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.

Dec 192014
 

Bioidentical hormones can be quite effective in helping you achieve hormonal balance when you are experiencing symptoms due to hormone reduction due to age, injury, or genetics.  Bioidentical hormone replacement therapy has come a long way in recent years, and as doctors become better at this craft, formulas get more effective, and the science behind this approach develops we see more effective therapies.  That said, there are other choices you can make and activities you can pursue to make your BHRT even more likely to succeed, and can add to the potential of this type of treatment.  This post is dedicated to those adjunctive steps.

We start with fitness programs which can help augment the power of bioidentical hormone replacement therapy.  Staying fit and doing both cardio and muscle toning work can be an effective way to balance hormone levels or at least help ensure that your bioidentical hormones can work most effectively.  You don’t have to overdo it, but rather you need to do enough to stay fit and keep your weight down.  Of course the non-hormone-related benefits of exercise will be beneficial as well and help you feel better.

Nutrition planning can be quite important as an adjunct to your bioidentical hormone replacement therapy, and your BHRT doctor may send you to a nutritionist to work out a diet that will compliment things.  She or he may also give you nutritional supplements as well.  This diet planning works well in conjunction with the fitness step listed above for an overall approach

Stress reduction will also help ensure that your bioidentical hormones work well, and may particularly ensure that stress does not reduce their effect or cause symptoms to worsen.  You may learn general stress reduction techniques, or specific ways to reduce your unique patters and triggers of stress.

 

 

Dec 162014
 

Bioidentical hormone replacement therapy can be a very effective way to re-balance hormone levels and give certain hormones a boost.  However, the doctor needs to be sure that you will respond to BHRT, and more importantly that it is actually an imbalance that is causing you problems in the first place.  People may want to rush in and start their therapy with bioidentical hormones right away, but there are very important steps that must happen first, and in this post we cover one of the more important steps in the process, the hormone level assessment.

The first step that any good doctor will perform in bioidentical hormone replacement therapy is measuring hormone levels.  It may seem like this would be an easy process, and that quite quickly an assessment could reveal exactly which bioidentical hormones would help, but it is actually quite complex in some cases to decide which natural hormones would be helpful.  Let’s take the issues involved in measuring the levels of one of the more frequent targets of bioidentical hormone replacement therapy, progesterone.  We use this particular hormone as an example, but testing for others is quite similar

Progesterone is a central hormone with many direct functions, and it also helps create an effective balance of estrogen and testosterone.  A precursor to the “stress hormone” cortisol, progesterone can be depleted if you are experiencing a lot of stress in your life.  There can also be declines for other reasons as well.  Progesterone can be measured prior to BHRT through blood levels both at the beginning of treatment and during, although some have noted that serum (blood) progesterone levels are not accurate when a person is using a bioidentical cream.  Saliva testing for Progesterone levels is not as accurate because it only measures the amount of this natural hormone that is freely available at the point in time when the test is given.  This can be helpful during treatment as a quick and easy test of how things are going, but may not be accurate enough for the initial assessment.

One drawback to saliva testing is that it may take longer for levels to come down if you have levels that are too high after bioidentical hormones are used. You need to be sure to tell your doctor about any over the counter preparations you have taken, or any relatively recent bioidentical hormone replacement therapy you have had if she or he is doing a saliva test – some of your level measured in this way may be artificially high because the progesterone that was boosted remains available in the saliva.

The same type of testing can be used for a variety of hormones, and your bioidentical hormones doctor will choose which hormone level(s) to test based on your symptoms, history, and other reports.  She or he can also do a panel that involves several of the potential targets for bioidentical hormone replacement therapy to compare and contrast.  You will also have hormone level testing throughout the course of your treatment so you know how things are progressing.  And then after your BHRT is finished you will also want to have hormone testing if your symptoms return, or just at certain intervals to ensure that you maintain the positive effects.

