Sidney Allen

Bioidentical hormone replacement therapy is a powerful yet all natural alternative to synthetic hormone replacement, and Mr. Allen covers this new form of addressing hormone imbalances in his blog. Mr. Allen aims to provide independent and unbiased information and advice, and does not have a stake in what you choose to do re: BHRT.

Jul 132014
 

If you are looking to bioidentical hormone replacement therapy to treat the specific symptoms that have been known to occur with certain hormone imbalances and deficiencies, and you have some reason to think you have such a hormone deficiency or imbalance, then this natural hormone replacement approach is likely to work for you.  Take the most obvious example of a woman who is again and feeling symptoms that have been associated with the decrease in estrogen that comes with the aging process.  She has reason to be confident in this approach.  But in situations that are less than obvious, or for problems that have less of a direct association with hormonal issues, you should be careful and know the limits of bioidentical hormone replacement therapy.

Some examples of how the natural hormone replacement hype got away from itself involves anti-aging claims that appear too general.  Wrinkles on the skin, for example, are a natural part of aging and any connection with a hormone imbalance, as well as any related suggestion that a natural hormone treatment could dramatically reduce the incidence or severity of wrinkles has got to be treated with extreme caution.  The problem with looking to bioidentical hormone replacement for treatment of these problems is two-fold: First it is likely to work only minimally if at all, and second it is likely to require you to stay on the treatment for very prolonged periods of time, which can be expensive and increase your chances for side effects.

Even if your own primary care physician is skeptical of bioidentical hormone replacement therapy, she or he can at least tell you whether your symptoms are related in general to hormonal imbalances or deficiencies.  If they are not, and just merely a sign of aging or due to a genetic predisposition that exists completely aside from any hormonal issue, then the natural hormone therapy is unlikely to do a thing.

Jul 032014
 

If you are considering natural hormone replacement you will be happy to know that some of the most common formulas are FDA approved.  The fact that there are a good number of FDA approved bioidentical hormones helps the industry overcome perceptions that all-natural somehow means that they do not work as well, or that there could be problems that engineered hormones would not have.  This approval gives these formulas legitimacy and takes some of the worries about risk away.  Of course the natural hormones that do get approved are more standard formulas, and anything that is custom compounded for you cannot be specifically approved, though it is possible that something quite close is.

Now we should mention that just because there are FDA approved bioidentical hormones does not mean that they will necessarily work for you or that there are no potential side effects.  Before we provide a listing of the FDA approved bioidenticals we want to offer the strong caution that any natural hormone replacement must be preceded by a comprehensive assessment that helps to show whether you need this approach and whether they are likely to help given your unique presentation.  And during treatment there is no guarantee that you will not experience side effects just because they are approved.  Those qualifiers aside, we do want to offer information that helps you know which choices have been studied and approved.

The following is a brief listing of the FDA approved Bioidentical Hormones:

Estrogens: Many forms of estrogens are FDA approved Bioidentical Hormones including the most common which comes under the name estradiol.  You can get estradiol in many forms, all of which are FDA approved, including pills, creams, patches, tablets, lotions and gels.  Of the FDA approved bioidentical hormones, estradiol is the most commonly used and has been the most widely studied and reported on..

Progesterone: Another of the common FDA approved bioidentical hormones is progesterone, which comes most commonly in pills and gels.  While progesterone does not have the base of information and scientific study that the estrogen have, it has been studied enough to pass all of the scrutiny that comes during the approval process.

Combinations: The last one of the FDA approved bioidentical hormones are combinations that often include estradiol.  Many of these combinations involve a non-bioidentical second ingredient.  Both ingredients are approved in these cases, but only one is a natural hormone.  These combinations do allow you to get as much of the natural hormone as you can while augmenting with something else that is approved.

Just because a formula does not appear on this listing of FDA approved bioidentical hormones does not necessarily mean it is unsafe or that you should not try it.  Approval takes time, and some formulas are too new or have not been studied enough to get approved.  You may need to ask additional questions, however, such as how long that formula has been in use, what the science is behind it, how long that practitioner has been using it, and what are the known risks.  There is certainly an added comfort that comes with the use of a formula that has been approved, so if progesterone or estrogen is what you need you can choose something that provides that added security.

We will of course keep this post and the entire site updated as there are more FDA approved bioidentical hormones.  Many are in process now and with more information and research the pipeline may continue to be strong.  And we will also cover those formulas that have not yet been approved on this website so this may be a good page to refer back to if you are wondering about the approval status.

