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MODIFYING A DOSAGE REGIME

Although quite straightforward, the original prescribing and fine-tuning of formulae does require a thorough understanding of the signs and symptoms of over and under dosing each hormone. Approximately six weeks after starting treatment, the blood hormone profile is re-tested. The ideal blood hormone levels are patient specific, but in general aim for the top 2/3’s of the reference range. Some women require a little estrogen whilst others require significantly more. Estradiol levels of 200pmol/L, FSH 10-20 can be used as guides. Consider the hormone levels together with any patient symptoms to fine-tune their prescription.

PATIENT SYMPTOMS INDICATIVE OF HOW TO MODIFY DOSE
Fluid retention in hips & chest; nausea; lack of concentration; headaches; forgetful; disrupted sleep Low Progesterone: But directly related to balance with estrogen Add/increase Progesterone or decrease estrogen
Hot flushes; anxiety; tiredness; agoraphobia; cystitis; itching & burning; dry eyes; dry vagina; specific and unusual aches and pains; ‘cotton-wool head’ Low Estrogen Increase Triest or considerusing Biest
Bloating; sore/ tender nipples & breasts, rapid weight gain; red rash (rosacea); mood swings; weeping; heavy or irregular menses; sleep problems; headaches High Estrogen Increase progesterone – continuously in menopause or cyclically in pre- or peri- menopause. Usual to increase progesterone in a separate troche or reduce estrogen
Low libido; tiredness; no energy; lack of muscle tone; depression Low Testosterone Add in or increasetestosterone dose
Lack of energy; no motivation; zest for life absent. Low DHEA Increase DHEA dose

 

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