Frequently Asked Questions

Functional Medicine FAQ

What is functional medicine?

Functional medicine is a systems biology-based approach that focuses on identifying and addressing the root cause of a disease. 
Each symptom or diagnosis may be one of many contributions to an individual’s illness. For example, depression can be caused by one or more factors in an individual’s life. The precise manifestation of each cause depends on an individual’s lifestyle, genes, and environment, and only a treatment specific to that individual will address all of these drivers.

How does functional medicine differ from conventional medicine?

There are several ways that functional medicine differs from conventional medicine:
– Functional medicine is proactive, focusing on the prevention of diseases and is cost-effective in the long term. Conventional medicine is reactive, focusing on detecting diseases once you already have them. This can become very expensive in the long term. 
– Functional medicine focused on the biochemical uniqueness of an individual while conventional medicine often treats people based on algorithms.
– Functional medicine is holistic while conventional medicine is specialized.
– Functional medicine focuses on the root cause of a disease while conventional medicine treats the symptoms, not the disease.
– Functional medicine is patient-centric and health-oriented, whereas conventional medicine is physician-centered and disease-oriented.
– Functional medicine treats chronic illnesses while conventional medicine focuses on acute illnesses.

What are the benefits of functional medicine?

Functional medicine addresses the whole person, not just a set of symptoms or diseases. Functional medicine practitioners use a holistic approach to understand who you are, knowing that every person is unique and should have a medical plan that is custom fit for their needs.
To put it simply, functional medicine helps you prevent ever getting a disease, rather than merely detecting and treating a disease after you develop one. 

Why doesn’t my Primary Care Physician practice functional medicine?

Functional medicine by nature is a very individualized and personalized approach to medicine. Between balancing large patient rosters, paperwork, and dealing with insurance premiums, primary care physicians simply don’t have the time to dig deeper into each patients’ medical history. Instead, their focus tends to be on symptoms, not causes. 

Are lab tests covered?

No. However, Boston Direct Health negotiates significantly lower costs for medications and lab tests.

What approach does Boston Direct Health use?

Boston Direct Health specializes in functional medicine and emboldens every patient to perform at their very best. 

What should I bring to my first visit?

To make best utilization of your time for your visit, you should have medical records and recent labs sent to our office prior to your Functional Medicine Evaluation. Our office staff can help facilitate getting records sent. We ask that patients fill out the “Medical Symptom Questionnaire” and the “Three Day Food Journal” on the patient portal: http://bostondirecthealth.md-hcom. Come with a list of questions and goals for the visit.

What happens during my first visit?

Your first visit will include a thorough review of your history, a physical exam, and a detailed plan on recommended laboratory tests (some tests can be done through insurance). Your consultation also includes a follow-up to review your lab results, recommendations on diet, supplements, and possible prescription medications. 

How much does it cost?

A single visit, 90 min functional medicine consultation is $500 plus the cost of labs. 

Botox FAQ

What are botulinum toxin neuromodulators?

Neuromodulators are naturally-occurring proteins that temporarily block muscle movement. Neuromodulation is commonly used to treat and enhance peoples’ quality of life, and botulinum toxin neurotransmitters are no different. 
Botulinum toxin neurotransmitters – commercially known as Botox, Dysport, and/or Xeomin – are used to treat frown lines, crow’s feet, and wrinkles. By injecting just a miniscule amount of these neuromodulators directly into the underlying muscle, it causes it to relax and gradually smooth out the appearance of the overlying skin. 
At Boston Direct Health, we primarily use Botox.

How does Botox fight wrinkles?

When Botox is injected into the muscle, it blocks signals from the nerves to the muscles, making them unable to contract. This allows for the wrinkles to relax and soften, resulting in fewer wrinkles and smoother skin. 

Can Botox prevent wrinkles?

Botox specifically prevents wrinkles caused by muscle movements and can reverse mild lines, stopping them from developing at all. Wrinkles are developed over time because your skin weakens and has more difficulty bouncing back from your face’s many motions (laughing, raising your eyebrow, etc.). Botox, when used with a topical product that can stimulate collagen, strengthens your skin and relaxes your facial muscles, preventing them from constricting and wrinkling overlying skin together. 

How do dermal fillers work? Do they differ from Botox?

