Hi! I started OP about 2-1/2 weeks ago with amazing results - no bleeding gums, skin getting smooth and even. I've had extreme fatigue, which seemed reasonable due to the detox (although it's still occurring). I've been on bioidentical HRT for a long time, very low dose, but I had to have a hyst 13 years ago. The bioidenticals have always kept fatigue and hot flashes in check, but I've had hot flashes the last 3 days. Could the OP be removing the hormones I'm replacing?