Pełna transkrypcja odcinka How a Shift from Traditional Medicine Led to a Holistic Approach to Wellness

and it's really discounted. Like I only charge $100 a month and then they have all of this to their access. So it's kind of like concierge medicine and even like patients who have insurance they sometimes pay for this so that they can be seen you know when you're sick and you call the doctor and they're like we'll see you in three weeks well you're not gonna be sick in three weeks right so that's kind of like an added bonus and it's it's just tailored medicine to the patient The Optimized NP: Yeah. And I think that that's the most beautiful part of it. And I hear the commonest conception. Oh, I have to have one or the other. And you bring up a really good point. You can have both. I've had both forever. The benefits of the DPC far outweigh anything you get from traditional, but there are going to be periods of time where if you have an extensive surgery or you have a traumatic experience, that insurance plays a role. But for prevention and optimization and overall wellness, that's where the DPC shines. We want to keep you out of the hospital. Now I'm not a DPC practice. I want to make that very clear guys. I don't do primary care, but what would you say are some of the biggest differences between a DPC practice and one that has to basically bow to insurance? Jennifer Parker: So the difference is we can do whatever we want. Like if the patient comes in and says, hey, you know, I want to run this test, this test. I saw on TikTok that like, this is the labs I want to do. We can do them and they can pay for them. And it's not a big deal where with insurance, you have to have a reason, a diagnosis. Did you do this test first? And so, you know, it's more tailored to the patient. It's more focused on prevention and wellness and keeping them healthy. I feel like primary care with insurance is sick care, not healthy, like preventative care. And I feel like that's the huge difference for me. The Optimized NP: Mm-hmm. Yeah, huge. And so one of the other issues too is time. The time you get to spend with a patient, the time you actually get to build that connection. What are the average times that you spend with a patient? Jennifer Parker: Yes. So my brand new patients, get an hour. Every consult is an hour visit. And then follow-up patients are normally 30 minutes, depending. If they're just coming in for labs, it's quick. Or if they're coming in for a quick injection, those are a little quicker. But typically, it's 30 minutes follow-up, one hour for new patients. The Optimized NP: Yeah, and see when you're going through a traditional practice, guess what? You got 15 minutes, 15 minutes to cram everything in and it never goes well. There's always things that, you know, get missed, right? You actually know your patients on a pretty personal level. And so do you also do telehealth? Jennifer Parker: 15 minutes. I do, I do virtual visits as well as in-person visits, which, you know, they take advantage of. And some people just love to come in person. They love

coming to my clinic. They love my personality. They love my staff and they have like a fun time. They always say it feels like they're at home. So most of them come in, but I do offer virtual visits. The Optimized NP: Yeah, virtual, it's picking up. I love virtual. If I could do virtual for anything, I will do it. Now, I know I looked at your website, of course, and you offer quite a few services. Do you want to just kind of run us through some of the services outside of DPC that you offer? Jennifer Parker: Yeah. Yeah, definitely. So we do offer weight loss like every other wellness clinic. We do the injectables with GLP-1s and we also offer Fentermine. We try to do some education with that too. We do hormone therapy for both men and women. We focus on both, but we mostly have women right now. They feel more comfortable obviously, because I'm a woman. We have red light therapy, IV vitamin hydration. The Optimized NP: Sure. Jennifer Parker: We do peptide therapy here. A couple other things, some allergy testing and stuff. The Optimized NP: Yeah, saw that. Yeah, the allergy testing. That's a first for me. That's pretty cool. I don't see a lot of clinics to do that. So you're really like a one-stop shop. Like you want full optimization. Guess what? We got you taken care of. Now I know on your TikTok, what really kind of brought me to you in the first place is I saw all the wonderful content on perimenopause because you know, it's no secret that, you know, women's hormones have been severely neglected. And so what are some of your thoughts on that as far as like the general Jennifer Parker: Yes. The Optimized NP: idea of hormone replacement therapy and where we're going with it. Jennifer Parker: I feel like normal, typical primary care shuns it. It's very hush-hush, don't talk