Adrenal Fatigue/Thyroid Imbalance

The hormones cortisol, estrogen, and testosterone are secreted by the adrenal glands, which reside on top of the kidneys. These hormones affect the body in a myriad of ways, including in regard to weight distribution, allergic reactions, and sexual traits. Intense or long periods of emotional and/or physical stress along with various illnesses can cause Adrenal Fatigue. When this happens, it severely inhibits the body’s ability to reduce allergic and harmful reactions, like cancer and autoimmune disorders. Cortisol and similar hormones directly affect the use of carbohydrates, fats, cardiovascular function, gastrointestinal function, and the translation of fats and proteins into energy. Appropriate adrenal support is fundamental to facilitate the proper hormonal structure for optimal wellness and requires correct nutrition, adequate sleep, habitual exercise, stress management, and supplementation of any deficient adrenal hormones.

What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS, Chronic Fatigue and Immuno-Deficiency Syndrome, CFIDS) refers to severe, continued tiredness that is not relieved by rest and is not the direct result other medical conditions. It often presents as a hypothalamic, pituitary, and/or immune dysfunction.

How is CFS treated?

In most CFS patients, the pituitary dysfunction, thyroid resistance, and high reverse T3 produce hypothyroidism. When this occurs, supplementation with T4 alone is often unable to produce a favorable outcome. T3 or a combination of T3 and T4 are a preferred alternative. Unfortunately, the retail medication Cytomel, a short acting T3, and is very difficult to use, due to its tendency to spike blood levels and cause undesired adverse reactions, such as arrhythmias, MI, angina, hyper or hypo tension, and even heart failure. At AgeVital, we can compound sustained-release T3 that your practitioner can use to avoid spiking blood levels and help you to reach your goals for effective CFS or FM therapy.

While hypothyroidism is often manifested in CFS, it is not the only condition. Other treatments aside from thyroid hormone supplementation can be beneficial. Various nutritional supplements, proteins, amino acids, and hormones can complement and strengthen the immune system. Since the immune system is often degraded by free radical damage, antioxidants, such as ascorbic acid, may also prove advantageous. Low thyroid or adrenals gland can also inhibit the absorption of vitamin B-12. Since low B-12 has been associated with fatigue and depression, supplementation could be beneficial. Also, D-ribose supplementation has been known to reduce symptoms, with improvements in energy and well-being of over 30% on a visual analogue scale. Supplementation with NADH for one month has resulted in significant improvements in CFS, and magnesium has also produced some measurable improvements. Since most CFS patients tend to respond poorly to placebo treatments, favorable, measurable results in regard to supplementation is often interpreted as confirmation of successful treatment.

Thyroid Hormone Therapy

The treatment of thyroid conditions is complex and can vary drastically from one patient to another. The medications are precisely adjusted and may not be substituted haphazardly. One could argue that dosing for thyroid is as much an art as it is a science, and it is for such reasons that we often speak of the “practice” of medicine.

Low levels of thyroid hormone (hypothyroidism) can lead to aching muscles, aching joints, anxiety, cold and heat intolerance, constipation, decreased heart rate, deep voice, depression, dry hair, dry skin, enlarged tongue, fatigue, fluid retention, headaches, high cholesterol, high triglycerides, hypoglycemia, hypotension, infertility, irregular menstruation, low sex drive, memory impairment, slowed metabolism, swollen neck, and weight gain.

Hashimoto’s Disease

While hypothyroidism is a condition, Hashimoto’s is a disease. Hypothyroidism is commonly caused by Hashimoto’s disease, but not always. Sometimes known as Hashimoto’s thyroiditis, autoimmune thyroiditis, or chronic lymphocytic thyroiditis, Hashimoto’s is an autoimmune disease where antibodies interact with proteins in the thyroid gland, causing a gradual degradation of the gland, and decreasing the gland’s production of thyroid hormones. Possible symptoms include those common in hypothyroidism and is usually diagnosed with a clinical examination demonstrating one or more of the following:

A goiter (enlargement of the thyroid) A radioactive uptake scan showing diffuse uptake in an enlarged thyroid An ultrasound revealing an enlarged thyroid Fine needle aspiration (biopsy) of the thyroid showing lymphocytes and macrophages High antibody levels against thyroid peroxidase (TPO) and thyroglobulin (TG) detected with a blood test Periods of anxiety, diarrhea, insomnia, and/or weight loss may come and go or be followed by periods of constipation, depression, fatigue, and/or weight gain as Hashimoto’s causes fluctuations in thyroid performance. Such cycling can be typical with Hashimoto’s but is not always evident.

Often Hashimoto’s is caused by environmental triggers such as iodine, infection, pregnancy, or cytokine therapy, resulting in the generation of large numbers of T helper cells, cytotoxic lymphocytes, and autoantibody-producing B cells. Immune cells accumulate in the thyroid and lead to a prevalence of T helper mediated autoimmune responses and cytotoxic effects of T lymphocytes. All of this results in apoptosis (destruction) of thyrocytes, which is the ultimate cause of Hashimoto’s thyroiditis.

How is Hypothyroidism treated?

