Nature Knows Best: Individualized Human Hormone Replacement Therapy |
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Ben Briggs
Ben Briggs RPh, CNC, IACP
Ben is a compounding pharmacist and nutritionist with a background in functional endocrinology. He is the founder, in 1979, of Lionville Natural Pharmacy and Health Food Store and Holistic Center. He has published articles on holistic and compounding topics and has presented seminars to physicians, hospital support groups, the general public and is a guest speaker at wellness seminars. Ben is the host of “Health Focus Brandywine” - a weekly radio program on alternative medicine. The program airs online via the Internet at www.brandywineradio.com on Saturdays at 10:00 AM. Private hormonal and nutritional consultations are available by appointment. www.lionrx.com. 610-363-7474.
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My experience with human hormone replacement therapy, also known as Bio-Identical hormone replacement therapy, spans almost 30 years. I have worked with hundreds of physicians, compounding thousands of customized prescription for patients. The most frequently requested prescription compounds are for human hormone replacement therapy.
These prescription compounds are chemically identical to human hormones produced by our body. The raw material used in these compounds are United States Pharmacopeia (USP) approved agents, source certified and purchased only from manufacturers that provide approved certificates of analysis. The FDA has approved the use of these USP approved raw materials for compounding prescriptions. State Boards of Pharmacy regulate Pharmacy compounding.
Unlike conventional prescription preparations, i.e., basic filling of prescription orders, the compounded hormone prescription order is custom formulated after I review blood, saliva, urine analysis and provide a private nutritional consultation. I discuss the therapy with the patient and their physician and we prepare prescription(s) that therapeutically match the patients’ hormonal deficiency. The goal is to bring the individuals hormonal levels into balance with the least amount of medication to relieve symptoms.
My introduction to compounded hormones began with a request by a physician specializing in fertility, to formulate progesterone therapy. At that time the delivery route was by vaginal suppository. Today, administration modalities include injectables, pellet implantation, slow and rapid release oral formula, transdermal (topical) creams and gels, sublingual lozenges and nasal sprays.
Human sex hormones include: estrone, estradiol and estriol (the human estrogens), progesterone, pregnenolone, testosterone and DHEA. Due to the limited scope of this article I will discuss therapeutic uses of estradiol, estriol (2 of the estrogens) and progesterone. Testosterone and DHEA will be discussed in future articles on Andropause (male menopause) and anti-aging therapies. More information and references can be found on our website www.lionrx.com.
There are considerable differences between human hormones, synthetic hormone versions (birth control) and equine hormones, (Premarin & Prempro). First of all, humans do not produce synthetic hormones nor do they produce equine hormones. Secondly, the metabolites (chemical by-products) of the synthetic and equine hormones are more difficult to eliminate and neutralize by the detoxification pathways. Thirdly, though the synthetic and equine hormones are capable of relieving symptoms, they are not as efficient at the cellular level i.e. receptorsite, as human hormones. Lastly, humans produce sex hormones bio-chemically from cholesterol and they are produced in varied amounts during the day and during menstrual cycle. This varied daily and monthly dosage is an important consideration when developing a hormone replacement therapy. Each individual has unique and variable dosage needs because of their metabolism and their age, i.e. one size dose not fit all!
Estriol is a weak estrogen. It is an end-point of estrogen metabolism and is usually associated with receptors below the waist. Also known as the forgotten estrogen, it is used predominantly in European therapy regimens because of its safety profile. When used intravaginally, estriol is an affective treatment for vaginal atrophy/dryness.
Estradiol is the most potent estrogen and has been formulated by the pharmaceutical industry as patches, vaginal inserts, oral tablets and recently into gel forms. Estradiol targets are considered to be above the waist. Breast tissue, skin, eye moisture and brain/mental acuity are targets for estradiol. We do not use estradiol alone.
Bi-Est is a term associated with a combination estrogen therapy compounded for menopausal symptoms that contains estriol and estradiol. This combination allows for a better balance of estrogen therapy because females naturally produce a ratio of about 60-80% estriol and 10-20% estradiol and estrone. We do not use estrone in our practice due to research that suggests negative risks for cancers. With the exception of estriol vaginal cream, we do not recommend estrogen therapy without progesterone therapy.
