foggy does not have to be the ‘new normal’ for you. Dietary changes to regulate blood sugar, such as the elimination of most grains and sugars, will often help improve these issues.

Irritability, anxiety, and depression.

Irritability, anxiety and depression often point to an imbalance, exposure to toxicity, being overworked or stressed out, or experiencing a lack of proper nourishment. Take steps to reduce these harmful actions before turning to pharmaceuticals.

What to do if You Are Concerned About Hormone Imbalance

Your efforts to eat better, mange stress appropriately get good quality sleep and regular exercise can go a long way to help you reduce the discomfort of hormone change.

New formulas and preparations allow hormone replacement therapy to provide low, safe doses to help control your symptoms. HRT requires careful adjustments to work successfully with your unique body chemistry and metabolism.

If you are considering HRT to benefit your health, talk with your doctor. Managing your symptoms safely and effectively requires a detailed health assessment and a treatment plan that is designed for you.

Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Get answers to your question in a no-cost consultation:
Request an appointment

Is Hormone Rebalancing right for you?

Want to feel your best? Wonder how integrative medicine can help?
Get the Latest Information on Hormones and Your Health FREE

Breast Cancer Risk and Hormone Replacement Therapy

It was 2002, and millions of women using hormone replacement therapy suddenly stopped taking their medication Doctors who regularly recommended hormones for women near menopause stopped prescribing it. That year, the Women’s Health Initiative (WHI) ended their HRT trial early after finding that health risks outweighed benefits. Researchers had observed an increase in the risk of breast cancer for participating women who took estrogen with a synthetic form of progestin.

Uncertainty and confusion remains more than 10 years after this study. Women still want to address menopausal symptoms, but are unsure whether hormone replacement is a safe option.

Discomfort and difficult symptoms of menopause include:

  • Irregular period
  • Hot flashes
  • Moodiness/depression
  • Insomnia and other sleep problems
  • Vaginal dryness and painful intercourse
  • Vaginal atrophy
  • Need to urinate often or urinary incontinence
  • Increased Urinary Tract Infections
  • Changes in skin and hair

Today, many women don’t consider treatment for debilitating symptoms. The lack of updated information has denied almost a generation of women the opportunity to improve their quality of life during their menopausal years.

Risks Linked to Estrogen Combined With Synthetic Progestin

Further analysis of the WHI study shed more light on reasons for these results. Researchers found that some women had been taking estrogen and progesterone before the study began. Others participants had additional risk factors to health such as obesity, high cholesterol and high blood pressure.

New research shows that health risks depend on how long hormone replacement therapy lasts. It also depends on whether estrogen alone, or estrogen and progesterone together are used. New findings show that estrogen-only HRT presents much lower risk of breast cancer. And the risk of breast cancer only increases when it is used for longer than 10 years.

More recent studies confirm that the type of progesterone used in treatment matters a great deal to breast cancer risk. Synthetic progestin (different in many ways from the body’s own progesterone)is linked with an increased risk for breast cancer. But studies are showing that formulations using bioidentical hormones — those made to have the exact same chemistry as the body’s own hormones — are linked with lower risks than synthetic versions. Other studies show a decrease in the risk of breast cancer using estrogen and bioidentical progesterone. The potential protective role of bioidentical HRT needs further study to confirm these findings.

A Better, More Natural Way

For women looking to reduce discomforts of hormone imbalance and improve quality of life, safer treatments are now available.

New forms of hormone replacement therapy offer options worth considering. Doctors who have the latest information can offer treatments with closer monitoring and safer hormone formulations.

The specific preparations, strength and duration of your treatment will depend on your unique needs. You and your doctor will need to perform careful testing to determine your best treatment. Talk to Dr. Betty Keller about whether hormone replacement therapy can safely give you the relief and results you want for better health.

Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Get answers to your question in a no-cost consultation:
Request an appointment

Is Hormone Rebalancing right for you?

Want to feel your best? Wonder how integrative medicine can help?
Get the Latest Information on Hormones and Your Health FREE

Low Libido in Women – How Can Hormone Therapy Help?

Having a low libido isn’t something that most women want to talk about. It is not easy to admit to ourselves or our partners that we are losing our sex drive. One recent study shows that as much as one third of women between 18-59 are concerned about their loss of sexual desire.  Other studies show even a higher proportion of women feel an unwelcome loss of interest in sex. If you feel this way also, you are not alone.

