What is the Meaning of Physiologic Dosing?

Physiologic Dosing is a clinical strategy that administers exogenous hormones, peptides, or pharmaceutical agents in amounts and patterns designed to closely mimic the body's natural, endogenous production. This dosing paradigm aims to restore hormonal concentrations to the levels and temporal rhythms characteristic of a healthy, younger individual, thereby minimizing disruption to the body's natural feedback loops. The objective is to achieve therapeutic benefit while avoiding the supraphysiologic peaks and troughs associated with conventional, high-dose replacement therapies. Adherence to physiologic dosing is a core tenet of bioidentical hormone replacement and precision medicine.

What is the Origin of Physiologic Dosing?

The term combines "physiologic," meaning consistent with the normal functioning of an organism, with "dosing," referring to the amount and frequency of administration. This concept developed in endocrinology as clinicians sought to replicate the body's subtle, pulsatile, and circadian release patterns, recognizing that the pattern of hormone exposure is often as important as the total amount. It contrasts sharply with pharmacological dosing, which often uses much higher concentrations to force a therapeutic effect.

What is the Mechanism of Physiologic Dosing?

The mechanism relies on maintaining a concentration gradient that is recognized as normal by the body's primary regulatory centers, such as the hypothalamus and pituitary gland. For instance, administering testosterone via a transdermal cream or frequent, small injections can replicate the steady, non-pulsatile secretion profile, whereas a large weekly injection causes a supraphysiologic spike followed by a rapid decline. By maintaining levels within a narrow, natural range, physiologic dosing minimizes negative feedback inhibition on the Hypothalamic-Pituitary-Gonadal (HPG) axis, thereby reducing the risk of testicular atrophy or suppression of endogenous hormone production.

Physiologic Dosing ∞ Area

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