Most often, hypothyroid patients are treated with levothyroxine (synthetic T4). However, some patients remain symptomatic, and T3 is sometimes required for optimal therapy. Both T3 and T4 are secreted by a healthy thyroid gland. Unfortunately, the only commercially available T3 is a synthetic liothyronine sodium in an immediate release form which is absorbed rapidly and can lead to high systemic T3 concentrations in the body, resulting in undesirable side effects, such as heart palpitations. AgeVital can compound sustained-release T3 which could be an alternative when the administration of T4 alone has not proven sufficient to produce the desired results. Some studies have shown that the inclusion of T3 in thyroid hormone replacement therapy has improved cognitive performance, neuropsychological function, overall physical status, and has reduced depression when compared to therapy with T4 alone.

Contact us if you have any additional questions about thyroid disorders or treatments. We are more than willing to assist you in your quest for information, and would welcome the opportunity to become part of your health team.

Chronic Fatigue/Fibromyalgia

Chronic Fatigue Syndrome (Chronic Fatigue and Immuno-Deficiency Syndrome, CFIDS) and Fibromyalgia (FM) are illnesses that often coexist and affect millions of Americans. Symptoms vary but commonly include severe fatigue, sleep disturbances, cognitive problems commonly called brain fog, muscle pain and multiple infections. CFIDS and FM often seem to begin after an infection or a severe shock (physical or emotional), and the symptoms are very similar. The difference seems to be that for some people the fatigue element is the most dominant while for others the muscular pain symptoms are more severe.chronic-fatigue2The medical literature is now clear that these are legitimate diseases and individuals with CFIDS/FM have measurable hypothalamic, pituitary, immune and often thyroid dysfunction. The hormonal dysfunction results in multiple deficiencies that are often not detected with standard blood tests. Neurotransmitter abnormalities and nutrient deficiencies have also been shown to occur with CFIDS/FM.

Due to their complexity, these conditions often have been inadequately treated, partly due to the intensive evaluation and follow-up that is required, which can not be addressed in a short office visit. When multifaceted treatment addresses the entire spectrum of these diseases, truly remarkable success can be obtained. Treatment needs to be individualized, ultimately each patient should have a maintenance program with the minimal medications and supplements that are necessary to remain symptom-free.

Treatment for infections and enhancement of immune function is key.Komaroff et al. of Brigham and Women’s Hospital, Harvard Medical School, have concluded that CFIDS “is an illness characterized by activation of the immune system, various abnormalities of several hypothalamic-pituitary axes, and reactivation of certain infectious agents.” Multiple infections either may cause or contribute to CFIDS/FM. Immunological defects may underlie CFIDS/FM, and if a poor immune system is not addressed, successful eradication of the organisms is not likely. Also, if an infective organism produces neurotoxins, these substances can remain in the body and continue to cause symptoms long after the infection is gone.

Restoring Vitality with Natural Hormone Replacement for Men

hormone for menNumerous changes are associated with an age-related decline in the hormone testosterone. Some men may go through a rather sudden change in testosterone levels that might correlate with the hormonal changes that women experience at menopause. However, most men have a slower and more subtle hormonal decline experiencing symptoms over a period of time. Symptoms of testosterone deficiency are often denied by the patient or attributed to other problems.

Andropause may consist of a variety of signs and symptoms, including:
  • weakness, reduced muscle mass
  • fatigue
  • disturbed sleep, insomnia
  • reduced libido
  • erectile dysfunction
  • osteoporosis
  • heart disease, atherosclerosis
  • irritability
  • low sperm counts
  • depression, anxiety
  • memory impairment
  • reduced cognitive function


Natural Testosterone Replacement is Central to the Treatment of Andropause.

When hormones are replaced or restored back to physiologic levels considered normal for younger males, men may experience a dramatic reversal of many of these changes.On the average, a man’s testosterone levels begin to decline at a rate of 1% per year after age 40. It is estimated that 20% of men aged 60-80 years have levels below the lower limit of normal. The diagnosis of low testosterone levels (medically termed “hypogonadism”) is based on the presence of signs or symptoms and must be confirmed by laboratory testing, which should include Total testosterone, Bioavailable testosterone (Free plus Albumin Bound), Estradiol, Cholesterol, Prostate Specific Antigen (PSA), Complete Blood Count (CBC), Hemoglobin, and Hematocrit. Screening for potential risks of androgen therapy should be performed prior to the initiation of treatment. Evaluation should include a history of or potential for sleep apnea, arrhythmias, significant symptoms of benign prostatic hypertrophy (BPH) or personal or family history of prostate carcinoma, and a physical exam. Proper monitoring of laboratory values and clinical response are essential when prescribing testosterone replacement therapy.Natural testosterone must not be confused with synthetic derivatives or “anabolic steroids,” which when used by athletes and body builders have caused disastrous effects. For example, administration of synthetic non-aromatizable androgens, like stanozolol or methyltestosterone, causes profound decreases in HDL-C (“good cholesterol”) and significant increases in LDL-C (“bad cholesterol”), and has been associated with serious heart disease. Yet, hormone replacement with testosterone, an aromatizable androgen, results in lower total cholesterol and lower LDL cholesterol levels.