It may be tempting to make conclusions based solely on symptoms, family history, and your own gut feeling, but hormone level assessment can truly ensure that your bioidentical hormones doctor gets your formulas jus right from the start.  This is a valuable step in the process and one that cannot be overlooked.  It also provides a baseline so that you can know exactly how much you’ve progressed during the course of your bioidentical hormone replacement therapy.

 

Dec 142014
 

In the world of bioidentical hormones, a common question that is asked is what the difference is between estrogen and estradiol.  Some believe that estradiol is just the ingredient used in bioidentical hormone replacement therapy, and is not otherwise naturally produced.  Others think these are just two names for the same natural hormone.  But in reality, estradiol is a natural hormone that is one of the three major components of estrogen, and since it is the one that often fluctuates the most and shows the greatest signs of reduction as women age, it is also the one most frequently mentioned in BHRT assessments and treatments.

If we back up a second we find that there are several different hormones that are all different estrogens.  Bioidentical hormones may be structured to address any of these.  Here are three:

  • Estradiol is the most common type of estrogen that is assessed as part of a bioidentical hormone replacement assessment.  This hormone fluctuates during the entire menstrual cycle. During and after menopause, this hormone is lower in almost all women, and for many it can be too low requiring or at least suggesting BHRT.
  • Estriol is a type of estrogen that is mostly associated with pregnancy.  It is produced by the placenta and increases as pregnancy goes on.  This type of estrogen is not usually address with therapy, including bioidentical hormone replacement.
  • Estrone is a nother commonly measured type of estrogen and it does get lower in most women who have gone through menopause because it too (like estradiol) can provide a good picture of the overall estrogen levels.

Estrogens in general are responsible for female reproductive function and health.  Most estrogens are produced in the ovaries in premenopausal women, and also in the placenta for those who are pregnant.  After menopause, small some estrone is made outside the ovaries, and this becomes the major source of estrogen.  For bioidentical hormone replacement therapy, however, estradiol is the hormone most often measured and addressed.

Dec 072014
 

Bioidentical hormone replacement therapy is most commonly used to replace estrogen in women who have lost this hormone during the natural aging process.  But men can definitely benefit from BHRT and with the problems of low T getting more notice lately it would not be surprising to see more and more men opt for bioidentical hormones.  The appeal of using natural ingredients to address issues with low T or any other hormones imbalance in men would be the same as it is for women.  In this post I want to go over what men, in particular, should look for when looking to bioidentical hormone replacement therapy, including:

  • First you want to find a clinic or doctor that is trained and specializes in Bioidentical Hormones for Men.  This means that they can describe for you how they went above and beyond in their training and other preparation for treating men with your issue.  Just stepping into this specialty is not enough – there should be evidence of a real effort to specialize.
  • Hormone Level Assessment such as Blood, Saliva and Urine testing should be specifically tailored to understanding the correct levels for men and truly understanding the signs of imbalance.  The doctor or practitioner who you are looking for to provide your treatment should be fluent in knowing how to read things for a man’s needs.
  • The practitioner who is going to deliver bioidentical hormones for men should be able to interpret lab results, symptoms, your medical history and your family medical history in a very gender specific way, knowing exactly what each sign and symptom means for the BHRT approach.
  • Finally, the doctor or other practitioner who is going to lead the use of bioidentical hormones for men must be able to tell you what to expect along the way – how you will know if things are working and when to change ingredients or approaches.

Aside from all of this, the doctor should know what adjunctive steps you can take, such as exercise, nutrition and other steps to help with the core problem and to assist the BHRT in working optimally.  For example:

1. A bioidentical hormones doctor should be able to think outside the BHRT box and tell your what supplements and perhaps even a diet will help your treatment go further, or can produce some changes beyond the BHRT course.  A well-rounded bioidentical hormones doctor, and perhaps especially one that will focus on treating a man, should know what steps you can take as far as nutrition and diet and not just be focused on the actual bioidentical hormones.

