FAQ

Most frequent questions and answers.
Please note that this is a resource for my patients but it is open to the public to read. It does not take the place of medical advice and you should still see a medical doctor if necessary.

I recommend you perform the test over 3 consecutive mornings to find an average. Also, to increase accuracy of the test, you must do it as soon as you wake up in the morning before putting anything in your mouth. Also ensure you are free of symptoms before you perform the test (heartburn, indigestion, pain etc)

  1. Mix 1/4 teaspoon of baking soda in 120-180 ml’s of cold water first thing in the morning before eating or drinking anything.
  2. Drink the baking soda solution.
  3. Time how long it takes you to burp. Time up to 5 minutes.
  4. If you have not burped within five minutes, stop timing.

In theory, if your stomach is producing adequate amounts of stomach acid you’ll likely burp within two to three minutes. Early and repeated burping may be due to excessive stomach acid (but don’t confuse these burps with small little burps from swallowing air when drinking the solution). Any burping after 3 minutes indicates a low acid level.

Each person will have a specific supplementary HCL dosage.

  1. Eat a meal that contains at least 15-20 grams of protein.
  2. Start by taking 1 pill (650mg or less) of Betaine HCL during the beginning of the meal.
  3. Finish the meal as normal and observe your body for any changes in feeling associated with the stomach and belly button area. Things to look for: heaviness, hotness, burning, or other gastrointestinal distress.
  4. Stay at this dosage of 1 pill for another day of meals with protein and if you don’t notice anything on the 3rd day, try 2 pills.
  5. Stay there for another day and then try 3 pills.
  6. Keep increasing the number of pills taken with each meal until you notice some GI discomfort described in step #3.
    When this happens, you will know your ideal Betaine HCL dosage is 1 pill less. For example, if you felt the discomfort going from 5 pills to 6 pills, then 5 pills is your proper dosage for a normal meal.

Questions relating to the elimination diet:

No, as detox coffee in fact contains small amounts of caffeine, it is not allowed on the diet.
This refers to pre-prepared food such as shop bought food that will contain preservatives and additives.
Eggs are potentially allergenic and as such, could be contributing to your inflammatory load even though you may not be experiencing classic allergy symptoms.
Sometimes our food intolerances involve more immediate symptoms which can be noticed in our bodies within a short space of time (hours to days). On other occasions, we have a subliminal immune response that is occurring on a cellular level that we may not be aware of.

Questions relating to hormone use:

Tablets:

DHEA/7 keto DHEA: Take tablets as per the label. DHEA is always taken in the morning.
Low Dose Naltrexone: Take tablets as per the label. Low Dose Naltrexone is always taken at night.
Progesterone: Take tablets as per the label. Progesterone is taken at night.

Creams:
  • Timing
    The best time to apply Estrogen or Testosterone cream is in the morning. Apply Progesterone cream in the evening, as it will help improve sleep patterns.
  • Preparation
    Make sure your hands and the application area are clean and dry. Do not apply creams or oils to the application area or this will reduce the absorption of the hormones. Wash hands after application.
  • Where to apply
    Hormones may be applied to upper inner arms, shoulders or backs of knees. Be sure to remain consistent throughout the month in order to build up hormone deposits at the application site. The larger the application area, the better the absorption will be.
  • How to apply
    Applying the cream on large skin surfaces (i.e., the inner and outer side of the arms and shoulders) produces a longer action that will last a full 24-hours. The reason is that once the estradiol or testosterone has penetrated in the skin, it accumulates in the fat just beneath the skin. The subcutaneous fat under the skin forms a reservoir of estrogen/testosterone that slowly and progressively gets released into the bloodstream over a 24-hour period. In contrast, when all the cream is applied on a small skin surface (for example on the inner part of the forearms only), then most of the penetrated estrogen/testosterone will not accumulate in a fat reservoir, but directly go into the bloodstream. This surplus will quickly reach a peak level in the blood and quickly disappear from it, resulting in a loss of estrogen/testosterone effects later on in the day. Rub the cream not twice but ten times back and forward on the skin surface. The repeated rubbing improves deep penetration and absorption of the cream into the skin.
Cautions
  • If you will be in direct skin contact with men, children or animals-cover the application site with clothing for 1 hour after application.
  • Avoid estrogen sensitive tissue such as the breasts.
  • Do not bathe for 40 minutes after applying hormone creams.
  • Do not exercise, or do anything to promote excessive sweating for 2 hours after
    application.
  • Do not layer over any other creams.
Progesterone

Ovulating
Begin using Progesterone after you have ovulated. Ovulation usually occurs about 10 to 14 days after your period begins. Count the day the period begins as the first day. Apply every day from day 14 to day 25.

Peri-menopausal (still menstruating but with menopausal symptoms)
Count the day the period begins as the first day. Day 1 to 6, do not use progesterone cream. Apply every day from day 7 to day 27.
If your cycle begins early, stop using progesterone while you are menstruating. Count the first day of menstruation as day 1 of the cycle and begin the counting all over again.

Post-menopausal
Choose a calendar day (e.g. the first day of the month) as Day 1. Day 1- 25 apply Progesterone daily. Day 25 – 30 (or 31), stop using the Progesterone OR use it from Monday to Saturday with a break on the Sunday.

Estrogen and Testosterone Creams

Apply cream daily for 25 days and then break for 5 -6 days (as above) OR use it from Monday to Saturday with a break on the Sunday.

Your first set of blood tests will be drawn 2-3 months after you start your hormones. Once stability is reached on hormones, the tests will usually be 6 monthly. You will still be expected to have your routine gynae checks (paps, breast checks, mammograms/thermography and pelvic scans).

Have blood drawn early in the morning and do NOT apply hormones until AFTER your blood has been drawn. If progesterone is being drawn and you are still having cycles, this should be on day 21 of your cycle. If you are not having cycles, they can be drawn on any day.

Try and avoid any form of strenuous exercise 24 to 48 hours prior to hormonal blood tests.

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