Lower the Dose™
Frequently Asked Questions
Your Partner in Root-Cause Wellness, Hormone Health & Metabolic Optimization
We believe clarity is the first step in healing. Below are the most common questions patients ask before joining our practice—answered with transparency, professionalism, and care.
About
our philosophy & approach
Why did you change the name from Capitol Endocrinology to Lower the Dose™?
Capitol Endocrinology served this community for over 15 years, and many of you have been with us since the beginning—we’re deeply grateful for that trust. But healthcare changed. The pandemic revealed how reactive and fragmented the system had become. Too many patients were stuck in prescription cycles, dismissed when labs were “normal,” and left to manage stress, fatigue, and weight gain without a clear path forward.
We created Lower the Dose™ to reflect a new mission: shifting the focus from disease management to deep, root-cause healing.
While Capitol Endocrinology focused on diagnosing and managing endocrine and metabolic conditions, Lower the Dose™ is about helping patients reclaim control—physically, mentally, and metabolically.
We help patients lower the dose of:
- Prescriptions they no longer need
- Complications they can prevent
- Stress, confusion, and fear that often accompany chronic illness
This name reflects how we now practice: doctor-guided, data-driven, and lifestyle-powered. Lower the Dose™ is more than a name—it’s a method, a mindset, and a promise to help you move beyond survival and into lifelong vitality.
Why is traditional healthcare falling short?
Because it wasn’t designed to prevent or reverse chronic illness. Most care today is:
- Rushed
- Symptom-centered
- Disconnected from your lived experience
Root causes like hormone imbalance, nervous system overload, emotional stress, and lifestyle misalignment are often ignored.
You don’t need more prescriptions—you need a plan.
At Lower the Dose™, we address what’s driving your symptoms and create a healing framework that honors your full story—body, mind, and metabolism.
What makes your approach different?
We care for the whole person—your story, your biology, and your ability to heal. Our model is built on three core pillars:
- Strategy – Personalized risk mapping and planning
- Discover – In-depth diagnostics and functional assessments once you join
- Transformation – Ongoing support and lifestyle implementation
We integrate:
- Endocrinology + Hormone Optimization + Metabolic Medicine
- Mind-Body Science + Mindfulness
- Emotional Healing + Nervous System Rewiring
Every plan is personalized. Every session is intentional. This is care you can feel.
What kinds of concerns or goals do you support?
At Lower the Dose™, we help adults 50 and forward reclaim their health by addressing the most common concerns of midlife and beyond, including:
- Hormone imbalances in both men and women
- Bioidentical hormone therapy for menopause and testosterone support
- Weight gain, insulin resistance, prediabetes, and type 2 diabetes
- Chronic inflammation, metabolic dysfunction, and burnout
- Thyroid issues, fatigue, brain fog, and low energy
- Osteoporosis, bone loss, and musculoskeletal decline
- Elevated blood pressure, cholesterol, and cardiometabolic risk
We also support those looking to prevent illness before it starts—especially if you have a family history of:
- Heart disease
- Diabetes
- Autoimmune or hormone-related conditions
- Menopause
- Insulin resistance
Whether you’re facing symptoms or planning ahead, we help you take control of your future—through personalized care that targets the root.
What makes your care model different?
Our entire approach is built around our framework: The HEALING Equation™, which guides all patient care:
HEALING = Mapping + Tools + Protection
- Mapping your risks and root causes using advanced diagnostics, hormones, and genetics
- Tools include supplements, nutrition, breathwork, stress regulation, coaching, and self-paced education
- Protection for your future by preventing complications through ongoing support and structure
We don’t chase symptoms—we build resilience from the inside out.
What Are the Phases of Transformation in Lower the Dose®?
At Lower the Dose™, we guide you through a proven, step-by-step journey to reverse chronic symptoms and restore vibrant health. Our process is built on the Healing Equation™: Mapping + Tools + Protection—and delivered through three key phases:
- Strategy: We begin with a 1:1 Strategy Session to understand your risks, goals, and health history. This helps us design a plan that aligns with your biology—not generic protocols.
