FAQ
Contents
- 1 Content
- 1.1 Who can benefit from functional medicine detoxification?
- 1.2 How long does a functional medicine detoxification program last?
- 1.3 Is functional medicine detoxification safe?
- 1.4 Does Kybella® really work?
- 1.5 Can Kybella® be used on belly fat?
- 1.6 What are the most common side effects of Kybella®?
- 1.7 Can I combine functional medicine with other forms of treatment?
- 1.8 Are there any downsides to functional medicine?
- 1.9 What are the benefits of Functional Medicine?
- 1.10 What are some common conditions that functional medicine can treat?
- 1.11 How is functional medicine different from traditional medicine?
- 1.12 What is the average cost of a new patient visit including tests, medications, and supplements?
- 1.13 How often should I retest?
- 1.14 Where can I get bloodwork done?
- 1.15 How long are the consultations with Dr. Shapiro?
- 1.16 Can I do bloodwork at Quest Diagnostics?
- 1.17 Do you offer mobile phlebotomy?
- 1.18 Can I become a patient if I live outside of Florida?
- 1.19 How are patients invoiced for services rendered?
- 1.20 Does Dr. Shapiro accept medical insurance?
- 1.21 Will I be on the medications forever?
- 1.22 How can I start Dr. Shapiro’s Functional Medicine program?
- 1.23 What is Functional Medicine?
- 1.24 Who is not a candidate for Ozempic or Semaglutide?
- 1.25 How often do I take Ozempic or Semaglutide?
- 1.26 Is Ozempic or semaglutide covered by my insurance?
- 1.27 What are the most common side effects of Ozempic?
- 1.28 How does Ozempic (Semaglutide) work?
- 1.29 What is Ozempic (Semaglutide)?
- 1.30 If I stop growth hormone peptides (ex. Ipamorelin), will it stop me from making my own growth hormone?
- 1.31 What are the main benefits of growth hormone peptides (ex. Ipamorelin)?
- 1.32 How long does it take for growth hormone peptides (example Ipamorelin) to work?
- 1.33 Am I a candidate for Ipamorelin or other growth hormone peptide therapies?
- 1.34 How is Ipamorelin prescribed to the patient?
- 1.35 What are the most common side effects of Ipamorelin?
- 1.36 When is the best time to take Ipamorelin?
- 1.37 What is Ipamorelin?
- 1.38 Which patients are contraindicated to starting testosterone replacement therapy?
- 1.39 What are “normal” levels of testosterone?
- 1.40 Am I a candidate for testosterone?
- 1.41 Is testosterone used for women as well?
- 1.42 What is the difference between testosterone cream, injections, or pellets?
- 1.43 What is Testosterone Replacement Therapy (TRT)?
- 1.44 What to expect immediately after the Sculptra procedure?
- 1.45 How long does it take for Sculptra to work?
- 1.46 What areas are best treated with Sculptra?
- 1.47 Is the Sculptra procedure painful?
- 1.48 How long does the Sculptra procedure take?
- 1.49 How does Sculptra work?
- 1.50 Are lip fillers reversible?
- 1.51 How long will the lip augmentation procedure last?
- 1.52 How common is bruising and swelling after lip augmentation?
- 1.53 Is lip augmentation painful?
- 1.54 What is the best filler for lip augmentation?
- 1.55 Is there downtime after the Kybella® procedure?
- 1.56 How long does the Kybella® procedure take?
- 1.57 Does Kybella® hurt?
- 1.58 Is Kybella permanent fat removal?
- 1.59 How soon can you see the results from Restylane and Juvederm?
- 1.60 Is there downtime with dermal fillers?
- 1.61 What facial areas are typically treated with dermal fillers?
- 1.62 Is Juvederm or Restylane painful?
- 1.63 Are dermal fillers reversible?
- 1.64 What’s the difference between dermal fillers and botox?
- 1.65 What areas can you treat with Botox, Dysport or Jeaveau?
- 1.66 Is Botox painful?
