Tonight, while getting the mail and going to the farmers' market downtown, I saw a sign in a local pharmacy's window advertising a seminar tonight on Bio-Identical Hormone Replacement Therapy.
I had heard a short talk recently, and have heard about Suzanne Somers' book. I was interested, and I went. I'm glad I did. My wife and I are going to be making appointments tomorrow to follow up on the presentation that I saw.
here are some things I stole off the web at
http://losaltospharmacy.com.
I suggest you not read this, but skim to any areas of interest you might have.
Not yourself?
Depressed?
Low sex drive?
Weight gain?
Alleviate these symptoms with
Bio-identical Hormone Replacement.
Balance your hormones ...
Naturally!
Dr. Kent Holtorf is a leading authority in the field of hormone replacement therapy, and is also a board examiner for the American Board of Anti-Aging Medicine (ABAAM). Dr. Holtorf talked to Sunday Magazine about Bio-Identical Hormone Replacement Therapy.
http://losaltospharmacy.com/pharmacy_content/s_bio/bio_main.htm
Click here to read Dr. Holtorf’s article about the benefits of customized Hormone Replacement Therapy.
Structural differences exist between human, and synthetic and animal hormones. In order for a replacement hormone to fully replicate the function of hormones which were originally naturally produced and present in the human body, the chemical structure must exactly match the original. There are significant differences between hormones that are natural to humans and synthetic or horse preparations. Side chains can be added to a naturally-occurring hormone to create a synthetic drug that can be patented by a manufacturer. A patented drug can be profitable to mass produce, and therefore a drug company can afford to fund research as to the medication's use and effectiveness. However, naturally-occurring substances can not be patented, so scientific studies are less numerous on natural hormones, because medical research is usually funded by drug companies.
Natural hormones include estrone (E1), estradiol (E2), progesterone, testosterone, dehydroepiandrosterone (DHEA), and pregnenolone. Our compounding specialists work together with patients and prescribers to provide customized hormone replacement therapy that provides the needed hormones in the most appropriate strength and dosage form to meet each woman's specific needs. Hormone replacement therapy should be initiated carefully after a woman's medical and family history has been reviewed. Every woman is unique and will respond to therapy in her own way. Close monitoring and medication adjustments are essential.
Armour Thyroid® Shortage is Affecting your Patients.
Armour Thyroid® has been plagued by unexplained product shortages and back orders. Nature-Throid™ and Westhroid™ are also unavailable.
Many patients have tried synthetic thyroid hormones, such as levothyroxine and liothyronine, and have found that Natural Thyroid is the only form that works adequately for them, reporting that they simply do not feel as well when they take levothyroxine alone or with liothyronine.
Currently, certain forms and strengths of Natural Thyroid are available only through compounding pharmacies. In addition, we can blend T4 and T3 pure powders in a specific ratio by prescription.
Commercially available tablets contain fillers and excipients that may not be tolerated by all patients. When we compound customized dosages, we have the ability to omit any problem-causing inactive ingredients and substitute non-reactive fillers. We welcome your questions and the opportunity to help your patients.
Adrenal Fatigue
The adrenal glands secrete hormones such as cortisol, estrogen, and testosterone that are essential to health and vitality and significantly affect total body function. After mid-life, the adrenal glands gradually become the major endogenous source of sex hormones in both men and women. Intense or prolonged physical or emotional stress commonly associated with modern lifestyles or chronic illness can lead to Adrenal Fatigue, which is an important contributing factor in health conditions ranging from allergies to obesity.
Anti-inflammatory and anti-oxidant adrenal hormones like cortisol help to minimize allergic and negative reactions, such as cancer and autoimmune disorders. These hormones closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy, and cardiovascular and gastrointestinal function. Proper adrenal support is essential to complete the hormonal pathway to optimal health, and includes proper nutrition, getting plenty of sleep, regular moderate exercise, stress management, slowing down to regain a proper perspective on life, and replacement of deficient hormones.