- Mapping: In the first 30 days, we use advanced lab testing and diagnostics to map your metabolic, hormonal, and lifestyle imbalances. From this, we create your personalized health blueprint.
- Transformation: With your blueprint in hand, we implement a targeted plan to reverse metabolic dysfunction, rebalance hormones, and restore vitality—through lifestyle medicine, supplementation, coaching, and continuous support.
Every step is personalized, practical, and designed to deliver real, lasting change.
Lower the Dose™ isn’t just a name—it’s our mission. By moving through these phases, you’ll not only reverse disease—you’ll reclaim your vitality, purpose, and peace of mind.
Who will I be working with?
Your care is led by Dr. Jaiwant Rangi, a board-certified endocrinologist with 25+ years of clinical expertise in hormone health, metabolic optimization, and mind-body healing. Depending on your membership tier, you may also receive support from:
- Health coaches
- Nutrition and supplement specialists
- Mindfulness and stress-rewiring experts
Courses,
Community, & Ecosystem
What educational support do you offer?
Our educational resources are housed within the Lower the Dose™ Community—a private online portal hosted on BodySite. It includes:
- On-demand courses:Lower the Dose: Diabetes Education
- Lower the Dose™: Mind Education
- Lower the Dose™: Hormone Education
- Guided meditations
- Monthly masterclasses
- Research updates
- Access to Q&A and discussion forums
These offerings complement your clinical journey or can be licensed independently by providers.
Do you offer training for providers?
Yes—Dr. Rangi has over 20 years of experience teaching endocrinologists, primary care physicians, nurse practitioners, and physician assistants.
She offers live and virtual training sessions for healthcare providers who want to stay up to date with the latest in diabetes and endocrine care. Topics may include medication advances, diagnostic strategies, technology integration, and lifestyle-based approaches to chronic disease.
Training can be tailored to the needs of individual providers, group practices, or clinical teams. To schedule a session or inquire about fees, please contact Dr. Rangi directly.
Services,
Testing & Support
Where are appointments held?
You may choose to be seen in person at our Folsom, CA office (1600 Creekside Dr, Suite 2700) or receive care 100% virtually from anywhere in California.Do you bill insurance?
Yes. We bill insurance for eligible services like labs, prescriptions, and covered medical visits. Our membership-based model—including extended strategy sessions, coaching, and lifestyle redesign—is not billable to insurance.
Can I use my HSA, FSA, or HRA to pay for membership?
Yes. Most services qualify as eligible medical expenses. Please confirm with your plan administrator.
What’s included in my membership?
Your Lower the Dose™ membership is designed to deliver ongoing support, expert guidance, and personalized care. Depending on your membership tier, you’ll receive:
- Ongoing strategy sessions directly with Dr. Rangi
Ongoing reviews of your hormone and metabolic health - Nutrition and supplement guidance tailored to your biology
- Full access to our diabetes and lifestyle course library
- Invitations to workshops, live events, and member Q&A sessions
- Access to stress and mindset tools, plus optional group support in select tiers
- Secure messaging between visits for support and follow-up
- Ongoing strategy sessions directly with Dr. Rangi
What’s not included in membership?
Some standard labs and imaging are included. If advanced diagnostics are recommended, we’ll discuss any associated costs beforehand. Prescriptions and supplements are typically separate. Select supplements may be included for a limited time during your lifestyle program, but ongoing supplement costs are not part of membership.
Will I still need a primary care provider?
Yes. We recommend maintaining a relationship with your primary care physician for urgent visits, screenings, and vaccinations. We focus on specialty and preventive care.
Do you offer urgent or emergency care?
No. We are not equipped for emergencies. Call 911 or visit your local ER in case of urgent medical issues.
Will you coordinate with my other providers?
Yes. We are happy to collaborate with your PCP, OB-GYN, cardiologist, or any specialists to ensure continuity of care.
How do I contact the office between visits?
You can reach our team through secure email, text, or your patient portal. We respond promptly during business hours and prioritize timely care coordination to keep your plan on track.
Will I have direct access to Dr. Rangi?
