Personalized endocrine and hormone care with Dr. Anna Frisch, delivered privately by secure video.

Frequently asked questions

What is natural desiccated thyroid (NDT) and how is it different from synthetic thyroid medication?

Natural desiccated thyroid (NDT) is derived from porcine (pig) thyroid glands and contains both T4 and T3 hormones in their natural ratio, along with T2, T1, and calcitonin. Synthetic medications like levothyroxine contain only T4, which your body must convert to the active T3 hormone. Some patients feel better on NDT because they receive both hormones directly, especially if they have poor T4-to-T3 conversion.

Am I a candidate for natural thyroid therapy?

Many patients are candidates for NDT, particularly those who haven't felt optimal on levothyroxine alone, have persistent symptoms despite normal TSH levels, or have confirmed poor T4-to-T3 conversion. Dr. Frisch conducts a comprehensive evaluation including detailed lab work, symptom assessment, and medical history to determine if NDT or another thyroid formulation is right for you.

Does Dr. Frisch prescribe synthetic thyroid medication?

No. Dr. Frisch is expert in the full spectrum of thyroid hormone replacement therapies, including synthetic T4 (levothyroxine), synthetic T3 (liothyronine), combination T4/T3 therapy, and natural desiccated thyroid. She individualizes treatment based on each patient's unique needs, lab results, symptoms, and response to therapy.

How long does it take to feel better on thyroid medication?

Most patients begin noticing improvements within 2-4 weeks of starting or adjusting thyroid medication, with continued improvement over 8-12 weeks as hormone levels stabilize. However, finding your optimal dose and formulation may require several adjustments over 3-6 months. Dr. Frisch provides close monitoring during this optimization period.

How do telemedicine appointments work?

All appointments with Dr. Frisch are conducted via secure video conferencing. After booking, you'll receive a confirmation email with preparation instructions, and our office sends your secure video link before your appointment. You can join from any device with internet access. Appointments run the same way as in-person visits, with comprehensive discussion of your symptoms, review of labs, and personalized treatment planning.

What do I need for my first appointment?

Before your first visit, please obtain recent thyroid labs (TSH, Free T4, Free T3, thyroid antibodies if available) and any relevant medical records. Dr. Frisch will provide specific lab orders if needed. Have a list of current medications, nutraceuticals and vitamins, and your main concerns ready to discuss.

Does Dr. Frisch accept insurance?

Frisch Integrative Medicine operates on a self-pay, cash-based model and does not accept insurance. This allows Dr. Frisch to spend adequate time with each patient without insurance constraints. While we don't bill insurance directly, we provide superbills that some patients successfully submit for out-of-network reimbursement.

Can Dr. Frisch prescribe medication in my state?

Dr. Frisch provides telemedicine services to Florida residents. All appointments are conducted via secure video conferencing from anywhere within the state of Florida.

How often will I need follow-up appointments?

After starting or adjusting thyroid medication, follow-up appointments are typically scheduled every 6-8 weeks until your levels are optimized. Once stable, most patients have check-ins every 3-6 months. For questions or concerns between appointments, call the office at 833-4-THYROID (833-484-9764).

What makes Dr. Frisch's approach different?

Dr. Frisch combines elite academic training with a personalized, root-cause approach. She looks beyond TSH levels: she listens to your symptoms, evaluates comprehensive labs including Free T3 and Reverse T3, considers metabolic factors, and optimizes therapy until you feel your best. Her extensive experience with natural thyroid therapy and willingness to use innovative combinations sets her apart.

Will I need lab work? How often?

Yes, lab work is essential for proper thyroid management. Initial evaluation includes comprehensive thyroid panel (TSH, Free T4, Free T3, thyroid antibodies), and often metabolic markers. Follow-up labs are typically done 6-8 weeks after medication changes, then every 3-6 months once stable. Dr. Frisch can order labs through convenient national laboratory networks.

What if I'm already on thyroid medication but still don't feel well?

This is one of Dr. Frisch's areas of expertise. Many patients come to her feeling suboptimal despite being told their thyroid levels are 'normal.' She evaluates whether your current medication type and dose are truly optimal for you, checks for conversion issues, assesses for other contributing factors, and adjusts therapy accordingly. Many patients experience significant improvement after proper optimization.

Does Dr. Frisch treat other hormone issues besides thyroid?

Yes. As a board-certified endocrinologist, Dr. Frisch treats the full spectrum of endocrine disorders including adrenal dysfunction, metabolic issues, and hormone imbalances. However, her particular expertise and reputation center on complex thyroid disorders and optimization of thyroid hormone therapy.

What are Aesthetic Endocrinology and Aesthetic Metabolism™?

Aesthetic Endocrinology, as defined by Dr. Anna Frisch, MD, PhD, is the application of endocrinology to cosmetic medicine: understanding how hormones, thyroid function, and metabolic health influence appearance, and using that understanding to plan aesthetic care. Aesthetic Metabolism™, the term she coined, is the framework she developed from her work in Aesthetic Endocrinology.

Can a video visit help with hormone-related skin or hair changes?

Yes. Hormone, thyroid, and metabolic concerns are evaluated through Frisch Integrative Medicine by secure video for Florida residents. Cosmetic treatment is planned separately at Palm Beach Cosmetic Medicine in Wellington. Dr. Frisch leads Aesthetic Endocrinology, as she defines it, at Palm Beach Cosmetic Medicine, the home of Aesthetic Metabolism™, the term she coined. Not every cosmetic concern is hormonal. Consultations are free.

What are the payment policies?

Payment is required at the time of booking to reserve your specific appointment date and time. We operate on a self-pay, cash-based model with no insurance billing. Payment secures your dedicated consultation time with Dr. Frisch and confirms your appointment slot.

Are appointments transferable?

No, appointments are non-transferable. Your payment reserves a specific date and time slot exclusively for you. Appointments cannot be transferred to another person or rescheduled to a different date without following our rescheduling policy and potentially forfeiting your original payment.

What happens if I miss my appointment?

If you miss your scheduled appointment without prior notice, you will need to reschedule and make a new payment. The original payment is forfeited as it reserved that specific time slot. We strongly encourage contacting us at least 48 hours in advance if you need to cancel or reschedule.

What is the cancellation and rescheduling policy?

Please provide at least 48 hours notice for cancellations or rescheduling requests. With adequate notice, we can work with you to find an alternative appointment time. Last-minute cancellations (less than 48 hours) or no-shows may result in forfeiture of your appointment fee.