FAQ

Ozempic utilizes the active ingredient semaglutide, which belongs to a class of medications known as GLP-1 receptor agonists. GLP-1 (glucagon-like peptide-1) is a hormone naturally produced in the body that plays a key role in regulating blood sugar levels and appetite.

Ozempic mimics the effects of GLP-1 by binding to GLP-1 receptors in the pancreas. This binding stimulates insulin secretion in response to meals, which helps to lower blood sugar levels. Additionally, semaglutide slows down gastric emptying, which can reduce appetite and promote a feeling of fullness, leading to decreased food intake and potential weight loss.

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Ozempic is administered as a subcutaneous injection, meaning it is injected just beneath the skin using a pre-filled pen or syringe. This method ensures that the medication is delivered directly into the fatty tissue under the skin, where it can be absorbed into the bloodstream gradually over time.

The injection sites commonly used include the abdomen, thigh, or upper arm. This mode of administration allows for precise dosing and consistent absorption of Ozempic, supporting its effectiveness in managing conditions like type 2 diabetes and obesity. It is a straightforward process that can be easily performed at home or under medical supervision, providing patients with convenience and reliability in their treatment regimen.

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GLP-1 medications, like Ozempic, benefit individuals with type 2 diabetes by improving glycemic control and promoting weight loss. They are also helpful for those struggling with obesity or prediabetes, offering a non-surgical option for weight management. Overall, GLP-1 medications offer a convenient and effective solution for improving metabolic health and controlling appetite.

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Ozempic has shown promising results in aiding weight management, including for individuals with conditions like PCOS. By reducing appetite and promoting a feeling of fullness, semaglutide can support weight loss efforts in combination with a healthy lifestyle.

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Ozempic is manufactured by Novo Nordisk and approved by FDA in the late 2010s. Millions over Americans take Ozempic weekly for diabetes and weight loss.

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Here are the common side effects of Ozempic injections:

• Gastrointestinal symptoms like nausea, vomiting, diarrhea, and constipation
• Injection site reactions such as redness, itching, or swelling
• Possible episodes of low blood sugar (hypoglycemia), especially when combined with other diabetes medications
• Headaches
• Decreased appetite
• Fatigue
• Gallbladder-related issues, including gallstones or inflammation

These side effects are usually mild to moderate in severity and tend to improve over time as the body adjusts to the medication. However, it's important to discuss any persistent or bothersome side effects with a healthcare provider.

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Yes, Ozempic is a prescription medication. Oana provides prescription services and delivers the medication if approved by one of our healthcare providers who deems it suitable for the patient's condition and needs.

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No prior prescription is required. Our medical team handles it for you.

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Oral minoxidil is generally well-tolerated, but like any medication, it can cause side effects. Common side effects may include:

1. Low blood pressure (hypotension): Especially when starting the medication or increasing the dose.
2. Fluid retention: This may cause swelling (edema) in the ankles and feet.
3. Increased heart rate (tachycardia): Some people may experience a rapid heartbeat.
4. Hypertrichosis: Unwanted hair growth on the face and body.
5. Dizziness or lightheadedness: Particularly when standing up quickly.
6. Skin reactions: Such as rash or irritation.
7. Fatigue or weakness: Occasionally reported.

These side effects are usually mild and tend to resolve over time or with dosage adjustments. It's important to discuss any concerns with your healthcare provider and follow their guidance closely while using oral minoxidil.

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Generally, it may take around 3 to 6 months of consistent use to notice significant improvements in hair growth and reduction in hair loss. Some individuals may see results earlier, while for others, it may take longer. It's important to continue using oral minoxidil as prescribed by your healthcare provider to achieve the best outcomes. Regular follow-ups with your doctor can also help monitor progress and adjust treatment as needed.

Yes, oral minoxidil is considered “off label” and requires a prescription. Oana provides prescription services and delivers the medication if approved by one of our healthcare providers who deems it suitable for the patient's condition and needs.

Oana's partner state-licensed compounding pharmacy adheres to strict quality standards and regulatory requirements enforced by both the FDA and state pharmacy boards. This ensures that the medication meets the highest standards of safety and efficacy.

