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We're incredibly grateful for the trust you've placed in us to guide you towards your optimal health goals. To assist you further, we've prepared a reference guide that details hormone application specifics, outlines what to expect, and provides answers to common questions once you start your program. Our goal is to walk side by side with you on this journey, making it as smooth and rewarding as possible! We're here for you, ready to transform your journey into the epitome of health and vitality.

Thyroid Medication Basics

Take your natural thyroid medication on an empty stomach in the morning and wait about 30-60 minutes before eating. If you're splitting your dose to morning and afternoon, the second dose should ideally also be on an empty stomach. But if you end up eating, ensure to take your medication regardless. To remember, set a phone reminder!

Finding the right thyroid dose is crucial. If it's too high for your body, you might feel jittery, experience palpitations, anxiety, or a sense of overdrive. If this happens, reduce to a symptom-free dose, discontinue taking it, or call our office to discuss.

Important: Do NOT take your morning thyroid dose before blood tests. Have your dose after the blood draw to avoid artificially elevating results. Also, stop taking biotin supplements at least 3 days before a blood draw.

When do I start using them? 

For women still experiencing menstrual cycles, Day 1 is designated as the first day of bleeding. If you're prescribed estrogen, start using it from your next Day 1. However, you can use the prescribed progesterone and other hormones and supplements as soon as you get them. If by chance, your cycle doesn't arrive as expected, start your hormones on the day you would've expected Day 1 to fall on.

And for those who are no longer cycling, you can kick-start all your prescribed hormones and supplements as soon as you receive them. 

What if my cycle comes early?

If there's any early bleeding issue, pause your progesterone intake for two days, then resume as designed. Continue with your other hormones as advised, and remember to keep a calendar tracking your experiences. Your observations provide invaluable insights into understanding how your body is adjusting.

What if my cycle doesn't come?

If you miss your period, take a break for two days from your expected Day 1, then restart your protocol.

Remember, adjustment periods can happen, and it can take up to three months for your cycle to regulate after initiating a new hormone regimen. If you notice these irregularities persisting to the next cycle month, it'd be best to reschedule your follow-up appointment to earlier, so we can thoroughly review what's happening.  

Where do I apply my estrogen patch?

Stick the patch onto your lower abdomen, swapping sides each time for even application. The packaging has a helpful diagram for this. Choose two set days per week, like Monday and Thursday, to change your patch. Keep a patch on always—even during hormone level tests. The transparent, resilient patch remains intact during showers, swims, etc. Although rare, if you notice any adherence issues or skin irritation, don't hesitate to get in touch with our office. 

Where do I apply my creams?

Applying hormone creams needs some careful consideration. Choose areas with thin skin and minimal hair, like triceps, forearms, inner thighs, or behind the knees. Also, it's essential to avoid the face or neck to prevent saliva gland contamination, which can skew saliva test results.

It's ideal to use gloves for application, rubbing the creams in until fully absorbed. Additionally, be mindful of potentially transferring hormones to the face or neck, especially during sleep. It’s advisable to use lower body areas for nighttime application.

After finishing your morning and evening face routines, apply the hormone creams. Thoroughly washing your hands with soap is vital.

Also, always apply estrogen and progesterone creams to separate areas as they compete for the same receptor. You can alternate the application sites monthly, like January on the inner thighs, February on triceps, and March behind the knees. Remember, these simple measures can help maximize the effectiveness and accuracy of your hormone therapy.

Should I avoid transfer to my family?

Using gloves while applying hormone creams can prevent unwanted transfer. If the creams are applied to skin areas that can be covered with clothing, it further reduces the risk of accidental contact with others. Always keep them out of reach of children.

While progesterone, testosterone, and DHEA are usually well-tolerated by men, avoid exposing them to estrogen-based creams. If you apply creams at night, do so a few hours before bedtime, and cover the area with clothing if possible. In consideration of intimate activities, it's crucial to apply these creams afterward, especially if you're using any vaginal or labial cream.

Keeping these precautions in mind can ensure your hormone cream use is safe and effective. 

I haven't had my cycle in years, and now one came?

It's okay! Experiencing minor menstrual bleeding is not uncommon, and it's certainly not an emergency. Your newly introduced hormones are working their magic on various tissues in your body, including your uterus. The lining could've thickened in response to the estrogen, reminiscent of your cyclic changes during your reproductive years. Now, it might be shedding.

Remember, adjustments can be made to your treatment plan to possibly prevent this from recurring. In case the bleeding feels severe, please consult your gynecologist for immediate attention, and to also assess the health of your uterine lining if necessary. 

I started spotting, now what?

If you begin spotting, promptly increase your progesterone cream dosage to twice a day for two days. If spotting ceases, revert back to your usual dose. If it continues, start counting that day as a new Day 1 and proceed with your protocol as directed. Don't hesitate to call our office for further guidance. 

My breast are tender?

If you're experiencing discomfort, it could be tied to alterations in your estrogen levels. Generally, these symptoms subside within a few days to a week. If they persist beyond a few weeks, reach out to our office. We might need to adjust your dosage or conduct estrogen and progesterone level checks, as high progesterone can also trigger such symptoms.

I'm now getting hot flashes / my hot flashes are getting worse

If you're experiencing hot flashes, dividing your estrogen dose into two daily doses instead of one might help by allowing your receptors to adapt more smoothly. If there's no change after a week, please contact our office or send us a portal message to schedule a brief consultation.

Remember, hot flashes are generally linked to shifts in estrogen levels and can be exacerbated by stress, sugar intake, caffeine, and alcohol.

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