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Natural Testosterone Replacement

Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone growth, a sense of well-being, and sexual function.

Inadequate production of testosterone is not a common cause of erectile dysfunction; however, when ED does occur due to decreased testosterone production, testosterone replacement therapy may improve the problem.

As a man ages, the amount of testosterone in his body gradually declines. This natural decline starts after age 30 and continues throughout life. Other causes of low testosterone levels include: Injury, infection, or loss of the testicles, Chemotherapy or radiation treatment for cancer, Genetic abnormalities such as Klinefelter's Syndrome (extra X chromosome), Hemochromatosis (too much iron in the body), Dysfunction of the pituitary gland (a gland in the brain that produces many important hormones), Inflammatory diseases such as sarcoidosis (a condition that causes inflammation of the lungs), Medications, especially hormones used to treat prostate cancer and corticosteroid drugs, Chronic illness, Chronic kidney failure, Liver cirrhosis, Stress, Alcoholism, Obesity (especially abdominal) Without adequate testosterone, a man may lose his sex drive, experience erectile dysfunction, feel depressed, have a decreased sense of well-being, and have difficulty concentrating.

Low testosterone can cause the following physical changes: Decrease in muscle mass, with an increase in body fat, Changes in cholesterol levels, Decrease in hemoglobin and possibly mild anemia, Fragile bones (osteoporosis), Decrease in body hair, Changes in cholesterol and lipid levels.

The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. Because testosterone levels fluctuate throughout the day, several measurements will need to be taken to detect a deficiency. Doctors prefer, if possible, to test levels early in the morning since this is when testosterone levels are at their highest.

Testosterone deficiency can be treated by: Intramuscular injections, given anywhere from two to 10 weeks apart, Testosterone patch worn either on the body or on the scrotum (the sac that contains the testicles), Testosterone gel applied to the skin or inside the nose, Mucoadhesive material applied above the teeth twice a day, Oral tablets, Long-acting subcutaneous implant , Testosterone stick (apply like underarm deodorant).

Each of these options provides adequate levels of hormone replacement; however, they all have different advantages and disadvantages. Talk to your doctor to see which approach may be right for you.

Like any other medication, directions for administering testosterone should be followed exactly as your doctor orders. If you are unsure or have any questions about testosterone replacement therapy, ask your doctor.

Please contact our compounding pharmacy for more information on customized medications.

HORMONES are chemical messengers that course through our bloodstream and enter tissues where they turn on switches to the genetic machinery that regulate everything taking place in our bodies. Hormones can be thought of as the life giving force that controls our physical, mental, and emotional well being.

Different glands and organs throughout the body produce hormones. For example, the pancreas produces the hormone insulin, whereas the ovaries produce estrogens and progesterone. Other glands such as the pituitary and hypothalamus in the brain secrete hormones such as FSH (follicle stimulating hormone) and LH (luteinizing hormone) that control how much estrogen and progesterone are produced by the ovaries. LH stimulates production of testosterone in the testes for men.

Natural hormones are obtained from sterol analogues found in many varieties of plants, primarily soybean and wild yam. These estrogen and progesterone like compounds are then transformed in the laboratory to the human bio-identical natural hormones.

Estrogen is actually the name of a class of hormones. The three major estrogens produced by women are estriol, estradiol and estrone. Estradiol is the most potent of the three, is the most stimulating to the breast tissue, and is the strongest symptom reliever for hot flashes, night sweats and other deficiency symptoms.

Progesterone, a naturally occurring hormone in both men and women, is essential for many vital functions in the human body. The ovaries produce the majority of progesterone, but only if ovulation occurs. As women approach menopause, less progesterone is produced. Progesterone deficiency is responsible for many of the symptoms associated with menopause. Progesterone’s many functions include improving sleep, naturally calming, balancing body fluids, improving fat metabolism, promoting bone formation, possible protection against breast cancer and protecting the uterus against cell proliferation. Progesterone also balances the effects of estrogen and should always be taken in conjunction with estrogen therapy even after hysterectomy.

Androgens (testosterone, DHEA, androstenedione) play an important role in tissue regeneration, especially the skin, bones, and muscles. The principal androgen in both men and women is DHEA. DHEA levels decline with age, and in some cases, supplementation with DHEA can restore energy, improve immune function, lift depression and improve mental function. Testosterone is involved in maintenance of lean body mass, bone density, skin elasticity, sex drive and cardiovascular health in both sexes. Men make more of this hormone, accounting for their greater bone and muscle mass. Androstenedione is a precursor for both estrogens and testosterone, especially in females. It can be produced in excess by the ovaries, especially during early menopause, and can cause some of the “androgenic” symptoms such as scalp hair loss and facial hair growth. This is somewhat over simplified. Scalp hair loss is believed to actually be caused by a metabolite of testosterone.


