HMCompounding

Integrative Healthcare Symposium 2012

2012-02-08T08:15:00.000-08:00

Come visit us at booth 628.

Integrative Healthcare Symposium is THE premier gathering place for the most influential and inspiring multi-disciplinary practitioners and healthcare professionals who are dedicated to improving patient care and defining the future of integrative healthcare.

http://www.ihsymposium.com/12/public/enter.aspx

PCAB

2011-12-23T08:07:00.003-08:00

PCAB sets tough, national standards that pharmacies will have to meet to obtain accreditation. The process ensures that pharmacies have in place sound practices, processes, facilities, equipment and personnel to prepare compounded medications for their patients. Is your compounding pharmacy PCAB Accredited?

PCAB

2011-12-23T08:07:00.001-08:00

Please read

2011-12-12T06:12:00.001-08:00

2011-09-15T06:29:00.001-07:00

Its National Prostate Cancer Awareness month. Special on HM Compounding Ultra Prostaguard, $31.00 with Free shipping for September.

New York State Medicaid

2011-09-13T06:39:00.001-07:00

Did you know…

HM Compounding accepts New York State Medicaid? Having access to a PCAB Accredited compounding pharmacy should be available to all. We strive to make our services attainable to all patients. If you have any questions about access to the highest quality and safest compounds, please call us today. 800.419.2804

Are you affected by a drug shortage?

2011-08-30T10:19:00.001-07:00

Are you affected by a drug shortage?

The following shortages are available to be compounded from HM Compounding, New York City’s First PCAB Accredited compounding pharmacy. Call today for more details (800) 419-2804

• Hyaluronidase 150 U/mL Injection Solution (PF)

• Dichloralphenazone 100 mg/Isometheptene Mucate 65 mg/ Acetaminophen 325 mg Capsule

• Lorazepam Injection Solution

• Acetaminophen 80mg Suppository

• Acetylcysteine 20% Inhalation Solution

• Cyanocobalamin 1000 mcg/ml Injection Solution

• Dexamethasone Phosphate 4 mg/ml Injection Solution

• Betamethasone Acetate/Betamethasone Sodium Phosphate Injection Suspension

• Paregoric, Alternate

• Ivermectin 3mg Capsules Size #3

• Vitamin A Palmitate 50,000 Units/mL Injection Emulsion (IM)

• Amikacin Injection Solution (PF)

• Methocarbamol 100 mg/ml Injection Solution

We are providing this list of compoundable products to keep you informed of several backorder or discontinued manufactured products that we are able to compound.

Hospitals

Emergency clinics

Veterinarians

Physical therapists

pain management clinics

musculoskeletal specialists

Hospitals and clinics who use injectable antibiotics

surgical centers

burn & wound centers

tuberculosis clinics

pediatricians

general practitioners

bariatric centers

Oncologists

Hospice

OB/gyn

anybody involved with

diet clinics

hormone therapy

pulmonary specialists

orthopedic specialists

dentists

GI specialists

Dermatologists

ophthalmologists

internists

dermatologists

plastic surgeons

pediatricians

developmental specialists

hematology specialists hospitals

renal specialists

epilepsy specialists

alcohol treatment practitioners

Menopause Article by Labrix

2011-08-16T07:00:00.001-07:00

Menopause

Contrary to popular belief, Menopause is not simply the result of estrogen deficiency; although, estrogen levels do decline during the latter phases of a woman's reproductive cycle. Estrogen levels drop by approximately 40% at menopause while progesterone levels plummet to approximately 90% of the pre-menopausal levels.
It is the relative loss of progesterone that causes the majority of symptoms. The disproportionate loss of progesterone begins in the latter stages of a woman’s reproductive cycle, while unbeknownst to her, the luteal phase of the menstrual cycle begins to malfunction. The malfunction is initiated when the remnant tissue of the follicle (corpus luteum), the primary source of progesterone, begins to lose its functional capacity. By approximately age 35, many of these follicles fail to develop creating a relative progesterone deficiency. As a result, ovulation does not always occur and progesterone levels steadily decline. It is during this period that a relative progesterone deficiency, or what has become known asEstrogen Dominance, develops.
Typical symptoms of estrogen dominance are:

