Bio-Identical Pellet Hormone Therapy

Bio-Identical Pellet Hormone Therapy Overview

Studies have shown that balanced hormones are necessary for good health and disease prevention for women and men as we age. Bio-Identical Hormone pellets optimize hormone levels with tiny pellets under the skin. Hormone pellets release Bio-Identical Estrogen and Testosterone and are absorbed by the body as needed.

General Q&A

-For women: usually every 3-4 months.

-For Men: usually every 4-5 months.

Pellets are pure hormones that will not be metabolized into by-products by going through the liver, stomach or skin. This delivery system allows your body to use the right amount of hormone from the pellet as the blood flow surrounding the pellets picks up what is needed.

The pellets completely dissolve because they are pure hormones without fillers or synthetic ingredients.

That depends on how much you exercise and work with weights, as well as your age. Testosterone decreases fat and increases muscle and lean body mass. Testosterone also increases your natural growth hormone and therefore will improve your stamina to workout and increase muscle mass.

Good hormone balance will greatly improve your libido. The addition of Testosterone in pellet form will change everything for the better.

Bio-Identical Hormones for Women

Hormone levels can start to decline in women in their 20’s & 30’s. In studies, when compared to conventional hormone replacement therapy, pellets have been shown to be extremely effective for relief of menopausal symptoms, maintenance of bone density, restoration of sleep patterns, improved sex drive, sexual response and performance, relief of depression, anxiety, irritability, mood swings and many others. Pellet implants have been used to treat migraine and menstrual headaches. It also helps with vaginal dryness, incontinence, urinary urgency, and frequency to name a few. Moreover, hundreds of studies show natural testosterone to be HIGHLY PREVENTATIVE against breast cancer, osteoporosis, Alzheimer’s dementia and heart disease to name a few.

Q&A for Women

YES. We have had great success especially with women who have menstrual migraines and new migraines that appear after age 35 y.o..

If you still have uterus, you will need to be on natural progesterone as well.

Estrogen is the most important hormone for a woman. It protects women against heart attack, stroke, osteoporosis and Alzheimer’s. It also keeps you looking young and healthy.

Testosterone is the third female hormone and is as essential as estrogen and progesterone. We need this hormone to keep our thought processes quick and our libido healthy. It improves muscle mass, strength and prevents some types of depression. It is also the source of energy and solid sleep.

There is less chance of excess hair growth with natural testosterone than with synthetic hormones. Facial hair will grow with testosterone pellets but normally no more than when you were in your thirties.

Bio-Identical Hormones for Men

Testosterone levels begin to decline in men beginning in their early 30’s. Symptoms of testosterone deficiency in men include fatigue, lack of mental acuity, loss of libido and difficulty achieving and or sustaining as erection. It is never too late to benefit from hormone therapy. Pellet therapy achieves the sustained levels of testosterone that would be produced by normally functioning testes. This form of therapy is the only kind that produces and sustains optimal levels of hormone that men need. Because the testosterone used is totally natural, Pellet Therapy is ideal for men wanting the benefits of a natural hormone, without the drawbacks of a synthetic.  Moreover, many studies show “optimal” testosterone levels over 800 in men, may have preventative effects for many disease states such as cardiovascular disease, Alzheimer’s disease, prostate cancer, osteoporosis and more.

Typical oral and transdermal forms of therapy have the potential for “roller coaster” blood levels of testosterone, which can result in mood and energy fluctuations for the patient. Pellets produce a more steady state hormone level in the blood stream.

Q&A for Men

Some men still convert to these metabolites even on testosterone pellets. If they are converting, we troubleshoot with natural supplements and or an aromatase inhibitor prescription.

Testosterone Pellets will make it better if you do not convert it to DHT: we will treat that if it happens.

Yes, they will. Testicles are suppressed by taking any kind of testosterone and they will not make as much testosterone while the pellets are working. This is not permanent, and the testicle retains its ability to produce testosterone. There are alternative treatments to testosterone therapy in men who wish to preserve fertility.