Progesterone is a modulator for all hormones and is found in male and female patients. A dangerous misconception about hormone replacement therapy occurs when a physician prescribes estrogen therapy (human or otherwise) alone, without progesterone. Patients with hysterectomies have been told they do not need progesterone because the uterus has been removed therefore progesterone is not necessary. Synthetic prescription progestins, like Provera (medroxyprogesterone acetate, the “Pro” part of Prem-Pro) and Aygestin (norethrindrone), ARE NOT PROGESTERONE!
Progesterone therapy is safe to use alone and can often relieve symptoms of estrogen dominance: PCOS (polycystic ovary syndrome), PMS, and peri-menopause. The last thing an estrogen dominant female needs is more estrogen but this often not the case. Progesterone balances fluid and water retention, aids carbohydrate metabolism, relieves mood swings, hot flashes and night sweats. Dr. John Lee M.D., Ob/Gyn, was a pioneer in progesterone therapy. His discovered that progesterone stimulates osteoblasts formation (new bone cells) where as estrogen slows the breakdown of osteoclasts, (mature bone cells. In other words, progesterone stimulates the production of new healthy bone cells). Dr. Helene Leonetti M.D., of Bethlehem, PA, is in the process of completing an FDA approved clinical trial using transdermal progesterone for osteoporosis.
The misconceptions about compounded preparations of human hormones are unfounded, because compounding pharmacists are responsible for information published in scientific literature concerning prescribed medication. Numerous certified continuing educational programs are provided through International Academy of Compounding Pharmacists, The Professional Compounding Centers Of America and The Pharmacy Compounding Accreditation Board. Compounded human hormone replacement therapy can be a better choice for the individual. Logically, natural customized therapy fills the void without excess or shortfalls. More information can be found at www.iacprx.com, www.ijpc.com and www.lionrx.com.
Next issue: Type II, Subclinical Hypothyroidism: It might be your thyroid after all. Ben Briggs RPh, CNC, IACP Ben is a compounding pharmacist and nutritionist with a background in functional endocrinology. He is the founder, in 1979, of Lionville Natural Pharmacy and Health Food Store and Holistic Center. He has published articles on holistic and compounding topics and has presented seminars to physicians, hospital support groups, the general public and is a guest speaker at wellness seminars. Ben is the Host of “Health Focus”, a weekly radio program on alternative medicine WCOJ 1420AM, Saturdays 9AM. Private hormonal and nutritional consultations are available by appointment. www.lionrx.com 610-363-7474.
These prescription compounds are chemically identical to human hormones produced by our body. The raw material used in these compounds are United States Pharmacopeia (USP) approved agents, source certified and purchased only from manufacturers that provide approved certificates of analysis. The FDA has approved the use of these USP approved raw materials for compounding prescriptions. State Boards of Pharmacy regulate Pharmacy compounding.
Unlike conventional prescription preparations, i.e., basic filling of prescription orders, the compounded hormone prescription order is custom formulated after I review blood, saliva, urine analysis and provide a private nutritional consultation. I discuss the therapy with the patient and their physician and we prepare prescription(s) that therapeutically match the patients’ hormonal deficiency. The goal is to bring the individuals hormonal levels into balance with the least amount of medication to relieve symptoms.
My introduction to compounded hormones began with a request by a physician specializing in fertility, to formulate progesterone therapy. At that time the delivery route was by vaginal suppository. Today, administration modalities include injectables, pellet implantation, slow and rapid release oral formula, transdermal (topical) creams and gels, sublingual lozenges and nasal sprays.
Human sex hormones include: estrone, estradiol and estriol (the human estrogens), progesterone, pregnenolone, testosterone and DHEA. Due to the limited scope of this article I will discuss therapeutic uses of estradiol, estriol (2 of the estrogens) and progesterone. Testosterone and DHEA will be discussed in future articles on Andropause (male menopause) and anti-aging therapies. More information and references can be found on our website www.lionrx.com.
