Transcript Natural Hormone Replacement Therapy

Bioidentical
Hormone Restoration
Best Medical Practice
[email protected]
Hormones
Neuro-endocrine-immune system
Travel via blood to cells’ receptors
Control cells’ proliferation, protein
manufacture, metabolic rate, etc.
Most powerful molecules in our
bodies
Optimal levels essential for health and
quality of life
Hormones and Aging
Why Doctors Don’t Get It
Bioidentical Hormone Restoration
is Common Sense
If a hormone is missing, replace it!
If present but insufficient, optimize it!
Type 1 Diabetes: bioidentical insulin
Hypothyroidism: bioidentical T4
Growth hormone def.: bioidentical GH
Adrenal insufficiency: bioidentical cortisol
But what about hormones lost to aging?
Pregnenolone—Mother Steroid
J Clin Endocrinol Metab. 1997 Aug;82(8):2396-402.
DHEA

DHEA-S
J Clin Endocrinol Metab. 1997 Aug;82(8):2396-402.
Somatopause
Growth Hormone (GH)
Normal Adults
Pituitary Disease
Sufficiency
fatigue
Log scale
J Clin Endocrinol Metab. 1999 Jun;84(6):2013-9.
Testosterone Progesterone Estradiol
pg/ml
8000
7000
6000
5000
4000
3000
2000
1000
0
Andropause
Menopause
T
P
E
Young ♂ Old ♂ Young ♀ Old
♀
DHEA–10,000 pg/ml, DHEA-S 5,000,000 pg/ml !
Hormonal Changes With Aging
Hormones that build tissues and improve
immunity decline with age by 50-80%
(DHEA, Testosterone, GH)
Progesterone starts to decline at age 30.
Estradiol disappears at 50—menopause
Thyroid hormone production and sensitivity
decline
Insulin output declinesDiabetes
By age 50—20 years of hormonal
deficiency
Conventional View of Hormones
and Aging
The loss of hormones is adaptive–helps
us to live longer
Persistence of youthful levels of hormones
would cause more heart attacks and
cancers as we age
Losing our hormones is good for us(?!)
Fits the Pharmaceutical Agenda: Take
drugs for every symptom and disorder
caused by hormone loss!
Against the Conventional View
Aging is a self-destruct program that kicks in
at age 25 in humans
Aging is natural degeneration!
Weight gain, high blood pressure, high
cholesterol, cancers, heart attacks, autoimmune
diseases, etc. occur years after hormone
deficiencies begin and occur more often in
people with lower hormone levels!
Studies of balanced hormone restoration show
the expected benefits and no proof of harm!!
Example: Growth Hormone
Declines 14% per decade after age 25
IGF-1 of many adults equal to hypopituitary
patients (only 80-110 vs. 350 @25yrs.old)
Deficiency heart disease, frailty, depression,
body fat, bone loss
GH restoration reduces abdominal fat, lowers
blood sugar and blood pressure
Improves cognition, mood, sleep, energy
Increases muscle, decreases fat & cholesterol
Improves bone density, skin thickness
Downside: high cost, nightly injections
The Endocrinology of Aging
Endocrine glands and their feedback control
systems deteriorate with age
Our bodies cease to regulate our hormones for
optimal health
Hormone losses speed our general
deterioration: a vicious cycle.
The symptoms of hormone loss are warning
signs of physical deterioration
Win-Win: Hormone restoration makes you
feel better and improves your health!
Since the Loss of Hormones is
Harmful,THEN…
Restoring youthful hormone levels is:
essential preventative medicine
essential to the treatment of disease
essential to Quality of Life!
We have the need and the right to
restore hormones lost to aging!
Hormones and Aging
Any Questions?
Human Steroid Hormones
Estradiol
Testosterone
DHEA
Progesterone
Cortisol
Where Do They Come From?
All steroid hormones (including substitutes)
are chemically synthesized from diosgenin
(wild Mexican yams, soy, and other plants).
