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Millions of people across the U.S. suffer from thyroid-related disorders, which can be managed through thyroid medication made of thyroid hormones. The careful administration of specific types of thyroid hormones can help reduce and reverse the symptoms of some thyroid conditions.
Hypothyroidism
Thyroid hormones are connected to almost every other system in the body and other hormone systems, including neurotransmitters, reproductive hormones, and the adrenal system. When one is out of balance, it can throw the others off as well, creating a cascade of symptoms that can be debilitating.
With even a small hormonal imbalance in the thyroid, even a little bit, people can suffer from a range of symptoms.
Hypothyroidism occurs when the thyroid is not producing enough hormones. Symptoms of hypothyroidism can be broad and, without a thorough thyroid panel, can be challenging to diagnose. Hypothyroidism can affect sex hormones, cortisol production, and insulin sensitivity.
Conditions Associated with Hypothyroidism:
Low blood pressure
Slow heart rate
Constipation
Menstrual irregularities
Infertility, premenstrual syndrome
Feeling cold
Fibromyalgia
Fibrocystic breasts
Depression/anxiety
Diabetes
Digestive problems (e.g.: (leaky gut, constipation)
Fatigue
Hair loss
Weight loss or gain
Reproductive symptoms resulting from either hypo or hyperthyroidism include irregular menstrual patterns, worse PMS, infertility, and polycystic ovary syndrome.
Where hypothyroidism describes an underactive thyroid, hyperthyroidism can also be the case, where the thyroid is producing too many thyroid hormones. Some symptoms of hyperthyroidism can swing towards the opposite of hypothyroidism, where there is, for instance, rapid heart rate instead of slow, and nervousness instead of fatigue.
It is possible that people taking thyroid medication in incorrect dosages can swing too far over to hyperthyroid if they are hypothyroid, and vice versa, in this delicate balance.
Regular hormone testing allows practitioners to offer the proper medication in adequate doses and adjust it when needed.
Medication for Thyroid Disorders
There are various thyroid medications on the market. The type of symptoms a person has will help determine which type is optimal for them.
Conventional doctors often only test for Thyroid-Stimulating Hormone (TSH). It used to be thought that TSH should be under 10mlU/L, but some endocrinologists and functional practitioners (Endocrine Society) now would consider a typical range from between .3 and 3.0 MlU/L. Some practitioners consider TSH greater than 2.0 less than optimal. If a person’s TSH appears to be in a normal reference range, the doctor may not continue to test for thyroid problems, even though other hormones might be out of balance, or they may consider the optimal range too broad.
It’s also important to test free T4 and T3 relative to each other.
Factors That can Inhibit T4 to T3 Conversion
Vitamin and mineral deficiencies (Zinc, Copper, A, B3, B6, B12, C, E, Selenium, Chromium, and iron)
Excess Alpha Lipoic Acid, Copper, Calcium, Epinephrine, Norepinephrine levels.
Elevated cortisol
Heavy metals
Elevated reverse T3
Aging and diabetes
Inflammation
Fasting, illness and alcohol use
Low progesterone
The use of Amiodarone and Beta-blockers
If a thyroid problem is suspected, practitioners should do a full thyroid lab which includes all the thyroid hormones and measures them relative to each other.
Lab Testing – Optimal Ranges
TSH: 0.4-1.9 mIU/L (Endocrine Society “normal” range is 0.3-3.0)
Free T4: high middle to high normal range
Free T3: 3.5-4.3 pg/ml
Reverse T3: lower half of normal range
TPO: within normal lab range
Treating Thyroid Problems with Medication
There are several different medications on the market today which are used to treat thyroid problems, classified into four main categories. Prescriptions should be based on a patient’s full thyroid panel and regular testing.
Synthetic T4 Medications
Synthetic T4 medications are widely prescribed for a variety of thyroid health issues. Common brand names include Levothyroxine, Synthroid, and Levoxyl. This can be useful in cases where the body is prepared to convert T4 to T3 properly. Unfortunately, if the thyroid is not functioning properly, many people aren’t able to convert T4 to T3 at the appropriate rates. This means that T4-only medications can also lead to an imbalance and continued symptoms of thyroid problems if they aren’t administered carefully.
