Hello, Welcome to Healthcare Magic. I have read your question fully and understand your concerns. Premarin does come in various strengths – 0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg and1.25 mg. The strengths available would depend on the country where you reside. You could check in your local pharmacy about the various strengths of Premarin. In a small percentage of women, a higher dose of Premarin can cause side effects like tiredness and problems with concentration. May be you could decrease your Premarin dose and see if your symptoms settle down. You have to find the optimal dose that suits you – which will keep your menopausal symptoms away, and yet not make you feel tired etc. Despite reducing the Premarin dose, if you still have the tiredness and other symptoms, you could get a Full blood count/complete blood picture , TSH, serum creatinine and blood glucose levels checked to rule out other causes of tiredness. Rather than cutting your current Premarin tablet, it is better to take lesser strength tablet (at least you know you will take the same strength everyday, by cutting you may take either more or less of the hormone, which will again cause fluctuations).HRT would not deplete your body of vitamins/minerals etc. I hope this answer has helped you. Thank you Regards Dr Sunita Sayammagaru