Peter Lee's Top Ten Tips for Success with BHRT

The Most Common Pitfalls with Bio-identical Hormones

After having worked with Bio-Identical or Natural Hormones for about 15 years now and having dispensed and consulted on literally thousands of RXs in this time frame, I have come up with my top 10 tips to watch out for to help keep you on track for success!

1. Get on the right hormones at the right doses

You may have heard this before but balancing your hormones is a delicate process.  Get a dose that is too high or get put on a hormone that is not needed and you will create further hormone imbalance or chaos.  For example the most common pitfall on a progesterone RX would be an excess dosage.  Everyone has heard the great health benefits of progesterone so from time to time I see clients getting dosages that are beyond what the body would normally produce naturally.  When this occurs it can lead to worsening of symptoms or the emergence of new unwanted symptoms.  There is the old saying of "less is more" and this can be very applicable here with the use of natural hormones. There have also been cases where the progesterone has stopped working when the dose has been in excess of what the body actually needs.  In a situation like this the client saw great benefits at first but over a period of time they have over saturated themselves with this wonderful hormone and as a result of this those great benefits are no longer seen. In addition prolonged use with no break can also lead to desensitization of the progesterone receptors and hence the positive effects of the progesterone are lost again due to an excess dose.  I do occasionally see clients get under dosed as well but the over dosage is much more common than the under dosage!

2. Had a hysterectomy - You still need progesterone!

If you are a woman who has had a hysterectomy please do not let your doctor convince you not to take progesterone.  This is really considered a myth and as with any myth it is so challenging to dispel or debunk!  Being conventionally trained as a pharmacist this is what was taught to me in pharmacy school and the medical doctors have been educated the same way.  I have learned over time it is the furthest thing from the truth!  Your body has progesterone receptors throughout including in the brain, breast, bones, blood vessels etc.  Many women who have undergone a hysterectomy will typically get estrogen only therapy and as result will likely experience side effects from it or further throw their hormones out of balance.  On a side note if you truly need estrogen you need to supplement with progesterone as well.  Do not use estrogen without progesterone or you will increase the chances of developing side effects.  Please read Dr. John Lee's book What Your Doctor may NOT tell you about Pre-Menopause as it may save you from having the hysterectomy in the first place!

3. Make sure you are cycling your hormones

That is make sure you are taking the hormones on the right days of the month or cycle.  Depending on your age, menstrual status and the medical condition you have been diagnosed with chances are you will need to take a break on progesterone and/or estrogen though there may be unique situations where one may take it throughout the month/cycle.  There have also been situations where the hormones have lost their effectiveness with continued use (i.e. no break) as mentioned in tip number 1.  The fundamental principle here is we want to mimic human nature as much as possible as this will help you get the most out of your therapy.  Please read Dr. Jonathan Wright's book, Stay Young and Sexy with Bio-Identical Hormone Replacement to learn more about this.

4. Strengthen your adrenals if necessary

If you have been diagnosed with both adrenal fatigue and hypothyroid consider focusing on strengthening your adrenal glands first.  This may indirectly help improve your thyroid functioning.  If your adrenals are extremely weak and you focus on your thyroid only you may experience new unwanted symptoms and/or worsening of current symptoms. Since the adrenals are a source of hormone production, rebuilding and nourishing tired adrenal glands are a cornerstone to regaining optimal hormone health!

5. Natural hormones are not a silver bullet by any means - How you live your life is key

If a person has an overwhelming amount of stress in their life and they are relying solely on just natural hormones for relief, they will likely be wasting their money and be disappointed with their therapy.  The treatment here is likely going to be ineffective or have minimal effect because the amount of stress the individual is experiencing is just too much and overwhelming. Other factors such as eating/drinking more sensibly, breaking less than optimal lifestyle habits and reducing toxin load need to be strongly considered in conjunction with natural hormone therapy and a comprehensive nutrient/supplement program for this individual to truly regain their vitality.

