Understanding Bio-Identical Hormone Replacement
Why does it seem so elusive to get straight answers about bio-identical hormones? Bio-identical hormones consist of a combination of some or all of the following: Estrone, estradiol, estriol, progesterone, testosterone, dehydroepiandrosterone, hydrocortisone, levothyroxine and liothyronine. A successful bio-identical hormone replacement regimen consists of a balance incorporating family and personal history, side effects, dosage form preference and clinical response.
Side effects and disease states should be taken into consideration. Side effects of too much estrogen can include irritability, bloating and weight gain. Breast cancer is a potential concern in individuals with a predisposition. This would include a family history, low antioxidant load and a compromised immune system, especially stress. When used appropriately, they can help with hot flashes, night sweats, osteoporosis, mental clarity, vaginal dryness and vaginal atrophy. The side effect of progesterone is drowsiness when taken orally, though any sudden drop in levels can cause spotting or a period. When used appropriately, it can help with mood swings, osteoporosis, breast cancer and uterine cancer. Side effects of too much testosterone and dehydroepiandrosterone can include oily skin, acne and hair growth. When used appropriately, they can help with sex drive, energy, lean body mass and osteoporosis. Side effects of too much hydrocortisone (>50mg) can include weight gain and osteoporosis. When used appropriately, it can help with energy. Side effects of too much levothyroxine and liothyronine can include a rapid heart rate and anxiety. When used appropriately, they can help with energy, weight gain and speeding up metabolism.
The route of administration varies based upon preference and response. Choices include: Transdermal creams, sublingual troches and sustained-release oral capsules. Typical dosage ranges are:
Bi-estrogen (Estriol/Estradiol) 0.1mg – 2.5mg
Progesterone 12.5mg – 200mg
Testosterone 0.25mg – 20mg
Dehydroepiandrosterone 5mg – 20mg
Hydrocortisone 5mg – 20mg
Levothyroxine/Liothyronine (T4/T3) 25mcg/3mcg – 200mcg/100mcg
Bio-identical hormones are tailored to your specific needs and must be compounded in a compounding pharmacy. Not all compounding pharmacies are the same. Significant differences exist in experience, training, facilities and safety. It is highly advisable to get compounded prescriptions from a PCAB-accredited, ACHC-Accredited compounding pharmacy. Ask your doctor about bio-identical hormone replacement. If your doctor will not assist you, you can call Compounding Corner Pharmacy, Inc. ® at (281) 494-7777 for referrals. Participating in bio-identical hormone replacement is a choice each individual must make based on a risk versus benefit comparison. In a world riddled with stress and disease, this is an opportunity to make a positive improvement in energy, sleep, sex drive, mental acuity, mood enhancement, bone density, body composition and subsequent quality of life.
Shannon M. Maguadog, Pharm.D.