about that, it's not safe. Where I feel that it's going to where it's offered more and it should be part of routine care. I find it to be very important. Women start experiencing symptoms in their 30s, sometimes even in their 20s, and they are just feeling like something's wrong with them. And really, it's just a small... The Optimized NP: Mm-hmm. Jennifer Parker: imbalance that you can fix and then make them feel so much better. So I feel like it's going in the direction of like hormone optimization is important. I'm hoping for that at least. It sounds like the FDA is know doing more studies and making it more available. So here's to hoping. The Optimized NP: Yeah, me too. Yeah, here's to hoping guys, here's to hoping. And you know, it's kind of funny when I started my clinic, it was actually just a men's only clinic. It was men's only testosterone because of course it's a biased opinion, but I thought, man, we're underserved. No one understands that, you know, we need testosterone, right? And I remember very vividly one day I was in my office and I had someone call and it was a female on the other end, which isn't unusual. Sometimes some wives would call for their husbands, but she was crying. And she said, look, I know You're a men's only clinic, but I need help. Will you please just please prescribe me something because no one else will even hear me out. And it was at that moment that I just had this, this pivotal moment of like, my God, I'm really, you know, I guess when I was underserved as we thought women are really underserved. And as I went down that rabbit hole, couldn't be more clear to me, even from the women's health initiative in the two thousands, that was a botched study that we're still suffering from. And so Jennifer Parker: Yeah. Right. The Optimized NP: Now, I probably do treat more women than men, but it's more intricate, right? It's a lot easier to treat a man than it is a woman. You give me testosterone, I'm going to feel amazing. It's a guaranteed thing. With women, we're balancing some things out. We're having to be more, and women are just more in tune with their bodies. Let's just be real. They are. So women are going to be able to be able to tell you like, hey, you know what? When we made that change, I wasn't feeling as good. There are more variables. Jennifer Parker: yeah. Right. The Optimized NP: And so when you start your treatment for a woman, let's say perimenopause, they're still having menstrual cycles. Are there specific teaching points or specific protocols or thought process that you go down? Jennifer Parker: Yes. So basically I make sure when they're coming in, do their labs and their luteal phase, which is like, you know, day 16 to 28, I make sure that they're going to be at their highest peak for their hormones. So they come in, we discuss all their symptoms. And typically, you know, a woman is in perimenopause or menopause based on their symptoms and what they're saying to you. So, but we always get blood work to back it up, to make sure that we're doing the right thing, providing the right treatment. The Optimized NP: Mm-hmm. Mm-hmm. Jennifer Parker: And typically in perimenopause, most of the women just need progesterone or testosterone. Most of the time they don't need like estrogen or anything like that unless they're having like pelvic pain, know, pain during intercourse, stuff like that, chronic UTIs. But typically we'll do the treatment plan after we get the labs. We'll sit down together, we'll review everything. I'll give my opinion. The Optimized NP: Mm-hmm. Jennifer Parker: and just let them know like this and this would be helpful for you. And then I ask them for feedback, because it's all about them. I don't make them do anything they don't want to do, and I make sure they fully understand. And I give them a lot of education when they come for their consult. They get a folder with different things, why we need this hormone, why we need that hormone, and the reason we use bioidentical hormones and go from there. The Optimized NP: Beautiful, Yeah, very, very similar on this end too. I think that what you said, testosterone, there's probably some women out there