Oral minoxidil can benefit individuals experiencing hair loss who have not seen desired results from topical treatments or prefer the convenience of a once-daily pill. It is particularly useful for those with androgenetic alopecia (pattern hair loss) and can also be effective for hair loss related to PCOS (polycystic ovary syndrome). Additionally, it may be prescribed for other types of hair loss as determined by a healthcare provider. At Oana Health, you can connect with one of our knowledgeable doctors who will assess your condition and determine if oral minoxidil is a suitable treatment option for you. Our service is convenient, quick to respond, and provides personalized care to help you manage your hair loss effectively. Consult with an Oana Health doctor today to get started on your treatment plan.

Minoxidil works by promoting hair growth and slowing hair loss through several mechanisms:

1. Vasodilation: Minoxidil widens blood vessels, increasing blood flow to hair follicles. This enhanced blood supply delivers more oxygen and nutrients, stimulating hair growth.
2. Follicle Stimulation: Minoxidil extends the anagen (growth) phase of hair follicles, allowing them to produce longer and thicker hair strands. It also shortens the telogen (resting) phase, encouraging dormant hair follicles to enter the growth phase sooner.
3. Potassium Channels Activation: Minoxidil opens potassium channels in cells, which is believed to play a role in promoting hair follicle activity and growth.

Overall, these effects combine to enhance hair density, reduce hair shedding, and support the health and function of hair follicles.

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Oral minoxidil contains the same active ingredient as topical minoxidil (generic Rogaine). While topical minoxidil is FDA-approved for hair loss and available over-the-counter, oral minoxidil is used "off label" and requires a prescription. Originally FDA-approved at higher doses for high blood pressure, doctors noticed that low-dose oral minoxidil could effectively treat hair loss due to its side effect of promoting hair growth.

Yes, semaglutide is a prescription medication. Oana provides prescription services and delivers the medication if approved by one of our healthcare providers who deems it suitable for the patient's condition and needs.

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No prior prescription is required. Our medical team handles it for you.

Here are the common side effects of semaglutide injections:

• Gastrointestinal symptoms like nausea, vomiting, diarrhea, and constipation
• Injection site reactions such as redness, itching, or swelling
• Possible episodes of low blood sugar (hypoglycemia), especially when combined with other diabetes medications
• Headaches
• Decreased appetite
• Fatigue
• Gallbladder-related issues, including gallstones or inflammation

These side effects are usually mild to moderate in severity and tend to improve over time as the body adjusts to the medication. However, it's important to discuss any persistent or bothersome side effects with a healthcare provider.

Oana's compounded semaglutide is manufactured in our partnerFDA-registered compounding pharmacy. Our partner pharmacies adhere to rigorous quality standards to ensure the safety and efficacy of this and all other compounded products, ensuring the best possible outcomes for our patients.

Semaglutide has shown promising results in aiding weight management, including for individuals with conditions like PCOS. By reducing appetite and promoting a feeling of fullness, semaglutide can support weight loss efforts in combination with a healthy lifestyle.

GLP-1 medications, like semaglutide, benefit individuals with type 2 diabetes by improving glycemic control and promoting weight loss. They are also helpful for those struggling with obesity or prediabetes, offering a non-surgical option for weight management. Overall, GLP-1 medications offer a convenient and effective solution for improving metabolic health and controlling appetite.

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Semaglutide is administered as a subcutaneous injection, meaning it is injected just beneath the skin using a pre-filled pen or syringe. This method ensures that the medication is delivered directly into the fatty tissue under the skin, where it can be absorbed into the bloodstream gradually over time.

The injection sites commonly used include the abdomen, thigh, or upper arm. This mode of administration allows for precise dosing and consistent absorption of semaglutide, supporting its effectiveness in managing conditions like type 2 diabetes and obesity. It is a straightforward process that can be easily performed at home or under medical supervision, providing patients with convenience and reliability in their treatment regimen.

‍

Semaglutide utilizes the active ingredient semaglutide, which belongs to a class of medications known as GLP-1 receptor agonists. GLP-1 (glucagon-like peptide-1) is a hormone naturally produced in the body that plays a key role in regulating blood sugar levels and appetite.

Semaglutide mimics the effects of GLP-1 by binding to GLP-1 receptors in the pancreas. This binding stimulates insulin secretion in response to meals, which helps to lower blood sugar levels. Additionally, semaglutide slows down gastric emptying, which can reduce appetite and promote a feeling of fullness, leading to decreased food intake and potential weight loss.

Yes, oral semaglutide is a prescription medication. Oana provides prescription services and delivers the medication if approved by one of our healthcare providers who deems it suitable for the patient's condition and needs.