2. In a related way, your bioidentical hormones for men practitioner should be able to give you advice about exercise and hormone levels – everything from what exercise will help to how often to do it and at what duration.  To be fair, the doctor may not know too much in this area, so at least he or she should at least be able to refer you to someone who does know.

3. The other areas where he or she should be able to give you advice are sleep and relaxation.  You should be able to get advice about your normal sleep pattern – how long you sleep and from what time to what time, and also your pattern of relaxation – when do you take breaks to relax, especially if your life is hectic or your job stressful.  These are factors that can affect your hormone levels, so the doctor should be able to help directly or at least know someone to refer you to.

If you are a man or thinking or someone you are close to and looking into BHRT, we hope you find this information and that on our Bioidentical Hormones for Men page helpful!

 

Nov 222014
 

Could bioidentical hormone replacement therapy be the perfect gift for the holidays?  That is quite possible and we want to introduce this possibility here.

Bioidentical hormones have been beneficial for many people for a variety of reasons, and as they have gained FDA approval they have also gained more acceptance.  There is an increase in bioidentical doctors with the experience you can trust, and more compounding pharmacies that have been doing this work for a long time.  So if you have a friend of relative who may be suffering with a hormone deficiency, why not consider BHRT as a potential holiday present?   Perhaps they have already tried synthetics and did not find success, or maybe they have recently had hormone testing and told you the results.  One way or another it could be a thoughtful gift.

Now of course there could be certain drawback to giving bioidentical hormone replacement therapy as a gift during the holidays.  The first, of course, is the fact that this is a hugely practical holiday gift and certainly not romantic or cute.  You’d really have to know that the person who would receive the gift of bioidentical hormones would appreciate it.  Maybe they told you that their insurance would not cover their BHRT, or that there would be a high deductible or co-insurance.  Maybe they said that they did not want to pay, or that the reason they are looking into BHRT was one that would not be covered.  One way or another, if you knew that this was an expense that they could not afford, that they do not mind practical gifts, and that it would bring them relief from symptoms, you might choose this course.

So how would you go about giving bioidentical hormones as a gift?  That depends on what you know about the person’s plans.  So, for example:

  • If they’ve already identified a bioidentical hormones doctor, you could pre-pay some amount, such as the deductible or co-insurance.  This way they can get BHRT without worrying about the out-of-pocket cost.  Between your gift and what insurance will pay for they will be all set.
  • You could more generally give a credit card gift card and say what you were thinking they could use it for.  Some gift cards are even customizable as far as what they look like.  This way if your gift falls flat and they’d rather have the money for something else they would have that flexibility.
  • You could pay for some specific aspect of bioidentical hormone replacement therapy, such as the initial hormone testing.  This might be a good choice if insurance will not pay at all for BHRT or will not pay for some aspect.
  • Finally, you could pay for something peripheral to their bioidentical hormones, such as a nice meal for when they are feeling better, or new clothing for when they feel more like going out.  This way you are supporting them without actually paying for the treatment.

Getting someone bioidentical hormone replacement therapy for the holidays is tricky, and may come across anywhere from thoughtful to intrusive.  You really need to know the person well, and know what kinds of presents they want before making this choice.  That said, for some people this may be a way to help them either afford BHRT or know that people they are close to support their treatment.  Some people do prefer more practical gifts, and this is one way to give something that will make them feel better.  Perhaps if you do not go so far as to buy the gift of natural hormone replacement you might at least be sure that during the holiday season when you spend time together you show your support and hear how your friend or relative is doing if they are pursuing this type of treatment or are considering bioidentical hormone replacement therapy.

 

 

Nov 162014
 

Many people turn to bioidentical hormone replacement therapy because they want to be able to fully understand what ingredients are being used, and they like the assurance that what is being used to replace hormones that are too low is as natural as the original hormones were.  One door that the BHRT path opens is to formulas that are uniquely created for each person – as opposed to synthetics that are mass-produced in pre-made formulas, bioidentical hormones can be custom compounded.  THis may seem like an obvious positive, but things are a little more complicated than that.