Healthy Lifestyle

A healthy lifestyle has been shown to be associated with higher hormone levels, and higher hormone levels seem to induce a more active, healthier lifestyle. When hormone levels decline, people become less active and gain weight. As people gain weight, hormones are stored in fat and become unavailable to meet the body’s demands. Lack of exercise, excessive alcohol use, and many diseases can reduce bioavailable hormone levels. For optimal results, it is essential that hormone replacement therapy be combined with adequate exercise, proper nutrition, and appropriate use of natural supplements.

Hormone Replacement for Women

Customized Hormone Replacement Therapy (HRT) is the replacement of deficient hormones with hormones that are chemically identical to those that the body naturally produces, but which have declined due to aging or illness.

hormone replacementCustomized HRT has improved the quality of life for millions of women who suffer from hormonal imbalance. The ideal process for achieving hormonal balance includes an assessment of hormone levels and complete evaluation of signs and symptoms, followed by replacement of the deficient hormones in the most appropriate dose via the most effective route for each woman, and monitoring to fine tune the therapy.

Estrogen is prescribed to relieve menopausal symptoms and treat postmenopausal problems such as vaginal dryness and tissue breakdown, painful intercourse, and various urinary disorders. Estrogens have been shown to decrease the risks of osteoporosis and colorectal cancer.

Progesterone is commonly prescribed for perimenopausal women to counteract “estrogen dominance”, minimizes the risk of endometrial cancer in women who are receiving estrogen, and may enhance the beneficial effect of estrogen on lipid and cholesterol profiles.

Published research has shown that the risk of breast cancer is increased by long-term use of conjugated equine estrogens, which are the most commonly prescribed form of commercially available estrogen, and the risk is further increased when the synthetic progestin medroxyprogesterone acetate is added.4,5 Conjugated estrogens are derived from pregnant mares’ urine, but most estrogens from horses are NOT naturally produced by humans. Additionally, synthetic medroxyprogesterone acetate does not confer all of the benefits of natural progesterone. That is why we recommend the use of natural estrogen and progesterone.

Androgens are a class of hormones that include DHEA and testosterone, which are normally produced in a young healthy woman, and are important for libido as well as integrity of skin, bone, and muscle. When women enter menopause, testosterone and DHEA levels may decline. Experts now recognize the importance of supplementing androgens for women who are deficient.

While women have benefited from therapy with estrogens, progesterone, and androgens that are “chemically identical” to the hormones produced naturally by the human body, researchers and health care professionals realize that this is just the “tip of the iceberg” when it comes to achieving hormonal balance. Thyroid and adrenal function, as well as nutritional status, should also be evaluated and treated when indicated.

Women Prefer Natural Hormones

Mayo Clinic researchers surveyed 176 women taking natural micronized progesterone who had previously taken a synthetic progestin (medroxyprogesterone acetate, or MPA) to see if progesterone improved the women’s overall quality of life, menopausal symptoms, and satisfaction with HRT. After one to six months, the women reported an overall 34% increase in satisfaction on micronized progesterone compared to their previous HRT, reporting these improvements: 50% in hot flashes, 42% in depression, and 47% in anxiety. Micronized progesterone was also more effective in controlling breakthrough bleeding. In other studies, women using micronized progesterone had specific improvements in the areas of cognition, sleep, and menstrual problems.

Saliva Testing

Convenient home collection, accurate, and inexpensive, Saliva Testing provides a true picture of the bioavailable levels of steroid hormones.

saliva2Capillary Blood Spot Testing

Capillary Blood Spot Testing offers easy alternative to venous blood draws in the laboratory or doctor’s office.

Combination Saliva and Capillary Blood Spot

Combines both Saliva and Capillary Blood Spot test materials in an all-in-one test kit for easy home collection of the major hormone groups— reproductive, adrenal, and thyroid – on the same day at the optimal time.

Female Fertility Profiles I and II

If there is no physical reason for infertility such as tubal damage, many of the different causes of female infertility can be related to hormonal issues. These include ovarian insufficiency, luteal phase deficiency, polycystic ovarian syndrome, thyroid deficiency, and stress. This simple test can identify potentially correctable hormone imbalances and move couples further towards their goals of achieving pregnancy.

CardioMetabolic Risk Profile in Blood Spot

(now includes total and LDL cholesterol). Cardiometabolic risk includes disorders related to obesity and insulin resistance, which can lead to Type 2 diabetes and/or heart disease.

Vitamin D Testing in Blood Spot (25-OH, Total)

Saliva testing is a convenient, inexpensive, and above all, accurate means of testing steroid hormones. Scientific studies have shown a strong correlation between steroid hormone levels in saliva and the amount of hormone in the blood that is active or “bioavailable.” It is this fraction of total hormone that is free to enter the target tissues in the brain, uterus, skin, and breasts. Saliva testing can be done anywhere anytime. Testing that relies on blood draws (which need to be done in an office or lab) makes it harder to obtain samples at specific times (such as in the early morning) or multiple times during the day. In addition, hormones in saliva are exceptionally stable and can be stored at room temperature for up to a week without affecting the accuracy of the result. This offers maximum flexibility in sample collection and shipment.