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Common side effects of oral semaglutide may include:

1. Nausea
2. Vomiting
3. Diarrhea
4. Constipation
5. Headache
6. Abdominal pain

These side effects are usually mild to moderate in severity and tend to improve over time as the body adjusts to the medication. However, it's important to discuss any persistent or bothersome side effects with a healthcare provider.

Weight loss results with oral semaglutide can vary, but on average, patients lose about 5% to 10% of their starting weight over 12 weeks. For someone weighing 200 pounds, this equates to losing approximately 10-20 pounds. Combining the medication with a healthy diet and increased physical activity can enhance these results.

Oana Health is dedicated to making semaglutide affordable for everyone. We offer clear and consistent pricing so you can access this advanced treatment without worrying about unexpected costs.

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Oana's partner state-licensed compounding pharmacy adheres to strict quality standards and regulatory requirements enforced by both the FDA and state pharmacy boards. This ensures that the medication meets the highest standards of safety and efficacy.

Oral GLP-1 is typically taken by placing a measured dose under the tongue (sublingually) each day. This allows the medication to absorb directly into the bloodstream. The dosage may be adjusted gradually based on individual response and tolerability, with a maximum recommended dose of 1mg per day.

Oral GLP-1 medications, like semaglutide, benefit individuals with type 2 diabetes by improving glycemic control and promoting weight loss. They are also helpful for those struggling with obesity or prediabetes, offering a non-surgical option for weight management. Overall, oral GLP-1 medications offer a convenient and effective solution for improving metabolic health and controlling appetite.

Oral semaglutide works by mimicking the action of a naturally occurring hormone called glucagon-like peptide-1 (GLP-1). When you take oral semaglutide, it stimulates GLP-1 receptors in your body, primarily located in the pancreas and brain. This stimulation leads to several beneficial effects:

1. **Increased Insulin Secretion**: Oral semaglutide triggers the pancreas to release more insulin in response to elevated blood sugar levels. This helps lower blood sugar levels after meals.

2. **Slowed Gastric Emptying**: Oral semaglutide slows down the emptying of the stomach, which can help regulate appetite and reduce the rate at which glucose enters the bloodstream after eating.

3. **Reduced Glucagon Secretion**: Glucagon is a hormone that increases blood sugar levels by promoting the release of glucose from the liver. Oral semaglutide inhibits the secretion of glucagon, helping to keep blood sugar levels stable.

4. **Increased Satiety**: Oral semaglutide can increase feelings of fullness and satiety, which may lead to reduced food intake and weight loss over time.

Overall, oral semaglutide helps improve blood sugar control and promote weight loss by targeting multiple mechanisms involved in glucose metabolism and appetite regulation.

Oral semaglutide is a medication taken sublingually (under the tongue) that helps manage blood sugar levels and promote weight loss by mimicking the GLP-1 hormone.

You’ll likely notice a difference in mood and energy within a few hours of taking it. It could take 4 weeks or longer before you feel the full benefit of bupropion. If you don’t feel any improvements after 4 weeks, talk with your provider about switching to another medication or increasing your dose.

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Because of its potential for abuse, bupropion should only be taken as directed and should not be prescribed for patients with a history of drug or alcohol dependence. As with all antidepressant drugs, bupropion should be used cautiously when treating patients with seizure disorders because it may lower the seizure threshold. Bupropion may also cause an increase in your blood pressure. Bupropion should not be used if you have a history of an eating disorder. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Because bupropion may make you drowsy, do not drive a car or operate machinery until you know how this medication affects you.

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Bupropion comes as a regular tablet and as a sustained-release or extended-release tablet to take by mouth. Take bupropion as directed, and follow the directions on your prescription label carefully. Do not take more or less of bupropion than prescribed by your provider. Your provider may start you on a low dose of bupropion and increase your dose gradually.

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The most common side effects are loss of appetite, headaches, insomnia, and nausea. Other side effects include dry mouth, constipation and dizziness. More serious side effects include confusion, muscle or joint pain, rashes, and irregular heartbeat. If you experience more serious side effects, call your doctor immediately or get emergency medical treatment.

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Bupropion works by affecting levels of dopamine and norepinephrine in your brain. These neurotransmitters are chemicals that help relay messages between nerve cells in your brain. Bupropion helps prevent them from being absorbed back into nerve cells after they have sent messages to other cells, improving your mood and sense of well-being.

