FREQUENTLY ASKED QUESTIONS ABOUT CHEMICALLY-IDENTICAL HORMONE REPLACEMENT THERAPY

What is CHRT?
CHRT stands for Chemically-Identical Hormone Replacement Therapy (Customized Hormone Replacement). The hormones are derived from yam and/or soy. Once extracted from their natural source, the hormones are refined so that they are identical to the human hormone molecule. CHRT fits the body’s receptor like a “key in a lock”. Additionally, our body has the right enzymes to break down and metabolize the hormones properly and efficiently.

What is the difference between CHRT and synthetic HRT?
HRT stands for Hormone Replacement Therapy. It differs from CHRT in the type of hormone(s) used. Any type of hormone may be prescribed in HRT. Most commonly, physicians will use either hormones extracted from the urine of pregnant horses, or hormones assembled in a laboratory. Neither type is identical to the human hormone molecule. The improper ratios and different chemical structures account for treatment failures and the potential for side effects.

What is the difference between Over-the-Counter (OTC) herbal products and CHRT?
OTC products are “plant estrogens”. They are not identical to the human hormone molecule. These products (soy, black cohosh, dong quai, red clover, etc.) are aimed at symptom control for the “peri-menopausal” patient. They do not typically control symptoms for the menopausal patient, nor do they help with long-term protection from disease states (cardiovascular disease, osteoporosis, alzheimers/dementia or colon cancer).

Will I gain weight?
Women going through menopause gain an average of 10 pounds. Women on synthetic hormones typically gain 20+ pounds. Women on CHRT typically gain less than 10 pounds. The idea of CHRT is to maintain proper hormone balance thus enabling the body to slow the aging process.

Will I get my period again once I start taking CHRT?
Once a woman has gone 12 or more months without a period, generally, her period will not return. We cycle our peri-menopausal patients, which helps periods fluctuating from every 2 weeks to 4 months, become more regular. The periods will get lighter and eventually taper off as the patient gets older. Our Cycle Pak  therapy allows a woman’s period to stop on its own, without forcing a cycle or suppressing the cycle. This allows our patients to age naturally while optimizing their health potential.

Will it help with my sex drive?
Many factors affect the sex drive during the aging process. Keeping the hormones (estrogen, progesterone and testosterone) in balance and at optimal levels will all play a role in maintaining a healthy sex drive. Customized Testosterone Replacement Therapy works well for both women and men. The most common dosage form is a topical cream. We also make sure our patients’ adrenal and thyroid glands are functioning properly. Many symptoms of low adrenal and or low thyroid function are similar to low testosterone.

How soon should I be able to tell a difference after I start taking CHRT?
Although we have many patients call after only 1-2 weeks and say “I haven’t felt this good in 10 years”, we educate our patients that it does take a while to raise the hormone levels. During the 1st 30 days, the levels will start to build and we will see mild changes in symptom alleviation. During the next 30 days, the hormones will really start to “kick in” and we see quite a difference. By 90 days, we have a good idea of where patients’ hormone levels and symptoms are. This is typically when we have a follow up consultation and reevaluate labs and patient symptoms.

Does insurance cover the prescription?
Most insurance companies do pay for CHRT. Since they are compounded, we have to submit it differently than a typical prescription manufactured by a drug company. We have our patients sign and date the universal claim form, and then we mail it to the insurance company for the patient. Most of our patients get reimbursed what they paid, less their co-pay, within about 4-6 weeks.

Can I get CHRT anywhere?
Chemically-Identical Hormone Replacement Therapy has to be compounded. Although all pharmacies may compound, not all pharmacies do. South River Compounding Pharmacy & Wellness Center is a Compounding-only pharmacy. We have a 750 square foot laboratory, special equipment, USP pharmaceutical grade chemicals, specially trained pharmacists and pharmacy technicians, all dedicated to assuring each and every prescription is made exactly as prescribed for each individual patient, one patient at a time.

What is a compounding pharmacy?
All pharmacies can legally compound, but we are known as a “Compounding Only” Pharmacy. Compounding is our specialty and CHRT and endocrine balance is our focus. Our entire staff is dedicated to meeting the individual needs of each patient. The definition of compounding is “the mixing of 2 or more ingredients to form a final product”. With regards to CHRT, this might include: capsules, troches, creams, gels, sublingual drops, injections, tablet triturates, lollipops, suppositories, and oral suspensions.

