By: Ben Briggs RPh, CNC, IACP
www.lionrx.com

A recent Oprah Winfrey show with guests Suzanne Somers, Christiane Northrup, M.D. and others has sparked new interest in Bio-Identical Hormone Replacement Therapy. On February 23, 2009 a new clinical analysis published in the Postgraduate Medical Journal, a leading peer-reviewed publication for practicing clinicians, revealed Bio-Identical Hormones are associated with reduced health risks and are more efficacious than their synthetic counterparts. (www.HoltorfMed.com).

The analysis was conducted by a leading expert in hormone replacement, Dr. Kent Holtorf, M.D., medical director of the Holtorf Medical group in Torrance, California. The paper reviewed and evaluated the results from more than 200 physiological and clinical studies.

The analysis demonstrated that Bio-Identical Hormone replacement therapy is both more effective and has greater health benefits for women suffering with symptoms of menopause than hormone replacement therapy with synthetic hormones.

My experience with Bio-Identical hormone replacement therapy spans almost 30 years. I have worked with hundreds of physicians, compounding thousands of customized prescription for patients. Many patients have chosen Bio-Identical hormones because of negative experiences with conventional hormone therapy.

Bio-Identical Hormone prescription compounds are bio-chemically identical to human hormones that are produced by our hormone producing glands. 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 all pharmacies including compounding pharmacies. Dr. Lauren Streicher, a guest on the Oprah show and opponent of Bio-Identical Hormones, suggested that compounding pharmacies were unapproved by the FDA. In fact, there are no FDA-approved pharmacies.

Unlike conventional hormone replacement therapy, the compounded hormone prescription order is custom formulated. After an analysis of blood, saliva, and urine and 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 individual’s hormonal levels into balance with the least amount of medication to relieve symptoms.

Today, administration modalities include injections, 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.

More information and references can be found on our website at www.lionrx.com.

There are considerable differences between human hormones, synthetic hormone versions (birth control) and equine hormones, (Premarin & Prempro). First, synthetic hormones and equine (horse) hormones are not found in the human body. Second, the metabolites (chemical by-products) of the synthetic and equine hormones are more difficult to eliminate and neutralize by the detoxification pathways. Third, though the synthetic and equine hormones are capable of relieving symptoms, they have been shown to increase the risks for cancer, heart disease, thyroid dysfunction and blood clotting disorders. Lastly, humans produce sex hormones bio-chemically from cholesterol 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 does not fit all!

There are three human estrogens; Estrone, Estradiol and Estriol. Estriol is a weak estrogen. It is an end-point of estrogen metabolism and is usually associated with receptors below the waist. Estriol is a weak, safe estrogen used predominantly in European prescription therapy regimens because of its safety profile. When used intravaginally, estriol is an effective 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 receptor targets are considered to be above the waist, i.e., breast tissue, skin, eye moisture and brain/mental acuity. We do not use estradiol without progesterone.

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. A dangerous misconception about hormone replacement therapy occurs when a practitioner prescribes estrogen therapy alone without progesterone.

Progesterone is a modulator for all hormones and is found in male and female patients. 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), Aygestin (norethrindrone) and all other progestins ARE NOT PROGESTERONE. Natural progesterone has properties that are very distinct from synthetic progestin.

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. This concept is often misunderstood and more estrogen is prescribed in the form of low dose birth control formulas. Progesterone balances fluid and water retention, aids carbohydrate metabolism, relieves mood swings, hot flashed and night sweats.

Dr. John Lee, M.D., OB/GYN, was a pioneer in progesterone therapy. He 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, Pennsylvania 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. Compounding pharmacists are responsible for information published in scientific literature concerning prescribed medication. Numerous certified continuing educational programs are provided through the International Academy of Compounding Pharmacists, The Professional Compounding Centers of America and The Pharmacy Compounding Accreditation Board.

Logically, Bio-Identical customized hormone therapy is the best choice for patients in need of hormone replacement as long as the patient, compounding pharmacist and physician work together to monitor and access the therapy throughout the regimen.

More information can be found at www.iacprx.org, www.ijpc.com, www.bioidenticalhormoneinitiative.org and www.lionrx.com.

Fall Seminar:
Bio-Identical Hormone Replacement. Presented by Ben Briggs RPh, CNC IACP.  Saturday October 16th @ Lionvillle Natural Pharmacy.
Call for information and signup, space is limited.

P.S. For more upcoming events at Lionville Natural Pharmacy and Health Food Store check our website at www.lionrx.com.

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.