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.

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.

Jan 082014
 

The start of a new calendar year gives us a chance to reflect back and look forward when it comes to bioidentical hormones replacement therapy.  And in doing this assessment of bioidentical hormones we arrive at several predictions for the coming year.  Of course predictions are guesses, even if educated ones, so we will revisit these predictions about BHRT in about twelve months to see how we did.  For now, here is what we expect could happen in 2014 in the field of bioidentical hormone replacement therapy:

1. The positive reputation of bioidentical hormones will grow as more time passes since the initial problems that had more to do with poorly trained custom compounding centers than anything else.  As more women and men have bioidentical hormone replacement therapy than ever before, the positive effects of BHRT will become more widely known, and as practitioners get better at their craft and more able to foresee and avoid potential problems, the overall reputation of this alternative hormone treatment will grow.

2. We may see a decrease in custom compounding rather than an increase, a possibility that goes against conventional wisdom.  One might think that people would be attracted to custom compounding of their bioidentical hormones, but those same people may be attracted to the science of knowing exactly whether a particular formula has proven effective for others.  In other words, men and women may feel more comfortable with a bioidentical hormone formula that the practitioner has used effectively on many patients, rather than going with a unique and therefore unproven formula.

3. Finally, we expect that bioidentical hormone replacement therapy will be used for more presenting concerns, and particularly for more men.  Of course the rollout of bioidentical hormones was with larger and clearer groups who needed this type of treatment, such as women who needed estrogen replacement.  But as the field of BHRT gets more evolved we’ll see more men with the need for bioidentiacl hormones approach this type of care.

Dec 152013
 

Many medical procedures necessitate missing work or taking significant timeout of activities with family.  Sometimes its obvious, such as when you have an elective procedure that requires you to stay completely off your feet.  Sometimes it’s less obvious like when a process makes you feel uncomfortable enough to use some sick days.  Usually these procedures are still worthwhile, even if elective, and the benefits make missing work a normal and accepted part of things.  However, when it comes to bioidentical hormones and bioidentical hormone replacement therapy the good news is that you do not need to miss any time with work or family.  The treatment does not make you feel uncomfortable and certainly would not make you unable to work.

Now of course there are exceptions to this rule of bioidentical hormones always not causing discomfort.  Whenever you ingest anything, especially anything with ingredients that ae new to your system – even if they are all natural – you run the risk of symptoms such as nausea and headaches.  This will not happen to the majority of people, and a good bioidentical hormone replacement therapy doctor will be able to ask many of the right questions to be sure that he or she can keep the side effects of bioidentical hormones low for you.  And of course he or she will be able to respond quickly if you do have side effects from bioidentical hormones.

One might think that the risk of side effects from bioidentical hormones is less for custom compounded BHRT that can leave out tricky ingredients, but actually the relationship is complicated since the practitioner likely has more experience with formulas she or he has used more often.

So the good news about bioidentical hormones is that you are unlikely to miss work or school or fun activities.  You will only just be waiting, while your normal routine goes on, for relief from the symptoms that your hormone imbalance is causing.

Oct 222013
 

One common question people ask before starting bioidentical hormone replacement therapy is whether they need to stop taking other supplements in order to let the bioidentical hormones work optimally.  Of course the short answer to the question is to run the list of supplements you are taking by your bioidentical doctor and get her or his advice.  But there are some guidelines you should use and talk to your BHRT doctor about, so this post should help guide your conversation.

First, it is a little less likely that supplements taken for issues completely unrelated to hormonal issues are less likely to interfere.  This is not an absolute, and you still need to fill in your bioidentical hormone replacement doctor on what else you are taking, but you’re more likely to get a positive answer if the supplement is doing something else.  This is not as much because of concern that it will be hard to know the effect of BHRT if you continue taking the supplement (though this could be an issue), but more because two different supplements for the same issue have a higher likelihood of interaction effects.

Second, the supplement you are currently taking may have a profile that suggests it is more likely than others to cause interaction effects.  For one reason or another the supplement might work in a way that is more likely to have a negative effect on any other supplement, whether bioidentical hormones or something else.  The opposite could be true of course, and you may be taking a supplement that rarely interferes with other supplements.

Finally, you may need to stop taking your other supplement because your doctor wants to be sure he or she gets a clear picture of exactly what the bioidentical hormones are doing, and as a scientist she or he does not want anything interfering with that picture, at least at first.

Oct 162013
 

Hormonal changes do not happen overnight.  It is very likely that your symptoms, whether you have low estrogen, progesterone, or testosterone came on gradually and may have even been hard to perceive at the beginning.  In fact, many people look back and realize that their symptoms that require bioidentical hormone replacement therapy started longer ago than they initially thought.  (And if your symptoms do come on more suddenly than this you need to see your doctor because there may be something going on medically that needs more urgent treatment than either bioidentical hormones or conventional hormone replacement therapy).  It follows that any hormone replacement therapy will take a little while to work.  But how long?

The short answer is that bioidentical hormones take anywhere from a few weeks to a few months to work.  Usually they don’t just suddenly work one day, but rather begin to work gradually as they are regulating hormone levels in your body.  There may be a period where they do not improve things – while they are building up in your body to therapeutic levels that can truly make a difference.  After that the changes you might experience from BHRT may be gradual but noticeable until they have truly fixed the problem.  Whether this takes a few weeks or a few months depends on factors such as the degree of your hormonal imbalance, how long it has persisted, and how well your body metabolizes the bioidentical hormones.

Your BHRT practitioner may be able to estimate how long it will take bioidentical homrone replacement therapy to work for you, given your symptom level and progression, the time period within which you’ve had them, and the doses of bioidentical hormones she or he plans to use.  However, this estimate will always be a guess, and you may begin to feel the positive effects sooner.

Sep 192013
 

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There are often questions about whether bioidentical hormones affect the metabolism of certain vitamins, especially from those who have taken certain vitamin regimens for a long time. In many cases people are taking these extra vitamin supplements on the advice of their doctor due to a certain issue or deficiency, and of course the question of whether bioidentical hormone replacement therapy will interfere is pertinent. The answer to the question can sometimes be complicated, but usually is a relief.

Bioidentical hormones have all natural ingredients that work to balance a hormone level or add hormones where there is a deficiency. There is usually little or no interference with the metabolism of vitamins or minerals, and the digestive process is usually left alone. Thus the simple answer to anyone concerned that their bioidentical hormone replacement therapy will have a negative effect on an important vitamin regimen is that it won’t.

All of that said, there are times where bioidentical hormones due indirectly effect vitamin metabolism. In these cases it’s usually not the BHRT but the effects of rebalancing hormone levels that can affect things. Certain hormonal changes can lead to changes in overall metabolism and digestion, which in turn can have an effect on the amount of certain vitamins that is useable.

It would be well beyond our scope here to compare all sorts of vitamins with the variety of bioidentical hormones – or more specifically the variety of hormonal imbalances they correct. Suffice to say that as we’ve mentioned elsewhere many times, any time you consider a medical treatment, even something as natural as BHRT, you should check with your primary care physician. And if she or he already had you on a regimen such as taking certain vitamins or minerals it may be even more important to check in first.