Important Health & Medical Information in Dee Why

Topics:

Menopause

Female menopause is the time in a woman's life when the ovaries cease to produce an egg cell every four weeks; therefore, menstruation ceases, and the woman is no longer able to become pregnant. Menopause is diagnosed after 12 months without a period.

Forms of Menopause:

Late menopause occurs when menopause happens beyond the age of 55.

Perimenopause is the five to ten-year period prior to menopause. The hormonal changes associated with menopause can actually commence then. Some menopausal symptoms may occur during this period, even though the woman is still menstruating.

Premature menopause occurs before the age of 40. Approximately 5% of women experience premature menopause.

Symptoms of menopause may include:

Research is showing the importance of maintaining a balance between progesterone and oestrogen for overall health and well-being. Hormones can be measured via a blood test or a saliva test. If there is a lack of either hormone or an excess of either hormone, the following symptoms may occur:

LACK OF PROGESTERONE

LACK OF OESTROGEN

EXCESS PROGESTERONE

EXCESS OESTROGEN

Dosage Forms

Hormone Replacement Therapy (HRT) can be different for each individual. There are many different types of HRT. However, the way it is administered can make all the difference to the individual. There are many dosage forms available, especially for those who have difficulty swallowing medicine.



Some may have allergies or sensitivities to certain preservatives, dyes or fillers. Others cannot tolerate the taste. Often, medication is prescribed in an alternate dosage form, such as troche, lozenge, suppository, pessary or cream, to allow the medication to enter the bloodstream directly. Avoiding the first pass of stomach entry can mean that the drug does not get destroyed by stomach juices.

Examples of dosage forms:-

Bio-identical HRT 

What are biologically identical hormones?

Biologically identical hormones or bio-identical hormones are derived from plants, such as the wild yam or soybean plant. The wild yam is rich in precursor molecules that can be converted into oestrogens and other hormones, and its molecular structure is the same as that produced naturally in the human body.

Oestrogen is not one hormone but a group of three hormones: oestrone (E1), oestradiol (E2) and oestriol (E3), which are natural human hormones. A high ratio of oestriol to other oestrogens has been associated with a lower risk of breast cancer. Premarin®, a drug commonly used in oestrogen replacement therapy, is derived from pregnant mare urine. Because horse oestrogen is foreign to the human body, people may lack the enzymes and cofactors to metabolise it safely.



Progesterone may be needed to balance the effects of oestrogen on the uterus as well as the rest of the body, and it may also help build bone. Natural progesterone might be safer than synthetic progestins (like Provera®), which may have a negative effect on the cardiovascular system. Likewise, natural testosterone (typically thought of as a male hormone but also produced in the ovaries) may be safer than synthetic methyl-testosterone for treating problems with libido.

Synthetic vs Bio-Identical Hormones 

Bio-identical hormones are the exact copies of those that naturally occur in the human body.

Synthetic hormones are not found in the human body and are not identical in structure or function to the hormones they are intended to replace. Bio-identical hormones are derived from a plant molecule found in soybeans and wild yams. Bio-identical hormones are said to be natural bio-identical hormones, not because of their source but because their chemical structure is the same as that of the hormones our bodies produce. The plant molecule (diosgenin) is taken to a laboratory to be converted into progesterone. Progesterone can then be converted into the three oestrogen hormones, oestrone, oestradiol and oestriol and then also converted into testosterone, cortisol, DHEA and pregnenolone.

Supplementing the body with hormone molecules that are identical to those we produce allows our body to benefit identically, the same way as it would when the body produces them. The bio-identical hormones are recognised by the body and bind quickly to receptors, causing the appropriate effect. They are then broken down quickly and metabolised so they may be excreted from the body. Bio-identical hormone replacement therapy (BHRT) can, therefore, be used effectively and safely.



Can just anyone take hormones?

No, not every patient can take all hormones (synthetic or bioidentical), for example, estrogen.