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Bupropion, sold under the brand name Wellbutrin among others, is a medication primarily used as an antidepressant. This drug has also been used for smoking cessation, seasonal affective disorder (SAD), and to help patients with Attention Deficit Hyperactivity Disorder (ADHD) concentrate better. Bupropion restores the chemical balance of dopamine and norepinephrine in your brain.

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It is also part of Contrave, a FDA approved medication for weight loss.

Some side effects of Eflornithine topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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More common:‍

Acne

Less common:

Burning or bleeding skin

chapped, red lips

chronic acne

hair bumps

numbness

tingling skin

arrythmia

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Eflornithine blocks the action of an enzyme called ornithine decarboxylase, which is found within the hair follicles. Blocking this enzyme will slow down the growth of unwanted hair on the face and under the chin in PCOS women. It may also make the hair finer and lighter. It does not remove hair or cause the hair to fall out.

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Yes, Eflornithine 12% is a prescription medication cream. A consultation with a healthcare provider is necessary to obtain a prescription and to ensure that it is an appropriate treatment option for you. Get Eflornithine and one of our doctors will evaluate your health history to determine whether Hairless Hype is suitable for you.

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Yes, you can apply sunscreen or makeup once the cream has dried completely (a few minutes). Talk to your healthcare provider if you're using other prescription or over-the-counter medications on your face before using Eflornithine.

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Yes, you can apply sunscreen or makeup once the cream has dried completely (a few minutes). Talk to your healthcare provider if you're using other prescription or over-the-counter medications on your face before using Hairless Hype.

Yes, Hairless Hype is a prescription medication cream. A consultation with a healthcare provider is necessary to obtain a prescription and to ensure that it is an appropriate treatment option for you. Get Hairless Hype and one of our doctors will evaluate your health history to determine whether Hairless Hype is suitable for you.

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The usual starting dose of metformin extended-release tablet is 500 mg once daily with an evening meal. Chat with Oana doctors to figure out the dosage that's appropriate for your needs.

While Metformin ER is primarily prescribed to manage blood sugar levels in people with type 2 diabetes and to address symptoms of PCOS, some patients may experience weight loss as a side effect. It's believed that Metformin can influence appetite and energy expenditure.

A single dose of metformin ER has the capability to regulate your blood sugar levels for approximately 12 hours. However, should you cease taking the medication, it typically requires around 4 days for the majority of it to be expelled from your body. This duration is largely calculated from the half-life of metformin ER and may vary based on individual health factors and genetic makeup, meaning the exact time frame could differ from person to person.

Metformin ER (extended-release) and metformin IR (immediate-release) are utilized in the treatment of Polycystic Ovary Syndrome (PCOS) to manage insulin resistance, a common condition associated with PCOS. Metformin ER is designed to release the medication gradually in your body, reducing the risk of gastrointestinal side effects commonly associated with the immediate-release form of Metformin. This slower release also means it can be taken less frequently which can improve adherence to the medication regimen.

Yes, Spironolactone can be used to treat certain types of hair loss in women, particularly those that are believed to be related to an excess of androgens (male hormones), such as androgenetic alopecia (female pattern hair loss). Spironolactone acts as an anti-androgen, blocking the effect of male hormones that can contribute to hair thinning and loss. By reducing androgen levels, it can help slow down the progression of hair loss and, in some cases, may promote regrowth or increase the thickness of the hair.

Yes, Spironolactone can indirectly help regulate menstrual cycles in some women, particularly those with Polycystic Ovary Syndrome (PCOS). PCOS is often characterized by an imbalance of hormones, including elevated levels of androgens (male hormones), which can disrupt the menstrual cycle and lead to irregular periods.

Spironolactone works by blocking the effects of androgens, which can help reduce symptoms caused by their excess, such as acne and hirsutism (excessive hair growth). By lowering androgen levels, Spironolactone can contribute to a hormonal balance more conducive to regular menstrual cycles.

However, Spironolactone is not primarily used as a treatment for menstrual cycle regulation. It is usually prescribed as part of a broader treatment plan for PCOS or other conditions that might include hormonal contraceptives (birth control pills), which directly target menstrual cycle regulation. It's important to consult with a healthcare provider to determine the best treatment plan for your specific situation and to understand how Spironolactone might fit into that plan.