Hormones tested in the saliva profiles include:

  • Estradiol
  • Progesterone
  • Testosterone
  • DHEA
  • Cortisol


Blood Spot testing is the future of blood testing. The process requires only whole capillary blood from a nearly painless finger prick and several tests can be run from a single sample. Blood spot testing provides results on a par with those from serum tests but without the cost and inconvenience of conventional blood drawing. In addition, collection times can be optimized for fasting baseline hormone levels and assessment of HRT dosing and diurnal hormone testing.

Tests offered in the Blood Spot Profiles include:

  • Thyroxine (T4), free
  • Triiodothyronine (T3), free
  • Thyroid Stimulating Hormone (TSH)
  • Thyroid Peroxidase Antibodies (TPO)
  • Testosterone, total
  • Sex Hormone Binding Globulin (SHBG)
  • Prostate Specific Antigen (PSA)
  • Insulin-like Growth Factor (IGF-1)
  • Estradiol (E2)
  • Progesterone (Pg)

The Comprehensive Hormone Profile

Putting saliva and blood spot test materials together in one combination kit makes it convenient to collect hormones of the three major glandular systems–reproductive, thyroid, and adrenal–on the same day at the optimal time. Tests include: In saliva: Estradiol (E2), Progesterone (Pg), Testosterone (T), DHEA, and the four diurnal Cortisols. In bloodspot: free T3, free T4, TSH and TPO antibodies

Osteoporosis -The Silent Disease bone

Osteoporosis is a painful, crippling disease characterized by low bone density, but it is both preventable and treatable. Osteoporosis occurs when not enough new bone is formed or too much bone is lost, or both, and therefore bone is brittle, weak and more likely to fracture. Osteoporosis is often called “the silent disease” because it can progress painlessly until a strain or fall causes a bone to fracture, and many times people don’t know they have the problem until the first fracture occurs.Bone is not a hard and lifeless structure; it is complex, living tissue. Bones provide structural support for muscles, protect vital organs, and store calcium which is essential for bone density and strength.

Signs and symptoms of osteoporosis include:

  • Pain in the back, ribs and abdomen.
  • Loss of height is normal as people age, but is increased by osteoporosis.
  • Fractures of the hip, spine and wrist, as well as ribs, humerus, and pelvis.
  • Humped back, known as “Dowager’s Hump.”
Of the individuals who fracture a hip, one-half will be permanently disabled, and almost 20% will require long-term nursing care. One in five individuals with hip fractures die within one year, usually from complications such as pneumonia or blood clots in the lung related to either the fracture or subsequent surgery.Osteoporosis affects approximately 25 million Americans and 250 million people worldwide, predominately women. Osteoporosis can strike at any age. Significant risk has been reported in people of all ethnic backgrounds. However, whites and Asians are more susceptible.Menopause is a known risk factor for osteoporosis. Osteoporosis is most common in older women, occurring in about 25% of those over 60 years of age. Women who have either had their ovaries surgically removed before age 45 or undergone early menopause, without receiving hormone replacement therapy, are also more likely to develop osteoporosis. Other female risk factors are small body frame and excessively strenuous exercise that stops menstrual periods.

Additional risk factors for osteoporosis include:

  • Family history of osteoporosis
  • Smoking
  • Excessive use of alcohol
  • Low body weight (less than 127 lbs)
  • Sedentary lifestyle
  • Low dietary intake of calcium
  • Use of corticosteroids, anticonvulsants, certain cancer treatments and aluminum-containing antacids
  • Certain hormonal disorders such as hyperthyroidism, hyperparathyroidism and Cushing’s Disease
  • Other diseases such as chronic liver and intestinal disorders

Prevention

Although there is no cure for osteoporosis, these steps may slow or stop its progression.
  • Eat a balanced diet – Nutritious food is important in maintaining an appropriate weight, also a factor in preventing osteoporosis. Avoid caffeine and carbonated beverages which can cause calcium to be eliminated from the body.
  • Exercise – Daily weight-bearing exercise helps to reduce bone mineral loss.
  • Stop smoking and limit alcohol.
  • Have bone density baseline testing in your 30’s and then every one to three years.
  • Take quality nutritional supplements.

Testing & Diagnosis: Early Detection is Key

Specialized bone density tests can measure bone mineral density (BMD) in various sites of the body. Bone density testing is painless, noninvasive and safe. Test results can help you and your doctor decide the best course of action for your bone health.
A bone density test can:
  • Detect osteoporosis before a fracture occurs
  • Predict your chances of fracture in the future
  • Determine your rate of bone loss and/or monitor the effects of treatment
>h3>Treatment Customized Hormone Replacement Therapy (HRT) - Replacement of declining hormones slows the loss of bone and increases bone density, which helps to decrease the risk of fractures. Estrogen can prevent bone loss, and many practitioners report increased bone density following progesterone administration. Testosterone therapy may also be utilized to improve bone health. Thyroid hormone is required for normal bone remodeling to take place. If thyroid hormone is deficient, old bone that is not as strong and is abnormally thick tends to accumulate. However, excessive thyroid hormone may cause osteoporosis.
Calcium supplements, and other vitamins and minerals (including magnesium, manganese, folic acid, boron, zinc, strontium, copper, silicon, and vitamins A, B6, C, D, and K) are important to bone formation and maintenance.
Ask our health care professionals for more information.

