Expertise · Hormone Therapy
Testosterone replacement, GLP-1 agonists, estrogen and thyroid therapy, and adult growth hormone — reviewed by a board-certified endocrinologist who manages these regimens in clinic and measures them against the guidelines in force at the time of care.
Hormone litigation is a documents case wearing a medicine costume. The Endocrine Society, AACE and menopause-society guidelines set out exactly what should precede a prescription — confirmed biochemistry, screening for contraindications, a monitoring schedule — and the chart either contains that work or it does not. My reports walk the record against those requirements line by line, distinguishing genuine clinical judgment from care that skipped the questions entirely.
I am board-certified in endocrinology in both the United States and Canada, prescribe and monitor these exact therapies in active practice, and have published peer-reviewed research and clinical reference texts in hormone medicine — the credentials that hold when the opinion is tested under cross-examination.
Case Patterns
TRT started without two confirmed morning testosterone levels or any workup of the cause, cardiovascular and thrombotic events on therapy, polycythemia with a hematocrit that was never rechecked, and fertility loss in young men who were never told suppression was expected. The monitoring record — or its absence — usually decides these cases.
Semaglutide, tirzepatide and their compounded copies — gastroparesis, pancreatitis, gallbladder disease and severe hypoglycemia claims; dosing errors with compounded multi-dose vials; prescribing without weight, glycemic or contraindication screening; and the widening gap between FDA-labelled use and telehealth-driven prescribing.
Menopausal hormone therapy continued or initiated against contraindications, thromboembolic events on estrogen, thyroid replacement titrated to symptoms rather than labs, and "bioidentical" pellet protocols producing supraphysiologic levels no guideline endorses. These matters turn on whether the regimen ever had a defensible target.
Adult growth hormone prescribed for wellness, body composition or anti-aging without stimulation testing to establish deficiency — an indication no guideline supports — and without the IGF-1 monitoring that labelled use requires. The diagnostic file is usually where the case begins and ends.
Subscription hormone clinics running standing protocols — same starting dose, same refill cadence, minimal labs — across thousands of patients. When one is injured, the systemic questions matter: who reviewed the labs, who held prescribing authority, and whether the protocol itself fell below the standard of care.
What the Record Shows
Related expertise
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