- 1.67 How quickly does Botox start working?
- 1.68 How many units do women or men typically need?
- 1.69 How long does Botox, Dysport, or Jeuveau last?
- 1.70 How Long Does It Take for HRT to Work?
- 1.71 What are common side effects of taking Testosterone?
- 1.72 Who Should Consider HRT?
- 1.73 How Long Does It Take for BHRT to Work?
- 1.74 Are side effects common with BHRT?
- 1.75 Who Should Consider BHRT?
- 2 Contact TribecaMed Today
Content
Who can benefit from functional medicine detoxification?
Functional medicine detoxification can benefit anyone looking to improve their health and wellness through reversing toxin exposure. It is particularly beneficial for individuals experiencing symptoms such as fatigue, brain fog, digestive issues, and chronic inflammation.
How long does a functional medicine detoxification program last?
The length of a functional medicine detoxification program varies depending on the patient and their unique health concerns. Dr. Shapiro will work with you to develop a customized treatment plan that meets your specific needs and goals
Is functional medicine detoxification safe?
Yes, functional medicine detoxification is safe when done under the guidance of an experienced medical doctor. Dr. Shapiro will determine the safest and most effective detoxification program for you.
Does Kybella® really work?
Yes, Kybella® permanently destroys fat cells (adipocytes) regardless of the treatment area.
Can Kybella® be used on belly fat?
Yes, Kybella® can be used to remove superficial belly fat under the skin as well as many other similar areas. These areas include upper back or bra fat, inner and outer thighs, and upper arms.
What are the most common side effects of Kybella®?
The most common side effect include post-procedure swelling in the treatment area, redness, and occasional bruising.
Can I combine functional medicine with other forms of treatment?
Yes, Dr. Shapiro encourages patients to integrate his medical recommendations with the care plan of their other physicians. He finds integrating functional medicine with traditional medicine reaps the benefits of both.
Are there any downsides to functional medicine?
As functional medicine is not yet fully accepted by insurance carriers, it requires a personal investment of time and money in order to see its benefits.
What are the benefits of Functional Medicine?
Functional medicine identifies the root cause of disease, rather than simply treating symptoms. This approach leads to sustained optimization of health and well-being. Additionally, functional medicine takes an individualized approach and is tailored to each person’s unique needs and circumstances.
What are some common conditions that functional medicine can treat?
Functional medicine can be used to treat a wide variety of chronic conditions, including low testosterone, female hormone imbalances, obesity, diabetes, thyroid disease, digestive disorders, autoimmune diseases, and mental health conditions just to name a few.
How is functional medicine different from traditional medicine?
Traditional medicine treats the body as a collection of separate systems, each with its own set of diseases. Functional medicine, alternatively, views the body as one interconnected system.
It also factors every individual’s unique circumstances, including lifestyle, diet, environmental or work exposures, and genetics.
What is the average cost of a new patient visit including tests, medications, and supplements?
The cost of your first visit will depend on the functional testing kits, blood work, supplement programs, and compounded medications recommended for you to purchase. In general, your initial diagnostic testing and Dr. Shapiro’s consultation average between $1,000 and $3,000 depending on the complexity of the case.
After your consultation, Dr. Shapiro will present you with his medical recommendations which may include prescribed medications, personalized supplement programs, IV nutrition programs, and lifestyle recommendations just to name a few.
How often should I retest?
Dr. Shapiro requires initial patients to retest every 3 months to monitor improvement and adjust medications as needed. Once a patient achieves their desired health results, Dr. Shapiro may recommend biannual or annual testing to maintain optimal health.
Where can I get bloodwork done?
We offer several options: blood work done in our office, at a LabCorp near you, or we can send a mobile phlebotomist to your home.
How long are the consultations with Dr. Shapiro?
The initial patient consultation typically lasts 60-90 minutes depending on the complexity of the patient’s health issues. Follow up appointments typically last 30-45 minutes however Dr. Shapiro frequently extends beyond this time period as is needed. Every patient is different.
