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Recent episodes
95: Thyroid Labs: Why a Low Free T3 After Treatment Does Not Mean Failure
May 4, 2026
Unknown duration
94. Progesterone and Alzheimer’s: The Ratio That Changes Everything
Apr 27, 2026
Unknown duration
93. HRT vs Functional Medicine: Hormones Are the Foundation
Apr 20, 2026
Unknown duration
92. Compounded HRT: Why the Anti-Compounding Argument Fails
Apr 14, 2026
Unknown duration
91. Starting a Healthcare Practice from Scratch
Mar 30, 2026
Unknown duration
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| Date | Episode | Description | Length | ||||||
|---|---|---|---|---|---|---|---|---|---|
| 5/4/26 |  95: Thyroid Labs: Why a Low Free T3 After Treatment Does Not Mean Failure | Your patient started thyroid medication. She is feeling better than she has in months. And then you open her follow-up labs and her Free T3 barely moved.This is the moment where most providers either overcorrect or lose confidence. They increase the dose beyond what is needed, switch to a less effective medication, or start questioning whether the treatment is working at all. None of those are the right call. The problem is not the medication. It is a misunderstanding of what the lab is actually showing you.In this episode, Nico Misleh, MSN, FNP-C walks through the clinical distinction between peak and trough Free T3, explains why a seemingly unchanged number on follow-up labs can actually reflect meaningful improvement, and breaks down the pharmacokinetics that make this one of the most common thyroid management mistakes in clinical practice. If you have ever second-guessed yourself after seeing a low Free T3 on a patient who is clearly doing better, this episode will change how you read those labs.The HRT University Master Course is jointly accredited through Pinnacle Conference LLC (ACCME, ACPE, ANCC) and offers 30 CE credits across six modules, including a dedicated Thyroid Optimization module that covers lab interpretation, medication selection, and dosing strategy in depth. LinksExplore the Master Course: https://bit.ly/4twBb0DJoin the Free Newsletter: https://nicomislenp.kit.com/8050eeea5fFacebook Community: https://www.facebook.com/groups/1179376819949373/Website: https://hrtuniversity.comFollow HRT University on Instagram: @hrtuniversity | — | ||||||
| 4/27/26 |  94. Progesterone and Alzheimer’s: The Ratio That Changes Everything | The Alzheimer’s conversation in HRT has been almost entirely about estrogen for 20 years. A 2025 Nature study says that framing is only half the picture. The real driver is the ratio of estradiol to progesterone during perimenopause, and what happens to the brain when that ratio stays unbalanced for years.In this episode, Nico Misleh, MSN, FNP-C walks through the full metabolic cascade the study identifies: estrogen receptor alpha destabilization, ERR alpha dysfunction, mitochondrial energy failure, glutamate excitotoxicity, and the on-ramp to neurodegeneration. He explains why unopposed estradiol can actually worsen the neuronal environment, why synthetic progestins like MPA do not deliver the same neuroprotection as bioidentical progesterone, and why perimenopause, not postmenopause, is the window that matters most.If you prescribe HRT or are reconsidering whether to, this is the clearest mechanistic argument for treating progesterone as foundational rather than optional.HRT University is a jointly accredited, physiology-first clinical education program for licensed providers. Learn more about the Master Course.HRTU Newsletter: https://nicomislenp.kit.com/8050eeea5fJoin the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/ | — | ||||||
| 4/20/26 |  93. HRT vs Functional Medicine: Hormones Are the Foundation | Functional medicine and HRT keep getting framed as rival philosophies. That framing is wrong, and patients are the ones paying for it. In this episode, Nico Misleh, MSN, FNP-C walks through why hormones are foundational, why lifestyle alone has a ceiling, and how to sequence HRT and functional medicine for real clinical outcomes.He tells the story of a 35-year-old patient who did everything right, was offered an antidepressant by her primary care, ended up on a shopping bag of supplements through a functional provider, and only turned the corner once progesterone and testosterone were restored. Then he flips the argument and names the HRT-only mistake clinics make when they prescribe hormones without terrain work.Learn more about the Master Course: https://bit.ly/4twBb0DHRT University is a physiology-first clinical education program for licensed providers. Jointly accredited with 30 CEs. | — | ||||||