Yes. Dr. Rangi personally oversees your care and meets with you during key sessions. Depending on your membership tier, you may also receive enhanced access, including more frequent strategy sessions or direct messaging for guidance and support.
Do you offer advanced testing?
Yes. Based on your goals, we may offer:
- Prenuvo full-body MRI
- Galleri multi-cancer screening
- Coronary Artery Calcium scoring
- Genetic & nutrigenomic testing
- Food sensitivity & gut panels
- Brain health assessments
- Mind-body stress profiling
These tools help us personalize your care far beyond routine labs.
What if something in my plan doesn’t feel right?
We adjust together. Your plan is a collaborative process, and we always honor your feedback—physically, emotionally, or logistically.
I’m overwhelmed. Do I need to be motivated or already healthy to benefit?
Not at all. Many patients come to us feeling exhausted, discouraged, or stuck. You don’t need to be perfect—you just need to be ready to begin. We’ll walk with you from there.
How do I get started?
Getting started is simple—and begins with clarity.
Step 1: Schedule Your Discovery Call
Book a 15-minute, discovery call with Dr. Rangi to review your health history, symptoms, and goals. We’ll map out your unique risks and explore the best path forward.Step 2: Map Your Health
Based on your presentation and risk factors, we recommend targeted diagnostics to understand your biology. Together, we create your personalized health blueprint before initiating any treatment.Step 3: Begin Your Transformation
Your plan is implemented step-by-step through the Lower the Dose™ Method—rooted in our Healing Equation™: Mapping + Tools + Protection. You’ll receive expert guidance, education, and continuous support to restore vitality and achieve long-term success.
Labs,
Imaging & Testing
What lab facilities do you recommend?
We commonly use Quest, LabCorp, and local hospital-based systems such as Sutter, Dignity Health, and UC Davis. We’ll recommend the most convenient and cost-effective lab option based on your location and insurance at the time of your visit.
What if I need imaging, a biopsy, or bone density testing?
We typically refer to Sutter Imaging but are happy to work with any center you prefer—including UC Davis, Dignity Health, or your preferred radiology provider.
My labs are “normal,” but I still feel off. Can you help?
Yes. We treat your story—not just your labs. “Normal” doesn’t always mean optimal, and we look deeper to find the root causes of imbalance.
Do you offer advanced testing?
Yes. Based on your goals and clinical presentation, we may offer:
- Prenuvo Full-Body MRI
- Galleri Multi-Cancer Screening
- Coronary Artery Calcium Scoring
- Genetic & Nutrigenomic Testing
- Gut Health & Food Sensitivity Panels
- Brain Health Assessments
- Mind-Body Stress Profiling
Why do I need to do labs on three different days?
Hormones are dynamic and influenced by daily rhythms, stress, and—if applicable—your menstrual cycle. A single blood draw may miss critical information.
That’s why we often use a 3-day sequence to capture a more complete picture:
- Day 1: Morning fasting labs (ideally between 7–8 AM and on Day 3–5 of your cycle if premenopausal) — to measure peak levels of cortisol, testosterone, estrogen, and more.
- Day 2: 24-hour urine collection — to assess hormone metabolism, adrenal output, or calcium loss across a full day.
- Day 3: 1 mg dexamethasone suppression test — to evaluate how your adrenal glands regulate cortisol and stress.
This structured approach offers insights standard labs often miss—helping us personalize your care with clarity and precision.
What is a 1 mg dexamethasone suppression test?
This test helps assess adrenal function. You’ll take 1 mg dexamethasone at 10–11 PM and complete fasting labs the next morning to check cortisol suppression.
Why do you use multi-day hormone testing?
Hormones fluctuate due to sleep, stress, and biological rhythms. Our multi-day method—including fasting labs, urine panels, and suppression testing—provides a fuller view of your hormonal landscape, leading to more accurate diagnoses and targeted treatment plans.
Supplements
& Re+SET™ Bundles FAQ
Do I need to take supplements to benefit from this program?
Not necessarily. Supplements are optional—but they can accelerate your results by supporting your metabolism, hormones, gut, and nervous system at a deeper level.
What are Re+SET Bundles?