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Like any medication, Metformin lotion has the potential to cause side effects. Some common side effects include:

• Feeling dizzy
• Feeling or being sick
• Muscle or leg cramps
• Feeling tired or low energy
• Breast pain and enlargement

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In the context of Polycystic Ovary Syndrome (PCOS), Spironolactone works primarily through its anti-androgen effects, targeting one of the key hormonal imbalances associated with this condition. Here's a detailed look at how Spironolactone functions in the management of PCOS:

1. Reduces Androgen Levels: PCOS is characterized by elevated levels of androgens (male hormones), such as testosterone, which can lead to various symptoms including acne, hirsutism (excessive hair growth on the face and body), and scalp hair thinning or loss. Spironolactone combats these symptoms by blocking androgen receptors in the body, reducing the action of these hormones on target tissues. This helps alleviate the dermatological and hair-related symptoms associated with high androgen levels.
2. Indirectly Affects Menstrual Regularity: By decreasing androgen levels, Spironolactone can also have an indirect effect on menstrual regularity. High levels of androgens can disrupt the normal ovulation process, leading to irregular menstrual cycles or amenorrhea (absence of menstruation). While Spironolactone does not directly induce ovulation, reducing androgen levels can contribute to a hormonal environment that is more conducive to regular menstrual cycles.

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Metformin helps lower blood sugar levels by reducing the amount of glucose produced by the liver and increasing the sensitivity of cells to insulin.

Your privacy and the security of your data are of utmost importance to us. The Oana platform is engineered to adhere to all applicable privacy regulations, and we've established rigorous security measures to safeguard your personal details. Please read our Privacy Policy for more details.

Oana is for adults with PCOS who want to improve or support their symptoms & health - and prefer to do so from the comfort of their home.

We hold our providers to the highest standards. We only work with providers with clean records and a sufficiently long tenure practicing.

Get to know our providers here:

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Bhavesh Patel MD, MBA

• Dr. Patel has over 10 years of clinical experience at UNC Hospitals, GoodRx, Hims and KHealth
• Dr. Patel completed their residency at The Ohio State University Wexner Medical Center in 2016,
• They began working in outpatient family medicine at the University of North Carolina and entered the telehealth field in 2018 with roles at Roman/Ro Health and GoodRx/HeyDoctor, eventually overseeing a large team of providers.
• Dr. Patel obtained an MBA from The Ohio State University Fisher School of Business in 2017. They have a strong passion for telehealth and have held various positions, including being licensed in 40 states and working for Hims/Hers, Wheel, and Wyndly

We hold our pharmacies to the highest standard and require all our partners to be Legit Script certified.

Here is our current partner:

Foothills Pharmacy

• website
• 2727 W Baseline Road Suite 1, Tempe, AZ 85283
• P: 480-496-4444
• F: 480-496-4450
• rx@foothillspharmacy.com

We currently operate in:

AZ, CA, CO, CT, DC, FL, GA, IA, KY, ME, MD, MI, MN, MT, NE, NV, NH, NC, ND, OH, OK, SC, SD, TX, UT, WA, WI, WY

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We utilize e-prescribing to ensure our prescriber has choice of medication, and the patient has choice of pharmacy.

Administer the topical spray once daily at bedtime. HairPlusPlus is gentle enough to be used on all skin types and is safe to use on color-treated hair.

The ingredients used in the Hair Improvement Protocol pose minimal risk of side effects. Erythema (redness of the skin) is the most common side effect associated with topical application of latanoprost. Side effects associated with minoxidil use are rare but include dryness, itching, scaling, flaking, redness. Retinoic acid has similar potential side effects to minoxidil, including redness, dryness, scaling, burning, itching. Report all side effects to your prescribing doctor.

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References:

1. Blume-Peytavi U, Lönnfors S, Hillmann K, Garcia Bartels N. A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia. J Am Acad Dermatol. 2012 May;66(5):794-800. doi: 10.1016/j.jaad.2011.05.026. Epub 2011 Aug 27. PMID: 21875758.

2. Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. 2019 Aug 9;13:2777-2786. doi: 10.2147/DDDT.S214907. Erratum in: Drug Des Devel Ther. 2020 Feb 10;14:575. PMID: 31496654; PMCID: PMC6691938.

3. Noble S, Wagstaff AJ. Tretinoin. A review of its pharmacological properties and clinical efficacy in the topical treatment of photodamaged skin. Drugs Aging. 1995 Jun;6(6):479-96. doi: 10.2165/00002512-199506060-00008. PMID: 7663068.

