The Perimenopause Trap: Why More Estrogen is Rarely the Answer
There is RARELY a need to start estrogen during perimenopause. Doing so results in adverse effects more often than not and I have seen far too many women stop hormone therapy completely because of an uninformed "menopause specialist" cluelessly creating an environment of estrogen excess.
Many practitioners, even self-proclaimed "menopause specialists", fail to understand the fundamental physiology of the perimenopausal transition. They operate under the false assumption that because a woman is experiencing hot flashes or night sweats, she must be estrogen deficient. In perimenopause, the reality is often the exact opposite.
Women's health matters. By understanding the physiology of perimenopause, we can save women from unnecessary suffering and keep them on a path to optimal health.
A Brief Blurb about Hormone Optimization
hormone optimization is about augmenting the levels that naturally decline with age to prevent the diseases associated with aging. We aren't just trying to make you feel good; we are using evidence-based medicine to protect your bones, brain, & heart.
Cognitive Dissonance: The Silent Barrier Preventing Optimal Patient Care
How can we improve the quality of care our patients receive if we are unwilling to acknowledge our cognitive dissonance and engage in educated discourse?
Misinformation is dangerous and it destroys trust in the medical system. I believe a significant amount of misinformation is unintentional, but that doesn't make it any less dangerous. Cognitive dissonance is the profound mental discomfort that arises when presented with evidence that directly contradicts one's deeply ingrained, established beliefs. This discomfort fuels confirmation bias, maintaining outdated dogma and often leading to the continuation of ineffective or potentially harmful treatments.
The challenge of Cognitive Dissonance is formidable, but surmountable. It requires professional humility, the willingness to acknowledge that what we once believed may no longer be true. Our duty is to provide transparent, coherent education, illuminating the profound difference between the old dogma and the new science. To truly progress and deliver optimal outcomes, we must embrace intellectual humility and let go of our cognitive dissonance. We must abandon this fast, comfortable thinking and confront the harsh reality of flawed historical teaching, enabling us to embrace the truth of the current science, regardless of how uncomfortable it makes us or our peers.
Melatonin: A Deep Dive into the Science Beyond Sleep
You've been told melatonin is just a simple sleep aid, but that's barely scratching the surface. Despite recent, misleading headlines from the AHA , melatonin is one of the body's most potent protective molecules.
This deep dive into the research reveals its true role as the "body's night-shift supervisor". I explore its power as a master antioxidant that boosts glutathione and a strong anti-inflammatory. Discover its critical function in metabolic health, where it improves insulin sensitivity and allows your pancreas to heal at night. Learn how it's essential for neuroprotection, enhancing the brain's "glymphatic detox" system during deep sleep to clear beta-amyloid proteins linked to Alzheimer's.
I also bust dangerous myths about dosing (no, it won't shut down your natural production ) and explore why it's a far superior choice to pharmaceuticals like Ambien, which may reduce this vital brain-cleaning process.
Progesterone's Role in Uterine Bleeding Control
Progesterone’s role in uterine bleeding control is a critically important area of discussion, and one that highlights a frequent point of confusion among patients and even some practitioners. Understanding the true relationship between progesterone and uterine bleeding is foundational to safe and effective hormone optimization, fostering optimal health within you and your patients.
Apolipoproteins: Key Drivers of Cardiovascular Health and Risk
Managing cardiovascular risk demands we look far beyond conventional cholesterol panels. The true drivers of atherosclerosis are the ApoB-containing particles, which I often refer to as the "bullets" that directly cause vascular injury. Today's article explores Apolipoproteins and how they are key drivers of cardiovascular health and risk.
Leaky Gut and Metabolic Health: Causes, Consequences, and Cures
The root cause of chronic insulin resistance and resulting conditions like visceral fat accumulation often begins in the gut. When the protective intestinal barrier fails, toxins like LPS flood the system, triggering chronic inflammation known as metabolic endotoxemia. Check out my latest article to learn more about the causes, consequences, and cures for leaky gut.
Hormones, Vision, and Ocular Protection
the interplay between hormones and vision is a topic of profound importance, yet it is often overlooked in conventional practice. It is a perfect example of how system-wide hormonal health underpins specific organ function, including the delicate structures of the eye and the visual processing centers of the brain.
Drawing from the research, we can dissect the relationship between hormones and vision into three primary areas: the protective role of specific hormones, the function of hormones as diagnostic indicators, and the management of visual symptoms related to hormone deficiencies and optimization therapies.
Statins: Common Perceptions Versus Clinical Reality in Women
Statins are widely prescribed medications, primarily known for their ability to lower cholesterol, but what is the clinical reality of statin use in women?
In my clinical practice, and supported by a growing amount of scientific literature, the approach to cardiovascular health, especially in women, necessitates a shift from a "cholesterol-centric" view to a holistic, hormone-optimizing strategy. While statins remain an option for secondary prevention, particularly in specific indications, it's crucial to acknowledge their limitations and potential collateral damage. The profound protective effects of optimized hormones, often able to reverse the very pathology statins struggle to address, present a compelling and evidence-based alternative or complementary strategy that is unfortunately underutilized and often misunderstood within conventional medicine.
Ultimately, empowering patients with this knowledge allows for true shared decision-making, where the full spectrum of benefits and risks from all available therapies, including hormone optimization, can be thoroughly considered.
The role of DHEA in Mental Health
I doubt anyone would disagree that you must first repair the foundation before you can expect the house to be stable. When it comes to our mental and physical health, our neuroendocrine system is that very foundation.
Prescribing an antidepressant for depression without evaluating for and treating hormonal deficiencies is akin to giving pain medication for a nail in the foot without removing the nail. You are masking the symptom without addressing the root physiological dysfunction.
By optimizing the foundational hormonal milieu first, you give the body the necessary tools to regulate itself. If depressive symptoms persist after hormonal optimization, then and only then should an antidepressant be considered as an adjunctive therapy. We must treat the patient, not just the symptom.
Hormones, Metabolism, and Refractory Depression: What is the connection?
What is the connection between hormones, metabolism, and treatment-resistant depression? Let's expose the elephant in the room that conventional psychiatry often overlooks.
What Zulresso & Postpartum Depression Can Teach Us About Conventional Medicine
How has conventional medicine become so good at ignoring the elephant in the room?
Response to the FDA's August 2025 statement on Desiccated Thyroid
The FDA posted a statement last week warning about the use of desiccated thyroid (DTE), making unsubstantiated claims about DTE and stating they have “concerns with the safety and effectiveness of the unapproved animal-derived thyroid medications”. I find the discussion surrounding desiccated thyroid both perpetually fascinating and, at times, profoundly frustrating due to persistent misconceptions. The evidence surrounding the use of desiccated thyroid is quite clear and this recent statement made by the FDA provides very strong evidence, in my opinion at least, that the FDA does not base its guidelines on evidence-based research.