If you’re exhausted, gaining weight, losing libido, or feeling unlike yourself despite “normal” labs, HFW looks deeper — estrogen, progesterone, testosterone, thyroid, cortisol, insulin, inflammation, gut health, and metabolism — before building a physician-guided HRT plan when appropriate.
Physician-Led
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Nationwide
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Trusted by 1000+ patients across USA
Jenny Pourakis
Stella Blanch Apo
It’s been a blessing working with Dr. Landi and his entire team! After getting my test results, Dr. Landi walked me through a number of helpful steps to restore my health. He is very knowledgeable and uses an in-depth functional medicine approach in addressing health concerns. Bernadette is also very kind and thoughtful and I enjoy the interpersonal connection I have built with all of them.
Chase Natale
Fatimah Fahmy
Lauren Griffith
Kevin Heckman
Hormonal change can affect almost every part of your life.
HRT may be worth discussing if you are dealing with:
Too many hormone plans are either too dismissive or too aggressive.
Hormone therapy should answer:
At HFW, TRT is not the starting assumption.
It is one possible tool inside a larger testosterone optimization strategy.
At HFW, TRT is not the starting assumption.
We do not just replace hormones. We evaluate the system they live in.
| Typical HRT Care | HFW Longevity | |
|---|---|---|
What they look at |
Age, symptoms, and basic hormone ranges
|
Hormones, metabolites, thyroid, cortisol, insulin, gut health, inflammation, nutrients, body composition, and biological aging
|
What you hear |
“Your labs are normal” or “Here’s a prescription”
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“Your symptoms are real. Let’s find out what is driving them.”
|
Testing |
Basic bloodwork or isolated hormone values
|
DUTCH, comprehensive bloodwork, thyroid, metabolic, adrenal, nutritional, gut, DEXA, and longevity testing when appropriate
|
Treatment |
Generic HRT, pellet therapy, or symptom medication
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Personalized hormone strategy with safety review, dosing, delivery method, and monitoring
|
Support |
Short visits and limited follow-up
|
Quarterly labs, symptom review, biomarker tracking, and protocol adjustment
|
Goal |
Reduce symptoms
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Improve sleep, energy, libido, mood, metabolism, recovery, bone health, and long-term hormone resilience
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Access |
Office visits and long waits
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100% telehealth with at-home and local testing options
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When clinically appropriate, hormone therapy may help address symptoms connected to hormone decline or imbalance.
| Hormone Area | Why It Matters |
|---|---|
|
Estrogen
|
May support hot flashes, night sweats, vaginal comfort, sleep, mood, skin, urinary symptoms, and bone health.
|
|
Progesterone
|
May support sleep, nervous system calm, mood stability, cycle changes, and endometrial protection when estrogen is used in patients with a uterus.
|
|
Testosterone
|
May support libido, motivation, energy, muscle, recovery, mood, and body composition in properly selected men and women.
|
|
Thyroid
|
Supports energy, metabolism, temperature regulation, hair, mood, digestion, and weight response.
|
|
Cortisol Rhythm
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Affects sleep, anxiety, cravings, inflammation, recovery, belly fat, and energy rhythm.
|
|
Insulin
|
Drives metabolic symptoms, cravings, fat storage, inflammation, and energy crashes.
|
|
DHEA / Adrenal Patterns
|
May influence energy, resilience, stress response, immune patterns, and hormone pathways.
|
Good hormone care includes knowing when not to prescribe.
Before recommending hormone therapy, HFW reviews your symptoms, history, medications, family history, risk factors, labs, safety markers, and clinical fit.
We consider:
The goal is not to put everyone on hormones.
The goal is to know whether hormones are the right tool for you.
We test before we replace.
| Test | What It Can Reveal |
|---|---|
|
DUTCH Complete Hormone Test
|
Estrogen, progesterone, testosterone, androgen activity, hormone metabolites, cortisol rhythm, adrenal patterns, melatonin, and hormone clearance
|
|
Comprehensive Hormone Bloodwork
|
Estradiol, progesterone, testosterone, free testosterone, SHBG, DHEA-S, LH/FSH when appropriate, and safety markers
|
|
HRT Safety Bloodwork
|
CBC, CMP, liver markers, kidney markers, lipids, glucose, insulin, inflammation, and other safety indicators
|
|
Full Thyroid Panel
|
TSH, Free T3, Free T4, Reverse T3, thyroid antibodies, and possible thyroid conversion issues
|
|
Comprehensive Metabolic Bloodwork
|
Fasting insulin, glucose, HbA1c, lipids, liver markers, inflammation, and cardiometabolic risk patterns
|
|
Adrenocortex Stress Profile
|
Cortisol output and rhythm patterns that may affect sleep, anxiety, recovery, inflammation, and weight
|
|
Metabolomix+ Nutritional Panel
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Nutrient deficiencies, oxidative stress, amino acids, mitochondrial markers, gut metabolites, and cellular energy patterns
|
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GI-MAP Stool Analysis
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Gut dysbiosis, inflammation, digestion, immune activity, and gut-related hormone or metabolic triggers
|
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TruAge + TruHealth Testing
|
Biological age, pace of aging, and organ-system health across immune, metabolic, hormonal, cardiovascular, and cellular systems
|
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DEXA / Bone Density When Appropriate
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Bone density, lean mass, fat mass, visceral fat, skeletal aging, and body composition trends
|
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Genetic Testing When Appropriate
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Nutrient processing, detox pathways, hormone metabolism, inflammation tendencies, and long-term personalization strategy
|
|
TruAge + TruHealth When Appropriate
|
Helps evaluate biological age, pace of aging, and organ-system health.
