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For more information about these community pharmacy/education/wellness centers, contact:

Bill Burch, RPh
Jennifer Burch, PharmD
Sejjal Patel, PharmD
Donna Ferrell, RPh
Michael Verble, PharmD
Kayla Harris, PharmD
Ziyad Jabar, PharmD


2609 North Duke Street, #103
Durham, NC 27704
Telephone: (919) 220-5121
Fax: (919) 220-6307


6224 Fayetteville Rd, #104
Durham, NC 27713
Telephone: (919) 484-7600

Call to schedule a consultation with our pharmacists.

Critical Testing for Hormonal Balance

Dr. Jennifer Burch continues to promote, and demonstrate, the many benefits of compounding pharmaceutical prescriptions for specific patients and conditions, as their physicians prescribe, in her role as the head of Central Pharmacy Compounding Center in Durham.

Pharmacist Jennifer Burch (right) looks on as Pharmacy Technician Laura Cooper weighs ingredients for the progesterone cream she is compounding.

“Unlike regular corner pharmacies,” she notes, “a com-pounding pharmacy customizes prescriptions for specific indivi-duals. Doctors can prescribe exact strengths, dosages, ingre-dients, flavors, and even methods of convey-ance for their patients, instead of mass-produced—one size fits all—medications.”

Balancing Hormones

Dr. Burch divides her time between compounding and consulting. Of particular interest is her work with patients engaged in bioidentical hormone replacement therapy (BHRT)—a subject about which she has considerable expertise.

“It’s important to note that hormones affect every cell in the body,” she points out. “And an imbalance causes symptoms such as hot flashes, sleep issues, increased headaches and anxiety, fatigue, night sweats, weight control, and uterine fibroids. Sometimes there’s water retention and low sex drive and vaginal dryness. Mood swings and irritability can last all month and symptoms can vary in intensity.

“We live in a high stress world and stress is a major factor in hormonal imbalance,” she points out. “Under stress, our adrenal glands produce chemicals to help our body cope with stress and produce more energy. The adrenal glands are endocrine glands and produce estrogen, progesterone, DHEA, cortisol, and other hormones.”

Testing: Key to Correcting Hormonal Imbalance

“I really believe that testing women’s hormones should be standard practice,” Dr. Burch notes. “Hormones out of balance contribute to poor health. Unfortunately, regular hormone testing is not standard. Too often, women with hormonal issues aren’t tested, but are advised to ‘just take this.’ Comprehensive hormone testing and monitoring is important—because it allows for accurate hormone adjustments. Just as we wouldn’t give a diabetic insulin to lower blood sugar without first testing it, we shouldn’t adjust hormones without thorough testing.”

The hormone testing protocol at Central Pharmacy is comprehensive, says Dr. Burch. “It includes measuring levels of all hormones—estradiol, estradiol progesterone, testosterone, DHEA—as well as cortisol levels. Cortisol affects aging, depression, chronic fatigue, immune function, heart disease, thyroid function, inflammation and pain, and more. Stress influences cortisol, whose levels are higher in the morning, and lower at night. So, we measure cortisol levels several times throughout the day to get the most accurate reading.

“After the initial testing, an abbreviated test three months later may need to be done on estradiol, progesterone, and testosterone. Different factors, such as weight gain or loss, can influence how we metabolize hormones—and it’s all about balance. Think of a symphony with one squeaky instrument making the whole orchestra sound bad. One squeaky hormone makes all the hormones out of sync and changes how we feel. An annual recheck should be on your to-do list.

“My favorite method of testing hormones,” says Dr. Burch, “is either the saliva test or a capillary blood spot, a finger-stick much like a glucose test. These two tests examine the free usable hormone that’s available in the body. When blood tests are used, the serum gathered is not as good an indicator of hormone levels because it carries what’s headed back to the liver to be processed to get out of the body. I find that if blood tests are used, patients typically end up being prescribed much higher dosages of hormones than they would be if they had used salivary hormone testing.”

Testing, Not Assumptions

Dr. Burch recounts a case that illustrates the importance of accurate hormone testing. “A woman who had just had a hysterectomy recently came to us at the urging of her doctor. He had placed her on a fairly typical hormone replacement therapy program, based on the assumption that if your uterus is removed, you no longer need progesterone. So, estrogen was her only hormone supplement.

“Within a few months, she was in bad shape, unable to work, on disability, experiencing all kinds of problems such as brain fog and other ailments. I thought she might have a progesterone deficit, and testing confirmed this. We started balancing her hormones, and soon saw positive results.”

Compounding Custom Treatments

Dr. Burch works 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. And that is why compounding is such a powerful tool. It allows us to customize individual dosages so we can give whatever amount of hormone is needed—estrogen, progesterone, and testosterone—and in a form most suitable to the individual patient.

“For example, there aren’t any commercially available testosterones on the market for women, but we are able to compound low-dose testosterone. Typically, hormones are either delivered via creams or capsules; we are also able to provide a lozenge that will dissolve between the cheek and gum. Topical creams bypass the liver, so you can typically use some lower doses to get the same effect. But there are times when a capsule might be more effective.”