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 |