Relative contraindications to oestrogen therapy include:

Absolute contraindications to oestrogen therapy include: 

Contraindications to progesterone therapy include:

If already on synthetic HRT, how difficult is it to switch to biologically identical hormones?

In most cases, the transition is a smooth one.

Hormone Testing

The family of steroid hormones support a wide range of essential physiological functions, such as blood lipid balance, bone mineral density, fertility, sexuality, a general sense of well-being and certain aspects of brain functioning.

Adequate levels and an appropriate balance of steroid hormones are necessary for well-being and optimal health. This applies to both men and women. Hormones can be tested via a saliva test or a blood test. Doctors have their own preferences for one or the other.

The saliva test measures levels of specific hormones that are produced in the body and consumed as foods, dietary supplements or medications. Saliva yields a direct measure of "free hormone" level and is comparable to that measured by blood.

Testing provides a means to establish whether or not your hormone levels are within the expected normal range. It is appropriate to monitor and titrate doses to minimise side effects and risks without compromising the benefits of replacement therapy.

Hormones tested:

Quality Standards

Dee Why Health Care Pharmacy is an experienced and comprehensive compounding facility. Our specialised training, high-tech equipment & state-of-the-art technology allow us to provide "quality" tailor-made medications to suit individual needs.

We only invest in the highest quality ingredients, which must meet the highest quality standards for USP and BP grades.



Professional quality care advice is what to expect from our team. Quality care and customer service are our mission and our passion.

Andropause 

Andropause is the result of low testosterone and a natural part of male ageing due to a decline in testicular function. Andropause (or the "male menopause") is the counterpart to the female menopause.

Testosterone levels in men remain relatively constant until about the age of 50, at which time they begin to fall slowly. However, the decline in male hormone production is much more gradual than the decline in female hormone production.

Symptoms of andropause include a decrease in libido & erectile dysfunction, decreased energy and strength, increase in body fat, loss of muscle mass, enlargement of the prostate, osteoporosis, depression, inability to concentrate, loss of enthusiasm and reduced mental agility.

Research studies have directly linked depression in elderly men with low levels of testosterone. Results found men with the lowest levels of testosterone were three times more likely to suffer depression than those with the highest levels. These results were independent of a man's health, and this is significant because poor health is known to increase the risk of depression.

Men with low testosterone (hypogonadism) are given testosterone replacement therapy for a variety of reasons. It may enhance libido, decrease heart disease risk, increase lean body mass and prevent osteoporosis. Testosterone may also lower total cholesterol and LDL and decrease insulin resistance.

As men age, the balance between testosterone and oestradiol changes, tilting towards more oestradiol production. The pituitary hormone responsible for stimulating testosterone is LH (luteinising hormone). 

Excess oestradiol may decrease the level of LH and, therefore, the level of testosterone.

It is surprising to learn that the average 60-year-old male has more circulating oestrogen in his bloodstream than the average 60-year-old female.

The conversion of testosterone to oestradiol takes place under the influence of the enzyme aromatase. Testosterone and androstenedione are both "aromatisable " to oestradiol.

In many cases, levels of oestrogen are found to be elevated. If this happens, it is possible to block aromatase activity, so the chances that the testosterone given will be converted to even more oestrogen may be reduced.



Currently, there are several aromatase inhibitors on the market for prescription use as treatments for breast cancer. These aromatase inhibitors might block the conversion of testosterone to oestrogen in men as well. There is also a natural aromatase inhibitor called chrysin.

Veterinary Compounding

We can assist pets with their medication administration requirements.

Flavouring medication can assist, especially when "difficult to administer" medication is required.

The advantage of compounding for animals is the ability to change the strength of the medication and the mode of administration. This includes chewable products, transdermal products, solutions, etc.



Commercially discontinued medication can often be compounded.

Paediatric Formulations

Sometimes, it can be a challenge to give medication to children. Convincing a child to take his or her medicine can be a difficult task.