Thyroid Hormone Therapy
Symptoms of hypothyroidism (low levels of thyroid hormone) include fatigue, cold and heat intolerance, hypotension, fluid retention, dry skin and/or hair, constipation, headaches, low sexual desire, infertility, irregular menstrual periods, aching muscles and joints, depression, anxiety, slowed metabolism and decreased heart rate, memory impairment, enlarged tongue, deep voice, swollen neck, PMS, weight gain, hypoglycemia, and high cholesterol and triglycerides. Yet, more than half of all people with thyroid disease are unaware of their condition.
Although both T4 (thyroxine, an inactive form that is converted to T3 in other areas of the body) and T3 (triiodothyronine, the active form) are secreted by the normal thyroid gland, many hypothyroid patients are treated only with levothyroxine (synthetic T4). Some hypothyroid patients remain symptomatic, and T3 may also be required for optimal thyroid replacement therapy. However, the only commercially available form of T3 is synthetic liothyronine sodium in an immediate release formulation which is rapidly absorbed, and may result in higher than normal T3 concentrations throughout the body causing serious side effects, including heart palpitations. Research indicates there is a need for sustained-release T3 preparations in order to avoid adverse effects.
A randomized, double-blind, crossover study found inclusion of T3 in thyroid hormone replacement improved cognitive performance, mood, physical status, and neuropsychological function in hypothyroid patients. Two-thirds of patients preferred T4 plus T3, and tended to be less depressed than after treatment with T4 alone. Patients and their physicians may wish to consider the use of sustained-release T3 in the treatment of hypothyroidism, particularly when the response to levothyroxine (T4) has not been complete.
The Division of Endocrinology and Metabolism, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, reported the successful management of thyrotoxicosis in a seriously ill 47-year-old man with a perforated gastric ulcer in whom oral intake was contraindicated. Specially prepared suppositories containing 400 mg of propylthiouracil (PTU) were administered rectally every 6 hours. PTU was substantially absorbed from the rectal suppositories, with serum levels of PTU maintained within the high therapeutic range for 5 days until the patient was able to tolerate orally administered therapy. The patient improved clinically during this treatment. They concluded that this case strongly supports the rectal administration of PTU in suppository form as an appropriate alternative route in any patient with thyrotoxicosis, including the critically ill patient, when oral administration is not possible.
Chronic Fatigue Syndrome (CFS, Chronic Fatigue and Immuno-Deficiency Syndrome, CFIDS) and Fibromyalgia (FM, formerly called fibrositis) may manifest as hypothalamic, pituitary, and immune dysfunction.
A study in the Annals of Allergy, Asthma and Immunology [2000 Jun;84(6):639-40] demonstrated that supplementation with NADH for one month resulted in significant improvement, and other studies have shown some minimal improvement with magnesium.
Ann Allergy Asthma Immunol. 1999 Feb;82(2):185-91
Therapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome.
The combination of pituitary dysfunction, high reverse T3, and thyroid resistance, leads to inadequate thyroid effect in most, if not all, CFIDS/FM patients. T4 (levothyroxine) preparations are often ineffective for CFIDS/FM patients. A T4/T3 combination preparation or straight T3 (triiodothyronine) may be preferable. T3 works the best for many of these patients, but Cytomel, a very short acting T3 available at retail pharmacies, is also a poor choice because the varying blood levels cause problems such as heart palpitations. Compounded, sustained-release T3 may be the best treatment. However, standard blood tests may lead one to dose incorrectly and not obtain significant benefits. Ultimately, it is the expertise and dosing of the T3 or T4/T3 combinations and the makeup of the medications that determines the success of treatment.
Natural Therapies for CFIDS/FM: Proper nutritional supplements, proteins, and hormones can protect and enhance the immune system. Antioxidants may also be beneficial because free radicals play a role in causing damage to the immune system.
