A Functional Guide to Hormone Replacement Therapy

A Functional Guide to Hormone Replacement Therapy

There's more to wellness than just starting hormone replacement therapy. A functional approach to your health is the missing link.

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A Functional Guide to Hormone Replacement Therapy

A Functional Guide to Hormone Replacement Therapy

If you’ve ever started hormone replacement therapy (HRT) and thought, “Why don’t I feel better yet?”—you’re not alone. HRT isn’t a magic bullet, and if we’re being honest, the standard approach can sometimes miss the mark. Hormone replacement should never be a one-size-fits-all solution. It’s a highly personalized process that works best when supported by a functional and integrative plan.

This blog is your practical guide to understanding how to optimize HRT, which labs to request, and how to choose the treatment method that fits your body, lifestyle, and long-term health goals.


How to Optimize HRT


Optimization means more than symptom relief. It’s about supporting your entire body—especially your liver, gut, and adrenal function.


Why You Might Not Feel Better Yet:

- Your thyroid could be suboptimal
- You could be metabolizing hormones inefficiently due to poor detoxification or gut health
- You’re missing key nutrients like magnesium, B6, and zinc that are critical for hormone metabolism
- You’re only replacing testosterone and ignoring estrogen and progesterone



Functional Optimization Strategies:


- Evaluate daily lifestyle, sleep quality, and nutrition.
- Manage stress to balance cortisol.
- Improve insulin sensitivity and reduce inflammation with a whole-food diet and regular movement.
- Incorporate targeted supplements when needed (DIM, magnesium glycinate, B-complex).


Labs to Order for a Functional Approach:

- Estradiol, Progesterone, Testosterone (Free and Total), DHEA-S, FSH & LH
- Thyroid panel: TSH, Free T3, Free T4, Reverse T3, and antibodies
- Blood sugar markers: Fasting insulin, glucose, A1C
- Nutrients: Vitamin D, B12, Ferritin, Iron, Magnesium
- Optional: DUTCH test for hormone metabolites and adrenal rhythm


HRT Delivery Methods – Which One is Right for You?
The delivery method matters—and choosing the right one is just as important as choosing the right dose.


1. Creams
Pros: Easy to adjust, create a steady level of hormones versus extreme peak and troughs
Cons: Inconsistent absorption, can transfer to others, daily application.

2. Injections
Pros: Great for testosterone, predictable dosing, fast results.
Cons: Peaks and valleys, needles.

3. Pellets
Pros: Long-lasting
Cons: Requires procedure, can’t adjust dose once inserted, expensive, cannot achieve a steady-state to mimic natural hormones, side effects only subside when pellet wears off in about 3-4 months.

How Apex Health Functional Wellness Supports Your Hormones

At Apex Health, we individualize care and order a comprehensive set of labs. Each lab is interpreted in the optimal range, not the normal range, and a unique supplement & nutrition plan is created. We further layer cares to focus on longevity, by recommending peptides to support your health journey.

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