Standard HRT runs on minimal labs and a one-size dose. Patients who don't respond are usually told to be patient — or get bumped up without ever re-checking estradiol, SHBG, hematocrit, or thyroid.
We run the full panel up front: total and free testosterone, SHBG, estradiol, progesterone, DHEA, complete thyroid, cortisol, IGF-1, lipids, fasting insulin, HbA1c, hs-CRP, vitamin D. Then we re-test at 8–12 weeks and adjust dose, route, or supporting therapies based on what the labs and symptoms actually show.
Bioidentical only — molecularly identical to what your body produced at 25. Delivered as injections, pellets, creams, or capsules depending on what fits your physiology and schedule.