GETTING STARTED:

Compounded Medication requires a prescription by law.

To achieve the best possible outcome, we need to work with your doctor as well as YOU.

Filling your prescription
  • Fax your prescription to (02) 99827205
  • Phone to confirm arrival of fax and details such as name, address, phone number, when it will be ready & cost and payment details.
  • Payment can be made with credit card, money order or direct debit if posting If collecting, payment can be as above as well as cash or eftpos.
  • By Law, we require the original prescription, so we need for this to be either posted after faxing or to bring it to us upon pickup of prescription medication.
The pharmacy label on your dispensed prescription will state the number of repeats remaining (highlighted).  If it shows NIL Repeats or Last Repeat you will need to contact your doctor to make arrangements for a new prescription.
  • Home delivery
  • We  "express post" medication, or airmail if overseas
  • You may arrange your own courier if you wish.

 

Topics:

 

MENOPAUSE

Female Menopause is the time in a woman's life when the Ovaries cease to produce an egg cell every four weeks and therefore Menstruation ceases and the woman is no longer able to become pregnant.
Menopause is diagnosed after 12 months without a period.

Forms of Menopause:
Late Menopause occurs when menopause happens beyond the age of 55.
Perimenopause is the five to ten year period prior to menopause.   The hormonal changes associated with menopause can actually commence then.  Some menopausal symptoms may occur during this period, even though the woman is still menstruating.
Premature Menopause occurs when menopause occurs before the age of 40.  Approximately 5% of women experience Premature Menopause.

 

Symptoms of menopause may include:
  • Hot flushes  
  • Cold sweats
  • Weight gain
  • Rheumatic pains  
  • Cold hands and feet  
  • Breast pains
  • Headaches
  • Numbness and tingling 
  • Skin crawls  
  • Vaginal dryness 
  • Pain with intercourse
  • Urinary difficulty including recurrent bladder infections  
  • Feelings of suffocation
  • Heart pounding
  • Dizzy spells   
  • Pressure or tightness in head or body  
  • Fatigue  
  • Irritability and nervousness  
  • Depression 
  • Forgetfulness
  • Sleeplessness
  • Inability to concentrate  
  • Crying spells  
  • Panic attacks
  • Loss of interest in typical activities  
  • Tension  
  • Needless worry


Research is showing the importance of maintaining a balance between progesterone and oestrogen for overall health and well being.
Hormones can be measured via a blood test or a saliva test.
If there is a lack of either hormone, or an excess of either hormone, the following symptoms may occur:

LACK OF PROGESTERONE

Headache
Low Libido
Anxiety
Swollen Breasts
Moodiness
Fuzzy Thinking
Depression
Food Cravings
Irritability
Insomnia
Cramps
Emotional Swings
Painful Breasts
Weight Gain
Bloating
Inability to Concentrate
Early Menstruation
Painful Joints
Asthma
Acne

LACK OF OESTROGEN

Hot Flashes
Shortness of Breath
Night Sweats
Sleep Disorders
Vaginal Dryness
Dry Skin
Anxiety
Mood Swings
Headache
Depression
Memory Loss
Heart Palpitations
Yeast Infections
Vaginal Shrinkage
Painful Intercourse
Unable to Orgasm
Lack of Menstruation

EXCESS PROGESTERONE

Depression
Somnolence

EXCESS OESTROGEN

Water Retention
Fatigue
Breast Swelling
Fibrocystic Breasts
Premenstrual Mood Swings
Heavy or Irregular Menses
Uterine Fibroids
Craving for Sweets
Weight Gain

 

FAQ

What is Oestrogen?

Oestrogen is the name given to a class of hormones. There are three major oestrogens produced by women called oestriol, oestradiol and oestrone. Oestradiol is the most potent. Often spelt as estrogen,  estrone, estradiol, estriol

What is natural progesterone?

Progesterone is a naturally occurring hormone in both men and women. Progesterone is essential for many vital functions in the human body. The ovaries produce most of the progesterone, but this is only if ovulation occurs. As women approach menopause, less progesterone is produced. The deficiency of progesterone is responsible for many symptoms associated with menopause.