Commercially available medication can sometimes present problems when it comes to allergies or drug intolerance, or even dose strengths or dose forms may not suit their smaller body size and weight.

Many children have difficulty swallowing capsules or tablets. Standard commercial medications are often only available in dosages too high for a child. Children vary in size and weight, so the dose required to treat them also varies. 

Compounding can help solve these problems. By working closely with your child's paediatrician, we can assist in formulating the medicine that will meet the unique needs of your child.   

We can flavour lozenges or liquid medications to make them easier for children to take. This is important with medications that need to be taken for an extended period of time.

Many children cannot tolerate commercially available medications because they often contain preservatives, dyes, alcohol and sugar. We can formulate a medication that is free from all these allergens to suit your child's needs.



Pain Management 

Pain is the most common reason why patients seek medical help.

Pain can be classified as neuropathic pain (pressure or injury to nerve cells) or nociceptive pain (activation of normal pain fibres), acute or chronic pain, incident (upon activity such as movement, coughing) or breakthrough pain (pain occurring between regular doses of pain medication).

Compounding for pain management is a whole new approach to treatment. Compounding can offer solutions to the limitations of commercial pain medications such as unique dosage forms, unavailable medications, allergies, bad tasting or intolerable medication.

Often, commercial pain medication presents many side effects as it enters the body via the gastric area, causing irritation and other serious side effects.

Topical creams/lotions/gels offer the advantage of delivering the 'active ingredient' to the site of application. Transdermal preparations, when applied to the site of action, actually go through the skin and directly enter the bloodstream. This avoids the "first pass effect", which is the liver metabolism. This in itself eliminates or drastically reduces the potential for drug interactions. We can apply a lower level of 'active ingredient' as we do not need to survive gastric juice metabolism, rate of gastric emptying or motility, and also use known classic, effective ingredients transdermally without the risk of serious side effects.

Oral dosage forms such as capsules, lozenges, and flavoured oral suspensions can be more palatable; capsules can also be modified to make them slow-release capsules that stay in the body longer.

Rectal preparations, such as suppositories, are ideal for patients unable to take medication orally (i.e. nausea, vomiting, difficulty swallowing, obstruction, altered consciousness).

Nasal preparations such as sprays can deliver medication intranasally. This alternative route of administration has advantages in terms of rapid onset of action.

Some of the most commonly prescribed ingredients include ketoprofen, lignocaine, amitriptyline, baclofen, capsaicin, tetracaine, benzocaine and gabapentin.

Sleep Hormone 

Melatonin is a naturally occurring hormone produced in the pineal gland. Melatonin helps to regulate our circadian rhythm (body clock), which dictates our sleep and wake cycles. Melatonin plays a critical role in helping us to fall asleep and stay asleep through the night. 

Melatonin secretion increases soon after the onset of darkness. Melatonin peaks in the middle of the night (between 2 am and 4 am) and gradually falls during the second half of the night. Serum levels of melatonin are known to decrease with age, which may contribute to the increased frequency of sleep disorders in the elderly and the aging process itself.



Thyroid Hormone Replacement

Replacement and maintaining your natural balance.

More than half of all Australians affected by thyroid disease are unaware of their condition. Thyroid disease may not be picked up or diagnosed for many years. Women are more affected than men, probably due to women requiring higher levels of thyroid hormone than men.



Thyroid hormone (TH) is produced by the thyroid gland in response to the release of thyroid-stimulating hormone (TSH) from the pituitary gland. TH helps the body convert food into energy and heat, regulates body temperature, and impacts many other hormone systems in the body.

Symptoms of hypothyroidism may include:

During periods of stress, an inactive form of T3 can be formed, called Reverse T3 (Rt3). Under normal conditions, T4 converts to both T3 and rT3 continually, and the body eliminates rT3 quickly. However, sometimes, under certain conditions, more rT3 is produced, and the desired conversion of T4 to T3 decreases. This occurs during periods of fasting, starvation, illness (e.g. liver disease) and particularly during times of increased stress.

