CHAPTER 1
Educate, Evaluate and Expand
Everywhere you turn these days you hear and see more and more news and advertising about Hormone Replacement Therapies (HRTs). From large pharmaceuticals marketing the latest synthetic low testosterone replacement roll-on to celebrities extolling the virtues of Bioidentical Hormone Replacement Therapy, (BHRT) as a virtual fountain of youth.
The truth is there are a lot of mistruths about the role bioidentical hormones can have in the cure of several severe symptoms; the overall wellbeing of your patients and safety concerns about their use.
This book is to serve as a guide to understanding the role hormones have in assessing symptoms that may be aggravated by hormonal imbalances or deficiencies. The last half of this book contains a clinical reference guide to help healthcare practitioners check for hormonal imbalances and recommend dosing of bioidentical hormones in the treatment of their patients.
The goals of this book are to:
1. Educate healthcare professionals about the role of hormones in the wellness of their patients.
2. Educate the public of the significant role hormonal imbalances can play in their overall wellness.
3. Provide the necessary tools to determine if bioidentical hormone replacement therapies are appropriate for your patients.
4. Help expand healthcare practices through referrals by happy, healthy patients and bioidentical hormone replacement therapies that improve patient lives while making sound business sense to your practice.
The majority of the content in this book is taken directly from lectures and talks that compounding pharmacist and bioidentical hormone replacement therapy expert, Rudy Dragone has given to doctors, fire departments, police departments and thousands of others across the United States and around the globe.
Rudy had worked for years with Dr. William R. Lee, an internationally acknowledged pioneer in the study and use of hormone replacement therapy for women. Together, they were instrumental in the educating thousands of healthcare professionals about the role of hormones and the use of BHRT in healthcare. The fire department in Phoenix Arizona was so impressed; they approved the use and coverage of BHRT in the healthcare of their employees.
The roll that bioidentical hormone replacement therapy has in overall wellbeing for millions of people is simply remarkable.
Background Experience
In life, we have to take care of ourselves. Sometimes in helping others, we neglect what's important in our own lives. If you've ever flown, you've heard the flight attendant spiel about putting on your own oxygen mask first before helping others. Well, this is what I'm trying to help you to do in this book. I want you to help yourself be as healthy and complete as you can be and I'm going to show you some ways to work towards this so that you can help everybody else in your family feel and live a lot better too.
My name is Rudy Dragone and I am a compounding pharmacist. I'll give you a little background of who I am so that when listen to me you start saying to yourself, "Do I want to believe this guy or not?" You will at least have some background knowledge of who I am.
I am a pharmacist. That's all I ever wanted to be. When I was nine years old; my parents put me in a pharmacy in the Bronx. They said this is where we want you to be. We want you off the streets, away from the gangs and everything else that goes with it. So by the time I was 17 I was enrolled in pharmacy school and by the time I was 21, I was the youngest pharmacist in New York City.
When I was at the pharmacy in New York, I used to look up to this one person that had 5 pharmacies in the same neighborhood. I said to myself, "If I ever could have 5 stores, I would be somebody." By 1988, I had ten stores. Then, I sold everything I owned in New York and came to Arizona to retire.
But I couldn't retire from the desire to keep helping people so I bought another pharmacy in Carefree, Arizona just to keep my hands in it and make a positive impact in the wellbeing of my fellow man. It was during this time I met a true pioneer in development of hormone replacement therapies who had been working in the hormone replacement field for about 10 years, Dr. William Lee. Dr. Lee also had a significant role in developing a health program for the Phoenix Fire Department.
Hormones
Natural hormones, it's almost a miracle so few people know so little about them. Why don't more people know more about them? It cannot be patented. Not like Viagra or anything you see on television these days. Natural hormones cannot be patented because they occur naturally in nature. They were found in the 1930s. Because they cannot be patented none of the drug companies make them because they can't make the big money off of them. In fact, they actually take the same identical hormones that should be in your body and change them so they can patent them, package it and sell it.
We are totally against that. We are saying, "This is what God gave you, this is what Mother Nature gave you, and we want to give you the identical hormone that is in your body to begin with to cure your symptoms."
It just makes plain sense doesn't it? Replace the natural hormones that you lose through the years with the same bioidentical hormones that are already found in your body.
