What are Bio-Identical Hormone Pellets?
We have consolidated some useful information in an effort to help you better understand Bio-identical Hormone Therapy (BHT). While bio-identical hormones have been approved and available for use in the US since the 1930s, the use of bio-identical hormones have been slow to increase despite general agreement in the scientific literature that bio-identical hormone replacement is far better than using non-human hormones. The technology now exists that allows us to place time-release pellets of approved human hormones in the fat under our skin to deliver more youthful hormone levels directly into the bloodstream. While we are quick to admit that this therapy is not a “fountain of youth”, we are very confident that it can dramatically improve many people’s quality of life and health in measurable ways based upon hundreds of recent scientific studies.
It is vitally important that you continue to see your regular medical doctor for your usual health care, tests, and routine health maintenance. We are not replacing your medical doctor. If you don’t have a medical doctor, we will be happy to see you.
If you would like more information, or if you would like to schedule a consultation, please contact us today at (864) 603-6995.
What exactly are hormones?
Hormones are the body’s chemical messengers, secreted into the bloodstream and/or used locally, that affect cellular functioning. A hormone affects only specific cells called target cells that have unique receptors for that hormone. Think of it as a lock and key. Cells which do not have the specific receptor for a certain hormone cannot be influenced directly by that hormone. Some cells go even further, and regulate their own internal production of a needed hormone. For example: Estrogen is made inside every cell that utilize Estrogen (brain, bone, heart, etc.) from Testosterone through a process called “aromatization”.
What is meant by bio-identical, and why is non-bio-identical “bad”?
Bio-identical hormones have the exact same molecular structure as hormones that are made by the human body. The difference between the “identical human” (or bio-identical) hormone versus synthetic non-bio-identical is in the molecular structure (shape) of the hormone. In order for a replacement hormone to fully replicate the exact functions of a hormone which we naturally produce, the chemical structure must exactly match the natural, original molecule. It is the structural differences that exist between human bio-identical and non-bio-identical hormones that are responsible for many of the side effects and health risks that occur when non bio-identical hormones are used by humans.
Why are humans taking non bio-identical hormones?
In brief… “corporate greed and profit”. Since bio-identical hormones are naturally produced in humans, they cannot be patented regardless of their source. Therefore, large drug companies cannot significantly profit off the use and sale of bio-identical hormones. The pharmaceutical industry’s main revenue producing hormone drugs is manufactured by using animal hormones (for example, Premarin is derived from pregnant mare urine) to create products that are structurally different than human hormones and yet bind to human receptors – often acting unnaturally. Additionally, these non-human hormones are broken down into active products that have undesirable or toxic effects on our tissues. Mass production of non-human type hormones by drug companies is very profitable despite their serious health issues and potential side effects. Conversely, bio-identical hormones (especially the well-studied testosterone) have not been proven to have any serious health side effects. BHT had only a few powerful advocates until Oprah aired two shows in January of 2009. The quality of life and health benefits of bio-identical hormones are huge for those with deficient levels… which will include most of us as we age!
What is the goal of bio-identical hormone therapy (BHT)?
The goal of Bio-identical Hormone replacement therapy is to provide an adequate supply of a deficient hormone in a form that is molecularly identical to that which your body produces. Logically, this should result in the hormone’s normal healthy physiologic effects being restored. Every person is unique. Therefore, it is sensible for you and I to work together to customize a BHT program based upon your individual symptoms and hormone levels. The precise dosing of each person’s therapy will be determined after consultation and evaluation of laboratory blood tests, and symptoms. Periodic adjustment may be needed as symptoms dictate, keeping in mind that tissue levels not blood levels are what matter for symptoms!
How is the BHT administered in our practice?
Bio-identical hormone pellets are obtained in various strengths from a highly rated commercially licensed compounding pharmacy. The hormones are derived from an ingredient found in many vegetables including Yams and Soy beans. (The pellets used in our office are Yam based.) Usually, only Testosterone (a necessary male and female hormone) is placed via time released pellets inserted in the body fat. They are extremely small, usually painless to insert, and provide a steady hormone level for months. Bio-identical Estrogen and Testosterone are not suitable for oral ingestion as they are chemically inactivated during the intestinal absorption process. Any estrogen or testosterone like drug taken by mouth should be assumed to NOT be bio-identical.
Goals of bio-identical hormone replacement therapy include:
- Alleviation of the symptoms caused by decreased production of hormones. (Examples: sleep problems, mood swings, increased body fat, fatigue, decreased sexual function/desire, hot flashes, night sweats, anxiety, abdominal fat, etc.)