Understanding the causes of low libido is the first step in improving your well-being. Factors that regulate our sex drive are complex, and it’s is not always all ‘in your head’.  Identifying the causes of a low libido is the first step in changing how you feel for the better.

When is Low Sexual Desire a Problem?

It is natural for a woman’s interest in sex to rise and fall through life’s stages

There is no normal frequency of sexual intercourse or sexual activity in a partnership. If you and your partner enjoy being sexual less than you did before, but it’s working for you, there is no problem.

A problem with low sexual desire is more than just a low libido. A healthy body sends signals that it wants to be sexual. Whether and how you respond is up to you.  Sexual desire helps build intimacy in relationships and enables a spontaneous interest in sex.  When a woman notices a loss of interest in sex that is serious enough to interfere with intimacy and cause distress, then it may be time to do something about the problem.

Complex Causes of Lower Sex Drive

Both mental factors and physical ones can contribute to a lower libido.  Mental factors include a willingness to be sexual and enjoy intimacy prompted by a healthy sex drive. Physical factors include changes in hormone balance as we age.

A woman’s sex drive and interest in sex has complex of factors.  Among many causes that decrease sexual desire in women, these are some of the main ones:

  • Unresolved relationship issues. Emotions and family dynamics in a relationship have a big impact on a woman’s interest and ability to be sexual with her partner. If intimacy is missing, or there are intrusions like a new baby, or the need to care for a relative, a woman may experience a much lower sex drive.
  • Low testosterone: Though it’s thought of as a male hormone, testosterone is produced in a woman’s body as well.  It has a role in regulating sex drive in women, and levels diminish with age, most notably with menopause.
  • Medical conditions: Any medical illness or concern is likely to dampen sex drive for women. Medical problems impede sexual desire mentally and physically, whether you are facing an illness such as depression or a condition like fibromyalgia, chronic fatigue or thyroid imbalance.
  • Side effects of medication: Some prescriptions that help control blood pressure can also decrease sex drive.  Contraceptives have also been found to lower a woman’s sex drive by changing the natural balance of hormones.
  • Hormonal changes: Hormonal changes during transition to menopause are linked to a lower sex drive.Blood levels of hormones fall continuously in women as they age, but most dramatically with menopause.

Can Bioidentical Hormone Replacement Therapy Help?

It is important to identify all the factors that are likely to be part of the problem to develop an effective treatment plan. For women nearing menopause, hormone imbalance may be one of those factors. Potential treatments may include bioidentical hormone replacement therapy.

Bioidentical hormones, chemically the same as those naturally produced by the body, can provide relief with low risk of unwanted side effects.  Benefits of bioidentical hormone replacement therapy include:

  • Restored Hormone Balance: When the hormones in your body become unbalanced, you can experience a range of physical and mental problems — such as sleeplessness, fatigue, urinary problems, irregular heartbeat, mood disorders, bloating, hot flashes, and anxiety. These problems can lead to a lower libido as well as to depression. Once the hormones are rebalanced, many women feel better emotionally, mentally and physically.
  • Improved Self-Esteem: Hormone rebalancing combined with a healthy diet and exercise can allow you to maintain a healthy weight, increase lean muscle and reduce signs of aging. Often these changes work together, allowing you to feel more confident about yourself and your body. You may enjoy a much improved libido and interest in sex.

There is no magic pill that will restore a woman’s interest in sex, or make it something different than before.

Research to develop ways to treat sexual problems for women is ongoing. This is good news, as the attention to women’s sexual problems lags behind the attention paid to men’s concerns.

Treatments to rebalance hormones and improve female sexual problems are currently being studied to gain FDA approval. It is important to know that if your sex drive is missing, your sex life does not have to be over. If you are concerned about low libido, find out how Dr Keller can help you see whether hormone imbalance may be a major cause. Dr. Keller is committed to helping you restore and enjoy optimum health.

Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Get answers to your question in a no-cost consultation:
Request an appointment

Is Hormone Rebalancing right for you?

Want to feel your best? Wonder how integrative medicine can help?
Get the Latest Information on Hormones and Your Health FREE


Bioidentical Hormones and Synthetic Hormones: What Are the Real Health Risks?

HRT Prescriptions 2001 - 2005

HRT Prescriptions 2001 - 2005Before 2002, hormone replacement therapy (HRT) was widely prescribed for women near menopause, then after 2002, HRT sharply decreased. Do you wonder why this happened, and what we’ve learned since then?

