Tired of ten-minute visits?A doctor who listens and gets to know you.
A physician who gets to know you, investigates why you're feeling the way you do, and works with you toward your best health.
Triple board-certified physicianTelehealth throughout Florida
Dr. Kiswani-Barley
Triple board-certified physician
Get the time and care you deserve
High-volume, insurance-driven schedules can leave you feeling rushed or unheard. Thrive Rx is different: a direct-pay practice centered around you, with time, attention, and an ongoing relationship with triple board-certified Dr. Kiswani-Barley.
Time to look beyond symptoms
Dr. Kiswani-Barley takes time to understand your symptoms, health history, and daily life. With a thorough evaluation and diagnostic testing when appropriate, she investigates possible contributors so your care goes beyond managing symptoms.
Your physician, visit after visit
You see Dr. Kiswani-Barley each time, not a rotating list of providers. She gets to know your history and goals, follows your progress, and works with you as your needs change.
Care without the long wait
You don't have to wait weeks or months for an appointment. Get time with Dr. Kiswani-Barley during our evening and weekend hours, by appointment only.
Primary care is the foundation of all our services
Stay one step ahead with your health. Dr. Kiswani-Barley looks at the whole person, getting to know your history, lifestyle, and goals, not just your symptoms. With an expert physician by your side, you can take a proactive approach to prevention and ongoing care, rather than only reacting when something feels wrong. Medical weight loss and hormone care build on that same physician relationship.
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Symptoms and Conditions We Evaluate at Thrive RX
Many symptoms have overlapping causes. Dr. Kiswani-Barley routinely uses lab testing in her diagnostic evaluations and orders imaging when needed. She interprets results alongside your symptoms, health history, and clinical findings to investigate possible causes and guide personalized care. Testing is one part of the evaluation and may not identify a single cause. From everyday primary care concerns to complex hormonal and metabolic conditions, she takes a comprehensive approach. The conditions listed below are examples, not a complete list. Care is individualized, with in-person evaluation or specialist care recommended when needed.
Energy, Sleep, and Daily Function
- Ongoing fatigue and low energy
- Insomnia and sleep problems
- Sleep apnea evaluation
- Brain fog and difficulty concentrating
Fatigue and Low Energy
Persistent tiredness that does not improve with rest can signal thyroid dysfunction, iron deficiency, undiagnosed sleep apnea, hormonal imbalances, or vitamin D deficiency. An estimated 80% of moderate-to-severe sleep apnea cases go undiagnosed, making it one of the most overlooked causes of chronic fatigue.
Sleep Problems and Insomnia
Difficulty falling asleep, staying asleep, or waking unrefreshed can be caused by hormonal imbalances, elevated cortisol from chronic stress, thyroid dysfunction, or undiagnosed sleep apnea. Sleep problems also worsen other symptoms, including weight gain, brain fog, and mood changes, creating a cycle that requires root-cause intervention.
Brain Fog and Difficulty Concentrating
Persistent mental cloudiness, memory lapses, and difficulty concentrating can stem from thyroid dysfunction, hormonal changes during perimenopause or with low testosterone, sleep disorders, blood sugar instability, nutrient deficiencies in iron, B12, or vitamin D, and chronic stress. A physician-led evaluation, with lab testing chosen when appropriate, can help investigate these possible contributors and guide next steps.
Headaches and Migraines
Recurring headaches and migraines can be driven by hormonal fluctuations, thyroid imbalances, high blood pressure, nutrient deficiencies such as magnesium or B2, sleep disorders, and chronic stress. Identifying the pattern and triggers through a comprehensive evaluation is the first step toward meaningful relief without relying solely on pain medication.
Weight and Metabolism
- Obesity, weight management and weight loss resistance
- Muscle loss and weakness
Weight Loss Resistance
When diet and exercise are not producing results, there is usually a metabolic explanation. Insulin resistance, thyroid dysfunction, hormonal imbalances, elevated cortisol, and poor sleep quality can all prevent weight loss. FDA-approved GLP-1 medications like semaglutide and tirzepatide, combined with root-cause evaluation, help break through plateaus.