Jun 142014
 

The idea that hormonal issues can affect men as much as they affect women is still not widely known or accepted in the general public.  In most circles, hormone replacement is something that is associated with women who are aging and not men.  Yet as men age certain hormonal imbalances can occur, and when they do the symptoms can be just as disrupting, so we wanted to emphasize here that bioidentical homrones for men deserve attention.

Most of what we cover here are the types of hormonal imbalances more typically seen in women, such as the lowering of estrogen as women age.  And it is likely that women will remain the primary group that looks into natural hormone treatments given that these issues are a little more prevalent in women, and women are more likely to recognize them and decide to pursue treatment.  That said, there are bioidentical hormones for men that can prove to be extremely valuable in helping correct certain issues as men age, or reduce symptoms in some younger men who have a predisposition toward problems.  Bottom line: we want to be sure that we cover bioidentical hormones for men carefully and diligently in this blog, and this post is a start.

Of course the best known hormonal issue for men is low testosterone, and this is likely the number one reason why bioidentical hormones for men are getting increased press and notice lately.   Low T usually strikes men at middle age, but for some it can come earlier and there can also be a delay.  Like many hormonal issues, low T can be missed because it comes on so gradually and many men may just think that the symptoms can just be explained by the natural aging process.  As BHRT gets more attention, however, it may be that men will be more likely to realize that in some cases these problems can be corrected.  Bioidentical hormones for men are a great way to approach a guy who does not want to take prescription meds but would rather approach things more naturally.

But bioidentical hormones for men do not sytart and stop with testosterone.  Men have a balance of hormones that can change in many ways as they age, or even earlier due to other factors.  Thus there may be more complicated mixes of BHRT that men can benefit from even if testosterone is one of the ingredients.  You need to make sure you go to a BHRT practitioner who does not merely specialize in treating low T, but rather has the ability to treat with a wide range of bioidentical hormones for men.

Of course there are many doctors who are doing BHRT, but there are a few who truly specialize in bioidentical hormones for men.  For simple cases of low T it may not be necessary to see one of these specialists, but for more complex issues it is good to look into that option.  In addition, you can consider a practitioner who mostly sees women if they are well-trained and experienced with men as well – you may not find too many practitioners who only see men.

We welcome comments and feedback from any man out there who has had BHRT, whether for low T or anything else – did you find it helpful, what were the side effects, and what was tried.  There is no better way to get information about BHRT than from others who have entered treatment with similar symptoms and issues.  We will also update this post or add a new one when new treatments come out or new there are new ideas regarding these approaches, or when there are side effects or other aspects of the treatment you should know about..

Jun 042014
 

Many people are concerned about starting BHRT for fear of certain side effects or effects that are not quite side effects but may not be wanted.  The fact that bioidentical hormones have been tied to possible weight gain may scare some people off, though this effect has been overplayed and is not as likely as you might think.  In fact, the major link between bioidentical hormones and weight gain may actually be reversed.  We wanted to provide more information to help you understand this link, but of course your BHRT doctor is the best one to turn to for more information about your own unique formula and hormone imbalance.

Hormones in general can affect your weight.  There are two possible mechanisms of action by which this happens, one involving metabolism and the other through the indirect effect they have on energy and activity level.  When hormones are in a correct balance they allow you to have the energy you need and ensure that your metabolism is functioning well enough so that you can address any extra weight through diet and exercise.  For example, as men age they often experience a drop in testosterone, and with low activity this drop can happen even faster.  When this hormone is too low both metabolism and energy become too low, and that can lead to weight gain.

But the question for this post is more directly about bioidentical hormones weight gain.  The short answer is that there is little likelihood that you will experience a problem with bioidentical hormones and weight gain.  If you truly needed BHRT and it is done correctly, all that is happening is that you are fixing an imbalance and the result should be that you come closer to your natural weight, especially if one of the symptoms of your imbalance was an increase in pounds.  The longer answer is that you could experience a temporary increase in what you weigh due to changes in fluids – there could be some bloating and water retention as you get things corrected.  While to be fair this certainly falls into the category of bioidentical hormones and weight gain, this type of gain is not permanent and will resolve over time.

You should certainly approach your provider and get a prediction or estimate of any potential problems you might experience with bioidentical hormones and weight gain.  You should know what to expect, and there may be ways for your provider to estimate this possibility given your unique body type, history, and symptoms.

