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Sejjal Patel, PharmD
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Emily Vance, PharmD



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Durham, NC 27704
Telephone: (919) 220-5121
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Durham, NC 27713
Telephone: (919) 484-7600

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Hormonal Balance:
Critical for Optimal Health

““I can’t think about ‘optimal’ health without considering the impact of the past two years,” says Dr. Jennifer Burch of Central Compounding Center in Durham. “‘Optimal’ means the best under given circumstances—and the circumstances have been tough for all of us.

Dr. Jennifer Burch in Central Compounding Center's
compounding lab.

“Being healthy—really healthy—is largely about the choices we make,” she observes, “about giving our bodies what they need to function well, resist disease, and recover from illness. It’s a familiar list: we need good nutrition, water, exercise, sleep. But being healthy is also about our ability to respond to the stresses and health challenges we encounter. Something we cannot do if our hormones are out of balance.

“Hormones affect every cell in the body,” she points out. “They work together to help regulate all the body’s processes. An imbalance—too much or not enough of one or more hormones—can cause a variety of problems.

“Which brings us back to my initial thoughts. We live in a high-stress world—especially over the past two years. And stress is a huge factor in causing hormonal imbalances.

“Under stress, our adrenal glands produce chemicals to help our body cope and to produce more energy. The adrenal glands are endocrine glands that produce estrogen, progesterone, DHEA, cortisol, and other hormones—too much stress, and any or all of these hormones are affected.

“If we are to achieve optimal health in this context,” she says, “we have to address hormonal balance.”

Hormone Balance: A Complex Challenge

Dr. Burch takes a special interest in hormone balance issues—a subject about which she has considerable expertise. And she and her staff at Central Compounding Center have developed a comprehensive program to evaluate hormone problems and to provide bioidentical hormone therapy (BHRT).

“Hormonal imbalances are extremely complex conditions,” she says. “I would describe them as ‘hormone symphonies,’ in which a variety of factors contribute to the patient’s symptoms. Teasing out the precise nature of the imbalance—and its cause—is essential.

Need Help on Your Health Journey? Ask Your Pharmacist

“Pharmacists are the most over-educated and underutilized health care professionals in America,” asserts Dr. Burch. “And this is regrettable, because they can be an invaluable resource.”

Pharmacists, she points out, “are the best trained health care professionals in drug therapy management—and are perfectly positioned to help patients with questions related to over-the-counter drugs, either alone, or in combination with other medica-tions.

“And, she adds, “we are ideally suited to serve as the knowledge-able “bridge” between trying at-home or over-the-counter (OTC) options and seeking medical care. In today’s digital world, many patients bypass their doctor and the pharmacist altogether to seek information on-line. But it’s not easy to distinguish good inform-ation from bad. That’s something we do know how to do.”

Finding a “pharmacy home,” she advises “could be one of the most beneficial things you can do for your own health care.”

“For example, when one thinks of hormonal imbalances, conditions such as menopause and its hot flashes, mood swings, and exhaustion can come to mind. But those symptoms can be misleading.

“For example, while you and I might have similar symptoms, the hormones causing them might be entirely different. So, comprehensive hormone testing and monitoring—for each individual—is essential, because it allows for accurate hormone adjustments.”

Dr. Burch prefers to use either a saliva test or a finger-stick test for assessing a variety of hormone levels and balance, because these methods examine the free usable hormone available in the body. “Blood tests are less precise,” she says, “and as a result those patients typically end up being prescribed much higher dosages of hormones than they would be if salivary hormone testing had been used.”

The hormone testing protocol at Central Compounding Center is comprehensive. It includes measuring levels of all hormones—estradiol, estradiol progesterone, testosterone, DHEA—as well as cortisol levels.

“Cortisol,” notes Dr. Burch, “affects aging, depression, chronic fatigue, immune function, heart disease, thyroid function, inflammation and pain, and more. Stress influences cortisol, which normally peaks in the morning and declines throughout the day. So, we measure cortisol levels several times throughout the day to get the most accurate reading.

“Following testing, we set up consultations to work with folks to analyze the results and look at options. And it’s important to note that sometimes hormones are just a piece of the puzzle. When I do a consultation, I won’t be looking only at your hormones.”

She adds that they work closely with physicians, making recommendations about how to balance estrogen, progesterone, and testosterone, as well as providing specialized treatments.

“Some hormones, such as DHEA and cortisol,” she notes, “can be improved with over-the-counter supplements. But many hormonal treatments must be individualized. That’s why compounding is such a powerful tool. It allows us to customize individual dosages so we can give whatever amount of hormone is needed and in a form most suitable to the individual patient.”

Blood Glucose Dysregulation

“When we talk about balancing hormones,” notes Dr. Burch, “most often the focus is on estrogen, progesterone, or testosterone but, in fact, insulin is the hormone that is probably the number one health issue in the country. Insulin is a hormone made by the pancreas that allows the body to use sugar as energy and helps to keep blood sugar levels from getting too high or too low.

“When we eat the fast-release sugars and carbohydrates—available in great abundance in every fast-food restaurant, and all-too-common in our diets—there’s a spike in insulin that typically causes all of those incoming calories to be stored as fat,” she explains. “For the typical American who is not exercising, the consequence is weight gain.

“Out-of-balance insulin also causes inflammation in the body,” says Dr. Burch, “which contributes to a wide range of chronic health diseases—including cognitive decline. In fact, some experts have even begun referring to Alzheimer’s disease or dementia as ‘type 3 diabetes,’ citing insulin dysregulation as a contributor to cognitive decline.”

The basic message, concludes Dr. Burch, is that “when one hormone is out of sync, it can have cascading effects throughout the body. In that ‘hormonal symphony,’ we need all the players to be playing in the same key, hitting the same notes at the right time.”