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Zoe Stefanadis, RPh

109 Conner Drive, Suite 1200
Wilshire I Building

Chapel Hill, NC 27514

Telephone: (919) 967-8805

Fax: (919) 967-8205

Rejuvenating Benefits of
Hormone Replacement Therapy

Pharmacist Zoe Stefanadis, owner of Chapel Hill Compounding, frequently demonstrates that one of the ways for many people to revitalize their aging bodies is through bio-identical hormone replacement therapy (BHRT).

Pharmacist Zoe Stefanadis, RPH, left, with a new addition to her staff, Pharmacist Lisa McLaurin.

“It’s well-established that BHRT—when properly done—is helpful in reducing hot flashes in women, in maintaining muscle mass and strength, and in improving an overall sense of well-being,” she says.

BHRT is commonly made at a compounding pharmacy such as Chapel Hill Compounding. Owner pharmacist Zoe Stefanadis is often a guide on the path of rehabilitation and rejuvenation for many of her patients when exploring the benefits of hormone replacement.

She finds herself increasingly spending time testing hormone levels and their balance for both men and women, and compounding and dispensing life-enhancing, or rejuvenating, bio-identical hormones. “BHRT needs to be prescribed by your physician,” she explains. “But at times, we test with a take-home test kit. You simply prick your finger or collect saliva. If someone is just starting out and getting a baseline reading, the doctor will do a traditional blood test to assess hormone levels. Then we work very closely with patient and doctor to determine which hormone, in what strength and combination, is best for that individual.”

At Chapel Hill Compounding, hormones can be formulated to fit the needs of individual patients. “There are different delivery mechanisms to choose from when preparing the prescription,” Ms. Stefanadis notes. “Everyone absorbs medications differently. We do follow-up testing to make sure that the dosages are working and that the hormones are being absorbed.

“Hormones—especially testosterone—are not absorbed very well orally,” she explains. “They are rough on the liver, and hepatic toxicity can be associated with any type of oral testosterone, so we avoid oral delivery. Patients seem to respond better with transdermal creams and gels.

“Generally,” she says, “we’re also moving away from oral estrogens because the metabolites seem to be responsible for blood clots.  Application through the skin can mimic our body’s normal glandular release of hormones, so creams work well. However, taking the hormone progesterone orally is not only safe, but its metabolites can actually help you sleep.”

She further notes, “We pay careful attention to the level of hormones each individual needs. Men’s testosterone levels peak at around 19 to 21 years of age, producing about 10 to 20 milligrams a day. Some physicians prescribe testosterone replacement of upwards to 100 mg or even higher. In my experience, we frequently get a better response from men who are on 20 or 40 mg level of testosterone. If we use a superior gel or cream, we will experience better levels on the cellular level as well. We have to be mindful in this instance that testosterone might convert to estrogen, and if a man is converting his testosterone to estrogen, that will not give him the hormone balance he needs at the cellular level.”   

Finding Proper Levels

“I had a 60-year old male patient,” she recalls, “whose symptoms were lethargy, libido issues, and muscle tone (he had a significant amount of belly fat). Scientists have told us that we can build muscle well into our 90s. He was trying to work out, but when you have that adipose tissue as belly fat it reacts differently; it loves estrogen, which loves to live in body fat. He had been prescribed close to 400 milligrams of testosterone and my first inclination was that they had overshot the bar. If you give someone too much hormone medication you can get adverse consequences, and down-regulating receptor sites are overwhelmed.

“We tested for testosterone and estrogen levels to make sure he wasn’t converting and also discovered that his testosterone levels were way too high. We brought his dose down and changed his diet to help clear the excessive testosterone and estrogen. He was put on a natural aromatase inhibitor—which is also found in cruciferous vegetables like cauliflower, broccoli, and Brussels sprouts—to block the conversion process. A response to hormone replacement doesn’t happen overnight. It took a few months for everything to level out and then he started feeling better. His energy level and libido improved. On a lower dose, he was able to start losing weight, exercise more, and gain muscle tone. He was, in fact, taking ownership of his health.”

One of the side effects of low testosterone in women, notes Ms. Stefanadis, “is a lack of motivation from always feeling tired. Doctors will traditionally look at the thyroid, but if the patient keeps repeating that they’re consistently exhausted, then it’s time to check their testosterone. The unique thing about women is that sometimes we can take DHEA, a precursor to testosterone, and it will actually convert to testosterone. If that doesn’t do the trick, we’ll start with a very low dose of testosterone, such as 1 milligram. The benefits are improved muscle tone, energy, and libido.”

Hormone Balance Key to Whole Health

“If hormones are kept at adequate levels and balanced,” explains Ms. Stefanadis, “then the body can help protect itself from cardiovascular disease and osteoporosis—which are, in fact, many of the diseases of aging that we commonly see. I have a 92-year old father and an 84-year old mother whom I want to help. I would love to be able to convince my dad’s physician to give him a small dose of testosterone to increase his energy level. But doctors follow certain guidelines; more studies need to be done on the benefits of bio-identical hormone replacement therapy for the geriatric generation.”