Not Just “Sex Hormones”
Estrogen, progesterone, testosterone and
DHEA essential to cellular growth and
function in all tissues in both sexes!
Maintain brain function—modulators of
mood, cognition, pain, etc.
Maintain the immune system—progesterone
and testosterone are immunosuppressants
Maintain connective tissue: skin, hair, bone,
muscle, and blood vessels
Female Endocrinology
Nature makes special demands on the
female body for reproduction
Breast, uterine and ovarian tissues undergo
a monthly cycle of proliferation,
differentiation, and breakdown
Defects in this cycle can lead to cancers in
female organs and to many medical
disorders.
Estrogen—Progesterone
Complementarity
Estrogen promotes breast/uterine tissue
proliferation and growth
Progesterone stops proliferation and
promotes maturation and differentiation
Differentiated cells can’t become cancer
cells
High average progesterone/estrogen ratio
suppresses proliferation and prevents
cancers of female organs
Progesterone Deficiency
Estrogen Dominance
Allergies
Autoimmune diseases
Anxiety, irritability
Insomnia
Decreased sex drive
Depression
Bloating and edema
Fibrocystic breasts
Uterine fibroids
Breast cancer
Ovarian cancer
Uterine cancer
Thyroid dysfunction
Gallbladder disease
Heavy periods
Migraines
Seizures
Progesterone and Iodine/Kelp reduce estrogen
dominance
Historical Perspective
Throughout most of human history, women
were usually:
Pregnant—high progesterone
Breastfeeding—low estrogen
(both protect against breast cancer)
Women cycled for 4 years avg.; today many
cycle for 35 years
Cycling=risk of estrogen dominance and
other hormonal disorders
Perimenopause
Females born with a fixed no. of oocytes
which are continually lost to age and
ovulation
With aging, fewer oocytes of lower quality
are leftreduced progesterone production
beginning around age 30estrogen
dominance
No ovulation=no progesterone
Estrogen swings from very high to very
low—often for several years.
Normal Progesterone Dominance
Ovulation
Menstrual Cycle
Perimenopause
Luteal Insufficiency=Estrogen Dominance
Inadequate Luteal Phase
shorter periods, early spotting
Ovulation
Menstrual Cycle
Perimenopause
Anovulation=Estrogen Dominance
Menstrual Cycle
Menopause
Estrogen and Progesterone Deficiency
Also Uterine and
Ovarian Cancer
Menopause
Estrogen Deficiency
Progesterone Deficiency
Testosterone Deficiency
After menopause, women depend upon their
adrenal glands for androgens and estrogens,
so:
Menopause
+Adrenal Insufficiency
= BIG TROUBLE
Effects of Combined SexHormone Deficiency
Irritability, insomnia, brain dysfunction
Alzheimer’s dementia
Fatigue, aches and pains.
Osteoporosisfractures, loss of teeth
Genital atrophy, vaginal dryness
Atrophy of skin and connective tissue
Heart disease—higher risk than men after
65, higher mortality after 70!
Estradiol Restoration
Eliminates hot flashes
Restores mood and mental function
Probably protects against Alzheimer’s disease
Maintains genital/vaginal skin and lubrication
Increases thickness, fullness of skin and hair
Prevents heart disease
Prevents colon cancer and macular
degeneration
Improves insulin sensitivity—helps diabetes
Prevents osteoporosis and osteoarthritis
Speroff L, Fritz M Clinical Gynecologic Endocrinology and Fertility, 7th Ed.
Osteoporosis
In menopause 5% bone loss each year for
first 5 years=25%—all due to loss of
estrogen!
20 yrs. post menopause—50% reduction in
trabecular bone, 30% in cortical bone
50% of women >65 yrs. old have spinal
compression fractures
14% lifetime risk of hip fracture for 50
yr.old woman, 30% for 80 yr. old.
Speroff L, Fritz M Clinical Gynecologic Endocrinology and Fertility, 7th Ed.