Botox is used to relax your facial muscles so that they don’t cause wrinkles. Dermal fillers are used to stimulate collagen growth in the face and to plump and lift the skin, replacing the collagen you may have lost. 

How long do cosmetic injection results last?

You should see results within 7-10 days, sometimes even sooner. Typically, these effects last for about 3-4 months. 

What are the side effects?

The main side effects of Botox include:
– Headache or flu-like symptoms
– Pain, swelling, or bruising at the injection site
– Dryness of the eyes or excessive tearing
– Crooked smile or drooling
– Droopy eyelid or cockeyed eyebrows

Far less common side effects include:
– Muscle weakness
– Trouble swallowing or speaking
– Breathing problems
– Vision problems
– Loss of bladder control 

Call your doctor right away if you are experiencing any of these side effects after receiving Botox treatment.

Does it hurt?

Botox injections are very small, so pain is usually minimal. In preparation for the treatment, the area can be numbed with a topical anesthetic cream before the injection is given. You can also use a cold pack on the treated area for 10-15 minutes prior to injection to reduce any pain you might feel. 

What areas can be treated?

The most common areas treated with Botox include:
– Frown lines
– Forehead wrinkles
– Crow’s feet
– Under-eye lines (muscles around the eye)
– Migraine treatment protocol
– Masseter/Temporalis Muscles for Temporal Mandibular Jaw Pain (TMJ) and teeth grinding
– Underarms for treatment of hyperhidrosis (excess sweating)

What can’t I do after a treatment?

We recommend that you avoid all of the following after a Botox treatment:
– Heat and direct sunlight
– Washing your face
– Rubbing your face for at least the first 4 hours after treatment
– Excessive exercise within the first 24 hours after treatment
– Blood thinners
– Lying on your face – we recommend that you don’t take a nap after your treatment

You should also avoid caffeine, alcohol, foods high in sugar or sodium, refined carbohydrates, spicy foods, and cigarettes 24-48 hours after treatment. 

How much does it cost? – Good for internal link building to the page

DCP members can enjoy a 20% discount on Botox treatment. Get in touch for more information.

Diolaze FAQ

What machine is used for Laser Hair Removal?

Boston Direct Health uses Diolaze XL, an industry-leading advanced laser hair removal procedure that emphasizes comfort, speed, and efficacy. Diolaze XL treatments are more comfortable compared to competitive brands and are usually finished in half the time. Not only is Diolaze XL fast, but it’s also powerful enough to safely, gently, and efficiently remove even the most stubborn hair.

How does Laser Hair work?

Diolaze XL has a built-in cooling surface while a diode beam passes through the skin towards hair follicles. The penetrating energy hears up the root of the hair, preventing future growth. 

Does it hurt?

Diolaze XL’s has one of the largest built-in skin cooling surfaces in the industry. This increases the level of the comfort that patients experience. Patients often describe their sessions as “virtually painless.”

How many sessions are required?

Treatments work best when hair follicles are in their mature stage. At any given time, your hair is in various stages of growth, so most patients experience noticeable results after 4-6 sessions. Your hair color, hair type, body area, and skin tone can also play a factor in the number of sessions you may require. Diolaze XL can be safely used on most areas of the body that have unwanted hair. 

How much does it cost?

A full laser hair removal pricing list can be found here

Forma FAQ

What is Forma?

Forma (Functional Orthopedic Rehabilitation Medicine Associates) is a non-invasive skin tightening treatment that uses fractionated radio-frequency energy to stimulate collagen production for body remodeling. By using this technology, Forma can make your body and skin appear smoother, younger, and sexier. 

Is Forma for me?

If you have stretch marks, if parts of your body need tightening, or you are experiencing the effects of aging or weight fluctuation, Forma is for you. Forma can also treat textual irregularities such as enlarged pores, bumps, and/or rough patches on the skin common caused by sebum build ups and/or sun exposure. 

What results will I see and feel?

During treatment, most patients will feel a heat sensation and “feel” tighter. Over time, textual irregularities smooth out and appear more toned. After the treatments are completed, patients often feel more confident and like their best selves. 

What areas can be treated?

Forma is most commonly used to contour the sagging skin on your face, including your crows feet, upper and lower eyelids, smile lines, forehead lines, jowls, and nasolabial folds. Forma can also be used on your neck, back, inner and outer thighs, knees, abs, as well as other parts of your body.

Will it hurt?