Suzanne Sommers has been advocating the use of bioidentical hormones for some time now. More recently Oprah Winfrey and Dr. Oz have been touting the virtues of bioidentical hormones and keeping hormonal balance as a key to good health and wellbeing. So we have a good strong people as our advocate.
Today, I still compound bioidentical hormones specifically tailored to the unique hormonal needs of each and every patient for doctors around the country and internationally. I get calls all day long from doctors and healthcare provider about solutions to vexing medical problems that are easily solved through the proper use of BHRTs.
The words "proper use of BHRTs" is critical here because hormone replacement therapy, whether it is through synthetics or bioidentical hormone replace is not a one size fits all approach. Unfortunately for you and your patients, major pharmaceutical companies cannot tailor their dosing specifically to your patients' needs. Additionally, any hormone replacement therapy should include frequent and thorough testing and adjustments until each patient is in perfect hormonal balance. A "one pill fits all" approach with synthetics is simply not possible. However, working with a compounding pharmacist like myself, you can dial in the specific needs of each and every patient presenting with symptoms aggravated by hormonal imbalances or deficiencies.
When you get to understand everything that I'm going to be talking to you about, I know you will see the benefits that bioidentical hormone replacement can have in your practice and with the overall quality of your patients' lives. We're going to talk about things that are very sensitive; we're going to talk about things that are not so sensitive. By the time we finish, I will guarantee, you will not look to the person to the right or to left of you in the same manner as when you started. I guarantee, that when you go home, you will look at your spouses, you will look at your parents, you will look at everybody you associate yourself with in a different light and hopefully, if I've done my job correctly, you will be able to help those people.
For me it's not about making money. It's about helping people. I pray, I say a little prayer before every lecture because I really believe in this stuff. This stuff has changed my life. And by the time I'm finished with you, you'll see why I'm such an advocate of using bioidentical hormones to help people's lives.
Beginning with the basics; what are hormones? Hormones are the architects that read the DNA and constantly rebuild the body.
Hormones are chemicals that are secreted in the body by glands. There are over 100 of them. They are secreted in the body by glands that have their effect on target tissue.
Let's make believe that we are a one cell organism right now. On the outside of the cell there are all of these locks. A hormone is a key. The hormone key goes in, fits into a particular lock and then turns the lock. When that lock is turned it sends a message to the DNA at the very heart of the cell and it will actually change the DNA. It can alter the DNA and start metabolic processes.
When we were conceived, originally, we were one cell. Then due to a hormonal interaction, that 1 cell becomes 2 cells, 2 cells become 4 cells and eventually those cells began to differentiate. Soon there are bone cells and eye cells and hair cells and everything else that makes us up. There is a pattern by which these things come out. And the way that comes out is because of our hormones.
Hormones can actually take an embryo that is inherently female and turn it to a male. Guys, I hate to tell you this; but at one time we were all female then at a certain point you became man. Hormones unlocked the secret of the XY chromosomes during the fetal period of development.
Chromosomes are affected by hormones and if you think the synthetics hormones don't affect your chromosomes, you're very, very mistaken. Given a choice between synthetic and natural hormones, bioidentical natural hormones are the way to go.
Premarin Conversion
A woman came in to my pharmacy and said she had been on Premarin 0.625 mg for 10 years and before that she tried everything to relive her perimenopausal symptoms. Even though she still suffered from hot flashes, this is what she thought worked for her.
Then one day her daughter came to one of our seminars about BHRTs and now here is skeptical mom giving us a shot. "I can't believe that you guys can make anything better but my daughter says I should try so here I am" she explained.
I quickly told her about the risks of taking Premarin for so long and how much better natural hormone replacement will work for her. She told me that when she first started she was put on the 0.625 mg and went from 30-50 hot flashes a day to 5 a day. Then the doctor put her on the .9 mg and she began to have breast tenderness and break through bleeding.
She said, "If my choices are 5 hot flashes a day or break through bleeding and sore breasts, I'll take the 5 hot flashes a day!" and there she remained for 10 years with 5 hot flashes a day.
So we got her on a bioidentical hormone replacement therapy and awhile later she came in and said after using the treatment for 1 month that, "Your stuff is not as good as the Premarin. I went from 5 to 10 hot flashes a day!"