that are like, whoa, whoa, whoa, testosterone, that's for guys, okay? And that's a huge, huge misconception. I can tell you from the women that I've treated, it's probably the first thing that I get feedback on. Like, my God, that testosterone, as soon as we start testosterone, I'm sleeping better. Energy, not to mention, libido. It's not, shortly after they drag their husband in saying, Jennifer Parker: Yeah. right. The Optimized NP: We need he needs some help. He's can't he cannot keep up right and so do you ever kind of get I guess weird looks or pushback when you're talking about the benefits of testosterone Jennifer Parker: They are surprised because I don't think that women realize they do have testosterone. And that's what makes women so intricate. Like you said, there's three hormones, sex hormones that we're balancing, progesterone, estradiol, and testosterone. And when you tell them they need that, they're like, what do I need that for? And I'm like, well, do you want to have sex with your husband? Like, how's your sex drive? How's your energy? How's your mood? And they're like, The Optimized NP: Alright. Yeah. Jennifer Parker: I didn't know that's what that was. I'm like, yeah. The Optimized NP: Mm-hmm. And this is the thing to write intimacy This is such an important part of a relationship and I've seen a lot of marriages almost go south because of it and to have some someone come in and say my god like this saved my marriage like that's a very profound thing and I think that we really it's taboo we don't like to talk about it, but the reality is We can act on this stuff. And so now let's say we've transitioned to menopause Do you how do you address the the breakthrough bleeding conversation? Jennifer Parker: Right. So I always let the women know like it's very common. So when starting Estradial, your body's adjusting. So you will have breakthrough bleeding. I make sure they let me know because we can make adjustments, increase progesterone for a few days to help the bleeding stop. But I do give them paperwork on it too. So they know like this is a pretty common thing, but it will go away. Your body's just kind of adjusting to the different hormones that it wasn't having for however long, you know, they were ignored. The Optimized NP: you Jennifer Parker: So yeah, I try to address that with them at their visits too. The Optimized NP: Yeah, because that can be a little, a little scary sometimes, right? Post-menopausal bleeding, like, whoa, whoa, whoa, I already paid my dues, what's going on? And then, you know, the thing is, is like you said, right? Your body's going to remember these because these are bioidentical hormones. These are chemically the same as your body's already making. So your body's going to say, yeah, I remember these guys. And so of course, whatever that uterine lining is, it's going to have to shut. And so, you know, I will say as difficult as it is to manage the hormones, you know, testosterone, progesterone, estradiol, Jennifer Parker: Yeah. Yeah. Right. The Optimized NP: I'll say there's a lot of customization. There's nothing more rewarding than just getting a text or a call saying, hey, I finally feel normal, right? Like that's just one of the best things ever. And it's really sad that we have to work so hard just to get normal. You see what I'm saying? Now with your male patients, what's your typical approach? you prefer testosterone? Do you like HCG and clomaphene? Jennifer Parker: Yes. do testosterone, so that's my preference. If they're on the fence and they're like, I don't really know if I want to do testosterone because you have to be on that for life. I'm like, well, I mean, you do, but you don't, you know, and I try to explain that to them so they understand that that, yes, this is something that you need for life to keep your testosterone up, but you are not required to stay on it. But if they're on the fence, then sometimes I'll try Clomaphene. It's not my favorite. It's not anything I really like to do. The Optimized NP: Right, right. Jennifer Parker: But if they're adamant about it, I'll let them. I mean, that's what they want. But I will educate them that my preference is testosterone. HCG, I've done a couple of times for a few patients, but really testosterone is the key factor for testosterone deficiency. So that's always what I push. The Optimized NP: I feel the same exact way. You know, have I done HCG and Clomaphene? Sure. I mean, will you see some numbers improve? Most often, but it doesn't usually correlate to great symptom improvement because there so many variables, right? You have to assume that, you know, the gonads are going to function appropriately and the metabolism factors. So yeah, I agree. Testosterone, I think is fantastic. And like you said, you know, a lot of people say, well, hey, you know, is it true that my body will never make testosterone again? Jennifer Parker: Mm-mm. The Optimized NP: And I think that's kind of a common misconception that once you're on it, you're on it forever, right? Because I think where the misunderstanding comes from is when you're on these exogenous testosterone, these anabolic, guess what? Your brain, doesn't know you're injecting testosterone. Your brain thinks it's making too much. So it stops making natural testosterone. Now, when you get off of this, guess what, guys? Your testosterone is gonna drop and it's gonna drop below when you start it. It's gonna hit the ground and your brain is gonna sense that and say, dude, Jennifer Parker: Right. The Optimized NP: We need to start working again and your testosterone will come back up. Now there's a lot of variables, right? We're talking bioidentical testosterone. There's a lot of other synthetics out there too, like Nanjalon, Oxangelone, different worlds, very similar though. And so other than testosterone, guess, what are some of the main benefits you see? Like you start treating a guy, what are some of the things he says at that

