Beginning Hormone Replacement Therapy
STEP 1: Contact Us
Contact us so we can help you locate a prescribing professional near you or we would be happy to contact your physician if he or she is interested in working with us. He or she can write a prescription for hormone saliva testing so you can submit to your insurance provider for reimbursement. Some insurance carriers are covering part or all of the cost of the saliva testing.
STEP 2: Saliva Test
You are required to take a saliva test before seeing our pharmacist for consultation. We will send you a saliva kit by mail or it can be picked up at our lab. You will do the test at home, so no appointment is necessary. Our staff is available to answer all your questions and help you fill out the application. The test package is mailed to the assay lab in a pre-addressed UPS mailer. In about 3 weeks the lab results are sent to us for review. At that time we'll contact you for your first consultation.
STEP 3: Initial Consultation
The final lab results must be available before your consultation. Our BHRT specialists will spend about 45 minutes to 1 hour discussing the principles of bio-identical hormones, answering your questions, assessing your symptoms, explaining the test results and taking a detailed medical history. This consultation can be done in person or by phone.
STEP 4: Treatment
At the end of your initial consultation, your BHRT pharmacist, your physician and you will determine the course of treatment. Therapy begins at low dosages relative to the base line determined by your test results. You are requested to call us at the end of the first 2 weeks for a progress report. This method allows us to adjust dosages slowly upward, if necessary, without ever over-dosing. Custom-compounded medications will be ready the next day for your choice of pick-up, delivery or shipment.
STEP 5: Follow-Up
Hormone therapy is not an overnight remedy and for this reason most women should feel little if any change in early therapy. You will need to be patient while giving the initial dosage strengths about 2 months to start taking effect. Towards the end of your third month of therapy we require you to call one of our BHRT technicians to discuss your progress and revisit your initial symptoms. During this consultation, you will discuss the effects of the program and at this point, if necessary, your BHRT pharmacist will request your physician adjust your dosages accordingly. You will repeat this process in 2 to 3 months and again every 6 months thereafter, depending on your situation. In the unlikely event that optimum results are not achieved, it may be necessary to schedule an additional consultation with one of our BHRT pharmacists.
What if I'm not sure of what I need?
If after reading over most everything we've offered here about BHRT and you are still not sure what you might need, you may want a consultation (in person or by phone) with a specialist from our lab. So your time is not wasted on preliminary questions and background information you can make the most of your consultation by completing a Form we have provided. When we receive your form we will call you for consultation appointment.
Does your office accept health insurance?
Our office does not accept insurance for payment. However, this does not rule out the possibility of reimbursement by your insurance provider. We will be glad to provide you with properly coded invoices that you may submit for reimbursement. You may be subject to an annual deductible and a co-pay, depending on your coverage. Please contact your provider for more details on coverage.
Will my insurance cover the cost of prescriptions?
Some insurance companies do not cover the cost of compounded medications. For this reason, The Medicine Shoppe Compounding Pharmacy Lab does not accept insurance for direct payment. However, we will provide you with properly coded invoices that you may submit to your insurance provider for reimbursement. If you wish to determine coverage in advance, tell your insurance provider that you may be treated with compounded medications containing bio-identical hormones.
Will my insurance cover the cost of saliva testing?
Insurance plans will often cover some or all of the cost of saliva testing. Your chances of getting some coverage may be better if a copy of your prescription accompanies your claim form. Speak with your insurance carrier for more details. The list of tests we perform can be found here.
- Estradiol (CPT Code 82670)
- Progesterone (CPT Code 84144)
- Testosterone (CPT Code 84402)
- DHEA-S (CPT Code 82627)
- Cortisol (CPT Code 82530)
Can I use my own pharmacy?
Yes, but mostly likely they won't want to spend the time it takes, nor is it likely they will have the equipment or training necessary. Bio-identical hormone modulation is very different from prescribing "one-size-fits-all" drugs like synthetic Estrogens or Progesterone, which come right off the shelf in 3-5 or so dosage strengths. Every treatment regimen is custom-tailored to the individual based on the results of hormone tests, medical history, physical exam, and symptoms presented. With compounded medications, exact measurements of hormone powders are mixed with a cream base or loaded into capsules. Then very small adjustments are made during the course of therapy to keep pace with the natural chances of your body. With drugs like synthetic Estrogens or Progesterone you would have to jump to the next manufactured strength. There are many variables such as the absorption level of the cream base or sustained release properties of a custom-made capsule. We are better able to properly adjust the dosage in response to symptoms than your NON-compounding pharmacy.
How will I get my natural hormones?
We are currently consulting with and filling prescriptions for women in many states across the US. You can receive your prescription from our lab by Priority Mail (3 days) or Express Mail (next day). Once your hormones are "In Balance" and correct dosage levels have been determined, you may choose to have our lab set-up a regularly scheduled delivery.
How are the hormones administered? How often?
Hormones are self-administered once or twice per day via transdermal creams (estrogen, progesterone, testosterone), oral capsules (progesterone, DHEA, pregnenolone, melatonin).
What are the hormones made from?
Our bio-identical hormones are derived from the wild Mexican yam or soy. The molecules are then modified to exact replicas of the hormones currently in your body. They fit the receptors in exactly the same way.
What are the side effects?
Side effects are often minimal and manageable when restoring hormones to youthful levels. Some patients report breast tenderness or swollen joints when first starting bio-identical hormone replacement therapy; these and other adverse reactions can be remedied by reducing the dosage. None of our nearly 450 patients have reported long-term side effects.
Do you test cortisol levels?
Yes we do test cortisol levels in the saliva test.
What if I had a hysterectomy?
Bio-identical hormone replacement is perfectly safe after a hysterectomy. In fact, since the ovaries produce much of the testosterone in the female body, replacing this hormone is even more important.
How long do I need to stay on the program?
You should continue treatment as long as you wish to see results. The vast majority of the 800 patients we have treated are still on the program.
Have you had any success in treating fibromyalgia?
We are treating several patients with fibromyalgia and/or chronic fatigue, all with significant improvement in energy, level of pain, and frequency of exacerbation of symptoms. None have encountered a negative response. This does not assure similar response in all patients with fibromyalgia, but to date the response to therapy has been more effective than prior therapies.
Although our program is not specifically designed to attack the underlying cause of fibromyalgia, it does restore function and strength of the immune system, restore efficiency of mitochondrial production of energy with cells, and improves the bodies natural anti-inflammatory capacity.
If you are interested in pursuing treatment, contact the office to arrange for a saliva test prior to making consultation appointment. With the test results we will be better able to discuss possible benefits of our treatment specific to your current condition.