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HairPlusPlus uses 3 prescription strength ingredients to induce hair growth: Minoxidil, Retinoic Acid, and Latanoprost.

• Minoxidil is FDA approved for hair growth and is a vasodilator, increasing blood flow to the scalp.
• Retinoic Acid has clinical evidence of increasing the efficacy of minoxidil. It does so by upregulating enzymes in the skin that Minoxidil uses. In some studies Retinoic Acid + Minoxidil once per day was equivalent Minoxidil twice per day.
• Latanoprost was FDA approved as eye drops to reduce intraocular pressure. But it was later found to increase eye lash growth. Clinical studies show that it increases hair density when applied topically.

Yes, Spironolactone and Metformin both can be taken long-term for non pregnant individuals.

Spironolactone may affect the sexual development of a male fetus and should not be taken if pregnant or trying to conceive. You should stop spironolactone before trying to conceive but there is no necessary waiting period. Spironolactone does not affect your ability to get pregnant. There are no long term effects on reproduction.

Yes! These medications complement each other very well. Birth control pills help prevent pregnancy, something you’ll want to avoid while taking spironolactone. Birth control pills will also help avoid menstrual irregularities and spotting, which spironolactone can sometimes cause.

Metformin and Spironolactone are two medication that can help PCOS. Together, clinical studies show they're superior to each treatment individually.

study one  study two

Spironolactone is a medication that acts on androgens, or male hormones, in the female body. By blocking the effect of acne-causing androgens, spironolactone can be very helpful for hormonal acne after 2-3 months of consistent use.

Common side effects include breast tenderness, mild headaches, irritability, fatigue, menstrual spotting or irregularity, heavier periods, stomach upset, decreased libido and breast enlargement. Most mild side effects tend to improve with time.

Metformin is an insulin sensitizer and the first line treatment for Diabetes. In PCOS, Metformin can reduce androgen levels globally by improving the insulin sensitivity of ovaries. Metformin may lead to slight weight loss.

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Metformin is a known anti androgen that mildly reduces androgen levels. It may improve insulin sensitivity and inflammation in the applied region by slowing cell growth.

Azelaic Acid is a gentle skincare ingredient that slows down keratin production, weakening unwanted strands.

The effects of eflornithine in reducing hair growth are usually seen after about 4 to 8 weeks of regular use. One study showed that 81% of women showed clinical improvement within one year. Metformin and Azealic Acid may also help with improving efficacy.

The way Hairless Hype (Eflorinthine) works to combat Hirsutism is specific and targeted:

• Eflornithine blocks the action of an enzyme called ornithine decarboxylase, which is found within the hair follicles. Blocking this enzyme will slow down the growth of unwanted hair on the face and under the chin in PCOS women. It may also make the hair finer and lighter. It does not remove hair or cause the hair to fall out.
• Azealic acid is a gentle skincare ingredient that helps reduce inflammation, even skin tone, and fight acne.
• Metformin helps to reduce inflammation.

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Like any medication, Metformin lotion has the potential to cause side effects. Be sure to follow up with a healthcare provider if you experience any of the following: Common side effects may include skin irritation at the application site.

The risk of significant lactic acidosis associated with metformin is extremely rare when the medication is taken at appropriate doses and when the kidneys are functioning properly. However, as a precautionary measure, we recommend that patients discontinue metformin usage at least 3 days prior to undergoing any medical procedure or imaging that involves the use of contrast agents, such as a CT scan.

Some side effects of Eflornithine topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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More common:‍

Acne

Less common:

Burning or bleeding skin

chapped, red lips

chronic acne

hair bumps

numbness

tingling skin

arrythmia

Ozempic® is a semaglutide-based medication that is FDA approved to treat type 2 diabetes. Clinical trials have also demonstrated that Ozempic®, as well as semaglutide medications like Wegovy® (also manufactured by Novo Nordisk), can reduce weight, regulate appetite, and lower cardiovascular risk factors.

The most common side effects of Ozempic® include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder)

In general, Low Dose Naltrexone should not be used by anyone taking opioids, such as Codeine, Hydrocodone, Fentanyl, Hydromorphone, Meperidine, Methadone, Morphine, Oxycodone, or Oxycontin. Because Naltrexone and prescription opioids bind to the opioid receptors, they can render one another ineffective–or worse, cause opioid withdrawal syndrome. LDN should be avoided in patients with significantly impaired kidney or liver function.