When T4-only medications aren’t effective on their own, a practitioner may want to move to either trying a T3 medication or a T3 and T4 combination medication.
Synthetic T3 Medications
T3 medications are not as commonly prescribed as T4 medications. However, they might be a good choice for people with certain conditions, such as reverse T3 problems. When people can get enough T3, this can reduce the need for T4. Cytomel is a common brand name of T3 medication.
Natural Desiccated Thyroid
Natural Desiccated Thyroid (NDT) drugs are a prescription hormone treatment derived from natural sources, which are typically animals. In the United States, NDT is exclusively formulated from pig thyroid glands of pigs. There are multiple brands of NDT, including Nature-thyroid, Thyroid WP, Armour, and Acella. This is a promising and effective treatment, yet few doctors are using it currently.
Because NDT closely resembles human thyroid hormones, it is easier for the body to process. This medication is also highly customizable allowing for unique formulations of T4, T3, T2, T1, and other thyroid hormones and nutrients to be easily incorporated into the same treatment. It is also important to note that NDT is regulated by the FDA and undergoes rigorous quality assurance testing.
Compounded T4 and T3
With compounded T4 and T3, patients can receive the specific quantities of hormones needed for their unique situation, making it one of the most accurate and effective ways to offer hormonal support for the thyroid. This approach is preferred for some practitioners because it offers patients the opportunity to have a specialized dosage created in a compounding pharmacy. This also eliminates the potential of including thyroid-inhibiting substances such as lactose and gluten, common in many medications. Patients who have not done well using T4-only formulations or NDT frequently benefit from a specific compound treatment.
Learn to Administer Bioidentical Hormones for Thyroid Support
Health practitioners seeking alternative care models can learn how to administer BHRT to offer patients symptom relief and improve their quality of life.
Ready to learn more about how BHRT could fit into your practice? Click here to schedule a strategy call and get started.
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Is hormone therapy for menopause a safe option for women?
Recent research indicates that (bioidentical) hormone replacement therapy (BHRT or HRT) is both safe and effective when prescribed carefully.
Earlier studies pointed to risks of serious health consequences like breast cancer and stroke with HRT.
Despite a long history of health benefits reported in research to both conventional HRT and bioidentical forms of HRT, one big study, the Women’s Health Initiative, questioned the safety of hormone replacement.
Here we’ll discuss the safety and effectiveness of Bioidentical Hormone Therapy for menopause in light of more recent research.
How safe is hormone therapy for menopause?
People thinking of trying BHRT will be curious about the science behind it, and practitioners should be prepared to answer questions and offer this as a possible treatment.
Plenty of research exists to show that, when administered carefully and properly, BHRT (and possibly conventional HRT) should reduce symptoms of menopause and may even offer health benefits.
Concerns about the safety of hormone replacement therapy sprung primarily out of the controversial results from the Women’s Health Initiative Trial (WHI), which involved 30 000 women in two groups.
One group took a combination of estrogen and progestin, and the others took estrogen-only therapy.
The study stopped early because there were worries about breast cancer (group one) and stroke (group two).
(This article discusses the errors of the trial and where HRT went wrong)
Hormone Therapy May Lower Death Rates
A 2017 study published in JAMA and reported by the AARP discussed that mortality outcomes weren’t significantly higher in either group and that they may be lower or at least neutral.
What’s perhaps more surprising is that dementia rates were lower in the estrogen-alone category.
This was the case more so for women who were already in a lower-risk category for specific health issues (namely younger women).
But more importantly, it pointed to the need for a more careful and customized approach when treating menopausal women — and everyone else — with HRT.
Part of this is that the practitioner must have a clear picture of existing risk factors for health problems such as cardiovascular disease, stroke, and certain types of cancer.