Progesterone also balances the effects of oestrogen. Even after a hysterectomy oestrogen in the body needs to be balanced with progesterone.

Testosterone for women

Women's ovaries and adrenal glands also produce testosterone. During menopause women can experience a drop in oestrogen and testosterone production. Testosterone is important in maintaining sexual desire, strength and integrity of skin, muscle and bone. Low levels of testosterone will result in a decreased sex drive, fatigue and decreased sense of well being.

Where do hormones in compounded medication come from?

Natural hormones are obtained from sterol analogues found in many varieties of plants, primarily soybean and wild yam. These oestrogen and progesterone like compounds are then transformed in the laboratory to the human bio-identical natural hormones.

Can Hormone Replacement Therapy (HRT) cause side effects?

HRT's goal is to restore and maintain a physiological status. If hormone levels were normal from age 20 to 40, replacing them to restore the same level that was well tolerated for 20 years is unlikely to cause any serious side effects in later life. The risk is further reduced if only natural hormones are used. However, any type of medication can have side effects if not administered properly or taken in excess doses. The scientific studies show that the potential benefits of HRT are great; however, overdosing to excessive level causes most problems reported from HRT. To insure safety, hormone levels should not be raised above a normal youthful range, and side effects can often be relieved with a dosage adjustment.

How Are Natural Hormones Available?

Natural hormones can be prepared in a dosage form convenient to each individual patient. Women and men are no longer limited by the "one size fits all" medications that pharmaceutical manufacturers sell. Natural hormones can be made as capsules, topical creams, vaginal suppositories, injectables and sublingual liquids or tablets.


Can I get these from my any pharmacy?

Most pharmacies will not compound medications. Compounding requires extensive training, time, and specialised laboratory equipment & staff to meet the special reqirements of the patients and physicians. Our pharmacy has highly trained staff as well as 'state of the art equipment' necessary to provide compounding services.


How long should I take hormones?

The length of time will be different for each patient. It will depend on your current health and the chances of developing other serious diseases later in life, such as osteoporosis for example.


How do I get started on Natural HRT?

Natural hormone replacement therapy also known as bioidentical hormone replacement therapy must be tailored for the individual patient. A thorough review of symptoms and history is an effective and essential procedure by the doctor.

DOSAGE FORMS

Hormone Replacement Therapy (HRT) can be different for each individual.  There are many different types of HRT.  However, the way it is administered can make all the difference to the individual.
There are many dosage forms available, especially for those who have difficulty in swallowing medicine.
 Some may have allergies or sensitivities to certain preservatives, dyes or fillers. Others cannot tolerate the taste.  
Often medication is prescibed in an alternate dosage form such as troche, lozenge, suppository, pessary or cream, to allow the medication to enter the bloodstream directly.  Avoiding the first pass stomach entry can mean that the drug does not get destroyed by stomach juices.

Examples of dosage forms:-
  • Capsules
  • Slow release capsules
  •  Troches
  • Creams, Ointments & Lotions  
  • Gels - Topical or Oral 
  • Vaginal creams
  • Oral Suspensions  
  • Paediatric Formulations
  • Sugar-free Formulations  
  • Suppositories
  • Pessaries
  • Lip balms
  • Flavoured lollipops
  • Topical Powders
  • Nasal sprays and instillations
  • Veterinary formulations

BIOIDENTICAL HRT

What are biologically identical hormones?
Biologically identical hormones or bioidentical hormones are derived from plants, such as the wild yam or soybean plant. The wild yam is rich in precursor molecules that can be converted into oestrogens and other hormones where the molecular structure is the same as those produced naturally in the human body.

Oestrogen is not one hormone, but a group of three hormones: oestrone (E1),oestradiol (E2), and oestriol (E3) & are natural human hormones. A high ratio of oestriol to the other oestrogens has been associated with a lower risk of breast cancer. Premarin®, a drug commonly used in oestrogen replacement therapy, is derived from pregnant mare urine. Because horse oestrogen is foreign to the human body, people may lack the enzymes and cofactors to metabolise it safely.