If you are on thyroid medication, you may need to monitor your thyroid levels more closely as you start LDN.

If you develop symptoms of hyperthyroidism while taking LDN, such as heart racing, increased anxiety, restlessness, or trouble sleeping, please stop LDN and talk to your doctor who prescribes your thyroid medication.

Other conditions that require a modified protocol or require further consideration prior to use include:‍

Lyme Disease or other Chronic Infections (EBV, CMS, Bebesosis, Borellia, etc.)

Mast Cell Activation Syndrome/Disease (MCAS/MCAD)

Ehlers Danlos Syndrome (EDS)

Multiple chemical sensitivities or drug allergies (3 or more)

Mold or black mold illness or exposure

Mental illness (e.g. schizophrenia)

The short answer is “No.”

Naltrexone is FDA approved for obesity and the treatment of opioid and alcohol addiction- also known as the on-label indication. However, like many medications, naltrexone is used off-label for conditions such as PCOS and many symptoms and conditions. Like with any medication, once the FDA has approved a medication for one use, a medical doctor can prescribe it in any way they see fit for their patient.

Metformin is not typically associated with a risk of reducing blood sugar to dangerously low levels. However, individual tolerance to lower blood sugar levels varies. Consequently, Metformin might cause symptoms of low blood sugar in some patients, such as lightheadedness, nausea, and fatigue. Starting at a low dose and gradually increasing it can be helpful. Based on our experience, most patients with a history of hypoglycemia can tolerate lower doses of Metformin, such as 500mg per day.

It is commonly believed that Metformin can cause a reduction in Vitamin B12 levels, possibly by interfering with its absorption or through another mechanism. For this reason, we advise patients on Metformin to either monitor their B12 levels or take extra B12 as a precaution. However, some studies suggest there is no significant connection between Metformin use and B12 levels.

Regardless of Metformin use, it's important to maintain proper levels of Vitamin B12. For adults under 65, the easiest way to get B12 is to take at least one 2,000 mcg supplement each week or a daily dose of 50 mcg. Note that these doses are specific to cyanocobalamin, the preferred supplemental form of Vitamin B12.

As we age, our ability to absorb Vitamin B12 may decline. For those over 65, especially those on plant-based diets, supplementation should probably be increased to 1,000 mcg of cyanocobalamin daily.

B12 supplements are very cheap. Here is one option we found: 5c per 2500mcg tablet, so 5-15cents of cost per week depending on your age.

Topical Metformin is Metformin HCL compounded into a lotion for transdermal administration by an FDA-regulated pharmacy. It is applied like a lotion and pushes Metformin into the body through the skin where it is absorbed into the blood stream. This process bypasses the gastrointestinal tract, allowing the medication to reduce the common GI side effects associated with Metformin. Our formulations are based on clinical studies of the use of Metformin and topical Metformin in treating acne, PCOS, melasma, and CCCA.

You will always start by taking 1 capsule at bedtime for the first 2 weeks. As your body adjusts to the medication, you will begin titrating to the target dose. Your titration schedule will vary slightly depending on whether you are receiving 0.5 mg capsules or 1.5 mg capsules. For 0.5mg capsules, you will increase your dose by 1 capsule every 14 days for about 3 months, until you reach the target dose of 3.0mg, or 6 capsules. You will then begin receiving 1.5mg capsules and cap your dose at 4.5mg, or 3 capsules. For 1.5mg capsules, you will increase your dose by 1 capsule every 10 days until you reach the target dose of 4.5mg, or 3 capsules. However, not everyone finds these target doses most beneficial for them.

The active ingredient in Ozempic® is semaglutide. Semaglutide falls into a category of medications known as GLP-1 receptor agonists (GLP-1 RAs), which imitate the GLP-1 hormone to reduce the amount of glucose delivered into the bloodstream and encourage more insulin production from your pancreas. GLP-1 RAs also act on the digestive system to delay gastric emptying, thereby delaying the release of food from the stomach, and modulate brain activity to suppress appetite.

You only need to take Ozempic® once per week. It’s best to take your injection on the same day each week. You can take your dose at any time of that day, with or without food.

Do not take eflornithine by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn). Wash your hands before and after use. Use at least 5 minutes after you get rid of hair. Put a thin layer on the affected skin and rub in gently. Do not wash affected part for at least 4 hours. Makeup may be used after the skin has dried.