One final note.  Keep in mind that even if you do end up with a problem related to bioidentical hormones and weight gain that this may not be important enough to stop your BHRT treatment.  In other words, in many instances you may get relief from other symptoms and want to stay on the treatment, even if you may have to work harder to maintain your weight.  A lot of this depends on why the BHRT is causing this problem – if they are merely causing you to have less energy, for example, you may want to try to power through and still maintain a string exercise regimen.  If they are causing you to have a slower metabolism, however, this may be a harder decision.

As we said up front, it is unlikely that you will experience a problem with bioidentical hormones and weight gain, but if you do the problem may be correctable whether by overcoming the challenge, switching formulas, or even maybe putting up with the problem for a little  while to see if it goes away.  And of course you need to assess whether there actually is a relationship between your bioidentical hormones and weight gain in the first place.

Apr 142014
 

As we’ve covered here many times, there are several ways to take your natural hormones, and there is not necessarily and “right” or “wrong” way to take them for everyone.  The method of administration can depend on personal preference, your physiology, the dose you need, and the doctor’s preference.  Also, certain ingredients used in BHRT are more amenable to different routes of administration.  In this post we discuss bioidentical hormone cream, which is growing in popularity for its ease of use and potential in getting the medication into your bloodstream effectively.  Bioidentical hormone cream is not new, but many practitioners still do not use it as a cornerstone – perhaps concerned about how hard it is to initially dose.

Bioidentical hormone cream can be a very effective way to get your natural hormones, especially if you do not need a high dose and if yu want to avoid pills.  Bioidentical hormone cream delivers the dose of the natural ingredients you need through your skin, and the results can be very effective, if you administer it effectively and stay with it.  This method is often used when only one natural hormone is needed as opposed to a combination approach.  First some advice about using this method of natural hormone administration:

  • Do not vary the spots that you administer the bioidentical hormone cream, keeping things the same for at least three to four weeks.  This is for two reasons, first that different pars of your body may absorb and release the ingredients differently and you want to measure the same dose over time, and second is that there is a theory that the skin receptors in that spot will get used to the ingredients and this makes it easier for you to get the effect you want.
  • When choosing an area look for a place where the skin is naturally warm, on your upper body, and perhaps thin.  Warm skin areas tend to absorb creams faster, and of course thinner skin is closer to the bloodstream as opposed to skin that covers fatty areas.
  • Of course the best time to apply your bioidentical hormone cream is when you’ve just cleaned the area so that there are no chemicals or products to get in the way.  You can apply new chemicals, such as perfume around 5-0 minutes after applying the bioidentical hormone cream because by then it will be absorbed.
  • Do not rub in the cream to quickly or vigorously, or you might actually be removing the ingredients from your skin.  Make sure to get specific application instructions from your doctor and do not rush through them when you are using this method of BHRT.

Following the above instructions, many people find that the best place to administer their bioidentical hormone cream is in the crook of their elbows, inner wrist area, or a few inches below their neck.  If you have a mild reaction in the first area you try, you may want to try a different area right away, but if you don’t you should stick with one place for a while.

It is probably best to start with a conservative dose of bioidentical hormone cream, given that it may be unclear how fast and effectively your body will synthesize it.  Know that in addition to the potential side effects that any BHRT treatment can lead to, bioidentical hormone cream can also cause problems on the skin.  Some of these may go away quickly, or not recur if another area of skin is used.  But the most important part of this approach is getting the dose right, and unlike supplements this can be a little challenging.

Mar 292014
 

Many people ask the question “Are bioidentical hormones safe?”, and are frustrated with the range of answers they get back.  There is no clear answer, as much as people often want a yes or a no.  In fact, the best way to answer the question “are bioidentical hormones safe?” is to break the question up in two ways:

Are bioidentical hormones safer?

This question factors out whether hormone replacement therapy as a whole is safe.  In other words, since there are certain risks of both natural and synthetic approaches, you need to compare the approaches to each other as opposed to trying to answer the question in a vacuum.  So what is the answer?  Basically natural hormones are no safer than synthetic hormones.  Professionals in the field when asked are bioidentical hormones safe will state that they are derived from plants and not synthesized in a lab.  This is true and may be an advantage in some ways, yet it does not mean that they are necessarily safer.  And it should be noted that the procedure to pull the chemicals out of the plants still involves a process that is similar.  And the makers of synthetic will remind you that many of their chemicals are also derived from plants.

The makers of natural hormones will also will also say that the custom compounding process creates a unique formula for everyone, and that this is safer than synthetics which are made through one approach.  There is some potential that this might make bioidentical hormones safer, the problem persists that there are no conclusive studies and that there are still some quality issues at many of these pharmacies. commercially produced preparations.  This is an area we will need to follow closely, because it does have the potential to separate natural hormone therapies from synthetics.

