Hormone Replacement Therapy; HRT; Chronic Fatigue; Adrenal Fatigue; Adrenal Failure

Always Tired
Always Tired

If waking up in the middle of the night, and often not being able to get back to sleep, is leaving you with no energy throughout the day, you may be suffering from Chronic Fatigue. It can negatively impact daily life and inhibit normal day-to-day activities. Chronic fatigue develops with age as a result of a decrease in Adrenal Function. Essentially, the adrenal glands decrease in their effectiveness and function as we get “older.” This is the way the body ages. Fatigue and Insomnia usually result from adrenal fatigue or adrenal failure.

Fatigue itself is merely a symptom other underlying issues. Laboratory analysis is the best way to quantify exact amounts of hormones in the blood. This is a crucial first step. Giving someone hormone replacement without the having lab work done is not safe and maybe harmful. I only treat patients with Hormone Replacement Therapy after knowing their precise values, and then calculating a proper dosage for treatment. One hormone in particular, DHEA, or didehydroepiandrosterone, is most likely causing the feeling of fatigue itself. Improving DHEA blood levels may take care of the chronic fatigue.

The recent media explosion of “Low T” in men and the information they contain regarding hormone replacement is extremely misleading. The problem with testosterone products that are commercially available, is that they contain inadequate quantities of testosterone, and by using these commercially available “low T” products, there is nothing to prevent the body from taking this testosterone and degrading it to estradiol as it passes through the skin. That is the exact opposite of the desired effect.

We prefer to restore testosterone and other hormone levels in a compounded product that combines testosterone with a little bit of progesterone, and something called “chrysin.”. Adding an aromatase inhibitor, chrysin, prevents the enzymatic breakdown of testosterone to estradiol.



Adrenal Support Supplements






Thyroid Friendly B-Complex
Thyroid Friendly B-Complex






David S Klein, MD

David S. Klein, MD, FACA, FACPM was born in Washington, DC, and was raised in Chevy Chase, Maryland. He completed his undergraduate education at the University of Maryland with degrees in Chemistry and Psychology. Medical School was completed at the University of Maryland at Baltimore, followed by Internship in General Surgery at the University of North Carolina and Residency in Anesthesiology at the Duke University, Durham, North Carolina. Dr Klein has been practicing medicine since 1983, concentrating in Pain Medicine, Minimally Invasive Medicine and Surgery, and Neuroendocrinology. Earning Board Certification in Anesthesiology, Dr. Klein was elected Fellow in the American College of Anesthesiology, and he was elected Fellow in the American College of Pain Medicine. He is currently an adjunct Associate Professor at the University of Central Florida, School of Medicine. He has focused his private practice on treating patients with hormone imbalance issues, nutritional deficiency related medical problems as well as pain related issues and impairment. With a highly-complex, CLIA licensed laboratory in-house, he has been able to provide rapid-turn around analysis efficiently and cost-effectively. Lecturing extensively nationally as well as internationally, Dr. Klein has authored many articles on topics relating to pain, injury and nutritionally modulated illness. His radio show, “Pain Free Living,” received top ratings during the 6 years it was on the air. Currently practicing in Longwood, Florida, Dr. Klein practices entirely in the office setting.

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