| 4/14/26 |  92. Compounded HRT: Why the Anti-Compounding Argument Fails | There is a group of providers who oppose compounded HRT medications on principle. Their argument sounds evidence-based. Standardization. Regulation. Studies. It holds up until you look at what they are actually prescribing.In this episode, Nico Misleh, MSN FNP-C, walks through two clinical examples that expose the internal contradiction: the Androgel problem, in which providers who oppose compounding are instructing female patients to eyeball a fraction of a men's testosterone gel; and the progesterone problem, in which the FDA-only framework leaves patients with no option except a pharmacologically distinct synthetic progestin when commercial dose ranges fall short.The episode also goes into the regulatory reality of 503A and 503B compounding pharmacies, the neurosteroid pharmacology that makes progesterone and synthetic progestins non-interchangeable, and what individualized prescribing actually requires when a patient does not fit the commercial options.The compounding debate does not have to stay murky. This is the clinical argument.HRT University is a physiology-first clinical education program for licensed providers. Jointly accredited through Pinnacle Conference LLC (ACCME, ACPE, ANCC) for 30 CEUs.Learn more about HRT University:https://bit.ly/4twBb0DHRTU Newsletter:https://nicomislenp.kit.com/8050eeea5fJoin the HRT University Facebook Group:https://www.facebook.com/groups/1179376819949373/ | — | ||||||
| 3/30/26 |  91. Starting a Healthcare Practice from Scratch | Thinking about starting your own healthcare practice but unsure where to begin?In this episode of the HRT University podcast, Nico Misleh speaks with Nurse Practitioner Katie Edge about her journey toward opening her own independent practice. From working in emergency medicine to pursuing autonomy in patient care, Katie shares the real-world challenges and lessons she’s learning along the way.They discuss the importance of patient advocacy, navigating state regulations, finding collaborating physicians, and doing the necessary research to build a practice the right way from the start.If you are a nurse practitioner, physician assistant, or healthcare provider considering independence, this episode offers practical insight into what it actually takes to build your own practice.For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://bit.ly/4twBb0DJoin the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 3/23/26 |  90. Are Peptides Safe? | Are peptides actually safe, or are concerns being driven by misunderstanding and incomplete data?In this episode of the HRT University podcast, Nico Misleh explores one of the most common concerns in hormone therapy today: peptide safety. With changing regulations and limited human data on some newer peptides, many providers and patients are asking important questions about risk, safety, and long-term use.Nico walks through the historical lessons from hormone therapy that still impact medicine today, including the long-standing myths surrounding testosterone and prostate cancer, as well as the widespread fear that followed the Women’s Health Initiative (WHI) study. These examples highlight why understanding mechanisms matters more than blindly accepting conclusions from flawed or incomplete research.If you work in hormone therapy or are considering peptide-based treatments, this episode will help you better understand how to evaluate safety and think critically about emerging therapies.In This Episode, You'll Learn:Why many peptides have long-standing safety recordsHow flawed studies shaped hormone therapy historyWhat the testosterone and prostate cancer myth teaches usWhy the WHI study changed hormone therapy for decadesThe importance of understanding mechanisms of actionHow clinicians can evaluate new therapies responsiblyFor practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University:https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 3/16/26 |  89. Why Patients Leave Your Practice and How to Keep Them Long-Term | Why do patients leave a practice even when the care is good?In this episode of the HRT University podcast, Nico Misleh breaks down one of the biggest challenges for healthcare providers, patient attrition. Many practices focus heavily on acquiring new patients but overlook the systems needed to keep them engaged long term.Nico explains the three primary reasons patients leave a program, including perceived lack of value, lack of engagement, and major life changes. He also shares practical strategies providers can implement to strengthen relationships, improve communication, and create a patient experience that keeps people committed to their care.If you run a private practice, membership clinic, or hormone therapy program, this episode will help you understand how to reduce attrition and build long term patient relationships.For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 3/9/26 |  