|
Built around your symptoms, labs, safety markers, and goals.
1
Estrogen Therapy
When clinically appropriate, estrogen therapy may be considered for vasomotor symptoms, vaginal comfort, sleep disruption, mood changes, urinary symptoms, skin changes, and bone-health support.
2
Progesterone Therapy
Progesterone may be considered for sleep disruption, mood changes, nervous system support, cycle irregularity, and endometrial protection when estrogen is used in patients with a uterus.
3
Testosterone Therapy
Testosterone support may be considered for men or women experiencing low libido, low motivation, poor recovery, reduced muscle, mood changes, fatigue, or body composition shifts when symptoms and labs support it.
4
Combination Hormone Therapy
Some patients may need estrogen, progesterone, and/or testosterone support together. HFW evaluates which hormones are actually needed instead of assuming every patient needs the same combination.
Thyroid Optimization
If thyroid function is contributing to fatigue, weight resistance, hair changes, cold intolerance, constipation, mood changes, or metabolic slowdown, thyroid support may be considered.
Cortisol + Stress Regulation
If cortisol rhythm is disrupting sleep, anxiety, inflammation, blood sugar, or recovery, your plan may include adrenal and nervous system support.
Metabolic Support
Hormone symptoms often worsen when insulin, glucose, lipids, inflammation, and body composition are shifting. HFW addresses metabolism alongside hormones.
Gut + Liver Support
Gut health, digestion, inflammation, nutrient absorption, and liver detox pathways may influence hormone metabolism and symptom response.
Targeted Supplementation
Professional-grade supplementation may be used to correct deficiencies, support hormone metabolism, improve cellular energy, and reduce inflammation.
Peptide or Bioregulator Support
When clinically appropriate, peptides or bioregulators may support recovery, inflammation regulation, mitochondrial function, body composition, cellular resilience, and long-term longevity goals.
Nutrition + Lifestyle Strategy
A realistic plan built around protein needs, blood sugar stability, sleep, stress, inflammation, movement, gut health, and your actual life.
We review your symptoms, hormone history, cycle or menopause stage, sleep, mood, and goals, then talk through whether HFW is the right fit.
Hormone and safety testing looks past a single number to map estrogen, progesterone, testosterone, thyroid, cortisol, and metabolism. Kits ship to your door or get coordinated locally.
Your provider reviews the data and decides whether HRT, thyroid support, metabolic work, or a non-hormonal path makes sense, with clear reasoning.
We address what's driving your symptoms, replacing hormones where appropriate and supporting the gut, cortisol, and metabolic patterns around them.
Your plan begins with prescriptions when appropriate, pharmacy coordination, supplement and nutrition strategy, and ongoing monitoring.
Quarterly labs, symptom reviews, and safety monitoring help you protect your progress and adjust dosing as your body changes.
| We Track | Why It Matters |
|---|---|
|
Symptom Response
|
Shows whether sleep, mood, energy, libido, hot flashes, and recovery are improving
|
|
Estradiol + Progesterone
|
Helps guide hormone support and safety considerations
|
|
Testosterone + Free Testosterone
|
Helps evaluate libido, energy, muscle, motivation, and excess-androgen concerns
|
|
SHBG
|
Helps determine how much hormone is available for the body to use
|
|
DHEA-S
|
Helps evaluate adrenal and androgen patterns
|
|
Cortisol Rhythm
|
Helps explain sleep disruption, anxiety, cravings, fatigue, and stress physiology
|
|
Thyroid Markers
|
Helps identify thyroid conversion issues, antibodies, and metabolic slowdown
|
|
CBC + CMP
|
Tracks blood counts, liver function, kidney function, and general safety markers
|
|
Glucose + Insulin
|
Reveals metabolic resistance and blood sugar patterns
|
|
HbA1c + Lipids
|
Tracks cardiovascular and metabolic risk patterns
|
|
Inflammatory Markers
|
Shows whether inflammation may be affecting hormone response
|
|
Bone Density
|
Helps monitor skeletal aging and menopause-related bone risk
|
|
Body Composition
|
Tracks lean mass, fat mass, visceral fat, and hormone-related changes
|
|
Breast / Uterine Safety Factors
|
Helps determine appropriate route, dosing, and monitoring needs
|
You should not have to wonder whether your hormone plan is working.