Customized Medications Solve Problems for Mothers and Babies

Breastfeeding Oxytocin nasal spray can be compounded to help women who have problems with milk letdown. Lactation failure may result from insufficient oxytocin. A rise in the concentration of oxytocin causes contraction of cells around the alveoli and milk ducts, in preparation for suckling. Oxytocin nasal solution (Syntocinon®) was formerly commercially available, and indicated for use in stimulating lactation during the first week postpartum (not for continued use). Oxytocin nasal spray is contraindicated during pregnancy since it may provoke a uterotonic effect, precipitating contractions and abortion. The medication is still frequently requested and can be compounded per a prescription order.“All purpose nipple ointment” (APNO) is a combination of ingredients which seems to relieve many causes of sore nipples during breastfeeding. The presence of Candida albicans can cause nipple soreness and cracking, and cracks and erosions in the nipple harbour bacteria that can cause infection or delay healing, and can cause significant pain. APNO was originally developed by pediatrician Jack Newman, MD, who started the first hospital-based breastfeeding clinic in Canada in 1984. He noted, “It is always good, however, to try to assure the best latch possible, because improving the latch helps with any cause of pain.” Ointments often work better than creams to treat sore nipples, and Dr. Newman recommended a preparation containing mupirocin 2% ointment 15 grams, betamethasone 0.1% ointment 15 grams, with miconazole powder added so that the final concentration is 2% miconazole. Dr. Newman suggested that sometimes it is helpful to add ibuprofen powder as well, so that the final concentration of ibuprofen is 2%. The combination is applied sparingly after each feeding.

Stretch Marks

Topical application of tretinoin (retinoic acid) has been shown to significantly improve the appearance of pregnancy-related stretch marks. In a double-blind, randomized, vehicle-controlled study, 22 women with early, clinically active stretch marks applied either 0.1% tretinoin or vehicle daily for 6 months to the affected areas. Patients were evaluated by physical exam monthly and by analysis of biopsy specimens of stretch marks obtained before and at the end of therapy in comparison with untreated normal skin. After 2 months, patients treated with tretinoin had significant improvements in severity scores of stretch marks compared with patients who received vehicle. After 6 months, 8 of the 10 tretinoin-treated patients had definite or marked improvement compared with one of the 12 vehicle-treated patients. An open-label, multicenter, prospective study of 20 women found that tretinoin cream 0.1% applied daily for 3 months to pregnancy-related stretch marks in the abdominal area resulted in significantly improved clinical appearance.Another study reported that elastin content within the reticular and papillary dermis can increase with topical 20% glycolic acid combined with 0.05% tretinoin emollient cream therapy.This therapy should not be used while pregnant or breastfeeding.

Arch Dermatol. 1996 May;132(5):519-26
Adv Ther. 2001 Jul-Aug;18(4):181-6
Dermatol Surg. 1998 Aug;24(8):849-56

Diaper Rash (Dermatitis)

Approximately two-thirds of infants experience diaper rash. Customized diaper rash preparations -ointments, powders, or creams- tailored to treat each baby’s specific symptoms, can be compounded using ingredients which will protect the skin from additional irritation, soothe and encourage healing, and prevent secondary infections. Skin protectants (zinc oxide, petrolatum) provide a physical barrier against external irritants such as urine or gastrointestinal enzymes in stool. Antifungal creams can be used when a yeast(Candida) infection is suspected. Topical steroids (such as hydrocortisone 1%) should be reserved for severe diaper rash, because a baby’s skin can absorb enough medication to lead to systemic effects.Decreased gastrointestinal transit time can mean less time for bile acid resorption in the distal ileum, and high concentrations of bile acids in the stool can irritate the anus and buttocks in a manner similar to the skin irritation associated with ostomies. When applied topically, cholestyramine, a bile acid sequestrant, can irreversibly bind the bile and bring relief to the patient. Annals of Pharmacotherapy 30(9):954-956 reported the case study of a two-month old boy with reflux and regurgitation who was treated with a promotility agent. He developed a rash on his buttocks and anal irritation that progressed in severity despite the use of numerous topical products and extended diaper-free periods. A compounded topical cholestyramine ointment was administered and resulted in complete resolution within three days. Ask our pharmacist about economical therapies for diaper rash.

Pediatric Dosage Forms

Many medications needed by babies and children are not commercially available in pediatric strengths or dosage forms. We can eliminate the need to break or crush tablets or administer unpleasant drugs intended for adults, by compounding the best dose of the needed medication into a pleasantly-flavored dosage form such as a syrup or suspension, lollipop, or even a gummy bear or freezer pop. Rectal suppositories remain popular for children, and we can prepare suppositories that are not commercially available.