Women’s ovaries and adrenal glands do produce testosterone. Every woman will experience a drop in estrogen and testosterone production during menopause. Testosterone is important in maintaining sexual desire, as well as strength and integrity of skin, muscle and bone. Low levels of testosterone will result in a decreased sex drive, fatigue and decreased sense of well being.


Testosterone levels start decreasing at about the age of 30. It is called andropause. Since it is a slower change than what women experience, men typically do not see these changes occurring. Symptoms include loss of muscle mass, sex drive, energy, and sense of well being. In some cases, it can even effect ambition and competitive spirit.

Bio-Identical NHRT’s goal is to restore and maintain a physiological status. If hormone levels were normal from age 20 to 40, replacing them to restore the same level that was well tolerated for 20 years is unlikely to cause any serious side effects in later life. The risk is further reduced if only natural hormones are used. However, any type of medication can have side effects if not administered properly. The scientific studies show that the potential benefits of HRT are great, whereas, overdosing to excessive level causes most problems reported from HRT. To insure safety, hormone levels should not be raised above a normal youthful range, and side effects can often be relieved with a dosage adjustment.

Bio-Identical Natural hormones can be prepared in a dosage form convenient to each individual patient. We are no longer limited by the “one size fits all” medications that pharmaceutical manufacturers sell. Natural hormones can be made as capsules, topical creams, vaginal suppositories, injectables and sublingual liquids or tablets.

How long should I take hormones? The best answer is “as long as it is needed”. The length of time will be different for each person, depending upon their current health and the chances of developing other serious diseases later on in life. That’s one reason why it’s so important to have regular health check-ups

Getting Started

Natural Hormone Replacement Therapy must be customized for each person. Only after a thorough review of symptoms and history can an effective regimen be designed. You may want to discuss your interest in Bio-Identical Natural Hormone Therapy with your current health practitioner to determine if he/she is comfortable with it. Some are already very knowledgeable, others are interested and want to learn more and still others are closed minded and do not want to be bothered with it. If you need help finding a practitioner that will work with you, call us for a referral to one who will. We are available to help educate your practitioner and help him/her to determine appropriate dosing. A triad between patient, physician and pharmacist is essential to achieving optimal therapy.

Progesterone, a naturally occurring hormone in both men and women, is essential for many vital functions in the human body. The ovaries produce the majority of progesterone, but only if ovulation occurs. As women approach menopause, less progesterone is produced. Progesterone deficiency is responsible for many of the symptoms associated with menopause. Progesterone’s many functions include improving sleep, naturally calming, balancing body fluids, improving fat metabolism, promoting bone formation, possible protection against breast cancer and protecting the uterus against cell proliferation. Progesterone also balances the effects of estrogen and should always be taken in conjunction with estrogen therapy even after hysterectomy since there are progesterone receptor sites throughout the body.

Progesterone is also produced by the adrenal glands in women and, in col-xser amounts, in the testes and the adrenal glands in men. One of its most important functions is in the female reproductive cycle. Progesterone prepares the lining of the uterus for implantation of a fertilized egg, then helps to maintain it during pregnancy. If pregnancy does not occur it signals the uterus to shed this lining.

Progesterone also plays an important role in brain function and is often called the “feel good hormone” because of its mood enhancing and antidepressant effects. Optimum levels of progesterone can mean feelings of calm and well being, while low levels of progesterone can mean feelings of anxiety, irritability and even anger. Current research shows that progesterone may play a role in the maintenance of the nervous system, the sense of touch, and motor function.

For reliable absorption, the progesterone must be micronized before being incorporated into pharmaceutical and nutraceutical products.

The term “progesterone” is frequently used (in error) to describe all progestins. Progesterone is a progestin but the rest of the progestins are NOT progesterone

There is only one real progesterone – it is produced by the human body or in a laboratory from plant hormones into bio-identical progesterone. Otherwise, it is not progesterone – just a progestin. For absorption to take place, the progesterone that is given to a person needs to be micronized. This means that it is milled to a very col-xs particle size to allow the progesterone to pass into cells and distribute though out the body. USP indicates high purity and a product has to meet many standards of excellence to wear the name.

Testosterone usually considered a male hormone or androgen, women also produce testosterone although in much col-xser amounts than men do. Testosterone works differently in the bodies of men and women, but it plays a very important role in the overall health and well-being of both sexes. Often called the “hormone of desire” because of its powerful effect on libido, testosterone is also important in building strong muscles, bones, and ligaments as well as increasing energy and easing depression. Low levels of testosterone have been known to cause fatigue, irritability, depression, aches and pain in the joints, thin and dry skin, osteoporosis, weight loss, and the loss of muscle development.

