(Pete Hueseman, R.Ph., P.D.'s 7th visit to Power Surge) Dearest: My guest tonight in Power Surge Live! is been Power Surge's Pharmaceutical Consultant for about five years, PETE HUESEMAN, pharmacist for 27 years, who compounds natural, plant-derived, "bio-identical" hormones for women. Welcome back, Pete :) Pete Hueseman: It's great to be back! cricket: Just a litle background first to help. I'm 46 and had a hysterectomy 2 years ago. I've tried all kinds of estrogen and keep retaining fluid and gaining weight. What can I take? Pete Hueseman: Without knowing your total regimes tried, I would suggest adding a little progesterone. Dearest: Why would you suggest progesterone in this case, Pete? cricket: Even without a uterus? I thought progesterone was contraindicated Pete Hueseman: It has a mild natural diuretic effect oftentimes, and can help reduce the water retention caused by the estrogens. It is usually not used when no uterus, however it does have many benefits besides protecting the uterus. Dearest: Pete, isn't it true that years ago progesterone wasn't recommended for post- hysterectomy women, but the school of thought is different today? Don't they think it's important for all women to balance their hormones? Pete Hueseman: Yes, that is entirely correct, it helps balance the overall scheme of things hormonally. cricket: I've tried estratab, estrace, premarin, patches and would like to try a natural estrogen. Any ideas? Pete Hueseman: You can call me at work tomorrow, and we can discuss some options for you individually, including biest, progesterone, and possibly testosterone. cricket: Thanx Pete Hueseman: Biest is a very good natural estrogen, a combination of estriol 80% and Estradiol 20%. Dearest: Pete, please give Cricket your number. Pete Hueseman: 1-800-728-0288 cricket: Thanx, I'll call slucca: Pete, what can you tell me about Orthoest, I understand it's supposed to be a natural estrogen and only used for about 5 days, true? Pete Hueseman: It is a synthetic estrogen, and I thought it was used longer than for 5 days. You mean use it 25 days & off 5 days? slucca: I understood that it was natural, I don't use it but know someone who does. She only uses it for about 5 days a month. Pete Hueseman: I don't have at my finger tips what is in it exactly tonight. It is an ortho product, possibly derived from soy but probably esterified and therefore not natural to the human female. slucca: thanks anyway jeanc40: I've been on the climara 025 for a month and like the results however i change it at 5 days as you suggested and even before due to the "sticking " problem. What do you think of me switching to vivelle? At least if i loose a patch sooner it isn't so expensive and also living in FL with swimming and sweating i think a 3 day patch would be etter. do you have a favorite patch? Pete Hueseman: My favorite patch is Vivelle, and 2nd is estraderm. Dearest: Why not Climara? Pete Hueseman: Jeanc40, I do believe your reasoning is very accurate. jeanc40: ok thanks Pete Hueseman: Climara, is claimed to be a once a week patch, but it seems that it only lasts most women for 4.5 to 5. days. Dearest: Ahh.. thanks, Pete :) Nono, go ahead with your question. Nono: Do you need more natural hormones than you would synthetic to get the cancer risk reduced. Pete Hueseman: The dose of natural is usually a larger number, that would be equivalent to the synthetics, but the byproducts cause much less risk of cancer. Does that answer that question? You would still use as little as possible to get symptom relief. Dearest: Pete, is there anything in your naturally compounded bi-est, for example, than estriol and estradiol? Also, what about commercially prepared hormones like Estrace, do they contain anything other than the natural estrogens? Pete Hueseman: No, there is no other active ingredients in the biest compounded or the estrace, just fillers and excipients to form the tablets or capsules. Nono: What if you really don't need hardly any for symptom relief? Pete Hueseman: Nono: you would use the lowest dose necessary to solve symptoms, but don't let osteoporosis sneak up on you. Nono: you still need something for your body to be balanced and to reduce the risk of cancer, correct? Pete Hueseman: Yes, that would be the