Compounded Bioidentical Hormones

What Are “Bioidentical” Hormones?

Although they are generally created in a laboratory, bioidentical hormones are chemically identical to the hormones naturally produced by the human body. In deciding which hormone therapy to prescribe to their patients, a practitioner evaluates each individu­al’s hormone levels and takes into consideration the inter­actions among the different hormones, as well as other po­tential effects of each hormone throughout the body.

Dr. Kent Holtorf asserts when making choices about hormone therapies, “current evidence demonstrates that bioidentical hormones are associated with lower risks than their non-bioidentical counterparts.”

Bioidentical hormones are available from pharmaceutical manufacturers or compound­ing pharmacies. Manufactured bioidentical hormones are only available in limited dosing strengths and formulations. On the other hand, compound­ed bioidentical hormones may be prepared in indi­vidualized dosages or strengths, and several different formulations.

Why Compound?

Pharmacy compounding is a precise and careful process in which medications are prepared for an individual patient based on a practitioner’s prescription. Ingredients are combined to produce the exact strength and dosage form required to meet a patient’s specific needs. Practitioners have more options in treating their patients when prescribing compounded medications, especially when it comes to the individual needs of premature infants, babies, children, and the elderly.

Dr. David Brownstein is an advocate of compound­ed prescriptions, pointing out in a special report in Integrative Medicine that patients need individual­ized doses of hormones. “Pharmaceutical compa­nies want us to believe that everybody needs the same dose of all medications,” he writes. “In truth, everyone has a unique biochemical thumbprint; we don’t all need the same dose of phar­maceuticals, vitamins, or even the same amounts of nutrients in foods.”

Benefits of Working with a Compounding Pharmacy

• Practitioners can prescribe medication specific to their patient’s individual needs, decreasing the likelihood of the patient experiencing side effects.
• Prescriptions are more flexible: they’re not limited to the commercially available dosages, strengths, and forms. Practitioners can fine-tune or modify the prescription as the patient’s individual needs change. Dosage forms may be tailored to accommodate individual preferences and absorption abilities.
• Compounded prescriptions may be customized to different formulations that may be more efficient or easier to administer. (For example, if a patient has difficulty swallowing pills, the pharmacist may be able to formulate the medication as a cream or gel instead.)
• Multiple prescriptions may be combined into a single dosage form for convenience and to better ensure ease of use. In cBHRT, this includes combining multiple hormones into one dosage form.
• Preservative-free or allergen-free prescriptions can be compounded for patients with chemical sensitivities.
• Flavoring may be added to make drops and lozenges more palatable.

The Many Uses of Compounded Medications

Compounded medications are essential to the well-being of many individuals and are used in many facets of healthcare, such as pediatrics, geriatrics, internal medicine, obstetrics and gynecology, and endocrinology. Compounding is also helpful to the veterinary profession, as many more species and sizes of animals may be treated with individually tailored medications (learn more at www.pethealthrx.net). In each of these specialties, practitioners can address specific needs with individualized dosage forms, dosage strengths, flavors, routes of administration, or combinations of medications.

Thanks to compounding, hormone therapies may be prescribed to suit a patient’s individual hormone needs. Compounding pharmacists compound medications, as prescribed by a medical practitioner, into specific dos­age forms such as:

• Capsules
• Creams
• Gels
• Lozenges
• Tab­lets
• Suppositories

Compounding and Quality

The science of pharmacy originated in the practice of compounding. In the twentieth century, however, mass-produced drugs began to take precedence because these medications could be manufactured more efficiently and their contents more easily regulated. However, mass-produced drugs are sometimes unable to address patients’ needs on an individual basis, as many are available in limited dosage forms and strengths.

During the 1980s and 1990s, the importance of personalized medicine gained renewed recognition. As a result, the number of compounded prescriptions began increasing and instigated a renaissance in compounding pharmacy. Today, the demand for compounded medications makes compounding a rapidly-growing component of phar­macy practice as a whole.

In the pharmacy industry, compounding pharmacists are regulated by their state boards of pharmacy. Standards are set by the U.S. Pharmacopeia (USP) and National Formulary for qual­ity assurance. The Food and Drug Administration (FDA) also has jurisdiction over ensuring the quality of the ingredients involved in compounding.