Skin Care and Cosmeceuticals for Anti-aging

Cosmeceuticals
After a proper analysis reveals areas of dry, oily, or aging skin, we can provide the appropriate correction for each skin type in a cosmetic base containing the exfoliants, emollients, and micronutrients necessary for cellular repair.Antioxidants such as Alpha Lipoic Acid (ALA) and Ascorbyl Palmitate (Vitamin C Ester) are vital to the energy production of skin cells and formation of collagen. Alpha Lipoic Acid promotes optimum efficiency for production of energy and removal of intracellular waste products, essential for cellular healing and elimination of wrinkles and facial scars. Ascorbyl Palmitate also inhibits the body’s production of inflammatory arachidonic acid, which plays a role in the development of psoriasis and the micro-scarring that leads to the formation of wrinkles. Molecular biologist Olga Marko, Ph.D., found that Ascorbyl Palmitate stimulates the growth of fibroblasts which help to produce collagen and elastin in human skin. Studies have shown that antioxidants can be delivered percutaneously to directly supplement the skin’s antioxidant reservoir. Oral supplementation has not been successful in raising levels of antioxidants in the skin.Retinol assists in the rejuvenation process that leads to a more youthful appearance and provides the same benefits to skin as retinoic acid, but in a more gradual, gentle manner. Retinol works with Alpha Lipoic Acid to provide maximum benefits, effectively and gently. Alpha and beta hydroxyl acids may be used to exfoliate the skin, increase cell turnover, and reduce fine wrinkles and mottled pigmentation.

Amino acids such as DMAE (2-dimethylaminoethanol; deanol) tone and add firmness to the skin, prevent age spots, and aid in healing the micro-scarring which causes wrinkles. The benefits of DMAE include a potential anti-inflammatory effect with possible improvement in underlying facial muscle tone. In a randomized clinical study, 3% DMAE facial gel applied daily for 16 weeks was shown to be safe and efficacious in the mitigation of forehead lines and periorbital fine wrinkles, and in improving lip shape and fullness and the overall appearance of aging skin. These effects did not regress during a 2-week cessation of application. Long-term application of DMAE gel for up to 1 year was associated with a good safety profile. Am J Clin Dermatol. 2005;6(1):39-47

Cosmetically appealing preparations

Compounding pharmacists continue to develop new bases to improve both the aesthetic and therapeutic aspects of compounded medications. For example, anhydrous gels deliver medications which facilitate rapid absorption of the active ingredient into the skin and prolonged retention of the drug in the stratum corneum and epidermis, with minimal systemic transport of active drug. These cosmetically appealing gels are very stable and well accepted by patients.Chemical peels Chemical peelings with kojic acid, glycolic acid, and trichloroacetic acid (TCA), alone or in combination, are available for treatment of hyperpigmentations. Research has concluded that dermatologists should have a choice of formulations to satisfy individual patient needs.

Sunscreens

We can compound sunscreen formulations with low-allergenicity UVB protectors in combination with chemicals such as oxybenzone that extend protection to UVA wavelengths. For broad spectrum coverage that blocks or reflects UVA and UVB, physical sunscreens containing titanium dioxide or zinc oxide may be preferable. When vitamin C or a combination of vitamin C and E is formulated with a commercial UVA sunscreen (oxybenzone), an apparently greater than additive protection is noted against the phototoxic damage.

Skin Discoloration

Increases or decreases in skin pigmentation can be due to many conditions (such as acne, pregnancy, cirrhosis, chronic renal failure, celiac disease) or use of medication. Most types of skin discoloration are harmless from a medical viewpoint, but they may be cosmetically unacceptable. The goal of therapy in hyperpigmentation disorders is to lighten the skin so it blends into the surrounding normal skin. Most preparations that are used to lighten the skin contain the drug hydroquinone. Other commonly used medications include azelaic acid, glycolic acid, hydrocortisone, kojic acid, and tretinoin. Our compounding pharmacy can prepare customized dermatologics to meet each person’s specific needs. It may take three to six months of therapy before improvements in pigmentation are noticed. These preparations may increase sensitivity to the sun, so ask our pharmacist about an effective sunscreen.

Customized Topical Therapy for Cellulite

Cellulite describes dimpling of skin, caused by the protrusion of subcutaneous fat into the dermis. “Cellulite is hereditary, so much so that the indications of who will get it, and to what degree, are present almost from birth,” noted dermatologist Amy Newburger, MD, director of Dermatology Consultants of Westchester in Scarsdale, N.Y. Newburger says that creams and lotions whose key ingredient is a methylxanthine such as caffeine may be beneficial. “Caffeine creams work great to pull fluids out of the spaces between cells and induce lipolysis – fat burning in the layer just below the skin’s surface.” Newburger says a good delivery system to drive the creams into the cells, like liposome technology, is also important.Caffeine is effective in reducing the appearance of cellulite, improving micro circulation, and strengthening skin tone and firmness. Researchers have found that caffeine creams reduce fat cells in skin, with visible results in about eight weeks. In a double-blind, single-center, placebo-controlled study, a liposome-encapsulated caffeine-based cream was found to significantly reduce the thickness of the adipose tissue in all areas of the body. In addition, the more concentrated cream was significantly more effective than the less concentrated cream in the areas of the hips and the triceps.
Dermatol Surg. 1999 Jun;25(6):455-62Gotu Kola (Centella Asiatica) has a long history as a traditional medicine for improving skin tone and firmness. Studies show that Gotu Kola can reduce the appearance of cellulite by preventing and reversing the formation of fibrous connective structures that “trap” fat. Grape Seed extract is well known for its antioxidant properties and has been shown to improve circulation, strengthen connective tissues, and reduce the effects of aging on the skin. It also inhibits the enlargement of fat cells and the accumulation of fat tissues, thus improving the appearance of cellulite.