Muscle Loss and Weakness
Losing muscle mass, feeling weaker than expected, or struggling to build strength can indicate hormonal deficiencies, particularly low testosterone in men and declining estrogen in women. Thyroid dysfunction, vitamin D deficiency, inadequate protein intake, and metabolic conditions also contribute to progressive muscle loss.
Heart and Cardiovascular Health
- Hypertension (high blood pressure)
- High cholesterol and lipid concerns
- Coronary artery disease (ongoing primary care coordination)
- Heart palpitations
- Chest pain or tightness (may need urgent in-person or emergency evaluation)
High Blood Pressure
Often called the silent killer, high blood pressure affects nearly half of American adults and usually has no symptoms until it causes damage. Root causes include insulin resistance, sleep apnea, chronic stress, kidney dysfunction, and excess sodium intake. Regular monitoring, lifestyle modifications, and targeted treatment reduce the risk of heart attack, stroke, and kidney disease.
High Cholesterol
Elevated LDL cholesterol and triglycerides increase cardiovascular risk, but a standard lipid panel only tells part of the story. Advanced markers like Lp(a), ApoB, and LDL particle count provide a more complete picture. Diet, exercise, thyroid function, and metabolic health all influence cholesterol levels, and treatment should address the underlying drivers.
Heart Palpitations
Heart palpitations, a racing heartbeat, or skipped beats can feel alarming. While often benign, they can signal thyroid dysfunction, electrolyte imbalances, hormonal changes during perimenopause, anemia, excessive caffeine intake, or anxiety. A thorough evaluation with labs, EKG when indicated, and a review of contributing factors helps determine the cause.
Chest Pain and Tightness
Chest pain and tightness require careful evaluation. While some causes are musculoskeletal or related to acid reflux, others can indicate cardiovascular concerns. Chronic stress, anxiety, and costochondritis are common drivers. A comprehensive assessment with appropriate testing helps rule out serious causes and address the underlying issue.
Mood, Stress, and Mental Health
- Depression and persistent low mood
- Anxiety
- Mood swings and irritability
- Stress management
Anxiety Disorders
Persistent worry, panic symptoms, or anxiety that affects daily life deserves attention. Dr. Kiswani-Barley considers emotional stress, sleep, medications, and possible medical contributors alongside your history. Together, you discuss treatment options and whether behavioral health support or specialist care is appropriate.
Depression and Persistent Low Mood
Persistent sadness, loss of interest, changes in sleep or appetite, and difficulty concentrating can have several contributors. Evaluation considers your emotional wellbeing and physical health together, with testing when indicated. Dr. Kiswani-Barley discusses an individualized plan, follow-up, and referral when needed.
Stress, Mood Changes, and Irritability
Stress and changing moods can affect relationships, sleep, and everyday function. Care starts with understanding what has changed in your life and health. Sleep, coping strategies, medications, and hormonal or other medical factors are considered when relevant, rather than assuming a single cause.
Women's Health and Hormones
- Perimenopause and menopause, including hot flashes and night sweats
- PCOS, irregular cycles and weight gain
- Vaginal dryness and pelvic pain
- Low libido and sexual health concerns
- Frequent urinary tract infections and bladder concerns
Hot Flashes, Night Sweats, and Menopause Symptoms
Hot flashes affect approximately 75% of women during the menopausal transition. Along with night sweats, mood changes, sleep disruption, and vaginal dryness, these symptoms are driven by declining estrogen and progesterone. FDA-approved bioidentical hormone therapy can provide significant relief, often within 2 to 4 weeks.
Perimenopause and Early Hormone Changes
Perimenopause can begin in a woman's late 30s to early 40s, years before periods stop. Symptoms include irregular cycles, worsening PMS, new-onset anxiety, sleep disruption, and weight gain. Many women are told these changes are just stress when they actually reflect shifting hormone levels that can be identified and addressed.