In the 1990s, doctors began to prescribe hormones to women experiencing normal menopause. Estrogen and progestin were used together to relieve menopausal symptoms, and to protect against disease.

Most often HRT was routinely prescribed for women between 45 and 55, dealing with hot flashes, painful intercourse, irregular moods, and low libido. It was also used to help women with early menopause.

Then important findings in 2002 showed that HRT medications were linked to increased health risks to women. The study was designed to find whether the risk of heart attack, stroke, breast cancer and other health concerns was reduced by hormone therapy. HRT was largely stopped when researchers came to believe the risks outweighed the benefits.

Now you may be confused about whether or not hormone therapy is a good idea for you. Understanding your options and educating yourself are important first steps to deciding what’s best for your health.

Synthetic Vs Bioidentical Hormones

In more recent years, researchers learned that the chemical structure of hormones used to treat women matters a great deal to their health and safety. Before 2002, hormones used were usually synthetic, derived from animals. The body processed these differently than human hormones, with results that increased the incidence of disease.

Now, researchers have developed hormone formulas that copy human hormones exactly. The body responds to these bioidentical hormones just like those it makes naturally. Benefits include relief from hot flashes, night sweats, vaginal dryness, and discomfort during intercourse. Some research shows that bioidentical hormone treatment may reduce heart disease risk if begun early in menopause.

Studies find that a careful use of bio-identical hormones can lower discomfort and risk of developing some serious health conditions, while making the side-effects of menopause easier to manage.

Rebalancing With and Without HRT

While the symptoms of menopause may be common, there is no one-size-fits-all solution. When your body’s usual balance of estrogen, progesterone, and testosterone changes, you may experience very familiar symptoms. But re-balancing them requires careful adjustments that work for your unique body chemistry and metabolism.

Hormone replacement is not your only defense. Nutritional supplements and smart food choices can provide beneficial oils and herbs that relieve symptoms. Stress management and exercise can also be good choices to boost relief.

If you are considering HRT to benefit your health, talk with your doctor. Managing your symptoms safely and effectively requires a detailed health assessment and a treatment plan.

Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Get answers to your question in a no-cost consultation:
Request an appointment

Is Hormone Rebalancing right for you?

Want to feel your best? Wonder how integrative medicine can help?
Get the Latest Information on Hormones and Your Health FREE

Fatigue Caused by Underactive Thyroid: Could this be you?

Hypothyroidism, also known as an under-active thyroid, is fairly common. But because symptoms begin gradually and get worse over time, many don’t even realize that they are suffering from this disorder.

The thyroid is a small gland located in the neck, and produces thyroid hormone. Thyroid hormone helps regulate your temperature, metabolism, heartbeat, and how efficiently your body burns calories.  When the thyroid gland is underactive, thyroid hormone levels fall lower than normal, and your body’s energy level decreases. Think of your thyroid like a gas pedal. When operating properly, the pedal is pushed down and your vehicle (your body) is moving along at peak performance. When not producing enough of the hormone, the pedal is barely pushed down at all, and you feel like you are hardly moving.

Two of the most common symptoms of an under-active thyroid are fatigue and an increased inability to lose weight.  But people often mistakenly attribute these symptoms to getting older. In fact, a thyroid condition may go undetected for years because many people fail to question the gradual loss of energy, or the slow onset of depression.

Hypothyroidism far too often under-diagnosed.  Some physicians do not ask the right questions or they put too much faith in the lab tests that they customarily use, and do not explore past ‘normal’ results they see. A woman’s long and sometimes wide-ranging symptoms can lead doctors to attribute them to the onset of menopause, or depression. Some doctors rely too much on one test to determine thyroid function when they need to add tests for active thyroid levels.

If you’re not feeling your best, ask yourself if you have any of these symptoms:

  • Fatigue
  • Weight gain or difficulty losing weight
  • Depression
  • Brain fog (including poor concentration or memory)
  • Brittle nails and hair
  • Muscle and joint aches
  • Shortness of breath
  • Sensitivity to cold
  • Low libido
  • Thinning hair
  • Chronic yeast infections
  • Constipation
  • Poor sleep
  • Infertility

It is important to work with a doctor who takes a careful and complete health history and who uses appropriate lab tests to find what is causing your symptoms.