88. Progesterone and Brain Health: Debunking the Cognitive Decline Myth | HRT University® | Is oral progesterone harmful to brain health?Recently, claims have circulated suggesting that progesterone may contribute to cognitive decline or act similarly to benzodiazepines because of its metabolite allopregnanolone. In this episode, Nico Misleh breaks down the science behind these claims and explains why much of the concern comes from misinterpreted research.This conversation explores the role of progesterone in hormone replacement therapy, the difference between animal studies and human evidence, and why understanding hormone physiology is essential for both providers and patients.If you are navigating hormone therapy or want a clearer understanding of progesterone’s role in cognitive health, this episode offers an evidence-based perspective on one of the most misunderstood hormones in medicine.For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University:https:https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 3/2/26 |  87. Serotonin and Osteoporosis Risk in Post-Menopausal Women: What the Research Shows | HRT University® | Most people think of serotonin as a mood hormone. But what if it also plays a role in bone loss?In this episode, Nico Misleh explores emerging research linking elevated serotonin levels to increased osteoporosis risk in post-menopausal women. He breaks down a recent study examining serotonin markers and bone mineral density, and explains why this connection could reshape how we think about hormone balance and long-term bone health.If you are navigating menopause, managing osteoporosis risk, or interested in the deeper hormonal drivers of bone density, this conversation provides important insight into an often overlooked factor in women’s health.Chapters00:00 Introduction to Serotonin and HRT01:26 Understanding the Study on Serotonin and Osteoporosis04:44 The Impact of Serotonin on Bone Health09:27 Serotonin: The Misunderstood Hormone12:48 The Role of Hormones in Bone Density18:07 Chronic Stress and Its Effects on Bone Health20:32 Prevention and Understanding Osteoporosis25:18 The Importance of Continuous Learning in HRTFor practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 2/23/26 |  86 Health Insurance for Independent Medical Providers | HRT University® | Thinking about leaving your employed position and starting an independent practice? One of the biggest concerns for medical professionals is health insurance.In this episode, Nico Misleh sits down with Kevin and Joy Kincaid of Kincaid Solutions to discuss what really happens to your health coverage when you go independent. They break down common fears, explain the options available to private practice providers, and share how personalized guidance and transparency can make the transition far less overwhelming.If you are considering private practice, entrepreneurship, or stepping away from employer-sponsored benefits, this conversation will help you understand what is realistic, what is exaggerated, and how to move forward with confidence.For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
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| 2/16/26 |  85. Thyroid Combination Therapy and Better Hormone Care | In this episode, Nico Misleh discusses the critical role of thyroid in hormone replacement therapy (HRT), emphasizing that thyroid should not be viewed as an adjunct but as a foundational component. He critiques the conventional approach of using T4 monotherapy for hypothyroidism, highlighting the limitations of TSH as a diagnostic marker. Misleh advocates for combination therapy using T3 and T4, supported by recent studies showing its effectiveness in reducing risks of dementia and mortality. He encourages healthcare providers to adopt a pro-metabolic lens and to empower patients by moving away from outdated practices.Chapters00:00 The Importance of Thyroid in Hormone Replacement Therapy02:50 Monotherapy vs Combination Therapy for Hypothyroidism06:11 Understanding TSH and Its Limitations08:57 The Risks of T4 Monotherapy11:57 The Case for Combination Therapy14:47 Pro-Metabolic Lens on Thyroid Function18:10 The Role of T3 in Metabolism20:58 Empowering Patients and Providers24:03 Creating a New Standard in Thyroid TreatmentFor practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https:https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 2/11/26 |  84. Age Limits for HRT | In this episode of the HRT University podcast, Nico Misleh discusses the complexities and misconceptions surrounding hormone replacement therapy (HRT), particularly for women over 60 or 10 years post-menopause. He emphasizes the importance of bioidentical hormones, the risks associated with synthetic hormones, and the necessity of early initiation of HRT for better health