(Pete Hueseman, R.Ph., P.D.'s 20th visit)

Dearest: My guest tonight is Pete, Hueseman, R.Ph., P.D. Pete has been a Registered Pharmacist for 30 years. Although Pete is a registered pharmacist and dispense all sorts of prescription medications, he's focused his area of expertise on women's healthcare, and to naturally compounded, HIH - human-identical hormones, such as estradiol, estriol, estrone, tri-estrogen, micronized progesterone, DHEA, testosterone, pregnenolone.

Pete specializes in counseling patients and physicians on the use of natural hormones. He advises patients and physicians, nationwide, and is an acknowledged expert on the use of *natural* hormones or NHRT (natural hormone replacement therapy)

Pete 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. Pete also is co-owner of Bellevue Pharmacy Solutions.

Pete, welcome back for your 20th visit to Power Surge :)

Pete Hueseman, R.Ph., P.D.: Thanks for the kind introduction, and it is good to be back.

Dearest: Great to have you!

Would you recommend that just as one does research before choosing a doctor, that they should be certain they're using a reputable compounding pharmacy like yours -- Bellevue Pharmacy Solutions?

Pete Hueseman, R.Ph., P.D.: I would say that is a good idea, and since we ship everywhere and accept hundreds of insurance plans, they need to look no further, just call us. Questions one would ask would be -- what dose forms do you have, and how long have you been doing this for starters.

Niklinsha: is there a product for vaginal dryness in the way of hormones if you have had breast cancer estrogen +?

Pete Hueseman, R.Ph., P.D.: Yes, one could use our Vaginal cream consisting of Estriol and testosterone, on prescription and it would be safe to use in this situation.

First call in to me, for a saliva test. Once the labs are back, we can formulate something for you, but for only the vaginal dryness. As I said before, the Estriol and Testosterone vaginal cream works well.

Dearest: You can always read more about bioidenticals at www.power-surge.com/educate/naturalhormones.htm and at www.power-surge.com/educate/yourhormones.htm

TheIrishTeam: Just searching for the best solution for vaginal dryness due to a complete hysterectomy 12 years ago, any suggestions?

Pete Hueseman, R.Ph., P.D.: Irish Team, we will be able to figure something out for you.

RevyGirl: Hi Pete. I have been taking Estradiol .5 twice a day for 14 days and then 100mg of Progest for 14 days. Am I supposed to go off all for 7 days or continue on with the Estradiol? Is the period supposed to come during those 7 days? So far I have been bleeding every day, but I have only been on this for 2 weeks so far. Should your period be after the progesterone? Thanks

Pete Hueseman, R.Ph., P.D.: You should be taking the estradiol twice a day all month long, and then using the progesterone twice a day for the 13 or 14 days right before the expected period.

RevyGirl: So I wait 7 days after the 28 before starting again?

Pete Hueseman, R.Ph., P.D.: It sounds like you are still out of balance and need some fine tuning. Do not go off of all - only the progesterone. You will wait 14 days on the progesterone.

Sally-13: Does what you suggested need an prescription and is that a natural alternative to VagiFem tablets (that can be applied vaginally)?

Also, do over the counter phytoestrogens, or even the estrogen creams affect DHEA in the blood? My DHEA is high (219). I have taking testosterone cream (prescription) for about 4 months. Is there a natural form to that, too?

Pete Hueseman, R.Ph., P.D.: There is no such thing as natural testosterone cream. It's prescription only and a controlled substance. The Estriol and testosterone vaginal cream is prescription only also.

The phytoestrogen cream will not effect the the DHEA levels. Yes it is bioidentical.

Niklinsha: I've heard that estrone is the safe estrogen. Is there a vaginal cream for dryness with that? How much is the saliva test?

Pete Hueseman, R.Ph., P.D.: The saliva test price depends on how many hormones are tested. To test four hormones is $184.00. To test three hormones is $141.00. To test five hormones is $225.00 and can be covered for only a co pay if you have either Blue Cross or United Healthcare Insurance.

We can make estrone in the vaginal cream, but it is wrong to say this is the safest form of estrogen.

Immoloto: Hi, Pete! For six months I have been using Tri-est 1.25 mg twice a day monthly and Progesterone 150 mg twice a day for 14 days. I am trying to mimic the menstrual cycle. My next hormones level testing will be in March. Do you think it is time to change for Bi-est? What are the risks if I continue with Tri-est?

