The HRT University® Podcast

Is HRT Safe? What to Tell Patients About Cancer and Clots

Your patient is ready to start hormone therapy. Then she asks one question. My grandmother had breast cancer, so I can never take this, right? If the answer is not clear,

Leaving Your W-2 and What Year One Costs

A W-2 feels safe. It is one client who can fire you. That client can cut your role, change your comp model or sell the company, and your income goes with it. Ownership i

Ferritin: The Iron Marker Nobody Reads Right

A ferritin of 15 clears the reference range. The patient is still exhausted. She is shedding hair at the crown and the temples, her sleep is fine, and three providers hav

Postpartum Psychosis Is an Endocrine Event

A labor and delivery nurse was prescribed 13 psychiatric medications over four months. This is the Lindsay Clancy case. This episode asks a hard question: could thyroid s

TRT and Fertility: The Myth That Keeps Young Men Untreated

Zach's testosterone came back at 302, in a range that runs from 300 to 1000, and his endocrinologist told him he was fine. He had brain fog, no energy, and no sex drive.

How to Start an HRT Clinic Debt Free: Savings First, Staff Later

Nico Misleh sits down again with his wife, Cherrell, who runs the money and operations side of Apollo Health Optimization and HRT University, to talk about what it actual

Low Testosterone and Depression: A First Responder’s Story

This episode includes discussion of PTSD, suicidal ideation, and alcohol use. Garrett spent 18 years as a deputy sheriff and police officer, all of it on night shift. Ov

Testosterone for Women and Men: What Providers Should Order

Testosterone is the hormone nobody checks in women. Nico Misleh, MSN, FNP-C sat in an OB-GYN office with his wife not long ago and watched it play out. Nobody ordered it.

Progesterone for Men and Women: Why the Uterus Was Never the Point

Progesterone gets filed under women's health, and inside that, under uterine health. Nico Misleh, MSN, FNP-C argues that both filings are too narrow and that a provider p

Hair Loss and DHT, Why DHT Is Not the Real Problem

DHT gets blamed for hair loss more than almost anything else, and Nico Misleh, MSN, FNP-C thinks that blame is misplaced. In this episode he makes the case that dihydrote

Cortisol and Hormones, a Signal Not the Problem

Cortisol is one of the most misunderstood hormones in practice, and one of the most over-tested. In this episode, Nico Misleh, MSN, FNP-C makes the case that cortisol is

Seed Oils and Your Patients’ Hormones: The PUFA Problem Behind Stalled HRT

You have a patient who is doing everything right on paper. Hormones optimized, sleep handled, xenoestrogen exposure coming down. And still the weight will not move, the t

Early Puberty and Xenoestrogens: What It Means for Your HRT Patients

A century ago the average girl reached her first period at 16 or 17. Today it is closer to 12, and breast development is turning up routinely at 6, 7, even 8 years old. G

The Estrobolome: How Your Patient's Gut Is Recycling Estrogen

You have seen this patient. Her estrogen reads optimal. You have checked it two or three times. And she is still bloated, still constipated, still dealing with breast ten

PCOS Is Now PMOS, What the Rename Means

Polycystic ovary syndrome is no longer called polycystic ovary syndrome. A landmark consensus study in The Lancet, built on 22,000 clinicians and patients across 11 years

How to Market a Medical Practice: Email, Social Media, and Storytelling

You hired a logo designer, picked your brand colors, maybe even named your clinic something clever. And now you are ready to hand the whole thing to an ad agency and watc

The Cash-Pay HRT Practice: What Actually Works

This week I'm switching from clinical to business. I want to talk about the stuff nobody told me when I was building my own clinic. Apollo Health Optimization is three ye

Birth Control is Not Treatment: What Providers Should Use instead

A 16-year-old walks into your office with acne and walks out with a birth control script. So does the 28-year-old with heavy periods, the 35-year-old with PMS, and the 42

96. Hormones and Depression: Why SSRIs Are Not the Full Answer

Think about how many of your patients walk in with the same story. Low mood. Zero motivation. Brain fog that will not lift. They feel like a different version of themselv

95: Thyroid Labs: Why a Low Free T3 After Treatment Does Not Mean Failure

Your patient started thyroid medication. She is feeling better than she has in months. And then you open her follow-up labs and her Free T3 barely moved. This is the mom