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    One thing to keep firmly in mind as you go forward — the replacement hormone drugs belong to a group of drugs — like blood thinners and antiseizure medications — that have what pharmacists call a “narrow therapeutic index” (NTI). For them to work properly we have to maintain a specific concentration of them in the blood. We have to have regular blood level checks to make sure that the concentration is right. And changes in how we take the meds can interfere with that concentration. Even changing from one brand to another, or from one generic to another, can alter the concentration in the blood and throw things off. It is really important to be consistent. If you change how you take the meds, or if you start taking other meds at the same time, or if you change generics (a different drug store), or anything like that, you could be changing the concentration of the replacement hormone in your blood and throwing things off.