estriol and progesterone usually. Dearest: Dimples, your question, please? DimplesB: What do you think about hormonal testing using urine? What is most accurate...urine, saliva or serum? Pete Hueseman: I like blood the best, saliva and urine are also very accurate. DimplesB: What is the recommended range for the blood test? Pete Hueseman: It depends on which hormone you are testing, and what phase of the cycle you are in. DimplesB: I have no cycle..I've had a TAH/BSO Pete Hueseman: Which hormone? Many labs send the reference range back with the lab report, some labs measure differently. DimplesB: estrogen Pete Hueseman: Example: estrogen is best between 60 & 120 pg/ml. Dearest: Is there a best time to test estrogen levels in, say, perimenopausal women? Pete Hueseman: Best, and usually, done at day 21 or thereabouts of the cycle. Dearest: Thanks, Pete, Monnie, go ahead, please :) Monnie: What in your opinion is the best book to read about HRT. I've read most of the HRT Solution book....what other book would you recommend? Something very comprehensive hopefully. Dearest: You might try the Power Surge Bookstore, Monnie :) It's at http://www.power-surge.com/bookstore.htm Pete Hueseman: Hormones Without Fear by Ivy Greenwell or the Becki When are best times to call you & I can tell you my dosage then? Pete Hueseman: 1-800-728-0288 MaryM: After I had my TAH/BSO and recovered, I could get orgasm just like before, then after a few months, when my own hormones were completely depleted, I lost it. I was on Estratest HS, which was worthless. I have been on natural hormone gel, Biest 10/Prog 200/ Test 5.0 since May (thru your pharmacy with Mitch) and still no resolution. I still have terrible night sweats. I am 40, what would you recommend? The testosterone is absorbing well. The Biest will fix the orgasm problem? Dearest: Becky, please email me what you're taking - to Dearest@aol.com. Thanks. Becki I'll do that, thank you. I love your site! Dearest: Thanks, Becki :) Pete Hueseman: Mary: I would try our sublingual tablet and possibly a little Testosterone 2% thick gel to apply locally every evening. MaryM: I tried the thick gel. Only got local feeling, not full body feeling, if you know what I mean. Pete Hueseman: It sounds like we need to increase the biest dose too, and try it in a sublingual for better absorption. MaryM: Okay, thanks, I will switch over to sublingual and increase Dearest: Mary, why don't you call Pete and talk with him tomorrow. He can advise you best that way. Dimples, go ahead, please. MaryM: Okay, thanks DimplesB: If someone wanted to switch from sublingual bi-est to another delivery method...what would you recommend? Pete Hueseman: If you weren't happy with sublinguals, I would try a gel or an oral capsule next. DimplesB: but sublinguals offer the best absorption? Pete Hueseman: They do, but you said what if they wanted something else. DimplesB: I know...but just wanted to know find out for sure? Dearest: Pete, explain why you would recommend sublingual over orally ingested estrogen, please? Pete Hueseman: You get better absorption, and no stomach aches, if that has ever been a problem for anyone in the past, or if the oral is not metabolizing properly, you also bypass the liver with a sublingual on the first pass through the system. Dearest: Thanks, Pete! Lambmack, go ahead. lambmack: I have just started taking Loestrin - I have gastrointestinal problems now - I believe from progesterone, but my doctor says it's a virus. I tried progesterone in the past sublingually for PMS and had same gastrointestinal problem - is it because in Loestrin this is synthetic, or is this a problem consistent with progesterone. Also, is depression related to progesterone use? Dearest: I have heard this before, Lamb. lambmack: I'm upset with my side effects and no answers Pete Hueseman: You are on a synthetic, it can cause gastrointestinal upset. We could make a similar dose for you in a sublingual form and see if the gastrointestinal upset goes away. lambmack: This is for perimenopausal problems Pete Hueseman: Of course, we would use natural hormones too. lambmack: Would I call and speak with you about this personally? Dearest: And, yes, many women experience depression from progesterone use, but perhaps once you