About Hormone Therapy for Menopause
Menopausal women are probably the most significant group which can tap into the benefits of bioidentical hormone therapy.
While there is certainly interest in this type of therapy, many people don’t yet know that data indicated that this may be a safe and effective option that can help them reduce and manage intense symptoms of menopause and other symptoms of aging.
BHRT programs also allow practitioners to do more to monitor menopausal women as they move through a longer-term health plan.
This type of monitoring, along with repeated hormone testing, can help practitioners adjust prescriptions appropriately and immediately identify changes that need to be made.
Menopause is primarily due to an overall decline in estrogen — over the long term, it’s a decline; however, levels can fluctuate during perimenopause and even into menopause.
Factors (other than aging) that can worsen or trigger estrogen decline include:
Stress
Oophorectomy
Cancer therapies
Ovarian insufficiency
Adrenal fatigue
HPA Axis Dysfunction
Extreme diet or poor diet
Excessive exercise
Surgery
Statins
Bioidentical hormones may bring women struggling with menopausal symptoms more favorable or at least equally effective results than conventional hormone therapies.
Bioidentical Hormone Therapy for Menopause: Prescribing Estrogen
Bioidentical hormones may be more effective than non-bioidentical hormones for sleep, mood, and vasomotor symptoms.
When administered properly, data indicates BHRT does not have the same side effects demonstrated with non-bioidenticals.
Because estrogen affects so many different systems in the body, a sudden drop or even fluctuations can be associated with health problems associated with menopause, including:
Cardiovascular disease
Cognitive decline
Osteoporosis
Urinary incontinence
Frequent UTIs
Low libido
Vaginal dryness
Weight gain
Hot flashes
Night sweats
Dry skin, eyes, hair, and nails
Hair loss
Depression/anxiety
Fatigue
Brain fog and memory problems
Sleep problems
High blood pressure
Food cravings
Inflammation
Prescribing estrogen is not just a one-and-done type of thing and should not be treated as such.
Instead, symptoms should be monitored carefully through perimenopause and menopause to offer the best treatment.
Administering BHRT for Menopause
Earlier treatments used in the WHI study used non-bioidentical hormone treatments, and those problems were partly related to poor administration and dosing.
We know that BHRT may possibly be a safer and more effective hormone therapy for menopause, but this requires:
A proper diagnosis
Regular Hormone testing
A longer-term health plan
An understanding of the patient’s history
A clear assessment of a patient’s risk profile
Customized prescriptions
Assessment of patient lifestyle factors which may exacerbate menopausal symptoms
Last but not least, both patients and practitioners should be interested and willing to participate in regular discussions and consider this a long-term investment.
The highly individual and tailored approach is, in part, what makes BHRT potentially more effective and possibly lower-risk.
Want to Offer BHRT in Your Practice? Let’s talk!
More and more patients — especially menopausal women — want to have conversations about wellness and understand alternative options to standard prescriptions and standard treatments.
They want to have in-depth conversations with practitioners who can offer customized wellness programs to meet hormone-related health goals.
If you want to open a clinic or grow your practice, let’s get started!
Drop me a line — I’d love to hear from you!
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What are the benefits of BHRT pellet treatment?
Bioidentical Hormone Replacement Therapy (BHRT) is an increasingly popular treatment for individuals with testosterone deficiency (TD) or estrogen deficiency (ED).
Subcutaneous hormone pellet implantation (also referred to here as “pellets” or “pellet treatment”) is one of several possible delivery methods for hormone therapy. Different delivery methods may be preferred depending on an individual’s health needs and preferences.
Here we’ll outline the safety and benefits of pellet treatment and review recent research.
About Pellet Implantation
Pellet implantation is one of many hormone therapy delivery methods.
The process involves placing small implants under the skin, which release regular doses of hormones (usually estradiol or testosterone) over weeks and/or months.
Usually, the hormones in the pellets are compounded and “fused” into cylinders.