Bioidentical hormones that are custom compounded present a unique quandary for those interested in BHRT.  On the one hand, it makes complete sense that if your bioidentical hormone replacement therapy is using ingredients that are not only picked very uniquely for you and your symptoms, and then combined in doses that seem to be a good fit, you may respond even better to this course of treatment.  However, one would think that the research would back this fully, and would be very clear.  Unfortunately this is not the case, but that is not at all surprising: Research into custom compounded natural hormones is merely looking at the whole universe of custom compounding and everyone who has tried it without being able to look at the specific formulas that people were on because by definition they are all different.  In other words, any study is not looking at your custom compounded BHRT ingredients,  but rather a compilation of everyone’s.  Yours may be quite effective, even if in general the world of custom compounding brings mixed results.

So let’s say that your bioidentical hormone doctor wants to prescribe your natural hormones in a combination of doses that she or he thinks are perfect for you, or maybe he or she wants to take a formula that is usually taken by mouth and make it into a gel.  Even if the same ingredients that are in FDA approved bioidentical hormones are to be used, they will perhaps be used in different quantities or different forms so the approval does not hold up.  You will not be able to find a study that says that that formula definitely works, or that method of delivery is optimal.

All of this does not mean that you should not pursue custom compounded bioidentical hormone replacement therapy, but rather that you should be careful in your choice of a BHRT doctor and compounding pharmacy.  You should ask questions about why custom compounding is the option that is being chosen, and how much more effective this choice may be vs. the more traditional approach.  You might also want to ask whether the formula you will be on closely resembles a formula that your bioidentical hormones doctor has used before, and what the science is behind the choices as far as ingredients.  In short, when considering custom compounding three additional steps are warranted:

1. Make sure that your doctor generally has a lot of experience with this approach, and more specifically has treated people like you with your symptoms and the likely custom compounding formula that will be used.

2. Make sure that the doctor is using a trusted and well-established pharmacy that will be doing the compounding.  Ask questions about that pharmacy such as how long they’ve been in business and why the doctor chooses to use them.

3. Be even more involved during treatment, letting your doctor know how you are doing so that changes can be made as necessary – this not only takes advantage of the flexibility of custom compounding, but also makes sure that the approach works.

Custom compounding of bioidentical hormones opens up doors of possibility, but also must be approached with care and caution.

 

Nov 112014
 

Which formulas are FDA approved bioidentical hormones?  Of course that is a common question that people ask before deciding on natural hormone replacement therapy.  For many it is important to know that what they will be taking has been approved by the FDA.  If you are choosing a custom-compounded route for your BHRT you will not be taking FDA approved bioidentical hormones of course because your formula will be uniquely made.  But if you are taking a formula that is more standard you can look for FDA approved bioidentical hormones.  The following may not be an exhaustive listing but it is a good place to start, and of course the best person to ask is the BHRT doctor you have chosen.  She or he can tell you whether the choice for you includes FDA approved bioidentical hormones and what the benefits and drawbacks might be if you want to make sure that they are.

Before we get to our list we have two words of warning.  First, keep in mind that we strive to be independent and unbiased, and we are not here to promote a particular brand of formula.  So while there are some brand names here we are not qualified to say which ones work best or even that they work at all.  Second, this may not be an exhaustive listing of FDA approved bioidentical hormones and new ones may be approved all the time.  You should still ask your BHRT doctor first to make sure there have been no changes or additions to this listing.