get the dose right, it can be resolved. Pete Hueseman: It would be in 2 separate pills, estrogen every day and progesterone on days 13 thru 27 of the cycle. lambmack: I am also anxious about using HRT to begin with. Pete Hueseman: The synthetic progestins cause much worse depression than the natural micronized progesterone. slucca: Becki stated earlier that she hasn't had a cycle in 3 years, isn't it important that the uterine lining shed at least once a month? Also do the naturally compounded hormones, if used correctly, allow for shedding of the uterine lining? Dearest: Good question. In fact, Pete and I were just talking about this yesterday :) Pete Hueseman: Yes, it is important to shed the lining once a month or take continuous progesterone to help prevent a buildup, and the naturals can be given to shed the lining also. slucca: Thank you and I will be calling you DimplesB: What are your thoughts about DHEA? Are most TAH/BSO women deficient in this hormone? Pete Hueseman: Most people, men & women are deficient in this once they reach the age of 40. DHEA is produced by the adrenals mostly. DimplesB: And you offer test that check those levels? Is the test combined with any others? Pete Hueseman: You can buy a saliva test for just DHEA or combine with the other hormones. A blood test would work too. Dearest: You have the saliva tests, Pete? Pete Hueseman: Yes, we do sell the saliva test through our own Bellevue Pharmacy -- 1-800-728-0288. Barbieannz: I am 47, have had fairly reg. periods, am not on any med. and last period was 14 days long, I stopped it finally with mixing water and 2 tbsps. apple cider vinegar. is that OK to do? Dearest: It worked, Barbie? Pete Hueseman: I don't know anything about that therapy, if it works and does not upset your stomach, then try it, but I'm sure natural progesterone would work very nicely for you. Barbieannz: Yes, i should clarify, i drank it. i have been told it puts your ph back in balance, does that sound right? Dearest: Yes, I've heard of it before. It's also a common mixture for douches to restore proper ph balance. Pete Hueseman: It may help your pH, but that is not hormone balancing. Dearest: I think her concern is more her periods than hormones :) Barbieannz: does that mean my hormones are imbalanced? Pete Hueseman: Periods are regulated by estrogen and progesterone balancing, not pH adjustment. There is something out of balance, yes. Barbieannz: guess i will have to call my doctor.....thank you MaryO: I've been off Estrogen/provera for over 2 and a half years and on Revival Soy. I have no meno symptoms, no period for over 2 years. I can't think of any good reasons to use any kind of HRT...I'm at a very high cancer risk and I'm under pretty continual doctors care for other issues. I cannot think of any reason why I should go back on any form of HRT...can you? Pete Hueseman: You are correct, as long as your bone dexa scan come out ok and no signs of osteoporosis. MaryO: yes, they're ok now...I had some trouble with osteoporosis a while back, but that's been arrested. DimplesB: Pete another member mentioned the GI complaints and I've been having that too...I spoke with you the other day about it. Could candida cause the GI problems too? What if I wanted to try a seperate my hormones and use sublinguals for estrogen and progesterone in cream. Pete Hueseman: Yes, candida can cause GI upset sometimes, and yes we could put your hormones in into a cream and a sublingual to try. slucca: Pete, would you need to see a blood test and/or have a prescription from a doctor in order to compound the correct "mixture"? Also, some insurance companies cover natural meds, do you take insurance? Pete Hueseman: We do take many insurance plans nationwide, and yes, we need a legal prescription from a licensed physician to order a compounded hormone formula. slucca: Thank you, that's good to know Pete Hueseman: I can help you figure out what you need if you call me 1-800-728-0288 Dearest: And remember, Pete will talk directly with you AND your doctor as well. kiki: If vaginal dryness is main symptom of menopause, what is the best way to handle it? I am using Pro-gest right now. Pete Hueseman: I would suggest estriol vaginal cream .5mg./gm and insert 1 gram into vagina at bedtime for 