Osteoporosis
A hormone deficiency disease—the proper
treatment is hormone restoration!
Estrogen prevents resorption of old bone
while testosterone, progesterone, DHEA
and GH build new bone
J Clin Endo Metab. 1996; 81:37-43.
J Reprod Med. 1999 Dec;44(12):1012-20.
Combined BHR increases bone density far
better than Fosamax and preserves
normal bone remodeling (no “rotting jaw”,
eye inflammation, Ca++).
Estrogen, Progesterone,
and Osteoporosis
Any Questions?
Total and Free Testosterone in Men
Baltimore Longitudinal Study of Aging (BLSA). Harman et al., 2001
Andropause in Men
Testosterone levels decline slowly in men—
”Just getting old.”
Fatigue, reduced mental function
Passivity and moodiness—loss of drive and
ambition
Loss of muscle mass, increased abdominal fat
Lastly: loss of libido, no morning erections
Increased risk of heart and prostate disease
Increased risk of Alzheimer’s dementia
Increased risk of autoimmune diseases
Testosterone Restoration
Improves mood and sociability
Restores energy and ambition
Improves cognition
Increases libido and sexual performance
Increases muscle and bone mass
Reduces abdominal fat, improves insulin
sensitivity, lowers blood pressure--counteracts
metabolic syndrome
Testosterone and the Heart
Low testosterone levels, correlate with
coronary artery disease and stroke
Arterioscler Thromb. 1994; 14:701-706
Eur Heart J 2000; 21; 890–4
Int J Cardiol. 1998 Jan 31;63(2):161-4
Arterioscler Thromb Vasc Biol. 1996 Jun;16(6):749-54
T dilates coronary arteries—improves
angina
T increases heart muscle size, strength
T decreases fibrinogen levels—prevents
blood clots
Endocr Res. 2005;31(4):335-44.
Testosterone and the Prostate
Higher testosterone levels do not increase
the risk of prostate cancer.
Studies of testosterone supplementation
have shown no increase in prostate
cancer—even though so many men have it!
Low testosterone correlated with more
aggressive prostate cancers
Testosterone promotes prostate growth to a
point, but not prostate cancer
Where’s the Beef?
“These results argue against an
increased risk of prostate cancer with
testosterone replacement therapy.”
Testosterone replacement therapy and prostate risks: where's the beef?
Can J Urol. 2006 Feb;13 Suppl 1:40-3.
Estrogen Dominance Theory of
Prostate Disease
In many men, free testosterone declines >
estradiol
Estrogen dominance is a probable cause of
prostrate enlargement and a possible cause of
prostate cancer
Elevated estrogen/Test. ratios in BPH Scandinavian
Journal of Urology and Nephrology, 1995; 29: 65-68.
High levels of estradiol and estrone found in
BPH tissues
Estradiol upregulates oncogenes
Female Andropause
Young woman’s free testosterone level in
serum is 2x her free estradiol
Female testosterone levels decline 50%
between age 20 and 45
Birth control pillstestosterone and
DHEA levels
DHEA declines with age—main source
of androgens in women
Testosterone for Women
Improves energy, mood
Improves sexual desire and response
Increases muscle strength and reduces muscle
and joint aches
With estradiol, increases bone density
J Reprod Med. 1999 Dec;44(12):1012-20.
Probably decreases risk of heart attack
J Womens Health. 1998 Sep;7(7):825-9.
Given with estradiol and progesterone, reduces
risk of breast cancer
Menopause. 2003 Jul-Aug;10(4):292-8, Endocr Rev. 2004 Jun;25(3):374-88.
Menopause. 2004 Sep-Oct;11(5):531-5, FASEB J. 2000 Sep;14(12):1725-30.
Testosterone
Any Questions?
“My doctor says that hormone
replacement is dangerous and
there’s no evidence that
bioidentical hormones are safer!”
Two Approaches to Medicine
Natural-Scientific—Identify the
deficiency/excess at the molecular level and
correct it with bioidentical molecules
Pharmaceutical—Create non-natural,
patentable substances that will produce some
improvement
Natural Science should be primary;
Pharmaceutical Science secondary.
