Conditions · Hormone Imbalance
Energy, sleep, mood, weight, libido, focus — they run on hormones, and when the balance drifts, all of them can too. In Fredericksburg, VA, we test the full picture and optimize precisely, for men and women. Start with an initial appointment.
Thyroid, sex hormones, insulin, and cortisol all talk to each other. When one is off, the effects ripple — which is why fatigue, weight gain, poor sleep, low mood, and low libido so often arrive together and rarely resolve when treated one at a time.
At True You, Dr. Hoff tests the full hormonal picture and builds one connected, physician-guided plan to bring the system back into balance.
Why “normal” isn’t the goal
The difference is testing the whole system — against optimal, not just “not flagged.”
The conventional visit
The True You approach
A value can be “in range” yet far from optimal — which is why balanced-looking labs still leave so many people feeling off.
Signs that often point to a hormone problem — in women and men.
Low energy that rest and caffeine don’t fix.
Gain around the middle, or weight that won’t move.
Trouble falling asleep, night sweats, or 3am waking.
Irritability, low mood, or anxiety that feels new.
Less desire and changes in sexual function.
Irregular, heavy, or painful periods in women.
Acne, dryness, thinning hair, or unwanted hair growth.
Poor focus and memory that isn’t like you.
Some causes are part of life: perimenopause and menopause in women, and a gradual decline in testosterone in men. Others are driven by the way the hormonal system is connected. Chronic stress can disrupt cortisol rhythm, which affects sleep, blood sugar, and sex hormones. Insulin resistance can raise androgens in women and lower testosterone in men. Thyroid autoimmunity, such as Hashimoto’s, can slow everything down.
Sleep, body weight, nutrition, gut health, and certain medications play a role as well. Because the causes overlap, two people with the same symptoms can need completely different plans — which is why we test before we treat.
In women, imbalance often shows up around cycles and life stages: heavy or irregular periods, PMS that’s getting worse, perimenopause sleep and mood changes, or the higher androgens and insulin resistance of PCOS. A slow thyroid can sit underneath any of these.
In men, it more often looks like fading energy, drive, and strength, more belly fat, and lower libido — frequently tied to low testosterone, insulin resistance, poor sleep, or stress. In both, the answer starts with testing the whole system rather than one hormone at a time.
How it works
Connected testing, one connected plan.
Step 1
An in-person visit at our Fredericksburg office to map your symptoms, history, and goals.
Step 2
Thyroid, estrogen, progesterone, testosterone, cortisol, and metabolic markers such as insulin.
Step 3
Dr. Hoff reviews how your results fit together and what’s most likely behind your symptoms.
Step 4
Options may include bioidentical hormone therapy, thyroid support, metabolic care, and sleep and stress changes.
Step 5
Repeat labs and follow-up — many visits virtual — so the plan keeps up with you.
When hormones are low, replacing them can help — and bioidentical hormone replacement therapy is often part of the plan. But if insulin resistance, a sluggish thyroid, or a disrupted stress response is driving the imbalance, those need attention too. Treating them together is what lets results last. When the picture is complex, our functional medicine work-up ties it together.
Who it’s for
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The most-missed hormone driver of fatigue and weight.
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The estrogen–progesterone transition, optimized.
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Energy, drive, and strength restored for men.
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Precisely dosed BHRT/TRT to restore balance for men and women.
Learn moreBook an appointment with Dr. Hoff’s team in Fredericksburg, VA.
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Read articlePatient reviews
Rated 4.7 from 45 Google reviews
“Dr Hoff goes above and beyond to listen to you and respond with a program that can truly change your life. He’s very down to earth, easy to talk to, a wealth of knowledge, and genuinely cares about improving your life experience. I wish I would’ve found him and his staff sooner. I would give six stars if it were possible, thank you!”
“Dr. Hoff has truly changed my life in less than six months. I went from waking up every morning feeling miserable and constantly bloated to now feeling healthy, energized, and excited to take on each new day and experience life again. More importantly, I genuinely believe he is helping save my life in the long run by focusing not only on treating symptoms, but on improving my overall health and quality of life. Dr. Hoff is exceptionally knowledgeable and highly skilled in his field, but what truly sets him apart is the genuine care and compassion he shows his patients — something that has become far too rare in healthcare today. I’m also incredibly grateful for the entire staff and everyone there for creating an environment where patients feel heard, supported, cared for, and truly valued.”
“Outstanding experience from start to finish. Dr. Hoff is extremely professional and well-organized, with a friendly and welcoming staff. Dr. Hoff is knowledgeable, thorough, and truly took the time to listen and explain everything clearly. I felt genuinely cared for and confident in the treatment plan. Highly recommend!”
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