outcomes. Misleh advocates for patient empowerment through informed decision-making and shared understanding of the risks and benefits of HRT.Chapters00:00 Introduction to HRT University Podcast01:38 Understanding Hormone Replacement Therapy Risks06:45 Bioidentical Hormones vs. Synthetic Hormones12:15 The Importance of Early HRT Initiation14:09 Empowering Patients with HRT KnowledgeFor practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 2/9/26 |  83. Progesterone and Hormone Balance: What Is Often Overlooked in Hormone Therapy | HRT University® | In this episode, Nico Misleh explores the significance of progesterone, often overlooked in discussions about hormones. He emphasizes the importance of understanding the relationship between progesterone and estrogen, the misconceptions surrounding hormonal terminology, and the clinical implications of these misunderstandings. Misleh advocates for a more comprehensive approach to hormone replacement therapy (HRT), highlighting the benefits of bioidentical progesterone over synthetic progestins. He calls for a movement to reclaim the narrative around hormonal health, ensuring that both practitioners and patients are educated about the true nature and benefits of hormones.Chapters00:00 Introduction to Progesterone01:30 The Importance of Progesterone02:59 Understanding Hormonal Relationships05:56 Estrogen vs. Progesterone Dynamics09:20 Progesterone's Role in Metabolism11:43 Misunderstandings in Hormonal Terminology15:15 The Distinction Between Progesterone and Progestins19:50 The Clinical Implications of Hormonal Confusion23:57 The Broader Impact of Progesterone29:09 Progesterone Beyond Reproductive Health32:34 The Misconception of Progesterone Necessity35:44 The Dangers of Progestins39:39 Reclaiming Hormone Replacement Therapy43:37 The Future of Hormonal HealthFor practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://bit.ly/4twBb0D- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 2/2/26 |  82 Functional Medicine and Better Hormone Care: A Root-Cause Approach | HRT University® | In this episode, Nico delves into the principles of functional medicine, contrasting it with traditional allopathic medicine. He emphasizes the importance of a systems approach, curiosity, and the need for healthcare providers to ask deeper questions about patient health. Misleh encourages practitioners to start integrating functional medicine into their practice and highlights the significance of mentorship and community in this journey. He also discusses the intersection of hormone replacement therapy (HRT) and functional medicine, advocating for a holistic view of patient care.Chapters00:00 Introduction to Functional Medicine02:47 The Shift from Allopathic to Functional Medicine06:13 Understanding the Systems Approach in Functional Medicine08:51 Curiosity and the Importance of Asking Why11:47 Practical Steps to Start Practicing Functional Medicine15:05 Integrating Hormone Replacement Therapy with Functional Medicine17:55 The Role of Curiosity in Medicine20:53 The Importance of Mentorship and Community24:05 Exploring the Complexity of Human Biology27:07 Conclusion and Call to ActionReady to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 1/26/26 |  81. Growth, Humility, and Better Patient Care in Hormone Therapy | In this episode, Nico Misleh shares why being willing to admit you are wrong is essential for growth in hormone replacement therapy and patient care. He reflects on early beliefs around male progesterone, how mentor influence and cognitive bias shape clinical decisions, and why evolving with new evidence leads to better outcomes for patients.This conversation explores humility in medicine, the importance of real-world clinical experience, and how providers can build trust by staying open to learning and improvement.Ready to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 1/21/26 |  80. Unmasking Endocrine Disruption: The Hidden Crisis of Environmental Toxins and Hormone Health | In this episode, Nico Misleh breaks down the growing crisis of endocrine disrupting chemicals (EDCs) and their impact on hormonal health. From environmental toxins to modern medical blind spots, Nico explains why hormone replacement therapy should be viewed as a proactive solution—not a last resort—in today’s increasingly toxic world.Ready to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 1/19/26 |  79. How to Talk About Pricing Without Killing Trust | In this episode, Nico breaks down how healthcare providers can approach pricing conversations with confidence and clarity. From reframing cost discussions to understanding patient value, this episode explores why pricing isn’t sales — it’s part of patient careReady to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 1/14/26 |  78. Why DPC Practices Should Add Functional