Problems with Pharmaceuticals
Alien molecules: not recognized, not
easily eliminated
Negative functions: disrupt normal
physiology by blocking receptors,
inhibiting enzymes, etc.
Toxic:
1.
2.
3.
Side effects even at low doses
Allergic reactions
Long-term damage
Pharmaceutical Billions
Mission: Sell pharmaceuticals
Information control—journals, CME, med.
schools, professional org.s, etc.
Strategy: Suppress competition (natural
vitanutrients and hormones—human
physiology!!)
Conventional Docs: Unaware
Result: Unfounded fear of hormone
optimization; unfounded confidence in
toxic drugs
History of “Hormone
Replacement Therapy”
Horse-derived Premarin approved in 1942
Progesterone synthesized in 1942. Poorly
absorbed orally
Chemically altered to make “progestins”—
among the first drugs to be patented.
“HRT” came to mean the use of alien
molecules that had hormone-like effects
Drug co.s became dependent on HRT profits
Drug co.s push doctors to use hormone
substitutes and to ignore or fear natural
hormones!!
Dirty Secret:
Conventional “HRT” is really HST!
Progesterone substitutes:
medroxyprogesterone acetate (MPAProvera) and 30+ other “progestins”
Estradiol substitutes: conjugated equine
estrogens (CEE-Premarin) and ethinyl
estradiol (birth control pills)
Testosterone substitute: oral
methyltestosterone
Patented drugs—not hormones!
Most docs don’t know the difference!
Premarin
Conjugated Equine Estrogens (CEE)
Human
Estradiol-17β
Horse
Dihydroequilin-17β
CEE contains at least 10 estrogens, only 3 are human.
CEE contains 3x more Dihydroequilin than Estradiol.
DHE has 10% higher binding affinity for est. receptors.
DHE binds far less to SHBG and has a slower metabolic clearance The most
abundant estrogen in CEE is Equilin sulfate.
Kuhl H, Climacteric 2005;8(Suppl 1):3–63
EE in Birth Control Pills
Estradiol
Ethinyl estradiol
Acetylene
EE cannot be inactivated by normal oxidation!
EE does not interact with estrogen receptor !
EE is 12,000-60,000 times more potent by weight!
EE is much more thrombogenic than estradiol
Progesterone vs. Progestins
Progesterone
MPA (Provera)
Megestrol

Every progestin has a different spectrum of androgenic,
estrogenic, glucocorticoid, and progestational effects!
Progestin Zoo
Progesterone
Kuhl, Climacteric 2005;8(Suppl 1)
NAMS-”Call ‘em all Progestogens”
Headlines: “Testosterone therapies increase risk of breast cancer.”
Testosterone Substitution
Testosterone
Methyltestosterone
Methyltestosterone (in Estratest) aromatizes to
an alien estrogen and increases risk of breast cancer, also
causes liver damage and breast enlargement in bodybuilders
Sex Bias
If a Man’s testes are removed or nonfunctional, bioidentical testosterone
replacement is started immediately
If a woman’s ovaries are removed or nonfunctional, she is offered horse hormones
or hormone-like drugs; or is told to “Live
with it ”.
It IS a Man’s World!
Birth Control Hormone
Substitution is Dangerous
2x risk of stroke, heart attack
2-30x risk of blood clots
1-3x risk of breast cancer
Increased blood sugar, blood pressure
1.5x risk systemic lupus erythematosis
UpToDate 2006
Liver tumors
Instead::
Diagnose and fix the hormonal disorder
Use a copper IUD for contraception!!
2002 WHI Study—Menopausal
Prempro HST is Dangerous!
Oral CEE (Premarin) alone had adverse
effects in the first year (strokes, blood
clots)
Adding MPA (Provera, PremPro)
caused more adverse effects (breast cancers,
heart attacks)
CEE/MPA caused a large increase in
dementia
And we know why these forms of hormone
substitution are dangerous!
