Performance Medicine

06/02/2026

Can you take HRT if you have Factor V Leiden?

This is a question Dr. Rogers gets from women who have been told they can’t use hormones because of a blood clotting disorder.

His answer?

You have to be careful with the type of hormone therapy.

Oral estrogen is the problem because it goes through the liver, where clotting factors are made.

That’s why Dr. Rogers does not prescribe oral estrogen.

But bioidentical hormone creams are different.

They bypass the liver and do not affect clotting factors the same way oral estrogen can.

So if you have Factor V Leiden, it does not automatically mean you have to suffer through menopause with no options.

You need the right route, the right dose, and a doctor who understands hormone replacement therapy.

Have you been told you can’t take hormones because of clotting risk?

06/01/2026

Tired all the time… but don’t know why?

Bo McGregor, FNP says one of the most common things he hears from men with low testosterone is:

“I get home and I can instantly fall asleep on the couch.”

Now, everybody has reasons to be tired.
You work hard.
You have stress.
You have responsibilities.

But if you’re exhausted every day…
dragging through the afternoon…
and falling asleep the second you sit down…

It may be time to look deeper.

For a lot of middle-aged and younger middle-aged men, low testosterone can first show up as fatigue.

Not always.
Not for everybody.
But it’s worth checking.

Don’t just guess. Get the right labs and find out what’s really going on.

06/01/2026

Muscle is your longevity currency.

And as we age, it’s not just about being strong.

It’s about being able to move.

It’s about being able to trip on a sidewalk and catch yourself.

It’s about stumbling and not falling.

It’s about having enough power in your body to protect yourself.

That’s what people miss.

Power isn’t just how fast you can bench press or do a power clean.

Power is your ability to respond when life throws you off balance.

And when we lose muscle, lose strength, and lose power, that’s when we get into trouble.

Building and maintaining muscle helps decrease insulin resistance, lower your risk for heart disease and chronic disease, and protect your independence as you age.

So don’t just think of muscle as something for the gym.

Think of muscle as protection.

Think of muscle as independence.

Think of muscle as longevity.

Love this from Bo McGregor, FNP!

05/29/2026

05/29/2026

Can menopause make rosacea worse?

Dr. Joni Sago says yes — 100%.

Estrogen is very important for skin integrity. When women go through perimenopause and menopause, estrogen declines, and the skin starts losing collagen and elastin.

That matters because the skin barrier becomes weaker.

And when the skin barrier is disrupted, rosacea can become much harder to control.

The second piece is hot flashes.

When blood vessels dilate during a hot flash, it can bring more inflammation into the skin and drive the rosacea process.

So if your rosacea seems to flare more during perimenopause or menopause, you are not imagining it.

Hormones matter. Skin barrier matters. Inflammation matters.

If you’re struggling with rosacea, it may be worth looking deeper than just the surface of the skin.

05/29/2026

“In my opinion, unless you have a pretty good reason not to be on one of these GLP-1s, you should think about trying to get on one.” - Dr. Rogers

Exciting stuff coming out about GLP-1s. As always, do your own research.

05/28/2026

In my opinion, GLP-1s may be the most important medical discovery of this century.

I know that sounds like a big statement.

But when you understand how these medications work, it makes sense.

A lot of people think of them as “weight loss shots.”

That is not the whole story.

GLP-1 and GIP medications are working on natural gut hormones that many people simply do not have enough of.

This is about metabolism.

This is about inflammation.

This is about prevention.

This is about helping the right patient with the right tool.

There is a lot of misinformation out there right now.

Some people judge these medications before they understand the physiology.

My job as a physician is not just to write prescriptions.

My job is to educate, coach, check the labs, look at the metabolic picture, and tell patients the truth about what I believe they need.

These medications are not for everybody.

But for the right person, used the right way, they can be life-changing.

Do not make your decision based on headlines.

Get educated.

Ask questions.

And work with someone who understands the whole picture.

Tom Rogers, MD

05/28/2026

Muscle loss with GLP-1s? Yes, but only if you’re not consuming enough protein and doing resistance training.

05/28/2026

GLP-1s are not just “weight loss shots.”

That is where a lot of people get confused.

Dr. Rogers believes GLP-1s may be one of the most important medical discoveries of this century.

Why?

Because when you understand how GLP-1s and GIP medications work, you realize they are helping replace natural gut hormones that many people do not have enough of.

This is not about taking the easy way out.

This is about metabolism.

This is about inflammation.

This is about prevention.

This is about giving the right patient the right tool, with the right medical guidance.

Dr. Rogers says a good doctor should be more than someone who writes prescriptions.

A good doctor should educate you, coach you, check your labs, look at your metabolic health, and be honest about what you need.

There is a lot of misinformation out there about these medications.

But for the right patient, monitored the right way, GLP-1s can be life-changing.

Watch this before you judge GLP-1s based on headlines.

05/28/2026

Dr. Joni Sago, Dermatologist, says biologics have revolutionized medical dermatology.

These medications are different because they are very targeted.

They’re larger molecules, which is why most of them have to be injected. If you take them by mouth, your body will usually digest them because they’re proteins.

What makes biologics so powerful is that they target specific mediators of inflammation.

For example, Dupilumab is FDA-approved for atopic dermatitis, and it blocks interleukin 4 and interleukin 13.

That’s the direction medicine is going.

More targeted.
More precise.
Less of a “one-size-fits-all” approach.

For patients dealing with chronic inflammatory skin issues, biologics have changed the conversation.

This is why it’s so important to work with a provider who understands what’s driving the inflammation — not just what shows up on the skin.