The Compounding Pharmacy Debate..................

Many patients, me included, get at least some of their bioidentical hormones from compounding pharmacies. I get my progesterone cream, my estriol cream (for vaginal atrophy) and my T3 capsules compounded.  My estradiol and testosterone are purchased at my local big box store pharmacy. I inject both of those medications once weekly (for me, Sundays), and I have found that it is easier to keep my hormone levels optimal with the protocol I am on.

I know most of you are aware of the fiasco and many deaths from tainted injections made by the New England Compounding Center last fall.  Clearly the ball was dropped in regard to oversight over this pharmacy, which was not acting as a compounding pharmacy, but as a manufacturer, thus stepping way over the lines of what they were supposed to be doing.  It frightened (justifiably) many people, and I spent a couple months reassuring patients from a patient's point of view that this was an aberration, that this is NOT the way most compounding pharmacies do business. I have NEVER had a problem with any of the hormone creams I have taken, and I have used at least five different pharmacies over the course of the last  6 1/2 years.

There is much discussion in Congress right now about whether or not the FDA (Food and Drug Administration) should be given broader access to regulate compounding pharmacies, which now are under the control of state pharmaceutical boards.  I will be the first to tell you I am not a fan of the FDA, I think they are in bed with Big Pharma and have done a great deal to harm our health care system.  A couple of years ago, I read something in an article that really struck home "Remember that every drug recalled by the FDA has first been declared safe and effective by the FDA".  That's important.

Do we need to make sure that another rogue "compounding pharmacy" doesn't get greedy and decide to make oodles of money by stepping over the line to become a drug manufacturer instead of a compounding pharmacy? Sure do.  Does giving the FDA broad but ill defined power the answer?  Read this article and an opposing opinion from USA Today to help you decide.

Uterine Fibroids and Vitamin D

I've been doing this blog for about four years now, and the more women I talk to, the more I convinced that there are less than two dozen women over the age of 50 who still have their uterus.  I'm kidding. Sort of.  The number one cause of hysterectomy in women  is uterine fibroids.  I had a hysterectomy in 2002 for fibroids; they weren't huge but caused a lot of pain, and the bleeding was so heavy (and erratic) that I became severely anemic.  I had to have 8 weeks of iron infusions by IV (3 hour sessions---ugh) for 8 weeks preoperatively just to get my blood levels high enough to be cleared for the surgery.  What was supposed to be a 24 hour hospital stay post operatively ended being 8 days----I bled post operatively necessitating a second surgery, and then developed a urinary tract infection from the catheter.  Not my idea of a great time.

In the NY Times, I read about a new study out that suggests that a low level of Vitamin D increases the risk of uterine fibroids in women.  I was interested to see that the risk of fibroids was reduced even when a woman's Vitamin D level was as low as 20------even by the ridiculously low standards of mainstream medicine, a level of 20 ng/ml is considered insufficient.  Some mainstream (read that to mean old school) physicians consider 30 ng/ml to be "adequate:", but more and more doctors are striving to get their patients up to at least 50 ng/ml.  Dr. Carr (my physician) likes his patients in the optimal range of 70-100 ng/ml, and my last reading in February came in at 78.  I often get asked how much Vitamin D I take.  Right now I am taking 15000 IUs daily, 2 - 5000 IU capsules, and then I get another 5000 IUs in the L-Arginine powder I take daily (it's a supplement, has a lot of benefits including heart health, but also contains Vitamin D).  The brand of capsules I take is Ortho Molecular, I cannot stress enough the importance of taking a good quality supplement.  I ran out one time, and being lazy (and distracted, I forgot to add it to my supplement order) I picked up some at a big box store and took it for about 3 months.  When I had my blood work done, my Vitamin D level had dropped by about 10 point.  Vitamin D is not an expensive supplement, and the Ortho Molecular brand (I have also used Integrative Theraputics) is just about the same price as the drug store brands.  Now that we are (finally) getting into warm weather, I will be out in the sunshine more, and at the end of this month I will drop back to taking one 5000 IU capsule and my L-Arginine.  I swim outside about 5-6 days a week in the summer without sunscreen, so I get a good dose of Vitamin D courtesy of the NC sunshine!

If any of my readers are from the Boston area, my thoughts have been with you this week, and I am very glad they caught that second terrorist suspect alive.  I watched some of the coverage yesterday, but in my concerted effort to reduce my stress level, I didn't focus on it and went about my day and stayed as busy as I could.  Yesterday my back was really painful, so I had an in the house day (I refer to it as a play quietly day), I read, listened to music, did a little Zentangle artwork (I'm finding this a great way to meditate!), knit for a while, and did some gentle stretching every time I got up to move around.  My back is definitely better today, I am being careful not to sit for very long at a time, and thank goodness for my iPad to browse online when I am laying down resting.

Hope wherever you are and whatever you are doing, you are having a great weekend!

I haven't forgotten you------

But lately, there has been little news to share in the world of bioidentical hormones and related menopause issues.  I hope everyone is enjoying these first weeks of spring, which have been very slow to come to the Southeast. It's finally here, however, and I have been enjoying some beautiful, sunny, mild days, perfect for capri pants and sandals!  Luckily, the progesterone cream keeps me allergy free, but lots of folks around here are sneezing and have very itchy eyes.

Hard to believe tomorrow is tax day..........the month of April is half gone! I'll be back soon as soon as I have any good articles to share with you, in the meantime, enjoy the rest of your weekend!