As with all of the hormones, testosterone must be dosed properly to be effective without causing unwanted side effects. The dose in women is generally one-tenth that used in men. Because testosterone is not effective when it is taken orally it is usually prescribed as a topical gel, cream or as a sublingual tablet. Although testosterone was discovered more than sixty years ago, only very recently have we begun to fully understand and appreciate the power of testosterone.

Dehydroepiandrosterone, DHEA is a steroid hormone distinguished from others by its unique chemical structure. DHEA is produced by the adrenal glands (located just above the kidneys) as well as by the brain and the skin, and is the most abundant steroid in the human body.

As newborns, we have an extremely high level of DHEA, but within a few days after birth, our DHEA level drops to nearly zero. Then between the ages of six and eight, we experience the event called “adrenarche” in which our adrenal glands begin to stir and gear up for puberty. At the same time our DHEA level begins to rise steadily and continues to rise until it peaks at around age twenty-five to thirty. From that point on it declines at a rate of about 2 percent a year, and we begin to feel the result of this decline in our mid-forties. By eighty our DHEA level is only fifteen percent of what it was when we were twenty-five. This drop in DHEA levels correlates dramatically with the signs and “symptoms” associated with aging.

DHEA is currently the focus of some of the most exciting medical research of this century. Researchers at distinguished medical centers all over the country are studying the properties and promise of DHEA. It is proving to be a potent protector against cancer. It protects against heart disease by lowering blood cholesterol and preventing blood clots. Studies also demonstrate that DHEA improves memory, strengthens the immune system, prevents bone loss, and may even protect us from diabetes and autoimmune disease. It has been shown to fight fatigue and depression; it enhances feelings of well-being and increases strength. DHEA alleviates symptoms of menopause, reduces body fat, and is even known to enhance libido.

Pregnenolone is a superhormone that is key to keeping our brains functioning at peak capacity. Some scientists believe it is the most potent memory enhancer of all time. Perhaps what is even more amazing are the studies that demonstrate pregnenolone enhances our ability to perform on the job while heightening feelings of well-being. In other words, this superhormone appears to make us not only smarter but also happier.

Like the other steroid hormones pregnenolone is synthesized from cholesterol. In a complex series o steps, cholesterol is broken down into different steroid hormones as the body needs them. It is first synthesized into pregnenolone and used by the body in that form. What is not utilized undergoes a chemical change that “repackages” it into DHEA. DHEA in turn is used by the body as DHEA and is also broken down into estrogen and testosterone. This chain of hormones is known as the “steroid pathway.” Because pregnenolone gives birth to the other hormones, it is sometimes referred to as the “parent hormone.”

Pregnenolone was studied extensively in the 1940s. It was shown to be beneficial in elevating mood, improving concentration, fighting mental fatigue, improving memory and relieving severe joint pain and fatigue in arthritis. Pregnenolone has vast therapeutic potential and is currently undergoing further studies in these areas.

Triiodothyronine, for many years physicians prescribed Armour thyroid for hypothyroidism. Then the medical community “modernized” its thinking and changed over to levothyroxine. We are now starting to see that we stepped backwards instead of forward.

Armour thyroid is a combination of triiodothyronine (T-3) and L-thyroxine (T-4) along with various other materials from desiccated thyroid glands of pigs. For many years this was considered good.

Then along came the pharmaceutical companies such as Flint convincing every one of us that the way to treat low thyroid levels was with levothyroxine (Synthroid was their brand- that brand is now owned by Abbott and Forest now markets the Armour thyroid). What a great product- manufactured in the lab so as to achieve consistency and stability. Anyone who had taken Armour thyroid felt blessed by this new product. Armour thyroid smells bad, leaves a bad taste, represents slaughtering of pigs, and is somewhat inconsistent (so they claimed) because every pig’s thyroid is different. Flint even convinced us that we should NEVER substitute a generic brand because the generics are not close enough (FDA allows 10% plus or minus to be considered equivalent). Interestingly enough, “acceptable” dosing levels have changed over the years far greater than 10%. Currently there is a class action suit against Flint (and other owners of the Synthroid brand name) for misleading the medical community about safe substitution. Insurance companies and state medicaid agencies have been paying far too much for name brand Synthroid when generics would have had the same therapeutic results.

Now the treatment of hypothyroidism with levothyroxine by itself has become suspect. In simple terms, levothyroxin (T-4) is a storage form of thyroid. Triiodothyronine (T-3) on the other hand is an immediately active form of thyroid. Generally the body transforms T-4 into T-3 when it is needed. However, many people do not adequately make this transformation. These people can take relatively col-lg doses of T-4 and still feel tired, cold, depressed, and have dry brittle hair and nails.