Please note this excess stress does not necessarily have to be of the emotional form only.  Stress can also take form in chemicals, physical pain, infections, poor eating/drinking habits and intense exercise.  Even regular consumption of either caffeine and/or alcohol can wreak havoc on your hormones and create unwanted stress.  The use of recreational drugs on a regular basis can also really put the human body out of balance and under much strain.  Quite often excess stress also stems from being in a certain environment (i.e. the work place, at home etc.) or from poor financial (business) decisions or bad relationships with other individuals.  Unfortunately, the above are all common factors that can play a role in hormone balancing which many people may not view as potential issues or fail to acknowledge so.

6. Everyone's needs are different - What worked for your girlfriend may not necessarily work for you

Please keep in mind that the natural hormone needs for one individual may vary considerably from one person to the next.  After all we are all different in our own ways.  There are so many factors to consider but there will be situations where a small dab of progesterone cream is really all it took to resolve one individual's symptoms.  Whereas in more challenging situations, this other individual may benefit from the use of multiple hormones, significant changes to dietary/lifestyle habits as well as strategies to better manage excess stress. Generally, in all cases a supplement program of some form will be essential to help provide the nutrients an individual may be deficient in.

7. If your digestion is in the toilet (No pun intended here!) - That needs to be addressed first

There will also be situations where an individual's gut functioning is so poor that anything they take orally will not be well absorbed or just go right through them.  Here the individual really needs to consider focusing on correcting their digestive issues as a first priority though the use of some BHRT creams will more than likely be OK at the start here.  It may not be readily apparent to some individuals but good digestion in your gut is essential to optimal hormone health!

8. Have your BHRT RXs prepared by a pharmacy that is able to follow-up with you on your treatment plan

Not only is it important to have your compounded RXs made at a compounding pharmacy that has the training and expertise to prepare a high quality product but is also able to provide information that complements your doctors' advice.  All pharmacies and pharmacists will compound to a certain level but not all can compound the more specialized products and provide you with detailed information on how to monitor your therapy, explain your BHRT in detail and help you troubleshoot problems that might come up that your doctor may not have time for or can not address immediately.

9. Make sure your hormones are in the appropriate dosage form for your needs

Make sure you have your hormones compounded in a suitable dosage form (i.e. cream vs capsule vs troche etc.).  Depending on which hormone we are talking about there may be a preferred dosage form.  Estrogen in general is almost always prescribed in a cream form as the oral forms are generally not well metabolized (i.e. used effectively) by our bodies.  With progesterone it is quite a debatable topic between capsule and cream forms.  Two of the world's renowned BHRT experts, Dr. John Lee and Dr. Jonathan Wright, prefer the cream because it is considered a more efficient and natural way of delivering progesterone to the body as it bypasses the liver and avoids the build up of unnecessary by-products (i.e. metabolites) that one typically would get with the oral form of progesterone.  I personally prefer the cream myself having seen and followed up with so many clients over the years.  Having said this many practitioners have claimed to have had good results using the oral forms of progesterone as well.  Something to keep in mind is that the biochemical make up of each person is different so it is very possible that one dosage form may work well for one person but may not for another.

10. YOU are the key to your success - Please make sure you follow-up regularly and stick with the game plan!

Finally last but not least on the list here and perhaps the most important factor to your success is - YOU!  There is the old saying of "What you put into it is what you get out of it!"  That is you are the main player here on your journey to improved health.  The most successful clients have been the ones who follow up with their practitioners on a regular basis and are compliant with the plan that has been outlined to them.  Thus follow-up and compliance are the keys to success here!  There is really no point in spending money on consultation fees, hormones, supplements etc. and not seeing any positive health results because you are not able to commit.  This all takes a considerable amount of time, effort, discipline and some financial investment to take care of yourself.  But at the end - it is all worth it because you deserve it!  

"It is amazing that when the hormones are balanced I have had so many women tell me they are sleeping better, feeling more calm, feeling happier and can tolerate their husbands again!"

Peter Lee, Integrative Health Pharmacist
Natural Hormone Consultant

"Your Natural Hormone Compounding Specialist"