(Pete Hueseman, R.Ph, R.D.'s 11th visit to Power Surge) Dearest: Pete Hueseman, R.Ph., P.D., has been a registered Pharmacist for 27 years. His work in the area of hormone therapy is with bio-identical,naturally compounded plant-derived hormones. Pete compounds natural prescription hormones, such as progesterone, estradial, estriol, estrone, tri-estrogen, DHEA, testosterone and pregnenolone, plus other compounds. Pete's eagerness to answer our infinite questions about hormones, at a time when confusion seems to abound, has endeared Pete to the women of Power Surge. Pete Hueseman is professionally associated with NAMS, the Academy of Alternative Medicine, Alternative and Complementary Medicine Association, and is registered with more than one professional Pharmacist's Association. Welcome back, Pete. I'm curious about something -- if bio-identical hormones are given to women to replace the hormones their bodies have produced naturally for years, why should they have adverse side effects from even natural hormone therapy? Pete Hueseman, R.Ph., P.D.: The adverse reactions come in when the balance is still not correct for them, that is why I always say we will fine tune it over 2 or 3 months time. Dearest: Thanks, Pete. YoungOldMe: Pete, I have read all your talks - thanks for great info! I use compounded creams, progesterone and a Biest - I use every day, and wondering how to know when i am menopausal and stopped ovulating. Hard to navigate without a cycle! Pregnancy is a slight worry, too. Thanks. Pete Hueseman, R.Ph., P.D.: The best way to test to see if you are in menopause is to do a FSH test. YoungOldMe: FSH says no. Headaches if I go off, no headaches if I stay on. Pete Hueseman, R.Ph., P.D.: Then you are still perimenopause, use protection for birth control and cycle your hormones. Dearest: What sort of tests are required before determining doses of estrogen, progesterone and/or testosterone replacement therapy? (besides knowing how the woman feels) Pete Hueseman, R.Ph., P.D.: Test via saliva or blood the estradiol, progesterone, Testosterone, FSH in blood only. Dearest: And you recommend saliva tests over blood tests? Pete Hueseman, R.Ph., P.D.: Yes I do, not invasive, and can do in the A.M. (early) which is the best time to test hormones. k2: How would one go about switching from Prempro .625 to natural products, I hadn't slept well for over a year before I went on them. Pete Hueseman, R.Ph., P.D.: The switch over is easy, have your doctor order Biest 2.5 mg. & progesterone 100 mg. all in one oil capsule, and take one a day at bedtime. We can then fine tune the dose with time for you. k2: Thank You Bikearoux: What about constipation and constant feelings of PMS? Pete Hueseman, R.Ph., P.D.: I would need to know more history about you, before I could say how to solve that: age, if you're perimenopausal or menopausal, etc. Bikearoux: Age 47, peri and this is all so new to me. Pete Hueseman, R.Ph., P.D.: PMS usually is a sign of low progesterone just before your period. Girlie: Is it safe to take estradiol suppositories twice a week without taking progesterone? It's called Vagifemem. Pete Hueseman, R.Ph., P.D.: What did your doctor tell you? I would say you probably need to use progesterone with it at least quarterly. Donna: I have been taking black cohosh, red clover, soy isoflavones and still getting hot flashes bad and I don't sleep. Help! Pete Hueseman, R.Ph., P.D.: I would say you need to look into a natural estrogen like Biest, if you tested, your levels of estradiol would probably be quite low. Donna: Thank you Dearest: Pete, what are the sources of the natural hormones you compound? Pete Hueseman, R.Ph., P.D.: The sources are either Soy or Yam and the DHEA is from the Barbasco Plant or Giant Yam plant. Fran: What would you recommend for severe breast tenderness? Is Progest creme good for that? Pete Hueseman, R.Ph., P.D.: What are you using that might be causing the problem, sometimes more progesterone will relieve it, other times it could make it worse. Fran: I'm using about 1/2 tsp. per day of Progest and lots of vitamins. Pete Hueseman, R.Ph., P.D.: Is it the OTC cream or via prescription? Do you use it everyday or take a break for a week once a month? Are you on any estrogens with it? Fran: It's OTC. I use it for 3 weeks on, one week off. No estrogens with it. Pete Hueseman, R.Ph., P.D.: Do a saliva test, measure your estradiol level and lets see if you need to balance it with some estrogen. Feel free to call me to discuss it further. Fran: Thanks Pete Dearest: If anyone wants to follow up on a question, you can call Pete at 1-800-728-0288 or E.mail him at consultph@bpharmacysolutions.com Cynda: Should you receive hormone replacement during perimenopause and if so how do you know you need to? Pete Hueseman, R.Ph., P.D.: Many women these days do use HRT during the perimenopause, the best way to determine what is needed is to test levels first, and then do a complete clinical history with me. Wildflowers: My gyn is not receptive to anything but synthetic hormones, much less saliva testing. Do you have available at home saliva tests? Gynecologist is a wonderful doctor. We agree to disagree on hormones though. Pete Hueseman, R.Ph., P.D.: Yes I can sell you the test kit without an Rx and then I can help you interpret it. Wildflowers: Thank you. Dearest: You can call Pete at 1-800-728-0288 or E.mail him at consultph@bpharmacysolutions.com Dawn: Is the all natural compounded drug like taking regular hormone pills? I hear that the hormone pill has a 70% chance of breast cancer -- Is that true? Pete Hueseman, R.Ph., P.D.: The benefits are still there with a much lesser risk of getting cancer, and much fewer side effects. Dawn: Will I be at risk for bone loss without taking the hormone pill? Pete Hueseman, R.Ph., P.D.: Depends on many things, diet, genetics, exercise or lack of it, supplements used, etc. Dearest: Dawn, the risk of breast cancer is higher among women on synthetic hormones; however, I've never heard that women using hormones have a "70% chance of breast cancer." Additionally, there are many environmental factors that contribute to breast cancer as well. As much as 30% of breast cancer risk has been linked to the way we eat. Dietary changes to eat more fruits and vegetables may provide women with an easy way to reduce their risk of developing breast cancer along with using anti-oxidants, soy isoflavones, et al. Pete, I'm curious as to why DHEA can be a bigger problem for men. Thanks. Pete Hueseman, R.Ph., P.D.: It can stimulate in the higher doses more testosterone, and if the testosterone turns into estradiol it can cause much more problems with the prostate gland. YoungOldMe: I'm on my creams daily because after I added estradiol, I got bad headaches during the periods. I was taking about 100 mg of progesterone - the doc isn't really familiar with the creams - I cut back. I tested a little high for, of all things, testosterone (blood test, 79, normal was to 76). Estrogen levels were normal. I use Biest cream and Progest cream daily (love them). Would you recommend doing anything about the testosterone? Pete Hueseman, R.Ph., P.D.: I would have to know the exact doses of the hormones in the creams and exactly how you are using them, your statement is not real clear on that, then I could guide you. YoungOldMe: Estriol 1.7 mg, estradiol .4 mg daily in 1 g vaginally. prog 3% Pete Hueseman, R.Ph., P.D.: Your testosterone level is not that far outside of the range. JBancr5901: If testosterone is a bit high might it be okay to up Biest some to counter it? Anxiety adding progest. I really needed after surgical meno. Pete Hueseman, R.Ph., P.D.: Hi Jo, yes you could try that. JBancr5901: thanks Dearest: If anyone has additional questions, you can call Pete at 1-800-728-0288 or E.mail him at consultph@bpharmacysolutions.com Kari: My pregnenolone says not to take with alcohol or barbiturates. Why not? I take low doses of Xanax, will this harm me? Dearest: That's interesting. I've never heard that before and Xanax is not considered a barbiturate, right Pete? Pete Hueseman, R.Ph., P.D.: The Xanax will not harm you taking it along with the pregnenolone, and I wasn't aware that it ever said no alcohol or barbiturates. No, Dearest, Xanax is not a barbiturate, and I never read that caution on pregnenolone literature either. Dearest: Thanks, Pete. Silva50: I was using 1/4 tsp. natural progesterone for about a year only about 10 days a month. Now I break out in a rash. Why? It did help a lot with hot flashes and my moods. Pete Hueseman, R.Ph., P.D.: Did you switch brands? Maybe it is the base cream causing an allergic response, otherwise I don't know why it would happen suddenly. Silva50: No, same brand. Thanks Annemarie: Recent tests show my estradiol is 76, FSH 43, LH 50 and Progesterone 2.4. I feel dreadful all the time. Have had no periods since D&C last November (showed simple hyperplasia), HRT made me feel worse, I'm in England, what hormones do you think I need and how do I get them? Thank you. Pete Hueseman, R.Ph., P.D.: Do a test (saliva) maybe you need some estrogen to go with it, or maybe your progesterone dose isn't high enough or even to low now. We can ship to the U.K, I would like to send you my questionnaire via email to get more info, and then send you an answer. Dearest: Email Pete at consultph@bpharmacysolutions.com Annemarie: Thanks, I shall email you. Donna: You suggested I try Biest. What is Biest and do I need a doctors prescription for it? Pete Hueseman, R.Ph., P.D.: Yes, you do need an Rx for the Biest, and it is 80% estriol and 20% estradiol. Dearest: Pete, you seem to prefer Bi-est over Tri-est. Can you tell our audience the difference between the two and why you don't recommend estrone as often? Pete Hueseman, R.Ph., P.D.: I prefer Biest, because your body will metabolize the estriol and estradiol into all of the estrone it needs. If you get too much estrone it can turn into 16-hydroxyestrone which is carcinogenic and no one wants that. Dearest: Isn't estrone the most prominent estrogen in postmenopausal women and creates more of a risk for breast cancer? Pete Hueseman, R.Ph., P.D.: Yes that is correct. Dearest: Thanks, Pete :) JJ: Will you please discuss possible side effects of bi-est? It seems to cause "heartburn". Will this symptom subside? I have no previous history of digestive problems. Thanks! Pete Hueseman, R.Ph., P.D.: Try taking it with food, or as a sublingual tablet or topical gel, and then it probably will not cause heartburn. Possible side effects, if not balanced properly would be similar to any of the estrogens. Bakerdj: Are the OTC saliva test kits available at most pharmacies and are the normal value ranges listed with the kits? Pete Hueseman, R.Ph., P.D.: The saliva test kit is available through mail order from me, most pharmacies do not stock them, nor go over how to review the results with you. The ranges for the patient are sent along with your results from the lab. Bakerdj: How does one order from you? Pete Hueseman, R.Ph., P.D.: You can call me at 1-800-728-0288 Bakerdj: Ok, thanks! :) WithHope: Would you suggest different starting dosages NHRT for hysterectomy women losing ovaries? Pete Hueseman, R.Ph., P.D.: Yes, those women typically will start a little higher in dose than the women going through natural menopause. Estewie: I have cystic breasts. Should I take estrogen and progesterone in the natural form? My doctor prescribed Prometrium and estradiol. I am undecided as to take it because of the side effects. Pete Hueseman, R.Ph., P.D.: Those are both natural hormones, try it and see how you do, then adjust the doses as necessary to fit you best. Estewie: Ok thanks. Dearest: What's the difference between Prometrium and the natural, micronized progesterone you compound? Pete Hueseman, R.Ph., P.D.: There is no difference, except that the one we make is in safflower oil and not in peanut oil. Or we can make it in a long acting emthylcellulose base powder. Dearest: Isn't it true many women are allergic to the peanut oil base in Prometrium? Pete Hueseman, R.Ph., P.D.: Yes, there is a considerable number of women who are allergic to peanuts. Dearest: Thanks, Pete :) Kquest: They say I am perimenopausal, but I have had no period for 2 years. Previously, I had been very ill with respiratory problems and lost a lot of weight. Medications include inhaled steroids, 100 mg. Prometrium per day and estradiol gel @2.50mg.per day. Still have hot flashes - WHAT TO DO? (am from Canada!) Pete Hueseman, R.Ph., P.D.: I would say you are a candidate to use my sublingual tablet, and split your daily dose into two and use it under your tongue 2x a day. Dearest: Those of you not on the mailing list for reminders of our guest chats, you can sign up at http://www.power-surge.com/mailsubs.htm. In two weeks our guest will be Dr. John Lee. Kquest: Many thanks Pete and Dearest! Bikearoux: I'm 47 and in peri. I am having problems with constipation and always feelings of PMS. I am taking Dong Quai and Nerve & Osteo Support 2 D.Q. and 3 N.O. and supper time with a multi. Help Please! I do drink lots of water too. Pete Hueseman, R.Ph., P.D.: How much fiber or bulk do you get in your daily diet? Bikearoux: I find that fiber makes me bloated. Pete Hueseman, R.Ph., P.D.: Maybe you need to balance better with real natural estrogen and natural progesterone cyclically. Donna: Should I have a saliva test as you said to other before requesting Biest. And how do I know that is best for me? Pete Hueseman, R.Ph., P.D.: Yes, do the saliva test first, and try the Biest, we never know for sure what is best or