Q. Why can’t I start patients on a one half dose and titrate up?

• The minimum dose used by the Basic Wiley Protocol, although the only FDA equivalent is Estrasorb®, may seem a bit high; but it is actually the least amount needed to show consistent improvement clinically and even approach the bottom of the reference range in the blood work for healthy young women. The only women eligible for less are women 60 plus, who have not had exogenous hormones ever and then only one month at a time for three months maximum.
• There is no need because if the Wiley Protocol is adjusted to a therapeutic optimum, within three months, the vaginal tissues will have renewed and will retain moisture. After all, vaginal mucus is the hall mark of ovulation and normal hormonal peaks.

Q Why do patients feel fine on static dosing?

• Any hormone in any way is better (in terms of quality of life) than none at all. The dramatic improvement on the Wiley Protocol in all areas, in quality of life and clinical markers like bone density, hot flashes etc… is far more pronounced. What’s more Dr. Julie Taguchi’s work has shown a significant reduction in cancer risk compared to no hormone restoration at all. Her work will soon be published.
  
  Vaginal E3 is usually recommended when restoration of urogenital function is required. E3 is a metablolite of E2. If the urogenital system requires help, so do the rest of the hundreds of places in the body where estrogen is needed. Estradiol will convert to estriol and give the same benefits to the UG system as E3 alone; there is always metabolite to precursor ratio. Many physicians are afraid to give E2 due to fear of breast cancer, yet there is no data to support that giving E3 is safer than E2 anywhere.
  
  This misconception is based on the widely publicized fact and conclusion by Dr. Jonathan Wright that E3 is the major estrogen in third trimester pregnancy, and that pregnancy is linked to less breast cancer, therefore E3 must be breast tissue protective. The extremely high levels of E3 in third trimester pregnancy come from the fetal adrenal glands. There are studies that show if breast cancer occurs in pregnancy or very shortly after, it is more aggressive. The decreased risk of breast cancer is more closely associated with the number of pregnancies, age of first pregnancy, breastfeeding and other hormones, not E3 levels. With respect to the current data, we do not see the benefit of supplementing with spent metabolite. Again there would in nature never be more matabloite than precursor of E2. There is no substantial data to support that E3 is breast tissue protective.
  
  Hormones are dose dependant. For example, when a women approaches menopause the amount of estrogen produced by the ovaries steadily declines. Many internal changes take place without a perception of such, as increased bone loss, loss of skin collagen and elastic tissue, decreased rate of nerve tissue repair etc. However, when a critical point is reached many women experience hot flashes, psychological disturbances, sleep difficulty which brings them to their doctor. Many of these later symptoms can be relieved with small static doses of hormones, even synthetic ones. Many women with healthier adrenals can go through menopause without much difficulty. Logically to optimize mind and body function, hormones should dosed and administered as close as possible to how nature did it, it is not scientific to ignore this. Remember, hormones are signals, they work in concert with one another and the environment, and they cannot be on all the time. Hormones have rhythms which we must respect.

Q. They’re in adrenal fatigue so I’m giving them…

• Neurotransmitter “support”, even adrenal “support” products can only be effective with a full compliment of steroid hormones on board. However, since neurotransmitters and neurosteroids often cross-react in compensatory action it is prudent to under provide supplements unless you have a thorough understanding of rhythmic brain interaction in regard to the HPA Axis’ feedback to the HPO Axis. Sleep, diet and sex hormones should all be attended to before sitting down at the table with the Gods to try to control the consciousness interface response to stress and emotion with a pill.

Q. Why not saliva or urine, as opposed to blood tests?

• There are no baseline values for healthy young women in saliva or urine as of yet, which is a vital component to our premise for the Wiley Protocol.

Q. How do you know thyroid is inverse proportion to estrogen?

• TSH is a gonadotropin, just like FSH and LH, which is always in inverse curve production to estradiol.

Q. Why do I have to give DHEA with testosterone to men?

• DHEA provokes androgen receptors to receive testosterone and when DHEA, itself, is lodged in the androgen receptor, lowers estrogen reception.

Q. Why don’t men get a day off?

• Men get day 14 and day 28 off from the testosterone.

Q. How do I know when/how to adjust them off of the pharmaceuticals they’re on? (thyroid, anti-depressants, etc.)

• By month three (3) on the Wiley Protocol, with enough estrogen on board, it is possible to suspend or start to taper (at ¾, ½, ¼ …etc) pharmaceuticals with proper modeling. Furthermore, it’s reasonable to assume that if you can’t taper by month three, the full therapeutic value of the Wiley Protocol has not yet been attained.