FREQUENTLY ASKED QUESTIONS

What are bio-identical hormones?
Are measuring hormone levels important?
I don't feel good but my doctor says my lab tests are all normal?
At what age are our hormones most active?
If hormones levels naturally drop as we age, why should we try to raise them?
What other hormones besides estrogen change and cause symptoms as we get older?
How come more doctors aren't prescribing bio-identical hormones?
Can a woman with breast cancer use bio-identical estrogen hormones?
How does a person get bio-identical hormones?
What are compounding pharmacists?
Are bio-identical hormones more expensive than regular hormones?
Are there advantages to the different types of hormone deliveries?
What books do you recommend on bio-identical hormones?
Do men need hormone treatment, too?

1. What are bio-identical hormones?
Bio-identical hormones have exactly the same chemical structures as the hormones we naturally make in our bodies. They are mainly derived from plants and can also be synthesized in a production lab. Specialized pharmacists, called compounding pharmacists formulate hormone doses to match each woman's individual needs. In this way, lower amounts of hormones can be used and fewer side effects occur.
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2. Are measuring hormone levels important?
Symptoms of having way too much or too little amounts of hormones can usually be determined just by the symptoms you are having. Many times, however, abnormal levels may not be so obvious. Measuring your hormone levels is a more helpful way of deciding replacement amounts. These laboratory measurements enable us to correct your hormones faster and more accurately.
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3. I don't feel good but my doctor says my lab tests are all normal?
When reviewing your lab test results, you need to first understand how the "normal reference ranges" were determined. Large groups of individuals who did not have any signs or symptoms of hormone abnormalities were tested. Their results established the normal ranges. Doctors determine abnormalities of hormone function by lab results that lie outside of this normal range. The problem with interpreting hormone levels this way is that your own individual result can fall in the normal range for the population but yet may be low for you. You don't have to fall outside the normal reference range to experience symptoms.

In fact, some lab results combine both men and women into the same normal reference group. This decreases its accuracy. Some hormones are normally higher in men than in women. For example, women's normal thyroid levels generally run higher than men's. If a woman's thyroid level is compared against a man's normal level, she may still feel the symptoms of a low thyroid.

For some tests, all ages are mixed in - ranging from 18 to 80 years of age.

Studies prove that younger individuals normally have higher hormone levels than "normal" older people. Most hormones start to decline after age forty. This means that as you get older, the amounts of your hormones naturally drop. You may feel symptoms of decreasing hormone levels yet your lab level is still in the "normal reference range."

Unfortunately, many doctors are not aware of these laboratory differences and so make their diagnosis based on the lab's "normal reference range".
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4. At what age are our hormones most active?
Experts claim that hormones are most active at age 23, after which there is a gradual decline. Since hormones are powerful body regulators, the natural decline of their levels as we age will affect how energetic and healthy we feel. Studies sponsored by the National Institute of Aging show that the decline of hormone levels occurring with aging directly correlate with increases in heart disease, heart attacks, strokes, high blood pressure, diabetes, obesity, Alzheimer's, cancer and other age-related disorders.
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5. If hormones levels naturally drop as we age, why should we try to raise them?
Studies on aging sponsored by the National Institutes of Health show that the decline of hormone levels occurring with aging directly correlate with increases in heart disease, heart attacks, strokes, high blood pressure, diabetes, obesity, Alzheimer's, cancer and other age-related disorders.

If you set your primary health goals towards preventing diseases rather than treating them after you get them, it makes more sense to make earlier, simpler and less inexpensive hormone adjustments as your first line of defense.

Replacing deficient hormones to levels of those of a younger, healthier population is an effective and economical way to prevent or slow down the diseases of aging. Using the normal hormone ranges of men and women between the ages of 23 to 33 as our "optimal reference ranges" have been the best guides towards combating age-related diseases and achieving optimal health.
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6. What other hormones besides estrogen change and cause symptoms as we get older?
The main ones include thyroid, progesterone, testosterone, DHEA and insulin. All of these affect your energy, mood, sleep, coping ability, brain function, metabolism and body weight.
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7. How come more doctors aren't prescribing bio-identical hormones?
Most doctors are not aware of how hormones change with aging or how hormones can improve and even prevent many diseases of aging. Bio-identical hormone therapy is a relatively new treatment in the United States. It has been studied extensively and used in Europe for at least thirty years. By contrast, American physicians have only been learning how to use them for the past ten to fifteen years. This lag is most likely due to that fact that American medicine is focused on how to treat diseases with drugs while European medicine is more preventative. The evidence is clear that pharmaceutical companies completely influence the way most American physicians treat patients.