There are considerable differences between human hormones, synthetic hormone versions (birth control) and equine hormones, (Premarin & Prempro). First of all, humans do not produce synthetic hormones nor do they produce equine hormones. Secondly, the metabolites (chemical by-products) of the synthetic and equine hormones are more difficult to eliminate and neutralize by the detoxification pathways. Thirdly, though the synthetic and equine hormones are capable of relieving symptoms, they are not as efficient at the cellular level i.e. receptorsite, as human hormones. Lastly, humans produce sex hormones bio-chemically from cholesterol and they are produced in varied amounts during the day and during menstrual cycle. This varied daily and monthly dosage is an important consideration when developing a hormone replacement therapy. Each individual has unique and variable dosage needs because of their metabolism and their age, i.e. one size dose not fit all!
Estriol is a weak estrogen. It is an end-point of estrogen metabolism and is usually associated with receptors below the waist. Also known as the forgotten estrogen, it is used predominantly in European therapy regimens because of its safety profile. When used intravaginally, estriol is an affective treatment for vaginal atrophy/dryness.
Estradiol is the most potent estrogen and has been formulated by the pharmaceutical industry as patches, vaginal inserts, oral tablets and recently into gel forms. Estradiol targets are considered to be above the waist. Breast tissue, skin, eye moisture and brain/mental acuity are targets for estradiol. We do not use estradiol alone.
Bi-Est is a term associated with a combination estrogen therapy compounded for menopausal symptoms that contains estriol and estradiol. This combination allows for a better balance of estrogen therapy because females naturally produce a ratio of about 60-80% estriol and 10-20% estradiol and estrone. We do not use estrone in our practice due to research that suggests negative risks for cancers. With the exception of estriol vaginal cream, we do not recommend estrogen therapy without progesterone therapy.
Progesterone is a modulator for all hormones and is found in male and female patients. A dangerous misconception about hormone replacement therapy occurs when a physician prescribes estrogen therapy (human or otherwise) alone, without progesterone. Patients with hysterectomies have been told they do not need progesterone because the uterus has been removed therefore progesterone is not necessary. Synthetic prescription progestins, like Provera (medroxyprogesterone acetate, the “Pro” part of Prem-Pro) and Aygestin (norethrindrone), ARE NOT PROGESTERONE!
Progesterone therapy is safe to use alone and can often relieve symptoms of estrogen dominance: PCOS (polycystic ovary syndrome), PMS, and peri-menopause. The last thing an estrogen dominant female needs is more estrogen but this often not the case. Progesterone balances fluid and water retention, aids carbohydrate metabolism, relieves mood swings, hot flashes and night sweats. Dr. John Lee M.D., Ob/Gyn, was a pioneer in progesterone therapy. His discovered that progesterone stimulates osteoblasts formation (new bone cells) where as estrogen slows the breakdown of osteoclasts, (mature bone cells. In other words, progesterone stimulates the production of new healthy bone cells). Dr. Helene Leonetti M.D., of Bethlehem, PA, is in the process of completing an FDA approved clinical trial using transdermal progesterone for osteoporosis.
The misconceptions about compounded preparations of human hormones are unfounded, because compounding pharmacists are responsible for information published in scientific literature concerning prescribed medication. Numerous certified continuing educational programs are provided through International Academy of Compounding Pharmacists, The Professional Compounding Centers Of America and The Pharmacy Compounding Accreditation Board. Compounded human hormone replacement therapy can be a better choice for the individual. Logically, natural customized therapy fills the void without excess or shortfalls. More information can be found at www.iacprx.com, www.ijpc.com and www.lionrx.com.
Next issue: Type II, Subclinical Hypothyroidism: It might be your thyroid after all. Ben Briggs RPh, CNC, IACP Ben is a compounding pharmacist and nutritionist with a background in functional endocrinology. He is the founder, in 1979, of Lionville Natural Pharmacy and Health Food Store and Holistic Center. He has published articles on holistic and compounding topics and has presented seminars to physicians, hospital support groups, the general public and is a guest speaker at wellness seminars. Ben is the Host of “Health Focus”, a weekly radio program on alternative medicine WCOJ 1420AM, Saturdays 9AM. Private hormonal and nutritional consultations are available by appointment. www.lionrx.com 610-363-7474.