PMS, Perio-Menopause, Or Menopause - Where Do I Start As a Woman? - I Am Confused?
Since most medical doctors are not educated in the truly smarter realm of bioidentical hormone replacement therapy (BHRT) we as compounding pharmacist(s) and patient(s) must be very diplomatic in our approach to asking for help in this arena.
It has been my experience in my "neck of the woods" in northern Alberta, Canada that about 50% of the physicians that I deal with are "warm" towards BHRT and 50% are "cold" or "paralyzed my confusion".
After all even myself as a drug expert did not know that the human body had three types of estrogens when I first began learning the many new concepts involved with BHRT about seven years ago.
The thing I did do is keep an open mind! What we start with is the work up via: educating the patient with a cd rom and a quality web site; gathering the evidence whether that be blood or saliva testing or both; having a medical history filled out along with any questions the patient may have generated from the educational step.
Once these three essential steps have been accomplished then we sit down and do a thorough consultation by evaluating all these previous parameters that have been obtained.
We then write out an unvalidated prescription for that patient to take to their primary care physician.
If that physician is "warm" to BHRT then it is a "slam dunk" for a signature to proceed.
If however that physician is "cold" then I remind the patient that they have fulfilled their duty by informing their primary care physician of their intent and that they still want to keep that physician for other health care expertise but that they will seek another physician that is comfortable in this BHRT specialty field.
In other words, the primary care physician has no right to "hold them hostage" so to say because of their opinion only.
This is a valid therapy and to take it a step further the idea of not treating menopause in my opinion is a chronically harmful approach for women because they are then living the rest of their lives estrogen dominant or in other words with a super amped up cellular go signal on the loose due to mainly a lack of progesterone shielding.
If blood testing is asked for please ask for: P=progesterone; T=testosterone; E2= estradiol and DHEA as a minimum.
As a bonus I like to see their latest complete CBC and differential including TSH, free T4 and at least one free T3.
Then take this to your PCCA member compounding pharmacist as they are truly the best trained compounders out there in general.
Let the pharmacist guide you and then present the work up to your doctor in that order.
We then fill the prescription(s), counsel thoroughly and encourage you to call any day if further questions arise that the handouts cannot answer.
Finally, what is medical care without followup certainly not medical care...
right? We follow up at approximate 2 week intervals until we are comfortable that we have you "zoned in" and have you feeling the best that is possible.
We then recheck levels in 6 to 12 months based on patient preference.
We then may look at other areas such as tweaking your thyroid, adrenal glands, nutrition, etc.
It is best to get one part of the "orchestra in tune first" and then move on to the next to prevent confusion.
Sincerely, Robin Small (Bachelor of Science in Pharmacy)(Compounding Pharmacist)
It has been my experience in my "neck of the woods" in northern Alberta, Canada that about 50% of the physicians that I deal with are "warm" towards BHRT and 50% are "cold" or "paralyzed my confusion".
After all even myself as a drug expert did not know that the human body had three types of estrogens when I first began learning the many new concepts involved with BHRT about seven years ago.
The thing I did do is keep an open mind! What we start with is the work up via: educating the patient with a cd rom and a quality web site; gathering the evidence whether that be blood or saliva testing or both; having a medical history filled out along with any questions the patient may have generated from the educational step.
Once these three essential steps have been accomplished then we sit down and do a thorough consultation by evaluating all these previous parameters that have been obtained.
We then write out an unvalidated prescription for that patient to take to their primary care physician.
If that physician is "warm" to BHRT then it is a "slam dunk" for a signature to proceed.
If however that physician is "cold" then I remind the patient that they have fulfilled their duty by informing their primary care physician of their intent and that they still want to keep that physician for other health care expertise but that they will seek another physician that is comfortable in this BHRT specialty field.
In other words, the primary care physician has no right to "hold them hostage" so to say because of their opinion only.
This is a valid therapy and to take it a step further the idea of not treating menopause in my opinion is a chronically harmful approach for women because they are then living the rest of their lives estrogen dominant or in other words with a super amped up cellular go signal on the loose due to mainly a lack of progesterone shielding.
If blood testing is asked for please ask for: P=progesterone; T=testosterone; E2= estradiol and DHEA as a minimum.
As a bonus I like to see their latest complete CBC and differential including TSH, free T4 and at least one free T3.
Then take this to your PCCA member compounding pharmacist as they are truly the best trained compounders out there in general.
Let the pharmacist guide you and then present the work up to your doctor in that order.
We then fill the prescription(s), counsel thoroughly and encourage you to call any day if further questions arise that the handouts cannot answer.
Finally, what is medical care without followup certainly not medical care...
right? We follow up at approximate 2 week intervals until we are comfortable that we have you "zoned in" and have you feeling the best that is possible.
We then recheck levels in 6 to 12 months based on patient preference.
We then may look at other areas such as tweaking your thyroid, adrenal glands, nutrition, etc.
It is best to get one part of the "orchestra in tune first" and then move on to the next to prevent confusion.
Sincerely, Robin Small (Bachelor of Science in Pharmacy)(Compounding Pharmacist)