STAY AWAY FROM PALOMA Extremely Disappointing experience! First, upfront something that needs to be disclosed somewhere, and I found out only after six months: IT IS PALOMA'S POLICY NEVER TO CONDUCT TREATMENT TO WHERE TSH IS SUPPRESSED. This means doctors are not allowed even to consider issuing other alternatives addressing the potential TSH suppression issues as integrated medicine. I was very upset when I found out. I let the doctor know, and she said she would communicate with Paloma management my frustration. I got a call with a message that someone was going to contact me via e-mail, but nothing, and then the entire chat with my doctor was deleted, and now silence! My first visit: Less than 15 minutes, opening g question "what do you want?". I explained that it took me more than ten years to be stable and that a new primary doctor cut my NPT in half from one day to the next because of TSH suppression. While I would consider tweaking, the consequences already in 3 months had been: 15 pounds of weight gain, lack of focus, cholesterol shot up, triglycerides shot up, blood pressure shot up, and my face was swollen. She still kept me at half the prescription and added Levoxyl. Nothing improved. I texted her pictures less than a year apart to see the striking difference, and I'm miserable and frustrated. I know what it is already well with the right medication level. She said to be patient. During the last visit, she finally ups the NPT, but then I found out it would be lowered if TSH is suppressed because it is Paloma's policy! The doctor that had stabilized me (in another state, I moved) addressed risk factors with hormones and supplements, AND I have a cardiologist monitoring. That did not matter to Paloma. Then I realized they only gave me medicine for 30 days and expect blood tests again ( I just paid $100 for blood tests, plus Paloma's 10-minute sessions on my credit card as they don't accept insurance!). NEVER have received less than 60 days prescription to monitor changes. Also, btw, on my last 10-minute session, she had not checked my file prior to the call, so I had to catch her up! In conclusion, they are not as empathetic as they claim to be, they tie doctor's hands for truly integrated treatments, and you will not get true conversations (hardly in 10 minutes, even though they are supposed to be 20 minutes and 15-minute calls), plus no they do not believe everyone is different, they will still bow to the TSH number...PER POLICY! I wasted a lot of time, and I'm probably left hanging without medicine after 30 days because, as we all know, getting access to endocrinologists does not happen overnight. There is your completely non-empathetic Paloma for you.