Are bioidentical hormones safe?

The above describes whether natural hormones are safer than traditional synthetic hormones, but aside from that – pretending synthetics were not an option – are bioidentical hormones safe?  This is actually quite a complex question which can be difficult to answer because there is often no specific formula that is used widely.  Due to custom compounding and factors that make even those formulas that were not custom compounded unique it can be hard to systematically study these approaches.  In addition, since BHRT is used for such a wide range of problem it can be difficult to study their effect on specific symptoms and issues.  We do know that for some the answer to the question of whether bioidentical hormones are safe has been tainted by the fact that they’ve been overused for symptoms that would not respond to any type of hormone therapy, or when the underlying cause has been misidentified.

Our best conclusion is that when used for those problems that have been carefully addressed, in the hands of a qualified practitioner who does not overdo it, and when a compounding center is careful, BHRT is as safe as synthetic hormone treatment and may even be safer.  You can make sure that this is the case for you by taking three steps:

1. Choose a practitioner who is not only quite experienced but also does not have an exaggerated sense of what BHRT can do.  Look for someone who spends a good deal of time in the assessment phase, and who warns you that BHRT may not be the answer.

2. If you are having your natural hormones custom compounded, make sure you are not only researching your practitioner but also carefully looking into the compounding center they will be using.  Usually string practitioners use good compounding centers, but you should still be sure.

3. Get several opinions before agreeing to a course of treatment.  The best second opinion may be from someone who has no stake in what you choose, such as someone you pay merely for their opinion and not as someone who might do the process.

So, are bioidentical hormones safe?  The general answer is yes, but like any other medical treatment careful assessment, an excellent practitioner, a second opinion, and a careful look at the quality fo each step of the process is vital.

Mar 252014
 

Bioidentical hormones cost around the same amount or sometimes less than traditional synthetic hormone replacement therapy, and that fact has not changed much over the past few years.  As time goes on some of the more expensive synthetics actually go down in price since their patents expire and generics can be made, so while they used to be quite expensive they are now, to be fair, often in the same range as BHRT.  And with synthetics insurance is more likely to pay so if you are relying on not having to pay out of pocket you may struggle to afford the bioidentical hormones cost.  But if you were paying out-of-pocket for whichever solution you choose, you should not have to pay any more for BHRT than conventional hormone replacement.

The above is the short answer, but bioidentical hormones cost is actually quite complicated.  So much more goes into bioidentical hormones cost than just what you’d pay over the counter, such as:

1. The bioidentical hormones cost may be higher and sometimes much higher if you prefer to get them custom compounded.  Not only is this customization a more involved process, but there may be more ingredients that are more expensive this way.  As with anything that is customized you are paying more for the added work that has to go in and the fact that things have to be so carefully put together.  Then again, these aspects of custom compounded bioidentical hormones cost may also mean you need fewer overall treatments or that the BHRT will work more quickly and effectively, thereby offsetting the increase.

2. Bioidentical hormones cost may also be guided by which form you want – now that there are so many different ways of taking BHRT, from pellets to pills to creams, you may find that the cost varies widely.  Pills may be as little as $30-$50 each out-of-pocket, but creams may be significantly more.  And pellets may be significantly less when you consider how long they last.  Keep in mind that again you need to factor in not only your cost over time, but also the fact that if one approach leads to higher bioidentical hormones cost but is more effective, that still may be worth it.

3. We are seeing some insurance companies cover some of the bioidentical hormones cost, though you should make sure to research this carefully with regard to your own plan.  If they are covered than you should compare the deductibles involved.  They may be covered but may be at a higher tier as far as your deductible or co-insurance.  Make sure you are comparing apples to apples.

4. Finally, the bioidentical hormones cost may also depend on who your professional is – if an MD the process may be quite expensive, a nurse less expensive, and a non-nurse professional may be less than that.  Be careful that you don;t end up getting what you pay for – in other words make sure that a doctor, though more expensive, might not be more likely to get things tight the first time.

As you can see, assessing your bioidentical hormones cost is not as easy as it may seem.  There are many factors you need to consider, but it really boils down to your total cost over time, as well as how effective the treatment will be.  In many cases these choices are not obvious and require a lot of homework beforehand and sometimes a few trips to different professionals who use different approaches.  It is also important to balance giving your chosen course of treatment time vs. staying with an expensive treatment too long.  The good news is that for many people a few different approaches will work.