It is very important that preparations are massaged into the skin. Hygroscopic moisturizers are also recommended.

Thyroid Imbalance

Thyroid Hormone helps the body convert food into energy and heat, regulates body temperature, and impacts many hormonal systems in the body. Thyroid hormone exists in two major forms: Thyroxine (T4), an inactive form that is produced by the thyroid gland and converted to T3 in other areas of the body, and Triiodothyronine (T3), the active form. The role of thyroid hormone and consideration of its impact on multiple body systems is emerging as a critical component of balanced hormone replacement for men and women.

Symptoms of hypothyroidism (low levels of thyroid hormone) include fatigue, cold and heat intolerance, hypotension, fluid retention, dry skin and/or hair, constipation, headaches, low sexual desire, infertility, irregular menstrual periods, aching muscles and joints, depression, anxiety, slowed metabolism and decreased heart rate, memory impairment, enlarged tongue, deep voice, swollen neck, PMS, weight gain, hypoglycemia, and high cholesterol and triglycerides. Yet, more than half of all people with thyroid disease are unaware of their condition.

Although both T4 (thyroxine, an inactive form that is converted to T3 in other areas of the body) and T3 (triiodothyronine, the active form) are secreted by the normal thyroid gland, many hypothyroid patients are treated only with levothyroxine (synthetic T4). For example, T4 preparations are often ineffective for patients with Chronic Fatigue and Immuno-Deficiency Syndrome (CFIDS) and Fibromyalgia(FM). The combination of pituitary dysfunction, high reverse T3, and thyroid resistance, leads to inadequate thyroid effect in most, if not all CFIDS/FM patients.

A T4/T3 combination preparation or straight T3 (triiodothyronine) may be preferable to T4 alone. However, the only commercially available form of T3 is synthetic liothyronine sodium (Cytomel®) in an immediate release formulation which is rapidly absorbed, and may result in higher than normal T3 concentrations throughout the body causing serious side effects. Research indicates there is a need for sustained-release T3 preparations in order to avoid adverse effects. Ultimately, it is the expertise of the prescriber, use and interpretation of appropriate tests, dosing of the T3 or T4/T3 combinations, and the formulation of the medications that determines the success of treatment.
N Engl J Med 1999 Feb 11;340(6):424-9

Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. A randomized, double-blind, crossover study found inclusion of T3 in thyroid hormone replacement improved cognitive performance, mood, physical status, and neuropsychological function in hypothyroid patients. Two-thirds of patients preferred T4 plus T3, and tended to be less depressed than after treatment with T4 alone. Patients and their physicians may wish to consider the use of sustained-release T3 in the treatment of hypothyroidism, particularly when the response to levothyroxine (T4) has not been complete.
J Endocrinol Invest 2002 Feb;25(2):106-9

Levothyroxine therapy and serum free thyroxine and free triiodothyronine concentrations.
John M. Lee, M.D., an Australian physician, points out that any thyroid function problem should be examined in the larger context of adrenal fatigue, hormone imbalances such as estrogen dominance, nutritional deficiencies, liver dysfunction, and digestion and absorption problems. Many vitamins, minerals and amino acids are needed to convert T4 to T3, and to get T3 into the cells. Dr. Lee believes that conservatively, 40% of women in the U.S. have measurably low thyroid and as a result are suffering from fatigue, depression, cold hands and feet, dry skin and hair and many other symptoms associated with hypothyroidism (low thyroid). Dr. Lee has a unique approach to treating patients with low thyroid function and advocates using only T3 for thyroid hormone replacement, and because the use of commercially-available T3 (liothyronine) is associated with serious problems such as rapid heart rate, Dr. Lee uses a slow-release T3 and reports the therapy is successful.

Thyroid Hormone Therapy

Thyroid Hormone helps the body convert food into energy and heat, regulates body temperature, and impacts many hormonal systems in the body. Thyroid hormone exists in two major forms: Thyroxine (T4), an inactive form that is produced by the thyroid gland and converted to T3 in other areas of the body, and Triiodothyronine (T3), the active form. The role of thyroid hormone and consideration of its impact on multiple body systems is emerging as a critical component of balanced hormone replacement for men and women.Symptoms of hypothyroidism (low levels of thyroid hormone) include fatigue, cold and heat intolerance, hypotension, fluid retention, dry skin and/or hair, constipation, headaches, low sexual desire, infertility, irregular menstrual periods, aching muscles and joints, depression, anxiety, slowed metabolism and decreased heart rate, memory impairment, enlarged tongue, deep voice, swollen neck, PMS, weight gain, hypoglycemia, and high cholesterol and triglycerides. Yet, more than half of all people with thyroid disease are unaware of their condition.