T3 is the most potent of the thyroid hormones. Approximately 85% of circulating T3 is produced by monodeiodination of thyroxine (T4) in tissues such as the liver, muscles and kidneys. Selenium and zinc are required for this monodeiodination.

An increased production of rT3 is often seen in patients with metabolic disorders. Measurement of rT3 is, therefore, valuable in identifying thyroid disorders.

During later stages, after declining thyroid hormones then, your adrenals would also have been affected. This makes fatigue symptoms even worse, and so your body attempts to compensate by up-regulating your nervous system. At this later stage, anxiety gets worse, insomnia, inability to relax, nervousness and a mind that races and sometimes breathlessness, palpitations and even tremors can occur. Thyroid production, as with other hormones, tends to decrease with age.

Reverse T3 dominance, functional hypothyroidism, also known as Wilson's Syndrome, is a condition that reflects most hypothyroid symptoms even though blood levels of T3 and T4 are within normal test limits. This is a condition when T4 metabolism produces an excess of reverse T3 in relation to T3. Therefore, this is a problem with T4 activation rather than a lack of thyroid production.

Reverse T3 has the same molecular structure as T3; however, this means that it can bind to the receptor, preventing T3 from binding to the receptor and activating the appropriate response.

Other factors that adversely affect the conversion of T4 into T3 include nutritional deficiencies such as selenium, zinc, iodine, VitB6, B12 and E, antibody reactions, insulin resistance and toxicities such as heavy metals and environmental toxins.

Thyroid function can also be estimated by measuring your underarm body temperature each morning before getting out of bed. If your underarm temperature is consistently subnormal (below 36.5 C) for three days or more, your thyroid function may be low.

However, do not forget that adrenal function also influences your metabolic rate and, therefore, body temperature. This means adrenal function must also be considered if you have a low body temperature.

An Integrative approach should be taken when diagnosing hypothyroidism, making use of all the diagnostic tools as well as using signs and symptoms of low thyroid function.

If doctors rely totally on the TSH test without considering signs and symptoms, which has become common practice, then many patients with a sluggish thyroid go undetected and are therefore not treated appropriately.

If the thyroid is underactive, then usually the adrenal glands get overworked and run down while trying to compensate for the low thyroid hormone levels, resulting in adrenal exhaustion.

If you tend to be jittery on thyroid medication or if you are generally more alert at night, have rapid mood swings, have sugar or salt cravings, feel tired all the time, have dark circles under your eyes and are easily stressed, then your adrenal glands may also need help.

Your adrenal function can be determined by measuring DHEA and cortisol levels. If it is too underactive, it may also require treatment.

In mild to moderate cases, certain nutrients may be used to either improve thyroid hormone production or to improve the conversion of T4 into active T3. Test results would determine which would be more suitable.

Moderate to severe cases may be treated with appropriate compounded bioidentical thyroid hormone combinations or thyroid gland extract.

We also strongly recommend adrenal support, if tests indicate the need, along with nutritional support. Many thyroid patients we see also have adrenal problems, and both need to be addressed for a full recovery.

If the autoimmune system is involved, then certain steps should be taken in an attempt to control it. Conditions such as Hashimoto's disease and Graves disease may benefit from removing any foods that cause food allergies or intolerance reactions, such as gluten, dairy and yeasts. Heavy metals must be removed, and any digestive or leaky gut issues need to be treated. Adrenal, thyroid and sex hormones need to be appropriately balanced along with the use of certain supplements.

Compounded thyroid replacement allows for the avoidance of fillers such as lactose, which inhibit thyroid absorption. These are still used in many other poorly formulated commercially available products.

In addition, compounded thyroid medication can also provide T3 and T4 combination capsules in physiological ratios that are tailor-made to suit your individual requirements.