What is BHRT?
BHRT refers to the therapeutic use of hormones which are identical in every way to the hormones that the body produces naturally. One common source of confusion is the term ‘bioidentical hormone’ and if this also means that it is ‘natural’. All bioidentical hormones are produced from vegetable sources which undergo a chemical laboratory process. This manufacturing process is one which is not considered to be ‘natural’, although it does result in hormones that are identical on a molecular level to those produced by the human body. The term ‘human identical’ hormones is a much better term that provides more clarity. Unfortunately, the term bioidentical was coined first and is already in common use to describe this form of treatment.
BHRT vs. HRT
Both pharmaceutical and bioidentical hormones are created using chemical synthetic processes. Although, due to patent law restrictions it is not possible to patent naturally occurring compounds. As a result pharmaceutical hormones must differ molecularly than their human hormone counterparts. It is these differences that appear to have created some of the problems associated with hormone therapy (HRT) in the past. All hormone therapy, whether pharmaceutical or bioidentical, carries risks and must be monitored closely. Our BHRT program is set up with the intent of relieving the symptoms of hormone imbalance and deficiency, while keeping your safety first and foremost. Bioidentical hormones used in BHRT include estradiol, estriol, progesterone, DHEA, testosterone, and thyroid.
How long is it safe to stay on the hormone treatment?
At this time we do not place a time limit of BHRT treatment. Most people seek BHRT to reduce the troublesome symptoms of menopause or andropause (male menopause). BHRT is very effective at relieving symptoms; however, this relief often only lasts while the hormones are used. Conventional HRT in women uses agents that have been shown to increase the risk of breast cancer after 5 years of use. This has led to the concept of 5 years of HRT and then stop. The exciting aspect of BHRT is the suggestion that it can relieve symptoms and reduce the risk of breast cancer.
Most patients seek BHRT for symptom relief, although BHRT treatment acts further than this to:
- decrease inflammation
- increase muscle mass
- improve bone density
- improve mental function
- improve memory
- reduce risk of breast cancer
While improving overall health concerns it also effectively treats the troublesome symptoms that bring most patients in to see us in the first place. It is the old ‘win-win’ situation and this is the reason that we do not place a time limit on the use of BHRT at this time.
I buy vitamins and omega 3’s from Costco because they cost less. What is the difference to the vitamins sold at True Balance?
All of the vitamins and supplements sold at True Balance are of high quality and are made by reputable companies that hold quality of their products first and foremost. These supplements and vitamins are pure and subject to third party testing for potency and contamination. In the supplement world the old saying ‘You get what you pay for’ applies. For example True Balance omegas 3’s are certified to be mercury and dioxin free and are of guaranteed potency. They have achieved the ‘5 star’ rating by the International Fish Oil Society. This rating applies to only a handful of omega 3 products. Our multivitamin rated in the top three vitamins available in North America, in Lyle Macwilliam’s “Comparative Guide to Nutritional Supplements”.
I take anti-depressants/cholesterol pills/diabetes meds prescribed by my physician. Should I stop taking them? Will the BHRT affect their function?
The products prescribed by your BHRT practitioner will not interfere with your conventional medications. Over time, you may even be able to taper some of these medications as your health improves. Keep in mind medication adjustments should always be done with assistance from your family physician.
My family doctor has called and said that my bloodwork results show I am taking too much thyroid medication. What should I do?
- Did you remember not to take your medications the morning of bloodwork?
It is common for patients to remember the bloodwork instructions when they are doing our bloodwork, but to not think about it when they are doing bloodwork for their family doctor. Taking your medication that morning will result in blood levels being above normal range.
- Do you have any high thyroid symptoms? Heart palpitations, shakiness, or anxiety?
If any of these symptoms exist, then DECREASE your dose by 30mg of Desiccated thyroid per day.
Why doesn’t the clinic use saliva to test my hormone levels?
Using the Alberta Healthcare blood testing combined with our symptom forms we are able to accurately monitor “on treatment” levels without added cost to our patients. There is no scientific evidence or basis for testing hormones using saliva levels instead of blood levels. There is some value when evaluating baseline levels, but not when monitoring a patient on treatment. We do however in some cases still use saliva and urine testing to monitor adrenal function.
I would like to consider BHRT for my symptoms of low libido, fatigue, low energy. I am on the Birth control pill for contraception, but plan to get pregnant within 1yr? These symptoms are usually the result of low testosterone. The birth control pill dramatically increases the liver production of Sex Hormone Binding Globulin (SHBG). SHBG has a particular affinity for free testosterone and binds it tightly. When free testosterone is bound to SHBG, it is not available to your cells. Discontinuation of the pill, with use of a barrier method of contraception, may be enough to improve your symptoms. If not, use of a testosterone cream could be made, but please note, testosterone application in pregnancy is NOT safe. We can discuss options at your appointment.
I have been using the prescriptions for 2 weeks but haven’t noticed any changes, in fact I feel worse. Should I stop?
It is not unusual for BHRT to take several months to correct hormone imbalances and relieve symptoms. Indeed, after a change in hormone dose, we wait 6-8 weeks before a new blood test is done to check levels. This follow up bloodwork is very important to help us to understand how you as an individual are absorbing the medications, and what adjustments may need to be made.
Hormones are powerful but in the short term their effects are subtle. This patient should persevere till his/her next visit. A review of blood work and symptoms at that time will often show a person how far they have come.