T-3 can very effectively relieve these symptoms. It can be given in combination with T-4 or by itself. However, the pharmaceutical industry only makes three strengths of T-3. It is called Cytomel. Compounding pharmacies such as Acology can make many different strengths to fit any patient. We also make it slow release to minimize the stimulant affect often encountered with Cytomel. Another way to achieve a T-3 + T4 combination is with the old stand-by: Armour Thyroid.

There are recent studies suggesting that T-3 can be a very potent antidepressant. In fact, the manufacturer of Cytomel is promoting it for that purpose. Seratonin re-uptake inhibitors can take weeks to relieve depression whereas T-3 can achieve almost immediate relief. T-3 in a slow release form also has a more tolerable side-effect profile than do the antidepressants.

Estriol is the weakest of the three major estrogens. In fact it is 1000 times weaker in its effect on breast tissue. Estriol is the estrogen that is made in col-lg quantities during pregnancy and has potential protective properties against the production of cancerous cells.

An important article in the 1966 Journal of the American Medical Association by H.M. Lemmon, M.D., reported a study showing that higher levels of estriol in the body correlate with remission of breast cancer. Dr. Lemmon demonstrated that women with breast cancer had reduced urinary excretion of estriol. He also observed that women without breast cancer have naturally higher estriol levels, compared with estrone and estradiol levels, than women with breast cancer. Vegetarian and Asian women have high levels of estriol, and these women are at much lower risk of breast cancer than are other women. Estriol’s anticancer effect is probably related to its anti-estrone properties – it blocks the stimulatory effect of estrone by occupying the estrogen receptor sites on the breast cells.

Estriol is the estrogen most beneficial to the vagina, cervix and vulva. In cases of vaginal dryness and atrophy, which predisposes a woman to vaginitis and cystitis, intra-vaginal estriol is the most effective and safest estrogen to use. Because of the increase in secretions and reduction of pH, estriol is better than estradiol for the prevention of recurring urinary tract infections. It can be of significant help in cases of dry or uncomfortable sexual activity.

None of the American drug products contain Estriol, so it is not available in most drug stores, although it has been used widely in Europe for over fifty years. Because estriol cannot be patented it does not hold much interest for the pharmaceutical industry. Its availability through compounding has caused its use to grow rapidly throughout the country.

Estradiol, the principal estrogen found in a woman’s body during the reproductive years, is produced by the ovaries. Estradiol is very effective for the symptomatic relief of hot flashes, genitourinary symptoms, osteoporosis prophylaxis, psychological well-being and reduction of coronary artery disease.

Because it is much more potent than estriol, it can be more effective for symptomatic relief than estriol. When Estradiol is replaced using a parenteral (sublingual, percutaneous, or transdermal) route, it is not subject to first pass metabolism by the liver, and therefore does no produce high levels of estrone. Using these routes of administration a woman can mimic the physiologic release of estradiol from the ovaries, thus receiving natural hormone replacement.

Estrone is the estrogen most commonly found in increased amounts in post menopausal women. The body derives it from the hormones that are stored in body fat. Estrone does the same work that estradiol does, but it is considered weaker in its effects.

Tri-est is a combination of three estrogens: estriol, estradiol and estrone. It is most commonly found in a ratio of 80:10:10, estriol, estradiol, and estrone. This combination is very popular and contains all of the three major circulating estrogens. It is slightly weaker in its effect when compared to the same total mg of bi-est since it is only 10% estradiol. However, this can be compensated for by increasing the strength. Tri-est is also frequently written as 1:1:8 (estrone, estradiol, estriol). The 1:1:8 ratio is the same as that found naturally occurring in the female human body.

Bi-est is a combination of two estrogens: estriol and estradiol. It is most commonly found in a ratio of 80:20, estriol to estradiol. However, 50:50 or 90:10 ratios are prefered by some practitioners. This combination allows for all of the protection of estriol while providing the cardiovascular and osteoporosis benefits along with the vasomotor symptom relief of estradiol.

Patient Specific Natural Hormone Therapy

  1. Restores natural hormone balance safely
  2. Eliminates unwanted side effects
  3. Optimizes health and sexuality
  4. Is covered by most insurance plans
  5. Utilizes hormones that are bio-identical in structure to what our body produces

Bioidentical hormones are prepared daily in our laboratory and can be shipped the same day, ensuring that you can begin treatment at your earliest convenience.

Consult your practitioner about the benefits of Bioidentical Hormone Replacement Therapy (BHRT). Adverse reactions to Bioidentical Hormones may be related to dose or composition of the prescription. Patients should consult their practitioner or pharmacist if they experience any of these symptoms or have any questions.