Although both T4 (thyroxine, an inactive form that is converted to T3 in other areas of the body) and T3 (triiodothyronine, the active form) are secreted by the normal thyroid gland, many hypothyroid patients are treated only with levothyroxine (synthetic T4). For example, T4 preparations are often ineffective for patients with Chronic Fatigue and Immuno-Deficiency Syndrome (CFIDS) and Fibromyalgia(FM). The combination of pituitary dysfunction, high reverse T3, and thyroid resistance, leads to inadequate thyroid effect in most, if not all CFIDS/FM patients.

A T4/T3 combination preparation or straight T3 (triiodothyronine) may be preferable to T4 alone. However, the only commercially available form of T3 is synthetic liothyronine sodium (Cytomel®) in an immediate release formulation which is rapidly absorbed, and may result in higher than normal T3 concentrations throughout the body causing serious side effects. Research indicates there is a need for sustained-release T3 preparations in order to avoid adverse effects. Ultimately, it is the expertise of the prescriber, use and interpretation of appropriate tests, dosing of the T3 or T4/T3 combinations, and the formulation of the medications that determines the success of treatment.

N Engl J Med 1999 Feb 11;340(6):424-9 Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. A randomized, double-blind, crossover study found inclusion of T3 in thyroid hormone replacement improved cognitive performance, mood, physical status, and neuropsychological function in hypothyroid patients. Two-thirds of patients preferred T4 plus T3, and tended to be less depressed than after treatment with T4 alone. Patients and their physicians may wish to consider the use of sustained-release T3 in the treatment of hypothyroidism, particularly when the response to levothyroxine (T4) has not been complete.

J Endocrinol Invest 2002 Feb;25(2):106-9

Levothyroxine therapy and serum free thyroxine and free triiodothyronine concentrations.

John M. Lee, M.D., an Australian physician, points out that any thyroid function problem should be examined in the larger context of adrenal fatigue, hormone imbalances such as estrogen dominance, nutritional deficiencies, liver dysfunction, and digestion and absorption problems. Many vitamins, minerals and amino acids are needed to convert T4 to T3, and to get T3 into the cells. Dr. Lee believes that conservatively, 40% of women in the U.S. have measurably low thyroid and as a result are suffering from fatigue, depression, cold hands and feet, dry skin and hair and many other symptoms associated with hypothyroidism (low thyroid). Dr. Lee has a unique approach to treating patients with low thyroid function and advocates using only T3 for thyroid hormone replacement, and because the use of commercially-available T3 (liothyronine) is associated with serious problems such as rapid heart rate, Dr. Lee uses a slow-release T3 and reports the therapy is successful.

Hashimoto’s Disease

While hypothyroidism is a condition, Hashimoto’s is a disease. Hypothyroidism is commonly caused by Hashimoto’s disease, but not always. Sometimes known as Hashimoto’s thyroiditis, autoimmune thyroiditis, or chronic lymphocytic thyroiditis, Hashimoto’s is an autoimmune disease where antibodies interact with proteins in the thyroid gland, causing a gradual degradation of the gland, and decreasing the gland’s production of thyroid hormones. Possible symptoms include those common in hypothyroidism and is usually diagnosed with a clinical examination demonstrating one or more of the following:
  • A goiter (enlargement of the thyroid)
  • A radioactive uptake scan showing diffuse
  • uptake in an enlarged thyroid
  • An ultrasound revealing an enlarged thyroid
  • Fine needle aspiration (biopsy) of the thyroid showing lymphocytes and macrophages
  • High antibody levels against thyroid peroxidase (TPO) and thyroglobulin (TG) detected with a blood test

Periods of anxiety, diarrhea, insomnia, and/or weight loss may come and go or be followed by periods of constipation, depression, fatigue, and/or weight gain as Hashimoto’s causes fluctuations in thyroid performance. Such cycling can be typical with Hashimoto’s but is not always evident

Often Hashimoto’s is caused by environmental triggers such as iodine, infection, pregnancy, or cytokine therapy, resulting in the generation of large numbers of T helper cells, cytotoxic lymphocytes, and autoantibody-producing B cells. Immune cells accumulate in the thyroid and lead to a prevalence of T helper mediated autoimmune responses and cytotoxic effects of T lymphocytes. All of this results in apoptosis (destruction) of thyrocytes, which is the ultimate cause of Hashimoto’s thyroiditis.

How is Hypothyroidism treated?

Most often, hypothyroid patients are treated with levothyroxine (synthetic T4). However, some patients remain symptomatic, and T3 is sometimes required for optimal therapy. Both T3 and T4 are secreted by a healthy thyroid gland. Unfortunately, the only commercially available T3 is a synthetic liothyronine sodium in an immediate release form which is absorbed rapidly and can lead to high systemic T3 concentrations in the body, resulting in undesirable side effects, such as heart palpitations. AgeVital can compound sustained-release T3 which could be an alternative when the administration of T4 alone has not proven sufficient to produce the desired results. Some studies have shown that the inclusion of T3 in thyroid hormone replacement therapy has improved cognitive performance, neuropsychological function, overall physical status, and has reduced depression when compared to therapy with T4 alone.

Contact us if you have any additional questions about thyroid disorders or treatments. We are more than willing to assist you in your quest for information, and would welcome the opportunity to become part of your health team.