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The BHRT A-Z Guide College Pharmacy

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The BHRT A-Z Guide College Pharmacy BHRT Consultation Guide BHRT Consultation Resources © 2015 College Pharmacy Knowledge Changes Everything. Quality | Innovation | Experience | Since 1974 Prescribing Biologically Identical Hormone Replacement Therapy The BHRT A-Z Guide College Pharmacy Dear Healthcare Practitioner, Have you had an increase in patients requesting information about hormone imbalances and Biologically Identical Hormone Replacement Therapy (BHRT)? The following guide to prescribing biologically identical hormone replacement therapy (BHRT) is designed to help your patients as well as your practice. If you have patients that complain of ailments which have not responded to other therapies, declining hormonal function may be responsible. College Pharmacy is proud to offer a variety of professional services and resources to help simplify the process of introducing a BHRT program into the clinical practice, increasing practice profits, and patient satisfaction. Throughout the process of implementing BHRT into your practice, you can count on College Pharmacy’s team of experienced compounding pharmacists to provide you with the resources you need to create BHRT services tailored to your patients and practice. This reference guide discusses the differences between synthetic and biologically identical hormones, describes how to use lab and clinical evaluations to initiate hormone replacement therapy and BHRT dosing, explains the various modes of administration available to optimize and individualize therapy, and provides illustrative case studies. As you implement BHRT into your practice, you will soon be able to develop long-term monitoring programs for your patients to help ensure patient compliance and optimal treatment success. If implementing BHRT into your practice right away is not an option, College Pharmacy has been assisting healthcare practitioners in providing BHRT services to their patients for over a decade through our “Triad” Hormone Consult program. Available to both men and women, College Pharmacy offers complimentary personal hormone consultation services to assist patients and practitioners in individualizing BHRT. This program has benefited healthcare practitioners who are new to BHRT or need additional staff to fully implement a BHRT program into their clinical practice. As one of the most comprehensive and experienced compounding pharmacies in the U.S., the range of services that we offer our customers is surpassed only by our years of compounding experience. Our dedicated team of compounding specialists will help you choose the right drug, route of administration, and dosage that will help maximize patient outcomes. Please do not hesitate to contact us if you have questions about this reference guide or any other aspect of prescribing BHRT. Knowledge Changes Everything. Quality | Innovation | Experience | Since 1974 3505 Austin Bluffs Pkwy, Ste. 101 Colorado Springs, CO 80918 Tel: (800) 888-9358 / (719) 262-0022 Fax: (800) 556-5893 / (719) 262-0035 Email: [email protected] Web: www.collegepharmacy.com Facebook.com/collegepharmacycompounding Twitter.com/collegepharmacy The BHRT A-Z Guide: Table of Contents Hormone Replacement Overview .............................................................................................................................................................. 4 Hormone History ........................................................................................................................................................................................ 5 Synthetic Hormones & Biologically Identical Hormones ............................................................................................................................. 5 The Women’s Health Initiative Study ......................................................................................................................................................... 6 Why Individualizing Hormone Therapy is Crucial ...................................................................................................................................... 6 Hormone Overview .................................................................................................................................................................................... 7 Hormone Flow Chart .................................................................................................................................................................................. 8 Thyroid Health & Conversion Chart ........................................................................................................................................................... 9 Adrenal Function ........................................................................................................................................................................................ 11 Vitamin D3 ................................................................................................................................................................................................. 11 Vitamin K ................................................................................................................................................................................................... 12 Secretagogues ........................................................................................................................................................................................... 12 Oxytocin: Sexual Function & Response .................................................................................................................................................... 13 BHRT Dosage Form Overview .................................................................................................................................................................. 15 Topical Gel & Cream Dispenser Options ................................................................................................................................................... 16 Percutaneous Gels ..................................................................................................................................................................................... 17 BHRT Fused Pellet Implants ...................................................................................................................................................................... 18 Lipid Matrix Sublingual Tablets .................................................................................................................................................................. 20 Getting BHRT Started ................................................................................................................................................................................ 21 Laboratory Testing: Urine, Blood, Saliva .................................................................................................................................................... 22 Common Lab Values: Saliva Test .............................................................................................................................................................. 24 Common Lab Values: Blood Test ............................................................................................................................................................... 25 Dosing BHRT: For Women ......................................................................................................................................................................... 29 Hormone Phases & Symptoms .................................................................................................................................................................. 32 Contradictions to Estrogen Therapy .......................................................................................................................................................... 33 Suggested Conversion Guide .................................................................................................................................................................... 34 Andropause: Overview & Therapeutic Options .......................................................................................................................................... 35 Hormone Balancing Diet ............................................................................................................................................................................ 39 Rocky Mountain Green Carbohydrate Diet ................................................................................................................................................ 40 BioG MicroTabs: Personalized Nutritional Supplements ........................................................................................................................... 42 Case Studies ............................................................................................................................................................................................. 44 Compounding Pharmacies & BHRT .......................................................................................................................................................... 45 BHRT & Practice Autonomy ....................................................................................................................................................................... 45 Useful
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