Progesterone may be needed to balance the effects of oestrogen on the uterus as well as the rest of the body and also may help build bone. Natural progesterone might be safer than synthetic progestins (like Provera®), which may have a negative effect on the cardiovascular system. Likewise, natural testosterone (typically thought of as a male hormone but also produced in the ovaries) may be safer than synthetic methyl-testosterone for treating problems with libido.

SYNTHETIC VS BIOIDENTICAL HORMONES

Bio Identical Hormones are the exact copy of those that are naturally occurring in the human body.

Synthetic hormones are not found in the human body,  and are not identical instructure or function to the hormones they are intended to replace.  Bioidentical hormones are derived from a plant molecule found in soy beans and wild yam. Bio identical hormones are said to be natural BioIdentical Hormones, not because of their source but their chemical structure is the same as that of the hormones our bodies produce. The plant molecule, (diosgenin) is taken to a laboratory to be converted into progesterone.  Progesterone can then be converted into the three oestrogen hormones, oestrone, oestradiol and oestriol and then also converted into testosterone, cortisol, dhea and pregnenolone.

Supplementing the body with hormone molecules that are identical to those we produce, allows our body to benefit identically, the same way as it would when the body produces them. The bio identical hormones are recognised by the body & bind quickly to receptors causing the appropriate affect and then are broken down quickly & metabolised so they may be excreted from the body.  Bioidentical hormone replacement therapy (BHRT) can therefore, be used effectively and safely.

Can just anyone take hormones?
No, not every patient can take all hormones (synthetic or bioidentical ), for example estrogen.

Relative contraindications to oestrogen therapy include:
  • Family history of breast cancer (outside immediate family)
  • Benign breast disease  
  • Past history of recurrent  thromboembolisms (blood clots)
  • Moderate or severe endometriosis  
  • Enlarging fibroids or fibroids that produce heavy bleeding

Absolute contraindications to oestrogen therapy include: 
  • Presence of non-eradicated endometrial cancer  
  • History of breast cancer
  • Cancer history in first-degree relatives  
  • Active thrombosis (blood clot)  
  • Acute liver disease or chronic liver failure  
  • Unexplained vaginal bleeding  
  • Pregnancy
?    Contraindications to progesterone therapy include: 
  • Allergy to progesterone, progesterone-like drugs, or inactive ingredients  
  • Past or present blood clots  
  • Liver disease  
  • Known or suspected cancer of the breast or reproductive organs  
  • Unusual bleeding from the vagina, not evaluated by a physician  
  • Miscarriage with suspected tissue remaining in the uterus
  • Breastfeeding
If already on synthetic HRT, how difficult is it to switch to biologically identical hormones?
In most cases, the transition is a smooth one.

HORMONE TESTING

The family of steroid hormones support a wide range of essential physiological functions, such as blood lipid balance,  bone mineral density, fertility, sexuality, a general sense of well-being, and certain aspects of brain functioning.
Adequate levels as well as an appropriate balance of the steroid hormones are necessary for well-being and maintaining optimal health. This applies to both men and women.
Hormones can be tested via a saliva test or a blood test.  Doctors have their own preferences for one or the other.
The saliva test measures levels of specific hormones that are produced in the body, consumed as foods, dietary supplements or medications. Saliva yields a direct measure of "free hormone" level and is comparable to that measured by blood.
Testing provides a means to establish whether or not  your hormone levels are within the expected normal range. It is appropriate to monitor and titrate doses to minimise side effects and risks without compromising the benefits of replacement therapy.

Hormones tested
  • Oestradiol
  • Oestriol
  • Progesterone
  • Testosterone
  • DHEA
  • Cortisol
  • Melatonin
  • Total Oestrogens
 

QUALITY STANDARDS

Dee Why Health Care Pharmacy is an experienced and comprehensive compounding facility. Our specialised training,  high tech equipment & state of the art technology allow us to provide "Quality"  tailor made medications to suit individual needs.
We only invest in the highest quality ingredients which must meet the highest quality standards USP and BP grades.
Professional Quality Care advice is what to expect  from our team.
Quality Care Customer Service is our mission & our passion.