Vaginal Dryness and Discomfort
Vaginal dryness, pain during intercourse, and urogenital discomfort are common during perimenopause and menopause due to declining estrogen. These symptoms affect quality of life and intimate relationships but are treatable. Local and systemic hormone therapy options can restore comfort and tissue health.
PCOS, Irregular Cycles, and Weight Gain
Polycystic ovary syndrome affects up to 12% of women of reproductive age and is a leading cause of irregular periods, weight gain, acne, and hair thinning. Insulin resistance is a central driver in most cases. Treatment focuses on addressing insulin sensitivity, optimizing nutrition, and managing hormonal imbalances with formulations specific to PCOS, which differ from standard menopausal HRT.
Pelvic Pain and Painful Periods
Chronic pelvic pain, severe menstrual cramps, and pain during intercourse can indicate endometriosis, fibroids, or other gynecologic conditions. An estimated 1 in 10 women has endometriosis, and diagnosis is often delayed by 7 to 10 years. A thorough evaluation helps identify the source of pain and guide appropriate management.
Frequent UTIs and Bladder Issues
Recurrent urinary tract infections and bladder discomfort in women are often connected to declining estrogen levels, which thin the urogenital tissues and reduce protective bacteria. Women in perimenopause and menopause are especially susceptible. Addressing hormonal factors alongside acute treatment can break the cycle of recurrence.
Men's Health and Hormones
- Low testosterone symptoms
- Erectile dysfunction
- Fatigue, irritability and muscle loss
- Low libido
Low Testosterone Symptoms in Men
Fatigue, declining muscle mass, low libido, irritability, and brain fog in men often trace back to low testosterone. Testosterone levels decline approximately 1 to 2% per year after age 30. The TRAVERSE trial confirmed that FDA-approved TRT is cardiovascular-safe, and the FDA has since removed cardiovascular warning labels.
Erectile Dysfunction
Erectile dysfunction often serves as an early warning sign of cardiovascular disease, hormonal deficiency, or metabolic dysfunction. Low testosterone, insulin resistance, high blood pressure, elevated cholesterol, and psychological stress can all contribute. A physician-led evaluation, including metabolic and cardiovascular labs when appropriate, can help assess treatable contributors and guide care.
Digestive and Immune Health
- Heartburn and acid reflux
- Bowel concerns
- Digestive problems and food sensitivity concerns
- Frequent illness and immune health concerns
Digestive Problems and Food Sensitivities
Chronic bloating, irregular bowel movements, food sensitivities, and acid reflux often connect to gut health and immune system activation. These symptoms can also be linked to thyroid dysfunction and hormonal changes. Identifying food triggers and optimizing gut function can address multiple symptoms at once.
Heartburn and Acid Reflux
Chronic acid reflux and GERD are more than just discomfort. Long-term reflux can damage the esophagus and affect quality of life. Contributing factors include diet, meal timing, stress, obesity, and certain medications. Addressing root causes rather than relying on long-term acid suppression leads to more sustainable relief.
Allergies and Sinus Issues
Seasonal allergies, food allergies, chronic sinus congestion, and environmental sensitivities can significantly affect daily life. Allergy testing, when appropriate and interpreted alongside your symptom history, can help assess possible triggers, and treatment plans can include avoidance strategies, targeted interventions, and addressing underlying immune system function.
Getting Sick Often and Weak Immunity
Frequent colds, recurring infections, and slow recovery can indicate an overworked or weakened immune system. Common contributing factors include chronic stress and elevated cortisol, poor sleep, vitamin D deficiency, zinc deficiency, and underlying metabolic issues. A physician reviews your infection history and health concerns, with lab testing when appropriate to assess possible contributors.
