FAQ on compounding pharmacies
Q. What are compounding pharmacies and are they the best sources
for bio-identical hormones?
A. Compounding pharmacies provide
a specialized service of making up formulas (compounding) to the
specifications of the prescribing physician, so as to be customized
to the individual patient's tolerability. This is an extremely
important option to have available to a patient, as not everyone can
tolerate the inactive fillers and dyes often present in pre-made
pharmaceuticals, or perhaps the method of delivery of each drug,
which might affect rate of absorption. An example of when the
compounding service is invaluable is when a patient is
gluten-intolerant, since most pre-made pharmaceuticals contain the
gluten protein in the inactive fillers. While compounding pharmacies
are able to accommodate to patients' special needs through their
service of compounding, they are not necessarily the best source for
bio-identical hormones. In fact, the bio-identical hormone
ingredients they use in compounding medications begin with
pharmaceutical grade generic bio-identical hormones supplied by
pharmaceutical companies. FDA-approved name-brand bio-identical
hormones currently exist in the market in multiple forms (patch,
pill, lotion, gel, vaginal cream). Whether a patient needs
to/should go through a compounding pharmacy very much depends on
his/her individual medical situation.
Q. Are bio-identical hormones only available at compounding
pharmacies?
A. No. bio-identical estradiol and progesterone
are also available in name-brand, FDA-approved formulated tablets,
patches, gels, lotions, nasal sprays, and capsules. In fact,
Estrace, which is name brand estradiol oral tablet, has been
FDA-approved and available since the 1970s.
Q. Based on saliva testing that my compounding pharmacist
ordered, I was placed on bio-identical hormones, or sold certain
supplements to help me make more hormones. Is this appropriate for
my health?
A. No. While many compounding pharmacists truly do
possess great knowledge about bio-identical hormones, they are not
physicians, and are legally NOT allowed to prescribe treatment.
Their training is different from that of a physician's and they
should not be assumed to possess the same level of medical
expertise. They can consult with physicians if the physician has
first signed a collaborative agreement allowing the pharmacist to do
so. The use of bio-identical hormones has propelled to a billion
dollar industry, thanks to the efforts of Suzanne Somers, and
unfortunately, Dr. Chen has seen numerous cases where patients are
receiving their prescribed treatments from either compounding
pharmacies or laboratories, which she felt were inappropriate and
illegal! In these examples, the patients came to Dr. Chen because
the prescribed treatments they were receiving from the compounding
pharmacies and/or laboratories were causing side effects and/or not
adequately resolving their symptoms. There are obvious conflicts of
interest involved, and it is unfortunate that money seems to
motivate more than ethics on the part of these entities. It is also
inappropriate to make claims that simply taking supplements will
help the body to make more specific hormones, as the body has
multiple steps along the way of hormone synthesis, each
interconnected to multiple other loops, and each individual step
requiring enzymes (proteins), the regulation of which is under the
control of multiple variables that are individual to each person,
such as food, light exposure, sleep, and stress level.