What's my dose? Part 2

In last week’s column we began a discussion about how dosages for medications and supplements are recommended. We learned that many meds/sups have recommended dosage ranges. However, most don’t have specific information to help guide decisions based on age, sex, metabolic rate, or other individual factors. This puts physicians in the position of needing to recommend a specific dosage for their patients. In this week’s column we will discuss how the intended use of a medication or supplement can greatly affect the dosage recommended.

The term “lowest effective dose” was discussed last week. In general, this means using the least amount of a med/sup to get the desired effect. Today we will talk more about the desired effect. A common part of my practice revolves around supporting healthy hormone production with both natural and prescription items. The dose of a medication, hormone, or supplement can vary greatly depending on the intended outcome. To illustrate this, let’s take a look at a common example from my practice.

When a patient visits their doctor to treat hot flashes and night sweats they may receive a prescription for some combination of hormone replacement therapy. Testing may or may not be involved depending on the physician’s mode of practice. A common prescription for hot flashes and night sweats usually involves estrogen and/or progesterone. In many cases, the symptoms will improve over the course of a few weeks or so. The conclusion many people would come to is that the therapy was successful. However, when you look deeper and ask the questions that inevitably get asked (usually after the fact) you can see more to the story.

When this patient comes into my office we always have a discussion about the short-term, intermediate-term, and long-term goals they have. I try my best to find out why the hot flashes and night sweats are happening. I usually recommend saliva hormone testing on at least three days to evaluate their production of DHEA, estradiol, estrone, progesterone, testosterone, and cortisol. There’s quite a detailed process in order to give us the best chance to achieve the goals they identified.

Most patients I work with put a high priority on doing things right over the long-term vs. a short-term intervention that may put you behind the 8-ball later on. My recommendations typically have a timeline associated with them for types of treatments, dosages, and re-testing. Depending on the patients goals I may be prescribing HRT prescriptions, botanicals, vitamins, minerals, intravenous infusions, or other therapies. If the patient chooses prescriptions to be part of the treatment plan it is likely that we are using different dosages than they may have used with another physician who recommended them for the treatment of the symptoms.

I hope the above example helps illustrate how the goals of the patient and the intended use by the doctor may alter the dosage of a medication or supplement.

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About the Author

Dr. Brent Barlow is a Naturopathic Physician practicing at The Kelowna Wellness Clinic in downtown Kelowna. Dr. Barlow has been in practice in Kelowna since graduating from the Boucher Institute of Naturopathic Medicine in Vancouver in 2009.

Naturopathic Doctors are trained as primary care physicians, and primarily use natural medicine to treat disease and promote wellness. Dr. Barlow believes strongly in identifying and treating the causes of disease rather than focusing on the treatment of symptoms.

Naturopathic medicine utilizes diet therapy, botanical medicine, nutritional supplementation, acupuncture, spinal manipulation and other physical medicine treatments to treat the causes of disease. Dr. Barlow also trained in the specialized treatments of prolotherapy, neural therapy, intravenous nutrient infusions, and chelation therapy.

Dr. Barlow is in general practice and welcomes all individuals and families. As a naturopathic physician he is trained to treat all health conditions in the manner that best suits the goals of each individual patient. He also has special interests in natural treatments for pain management and digestive health.

To learn more about Dr. Barlow's treatments or to schedule a consultation, visit his website at www.drbrentbarlownd.com or call 250-448-5610.

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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