How to Read Thyroid Labs Like a Pro: Why a Low Free T3 After Treatment Does Not Mean Failure
Quick Answer: If your patient started thyroid medication, feels significantly better, but follow-up labs show Free T3 barely changed, you are likely looking at a trough level, not a peak. When you instruct patients not to take their thyroid medication before a blood draw, the result reflects the lowest point in their 24-hour hormone curve. […]
Do Psych Medications Cause PCOS? The Emerging Link Providers Need to Know
One of the best parts about practicing medicine with an engaged team is getting to nerd out over new studies. That’s exactly what happened when my teammate Leslie shared a fascinating review from the FDA Adverse Event Reporting System (FAERS). Now let me be clear—this isn’t a randomized controlled trial (RCT). It’s a database review, […]
Pod Ep # 70 The Communication Essentials of Successful Clinical Leadership
In this episode of the Nico Misleh Podcast, Nico shared a small, unassuming moment that revealed a pattern he had carried for years. At a live event, a colleague handed him a coffee mug with the words “Great question” printed on it. The room laughed because many people recognized the phrase as something Nico said […]
This New Study Is Blowing Up Cancer and HRT Fears
Someone in our private HRTU membership recently asked: “What’s the actual risk of cancer recurrence for uterine cancer survivors who need HRT?” We get this a lot. And it’s a great question. While breast cancer gets most of the attention when discussing hormone replacement therapy (HRT), uterine (endometrial) cancer has historically had a huge data […]
Pod Ep. #63 How You Can Maximize Productivity In Your Clinic With This Morning Routine
In this episode of the Nico Misleh Podcast, Nico lays out a candid, practical look at how he organizes his days, balances clinical work with education, and protects time for family and rest. He is honest about imperfections, but he shares the systems he uses to win small battles every day. Below is a clear […]
Part 1: Endotoxin and PCOS: The Hidden Root Cause No One Is Talking About
Today, I want to talk HRT by way of something that most providers completely overlook: endotoxin. This concept is front and center in the HRT University Master Course and will play an even bigger role in the Advanced Female HRT Course. When I first heard about endotoxin as a nurse practitioner student, I thought it […]
Why Every Provider Needs Bioidentical Hormone Training in 2025
Patients are searching for bioidentical hormones more than ever. They want a provider who knows how to prescribe them safely. If you don’t feel comfortable with BHRT, you are missing out on both patients and revenue. Why Providers Need Bioidentical Hormone Training BHRT is not fringe medicine. It is evidence based and built on the […]
Are You Losing Patients Because of This Simple Scheduling Mistake?
If you have ever finished a great phone consult with a potential patient and then heard crickets afterward, you are not alone. It is one of the most frustrating parts of running a cash-based HRT or wellness clinic—feeling like you nailed the call, only to lose the patient somewhere between “I’m in” and “I’m gone.” […]