How do I get started?
Give us a call. We can help coordinate labs with your doctor or get a Saliva Test kit for you. Then, we have our patients fill out an evaluation form. Next, we get in touch with the patient’s physician and make a recommendation for therapy. Once we receive the prescription from the physician, we compound it in the lab and call our patients once it is ready. We have most compounds ready within 24 hours of receiving the prescription from the doctor.

Do I need to have labs drawn? Which ones?
Yes, we highly recommend having labs drawn. Either a blood test or saliva test (Women: Total Estrogen, Progesterone, Testosterone, DHEA-S, and Sex Hormone Binding Globulin. Men: Total Testosterone, Estradiol, PSA, DHEA-S, and Prolactin). We recommend follow-up labs during the 3rd month of therapy and then a follow-up consultation. At this point, if necessary, we may recommend a thyroid panel (Free T3, Free T4, Total T4, TSH, reverse T3, and TPO) to evaluate thyroid function, and possibly a saliva cortisol test to help evaluate the adrenals. Keep in mind, we do not treat labs at South River Compounding Pharmacy, we treat the patient. We use the labs as a tool and a guide to help monitor therapy progress and response. It is not just an individual hormone level, but rather the balance of all the hormones and glands that will truly help us achieve optimal health and optimal aging for our patients.

Do I need a prescription?
Yes, a prescription is needed for us to compound CHRT for a patient. The prescription may be phoned, faxed, or mailed in to the pharmacy.

Which doctors prescribe CHRT?
Most physicians may prescribe Chemically-Identical Hormone Replacement Therapy. For example, we work with: Primary Care Physicians, Family Practitioners, Nurse Practitioners, General Practitioners, Internists, OB/GYN, and Endocrinologists.

What are the hormones derived from?
Soy and/or Yam

How much does it cost?
A 30-day supply of a typical estrogen/progesterone combination costs about $50.00 or about $1.55/day. Not much more that a single serving soda.

How long do I need to take it?
The answer is indefinitely. If we look at quality of life as we age the quality starts to decline around 35-40 years old. This correlates with the time ones hormone levels begin to decline and become unbalanced. By maintaining proper hormone levels and balance, the quality of life improves. In addition you will increase your protection against: Cardiovascular Disease, Osteoporosis, Alzheimer’s/Dementia, and Colon Cancer.
What other supplements should I take with the CHRT?
At South River Compounding Pharmacy, we recommend a high quality, high potency Multi-Vitamin Mineral Complex, Omega 3 Essential Fatty Acids, proper Anti-Oxidant support, and a correct balance of Calcium/Magnesium/Vitamin D along with other bone supporting nutrients.

Will CHRT help with my hair loss?
Proper endocrine balance will help with hair, skin and nails. This includes not only Estrogen/Progesterone/Testosterone balance, but also proper Thyroid and Adrenal balance. We compound various strengths and combinations of Thyroid Hormone. Everyday we have patients tell us that, after reading several books and doing research, they went to their doctor because they thought they had a thyroid problem. Their doctor agrees to order thyroid labs. Then, they get the phone call from their doctor “your labs are normal”. At least 10% of our patients have “normal” thyroid labs, but is not functioning at “optimal” health. They still experience fatigue, hair loss, weight gain, etc. even though their labs are “normal”. We target “optimal” levels that still fall within the wide range of normal values. We also have many herbal and nutritional supplements, which help aid in proper thyroid and adrenal function.

Why do I feel so much better on CHRT?
We are replacing the same exact hormones that are in your system. When following labs and symptoms, we can fine-tune a patient’s therapy. We give the patient the right combination and the right levels they need. Thus, not giving too much, nor too little. We continue to monitor our patients and make adjustments as necessary. We are able to maintain 95% of our patients on therapy. Plainly stated, they just simply feel better. Our patients tell us they “feel normal” again.

South River Compounding Pharmacy
Southside: 2300 Robious Station Circle, Midlothian, VA 23113
West End: 3656 Mayland Court, Richmond, VA 23233
Serving the Greater Richmond, Virginia area, including Chesterfield, VA, Hanover, Henrico, Powhatan