ANDROPAUSE

Andropause is the result of low testosterone and a natural part of male ageing, due to a decline in testicular function.  Andropause (or the "male menopause") is the counterpart to the female menopause.

Testosterone levels in men remain relatively constant until about the age 50, at which time they begin to fall slowly. However,  the decline in malehormone production is much more gradual than the decline in female hormone production.

Symptoms of andropause include a decrease in libido & erectile dysfunction, decreased energy and strength, increase in body fat,  loss of muscle mass, enlargement of prostate, osteoporosis, depression, inability to concentrate, loss of enthusiasm and reduced mental agility.

Research studies have directly linked depression in elderly men with low levels of testosterone.  Results found men with lowest levels of testosterone were three times more  likely to suffer depression than those with the highest levels. These results were independent of a man's health & this is significant because poor health is known to increase the risk of depression.


Men with low testosterone (hypogonadism) are given testosterone replacement therapy for a variety of reasons; It may enhance libido, decrease heart disease risk,  increase in lean body mass and prevent osteoporosis. Testosterone may also lower total cholesterol and LDL, and decrease  insulin resistance.
 As men age, the balance between testosterone and oestradiol changes , tilting towards more oestradiol production. The pituitary hormone responsible for stimulating testosterone is LH (luteinizing hormone ).  Excess oestradiol may decrease the level of LH and, therefore, the level of testosterone.

It is surprising to learn that the average 60-year-old male  has more circulating oestrogen in his  bloodstream than the average 60-year-old  female.

The conversion of  testosterone  to oestradiol takes place under  the influence of the enzyme aromatase. Testosterone and  Androstenedione are both  "aromatizable "  to oestradiol.
In many cases,  levels of oestrogen are found to be elevated.  If  this happens,  it is possible to block aromatase activity,  so the chances that  the testosterone given will be converted to even more oestrogen may be reduced.

Currently  there are several aromatase inhibitors on the market for prescription use as treatments for breast cancer.  These aromatase inhibitors might block  the conversion of testosterone to oestrogen in men as well. There is also a natural aromatase inhibitor called chrysin.

VETERINARY COMPOUNDING

We can assist pets with their requirements for administering medication.
Flavouring medication can assist especially when " difficult to administer"  medication is required.
The advantage of compounding  for animals is the ability to change strength of  the medication and the mode of administration. This includes chewable products, transdermal products, solutions etc.                         Commercially discontinued medication can often be compounded.

PAEDIATRIC FORMULATIONS

Sometimes it can be a challenge to give medication to children.  Convincing a child to take his or her medicine can be a difficult task.

Commercially available medication can sometimes  present  problems when it comes to allergies or drug intolerance,  or even dose strengths or dose forms may not suit  their  smaller  body size & weight.


Many children have difficulty swallowing  capsules or tablets.
Standard commercial medications are often only available in dosages too high for a child. Children vary in size and weight and so the dose required to treat them also varies.  
Compounding can help solve these problems.  By working closely with your child's paediatrician,  we can assist in formulating the medicine that will meet the unique needs of  your child.    

We can flavour lozenges or liquid medications to make them easier for children to take.  This is important with medications that need to be taken for an extended period of time.


Many children cannot  tolerate commercially  available medications because  they often contain preservatives, dyes, alcohol and sugar.  We can formulate a medication  that  is free from all these allergens to suit  your child's needs.

Some of the most commonly  prescribed ingredients are: Omeprazole as a suspension, melatonin suspension, propranolol suspension etc.

PAIN MANAGEMENT

Pain is the most common reason why patients seek medical help.