FDA approved bioidentical hormones: Estrogen

By far the largest category of FDA approved bioidentical hormones are the estrogens.  There are not only many choices, but many different modes of use that you can find under the FDA approved label.  A sampling of what you can choose (including some that are the common medical form called estradoil)  includes:

  • Pills such as Estrace, Gynodoil, and Innofem
  • Creams that can be used topically including Estrace
  • Many different types of trasndermal pathches such as Alora, Climnara, FemPatch and others
  • Gels that go on thicker than creams including Estrogel, Elestrin, and Divigel
  • A apray called Evamist

Once again, there may be other choices and we are not promoting any of these choices specifically but rather giving you an idea of your possible options.

FDA approved bioidentical hormones: Progesterone

There is fewer FDA approved bioidentical hormones if progesterone is what you need.  This may change over time of course, but for now that main one comes in the form of pills and is called Prometrium.  You can also find a gel called Crinone.  There are also many combination formulas that contain a bioidentical estrogen and a non-bioidentical progesterone (or other hormones for that matter).  We expect that more progesterone products will achieve FDA approval at some point and when we hear of them we will list them here.  Keep in mind that you are not limited to products that have been approved, but that approval may give you some peace of mind as far as the research and background study that has gone into your chosen product.

You may want to ask your practitioner if your product is either approved, is in line to be approved, or has tried to get approval but did not meet the standards.  We hope you will share your experience with any of these products, and also let us know if you know of others that have been approved.  Of course it is also helpful to let people know how you have done with products that are not approved yet.  We will continue to provide information and advice about the entire field of BHRT, but we will specifically update this page with additional FDA approved bioidentical hormones.

Nov 012014
 

Bioidentical progesterone side effects are reasonably rare, and in many cases they can be both foreseen and avoided.  Of course the best way to explore bioidentical progesterone side effects is to look at the main three categories: Side effects, interaction effects, and contraindications.  In all cases, of course, you should discuss the potential bioidentical progesterone side effects both with your BHRT doctor and your regular primary care physician, given that you may have a specific predisposition to one of these issues.

Side Effects: The most common bioidentical progesterone side effects are sedation and lack of energy.  Synthetic progesterone has been reported to have a greater range of side effects including fluid retention, breast tenderness, mood swings, and headache.  We are not suggesting that these are not also side effects of bioidentical progesterone as well, but they have not been reported quite as much.  The one side effects that does seem to be lessened with the natural form is mood swings.  There are also some side effects of bioidentical progesterone that are not as frequently reported for synthetics, including breathing difficulties.  Also, some studies reported that one common ingredient in bioidentical progesterone, wild yam, might cause adrenal damage.

Interaction effects: You own medical history and any medications you are on need to be carefully considered before you start BHRT.  We cannot go over every interaction effect that could occur here.  In particular, however, you should ask questions about bioidentical progesterone side effects and interaction effects if you are on any type of chemical birth control.  Other possible interactions involve the kidneys, so if you have any current issues or have a positive family history in this area you should make sure your doctor knows that.

Contraindications: The most important issue for us to mention is that if you are pregnant, may become pregnant, or are nursing you should not pursue a course of BHRT with progesterone.

Aug 242014
 

Bioidentical Thyroid Hormone use provides an alternative to well-known synthetic hormones that are used in the treatment of hyper or hypo thyroid conditions, and this specific form of BHRT is different from others in that it can be used for people of any age who are seeing an unwanted change in thyroid function.  This information may be helpful for those facing thyroid issues and looking into bioidentical thyroid hormone as a possibility, but as always we cannot diagnose any condition and you would need to go to your own doctor not only for the diagnosis but also recommendations about the correct treatment course for you.

So why is Bioidentical Thyroid Hormone an emerging approach in the BHRT lineup?  It’s actually quite simple: Many doctors have achieved success in treatment of hormonal issues with this approach.  Before we delve further into Bioidentical Thyroid Hormone more deeply, let’s go over what the thyroid does and how: When functioning properly, the thyroid gland makes two hormones, T3 (Triiodothyronine) and T4 (Thyroxine).  The important detail here is that the ratio of these two hormones must be correct. T4 can be seen as a storage hormone, which itself does not do much but can be converted to T3 as necessary.  T3 is then responsible for metabolism and energy level.  Any number of things can affect these hormones, from dietary issues, exposure to certain toxins, to genetics.  (As an aside, make sure you are tested for the “free T3″ hormone available in your body – this is the hormone that can actually be used.