Medicine & HRT | In this episode, Nico Misleh discusses the benefits of Direct Primary Care (DPC) and the integration of Functional Medicine and Hormone Replacement Therapy (HRT) into practice. He emphasizes the importance of providing personalized care that goes beyond conventional methods, addressing the needs of patients seeking wellness rather than just treatment. The conversation highlights the potential for DPC providers to stand out by offering innovative solutions and the necessity of continuous education in Functional Medicine. Nico shares real-world applications and success stories, encouraging providers to embrace these practices for better patient outcomes and satisfaction.Ready to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 1/7/26 |  77. Why Video Matters More Than Ever for Clinic Owners | In this episode, Nico sits down with Evan Renfroe to unpack why most clinic owners struggle with video marketing — and how a simple, systemized approach can turn content into a long-term growth asset. They cover the real pain points providers face, why trust matters more than trends, and how to build video systems that actually fit your communication style and business stage.Ready to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdrInterested in joining Evan's Facebook community - Video Systems for Clinic Owners : https://www.facebook.com/share/g/1816bsV5KX/Check out Evan's Video Systems for Clinic Owners Course - https://www.skool.com/video-impact-collective-8675/about?ref=9cdfedf2cda743d0be40d56ac8c94def | — | ||||||
| 1/5/26 |  76. The Systems that Separate 7-Figure Clinics from Chaos | In this episode, Nico Misleh discusses the essential elements that contribute to the success of seven-figure clinics. He emphasizes the importance of volume and intensity in business operations, the need for effective systems, and the significance of discipline and routine. Nico shares insights on maximizing time, the role of networking, and the balance between volume and intensity in marketing. He also addresses the realities of business ownership and the essential tools that can aid in achieving success.Ready to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 12/31/25 |  75. The Hidden Cost of Over-Relying on Clinical Guidelines | In this episode, Nico Misleh discusses the hidden costs of guidelines in hormone replacement therapy (HRT) and the importance of understanding principles over protocols. He reflects on his own educational background and how it shaped his perspective on standardization in medicine. Misleh emphasizes the need for creativity and open-mindedness in healthcare, arguing that strict adherence to guidelines can limit a clinician's ability to provide effective patient-centered care. He shares real-world examples of how guidelines can fail patients and advocates for a more nuanced approach to medical practice that prioritizes understanding and curiosity.Ready to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdr | — | ||||||
| 12/30/25 |  74. How To Avoid AI Slop: What Clinicians Need To Know | Want to learn what type of content reaches potential clients? Join Nico’s Daily Newsletter for more insights like this: https://nicomislenp.kit.com/8050eeea5fIs your clinic’s content being ignored? Your reliance on AI might be making your brand feel fake and pushing potential patients away. In episode 74 of the Nico Misleh Podcast, host Nico Misleh reveals why the flood of generic "AI slop" is a massive opportunity for clinicians who are willing to be authentic. Discover how to stop manufacturing content and start creating a personal brand that builds trust, attracts your ideal patients, and makes your practice stand out. Learn the simple, powerful strategies to develop a timeless message that reflects your true value as a provider and business owner.Ready to build a brand and practice that is as unique as you are? Learn the clinical and business systems to create a thriving hormone optimization practice with The HRT Master Course. This program offers 30 ANCC-accredited credit hours and gives you the expert guidance you need to succeed. Start your journey at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f(yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdrChapters:0:00 - What Is "AI Slop" & The Problem with Inauthentic Content 0:55 - An Exclusive Look at the New HRT University (HRTU) Merch 2:30 - Why AI-Generated Content Feels So Disingenuous 4:43 - How My Wife Got a $70,000 Pottery Barn Deal from Instagram 7:33 - The Difference Between Authentic vs. AI-Generated Content 9:29 - Are You a Creator or a Manufacturer? 