Can I do bloodwork at Quest Diagnostics?
Currently, we have a contract exclusively with LabCorp.
Do you offer mobile phlebotomy?
Yes, we work with several mobile phlebotomy companies around the country that travel to your preferred location to have blood, saliva, or urine testing done. This service is an additional fee depending on the location and testing required.
Can I become a patient if I live outside of Florida?
Yes, Dr. Shapiro offers telemedicine consultations to patients throughout the United States. Most of the required blood tests can be completed at a Labcorp near you.
Specialized testing involving stool, breath, saliva, or urine can be done in the comfort of your own home through home-delivered test kits. These tests come with very detailed instructions and a prepaid Fed Ex shipping label for you to send the sample back to the lab.
How are patients invoiced for services rendered?
Our patients pay for all testing and consultations prior to the appointment date with Dr. Shapiro. Once payment is processed, our patients will be provided with a copy of the receipt.
Does Dr. Shapiro accept medical insurance?
Dr. Shapiro does not accept any kind of medical insurance. This includes all testing, prescriptions, and supplements. Furthermore, his medical practice does not fill out insurance forms for patient reimbursement or physician authorization forms for medication reimbursement.
Will I be on the medications forever?
Our goal is to NOT keep you relying on medications forever. Dr. Shapiro’s programs are designed to quickly address your health focus areas and prevent or reverse them.
Once these health issues are resolved, at that time Dr. Shapiro will determine which medications to reduce or remove altogether.
How can I start Dr. Shapiro’s Functional Medicine program?
We have a 4-Step process. The first step includes various specialized testing as well as the completion of a HIPAA-protected intake form. The second step is a 60-minute consultation with Dr. Shapiro.
During that time, he will review all your testing data and identify your health focus areas. Step three is a personalized treatment plan designed by Dr. Shapiro to optimize those focus areas. The fourth step focuses on optimizing your health with follow-up blood work and consultations with Dr. Shapiro either in-office or through telemedicine conference calls.
The goal of this approach is to proactively and effectively optimize your health and overall wellness.
What is Functional Medicine?
Functional medicine takes a proactive approach to patient care. It focuses on the root cause of disease, rather than simply treating symptoms. It takes an integrative and individualized approach to healthcare, with the goal of restoring balance within the body.
Who is not a candidate for Ozempic or Semaglutide?
Dr. Shapiro will NOT prescribe this medication to patients with previously diagnosed medullary thyroid cancer, MEN type II, family history of medullary thyroid cancer, or a history of pancreatitis, pancreatic cancer, diabetic retinopathy.
How often do I take Ozempic or Semaglutide?
Dr. Shapiro will initially prescribe the medication once weekly at a lower dose and then slowly increase it based on your level of appetite suppression and side effect response. In some patients, Dr. Shapiro may prescribe it twice weekly but most patients respond very well to once-weekly dosing.
Is Ozempic or semaglutide covered by my insurance?
There are very strict guidelines for insurance coverage, focusing on a diagnosis of type 2 diabetes. However, Dr. Shapiro works with several private compounding pharmacies that produce this medication for his weight loss patients.
What are the most common side effects of Ozempic?
Transient nausea followed by the intended loss of appetite is the most common side effect. Some patients report loose bowel movements, vomiting or fatigue when starting this medication.
How does Ozempic (Semaglutide) work?
This medication mimics a naturally produced peptide, Glucagon-Like Peptide 1 (GLP-1), which lowers fasting and post meal blood sugar by stimulating insulin secretion from the pancreas in a glucose-dependent manner.
Semaglutide also delays gastric emptying and suppresses appetite which leads to gradual weight reduction over time.
What is Ozempic (Semaglutide)?
Ozempic is a once-weekly, anti-diabetes medication that we also use in our medical practice to suppress appetite and induce weight loss. It is prescribed as a subcutaneous injection into the abdominal skin with a very small needle.