Vitamin B-12 levels are often low in patients with CFIDS/FM. A malfunctioning thyroid or adrenal gland can decrease the ability of the body to absorb and utilize vitamin B-12. Vitamin B-12 is necessary for a healthy nervous system; it has been known for many years that depression and fatigue can be caused by low B-12 levels.
D-ribose significantly reduced clinical symptoms in patients suffering from fibromyalgia and chronic fatigue syndrome, with an average increase in energy on the VAS of 45% and an average improvement in overall well-being of 30%.
Hormone Replacement Therapy for Men
Approximately 30% of men aged 60-70 years and 70% of men aged 70-80 have low levels of testosterone in forms that the body can use (bioavailable; unbound; free).
Hypogonadism is a clinical condition in which low levels of serum testosterone (bioavailable testosterone less than 60 ng/dl) are found in association with specific signs and symptoms, including diminished sex drive and sense of vitality, erectile dysfunction, depression, anemia, reduced muscle mass and bone density, increased fat mass, frailty, and osteoporosis. A man may be considered hypogonadal at any age if total testosterone (bound and free) is less than 200 ng/dl. It is recommended that elderly men with symptoms of hypogonadism and a total testosterone level less than 300 ng/dl be started on hormone replacement.1
When hypogonadism occurs in an older man, the condition is often called andropause, or Androgen Deficiency of the Aging Male (ADAM), because testosterone is in a class of hormones known as androgens.
Bioavailable testosterone levels are significantly lower for depressed men, perhaps because an associated decrease in sexual function results in depression, irritability, and mood swings. Testosterone therapy might improve depressed mood in older men who have low levels of bioavailable testosterone.2,3
Osteoporosis-related fractures occur in 12% of all men over 50 years of age. Twenty-five percent of all hip fractures occur in men, and 33% of these patients die within one year of fracture. Gradual loss of testosterone is one of the major causes of osteoporosis in elderly men. Studies have reported beneficial effects of testosterone therapy on bone in older men, showing an increase in bone mineral density (BMD) and slowing of bone degeneration. Testosterone therapy in older men with low serum testosterone levels also increases lean body mass and decreases fat mass, improving physical performance and strength.4
Testosterone replacement therapy (TRT) has relieved symptoms and improved the quality of life for many men. TRT is well tolerated, and long term TRT appears to be a safe and effective means of treating hypogonadal elderly males, provided that laboratory values and clinical response are frequently monitored.
The only absolute contraindication to androgen replacement therapy is the presence of prostate or breast cancer. Guidelines recommend that TRT should not be initiated in older men with PSA serum levels above the normal range. Testosterone should be used with caution in men with severe heart, kidney or liver disease, increased red blood cell counts, and sleep apnea.5 Side effects of testosterone therapy can include mood swings, leg swelling, skin reactions, acne, alopecia, breast enlargement, and infertility. Liver toxicity has not been reported following testosterone administration using transdermal gels in physiologic doses.6 (Toxicity has occurred with methyltestosterone.)
Testosterone is well-absorbed from transdermal creams, gels, and lotions. Compounded preparations can be very advantageous because:
• the exact amount of hormone needed by each man can be applied as a single dose
• there is no need to shave the scrotum to apply one or more patches
• there is no skin irritation from patch adhesive.
A
healthy lifestyle is associated with higher hormone levels, and higher hormone levels seem to induce a more active, healthier lifestyle. For optimal results, it is vital that hormone replacement therapy be combined with adequate exercise, proper nutrition, and appropriate use of supplements.
References:
1 Am J Med. 2001 May;110(7):563-72.
2 J Clin Psychiatry. 2009 Jul;70(7):1009-16.
3 J Clin Psychopharmacol. 2009 Jun;29(3):216-21.
4 J Clin Endocrinol Metab. 2005 Mar;90(3):1502-10.
5 Ther Clin Risk Manag. 2009 Jun;5(3):427-48.
6 Expert Opin Drug Saf. 2004 Nov;3(6):599-606.