Skin and Hair Health
- Skin changes and rashes
- Adult acne
- Hair thinning and hair loss
Hair Thinning and Hair Loss
Hair thinning and hair loss in both men and women can signal thyroid dysfunction, iron deficiency, hormonal imbalances, elevated stress hormones, or nutritional deficiencies in biotin, zinc, or vitamin D. In women, hair loss during perimenopause and menopause is particularly common as estrogen declines. A physician-led evaluation, with lab testing when appropriate, can help investigate possible contributors and guide treatment.
Skin Changes and Acne
Adult acne, unexplained rashes, dry skin, and skin changes can reflect internal imbalances including hormonal shifts, insulin resistance, thyroid dysfunction, gut health issues, and food sensitivities. In women, hormonal acne often worsens with PCOS or during perimenopause. Addressing the internal cause produces more lasting results than topical treatments alone.
Chronic Disease Management
- Type 2 diabetes
- Prediabetes and insulin resistance
- Hypothyroidism
- Hyperthyroidism
- Hashimoto's thyroiditis
- Asthma
- COPD, including emphysema
- Allergies and sinus issues
- Fatty liver disease (NAFLD)
- Kidney health and early chronic kidney disease screening and monitoring
Type 2 Diabetes, Prediabetes, and Insulin Resistance
Over 37 million Americans have diabetes, and another 96 million have prediabetes, most without knowing it. Insulin resistance often develops silently for years before blood sugar levels rise enough for a standard diagnosis. We screen with fasting insulin, HbA1c, and fasting glucose to catch metabolic dysfunction early. Treatment combines lifestyle modifications, nutrition optimization, and when appropriate, FDA-approved medications including GLP-1 therapies that address both blood sugar and weight.
Thyroid Disorders
Thyroid conditions affect an estimated 20 million Americans, and up to 60% of those with thyroid disease are unaware of it. Hypothyroidism causes fatigue, weight gain, cold intolerance, hair loss, and brain fog. Hyperthyroidism causes anxiety, weight loss, rapid heartbeat, and heat intolerance. Hashimoto's thyroiditis, one of the most common autoimmune conditions, is frequently underdiagnosed. Based on your symptoms, health history, and initial results, your physician may select thyroid tests including TSH, free T3, free T4, and thyroid antibodies to help evaluate thyroid function and possible autoimmune disease.
Fatty Liver Disease and NAFLD
Non-alcoholic fatty liver disease affects up to 25% of adults and is the most common chronic liver condition. It is closely linked to insulin resistance, obesity, high triglycerides, and metabolic syndrome. Most people have no symptoms until the disease progresses. Liver function tests, metabolic panels, and imaging can detect it early. Weight loss of even 5 to 10% can significantly improve liver health.
Asthma, COPD, and Emphysema
Ongoing care for asthma and COPD, including emphysema, can include medication review, inhaler guidance, symptom monitoring, and care coordination. Breathing tests, an in-person examination, or pulmonology care may be needed. New or worsening shortness of breath requires prompt evaluation; severe breathing difficulty needs emergency care.
Kidney Health and Early CKD Screening
Chronic kidney disease affects 1 in 7 adults, and 9 out of 10 people with early kidney disease do not know they have it. Diabetes and high blood pressure are the leading causes. Routine screening with eGFR, creatinine, and urine albumin-to-creatinine ratio can help detect kidney dysfunction early, when intervention is most effective. Patients with diabetes or hypertension should be screened annually.
Acute Care and Common Illnesses
- Colds, flu, sinus infections and strep
- COVID-19, long COVID and post-viral concerns
- Bronchitis and respiratory infections
- Urinary tract infections
- Rashes and skin infections
Colds, Flu, Sinus Infections, and Strep Throat
When you are sick with a cold, flu, sinus infection, strep throat, or bronchitis, you need care quickly. Thrive RX offers acute care telehealth visits for single focused concerns at $100. You can see the same physician who manages your ongoing care, ensuring continuity and avoiding repeated medical histories. Prescriptions are sent directly to your pharmacy.