If I stop growth hormone peptides (ex. Ipamorelin), will it stop me from making my own growth hormone?
Stopping Ipamorelin or other growth hormone peptides will NOT stop you from making growth hormones. It will cause your pituitary gland to revert back to how it was making growth hormones before starting the peptide therapy.
What are the main benefits of growth hormone peptides (ex. Ipamorelin)?
The main benefits of optimizing your own growth hormone (and IGF-1) levels include loss of abdominal fat, leaner muscle mass, stronger bone density, more elastic skin, and a reduction in CRP (an important marker for inflammation).
How long does it take for growth hormone peptides (example Ipamorelin) to work?
Most patients notice a response to treatment within 3 months of peptide therapy.
Am I a candidate for Ipamorelin or other growth hormone peptide therapies?
Dr. Shapiro will determine if you’re a candidate in your functional medicine consultation where he will review your fasting blood work (IGF-1 level) as well as your symptoms to see if this peptide medication is right for you.
How is Ipamorelin prescribed to the patient?
In Dr. Shapiro’s medical practice, Ipamorelin is most commonly prescribed as a subcutaneous shot with a very small needle in the abdominal skin. Patients that don’t like needles prefer to take Ipamorelin as a “troche” or lozenge to be dissolved under the tongue instead.
What are the most common side effects of Ipamorelin?
In general, Ipamorelin is clinically well tolerated with a low side effect profile. Some patients report temporary redness at the injection site or subtle facial flushing or warmth after the injection. Most patient report a benefit in sleep induction however very rarely patients may report difficulty in going to sleep.
When is the best time to take Ipamorelin?
Dr. Shapiro recommends patients that are prescribed Ipamorelin to take the medication at night before bed. Night-time administration of Ipamorelin strategically triggers the pituitary release of growth hormone while the patient is sleeping which coincides with the circadian growth hormone secretion spike.
What is Ipamorelin?
Ipamorelin is a peptide made up of amino acids, which is designed to trigger the natural production of growth hormone from the pituitary gland.
Which patients are contraindicated to starting testosterone replacement therapy?
There are a litany of different conditions that would prevent you of safely starting TRT, all of which will be carefully assessed by Dr. Shapiro in your medical consultation.
The most common reasons to NOT start testosterone include the following: history of breast or prostate cancer, prostate cancer or hyperplasia (BPH), untreated and symptomatic obstructive sleep apnea, uncontrolled hypertension, and uncontrolled and severe heart failure.
What are “normal” levels of testosterone?
In healthy men, normal total testosterone levels can range from 350 – 1000 ng/dL however, Dr. Shapiro more accurately assesses your “free testosterone level” which is the active amount of testosterone available for use in the body.
Total testosterone can be misleading as it takes into account “bound testosterone” which is the inactive, useless form of testosterone in the body.
Am I a candidate for testosterone?
If you have symptoms of low T, you can contact Dr. Shapiro’s office to schedule a consultation which will include fasting blood work. Based on Dr. Shapiro’s medical evaluation of your health, blood work results, and symptoms, he will decide if testosterone is right for you.
Is testosterone used for women as well?
Yes TRT is a very common treatment option for women who have symptoms of low T like fatigue, weight gain, low libido, loss of muscle mass, and low energy just to name a few.
What is the difference between testosterone cream, injections, or pellets?
All 3 of these treatment modalities introduce bioidentical testosterone into the body but through different mechanisms. Testosterone cream is applied to the skin and causes testosterone to be directly absorbed through the skin.
Testosterone injections introduce testosterone directly into the muscle. Testosterone pellets are a concentrated amount of testosterone inserted into subcutaneous fat which is then slowly released over a period of months.
What is Testosterone Replacement Therapy (TRT)?
TRT describes a treatment regimen prescribed by Dr. Shapiro involving the use of bioidentical testosterone to treat patients with symptoms of Low T.
What to expect immediately after the Sculptra procedure?