Re+SET Bundles™ are curated groups of 3–5 clinical-grade supplements designed to target specific health goals—like blood sugar, sleep, gut health, brain function, or heart support.
Can I buy supplements individually instead of in a bundle?
Yes. Every product is available individually. The bundles are simply pre-selected to simplify your choices and support common health goals.
Are supplements safe to take with my medications?
Most are safe, but we always recommend reviewing your supplement plan with Dr. Rangi or your healthcare provider—especially if you’re taking prescription medications.
Where do your supplements come from?
All products are professional-grade, tested for purity and potency, and sourced from trusted manufacturers used in clinical settings. We only recommend what we personally use and trust.
What types of Re+SET Bundles™ are available—and how do I choose?
We offer 10 targeted bundles to support different areas of health, including:
- Sugar Re+SET™ – For blood sugar and insulin balance
- Heart Re+SET™ – For cardiovascular and blood pressure support
- Brain Re+SET™ – For cognitive clarity and stress resilience
- Gut Re+SET™ – For digestion and microbiome health
- Sleep Re+SET™ – For restful sleep and circadian reset
- Hormone Re+SET™ – For thyroid, testosterone, and menopause support
- Vitality Re+SET™ – For energy, aging, and overall wellness
- Immunity Re+SET™ – For immune strength and cellular defense
- Bone Re+SET™ – For bone density and musculoskeletal health
- Metabolic Re+SET™ – For weight balance and inflammation control
You don’t need all 10—just choose based on your goals. Not sure? We’re happy to help you select the right bundle.
What is MedPax and how is it different from regular supplements?
MedPax is a personalized daily supplement pack that combines your recommended nutrients into convenient, pre-sorted packets. No bottles, no confusion—just grab and go. Each pack is tailored to your health goals and simplifies your routine for better consistency and results.
How long should I take supplements—forever?
Not necessarily. Some supplements are for short-term support (like detox or gut repair), while others (like omega-3s, vitamin D, or magnesium) may be needed long-term depending on your labs and lifestyle. We reassess regularly to avoid unnecessary use.
Are your supplements covered by insurance or HSA/FSA?
Supplements are not covered by insurance, but many HSA or FSA cards can be used for eligible products. Check with your plan administrator to confirm.
Can I take supplements if I’m pregnant or breastfeeding?
We do not recommend starting supplements during pregnancy or breastfeeding without medical guidance. Please discuss with your OB or healthcare provider to ensure safety for you and your baby.
Disclaimer
This FAQ is for informational purposes only and does not override or replace the signed patient agreement. Care decisions and program policies are reviewed in detail during your onboarding session.
What is lifestyle medicine?
Lifestyle medicine is a branch of medicine that focuses on the use of lifestyle changes, such as diet, physical activity, and stress management, to prevent, treat, and potentually reverse chronic diseases such as heart disease, type 2 diabetes, and obesity. It recognizes that many chronic diseases are caused by lifestyle factors, such as poor diet, physical inactivity, and stress, and that these diseases can be prevented, treated, and often reversed through lifestyle changes.
How can patients with heart disease benefit from our lifestyle program?
Lifestyle changes can lower blood pressure, cholesterol, and reduce the risk of heart attack and stroke. It offers increased energy and quality of life. Decreased dependence on medication & improved overall health and reduce the risk of other chronic conditions.
Does everyone with prediabetes develop type II diabetes?
- Approximately 15-30% of people with prediabetes will develop type 2 diabetes within 5 years if they do not make lifestyle changes to improve their health. However, the exact percentage varies and depends on several factors, such as age, weight, and family history.
- Making lifestyle changes, such as losing weight, eating a healthy diet, and increasing physical activity, can help prevent or delay the onset of type 2 diabetes in people with prediabetes.
Why do people gain weight as they age?
- Decreased metabolism
- Decreased physical activity
- Hormonal changes
- Poor diet
- Medications
- Decreased muscle mass
What is type 1.5 diabetes or LADA?