Mar 162014
 

There have been several studies comparing bioidentical progesterone to traditional synthetic progesterone (called ” progestin”) and the results have been quite positive for fans of bioidentical hormone replacement therapy.  Among other positive findings, it was reported that women experienced improved quality of life and fewer side effects on bioidentical progesterone, particularly when the BHRT was a switch from more traditional hormone replacement therapies.  These studies compared bioidentical hormones and traditional hormones head-to-head, allowing for comparisons between the two approaches.

Perhaps the largest of the studies to date was done at the Mayo Clinic.  176 women who had been having synthetic hormone replacement therapy with progestin, a non-bioidentical hormone, but switched to bioidentical progesterone were studied.  The findings suggested that the women experienced a higher degree of improvement in their symptoms when on the bioidentical hormones.  The findings included:

- Almost two-thirds felt that the bioidentical hormones were better at symptom reduction overall, and 80% reported overall satisfaction with BHRT

- The bioidentical progesterone was seen as reducing sleep problems by almost a third, an important positive when it comes to hormone replacement since this is sometimes one of the major presenting issues.

- The bioidentical progesterone was seen as responsible for a 50% reduction in anxiety and a 60% reduction in depression, both of which are seen in those who look into hormone replacement

Other positive findings in this and other studies that directly compared BHRT and traditional synthetic approaches included less bleeding and breast tenderness, greater quality of sleep, and improved cognitive performance.  More studies are welcome and perhaps needed to truly sum up the differences between BHRT and traditional therapies, but it can at least be said that the initial results are quite promising and should give people who are considering bioidentical hormones a boost in confidence.  Your reaction will be unique of course, but these studies can provide at least an initial guide.

Feb 212014
 

Many doctors recommend hormone testing before a person starts with bioidentical hormones or regular hormone treatments.  And this may be a prudent thing to do, since symptoms alone cannot tell the whole story as far as what is going on with hormone levels.  It is best to somehow get a clear and scientific picture of what hormones are low before embarking on a course of bioidentical hormone replacement therapy.  But is it really possible to get such a clear picture of something as difficult to measure as hormone levels?  In some cases, unfortunately, the answer is no.

There are two types of testing that people go through before they try bioidentical hormones: saliva testing and blood testing.  Saliva testing that assesses current hormone levels has proven to be highly inaccurate on many occasions, and while it is still used to confirm the need for bioidentical hormones when symptoms are more severe or obvious, it does not seem reliable when things are more moderate or when other possibilities are clearly in play that would explain symptoms.  Blood testing is seen as a more accurate way to measure hormone levels, but the problem there is not with the testing but more with the nature of hormones themselves – given that levels can vary day by day, and even within any particular day, the testing may be measuring at a time when levels are particularly high or low.  Finally, we have the problem of most women not having a baseline hormone test that the doctor can compare the new results to see if there has been a change.

So what is the answer then?  Usually a doctor will combine several approaches when determining the need for bioidentical hormones.  Level testing may be one part, but gathering a detailed history plays a large role, as does family history and a deep understanding of any other medical issues.

Jan 142014
 

The title of this post is actually meant as a trick. In the past, bioidentical hormones and bioidentical hormone replacement therapy were in the news because inexperienced or over zealous practitioners were making mistakes, or custom compounding professionals were not adequately trained. But lately we are finding that the major place that we find bioidentical hormones and BHRT overall in the news is where new and innovative treatment possibilities and listed and explored. This of course is a welcome development for those of us who are fans of bioidentical hormones replacement therapy and thought it was getting a bad rep previously.

Now there are some pitfalls related to bioidentical hormones replacement therapy’s history, and that is that the media is waiting for the next problem, because it would be quite a story if the problems returned. Thus any small problem could be overblown, and any larger issue could be made to be bigger and more widespread than it really is. Unfortunately given its history – which quite frankly is not much different from what other promising treatments went through – bioidentical hormones replacement therapy is poised for increased media scrutiny.

The good news in all of this is that bioidentical hormones are considered worthy of that attention. No longer are they a fringe area that is not worth covering. Instead they are becoming more generally accepted and used. This the fact that the media is poised to cover an problems in the field of BHRT could be looked at as a compliment, or at the very least a sign of general interest in the field.

Of course the important thing will be for bioidentical hormones to stay out of the media as far as side effects or practitioner problems over the next few years. Supplements and alternative therapies that do work can become a story on their own, and that is what we e happens more and more with bioidentical hormones replacement therapy.