You can expect an immediate correction of volume loss at the treated area however this is a temporary correction as the swelling will subside within 24 hours. Ultimately, there will be a slow and steady increase in volume over weeks to months as the Sculptra continues to stimulate collagen production.
How long does it take for Sculptra to work?
Since Sculptra stimulates collagen production, it requires weeks to start that process. Most patients require 2-3 sessions, spaced 6-8 weeks apart in order to reach their aesthetic goals.
What areas are best treated with Sculptra?
Dr. Shapiro uses this product for patients with mid-face volume loss in order to create more volume and look more youthful. Sculptra can also be used for the temples, smile lines, cheekbone augmentation as well as for volume loss around the mouth and chin.
Is the Sculptra procedure painful?
With Dr. Shapiro, Sculptra is a PAIN-FREE procedure as he prepares the product mixed with lidocaine which is a local anesthetic. Also, Dr. Shapiro uses a soft-tipped, thin flexible micro cannula which reduces or prevents the risk of major bruising or bleeding.
How long does the Sculptra procedure take?
The entire procedure takes approximately 30 minutes, half of which is used to prepare the medication prior to injection.
How does Sculptra work?
Sculptra works by stimulating the body’s natural collagen production. Collagen production declines with each decade of life. Sculptra induces collagen synthesis which gives structural support to facial skin.
Are lip fillers reversible?
Yes, this procedure is reversible as Dr. Shapiro only uses hyaluronic acid-based dermal fillers for lip augmentation. For this reason, Hylase is a medication we have available to dissolve part or all of the dermal filler used in the procedure.
How long will the lip augmentation procedure last?
The dermal filler used, your lip profile size, and your goal size will determine the duration of the final result. Dr. Shapiro will review all these important decisions with the patients prior to their procedure.
How common is bruising and swelling after lip augmentation?
In general, you can expect little to no bruising but there may be some minor swelling that disappears within the first 3 days. Some patients have a greater tendency to bruise than others.
Is lip augmentation painful?
When done in our office by Dr. Shapiro, this is a PAIN-FREE procedure. Dr. Shapiro uses a 4-point dental block which allows the lips to be numb during the procedure.
What is the best filler for lip augmentation?
Every patient is different therefore the best filler will be determined by Dr. Shapiro at the time of the consultation in the office or by virtual consultation.
Is there downtime after the Kybella® procedure?
Following treatment, the treated area swells and remains slightly tender for a week or two; however, most patients are able to resume their normal routine the next day.
How long does the Kybella® procedure take?
Kybella® is a very quick procedure. It typically takes 15 minutes to complete the procedure and you can be in and out of the office usually within 30 minutes.
Does Kybella® hurt?
No, Kybella® is PAIN-FREE in our office. Dr. Shapiro mixes Kybella® with a local anesthetic (lidocaine) which allows our patients to have a completely pain-free experience.
Is Kybella permanent fat removal?
Yes, Kybella permanently dissolves fat which then gets removed from the body’s lymphatic system.
How soon can you see the results from Restylane and Juvederm?
You should be able to see a definitive improvement immediately after the procedure is done.
Is there downtime with dermal fillers?
You can expect some swelling after the procedure and sometimes bruising but this depends on the area treated. You can be back to your daily activities and routine within 1 hour after this procedure.
What facial areas are typically treated with dermal fillers?
Dr. Shapiro commonly used Juvederm or Restylane to treat cheekbone augmentation, lip augmentation, liquid rhinoplasty, facial hollowing, tear trough, marionette lines, smile lines, and jaw contouring.
Is Juvederm or Restylane painful?
In order to prevent unnecessary discomfort at the injection sites during the procedure, we recommend applying a topical numbing cream to our patients for 15-20 minutes prior to their procedure.
Are dermal fillers reversible?
Hyaluronic Acid (HA) dermal fillers, like Juvederm or Restylane, are 100% reversible. Other non-HA dermal fillers like Radiesse or Sculptra, are not immediately reversible. They need to dissolve over time (months to years).
