Practice Takeaway: I always try to taper the estrogen dose down over a period of 2-6 months depending on the individual’s difficulty with withdrawal symptoms. Once I have the patient on a lower dose (Premarin 0.3 mg or Estrace 0.25 mg every other day at the most), I will switch over to a bi-est consisting of 50% estradiol and 50% estriol. The reason for this is, if you stop the estrogen abruptly or…


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Testosterone replacement therapy has the potential to drastically improve quality of life of those who need it. However, many men who begin topical testosterone are given too much of the hormone. Explanations for this erroneous tendency are rooted in incorrect dosing principles that have been established on false assumptions, misconceptions, invalid conclusions and aggressive marketing instead of…


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Hypothyroidism is defined as “lack of thyroid hormone production from the thyroid gland.” However, many patients who produce sufficient hormone from the gland still suffer from low thyroid symptoms. When thyroid levels are not within normal ranges, many conventional treatment protocols rush into thyroid replacement therapy. Two problems exist with this approach: If the patient has normal levels of…


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When a patient says that she wants “natural” hormone therapy, does the term mean the same thing to you as it does to her? Let’s explore that question further by dissecting the terminology most commonly used by patients (and even some experts) when discussing hormone restoration therapy: “natural,” “synthetic” and “bio-identical.”NaturalThe term “natural” cannot be used to describe hormones or…


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