There is hope! There are a variety of treatment options for hypothyroidism including safe and proven medications, nutritional supplements to help regulate the thyroid balance, and even gradual lifestyle changes.

Dr. Keller is committed to helping you find safe and effective treatments to help you get back to living your best life. Contact us today to find out more about your symptoms, appropriate tests, and how to restore thyroid balance for your optimum health.
Dr. Betty Keller keeps up-to-date on the latest findings to help you develop a plan for optimal health.

Get answers to your questions with a consultation with Dr betty Keller.
Request an appointment

Is Hormone Rebalancing right for you?

Want to feel your best? Wonder how integrative medicine can help?
Get the Latest Information on Hormones and Your Health FREE


Hormone Replacement Therapy and Stroke Risk: Myths and Facts

Hormone Replacement Myths and Facts

Hormone Replacement Myths and FactsYou may be considering bioidentical hormone replacement therapy (BHRT) to benefit your health. But one of your main concerns may be the risk of stroke. Stroke is the third-leading cause of death for women in the U.S., and of course you want what’s best for your health.

If you’re confused, you’re not alone. There is a great deal of misinformation surrounding BHRT and the risk of stroke. You can start to separate fact from fiction by gathering updated information, and by speaking with a doctor who keeps up with the latest medical findings about BHRT.

Here you can find out the truth behind some common myths around BHRT.

Myth: BHRT increases the risk of stroke.

Fact: BHRT does not necessarily increase your risk of having a stroke.

There is a great difference in risk factors for stroke, depending on whether synthetic or bioidentical hormones are used in treatment. Also, how the hormones are taken (in pill form, or a patch or gel on the skin) yields different results. A long-running study of more than 100,000 women in France (called the E3N study) found that bioidentical estrogen hormone patches and gels were linked with lower stroke risk than estrogen pills. Women taking estrogen through low-dose patches with pill-form progesterone slightly lowered their risk of stroke compared to women not using hormone replacement therapy.

Research published in the Journal Maturitas studied a group of 16,906 Swedish women ages 45 to 73 over a period of 10.5 years. They found that the risk of stroke was no different for women undergoing hormone replacement treatments than for those who did not. Excess body weight, smoking, older age, and high blood pressure were all found to be factors that increased the risk of stroke. Women who started treatments before menopause had a lower risk of stroke compared to those who started treatment after menopause.


Myth: The Food and Drug Administration (FDA) has not approved Bioidentical Hormone medications.

Fact: The FDA has listed drugs approved for menopausal hormone therapy; many are bioidentical hormone medications.

Some bioidentical hormone products are approved and regulated by the FDA, and some that are not. All hormones used for hormone balancing are man-made. Confusion arises between compounds that are custom made by pharmacies, and those that the FDA has approved.  Many bio-identical hormone medications are commonly compounded by pharmacies according to a doctor’s prescription.

Compounding pharmacies are able to provide customized medications, including BHRT according to a doctor’s recommendations. They can prepare ointments, creams, and gels and other forms. They are not subject to FDA regulations.

The FDA has approved bioidentical hormone products including pill, gel, spray, and patch preparations.  A 2013 study mentioned by the Cedars-Sinai Medical Center shows that certain FDA-approved products (rather than compounded ones) may be tied to a slightly lower risk compared to synthetic hormones in pill form. Researchers stress that further confirming studies are needed.

Myth: Only one kind of Bioidentical Hormone Replacement Therapy is safest.

Fact: There is no one-size-fits-all treatment for hormone balance. Your treatment plan requires careful decisions that you and your doctor should make.

Like any treatment, hormone balancing presents benefits and possible unwanted side effects and risks. Each person has different risk factors for stroke and other threats to health. Hormone treatment is one of many factors that impact your long-term health. Changes to improve your nutrition, response to stress, and lifestyle routines make a big difference in lowering your risk of disease.

Whether or not to seek BHRT and which treatment plan to follow are decisions you’ll want to make with a doctor who has up-to-date information. 

Feeling smarter now? Take a moment and Like us on Facebook!

Next Step: Take Action

Dr. Betty Keller offers hormone rebalancing in Franklin Lakes, NJ at the Optimal Wellness Center.  Call us at 201-485-7930 to learn more about her approach to wellness and hormone replacement therapy for your optimal health.  You can also subscribe to her free health tips to help you look and feel your best.