Forma is virtually painless and requires no downtime. Patients often compare Forma treatments to a hot stone massage or claim that it feels like a heated wand ironing out the area(s) being treated. The treated area may remain slightly red after a session. This lessens within a few hours. 

Will it How many sessions are required??

Most patients go through a series of recommended treatments based off of an initial consultation. Typically, patients experience the best results via weekly sessions over the course of 6-8 weeks. Some patients will see improvements in fewer sessions with more weeks between each treatment. 

Can I use Forma in combination with other treatments?

Yes, Forma has been used in conjunction with other facials, laser treatments, filler, and/or other injectables. We recommend that you speak with your doctor before combining Forma with other treatments. 

What should I wear to my appointment?

We recommend that you wear something comfortable to your appointment, such as sweats or workout clothing. 

How much does it cost?

Forma’s full pricing list can be found here.

Bio-identical Hormone Replacement Therapy FAQ

What are bioidentical hormones?

Bioidentical hormones are man made hormones derived from plant estrogens that are biologically, structurally, and chemically identical to the body’s natural hormones. Their molecular shape is identical to the hormones made by the human body, so they “fit” perfectly into the receptor cells. In this sense, they are a better alternative to synthetic hormones, which come close to being the right shape, but not exactly, which can lead to adverse side effects. 

What causes hormone imbalances?

There are multiple factors that can lead to a drop in your hormone levels including but not limited to aging, increased stress, environmental toxins, and various medical conditions.

How do I know if I may be suffering from an imbalance or a deficiency in my hormone levels?

Hormonal deficiency or imbalance can be caused by many symptoms including:

For women:
 
– Insomnia or poor sleep
– Memory loss or “brain fog”
– Depression or just feeling “down”
– Low energy/fatigue
– Weight gain that’s non-responsive to diet and exercise
– Anxiety/palpitations
– Abnormal menstrual cycles including PMS, heavy menstrual cycles, missed cycles, spotting between cycles
– Irritable bowels and bloating
– Vaginal dryness or pain during sex
– Changes to the texture of skin, nails, and hair
 
For Men:
 
– Insomnia or poor sleep
– Memory loss or “brain fog”
– Loss of motivation, feeling down and depressed
– Fatigue, feeling lethargic
– Weight gain that’s non-responsive to diet and exercise
– Decreased sex drive
– Erectile dysfunction
– Loss of muscle mass
– Loss of body hair
– Lower energy level, endurance, and physical strength
– Reduced exercise tolerance
 
Of course, there are many possible causes for these symptoms. A complete medical evaluation is necessary to determine whether these are the result of hormone problems or something else.

How are bioidentical hormones prepared?

Bioidentical hormones are made from plant estrogens that are identical chemically to the hormones that our bodies produce naturally, as opposed to traditional hormones, which are derived from the urine of pregnant horses. 

Are bioidentical hormones safer than traditional (synthetic) hormones?

Published papers from PubMed/MEDLINE, Google Scholar, and Cochrane databases have compared the effects of bioidentical and synthetic hormones, including clinical outcomes and in vitro results. Their conclusions show that physiological daya and clinical outcomes have demonstrated that bioidentical hormones are associated with lower risk and are more efficacious than synthetic hormones. Currently, the US Food and Drug Administration and The Endocrine Society claim that there is not yet enough evidence that supports the claim that bioidentical hormones are safer than synthetic hormones.

How is hormone therapy taken?

Some hormone therapies can be taken orally. Others require an injection either under the skin or in the muscle. 

What are the long term health benefits of bioidentical hormone replacement therapy?

Studies have found that bioidentical hormones allow for better performance, have fewer side effects, and carry fewer long-term risks. By helping your body and brain return to optimal function, bioidentical hormones can improve your sleep, your mood, increase your libido, provide menopausal relief, and more. By restoring your hormonal balance, you are also allowing your body to produce elastic and collagen proteins, which allows for smoother, tighter skin, fewer wrinkles, and a healthier glow. Balanced hormones can also help you maintain muscle mass, improve your memory, and reduce hair loss. 

Could my hormones be impacting my sex drive?

Hormones regulate your sex drive, mood, and your reproductive cycle. If your hormone levels are low, they are very likely having a negative effect on your sex drive. 

Why do men need testosterone replacement?