Pain can be classified as neuropathic  pain (pressure or injury to nerve cells) or nociceptive pain (activation of normal pain fibres), acute or chronic pain,  incident (upon activity such as movement, coughing)  or breakthrough pain (pain occurring between regular doses of pain medication).
Compounding for pain management  is a whole new approach to treatment.  Compounding can offer solutions to  the limitations of commercial pain medications such as unique dosage forms, unavailable medications, allergies,  bad tasting or intolerable medication.

Often commercial pain medication presents with many side effects as it enters the body via the gastric area causing  irritation and other serious side effects.

Topical creams/lotions/gels offer the advantage of delivering the 'active ingredient' to the site of application.  Transdermal  preparations when applied to the site of action actually go through the skin and directly enter the bloodstream. This avoids the "first pass effect"  which is the liver metabolism. This in itself eliminates or drastically reduces the potential for drug interactions.  We can apply a lower level of 'active ingredient'  as we do not need  to survive gastric juice metabolism, rate of gastric emptying or motility   and also we can use  known classic effective ingredients  transdermally without the risk of serious side effects.

Oral dosage forms such as capsules, lozenges,  flavoured oral suspensions can be more palatable; capsules can also be modified as slow release capsules staying in the body longer.

 

Rectal preparations, such as suppositories are ideal for patients unable to take medication  orally (i.e. nausea, vomiting, difficulty swallowing, obstruction, altered consciousness).

 

Nasal Preparations such as sprays can deliver medication intranasally.  This alternative route of administration has advantages in terms of rapid onset of action.


Some of the most commonly prescribed ingredients include: Ketamine, Ketoprofen, Lignocaine, amitryptyline, baclofen, capsaicin, tetracaine, benzocaine, and gabapentin.

SLEEP HORMONE

Melatonin is a naturally occurring hormone produced in the pineal gland.  Melatonin helps to regulate our circadian rhythm  (body clock)  which  dictates our sleep & wake cycles.   Melatonin plays a critical role in helping us to fall asleep and stay asleep through the night.   

Melatonin secretion increases  soon after  the onset of darkness.  Melatonin peaks in the middle of  the night (between 2am and 4am)  and gradually falls during the second half of the night.  Serum levels of melatonin are known to decrease with age which may contribute to the increased frequency of sleep disorders in the elderly and the ageing process itself.

Melatonin can be compounded as capsules, slow release capsules, suspensions and drops in various strengths.

THYROID HORMONE REPLACEMENT

Replacement and maintaining your natural balance.


More than half of all  Australians  affected by thyroid disease are unaware of their condition.  Thyroid disease may not be picked up or diagnosed for many  years.  Women are more affected than men, probably due to women requiring higher levels of thyroid hormone than men.
Thyroid Hormone (TH) is produced by the thyroid gland in response to the release of Thyroid Stimulating Hormone (TSH)  from the pituitary gland.  TH helps the body convert  food into energy and heat,  regulates body temperature, and impacts many other hormone systems in the body.

Symptoms of hypothyroidism may include:
  1. Slowed metabolism and slowed heart rate
  2. Cold and heat intolerance - cold hands and feet
  3. Fatigue
  4. Fluid retention - face, legs, eyelids and abdomen
  5. Dry skin, eyes and/or hair
  6. Yellowed skin
  7. Loss of eyebrows
  8. Constipation
  9. Headaches, migraines
  10. Depression, apathy and anxiety
  11. Irritability - low self esteem
  12. Low sexual desire
  13. Infertility
  14. Memory and concentration impairment
  15. Enlarged tongue, deep voice and swollen neck
  16. Premenstrual syndrome,  irregular menstrual periods
  17. Lack of exercise  tolerance
  18. Weight gain (especially around the stomach area)
  19. Hypoglycemia (low blood sugar)


During periods of stress, an inactive  form of T3 can be formed,  called Reverse T3 (Rt3).
Under normal conditions T4 converts to both T3 and rT3 continually and  the body eliminates  rT3  quickly. However, sometimes under  certain conditions,  more  rT3 is  produced and the desired conversion of  T4  to T3 decreases.  This occurs during periods of  fasting, starvation, illness (eg liver disease) and particularly during times of increased stress.

