As an innovative compounding pharmacist and PCCA (Professional Compounding centers of America) member I have been well equipped and privileged (within the previous seven years) to develop a clientele of over a five hundred girls using BHRT (Bioidentical Hormone Replacement therapy).
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Additionally, the huge majority (over 75% in my opinion and experience) derive considerable benefit and an increased quality of life consequently. The following paragraphs will try to detail the differences between oral and topical BHRT dosing and why one route of administration is usually favored over the other for an assortment of reasons.
- Since first pass metabolism (which comprises: saliva, stomach acid, intestinal enzymes and liver destruction of hormone molecules happens with orally given meds) is overlooked when we calmly dose this translates in our capacity to provide fewer molecules or milligrams of hormones to attain similar effects as oral dosing. To put it differently, we get the work done with fewer molecules floating around in our body when we dose peacefully through the skin (this is just intelligent and no doubt safer). There have been recent studies that indicate the likelihood of blood clots have been greatly reduced with topical dosing when compared with oral dosing.
- Secondly, as a lotion is used we are now able to put it in a tube together with a rather accurate needleless syringe and titrate the dose from low to high based on symptom resolution or response. This is especially handy for the biestrogen lotions as the internet estrogen signal is what caused a woman to increase the lining of her uterus monthly and is consequently proliferative or a mobile go/grow sign in nature. We don’t need to do some dosing of a molecule that’s a mobile go/grow signal. I compare this to the analogy of hemming a pair of pants or purchasing a pair of sneakers specific to that person and not just willy nilly choosing a mg dose and hoping it works for everybody. For instance, the body may downregulate (remove) receptors if too high a dose is perceived by that men genetic type (as all of us change by genetics). If down regulation happens then at the point the”waters are muddied” and we could double or triple the dose and we get a number of the exact symptoms as we would if we were to have too small hormones. Hence, the significance of lotions for: using less molecules and for the ability to titrate from low to high dosage according to a people genetically determined response. This way we treat the individual and not just put them into a laboratory range somewhere.
- Thirdly, topical dosing does appear to dove tail well with saliva testing. I’d like it made clear that I don’t take sides between blood and saliva testing as I just can tell more from then either kind of test alone. One wants to be aware of the pharmacokinetics of each dose path and the corresponding scales between the two testing approaches become much clearer to understand.
- With oral dosing a higher dose as stated above is required to find the molecules beyond first pass metabolism . Moreover, there’s concern that since this greater mg dose has to go through the liver it might be “harder” on the liver period. At the minimum, as stated above there does appear to be a greater blood clot risk orally versus topically based on research (which applies to drug firm hormones too ). Therefore, and ultimately, topical BHRT dosing is without question the smarter way to begin with. That having been said, if we try all the angles with topical dosing and a woman is still fighting with her specific set of symptoms I will as a last resort offer her oral, sustained release,compounded, BHRT capsules.