Hormone care that doesn’t end at “your labs are normal.”

Common questions about hormone care

• My doctor said my labs are normal. Why do I still feel terrible? +

  “Normal” in conventional medicine usually means “within the standard reference range,” which is built from the general population, including a lot of people who don’t feel great. Optimal hormone levels for symptom resolution are often very different from the lower end of “normal.” We use functional reference ranges and treat based on labs and how you actually feel. If your testosterone is in the bottom 10% of normal, you don’t feel normal, and we don’t pretend you should.
• What hormones do you treat? +

  For women: estradiol, progesterone, testosterone, DHEA, thyroid (T3/T4 with consideration of reverse T3), cortisol patterns. For men: testosterone, estradiol management, DHEA, thyroid, cortisol. We also evaluate other markers that affect hormone signaling, SHBG, sensitive estradiol, free fractions, IGF-1, fasting insulin.
• What modalities do you use? +

  Telehealth-deliverable forms: oral (tablets, capsules), sublingual troches, transdermal creams and gels, and self-administered subcutaneous or intramuscular injections (with provider training). Pellet inserts and in-office injections will be available once our American Fork clinic opens.
• How is BHRT different from conventional HRT? +

  “Bioidentical” means the molecule is structurally identical to what your body makes, estradiol, progesterone, testosterone, rather than synthetic analogs (like medroxyprogesterone or conjugated equine estrogens). Most modern HRT is now bioidentical regardless of who prescribes it; the bigger differences are in delivery method, dosing precision, and monitoring. We use individualized dosing based on labs and symptoms, and we adjust often.
• Is hormone therapy safe? +

  For most appropriately-screened patients, yes, with regular monitoring. The 2002 WHI study scared a generation of women off HRT based on data that was, in retrospect, often misinterpreted. The current evidence (NAMS 2022 position statement, more recent reviews) supports HRT for most women within 10 years of menopause or under age 60 for symptom management and bone health. For men, TRT for clinically low testosterone has a substantial evidence base. Risks exist for both. We’ll review the full picture during your consultation, including who shouldn’t be on hormones.
• How often do you monitor? +

  Initial labs at intake. Re-check labs at 6 to 8 weeks after starting or changing a protocol. Then every 90 days during active titration, and every 6 months once stable. Provider visits track lab cadence. We don’t set protocols and forget them.
• What about pellets? +

  Pellet therapy requires in-office insertion. All visits are currently by telehealth for adults located in Utah and California. California patients are seen by Rayna Fowler, FNP-C. Our American Fork clinic is in development, and we’ll share an opening date once it’s confirmed. In the meantime we use other modalities (creams, troches, injections) that achieve comparable clinical outcomes with more dosing flexibility.
• How much does it cost? +

  Comprehensive Hormone Intake: $200 (45-minute video, includes pre-visit intake review, comprehensive hormone labs, initial protocol design). Ongoing monthly protocol management (30-minute follow-up visits): $200 per visit. Hormone medications themselves vary based on what you’re prescribed and where they’re sourced, typically $30 to 150/month. Some standard labs may be insurance-billable through LabCorp or Quest depending on your plan.