T3 is the most potent of the thyroid hormones.  Approximately 85% of circulating T3 is produced by monodeiodination of  thyroxine (T4) in tissues such as the liver, muscles and kidneys.  Selenium and  zinc are required for this monodeiodination.

An increased production of rT3 is often seen in patients with metabolic disorders.  Measurement of rT3 is therefore valuable in identifying  thyroid disorders.

During later stages after declining thyroid hormones then your adrenals would  also have been affected.         This makes fatigue symptoms even further and so your body attempts to compensate by  up-regulating your nervous system.   At this later stage, anxiety gets worse,  insomnia,  inability  to relax, nervousness and a mind which races,  and sometimes  breathlessness, palpitations and even tremors can occur.


Thyroid production,  as with other hormones  tends to decrease with age.
Reverse T3 dominance,  functional hypothyroidism also known as Wilson's Syndrome is a condition that reflects most  hypothyroid  symptoms even  though blood levels of T3 and T4 are within normal test limits.    This is a condition when T4 metabolism produces an excess of reverse T3 in relation to T3,  therefore this is a problem with T4  activation  rather than a lack of thyroid production.

Reverse T3 has the same molecular structure as T3 however;   this means that  it can bind to the receptor preventing T3 from binding to the receptor and  activating the appropriate response.

Other factors that adversely affect  conversion of  T4  into  T3  include:  nutritional deficiencies such as selenium, zinc,  iodine,  VitB6,  B12 and E,  antibody reactions,  insulin resistance,  toxicities such as heavy metals and environmental  toxins.

Thyroid  function can also be estimated by measuring your underarm body temperature each morning before getting out of bed.   If your underarm temperature is consistently subnormal (below 36.5 C) for 3 days or more  your thyroid function may be low.

However,  do not  forget  that adrenal function also influences your metabolic rate and therefore  body temperature.  This means adrenal function must also be considered if you have low body temperature.

An integrated approach should be taken when diagnosing hypothyroidism  making use of all the diagnostic  tools as well as using  signs and symptoms of low thyroid function.

 If doctors rely  totally on the TSH test without  considering signs and symptoms , which has become common practice,  then many patients with a sluggish thyroid go undetected and are therefore not treated  appropriately.

If the thyroid is under active then usually  the adrenal glands get overworked and run down while trying to compensate for the low thyroid  hormone levels resulting in adrenal exhaustion.


If you tend to be jittery on thyroid medication or if you are generally  more alert at night,  have rapid mood swings, have sugar or  salt  cravings,  feel tired  all  the  time,  have dark circles under your eyes and are  easily stressed then your adrenal glands may also need help.

Your adrenal  function can be determined by measuring DHEA and cortisol levels.   If it  is too under active  it may also require treatment.

In mild to moderate cases certain nutrients may be used to either improve  thyroid  hormone production or to improve conversion of T4 into the active T3 form. Test results would determine which would be more suitable.

Moderate to severe cases may be treated with appropriate compounded bioidentical thyroid hormone combinations or thyroid  gland  extract.


 We also strongly recommend adrenal support, if tests indicate the need, along with nutritional support.  Many thyroid patients we see also  have adrenal problems and both need to be addressed  for a full recovery.

If  the autoimmune system is involved  then certain steps should be taken in attempt to control it.  Conditions such as Hasimoto's  disease and Graves disease may benefit f rom removing any foods  that  cause food allergies or intolerance reactions such as gluten, dairy and yeasts, heavy metals  must be removed, any digestive or leaky gut  issues need to be treated,  adrenal, thyroid and sex hormones need to be appropriately balanced along with the use of certain supplements.

Compounded   thyroid replacement allows for the avoiding of  fillers such as lactose which inhibit thyroid absorption. These are still used in many  other  poorly  formulated commercially  available products.

In addition compounded  thyroid medication can also provide T3  and  T4  combination capsules in physiological ratios   tailor made   to suit your individual requirements.