10 days in a row, then twice a week thereafter. MaryO: That testosterone thick gel...do you need a prescription for that? Pete Hueseman: Absolutely, it is a controlled substance. DimplesB: How can I get my dhea level tested locally using your doctor, Pete? Pete Hueseman: Have your doctor, could be Family Practitioner, order a blood test at your local lab or we could send you a saliva test just for DHEA for $45.00. Or get your lab's phone number I will will have him call them to order the blood test for you. DimplesB: yes...I'll get the labs number and call ya. Dearest: Pete, what's the average time to get a woman adjusted to some form of hormone therapy? If there is any such thing as average. Pete Hueseman: One to three months...no, can't say just one month, not fair, an average range of time is 1 to 3 months. TK: Thank you. Does Bellevue Pharmacy make a natural for men who experience P.E.? <Dearest note: premature ejaculation > Pete Hueseman: That is usually not a hormone problem, but possibly psychological; if a doctor would want to try something, then yes we could make it. There is a good over the counter product called DETANE. It contains a local anesthetic. TK: The reason I am asking is for my husband. I am taking BiEst plus testosterone after 17 years without any hormones post hysterectomy and now that I am better with my hormones, my husband is now having a problem, but it has been going on for lots of years. Pete Hueseman: Have you seen a counselor? TK: No we have not. Pete Hueseman: Or have you tried Detane or something similar? TK: No, we have not tried detane. My husband saw urologist this week and was prescribed Prozac which I am not too keen about the Prozac. Dearest: I am not either. It's now being prescribed for PMS and hot flashes. Good grief. Pete Hueseman: Well Detane is a possible solution, try it for 3 to 4 weeks and see if it helps, then have him ask about an anesthetic for local use. and also think about a counselor. TK: Should his serum levels be tested? I know Prozac is prescribed for hot flashes, etc. Okay, but what would a counselor do? And, should he see alone or together? Pete Hueseman: You could have his testosterone, dhea and estradiol tested. Counselors would see you both, sometime together and sometimes separately, check it out. TK: Okay, thank you. Dearest: Linkaloo will be the last question for tonight. linkaloo: What would be considered too much progesterone? Can you OD on too much? I started using the cream, just love it, helps me sleep great! I hate to stop after using it 21 days straight. Pete Hueseman: That is definitely not too much, are you still having periods or post - menopausal, that would determine if you use it for 4 weeks per month or only 3 weeks out of 4. linkaloo: I'm still having my periods, but definitely perimenopausal, I'm 47 years old. Pete Hueseman: For any one person too much would be different doses; I would only use it for 3 out of 4 weeks in your case, probably 1/4 tsp 2 to 3 times a day on those days. 1/4 tsp in the morning and 1/2 tsp at night would be fine. linkaloo: Thanks Pete, appreciate your input! Dearest: Pete, thanks so much for joining us tonight to field questions about naturally compounded hormones :) Anyone interested in trying natural hormone therapy can talk with Pete at Bellevue Pharmacy. Pete will give you the number or you can write to him directly at consultph@bpharmacysolutions.com. See you all Tuesday at the Open House. I'm very tired, so I'm going to say goodnight. Brother is visiting from England. Pete Hueseman: Thanks for having me back. It was a great pleasure. I'm at 1-800-728-0288. Remember, if anyone's question was not answered to their satisfaction, please call me and we will discuss your individual case at length. Dearest: Please join me in thanking Pete for visiting Power Surge tonight. 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An appearance in Power Surge does not constitute an endorsement of a guest's views. None of these transcripts may be reprinted or reproduced without the express permission of Power Surge™ and the respective guest. Read other transcripts by returning to the Library. Dearest aka Alice Stamm Power Surge Founder, Facilitator, Host Copyright©1994- by Power Surge. All Rights Reserved.