Pete Hueseman, R.Ph., P.D.: If you are doing well, I would not change, or if your estrone comes out extremely high, then I would switch to the Bi-est.

Immoloto: What if I bleed while taking both?

Pete Hueseman, R.Ph., P.D.: Then your doses need to be adjusted. More estrogen and less progesterone, probably.

Laura47: Is the Climara Patch a bio-identical hormone? If not, is there a patch that is? I'm on .25 and still having terrible hot flashes. I had a total hysterectomy 6 years ago.

Pete Hueseman, R.Ph., P.D.: The Climara is bioidentical, and you are on a very low dose. I would switch to Vivelle, change it twice a week, and go to a 0.05mg strength. Or call me and let's talk about a sublingual dose form. My phone number is 1-800-728-0288.

TNT206: I was taking compounded thyroid 240mg. Then my doctor dropped that to 180mg. I've been taking this for three months and I notice hair loss this month. Could it be from the drop?

Also, I've been taking low dose HRT for three months. I take Biest 1.5mg once daily and progesterone 50mg on days 12-26. Could it be the HRT? Thanks

Pete Hueseman, R.Ph., P.D.: I think it might be the sudden drop in the thyroid. Why did the doctor lower the dose? Was testing done? Did you have a rapid pulse on the higher dose?

tnt206: I had sweating and moodiness and felt uptight.

Pete Hueseman, R.Ph., P.D.: Now we may have to increase the Biest dose for you, then.

Psyche921: Have you seen side effects from natural micronized progesterone such as increased sweating, headache, depression? A friend was prescribed the same and she believes it worsened her symptoms. My gynecologist prescribed the same for me (vaginal inserts), but I'm hesitating.

Pete Hueseman, R.Ph., P.D.: The side effects vary from individual to individual, but it can cause some lethargy and depression. It usually helps solve headaches and should not increase sweating unless the dose is too high. If it causes sweating, then we need to look at the estrogen levels, and adjust.

Psyche921: Is 100 mg high dose?

Pete Hueseman, R.Ph., P.D.: 100 mg is average.

Diggy: I had an hysterectomy approximately 3 years ago and I'm currently taking bioidentical hormones. I take Bi-est 70:30 and 1 mg progesterone 100mg. I take pills. Should I really be using the cream instead?

Pete Hueseman, R.Ph., P.D.: I would use the sublingual tabs or the long acting gel (our Duragel) instead of a cream.

Susan4129: I am postmenopausal. Is there any cancer risk from this type of supplementation?

Pete Hueseman, R.Ph., P.D.: There is always a cancer risk, but it is much less than using the synthetics, and remember, you have a risk even if using no hormones. Your quality of life is worth something.

Lilchel: I use compounded estradiol (100), testosterone and progesterone (200) in a lotion. I have had a total hysterectomy. Is there a benefit to taking it orally as opposed to a lotion that is applied to the skin; and is progesterone good for a calming effect? Thank you.

Pete Hueseman, R.Ph., P.D.: Progesterone does have a calming effect, but in too high a dose can cause bloating and breast tenderness. This dose for estradiol and Testosterone dose not look correct, though.

I would keep using a lotion or a long acting gel, or the sublingual tabs we make, not oral though.

CW1: My Dr wants me to take Medrol dose pak (steroid) for a week to see if it helps with pain. Any reasons I shouldn't take it? What are the negative side effects? Thank you.

Pete Hueseman, R.Ph., P.D.: I just took my Medrol dose pak for 1 week for inflammation in my back, and there were no side effects for me. Sometimes though it can cause water retention, headaches, bloating, and irritability. It can also make hormones less effective while using it.

CW1: Thank you. Did it help with your back pain? Did it return when you stopped?

Pete Hueseman, R.Ph., P.D.: The back needs surgery, and it did help.

Dearest: Glad your back is feeling better, Pete.

Pete Hueseman, R.Ph., P.D.: Somewhat better, thanks,

IAmPixie: What do you think about Effexor 75mg? Is this good for menopause? I also have hypothyroid and Fibromyalgia.

Dearest: You were prescribed the Effexor for menopause symptoms or depression?

IAmPixie: Menopause

Dearest: (shaking head)

Pete Hueseman, R.Ph., P.D.: To learn all about the antidepressant Effexor, go to your search engine and review all the literature, it can help depression, not related to hormone imbalance. It will not help hypothyroidism or Fibromyalgia very much at all.

IAmPixie: Then why did my doctor prescribe this for menopause?