Dangers of Oral Estrogen
Replacement
First-pass effect on the liverIGF-1,
SHBG, CRP, clotting factors 
blood clots, strokes, heart attacks in the
first year
Smokers have greater risk of clots
EE increases clotting much more than
estradiol, Premarin®
Transdermal estradiol has none of these
effects!
Dangers of Estrogen-only HRT
Estrogen alone, estrogen-progestin HST
and BCPs all reduce DHEAS and
testosterone levels 25-60%
Estrogen without progesterone and
testosteroneestrogen dominance and
 risk of breast cancer and other
medical disorders
Scientific studies show that:
Progestins are Dangerous
Provera
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•
•
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•
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
Causes birth defects
Can cause depression
Insomnia, irritability
Fluid retention
Raises blood sugar
Counteracts estrogeninduced arterial dilation
Worsens lipid profile
Causes heart attacks
Increases estrogenic
stimulation of breasts
Causes breast cancer
Progesterone
•
•
•
•
•
•
•
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•
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Maintains pregnancy
Improves mood
Improves sleep
Diuretic
Lowers blood sugar
Maintains estrogen-induced
arterial dilation
Improves lipid profile
No evidence of  CVD
Reduces estrogenic
stimulation of breasts
Prevents breast cancer
Atherosclerosis and Clotting
“In both peripheral and cerebral vasculature (of
live animals), synthetic progestins caused
endothelial disruption, accumulation of monocytes
in the vessel wall, platelet activation and clot
formation, which are early events in
atherosclerosis, inflammation and thrombosis.
Natural progesterone or estrogens did not show
such toxicity.”
Climacteric. 2003 Dec;6(4):293-301
Progesterone and Breast
Cancer—the Evidence
Premenopausal women with low P levels had
5.4 times greater risk of early breast cancer, 10x
greater risk for all cancers
Am J Epidem 1981;114:209-17.
Breast cancer victims have signs of
progesterone resistance
Br J Obstet Gynaecol. 1998 Mar;105(3):345-51.
P downregulates BRCA1 and induces apoptosis
in breast cancer cell lines.
Anticancer Res. 2005 Jan-Feb;25(1A):243-8.
Progesterone and Breast
Cancer—the Evidence cont.
Estrogen cream applied to the breast induces
proliferation, adding progesterone cream
reduces proliferation to baseline
Fertil Steril 1995; 63:785-91
Estrogen is carcinogenic in breast cell cultures
unless progesterone is present
J Steroid Biochem Mol Biol. 2003 Oct;87(1):1-25.
Estrogen upregulates cancer-promoting gene
bcl-2, progesterone downregulates it.
Ann Clin Lab Sci. 1998 Nov-Dec;28(6):360-9.
No Evidence that
BHRT is safer?
E3N-EPIC Study
Cohort study
54,000 women
5.8 years f/u
c/w WHI-16,000, 6 yr. f/u
Int J Cancer. 2005 Apr 10;114(3):448-54.
Bioidentical estradiol plus progesterone decreased the
risk of breast cancer!
Int. J. Cancer 112 (2004) (2), pp. 312–318.
ORDET Study
6,000 women
5 yr. F/U
Higher progesterone=lower risk of breast cancer
Progesterone and Breast
Cancer—Conclusion
“The balance of the in vivo evidence is that
progesterone does not have a cancerpromoting effect on breast tissue.”
J Steroid Biochem Mol Biol. 2005 Jul;96(2):95-108
In fact, the balance of the evidence indicates
that progesterone protects against breast
cancer!
So…women can be given estradiol as long
as it’s balanced by progesterone and
testosterone!
