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oday, more and more women and men are choosing to seek bio-identical hormone replacement therapy (BHRT) to address the hormonal imbalances often associated with menopause and andropause (male menopause). Unlike traditional hormone replacement therapy, BHRT utilizes hormones that are created with an identical molecular structure to those the body makes and focuses on an individualized, patient-centered approach. If you're thinking about BHRT, there are a number of components to consider. Following is a step-by-step overview of the process and things you'll want to keep in mind. Q: How is testing done? A: T esting of hormone levels is often the appropriate first step in determining a plan of care. Levels for the four sex hormones (estradiol, progesterone, testosterone, and DHEA-S) should be
Page 34 Healthy Cells Magazine Bloomington November 2013
tested. You can have this done via a saliva test kit available through many compounding pharmacies or by other means as recommended by your health care provider. Q: What do I do with my test results? A: Once your lab results are available, you should follow up with an in-depth consultation to review your health history and the results of your testing. This session should also include a discussion of your current symptoms, other medications you may be using, and your lifestyle. Using this information, along with your lab results, a compounding pharmacist will work directly with you and your health care provider to determine the appropriate custom compounded preparation. They may also recommend appropriate diet or lifestyle changes to improve your health.
Q: Do all practitioners prescribe BHRT? A: Many providers may prescribe BHRT including primary care physicians, family practitioners, nurse practitioners, general practitioners, internists, OB/GYN, and endocrinologists. It is best to ask if the practitioner you have selected is familiar with BHRT prior to setting an appointment. You may also ask a compounding pharmacist for practitioner referrals. Q: Can I get BHRT anywhere? A: When searching for a pharmacy, you should know that all pharmacies must be licensed, and all pharmacies may compound, but not all do. It's preferable to work with an experienced compounding pharmacy since the art of compounding is highly specialized. If you choose to work with an out-of-state pharmacy, they must be licensed in your state. If they aren't, you should opt for a pharmacy that is. The questions below will aid you in finding a pharmacy that is best suited to your needs. H ow long has the pharmacy been in existence, and how long they have been preparing compounded medications? A re the pharmacists and pharmacy technicians trained in compounding techniques? Quality compounding pharmacies have a dedicated laboratory, utilize specialized equipment, and invest in staff training and continuing education to ensure that each prescription is prepared for the individual patient to exact standards as prescribed. What is the extent of the pharmacist's knowledge of bio-identical hormone replacement therapy? Has he/she received additional training on the subject of BHRT? Use of bio-identical hormone replacement therapy is constantly evolving and it's important that your pharmacist remains current on the subject. A sk to personally speak to the pharmacist-in-charge. It's important to know that the pharmacist is willing to speak to you and will be responsive to both you and your health care provider. Is the pharmacy PCAB-accredited? Q: What is PCAB Accreditation? A: PCAB stands for Pharmacy Compounding Accreditation Board. PCAB is comprised of eight of the nation's leading pharmacy organizations who have joined to develop a system of standards by which all compounding pharmacies can be reviewed. PCAB-accreditation is currently a voluntary process. In order to demonstrate compliance with PCAB standards and earn accreditation, a pharmacy must undergo a rigorous review and evaluation of its processes, procedures, records, facilities, and equipment. Pharmacies earning the Pharmacy Compounding Accreditation Boards seal of accreditation have proven they meet these
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