follow-up to Jennifer Parker: Right. The biggest thing is sleep, their energy. They feel like at the end of the day getting home, they can actually hang out with their family and do things. And definitely the sex drive goes up and that's always exciting to a man. So they definitely are happy about that. The Optimized NP: yeah. Right. Absolutely. I mean, when you're not getting morning erections, guys, get that looked at. OK, that's that's a problem, right? We enjoy our morning erections. Now, as far as weight loss, the GLP ones, I mean, I think these are fantastic, wonderful medications. Do you offer both semiglutide and terzepatide? OK, and so kind of like along that along that route, I know a lot of people think like, Jennifer Parker: Right. Yes, yes I do. The Optimized NP: these GLP ones, they're cheating, right? Like, hey, you're not putting in the work, you're just taking a shot and losing all this weight. But in your opinion, like what are the realities of using these GLP ones? Jennifer Parker: mean, some people come to me, this is their last resort. They've tried diet, they've tried exercise, they've tried everything possible. Even some of them have gotten gastric sleeves, gastric bypass, and they're still struggling. So the GLP ones are amazing to me because for one, they tell your brain, okay, listen, you're full, like this is all you need. it... helps in metabolism. It's so good for your metabolic system. I feel like it helps with inflammation. You know, it does have side effects, obviously constipation, nausea, but you educate your patient. You provide them with the tools that they need to not have those symptoms. And it's really life-changing for people. The Optimized NP: Mm-hmm. Yeah, I've been on both. started with semi-glutide. It was okay. Tris-epidide, much better. I've been on tris-epidide for probably about a year and a half and I love it. A lot of people think like, hey, you're gonna lose all your muscle. Absolutely not. The reality is the most important key foundations are to understand it's a tool, right? It's not, a lot of people think it's like a map. It's not gonna tell you where to go or how to get there. It's going to be a tool that you have to use, right? You've gotta eat protein. Jennifer Parker: Yeah. The Optimized NP: You've got to exercise, weight bearing activity, everyone should do that. You're not going to lose muscle and you're going to be able to adhere to a better, healthier diet. It's time to retrain your brain on how to eat because even as children, these breakfast cereals that are just loaded with sugar, we're all addicted. We're all addicted to sugar. There's so many processes in the foods that we eat. How can we not? And so we're really just kind of evening the playing field. Jennifer Parker: yeah. The Optimized NP: So if people want to call it cheating, so be it. Whatever improves your health, your life, that's really what matters. Do you get a lot of people that feel kind of bad when they're on GLP ones? Jennifer Parker: Right. They do. And they actually come in and they're like, you know, I, I talk so much crap about this and look at me now I'm here on it. And I'm like, but why? Like, why are you so ashamed? You're doing something good for you. Like being overweight that increases comorbidities, know, heart attack, stroke, diabetes. So why can't people see it as a tool that, I'm changing my life. Like I'm decreasing my risk for all these comorbidities. And so I always tell them that, like, who cares? Nobody knows you're on it for one, so who cares? The Optimized NP: Exactly, and I get a lot of people that will call and they'll just try to justify like this is why I need it This is why I need it. It's like relax relax. It's okay. This is completely fine, right? This is a safe space because you know my train of thought Is it even people at a healthy body weight could benefit from it too, right? Maybe not the higher dosing, but there's so many metabolic health, know insulin sensitivity improvements There are many benefits to this outside of weight loss now Jennifer Parker: Right. Right. Right. The Optimized NP: As far as Red At True Tide, when that comes out, what do think that one's going to be like? Jennifer Parker: I haven't really looked into it that much. I have like a couple patients that have asked about it, but I really haven't done a lot of research on it yet. But I do know several people who have done it and they absolutely love it. So it will be something that I look into, but I haven't looked at it