Pharmaceutical Corps’ Dilemma
They need to control the HRT market
Their progesterone and estradiol substitutes
are dangerous
They can’t patent natural hormones
Pharm. Corps. have to get FDA-approval
for every natural hormone preparation $$$
Compounding pharmacies can dispense
natural hormones cheaply
Pharm. Corps’ Choices
Stop compounding pharmacies so they
can control of the BHR marketWyeth’s
appeal to the FDA, media propaganda blitz
Suppress BHR in favor of their substitutes
Keep looking for substitutes that will
provide benefits without risks
Result: Your doctors will never learn the
truth about hormones unless he/she goes
looking for it
Common Sense
Substitutes are alien molecules!
Problems caused by hormone
substitutes cannot be attributed to
human hormones until proven
otherwise.
Bioidentical hormone restoration
should be considered safe until proven
otherwise!
Hormone Substitution
Any Questions?
Metabolic Regulators:
Thyroid and Cortisol
Thyroid sets throttle, cortisol delivers fuel
Deficiencyreduced metabolic ratefatigue,
brain dysfunction, depression, pain
Subtle deficiencysymptoms and disease
Usual blood tests are insensitive
Irrational fear of supplementation
Underdiagnosed, undertreated—Docs
prescribe pharmaceuticals (SSRIs) instead
Hormone Ignorance: the Tyranny
of the Lab Report
Reference Range=95% of “normal people”
 optimum
Male free testosterone: 35-155
5x
Female free testosterone: 0.0-2.2

Free T3: 1.8-3.2
2x
TSH: 0.3-5
17x
If “within normal limits” no diagnosis;
pharmaceuticals for symptoms
If below normal, just replace to “WNL”
Hypothyroidism—Symptoms
Mental fog, depression, anxiety
Fatigue
Cold extremities
Aches and pains
Hair falling out
Weight gain
Constipation
Self-Test: Basal body temperature <97.8°F
axillary in bed in AM
Thyroid Hormone—T3
Maintains metabolism, mood, and energy
Controlled partly by thyroid stimulating
hormone (TSH) from the pituitary gland
TSH test is indirect: does not measure T3
levels or effects in various tissues
Docs prescribe T4 only (Synthroid and
Levoxyl)—prohormone that must be
converted to T3
Docs rarely measure free T3 levels!
We Need Optimal T3 Levels
Incidence of severe atherosclerosis doubled
with lower T3 or higher TSH levels within the
normal range
Clin Cardiol. 2003 Dec;26(12):569-73
Lowers cardiac risk factors: cholesterol,
triglycerides, C-reactive protein, homocysteine
and lipoprotein(a)
Lowers blood pressure, dilates arteries
Reduces tendency to form blood clots
Prevents weight gain
Fatigue, Fibromyalgia and
Depression Epidemic
Pre-TSH: Treat the patient’s symptoms
Post-TSH: Treat the test (?)
1970s—Doctors lowered doses by 30%
TSH-normalizing T4 doselow T3 levels!
Williams’ Textbook of Endocrinology. Saunders, Philadelphia, pp 357-488)
T3 alone often effective in fibromyalgia
T3 alone relieves depression even if tests
“normal”!
J Affect Disord. 2006 Feb
Rational Approach to Thyroid
Restoration
If S/S of hypothyroidism: Treat!
Give T4 plus T3 (Armour, Cytomel)
Endocrinology 1996;137:2490-2502
Increase dose until symptoms gone or S/S
of excess appear
Safe--even moderate TSH suppression does
not cause:
bone loss Horm Res. 2005;64(6):293-8. Epub 2005 Nov 1.
cardiac abnormalities J Clin Endo Metab. 2000 Jan;85(1):159-64.
muscle wasting Am J Phys Endol Metab. 2005 Jun;288(6):E1067-73.
Pharmaceuticals, Labs, and
Thyroid
Any Questions?