if it will even work for sure, until we try something for 3 to 8 weeks. Donna: I guess it would be best to email you. Pete Hueseman, R.Ph., P.D.: Donna, yes. That way we can go over your history. Donna: Thanks Dearest: If anyone needs additional information, you can call Pete at 1-800-728-0288 or E.mail him at consultph@bpharmacysolutions.com Bakerdj: At what age do you recommend testing hormone levels, or is it dependent on physical signs / changes, etc.? Pete Hueseman, R.Ph., P.D.: It all would depend on when you start to have problems, I would suggest all young women do a test at about 25 years old just to get a baseline for when they are healthiest, and file it for when they get older. Bakerdj: Thanks again! Class: I have read that estrogen levels can be negatively affected by Synthroid. Is this true and should one then increase the estrogen if menopausal symptoms are returning? Pete Hueseman, R.Ph., P.D.: You are correct and that is quite true. That is also what we have to do very often. Class: Thanks so much! WithHope: You haven't said much about testosterone. Do you recommend it? Pete Hueseman, R.Ph., P.D.: Absolutely, when it is needed, I always suggest to test for it and supplement with it if one is depressed, has a low libido, or low energy levels. WithHope: I would like to say thank you. Estewie: Pete, question for you. I am taking Revival Soy. Do I need estrogen? Pete Hueseman, R.Ph., P.D.: Yes, usually you will need a natural estrogen to go along with it to totally relieve menopause symptoms. Donna: I don't think my doctor ever mentioned a saliva test. Pete Hueseman, R.Ph., P.D.: Most doctors don't know about the saliva test. Kari: Why not Pete? Pete Hueseman, R.Ph., P.D.: I think they haven't been educated about it too well yet, so they aren't real aware of the saliva yet. Donna: So, Pete, the saliva tests are new? Pete Hueseman, R.Ph., P.D.: They aren't really new, but in medicine something new in the last 5 to 7 years is still new, if that makes sense. Debrikkia: Pete--I had a total hysterectomy 12 years ago. Shouldn't I be coming out the other side by now? Pete Hueseman, R.Ph., P.D.: Probably real soon now, how old are you? Debrikkia: Almost 52 Pete Hueseman, R.Ph., P.D.: I would say you are almost there then. Class: Saliva tests are not even available in Canada -- we're in the dark ages!! Pete Hueseman, R.Ph., P.D.: I can ship the saliva test to you in Canada. Donna: How much do the saliva tests cost? Pete Hueseman, R.Ph., P.D.: The price depends on the number of hormones you want to test. Wildflowers: So what is the average cost. I mean how many should you test for the first time? Pete Hueseman, R.Ph., P.D.: #1=$45.00 2= $79. 3= $113.00 4= $141.00 5= $170.00 etc. Debrikkia: Pete, I want the saliva test. You already have my info Pete Hueseman, R.Ph., P.D.: Debrikkia: please call me tomorrow or email me with the complete name and address and which hormones you want to test for. Kari: By the way Pete, I bought my pregnenolone from you and the warning about the barbiturates was on the label. Pete Hueseman, R.Ph., P.D.: Kari: I will review tomorrow why someone put that on there, I believe that label was in error. Dearest: I'm sorry to say that sometimes all the medications, hormones, what have you don't always make us feel as we did once before perimenopause kicked in. Pete Hueseman, R.Ph., P.D.: I know, and I wish I could fix that for all of you. Donna: I guess I really need to educate myself more. I don't know what hormones need to be tested. Pete Hueseman, R.Ph., P.D.: Donna: I usually recommend to test Estradiol, Testosterone, Progesterone, DHEA. Pete, thank you for another great chat about naturally compounded hormones in treating our menopausal symptoms. If anyone is interested in using naturally compounded hormones, you can talk to and purchase them directly from Pete. He an be reached at 1-800-728-0288 or E.mailed at consultph@bpharmacysolutions.com. Pete, everyone joines me in thanking you for spending this time with us fielding all our questions. You're an angel! Pete Hueseman, R.Ph., P.D.: Thank you for all the good questions. Dearest: Thank you for all the good answers! Nite, Pete. Dearest: My guest March 28th is Carol Schulz, author of 60 Second Menopause Management and on April 4th, returning to Power Surge, our guest will be Dr. John Lee, author of What Your Doctor May Not Tell You About Menopause and his newest book, What Your Doctor May Not Tell You About Breast Cancer. Goodnight, everyone. 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