yet. The Optimized NP: Yeah, sure, sure. Yeah, retichutide is going to be fantastic, right? It's going to activate GLP-1 receptor, GIP, also glucagon agonist. So it's really going to improve that metabolism. Yeah, people are getting it now. Granted, it's still in phase three clinical trials. know, most 503A pharmacies aren't doing this. But yeah, when it is actually available, you know, through these 503A pharmacies, it's going to be a big hit. Personally, being on terzepatide, not a significantly high dose. I will probably hold off on it because once you get up there, like, what are going to do? Come back down to terzapatite or semaglutide? No way. You're up there, right? Like my thought, you're stuck up there, right? My thought process is less is more, right? And my, my approach to therapy is I prefer like a split dosing or micro dosing approach where we do a smaller dosage twice a week as opposed to once a week. Jennifer Parker: Right, you're like stuck up there. yes. Yes. The Optimized NP: And we make small adjustments, maybe one to two units every two weeks just to cut out the food noise, right? I don't want full appetite suppression. I want the food noise gone. I say, throw your scale away, base your progress on your clothes, base it on how you feel. That's the main thing. The number on the scale, especially as you know, when you're starting hormone replacement therapy, guess what? We got a little bit of water retention. That

scale is not gonna tell you what you wanna hear. Jennifer Parker: Mm-hmm. The Optimized NP: If you're trying solely to lose weight, it's you're seeing yourself a first failure. Jennifer Parker: yeah, they get so disappointed when they do the hormone therapy and the injections. I'm like, this, I told you, you're gonna have water weight. You're gonna feel bloated. Like this is normal. It's gonna go away. But like it's the beginning. And I do the same for my GLP ones. I microdose. We do twice a week injections and we try to maintain the lowest dose possible until like we absolutely have to increase their dose because I tell them. The Optimized NP: you Jennifer Parker: This is not like your lifelong treatment. You need to learn lifestyle techniques to help you. This is something to help you with that. So that's what I do here too. The Optimized NP: Yeah, and I think that's really common. I think that's more of a common approach now than the traditional, let's start with a large dose once a week and double it every month, and then just give you medications for the nausea and the headaches and the constipation, which is just insane. If a medication's causing you to feel that crappy, don't take it. That's a poison now. It's not a medication. And so kind of going back to hormone replacement therapy for women. Jennifer Parker: Mm. Right. Right. The Optimized NP: Do you have a specific preference of like, do you typically do like a continual therapy, like everyday hormone therapy versus like a cyclic? Jennifer Parker: I do. I find that women like that better and it's actually easier for them in their lifestyle. Like, you know, trying to remember, is this day 18? I don't know what day I'm on. Is this... And they don't keep track. Most women aren't keeping track of their menstrual cycles. And so for me, I found it easier for my patients to just take it daily and then it keeps relieving their symptoms and all their problems consistently throughout the month. The Optimized NP: Mm-hmm. Yeah, and I mean, you bring up a good point, right? When we're taking over for the hormones, our goal is to keep things steady. We want things to be steady. We don't really want fluctuations because think about it, last time our hormones fluctuated, we were teenagers and teenagers don't make the best decisions, right? We're adults now. And so, I always discuss cyclic, but I've never had a female patient say, yeah, I wanna get these periods going again. It hasn't happened. So yeah, continuous therapy seems to be... Jennifer Parker: All right. Yeah, no. The Optimized NP: kind of the sweet spot. And as far as you know, what I like to do, I know there's so many different forms. I used to be almost 100 % cream. I didn't used to do testosterone injections for women, but I've gotten so much feedback from it. I did so much research that I found it's a very, very beneficial way to supplement testosterone, assuming you're using the correct concentrations. So what are some of your preferred