Type 1.5 diabetes, also known as Latent Autoimmune Diabetes of Adults (LADA), is a form of diabetes that resembles both type 1 and type 2 diabetes. It is characterized by the presence of autoimmune markers, similar to type 1 diabetes, but also involves insulin resistance, similar to type 2 diabetes. People with LADA often initially misdiagnosed as type 2 diabetes, but later progress to needing insulin therapy, like type 1. It is a less common form of diabetes and requires a different treatment approach than either type 1 or type 2 diabetes.
What is MODY?
MODY stands for Maturity Onset Diabetes of the Young. It is a rare form of diabetes that usually presents in adolescence or young adulthood and is caused by specific genetic mutations. MODY is characterized by insulin secretion defects, leading to elevated blood sugar levels. Unlike type 1 and type 2 diabetes, MODY is not treated with insulin therapy and has a milder course. It is important for individuals with MODY to receive an accurate diagnosis, as treatment and management can differ from other forms of diabetes.
Why should you choose us in your healthcare journey to lose weight and get healthy?
We provide comprehensive support to help you achieve your weight loss and health goals.
- Personalized support: We provide personalized support and create an individualized plan based on your specific needs and health conditions.
- Expert guidance: We have the expertise and training to provide evidence-based guidance on nutrition, physical activity, and lifestyle changes that can help with weight loss and overall health.
- Safety: We monitor your progress and make adjustments to your plan as needed to ensure your health and safety while you work towards your goals.
- Accountability: We provide accountability and help keep you motivated and on track.
- Addressing underlying health issues: We also help identify and address any underlying health issues that may be contributing to weight gain and provide guidance on how to manage them.
In summary, we provide you with the personalized support, expert guidance, and accountability you need to successfully lose weight and improve your health in a safe and sustainable way.
Who should be screened for prediabetes or diabetes?
- All 45 years of age or older
- All overweight or obese (BMI greater than or equal to 25 kg/m² or greater than or equal to 23 kg/m² in Asian Americans) adults of any age with one or more of the following risk factors:
- If you have 1st degree relative with diabetes
- High risk race/ethnicity (eg, African American, Latino, Native American, Asian American, Pacific Islander)
- Personal history of Heart Disease
- Personal history of Hypertension or on therapy for hypertension
- If HDL-C value < 35 mg/dL and/or triglyceride value > 250 mg/dL
- History of Polycystic ovary syndrome
- Physical inactivity
- Conditions associated with insulin resistance (eg, severe obesity, acanthosis nigrans)
What hormones are involved in weight management and apetite regulation?
Several hormones play a role in weight management and appetite regulation. Some of the key hormones involved include:
- Leptin: A hormone produced by fat cells that signals the brain to reduce hunger and increase energy expenditure.
- Ghrelin: A hormone produced primarily by the stomach that stimulates hunger and increases food intake.
- Insulin: A hormone produced by the pancreas that regulates glucose levels in the blood by promoting the uptake of glucose by cells.
- Cortisol: A hormone produced by the adrenal gland that is involved in the body’s response to stress and can impact weight and appetite regulation.
- Peptide YY (PYY): A hormone produced by the gut in response to food intake that suppresses appetite.
- Cholecystokinin (CCK): A hormone produced by the gut in response to food intake that suppresses appetite and stimulates digestion.
These hormones work together in complex ways to regulate energy balance and body weight, and imbalances or disruptions in their levels or actions can contribute to the development of obesity and related metabolic disorders. Understanding the interplay between these hormones and their mechanisms of action is an active area of research in the field of endocrinology and metabolism.
What is insulin?
Insulin is a hormone produced by the pancreas, an endocrine gland located in the abdomen. Its main function is to regulate glucose (sugar) levels in the blood by helping cells take up glucose for energy. Insulin signals the liver, muscle, and fat cells to take up glucose from the bloodstream, where it is either used for energy or stored for later use. Insulin also helps to reduce the production of glucose in the liver. Deficiency or resistance to insulin can lead to high blood sugar levels, which is a characteristic of diabetes. Insulin replacement therapy is a common treatment for patients with type 1 diabetes and some patients with type 2 diabetes.
Why don't diets work?