The Science Behind BHRT

  • Observational study of 70,000+ inhabitants of Cache County (NE Utah)
  • 1995-2013 Looked at HRT and Alzheimer’s
  • HRT beneficial but timing and duration important variables
  • Cache county study – HRT started late increased risk of Alzheimer’s but starting early showed a decrease risk in Alzheimer’s

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  • 1997-2001 study looked at 200 participants with CHD vs. 255 without CHD
  • HRT may be beneficial and not associated with increased risk for CHD. Even females who started HRT later in life had a decreased cardiovascular risk
  • This is a German Study
  • Oral E2 showed no increased risk of VTE/PE
  • This study showed that decreased insulin resistance with HRT especially oral and oral E2 is safe

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  • HRT and Osteoporosis, looking at Oral E2 – + Progestin vs just oral E2
  • 1990-2003 – 2016 perimenopausal women. An additional observation was a reduction in CVD with HRT
  • The subgroup was 502 for HRT and 504 for placebo
  • Important to note that this group took E2, while Premarin was used in the WHI
  • This was the longest oral E2 study >10 years. Oral E2 is safe with no increase in heart disease or DVT’s and there was a decreased risk of CVA and breast cancer
  • There was no increased risk of VTE/PE with oral E2
  • Oral E2 is safe

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  • 2005-2008 – 643 post-menopausal women
  • Proves the timing of HRT in relation to menopause is important in preventing
    atherosclerosis. Checked for carotid intima media thickness (CIMT) and CT coronary
    calcium scores
  • Used 1 mg of oral E2 vs placebo
  • Early is better than late for CIMT, but null results for CT calcium scores
  • Timing of HRT since menopause defined as <6 years and >/= 10 years
  • Oral E2 is safe

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  • 1994-1998 – 222 females
  • Measure distal common carotid artery intima media thickness on E2 one mg/day +/-
  • Pravastatin if LDL > 160
  • E2 decreases CIMT / oral E2 is safe
  • No increased risk VTE/PE with oral E2

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  • 1993 – 2009+ (ongoing study)
  • Approximately 521,000 participants and followed for 15 years
  • Looked at diet, nutritional status, lifestyle and environmental factors vs cancer/chronic diseases
  • In men, testosterone levels inversely related to CVD mortality, low testosterone predictive for those with high risk of CVD
  • EPIC – E3N( A French cohort study on cancer risk factors) P4 is safer than Provera for Breast Cancer

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  • 1999-2005 – 253 with VTE vs 597 without VTE (venous thromboembolism)
  • Case control French Study of Oral vs Transdermal E2 on VTE (mainly 17 B-estradiol)
  • Association with increased BMI (body mass index)
  • This was an observational study
  • Oral dose was 1.5 mg/day but transdermal was 50 micrograms/day
  • P4 does not increase clotting

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  • HRT vs Heart attacks/CVD
  • 1992-2001 – 2763 postmenopausal females (1380 HRT and 1383 placebo) treated for 4.1 years.
  • No benefit* against heart attacks/CVD (but results similar to WHI year one vs remainder of years showing early harm and later benefit). Funded by Wyeth-Ayerst Labs, makers of PremPro
  • Do not recommend HRT for secondary prevention
  • *First RCT to look at HRT and CVD. Had to have pre-existing CAD
  • *Possible adverse effects of Provera and also estrogen alone. See PEPI trial. Emphasize importance of basing treatment policies on RCT (randomized controlled trials) vs observational studies
  • HERS I – E2 and CHD, same curve as WHI
  • CEE – clotting RR 1.4 in year 1. Don’t recommend ERT despite RR 0.6 after 5 years, CVA risk not increased
  • Only 2.7 years vs 4 year follow up of 2321 females (1156 HRT and 1165 placebo)
  • Absence of overall long term benefit of HRT

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  • 1998-2000 – 1155 patients located in Tuscany, Italy. Follow-up 2007-2009
  • Studied various physiological subsystems important for mobility and chronic disease states
  • Antioxidants / physical performance / elderly = >/=65 y/o
  • Increase in total urinary polyphenols* associated with decreased physical performance decline
  • *Mediterranean diet which is high in fruits and vegetables
  • Relationship between low levels of anabolic hormones and 6-year mortality in older men
  • In this study high E2 levels associated with metabolic syndrome

