So wonderful to see the passion and watch hormone therapies take their rightful place in prevention and general medical practice. Thank you Dr. Yurth for the kind words. Indeed I have been working with bioidentical hormones in clinical practice since 1990s and have found what works and what doesn’t in real patients. Been honored to write articles in conventional medical journals and books for the public since 2002 and I’m still learning every day from my patients and peers about the marvels of hormones. Only now, I also know how to work with peptides and make it a perfect world for my patients in search of optimal health and wellness.
I do not prescribe oral estradiol or testosterone because as many of you have mentioned, they are toxic to the liver and their metabolites are even more toxic. Patients may feel good for a while but in the long run the data and the clinical findings don’t look great, patients gain weight, become irritable and develop gut issues if they don’t get alterations in bleeding profile.
Transdermal estradiol, testosterone and even progesterone in young patients work well if compounded with small molecules ( liposomes or smaller) , not oils or other substances that make them unable to enter the circulation and that is why you see low blood levels and poor results. Please note I only use one hormone per preparation. Using combinations confuses the results and makes it impossible to know who did what to whom and how to adjust dosing.
Patches ( Vivelle-dot, etc), Estrogel and Divigel ( FDA approved ) are good options albeit expensive but their pharmacokinetics are excellent and thus bioavailability is great. I use them routinely in my practice .
Testosterone is GREAT!!! It is equally as important in women as in men and sadly we have no FDA approved preparation or awareness of its impact on the wellbeing of women. I use testosterone in TD creams or injections. We did try pellets but found the data and the clinical results confusing and not physiologic in any way as well as mentioned by Dr. Yurth, unable to change the dosage so, easier to do TD or injectable and collect data. Some patients come into office and get IM shots some take SQ and invariably they are happy with results.
Progesterone as we all know the data suggest absorption is best in IM administration yet it’s painful so we don’t use it. We use oral or intravaginal since the results speak for themselves.
Before I end this diatribe; We don’t treat patients with only gonadal hormones. Each patient receives a 360 degree approach. Thyroid, adrenal must be supported at same time as diet, exercise, lifestyle, stress management, sleep, supplements and PEPTIDES!!!!!
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