Hormone Optimization

Get Started
First visit
75 to 90 minutes
Cadence
Quarterly with labs
Lead clinician
Marisa Holm, NP

What we mean by hormone optimization.

Hormones are the body's signaling system. When they drift out of range, the effects ripple across sleep, mood, body composition, recovery, libido, and cognition. The work is to find the actual signal in the noise: which axis is moving, which is downstream, and which has been compensated for at a cost.

Our model is conservative. We start from a complete clinical picture, not a checklist. We use bioidentical hormones where indicated and only at the lowest dose that gets the result. We retest, reassess, and tune.


Who this is for.

Patients who notice persistent changes in energy, sleep, mood, body composition, or libido that are not explained by stress, sleep, or activity alone. Patients who have been told their labs are "normal" but who feel otherwise. Patients in perimenopause, post-menopause, or andropause looking for a thoughtful path.

Who this is not for.

Patients seeking single-axis testosterone replacement without a broader workup. We do not prescribe hormones outside of a complete clinical picture, and we do not chase numbers without symptom correlation.


What we test.

  • Full thyroid panel: TSH, Free T3, Free T4, reverse T3, antibodies
  • Sex hormones: total and free testosterone, estradiol, progesterone, SHBG, DHEA-S
  • Adrenal axis: AM cortisol, four-point salivary cortisol when indicated
  • Metabolic context: fasting insulin, A1c, lipid panel, inflammatory markers
  • Nutrient cofactors: vitamin D, B12, ferritin, zinc, magnesium
Process

What to expect.

A typical hormone optimization protocol unfolds in four steps. We move at the pace your biology actually moves.

Step 01

Workup

Full intake, history, and a complete lab panel. We pull existing records and add what's missing.

Step 02

Plan

A written protocol with priorities, cadence, target metrics, and a clear sense of what changes first.

Step 03

Active treatment

The protocol begins with check-ins at 4 and 8 weeks. We adjust based on labs and how you feel.

Step 04

Long-term

Quarterly visits with labs. The protocol is reduced or sustained based on what your body actually needs.

What changes

Outcomes are individual.

We tune protocols to what your body actually does, not against an average. Your path may emphasize one of the themes below or all of them.

Energy & clarity

Steadier energy through the day, sharper focus, easier mornings.

Sleep & recovery

Deeper sleep, fewer days of feeling drained, faster recovery from training.

Body & mood

Body composition shifts, mood and motivation lift, the day-to-day feels lighter.

No outcome is guaranteed and timelines vary. We measure what changes for you, in your labs and in your life, and adjust accordingly.

“The first plan that addressed thyroid, adrenals, and sex hormones together. I felt the difference within a month.”

Patient, Hormone Optimization · 2024