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  • 2003 – 2006 – 17,802 participants
  • Is Rosuvastatin effective in primary CVD prevention, namely normal LDL cholesterol and elevated hs-CRP
  • Trial was stopped early due to the “44% reduction in composite end point in Crestor usage”
  • Analysis of the all-cause mortality curves shows that the curves were actually converging when the trial ended, suggesting that the borderline significant difference between groups may have disappeared had they had a longer follow-up
  • Funded by AstraZeneca (manufacturers of Crestor) who also collected the data and monitored the study sites.
  • Nine of the 14 authors had financial had financial ties to AstraZeneca and the lead investigator held a patent for the hs-CRP test.

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  • 2005–2012 – 727 Women
  • 727 women into 3 groups
    • Group 1 – low dose oral premarin and prometrium
    • Group 2 – transdermal E2 and prometrium
    • Group 3 – placebo
  • As expected, oral premarin improved lipids while transdermal E2 was neutral
  • Note: start HRT early, look at CIMT/coronary calcium scores

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  • 1976-2004+
  • Lifestyle / HRT vs overall health. Only married nurses could participate in Part 1
  • NHS Part 1 – 121,700 nurses
  • NHS Part 2 – 116,430 new nurses (1989)
  • NHS Part III – ???? (2010)
  • Very wide sweeping observational study. Discussed in detail in BHRT Workshops I – IV
  • Hormone levels and Breast Cancer
    • Estrone sulfate RR 1.37
    • SHBG RR 0.82
  • Unopposed HRT and breast cancer 5.0 – 9.9 years RR 0.87
  • >.=20 ears unopposed HRT RR 1.42
  • Prempro and Breast Cancer RR 1.66
  • E2 / post-menopausal female / CHD in the NHS RR 0.55
  • NHS: 50% decrease CVD/CVA/with HRT

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  • 1987-2000 596 – looked at endometrium, 875 postmenopausal women given Premarin +/- Provera/Progesterone
  • This study looked at estrogen, lipids and fibrinogen. Favorable study mainly unopposed estrogen, increased risk of endometrial hyperplasia
  • 3 year study on the endometrium
  • 596 women divided as follows:
    • Group 1 – CEE only
    • Group 2 – CEE (Premarin) + 10mg MPA (medroxyprogesterone)
    • Group 3 – CEE + 2.5 mg MPA
    • Group 4 – CEE + P4 (progesterone)
  • Looked only at endometrium: CEE alone is bad
  • CEE + P4/MPA protects endometrium
  • As expected, unopposed CEE leads to increased endometrial hyperplasia
  • P4 protects against endometrial hyperplasia
  • Oral E2 reduces CVD
  • Prempro worse CV outcome than with Premarin and P4

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  • 1990 – ongoing
  • Three cohorts – RS-1, RS-11, RS-III, RS-IV
  • 14926+ inhabitants of Ommoord (Rotterdam) observed for chronic conditions
  • Findings include a relationship between subclinical hypothyroidism and CVD
  • Also Vitamin D and metabolic syndrome
  • Independent inverse association between testosterone levels and aortic atherosclerosis
  • One observation talks about dietary patterns, BMD and hip structure in the elderly

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  • 1993-1999 461 females (231 E2 and 230 placebo)
  • HRT vs. secondary prevention of CVA (cerebrovascular accident)
  • Followed for 3 years on one mg of oral E2.
    • Results showed reduction in AD (in females with normal cognition at baseline, E2 is beneficial
    • No change in VTE or breast cancer risk
  • E2 showed no increase rates of VTE, breast cancer or CVA’s
  • Oral E2 is safe
  • No increased rates of VTE or breast cancer

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  • Study of postmenopausal women
  • There were 2 major parts to the study: A randomized clinical trial and an observational study
  • The entire WHI had 161,808 postmenopausal women
  • 1991-2004 68,132 in the clinical trial
  • 1993-2003 27,347 women in WHI hormone therapy
  • 1998-2010 93,676 women in the observational study
  • Multitude of conclusions to be reviewed and discussed in BHRT Parts I – IV

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