I said okay let me talk to the doctor about raising your Estrogen. We error on the side of safety and the Estrogen was raised.
The following month she came in and said, "Your stuff is just as good as Premarin. I have about 5 hot flashes a day."
Again, I said wait a minute and we again raised it just a little bit. The month passed and she came in again and I asked her how she was doing and she remarked, "I cannot believe it. ZERO hot flashes!" For 10 years she dealt with 5 hot flashes a day and now they were gone.
All those years of suffering through hot flashes because her synthetic Premarin hormone treatment regime wasn't tailored to her specifics needs could have been alleviated by a regiment of bioidentical hormones created to bring her body into a natural balance.
One Size Does Not Fit All
A perfect example of a "one size fits all" approach to the management of hormonal imbalances happens when we look at the range of what falls into "normal" when patients present with problems caused by their thyroid levels.
Let's say the range for the average person's thyroid falls between a 1 to a 10. If a patient who is at a 9 for most of his or her life drops down to a 2, their thyroid is still considered to be normal. For that patient, the quality of their life after this shift in what is considered normal for everyone else is anything but normal to them. They feel like crap.
One of the problems with conventional medicine today is that our testing parameters are off. Let me explain. If you go to a doctor, the doctor will say, your thyroid levels should be between 1 and 10. If you fall in the 2, he's going to tell you your thyroid is okay. He's going to pat you on the head and send you home. But you should say, "Wait a minute, I remember when I was younger, I could eat whatever I wanted, and I was always warm and never gained a pound. Now all of a sudden I just look down the Twinkie aisle and POOF my thighs start to pop out or my belly starts to pop out. Why is that happening? And I'm always cold, my hands are cold, my feet are cold, everything is bothering me, why am I so cold? My nails are brittle, my hair is breaking. I wasn't like that. Then I go to the doctor and the doctor tells me I'm okay. How can that be?"
Here is the first problem. Where did this range of what is consider to be a normal thyroid level come from? Well, every lab has different levels. The reason why every lab has different levels is because they take a look at the people that come in for a thyroid test and they make an average of where they should be or what is "normal".
Well, first things first, the people that are going to be tested for thyroid are being sent to the lab because they have signs of thyroid deficiency or are being tested because the symptoms they present are symptomatic of a hormone imbalance or a deficiency. So right off the bat, if you take a look at all the people who had thyroid symptoms, of course the levels are going to be lower then what should be in your body.
Then there's a second problem. Let's say you're 14, 15, 19, 21 years of age and you're running at a 9 in the thyroid range. All your life you never get tested. Why? Because you didn't have a thyroid problem all those years. You were warm, your body was consuming the food and everything felt great! Right?
Now you go to the doctor and you're a 2 on the thyroid range table. He's going to say you fell into the normal range. The truth of the matter is that a level of 2 is not normal for your body. Your body was used to running at a 9, now it's a 2. Therefore, you can't run your body the way you used to. You can use this example I'm giving here about thyroid and do it to all the hormones.
These hormonal imbalances reach well beyond the effect they have on an individual and can adversely affect those around them.
I love this example of a broken screen door. A woman, her husband and three children walked into the pharmacy and explained that she had been to many doctors and that no one had been able to help her. She had a full hysterectomy and at 28 and was in full blown menopause.
I have to add that she looked exhausted and so did the husband. The children looked unkempt. We started her on the program and helped her in achieving hormonal balance.
Several months passed and one day the whole family was in picking up her prescription. The husband and wife looked happy. Children were clean, orderly and well behaved. They saw me working in the back and asked to talk to me. After expressing their gratitude for helping her, he shared this story with me.
He said their life before the natural hormones was on the rocks. He said he had a screen door on the outside of their home and everyday he would kick it open and slam it shut so it was in terrible shape; holes in the screen and the door hanging loosely by the hinges.
But, that was before natural hormones. Once his wife got on the hormones, she started to feel better, she started to do more housework and look after the children. So he started to do the same. Soon this working together led to sex and not just sex but good loving sex. Soon he fixed the screen door. He tells me he did not realize it then but that broken down door stood there as a testament to how bad their marriage was. Now the new door is a sign of how good their marriage is.
Quality of Life
What happens to the quality of our life as we age? We start with a certain quality of life that changes through the years.