methods? Jennifer Parker: So for testosterone, most of my women are on injections. They don't wanna put cream on every day. I mean, me personally, I do hormone therapy and I use the cream and I love it. It's something that I like. But most of my women, no, they don't wanna do the cream every day. They just want once or twice a week injections and they wanna be done with it. So most commonly they're on injections. Yeah. The Optimized NP: Mm-hmm. Yeah, which are fantastic. mean, you have really precise control over them. I think they kind of get stigmatized as like bodybuilding for guys, but you got to realize we're talking completely different concentrations here. And once again, typically with my injections, men and women will typically do twice a week injections as opposed to once a week. Although I have noticed that women typically, some will do just fine on once a week. I have not seen any guys do fantastic on once a week. I mean, it's better than nothing. But the reality is, is once again, steady. Jennifer Parker: Yeah. Yes. The Optimized NP: levels. And then of course the oral micro, you know, the, the progesterone at night, oral micronized progesterone. And then as far as estradiol, do you typically do injections for that too or cream? Jennifer Parker: I do oral, so typically I do oral. the hormone course I took, really enhanced talking about the oral estradiol and how it's more absorbable. And so I did a bunch of research on it and I just started offering the oral. For women who have GSM symptoms like vaginal pain, chronic UTI, stuff like that, I'll do the vaginal. But most of the time it's oral. The Optimized NP: Okay. Mm-hmm. Was that the course by Neil Rousier? Jennifer Parker: No, Nico Mislaw, the HRTU University, yeah. The Optimized NP: yeah, okay, Nico's cool. Yep, yep. Yeah, I mean, there's so many ways to do this, right? And people will kind of get into these modes of like, no, no, no, you can't do it like that. This is the way you do it. This is the way you do it. That's insane. I've had people come on the podcast and say, pellets are the worst thing in the world. I may not offer pellets. I may not think pellets are the best way to do it, but I know some patients who do phenomenal on pellets, right? There's a thousand different ways to do this. And I don't think that there is a wrong way to do it. Jennifer Parker: yeah. The Optimized NP: as long as you are having open discussions with your provider, right? And you feel good because at the end of the day, the whole reason we start this is we're trying to improve your life. And this will typically happen on Facebook. Unfortunately, sometimes I get on Facebook and I get involved in talks and stuff and people will always say like, hey, if there's not a study or a protocol that supports that, how, know, what are you supposed to do? The reality is that's fear-based medicine, right? Fear-based medicine. reality is we're in the gray zone guys we are in the wild west of these hormones and

no one can tell me how how you feel other than you right I can't just say based off this number clearly you've got to feel this way which is sad that in most instances we look at that lab report as it's it's black or white how many times do you look at someone's labs before hormone replacement therapy and they're quote-unquote normal Jennifer Parker: Right. And that's what they say. They come to me. They're like, I've had my lab work done and I'm still having all these symptoms, but my doctor says I'm normal. And I'm like, well, you know, there's normal and then there's optimal. And which one do you want to be? And they're like, well, I want to be optimal. I'm like, well, okay, let's see your labs then. You know, and then you go over it they're like, wait a minute, what? So yeah, it's, it's pretty eye opening for the patients. The Optimized NP: Mm-hmm. Yeah, exactly. Yeah. Absolutely, to know that, wow, just because it's not in big bold red letters that I can actually do something to feel better because I'll tell you what, it's not normal to always be tired. It's not normal to have no limbedo. It's not normal to not sleep. None of that stuff's normal. And it's really easy. I'll say guys are probably the worst. We're pretty good at justifying depression and anxiety of, yeah, it's my job. Jennifer Parker: Mm-mm. The Optimized NP: the kids, it's all this, right? And we'll just kind of kick the can down the road. It's only until the penis stops working that it's like, if this is an emergency, we got to go to the hospital, something is wrong, right? And, and then with the females, it's you know, women just are very in tune. It's amazing. Women will say I've been tracking my cycle for 20 years. We were off by a little bit. I'm not sleeping as well. It's like, wow, I can't, I Jennifer Parker: Right. 100 % true. they are. Yeah. The Optimized NP: I totally agree. Like it's just, it's just amazing to see that contrast is that stark contrast. But what I do appreciate is that we are now getting into a realm where patients have such access to information that there's so much self learning you can do. And I always encourage it. Be the expert. I've learned so much from my patients. My patients will tell me something, text me something that I didn't even know. I had a patient who was on HRT and she was having a lot of gum sensitivity. Jennifer Parker: Right. The Optimized NP: And I just kept racking my brain. I'm like, okay, what's going on? What's going on? Well, come to find out progesterone in some women, it's pretty rare, can cause significant gum sensitivity, right? She'd gone to the dentist, they checked her gums, everything looked great. It was just this little tingling of her of her gums. I didn't know, right? So I learned something new and something I can apply moving forward. But when you're so close minded, I see this a lot, right? I'm the provider, right? I know everything. What I say goes. Jennifer Parker: yeah, yeah. The Optimized NP: That's never