Cortisol
Made in the adrenal glands
Maintains blood sugar (delivers the fuel)
Modulates immune system
Need high amounts when stressed
Too muchDiabetes, HTN, osteoporosis
Too littlehypoglycemia, fatigue,
autoimmune diseases, aches and pains
www.adrenalfatigue.org
Cortisol Deficiency
Fatigue, depression
Aches and pains
Can’t stay asleep
Can’t deal with exercise, stress, or illness
2nd wind late at night
Hypoglycemia, feels better after eating
Nausea, abdominal discomfort, diarrhea
Allergies, autoimmune diseases
Hard to gain, hard to lose weight
Low blood pressure, salt and sugar cravings
Mild-to-Moderate
Cortisol Deficiency
Blood tests are insensitive, need diurnal
salivary cortisol profile
Underdiagnosed: Docs taught only about
severe “adrenal insufficiency” due to
physical destruction of the adrenal glands
(Addison’s Disease) or pituitary
Common cause of chronic fatigue, pain
Clue: Felt great when taking prednisone
Normal Saliva Cortisol Profile
Cortisol Deficiency
Cortisol Deficiency—Normal Waking Cortisol
Depression—Elevated PM Cortisol
Cortisol Restoration
Mild deficiency can resolve with stress,
rest, nutrient restoration
Moderate-to-severe—need cortisol, not
cortisol substitutes like prednisone
Physiological doses (5 to 20mg=<1-4mg
prednisone)—NOT excessive doses that cause
hypertension, diabetes, osteoporosis, etc.
Fears of low-dose cortisol unfounded
Dr. William Jeffries’ Safe Uses of Cortisol
DHEA—The Other Adrenal
Hormone
Most abundant steroid hormone yet ignored
Cells make testosterone and estradiol with it
Levels decline with age, stress and disease
Anabolic—builds tissues, improves immunity
Reduces abdominal fat
Reduces pain—restores natural endorphins
Reduces inflammation (IL-6, TNF-, IL-2)
Anti-cancer effect in animal, in vitro studies
Lower levels assoc. with disease, mortality
Fatigue, Depression, and Pain
Should be considered as due to a
nutrient, thyroid, cortisol, or DHEA
deficiency until proven otherwise by
testing and by trials of nutrient and
hormone restoration.
Cortisol and DHEA
Any Questions?
What Else Can Hormone
Replacement Help?
Infertility, PMS, heavy bleeding
Insomnia—almost always helps
Heart failure
Mental disorders
Autoimmune diseases (systemic lupus
erythematosis, rheumatoid arthritis,
ulcerative colitis, Crohn’s disease, etc.)
Allergies, skin diseases
Hormone Restoration
Unresolved issues—more investigation
needed
Need more long-term randomized studies to
study long-term results
Questions about delivery and monitoring
Medical profession should be studying
bioidentical hormones instead of hormone
substitutes!
Local Compounding Pharmacies
Winola Pharmacy—Rt. 307 at Lake
Winola, 378-2885
Harrold’s Pharmacy—Wilkes-Barre, 8225794
Fino’s Pharmacy—Dallas, 675-1141
Hazle Drugs Apothecary—Hazelton phone
1-800-439-2026
Doing BHRT
History, consent, fees online
Initial visit: order tests
F/U visit: Results—prescribe—retest
Repeat until stabilized at proper dose
Follow-up office visit once every 6 months,
test only as needed.
Telephone and e-mail contact—charges for
clinical decisions, refills, etc.
Costs
Physician time only as required--first year
~$200-$400; then <$200/yr.
No insurance billing; may submit claim for
recognized diagnosis
Hormones—$10 to $70/month, some
covered by insurance (GH adds $130/mo.)
Diurnal salivary cortisol test—$120
Blood tests—insurance may pay, lab kits
$170-$220, Saliva/blood kit—$299
Out-of-pocket expenses tax-deductible
For More Information
The Miracle of Natural Hormones David
Brownstein, MD
How to Achieve Healthy Aging—Look, Live, and
Feel Fantastic After 40 Neal Rouzier, MD
The Hormone Solution—Stay Younger Longer
Thierry Hertoghe, MD
Life Extension Foundation (www.lef.org)
BHRT info. and hundreds of abstracts at
www.hormonerestoration.com.
Contact me: [email protected]