Diets often don’t work because they are not sustainable in the long-term. Most diets require people to restrict their caloric intake and eliminate certain foods, which can be difficult to maintain over time. Additionally, many diets do not address the underlying habits and behaviors that contribute to weight gain. As a result, people may lose weight initially, but then regain it once they return to their old eating patterns. Furthermore, diets can also be restrictive and can lead to feelings of deprivation and negatively impact mental health. To be successful in the long-term, it’s important to adopt healthy eating habits that are sustainable and address both physical and mental well-being.
What is insulin resistance?
Insulin resistance is a condition in which the body’s cells do not respond properly to insulin, the hormone that regulates glucose (sugar) levels in the blood. As a result, the pancreas produces more insulin to try to lower elevated blood sugar levels. Over time, if insulin resistance persists, the pancreas may become unable to produce enough insulin to maintain normal blood sugar levels, leading to the development of type 2 diabetes.
Insulin resistance can be caused by a variety of factors, including obesity, physical inactivity, genetic factors, and hormonal imbalances. It is also commonly associated with other conditions such as metabolic syndrome and cardiovascular disease. Treatments for insulin resistance aim to improve the body’s sensitivity to insulin, reduce blood sugar levels, and lower the risk of developing diabetes and other related health problems.
What is leptin?
Leptin is a hormone produced by fat cells that plays a role in regulating energy balance and body weight. It acts on the hypothalamus, a region of the brain, to reduce hunger and increase energy expenditure. Leptin signals the brain that the body has enough stored energy, reducing food intake and increasing metabolism. Obesity is associated with increased levels of leptin, but in some cases, the brain may become resistant to the effects of leptin, leading to continued feelings of hunger and difficulty losing weight. Leptin resistance can be caused by various factors, including inflammation, oxidative stress, and changes in the signaling pathways that respond to leptin.
Leptin plays a complex role in energy balance and body weight regulation, and research is ongoing to better understand its mechanisms of action and potential as a therapeutic target for obesity and related metabolic disorders.
What is ghrelin?
Ghrelin is a hormone produced primarily by the stomach that stimulates hunger and increases food intake. It acts on the hypothalamus, a region of the brain, to increase feelings of hunger and promote food consumption. Ghrelin levels are highest before a meal and lowest after a meal, helping to regulate appetite and energy balance.
Ghrelin has a number of effects on the body beyond regulating hunger, including stimulating the release of growth hormone from the pituitary gland, increasing gastric acid secretion, and promoting fat storage. Ghrelin levels are lower in people who are obese compared to those with a healthy weight, and some research suggests that alterations in ghrelin levels may contribute to the development of obesity and related metabolic disorders.
What is cortisol?
Cortisol is a hormone produced by the adrenal gland that is involved in the body’s response to stress. It is commonly referred to as the “stress hormone.” Cortisol helps to regulate the body’s metabolism and the immune system, and plays a role in the regulation of blood pressure, blood sugar levels, and the balance of salt and water in the body. In response to stress, cortisol levels increase, promoting the release of glucose from the liver to provide energy to the body and suppressing non-essential functions such as digestion and the immune system. This response is part of the “fight or flight” response that prepares the body to respond to stress or danger. Chronic stress or excessive cortisol production can have negative effects on the body, including weight gain, insulin resistance, and a weakened immune system. Cortisol levels can also be disrupted in various medical conditions, including adrenal gland disorders, and can be measured to help diagnose and monitor these conditions.
What is glucagon?
Glucagon is a hormone produced by the pancreas that works in opposition to insulin to regulate glucose (sugar) levels in the blood. Unlike insulin, which lowers blood sugar levels by promoting the uptake of glucose by cells, glucagon raises blood sugar levels by stimulating the liver to convert stored glycogen into glucose, which is then released into the bloodstream. This helps to maintain normal blood sugar levels, especially between meals or during periods of low insulin levels, such as during physical activity. Deficiencies or imbalances in the levels of glucagon and insulin can lead to abnormal blood sugar regulation and contribute to the development of conditions such as diabetes. In some cases, glucagon may be used as a treatment for hypoglycemia, or low blood sugar, which is a common complication of insulin therapy in people with diabetes.