Pathway
Pilots
The Approach
How We Approach This Pathway
Why This Approach Fits
Review goals, symptoms, travel patterns and options with your aviation responsibilities in view, and coordinate with your aviation medical examiner when appropriate.
How Care Works
We capture your pilot status and certification context early, hand off medication review, and assess sleep and fatigue, a natural link to Dr. Chu's sleep-apnea research.
Read Before You Decide
What Is Measured, and What We Ask First
What Is Measured
Laboratory results, symptoms, treatment tolerance and relevant biometric trends are reviewed together by your clinician, on a schedule you agree on at the start.
Before We Show Any Options
FAA guidance weighs both the condition and the medication. Telehealth approval is not an aviation clearance. Compounded and investigational peptides have no FDA approval and no FAA review, so we do not present them until you and your aviation medical examiner have discussed them.
Before You Start Anything
Do not start a new medication or supplement without checking it with your aviation medical examiner, including anything bought online. If you are unsure whether you are fit to fly, you are not.
By Life Stage
Where Care Starts
Ask Your AME First
A telehealth prescription is not an aviation clearance. Before you start anything, talk with your aviation medical examiner, who decides what is acceptable for your certificate and class. Tell us who your examiner is and we will coordinate when you authorize it.
Why Peptides Are Different
Compounded and investigational peptides are not FDA-approved, so there is no FAA position that clears them. Whether you are fit to fly on one is your responsibility under the regulations, and the effect on faculties at altitude is usually unstudied. We do not present them to pilots by default.
Approved Medicines and Hormone Therapy
Some options are approved medicines with a track record, and the FAA has published guidance for several. Hormone replacement therapy, for example, is not disqualifying by itself, and the FAA publishes when an examiner can issue and when the file goes to FAA review.
Sleep, Fatigue and Cardiovascular Health
For many pilots the most useful first steps are sleep, fatigue, blood pressure and metabolic health, which matter for flight safety and for your certificate. This is also where Dr. Chu's cardiology and sleep-apnea research is relevant.
Care Plans We May Discuss
Options for This Pathway
Longevity Panel
Longevity Panel
Energy and Longevity
Learn More →Hormone Review
Hormone Review
Intimacy and Vitality
Learn More →Metabolic Support
Metabolic Support
Weight and Metabolic Health
Learn More →This page describes a care pathway and is not a treatment recommendation. Compounded medications are not FDA-approved or evaluated for safety, effectiveness or quality. Prescriptions are issued only after clinician review.
The Evidence
What the Rules Say
14 CFR 61.53 (prohibition on operations during medical deficiency)
A pilot may not act as pilot in command or as a required crewmember while knowing of, or having reason to know of, a medical condition that would make them unable to meet the requirements of their medical certificate, or while taking medication or receiving other treatment for such a condition.
Read the Source ↗14 CFR 91.17 (alcohol or drugs)
No person may act or attempt to act as a crewmember of a civil aircraft while using any drug that affects the person's faculties in any way contrary to safety.
Read the Source ↗FAA Guide for Aviation Medical Examiners: Hormone replacement therapy (page last updated January 22, 2025)
Oral or repository contraceptives and hormonal replacement therapy are not disqualifying for medical certification. If the applicant has no adverse symptoms or reactions to hormones and is otherwise qualified, the examiner may issue the certificate.
Read the Source ↗FAA Female HRT Disposition Table (updated April 29, 2026)
For estrogen, progesterone or testosterone near physiologic levels, the examiner can issue if there are no side effects that would interfere with flight duties and no history of venous thromboembolism, and no history or increased risk of stroke, severe migraine or uncontrolled hypertension. All others are deferred for FAA review, with a current clinical progress note from the treating physician no more than 90 days before the exam.
Read the Source ↗Questions From Pilots
Can I Take Peptides and Keep Flying?+
There is no FAA approval for compounded or investigational peptides, so we cannot tell you they are acceptable. Flying while using any drug that affects your faculties is prohibited, and you are responsible for knowing whether you are fit. We do not offer peptides as a default for pilots. If you want to discuss one, your aviation medical examiner is the first conversation.
Is Hormone Therapy Allowed for Pilots?+
FAA guidance says hormone replacement therapy is not disqualifying by itself. The FAA's female disposition table says an examiner may issue when hormone levels are near physiologic and there are no side effects affecting flight duties, no history of blood clots, and no history or increased risk of stroke, severe migraine or uncontrolled hypertension. Other situations go to FAA review. See the Menopause and Midlife pathway for how we approach it.
Does Telehealth Approval Clear Me to Fly?+
No. FAA guidance weighs both the condition and the medication, and a telehealth approval is not an aviation clearance. Speak with your aviation medical examiner before starting anything.
Do You Work With My Aviation Medical Examiner?+
We coordinate with your examiner when appropriate and when you authorize it.
Why Do You Ask About Sleep and Fatigue?+
Sleep and fatigue matter for safety in the cockpit and for health generally, and they connect to Dr. Chu's research on sleep apnea.
Start Your Assessment
Ten minutes, no card, reviewed by a clinician.