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|