This type of treatment can be highly beneficial for those with health problems related to menopause and andropause. Examples include:
Poor libido
Hot flashes
Aches and pains
Vaginal dryness
Insomnia
Low mood
Headaches and migraines
Lethargy
Irritability
Fatigue
Males often find that pellet implantation is the most convenient way to get testosterone and prefer it over weekly injections.
Pellet implantation is an in-office procedure requiring local anesthetic and has little-to-no recovery time. Usually, implants are placed in the buttocks through a tiny incision.
Side effects are rare, with the most common one being slight bruising, bleeding, or swelling at the implantation site.
Whether the delivery method is pellet or other types of delivery, this should be an effective and safe way to reduce the symptoms of age-related hormone deficiencies.
This is the case so long as careful administration, monitoring, and regular hormone testing are done.
Benefits and Drawbacks of Bioidentical Pellet Implantation
The main benefit of pellet treatment is the psychological assurance of a specific, consistent dose of hormone treatment over time.
Alternatives to pellets include gels, creams, and patches. These offer similar results, but one drawback being that hormone release may not be as even or consistent.
Another key benefit of pellet treatment is that the patient does not need to remember to apply a daily cream or have a weekly injection ensuring compliance and convenience for the patient.
For practitioners, this delivery method offers easy monitoring and testing of hormones via saliva, serum, or dried urine.
BHRT pellets may have the added benefits of:
Improving bone density and preventing bone loss
Reducing the risk of certain cancers (e.g., breast cancer)
Improving cardiovascular health
It should be noted that BHRT hormone pellet implantation does not typically have a negative impact on blood clotting, blood pressure, glucose, or liver function.
Possible drawbacks for patients include:
A small risk of infection or allergic reaction at the site
Possible soreness
Cannot adjust the dosage or remove pellet at a later date
Less cost-effective than other delivery methods
The invasive nature and permanency of pellet implantation
BHRT treatment emphasizes careful monitoring and testing of all hormones to ensure that the right type and dosages are offered to patients.
We offer a pellet insertion training program to help practitioners understand how to administer BHRT pellet treatment safely.
Recent Research on the Benefits of Pellet Treatment
There is a common misconception that estrogen is the right choice of BHRT treatment for women and that testosterone is administered only to men.
However, women often will respond well to testosterone treatments for reducing the severity of perimenopausal or menopausal symptoms.
A study published in the European Journal of Breast Health conducted over 9 years on 2,237 patients had 35.5 % lower incidences of breast cancer in women who were taking BHRT pellet-form testosterone.
“This study reaffirms that hormone imbalances are an urgent medical condition for women and that optimizing hormones responsibly can not just improve quality of life, but prevent disease.” – Dr. Gary Donovitz (Business Wire)
The study works to dispel the common thought that estrogen therapy increases the risk of breast cancer.
Furthermore, it supports the theory that hormone therapy has the potential to prevent diabetes, some cancers, and other health problems.
Another study published just this past spring (2021) in Therapeutic Advances in Endocrinology and Metabolism reviewed the benefits of BHRT implants on patients’ health and quality of life.
This was a review of data collected over 7 years starting in 2012. The total numbers were 1,204,012 subcutaneous implant procedures on 376,254 patients. The patients were men with testosterone deficiency (TD), and women (85%) with TD / ED used implants.
Overall the complication rate here was less than 1%, and pellet extrusion, which is one minor complication, happened more often in men.
This was the most extensive study of this kind. It concludes that pellet implants are safe and possibly even more effective than other delivery methods of BHRT.
Teach Your Patients About the Benefits of BHRT
Pellet therapy is a safe and effective treatment method for individuals looking for testosterone or estradiol therapy.
Practitioners interested in offering this type of therapy should make sure they’re well-informed. They should understand the implications of delivery methods, dosages, combinations, and testing methods to answer questions and deliver effective therapy.
BHRT can be extremely helpful for patients and a lucrative revenue stream for practitioners.
To learn more about the benefits of pellet treatment or other aspects of BHRT, schedule a free strategy call with us.
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