The first U.S. prescribed estrogen, Premarin®, became available back in the 1950's. Premarin® comes from pregnant horses' urine and contains over 13 different types of horse estrogens. Women biologically make only three types of estrogen. With the lack of anything better, Premarin® was acceptable at the time. As technology advanced, so did our ability to develop bio-identical forms of estrogen. Despite newer, purer forms of estrogens, Premarin® still remains the number one brand prescribed to American women today.

There are many reasons why pharmaceutical companies have such a hold on the American medical establishment. Sadly, the main reasons are financial ones.

Pharmaceutical companies play the biggest role in what medications are promoted to doctors in the U.S. Regrettably, it is a simple matter of money. Drug companies do not promote bio-identical hormones because they cannot patent them. With no angle to profit from them, pharmaceutical companies compete by dissuading physicians from using bio-identical hormones.

Secondly, do not underestimate the political supremacy of the pharmaceutical industry. According to a July 7, 2005 news report, "the pharmaceutical and health products industry has spent more than $800 million in federal lobbying and campaign donations at the federal and state levels in the past seven years, a Center for Public Integrity investigation has found. Its lobbying operation, on which it reports spending more than $675 million, is the biggest in the nation. No other industry has spent more money to sway public policy in that period. Its combined political outlays on lobbying and campaign contributions are topped only by the insurance industry."
http://www.publicintegrity.org/rx/report.aspx?aid=723
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8. Can a woman with breast cancer use bio-identical estrogen hormones?
Bio-identical estrogens are real hormones and so the benefits and risks must still be weighed in your decision-making. In the past, most doctors have strongly discouraged women with a history of breast cancer from using any kind of preparations containing estrogen. As we learn more about how breast cancer behaves, hormone treatment options for many of these women are now changing. Many oncologists now feel comfortable in allowing women with who are five years out from their diagnosis and treatment to take low doses of estrogen for their menopausal symptoms. Every woman's case is individual. It is best to get several medical opinions about whether you should or should not take hormones if you have had treated breast cancer.
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9. How does a person get bio-identical hormones?
Bio-identical hormones need to be prescribed by a physician trained in using them. Your prescription is prepared by a compounding pharmacists.
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10. What are compounding pharmacists?
Compounding pharmacists are specially trained and certified pharmacists who are qualified to mix medications and hormone formulas according to your physician's prescription. They have the advantage over standard pharmacists in that they can prepare treatments specifically designed for you.
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11. Are bio-identical hormones more expensive than regular hormones?
No, in fact they are less expensive. Since patent, marketing and mass manufacturing costs are not needed, the compounded bio-identical hormone prescriptions cost much less to produce. This transfers to huge savings to you.
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12. Are there advantages to the different types of hormone deliveries?
Yes. Compounded hormones can be prepared as creams, pills, patches, drops or lozenges. The dosing, side effects, duration of effects and personal convenience are all things to consider.
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13. What books do you recommend on bio-identical hormones?
From Hormone Hell to Hormone Well, Discover Human-Identical Hormones as a Safe & Effective Treatment for PMS, Perimenopause, Menopause or Hysterectomy by C.W. Randolph, M.D.

Natural Hormone Balance for Women : Look Younger, Feel Stronger, and Live Life with Exuberance by Uzzi Reiss, M.D./Ob-Gyn,

Perfect Balance : Dr. Robert Greene's Breakthrough Program for Finding the Lifelong Hormonal Health You Deserve by Robert A. Greene, M.D.

Hormones, Health, and Happiness by Steven F. Hotze, M.D.

The Sexy Years: Discover the Hormone Connection--The Secret to Fabulous Sex, Great Health, and Vitality, for Women and Men by Suzanne Somers

FOR MEN:
The Testosterone Syndrome by Eugene Shippen, M.D.
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14. Do men need hormone treatment, too?
Yes, men also experience drops in hormones as they age past forty. This is especially true with testosterone. Stress also lowers testosterone. A lowered testosterone level leads to male menopause called "andropause." The main symptoms of andropause include: fatigue, loss of ambition, grouchiness, decreased mental sharpness, insomnia, loss of sense of humor, lowered sex drive or performance ability and less ability to cope with stress. So often diagnosed treated as depression, men significantly benefit from just hormone replacement rather than taking antidepressants. The absolute best book ever written on andropause is The Testosterone Syndrome, Reversing the Male Menopause by testosterone expert Eugene Shippen, M.D.
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