- Reestablishing the protective benefits which were originally provided by higher tissue levels of your naturally occurring hormones. (Examples include: bone density, cardiovascular health, immune function, balance, muscle mass, etc.)
- Reversal of diseases associated with aging (Examples: osteoporosis, loss of strength, fatigue, exercise intolerance, decreasing muscle mass, mental clarity, heart function)
- Enhance the enjoyment, sense of well-being, and quality of life over the long-term.
Testosterone is vital to the health and well-being of BOTH men and women. Testosterone in men is mainly produced by the testicles and in smaller quantities by the adrenal glands. In women, testosterone is produced in both the ovaries and the adrenal glands. Testosterone contributes to muscle mass, strength and endurance, decreased fat, increased exercise tolerance, enhancement of the sense of well-being and psychological health. Studies have shown that Testosterone protects against cardiovascular disease, breast cancer, prostate cancer, and reduces blood sugar. It can lead to improved lean muscle mass, increased bone density, decrease in total cholesterol, improved skin tone, improved healing capacity, and increased libido and sexual performance. It enhances the quality of life for both men and women by decreasing the diseases of aging. Cells that require Estrogen use Testosterone to manufacture Estrogen inside the cell by a chemical conversion that uses an enzyme called Aromatase. Testosterone is present and extremely important in both Women and Men. Therefore, adequate tissue levels are very important for health in both sexes. (It goes without saying that women require substantially less of it!)
Estrogen refers to a group of similar hormones produced in the body. Like testosterone, Estrogen is a required hormone (INSIDE the cells) for the health of BOTH men and women. The main three are estrone (E1), estradiol (E2), and estriol (E3). Estrogens inside the tissue’s cells are believed to be protective against many health disorders. However, the vast majority of women we treat need only testosterone pellets (see above) as their body, like men’s, makes all the intracellular estrogen it needs from testosterone. This testosterone only treatment, thus avoids the serious problems that can occur with high circulating estrogen levels in the blood. While estrogen supplementation is rarely necessary, it is important that any estrogen prescribed be a bio-identical estrogen and not a non-human estrogen.
Progesterone is primarily produced in the ovary just prior to and after ovulation. It is also produced in large quantities by the placenta during pregnancy and in small quantities by the adrenal glands. If you are on bio-identical estrogen, you should probably be on this hormone as well to help prevent intermittent uterine bleeding. Unfortunately, most U.S. women are prescribed a synthetic horse derived progestin (Provera) which can cause side effects such as bloating, headaches, fatigue, weight gain, and heart disease. Bio-identical progesterone has not been shown to have these side effects.
There can be nutritional deficiencies encountered in the BHT patient that may affect BHT effectiveness. Examples include iodine, and other trace mineral and vitamin deficiencies. If this is suspected, inexpensive non-prescription supplements may be recommended. Iodine appears to be critically necessary for the transportation of testosterone in to the cells. Almost every non-supplemented patient I tested has been found to have low iodine levels!
What is involved in starting on Bio-identical Hormone therapy?
You will fill out a brief medical history and a symptoms questionnaire. We will discuss your symptoms and review the results of your blood test (if you had it drawn prior to your visit.) Alternatively, you can receive a lab test form during your consultation and return in several days to discuss the results of the tests and your appropriateness for this therapy. Known risks and side effects are minor and infrequent, though these will be discussed with you as well. If you decide to proceed, it takes less than 10 minutes to insert the pellets painlessly. You can resume normal activities in a two days. You will refrain from strenuous exercise for 5 days). You can expect to feel some improvements within the first weeks. Follow-up: Approximately one month after your first insertion, you will be asked to get another blood test and return to discuss what you have experienced regarding symptom relief. We will decide whether any adjustment needs to be done to your future dosage based on your blood test and symptoms. I will also encourage you to further enhance your own health by using the new found energy from restored hormone levels to exercise regularly and eat well. In your first year of treatment, expect to have 3 or 4 insertions. Typically, men require insertion every 4 months and women require insertion every 3 months. You can stop this BHT treatment at any time, which will cause your hormone levels to drift back to your pre-treatment levels and all your pre-treatment symptoms to return. There is no age limit on treatment. Though it is uncommon, patients as young as 25 (such as those with ovaries removed) as well as men and women in their 80s or older have had wonderful benefits from this therapy.