11:08 - How to Develop a Creative Skill from Beginner to Expert 12:27 - Why Your AI Social Media Posts Make Me Sad 13:38 - Is AI Ruining Your Personal Brand? How to Spot the Telltale Signs 15:03 - My Honest Opinion on AI-Generated Content 16:40 - How to Properly Use AI to Save Time (The Right Way) 19:13 - Why a $100M Painting Is More Valuable Than an AI Replica 21:39 - The #1 Mistake Clinicians Make with Their Social Media 23:48 - How to Create Timeless Content for Your Clinic 25:38 - Is Marketing a Chore? How to Reframe Your Mindset 28:22 - The Secret to Making Your Clinic a Premium Brand 29:28 - How Apple is Fighting Back Against AI Content 30:43 - My Challenge to You: Please Create Your OWN Content 32:13 - How to Build a Brand That Reflects Your True Self 34:02 - The Real Reason Medical Conferences Are Valuable (It's Not the Lectures) 35:30 - The Uncomfortable Truth About Building a Business 38:11 - How Long Does It Take for Authentic Content to Work? 39:04 - The Two Words That Define All Successful Entrepreneurs 41:41 - How to Get Daily Inspiration & Master HRT | — | ||||||
| 12/24/25 |  73. Are TRT And Peptides Legal And Safe To Prescribe For Your Patients? | Ready to prescribe peptides without risking your license? Get Nico's daily legal and clinical tips for your practice here: https://nicomislenp.kit.com/8050eeea5f.Many clinicians are unknowingly violating FDA law by using popular peptides like BPC-157 from the wrong sources. In episode 73 of the Nico Misleh Podcast, host Nico Misleh is joined by top healthcare attorney Courtney Walker to discuss the truth about peptide legality, hormone optimization, and the specific rules you must follow to protect your license. Courtney breaks down the only three legal sources for medications, the dangers of "research use only" products, and shares her best advice for running a compliant and successful cash-based wellness clinic so you can avoid costly legal mistakes.Feeling confident in the law is just one piece of the puzzle. To achieve clinical mastery in hormone replacement therapy and build the profitable practice you've always wanted, check out the HRT Master Course. This comprehensive program, which includes 30 ANCC-accredited credit hours, gives you the tools to improve patient outcomes and grow your business. You can sign up and learn more at https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f (yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdrChapters:0:00 - Are Peptides Legal? The FDA's "Not Safe" List Explained 0:52 - Introducing Courtney Walker: The Go-To Attorney for Clinicians 2:11 - How a Farm Girl Became a Top Attorney for Wellness Clinics 5:55 - How to Lead With Empathy & A "Take No Sh*t" Attitude 7:39 - A Judge's #1 Rule for Success: How to Seize Opportunity 10:36 - Why You Must Reinvent Yourself Every 3 Years 12:22 - What Handling $100M+ Deals Taught Her About Money & Mindset 16:20 - Why Become a Lawyer? A Mission to Make Legal Help Accessible 20:28 - Lawyers Know the "Rules of the Game" We're All Playing 23:54 - Are Peptides Like BPC-157 & CJC Safe and Legal to Prescribe? 26:21 - The ONLY 3 Legal Sources for Your Clinic's Medications 29:37 - How Do Clinicians Get in Trouble Prescribing Peptides? 33:25 - "Research Use Only" vs. "Physician Use Only": A Dangerous Lie? 36:02 - Do Compounding Pharmacies Have Your Best Interest in Mind? 40:23 - How to Make a Confident Clinical Case for Using Peptides 44:00 - What is "The Residency" Program for Clinic Owners? 48:45 - The Goal: Preventative Legal Care for Your Business 51:58 - Why 100% Legal Compliance Is Impossible (And That's Okay) 53:51 - How to Identify and Manage Your Biggest Business Risks 58:57 - A CEO's Biggest Mistake: The "Illusion of Free" 1:01:29 - Does a Scarcity Mindset Still Affect Her Today? 1:05:20 - Where to Find and Work With Courtney Walker | — | ||||||
| 12/22/25 |  72. Our Medical Training is Flawed: A Clinician's Confession About HRT | Ready to learn what your medical training left out? Join Nico's Daily Newsletter for the clinical insights they never taught you: https://nicomislenp.kit.com/8050eeea5fYour medical training failed you. In episode 72 of The Nico Misleh Podcast, host Nico Misleh is joined by physicians Kelly and Tanner Buerger for a raw confession about the flaws in our medical system. They share their personal journey of being prescribed Zoloft for anxiety when the real issue was a progesterone deficiency, revealing the massive blindspot our education has around Hormone Replacement Therapy (HRT). This conversation uncovers why doctors often dismiss hormones, the moral injury pushing clinicians out of the "sick care" model, and the difficult but rewarding path from being a hospital employee to a purpose-driven clinic owner.Are you ready to confidently fill the gaps in your own HRT education? The HRT Master Course is your path to clinical mastery and autonomy, offering 30 ANCC-accredited credit hours to give you the skills and confidence to provide exceptional patient care. Sign up now and start your journey: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f (yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdrChapters:0:00 - Why Your Doctor Dismisses Hormone Replacement Therapy (HRT) 0:53 - Meet the Physician Couple Challenging the "Sick Care" Model 2:44 - The Brutal Reality of Physician Burnout in Corporate Medicine 4:45 - How Household Chemicals & Plastics Secretly Impact Infertility 6:25 - Prescribed Zoloft For Anxiety, But Was It A Progesterone Deficiency? 