COVID-19, Long COVID, and Post-Viral Fatigue
COVID-19 evaluation, testing guidance, and treatment are available via telehealth. For patients experiencing long COVID symptoms such as persistent fatigue, brain fog, shortness of breath, and exercise intolerance, a physician-led evaluation, with inflammatory markers, metabolic labs, and thyroid function testing when appropriate, can help investigate treatable contributors to ongoing symptoms.
Bronchitis and Respiratory Infections
Acute bronchitis, upper respiratory infections, and lingering coughs are among the most common reasons for urgent care visits. Since most cases are viral, telehealth evaluation focuses on symptom management, ruling out pneumonia warning signs, and determining whether further testing or treatment is needed. Patients with frequent respiratory infections may benefit from evaluation for contributing factors such as allergies, asthma, or immune function.
Urinary Tract Infections
UTIs are one of the most common acute conditions managed in primary care, with symptoms including burning during urination, frequency, urgency, and lower abdominal discomfort. Telehealth evaluation and prescription management allow for fast treatment without an office visit. Recurrent UTIs in women may indicate hormonal factors that benefit from further evaluation.
Rashes and Skin Infections
Many skin rashes, contact dermatitis, hives, and minor skin infections can be evaluated via telehealth using high-quality photos and video examination. Identifying whether a rash is allergic, infectious, autoimmune, or stress-related guides appropriate treatment. Severe, rapidly spreading, or blistering rashes may require in-person evaluation. Recurrent skin issues may warrant investigation into underlying hormonal or metabolic factors.
Pain, Joints, Bones, and Nutrient Deficiencies
- Back pain, neck pain and chronic pain
- Migraines and headaches
- Osteoarthritis
- Joint pain and inflammation
- Anemia and iron deficiency
- Vitamin D, B12 and other nutrient deficiencies
- Osteoporosis and bone density loss
Back Pain, Neck Pain, and Chronic Pain
Chronic back pain is one of the most common reasons adults visit a doctor. While some causes require imaging or physical therapy referral, many are connected to systemic inflammation, vitamin D deficiency, poor sleep, elevated stress hormones, and sedentary lifestyle. A thorough physician-led evaluation can help assess contributing factors and guide a treatment plan that considers both the pain and its possible causes.
Joint Pain, Arthritis, and Inflammation
Joint pain and stiffness can reflect osteoarthritis, injury, inflammation, or other conditions. Dr. Kiswani-Barley reviews your symptoms, function, and history and recommends appropriate treatment, testing, an in-person examination, or specialist evaluation when needed.
Osteoporosis and Bone Health
Osteoporosis affects over 10 million Americans and causes 2 million fractures per year. Women lose up to 20% of bone density in the 5 to 7 years after menopause due to declining estrogen. Men with low testosterone are also at increased risk. Vitamin D, calcium, weight-bearing exercise, and hormone optimization all play critical roles in bone preservation. Early screening with DEXA scans and vitamin D testing allows for intervention before fractures occur.
Anemia and Iron Deficiency
Iron deficiency is the most common nutritional deficiency worldwide and a major cause of fatigue, weakness, dizziness, shortness of breath, and brain fog. Women with heavy periods, vegetarians, and endurance athletes are at higher risk. When appropriate, a complete blood count with iron studies, ferritin, and TIBC can help your physician assess iron status and guide targeted supplementation and dietary strategies.
Vitamin D, B12, and Nutrient Deficiencies
An estimated 42% of American adults are vitamin D deficient, and B12 deficiency affects up to 15% of the general population. Symptoms of nutrient deficiency overlap with many other conditions, including fatigue, brain fog, mood changes, muscle weakness, numbness, and immune dysfunction. Your physician may choose lab tests based on your symptoms and risk factors to help assess specific deficiencies and guide supplementation rather than relying on generic supplements.