Bioidentical Thyroid Hormone In Practice

If you have had the proper workup and it is clear that you are deficient in T3, Bioidentical Thyroid Hormone is a solid choice.  There are several possibilities in this area, and we leave it to your BHRT doctor to decide which Bioidentical Thyroid Hormone to choose since there are many natural choices, each with different ingredients.  Many of these natural choices can do the trick is a safe and gentle way, just like other bioidentical hormone replacement therapy choices.  The Bioidentical Thyroid Hormone will contain T3 and T4 in the proper ratio, and will stimulate the thyroid to achieve balance.  This is as opposed to synthetic approaches which are usually designed to have either T3 or T4 as opposed to having both in the correct ratio.  Some have postulated that the fact that the BHRT approach has both T3 nd T4 is the reason it works so well, while others have said that it is because the thyroid responds more naturally to natural ingredients.

The most common form of Bioidentical Thyroid Hormone is a supplement taken orally, and of course, even though this BHRT approach is tested and has been used for years, there is no guarantee that you will not feel some side effects.  make sure to keep in close contact with your bioidentical hormone replacement therapy practitioner, especially at the beginning.

Conclusion

Bioidentical Thyroid Hormone is another powerful approach in the BHRT lineup, and we posted this to show an example of a need that is not necessarily related to age, and one that is quite specific and yet well-tested.  Many people have benefited from this natural treatment choice.  The biggest challenges are to make sure you get the most accurate diagnosis, and then to make choices about the specific ingredients that will go into your formula (many BHRT practitioners will have their own favorite, but many will offer a variety of choices).  Whether you have newly acquired this diagnosis, or have had it for a while and tried many things, the natural treatment approach may be something you want to try.

Natural products in the BHRT sphere have worked well for many and are made from ingredients you may have actually heard of, and Bioidentical Thyroid Hormone is no exception!

Aug 142014
 

Do bioidentical hormones cause weight gain?  This is not an east question to answer, given that there is such a variety of natural hormone approaches and conditions for which they treat.  The short answer to the question of “Do bioidentical hormones cause weight gain” is that they usually don’t, and for some people they actually cause weight loss.  But there can be a little variability, and this can get especially complicated if a little weight gain may be a good thing for someone who has lost too much weight due to hormone imbalances or depression.  For example, many males become less active due to a gradual decline in testosterone, and thus when they take bioidentical testosterone they may experience more energy and a higher metabolism, thereby causing them to lose some excess weight.

We are still left with the question do bioidentical hormones cause weight gain, and even if this is rare, it can happen.  Any time we introduce a change to our system the result can be a change in our appetite or metabolism.  In this case it is possible that a side effect of BHRT is a change in either one that causes weight gain.  But again, as with the example above, it may actually be a positive change that makes you less depressed, less lethargic, and more interested in daily activities that makes you more likely to get out more, go to restaurants with friends,  enjoy your meals, move around so that your body craves calories, etc.  In other words, the real answer to do bioidentical hormones cause weight gain in many cases is that they do because they make changes that make you want to live more fully.

We cannot guarantee that you will lose weight or stay the same if you try BHRT, but we can say that adding pounds is not a common effect and in many cases where it does happen its not because the BHRT does anything problematic, but because the weight gain is positive or the result of other positive changes.  You need to talk to your doctor and BHRT practitioner about this and get a prediction of how bioidentical hormone replacement therapy might affect your weight, but keep in mind that for most people the answer is either “no” or “only for good reasons” to the question do bioidentical hormones cause weight gain?