gonna end well. It has to be a collaborative effort. And you probably remember this from nursing school, but joint decision making process. Do you remember that? It is. Jennifer Parker: yeah, that's important. And you know, it's funny you said that I just had a patient recently, I've been doing this for two years, never once had a patient say, my progesterone is increasing my GERD. And she already really struggled a lot with indigestion, heartburn, GERD, so much that it was like ruining her life. And she was like, it's gotten worse with the progesterone. And I was like, I never heard of that. You know, so I had to do some research. The Optimized NP: Mm-hmm. Ugh. Mm-hmm. Jennifer Parker: Turns out it does, it increases that. So we had to switch her to cream and hope that that is enough for her. But she was like, no, can't. I want to feel good, but I need to do something different. So we had to change it. The Optimized NP: Exactly. Yep. And see the alternative that you could have done. And unfortunately, this probably happens more often is sorry, you can't be on HRT because it's not, you know, you can't tolerate progesterone. So boom, just kick them out the door. No way. There are thousands of ways we could do this, right? Even my guys, something that I'll see fairly typically with injections is we'll see those hematocrites climb, right? We'll see them climb, climb, climb. There are a lot of things we can do to address them. And really, it's rarely an issue. But you know what? Transdermal. Jennifer Parker: Now. The Optimized NP: transdermal preparations for men. I mean, do I prefer injections over transdermals personally? Yeah. But is transdermal a great form as well? Sure. And you know what? You're not going to see that level of erythrocytosis. I've had many men who've switched. Their hematocrit comes back down to normal, and they feel fantastic. It's a little more high maintenance. It takes a little more TLC. But there are thousands of ways to do all of this. Jennifer Parker: Yeah. Definitely, and you can come up with a different way, especially if your patient's willing to try. The Optimized NP: So another question I was gonna ask is, are you licensed in any other states than Florida? Jennifer Parker: I am, I'm licensed in, I always forget them because I never get to practice in them. Iowa, Oregon, and Arizona. So I am licensed in three other states, but it's not a popular thing for me. So I haven't really got to use them. The Optimized NP: Sure, sure, absolutely, absolutely. And you're taking patients currently, correct? And so we're going to of, you know, I'm going to have you send me links to the website and your social media and we'll have all of that in the description. But if a patient was interested in getting started at your clinic, what's the best way for them to reach out? Jennifer Parker: Correct, yes. So they can definitely go on the website and they can book an appointment. We have it available to do your own booking. But sometimes it becomes like a nuisance for people and like, I don't want to do that. So they can just call the clinic at 727-807-1178 and Casey, my front desk, she'll take their call. She's awesome. And she'll help them with whatever questions or concerns they have. The Optimized NP: Mm-hmm. Okay. And one last question for you, Jennifer. So for that person that's out there hearing this podcast and they're like, I've really been on the fence about really taking control of my health and having a say in my overall medical care. What do you want them to know about a DPC practice and aligning with those goals? Jennifer Parker: I mean, a DPC practice is really about you and what your goals are for your life and how you see your future. So if you're struggling, you're on the fence and you're like, I don't really know where to go or what to do. You you can always call a DPC provider and we'll walk you through the steps and help you get on your way to preventative care, you know, do your yearly labs, make sure all of your screenings are done and just keep you pretty optimized and so you can live longer. The Optimized NP: Awesome. Well Jen, thanks for being with us today. I appreciate it Jennifer Parker: Thank you. Thank you for having me. The Optimized NP: Of of course.