31 Aug Compounding hormones: The whys behind
A brief history of compounding hormones
As far back as 2000 years ago, Chinese alchemists were extracting human urine precipitate, mixing it with herbs and spices, and prescribing it to the wealthy interested in life longevity. This was the first time compounding hormones were introduced. Because it was considered rich in sex hormones urine from healthy teenagers was of a special value.
In 1940, FDA approved Hormone Replacement Therapy (HRT) for treatment of menopausal symptoms. This was an beginning of hormone replacement therapy and compounding hormones started to be common practice. Just after FDA approval, numerous clinical studies were conducted both supporting and opposing this treatment approach.
With bioidentical hormone replacement therapy, BHRT, as an option, things have rapidly changed and many women suffering from age transition symptoms have found relief and improved quality of life.
What does bioidentical hormone therapy mean?
A common misconception is that bio-identical are natural hormones, whereas regular synthesized hormones are not. However, both are isolated from natural sources, bio-identical from plants (wild yam and soya), regular hormone replacement from pregnant mares’ urine.
Very important difference comes with the word bio-identical which means life-identical, chemically identical or exactly the same as human hormones: progesterone, estrogen. What this infers to is that they bind the receptors with the exact same capacity as human hormones and our body recognizes them as our own.
On the other hand, the synthesized hormones are usually pro-drugs, which means they would metabolize in liver in order to become active. As a result of this the possibility for drug-drug, drug-food interactions may increase and therefore the incidence for side effects and safety concerns.
What are the hormonal imbalance symptoms?
There are many symptoms with the root cause of hormonal imbalances. Even if seems it is not related at all, many times by addressing the hormonal status, our patients experience great improvement in their symptoms, and overall health and wellness. Some of the symptoms that we should look into are:
Andropause (male menopause)
Blue moods – mood shifts
Early or difficult menopause
General body weakness
Hair thinning or loss
Hot flashes or night sweats
Lack of energy, fatigue
Lack of sexual desire
PMS difficulties and menstrual related symptoms
Reduced muscle mass
Symptoms might be a cause of the hormonal imbalance of one particular hormone, or more of them. However, usually the hormones work in very tight correlation one to another and it can be complicated to define very fine line between this correlations.
Some of the hormones are considered master hormones and they are first one to consider when looking into specific case scenario. We will describe some of the most important, master hormones.
Compounding hormones – Progesterone:
Basic role of the progesterone is a reproductive function in females. However, progesterone is much more than this since it regulates number of biological processes in many other tissues, in particular nervous system. Many studies indicate that progesterone has a positive effect on nerve regeneration, repairing the brain damage as well as myelin repair.
If used orally, for optimal absorption and therapeutic effect we use micronized progesterone.
Symptoms of high progesterone:
Symptoms of low progesterone
Inability to concentrate
Compounding hormones – Estrogen:
The estrogens are mainly perceived as female sex hormones, however, considering theirs wide role in the physiology they also have important function in male health and therefore cannot be solely seen as females.
Estrogens has a function in cellular growth of tissues related to reproduction.
In addition to this, estrogens play a significant role in regulation of bone homeostasis, lipid and sugar metabolism, skin aging, cardiovascular and central nervous system. Estrogens regulatory function and signaling expand far beyond reproductive system and it is a main anti-aging hormone.
Symptoms of high estrogen:
Craving for sweets
Heavy or irregular menses
Loss of sex drive
Symptoms of low estrogen:
Hot flashes, night sweats
Shortness of breath, heart palpitations
Dry skin, wrinkles
Memory loss, mood swings
Vaginal shrinkage, painful intercourse
Vaginal dryness, inability to reach orgasm
Lack of menstruation
Compounding hormones – Testosterone:
Testosterone, as main androgen hormone, has many physiological functions in men and women. It stimulates reproductive and sexual organs, libido, muscle growth, bone development, the production of red blood cells, brain cells, fat tissue.
Low Testosterone symptoms
Deceased sexual desire
Fatigue, decreased energy and motivation
Increase fat mass
Decreased muscle mass
Reduced insulin sensitivity
Impaired glucose tolerance
Elevated triglycerides and cholesterol
Compounding hormones – Thyroid hormone
Thyroid gland, small, butterfly shaped gland located in the font of the neck produces thyroid hormone.
There are several hormonal cascades involved in regulating thyroid gland, including iodine uptake, synthesis and secretion. Thyroid hormone is essential for normal development, growth, neural differentiation, and metabolic regulation. Thyroid hormones regulate the activities of almost every cell in the body, including body sensitivity to other hormones, especially estrogen and cortisol. One of the function is that it regulates how quickly we burn calories, therefore ruling our metabolism rate mood, as well as energy level.
There is also a big connection between depression and low thyroid levels. Scientists even said that hypothyroid brain looks like depressed brain in anatomy and physiology.
Unfortunately, thyroid issues are often missed or undiagnosed. The reason for this is mostly because the reference range and the national guidelines are mandating laboratory numbers only and in addition limited number or lab tests. There is also a misconception that low thyroid is normal part of aging.
If patient is hypothyroid, he is no making sufficient supply of thyroid hormones, T3 or T4, and he usually produces too much of TSH.
Low thyroid hormone symptoms
Hair loss, thin, brittle nails
Fatigue, brain fog, difficulty in concentrating
Mood changes, depression
There are several different options to consider when treating low thyroid hormonal imbalance. Some of these products would need to be dosage precisely in a very specific ratio, therefore they need to be customized with experienced compounding pharmacist. T3/T4 combinations capsules are defined by doctor prescription who has experience in treating thyroid conditions and carefully crafted with your compounding pharmacy.
Why compounding hormones might be a solution for you?
Everyone differs in the doses of medications required, in particular with delicate chemicals such as hormones. By compounding hormones, we tailor every preparation to patient’s specific needs. This is accomplished by having an individual approach to patient’s symptoms, exact hormonal status as a diagnostic parameter obtained by particular testing, comfort with the route of administration, sensitivity, allergy diversity and much more. The logic behind compounding hormones is to balance the hormonal status, restore what is depleted and not to overload on what is already abundant.
In addition, the hormones absorption is very good through skin, and administering them as a cream with a precise dose may be a better solution. Other options are available (e.g. troches, suppositories, injections) depending on patient unique medical needs.
One thing is certain, with compounding these preparations we make the most customized approach possible, and with the knowledgeable health professionals, the path to balanced and healthy life may be much easier to follow.