You should be able to see it.
Physician-led care. Root-cause strategy. Long-term optimization
Christina Warner, APN, NP-C
Board-Certified Nurse Practitioner
25 years of clinical experience with a focus on hormones, gut health, chronic inflammation, womenu2019s health, and root-cause care.n
Dr. Eric Landi, KICP
Functional Medicine Doctor
Over a decade of clinical experience with advanced functional testing, peptide therapy, metabolic optimization, and data-driven longevity protocols.
Medical Director
Book a free virtual consultation to review your symptoms, hormone history, prior labs, risks, goals, and whether HRT or a broader hormone optimization plan makes sense for you.
HRT stands for hormone replacement therapy.
It is used to replace or support hormones that have declined or shifted, most commonly estrogen, progesterone, and testosterone. At HFW, hormone therapy may also be evaluated alongside thyroid, cortisol, insulin, inflammation, gut health, nutrient status, and biological aging.
BHRT usually refers to bioidentical hormone replacement therapy.
Bioidentical hormones are chemically identical or structurally similar to hormones naturally produced by the body. They may be commercially available or compounded.
At HFW, the label matters less than the clinical question: is this hormone appropriate, safe, properly dosed, monitored, and helping the patient?
HRT can be appropriate and beneficial for the right patient, but it is not risk-free.
Safety depends on age, timing, symptoms, medical history, route, dose, hormone type, risk factors, and monitoring. The Menopause Society states that treatment should be individualized with periodic reevaluation, and that benefit-risk is generally more favorable for healthy women under 60 or within 10 years of menopause onset who have no contraindications. (American Medical Women’s Association)
If you have a uterus and use systemic estrogen, progesterone or a progestin is often needed to help protect the uterine lining.
ACOG notes that estrogen-only therapy can cause the uterine lining to thicken, increasing endometrial cancer risk, and that adding progestin decreases this risk. (sa1s3.patientpop.com)
Yes, hormone therapy is considered the most effective treatment for vasomotor symptoms such as hot flashes and night sweats, and it can also help with genitourinary symptoms of menopause and prevention of bone loss in appropriate patients. (menopause.org.au)
It can, depending on the cause.
Low libido may involve testosterone, estrogen, progesterone, thyroid, cortisol, sleep, stress, mood, relationship factors, vaginal comfort, and medications. HFW evaluates the full picture before deciding whether testosterone, estrogen support, or another strategy makes sense.
Yes, when clinically appropriate.
Testosterone may be considered for women with symptoms such as low libido, low motivation, poor recovery, fatigue, or body composition changes when symptoms, labs, and safety markers support it.
Yes, when clinically appropriate.
TRT may be considered for men with symptoms and lab patterns consistent with low testosterone, after reviewing safety markers, risks, goals, and follow-up requirements.
HFW focuses on personalized, monitorable hormone strategies.
The exact route — cream, injection, oral, or other options — depends on your symptoms, labs, safety factors, goals, and provider judgment. We prioritize approaches that can be adjusted responsibly.
Not every patient needs the same testing, but DUTCH may be recommended when clinically appropriate.
DUTCH can help evaluate hormone metabolites, cortisol rhythm, adrenal patterns, estrogen metabolism, and androgen activity, which may be useful for personalizing hormone therapy and tracking response.
“Normal” does not always mean optimal.
Standard labs may miss hormone metabolism, cortisol rhythm, thyroid conversion issues, insulin resistance, inflammation, nutrient deficiencies, gut dysfunction, and biological aging patterns. Symptoms matter. Trends matter. Context matters.
Some patients notice changes in sleep, hot flashes, mood, energy, libido, or brain fog within weeks.
More complex symptoms may take longer, especially when thyroid function, cortisol rhythm, insulin resistance, gut health, inflammation, nutrient deficiencies, or medication factors are involved.
Not necessarily.
Some patients use hormone therapy long-term with periodic reevaluation. Others adjust, pause, or change therapy based on symptoms, labs, age, goals, and risk factors. HFW reviews your plan over time instead of assuming it should stay the same indefinitely.
HFW operates on a cash-pay model.
HSA and FSA cards are accepted where applicable, and all major credit and debit cards are accepted.
No. HFW is 100% telehealth.
Consultations happen virtually. At-home test kits can be shipped to you, bloodwork can be coordinated locally, and eligible prescriptions may be managed through appropriate pharmacy partners.