Dearest: Effexor wasn't intended for menopause symptoms - it's really for depression and other psychological disorders.

Pete Hueseman, R.Ph., P.D.: Because the salesperson told him it would help. It may, in fact, decrease your libido also.

Dearest: Today, doctors are prescribing anti-seizure medications for menopause symptoms, too. It's unreal.

Dearest: Exactly, Pete.

Niklinsha: Can natural bio-identical hormones replace birth control pills?

Pete Hueseman, R.Ph., P.D.: Natural Bio-identical hormones make you more fertile. They can NOT be substituted for birth control pills if you need birth control.

Bioidentical hormones can replace the birth control pills if you're using for menopause symptoms though.

CW1: So Effexor is not good for hot flashes?

Dearest: Why get started with such a strong, serious drug for hot flashes when there are so many other remedies available? Effexor is a very strong drug.

Pete Hueseman, R.Ph., P.D.: No, it is not good for hot flashes in most cases.

Dearest: (next thing they'll be prescribing for menopause is heroin)

Immoloto: Hi! I know the natural hormones are made from soy and the wild yam. I am taking capsules. Do you think could alter my liver? What are the other ingredients, if there is any? Can I obtain like some kind of literature?

Pete Hueseman, R.Ph., P.D.: Email me directly, and we can email you back some specific information, once we know what you need. You can also visit our website, www.bpharmacysolutions.com as well as the many articles on power-surge.com.

They should not effect your liver enzymes adversely.

AngelzzByMySide: Is there a certain age or test that will determine if you are in menopause? My doctor keeps telling me I am too young. I have LS diagnosed in 1998. I've had depression since 1997. I have just changed from Effexor (it made me dizzy if I missed one dose) to Wellbutrin for depression. I am 44 years old. Could this all be related to menopause?

Pete Hueseman, R.Ph., P.D.: It definitely could be related to early menopause, to say you are too young is wrong. Your ovaries could have stopped working early. I would do an FSH test in blood to see if you're in menopause. Then, in saliva testing, order a test for Estradiol, progesterone, DHEA, and testosterone and do the test around day 21 of your cycle. We can guide you from there.

AngelzzByMySide: Where do I order the test?

Pete Hueseman, R.Ph., P.D.: Call me at 1-800-728-0288,

Dearest: Angel, write to Pete at consultph@bpharmacysolutions.com

Dearest: Or call him :)

Sally-13: Can topical creams be used at the same time as vaginal estrogen/progesterone compounds? Can you get too much? Is there any natural alternative for lubrication besides KY Jelly etc, which is irritating. Can you use jojoba oil or other oils as lubricants? Is there any benefit to using Vitamin E tablets vaginally? What about glycerin?

Pete Hueseman, R.Ph., P.D.: Yes, you can use them together, and yes you can get too much, Vitamin E oil does work also, and any of the oils you listed would work as a natural lubricant. Olive oil is great for a lubricant.

Dearest: There's also an excellent article about vaginal dryness at www.power-surge.com/educate/sexuality.htm

Psyche921: What is the safest form of bio-identical estrogen? (I have a family history of breast cancer and stroke on both sides)

Pete Hueseman, R.Ph., P.D.: The safest form would be the topical Duragel, and next the sublingual tablets, we do make both of them.

Jane25: I became allergic to the transdermal natural hormones I was using and had a very bad rash. I was told this is a common side effect and to use it on my wrists instead of my neck. It's not nearly as effective though. Any suggestions for me?

Pete Hueseman, R.Ph., P.D.: How about calling me tomorrow, and let's figure out what dose should be used for you sublingually. The sublingual still bypasses the liver on the first pass.

Diggy: After doing the saliva test, my cortisol was really elevated (20.4). How can I lower it?

Pete Hueseman, R.Ph., P.D.: By rest, relaxation, getting rid of stress, balancing your hormones naturally, and one of our adrenal products, say Pituitary Plus, which can help to rest your adrenal gland. We feature the Pituitary Plus on our February special this month, see our website at www.bpharmacysolutions.com

Dearest: Pete, thank you once again for educating women about our hormones and menopause. If anyone has further questions about naturally compounded hormones, you can ask Pete by typing into your browser, www.power-surge.com/asktheexperts.htm and Pete will get back to you on any questions regarding natural hormones and menopause, or you can call him at 1-800-728-0288 or E.mail him directly at Pharmacy@power-surge.com.