8:18 - The "Lightbulb Moment" Connecting Progesterone, PCOS & Anxiety 9:23 - What Medical School Fails to Teach Doctors About Hormones 12:20 - Is Physician Ego The Biggest Barrier to Modern Patient Care? 14:29 - Why Hormone Replacement Therapy (HRT) Belongs in Primary Care 17:21 - Do Doctors Know What They Don't Know? A Personal Journey 19:26 - Navigating Hospital Politics When You Practice Functional Medicine 20:42 - A Doctor's Story: When TRT is Wrongly Blamed for a Stroke 23:24 - Is The Culture of Medical Ego and "Knowing It All" Finally Changing? 26:12 - Why Two Successful Doctors Decided to Risk It All and Start a Business 29:27 - The #1 Reason Physicians Are Leaving Corporate Medicine for Autonomy 33:37 - Introducing Kindle Health: A New Clinic by Drs. Kelly & Tanner Buerger 35:36 - GLP-1s & HRT: A Powerful Combination for Metabolic Health? 37:34 - How We Balance Running a Clinic, Hospital Work, and Family Life 39:43 - What is the Future for Our Clinic? (And Will We Leave the Hospital?) 43:50 - The Future of Medicine: Will Cardiologists Soon Prescribe TRT? 47:24 - Why Younger Generations Are Rejecting Old-School Medical Advice 50:19 - A Patient's Question: How to find Kindle Health Online? 51:17 - Final Thoughts & What's Next for The Nico Misleh Podcast | — | ||||||
| 12/17/25 |  71. How Hiring the Right Employees Can Boost Your Clinic's Income Fast | Ready to stop feeling burnt out and finally grow your clinic's revenue? Join Nico’s Daily Newsletter for the exact steps: https://nicomislenp.kit.com/8050eeea5fFeeling trapped by endless tasks that don't actually grow your business is the biggest barrier to boosting your clinic's income. In episode 71 of The Nico Misleh Podcast, host Nico Misleh shares his personal story of how hiring the right people transformed his practice. He explains why doing your own bookkeeping is costing you money and reveals the exact moment you should hire an assistant to free up your time for revenue-generating activities. This episode provides a clear guide for any clinician who feels stuck and wants to scale their business without sacrificing their well being.Once you master your business operations, you can focus on your clinical excellence. Become the go to hormone expert in your area by enrolling in The HRT Master Course. This program provides the confidence and skills you need to master hormone replacement therapy and comes with 30 ANCC accredited credit hours. Sign up today and start your journey to clinical mastery at: https://hrtuniversity.com/hrtcourse/For practitioners who want to confidently grow their practice with guidance in TRT, HRT, and business strategy, find us below:- Nico's Daily Newsletter: https://nicomislenp.kit.com/8050eeea5f (yes, it's daily... and yes, people stay subscribed)- Join HRT University: https://hrtuniversity.com/- Join the HRT University Facebook Group: https://www.facebook.com/groups/1179376819949373/?ref=share&_rdrChapters:0:00 - The #1 Sign It's Time to Hire in Your Clinic 0:42 - Why I'm Not Sponsored By Spindrift (Yet) 1:46 - The Most Common Question I Get From Clinic Owners 2:50 - How We Started a Multi-6-Figure Clinic With No Debt 4:35 - The Exact Amount of Money We Saved to Start Our Business 5:53 - Why You Should NEVER Do Your Own Bookkeeping 7:10 - What "Time is Money" REALLY Means for a Business Owner 7:53 - The Difference Between a Business Owner and an Entrepreneur 10:05 - The Ultimate Goal for Every Entrepreneur (It's Not Money) 11:14 - Stop Wasting Time on Tasks That Don't Make You Money 14:41 - The Second Hire Every Clinic Owner Needs to Make 16:20 - How to Overcome the Fear of Hiring Your First Employee 17:03 - If You Feel This, It's Time to Hire Someone 18:21 - The Moment I Knew I Had to Hire Someone 19:48 - I Was Burnt Out, Miserable, and My Business Plateaued 21:59 - Who, Not How: The Book That Changed My Business 23:04 - A Warning Before You Hire Your First Employee 24:36 - How to Pay Your First Hire (And Why You Should Pay Them Well) 25:06 - How Hiring One Person Doubled My Business in 6 Months 28:06 - The 3-Step Checklist to Know if You're Ready to Hire 29:43 - When Should You Hire Another Medical Provider? 32:34 - The Simple Mindset Shift to Overcome Your Fear of Growth 35:10 - A Special Offer for HRT University Students | — | ||||||
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