Testosterone is a hormone that affects a man’s appearance and sexual development. It builds muscle and bone mass, stimulates sperm production, and improves their sex drive. Low testosterone levels can result in hair loss, fatigue, reduced muscle and bone mass, memory loss, erection difficulties, reduced semen count, depression, and irritability. 

Why don’t traditional doctors prescribe bioidentical hormones?

Traditional doctors often lack the time and/or the resources to seek expertise in bioidentical hormones. Doctors prescribing bioidentical hormones should be able to provide plenty of individualized attention, specialize in hormone health, and have undergone extensive, specialized training. 

What are the side effects associated with bioidentical hormone replacement therapy?

You can expect some side effects to occur when you begin bioidentical hormone replacement therapy simply because your body is not used to your new hormone levels. Many of these side effects improve as your body adjusts to these new levels. Some of these side effects include:
– Headaches
– Weight gain
– Acne
– Tiredness
– Blurred vision
– Cramping
– Bloating
– Mood swings
– Indigestion

What can I expect once I’ve become a patient?

As a patient at Boston Direct Health, you will first be asked about your health and wellness goals. We listen to your story and make note of risk factors that may result in abnormal hormone levels, symptoms of abnormal hormone levels, and contraindications to hormones. We then discuss the good, the bad, and the ugly of hormones, as well as the benefits and the risks. Depending on your story, we may discuss ways that lifestyle modifications can help improve your hormone levels. Then, we work together to come up with a personalized treatment plan based on your goals, story, and safety. 

Why do women need hormones before, during, and after menopause?

Women’s hormone levels drop before, during, and after menopause, resulting in night sweats, hot flashes, increased anxiety, memory loss, insomnia, poor sleep, and weight gain that’s non-responsive to diet and exercise, to name a few. By keeping their hormones in balance, women can continue living their lives with their mind and body functioning at optimal levels. 

What is bioidentical hormone replacement therapy (BHRT)?

Bioidentical hormone replacement therapy (BHRT) helps men and women who are struggling with decreased or unbalanced hormone levels.

How much does it cost?

Check out our bioidentical hormone replacement therapy page for more information. For pricing and to learn more about membership, contact us today!

Morpheus8 FAQ

What is Morpheus8?

Morpheus8 is a minimally invasive skin rejuvenation procedure that fractionally remodels and contours your face and body. Morpheus8 uses radiofrequency (RF) energy and microneedling to target the deeper layers of your skin and stimulates collagen production in the underlying layers of your dermis. It can penetrate up to 4mm deep and melt away fat, allowing you to contour and morph various parts of your body. Doing so triggers your body’s natural healing response and remodels your skin by prompting an organic anti-aging process

What areas can be treated?

Morpheus8 can be used on any area of your body that can benefit from subdermal renewal. Patients commonly use Morpheus8 to treat their lower face and neck. However, it can also be used to reduce acne scars, treat wrinkles, stretch marks, surgical scars, and much more. 

How many treatments will I need?

Most patients have up to 3 sessions.

How quickly will I see results?

Depending on your treatment regimen, you can expect to see results in 1-3 sessions. 

How long should I wait in between treatments?

We recommend waiting 4 weeks between treatments.

What is the benefit of fractionated energy?

Fractionated energy has been scientifically proven to reduce wrinkles and rebuild collagen. 

Who can use Morpheus8?

Morpheus8 can be used on all skin types. Treatment is often recommended for:
– Men and women between the ages of 30-55 who want to improve visible signs of aging.
– Patients with acne or acne scars that aren’t responding to topical and/or oral medications.

What is the benefit of RF energy?

Radiofrequency (RF) energy treatments are safe and effective for tightening skin, reducing the size of your pores and the appearance of wrinkles, and inducing new collagen and elastin production to help your skin become firmer and more youthful-looking. 

Can Morpheus8 be used in combination with other treatments?

Yes. Morpheus8 can be used in conjunction with other treatments.

How long should I wait after a treatment before applying make-up?

Patients can apply make-up 1-2 days after treatment. 

What kind of post-procedure care is required?

Patients should avoid direct sun exposure and tanning. We recommend that you moisturize the treated area and use broad spectrum sunscreen every day. Not only do these reduce the future risk of skin cancer, but sunscreens can also slow the aging process and reduce wrinkles. 

How much does it cost?

Morpheus8’s pricing list can be found here.