What’s the difference between dermal fillers and botox?
Dermal fillers are gel-like substances that add volume to specific areas of the face with the intention of creating a more youthful appearance.
Botox softens the muscles of facial expression causing the elimination or reduction of fine lines and wrinkles, resulting in a more youthful appearance.
What areas can you treat with Botox, Dysport or Jeaveau?
The most common treatment areas include the “angry 11’s” (between the eyes), the forehead, and the “crow’s feet” (smile lines around the eyes).
Dr. Shapiro has years of experience treating a wide variety of other areas including: gummy smile, lip flip, smoker’s lines, bunny lines, eyebrow lift, chin dimples, frown lines, “Nefertiti Lift” (neck botox), TMJ, masseter muscle, and hyperhydrosis (excessive sweating of the arm pits).
Is Botox painful?
In order to prevent unnecessary discomfort at the injection sites during the procedure, we recommend applying a topical numbing cream to our patients for 15-20 minutes prior to their procedure.
How quickly does Botox start working?
You can expect Botox, Dysport, or Jeaveu to start working within 3-7 days after being injected. Clinically, we have noticed Dysport activating a few days sooner than Botox, however, they both have the same duration.
How many units do women or men typically need?
The amount of units required depends on the areas being treated and the degree of wrinkling present. This will be determined by Dr. Shapiro during your consultation.
How long does Botox, Dysport, or Jeuveau last?
Botox and its competitors typically last 3-5 months. By month 3, you should start to see some slight movement with contraction of the facial muscles which should become more apparent towards the 5th month.
How Long Does It Take for HRT to Work?
Optimizing testosterone starts to work within days. There are several different ways to deliver testosterone which include cream, injection, pellet, and dissolvable lozenge. Depending on which type of delivery system being used will determine the rate of testosterone optimization.
Within one week, you can expect a noticeable change in how you feel which should continue as your hormones start to get balanced. Generally speaking, every person is different and as such, HRT can take varying amounts of time to reach the goal of resolving Low T symptoms.
Dr. Shapiro’s programs are designed to work quickly, with the majority of the symptoms improved within 90 days.
What are common side effects of taking Testosterone?
With any prescribed medication, there may be a risk of side effects if the medication is not prescribed correctly. Dr. Shapiro takes the prescribing approach of “start low and go slow” in terms of optimizing and balancing male hormones.
Common side effects of excessive testosterone dosing include uncontrolled blood pressure, symptoms of prostate enlargement, oily skin, acne, mood changes, as well as gynecomastia.
Who Should Consider HRT?
Men over the age of 30 who complain of an unexplained decrease in energy, libido, mood, or mental focus, as well as weight gain, should consider an HRT evaluation with Dr. Shapiro.
Men who also complain of poor mental focus or productivity at work, as well as those at risk for type 2 diabetes, high blood pressure, or obesity, may also be good candidates for an HRT evaluation.
How Long Does It Take for BHRT to Work?
Depending on the severity of the symptoms and the degree of imbalanced hormones, BHRT works relatively quickly. Within a week, you can expect a noticeable change in how you feel which should continue as your hormones start to get balanced.
Generally speaking, every person is different and as such, BHRT can take varying amounts of time to reach the goal of resolving all related symptoms. Dr. Shapiro’s programs are designed to work quickly, with the majority of the symptoms improved within 90 days.
Are side effects common with BHRT?
With any prescribed medication, there may be a risk of side effects if the medication is not prescribed correctly. Dr. Shapiro takes the prescribing approach of “start low and go slow” in terms of optimizing and balancing female hormones.
Generally speaking, bioidentical hormone therapy is very well tolerated when appropriately prescribed.
Who Should Consider BHRT?
Women who experience unexplained weight gain, lack of energy, low sex drive, poor work performance, or even noticeable skin laxity may be potential candidates.
Women with preexisting conditions like heart disease, liver disease, blood clots, or breast cancer should consult with their primary care doctor or gynecologist before considering BHRT.