Preventive Care, Screenings, and Wellness
- Wellness and preventive care
- Cancer screening and risk assessment
- Immunization guidance
- Medication review and management
- Lab testing when appropriate
Annual Wellness and Preventive Screenings
Preventive care is the foundation of long-term health. Comprehensive annual labs, metabolic screenings, hormone baselines, cardiovascular risk assessment, and age-appropriate cancer screenings catch problems early when they are most treatable. Our approach goes beyond checking boxes, providing a deep-dive into your health with same-physician continuity year after year.
Medication Management and Review
If you take multiple medications, regular review is essential. Drug interactions, unnecessary prescriptions, and side effects that mimic new symptoms are more common than most patients realize. We review your complete medication list, assess whether each one is still necessary, check for interactions, and adjust dosages or find alternatives when appropriate.
Cancer Screening and Risk Assessment
Age-appropriate cancer screenings save lives through early detection. We coordinate and order screenings including colorectal cancer screening, breast cancer screening referrals, cervical cancer screening, prostate cancer screening discussions, lung cancer screening for eligible patients, and skin cancer risk assessment. Family history review helps identify patients who need earlier or more frequent screening.
Comprehensive Lab Panels
Lab testing is tailored to your health concerns, history, and clinical findings. When appropriate, Dr. Kiswani-Barley selects tests from a broad range of options, including metabolic panels, thyroid panels with antibodies, advanced lipid profiles, fasting insulin, inflammatory markers like CRP and ESR, iron studies, vitamin D, B12, hormone levels, and more. Labs are completed at Access Labs or Quest Diagnostics near your Florida location, and results are reviewed in detail during your visit.
Staying Ahead of Health Issues
You do not need to wait until symptoms appear to take action. Baseline lab panels, family history review, lifestyle optimization, and early metabolic markers help identify risks before they become problems. Our virtual primary care model gives you consistent access to a physician who knows your complete health picture, with transparent pricing and no insurance hassles.
Care is individualized. Your physician may recommend labs, imaging, or a specialist consultation as appropriate, and will advise an in-person visit when a concern needs a hands-on exam. New or severe chest pain, trouble breathing, or other emergency symptoms need immediate care. For a medical emergency, call 911.
Medically reviewed by Vandhana Kiswani-Barley, MD. All content is for informational purposes and does not replace professional medical advice.
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Complete your patient registration and consent forms in the patient portal, then add a payment method to self-schedule. Visit our booking page for the full steps to schedule your first appointment.
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$250 initial consultation for every new patient, for any service.
Follow-up visits: $100 acute care, $200 primary care (up to 3 chronic conditions), and $250 complex care (4+ conditions).
No membership required. Labs and medications are billed separately. HSA/FSA eligible. A superbill is available for possible out-of-network reimbursement, depending on your plan.
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Patient perspectives
Time, attention, and care that patients notice
Selected reviews originally posted on Google. Individual experiences vary.
Outstanding medical care and professional staff
"I highly recommend Dr. Kiswani-Barley to anyone looking for a compassionate and professional physician. The level of medical expertise and attentiveness is unmatched. Staff included provide exceptional care. They take the time to answer all questions and never make you feel rushed."
Originally posted on Google
Can't say enough good things
"I can't say enough good things about Dr. Kiswani! I am currently a hormone therapy patient of hers, but she has gone above and beyond to help me with my health. She truly cares about her patients and takes the time to listen and understand your concerns."
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A personal story from our co-founder
Nevin Barley went from 272 to 220 pounds
For our co-founder, losing weight was part of a bigger change. Nevin shares how physician-directed care, nutrition changes, and resistance training shaped his journey toward better health.
Read Nevin's storyIndividual results vary.
Make sense of what you are feeling
A free educational quiz to reflect on symptoms, habits, and goals, and bring topics to discuss with Dr. Kiswani-Barley.
Take the Free Health QuizFor education only. This quiz cannot diagnose a condition or determine the cause of symptoms. It does not replace Dr. Kiswani-Barley’s individual medical assessment.