Mood Swings: Irritability, Depression
Irregular Periods
Heavy Menstrual Bleeding
Hot Flashes
Vaginal Dryness
Water Retention
Weight Gain: Hips, Thighs and Abdomen
Sleep Disturbance (Insomnia, less REM sleep)
Decreased Libido
Headaches
Fatigue
Short-term Memory Loss
Lack of Concentration
Dry, Thin, Wrinkly Skin
Thinning of Scalp Hair
Increased Facial Hair
Bone Mineral Loss (Osteoporosis)
Diffuse Aches and Pain

The most effective way to assess hormone status is to test saliva for the appropriate hormone levels. The reason that saliva is the best method of testing is that "active" tissue levels are measured, opposed to serum testing in which essentially measures the "inactive" levels.

http://www.labrix.com/page?pageid=a0Y5000000072tsEAA

http://www.hmcompound.com/

Pediatrics: Rectal Suppository Antibiotics.

2011-08-10T12:23:00.001-07:00

Drug absorption in the rectum

The mechanisms of rectal absorption of drugs are not significantly different from those in the upper part of the gastrointestinal tract. Hence, rectal absorption of drugs is governed largely by the general principles of transfer of antibiotics. The pharmaceutical formulation, therefore, plays a major role in the rectal absorption and consequently in the systemic distribution and pharmacokinetics of antibiotics administered via suppository.

Before prescribing any antibiotics to be compounded into a rectal suppository, it would be good to consult with a knowledgeable pharmacist, and use only a PCAB™ Accredited compounding pharmacy.

Labrix Article: Why Use Saliva?

2011-08-09T06:25:00.001-07:00

Why Use Saliva?

Saliva testing is an easy and noninvasive way of assessing your patient's hormone status and balancing needs and is proving to be the most reliable medium for measuring hormone levels.
Appreciating the reliability of saliva testing is based on understanding the difference between steroid hormones in saliva and serum. This difference is based on whether or not the hormones are bound to proteins in the medium used for testing. The majority of hormones exist in one of two forms: free (5%) or protein bound (95%). It is only the free hormones that are biologically active, or bio-available, and available for delivery to receptors in the body. Those which are protein bound do not fit those receptors and are considered non-bioavailable. When blood is filtered through the salivary glands, the bound hormone components are too large to pass through the cell membranes. Only the unbound hormones pass through and into the saliva. What is measured in the saliva is the bioavailable hormone, the clinically relevant portion which will be delivered to the receptors in the tissues of the body.
Salivary hormone levels are expected to be much lower than serum levels, as only the unbound hormones are being measured. When health care providers measure serum hormone levels and prescribe hormone replacement therapy based on those results, patients are often overdosed. If the patients are then tested using saliva, the results are extraordinarily high, and confusion results from a lack of correlation between the two methods.
This discrepancy becomes especially important when monitoring topical, or transdermal, hormone therapy. Studies show that this method of delivery results in increased tissue hormone levels (thus measurable in saliva), but no parallel increase in serum levels. Therefore, serum testing cannot be used to monitor topical hormone therapy.
Saliva Measures the "Unbound" Biologically Active or Free Hormone Levels in the Body:
When blood is filtered through the salivary glands, the bound hormone components are too large to pass through the cell membranes of the salivary glands. Only the unbound hormones pass through and into the saliva. What is measured in the saliva is considered the "free", or bioavailable hormone, that which will be delivered to the receptors in the tissues of the body.
Serum Measures the "Protein Bound" Biologically Inactive Hormone Levels in the Body:
In order for steroid hormones to be detected in serum, they must be bound to circulating proteins. In this bound state, they are unable to fit into receptors in the body, and therefore will not be delivered to tissues. They are considered inactive, or non-bioavailable.
Only Saliva Testing Measures Topically Dosed Hormones:

The discrepancy between free and protein bound hormones becomes especially important when monitoring topical, or transdermal, hormone therapy. Studies show that this method of delivery results in increased tissue hormone levels (thus measurable in saliva), but no parallel increase in serum levels. Therefore, serum testing cannot be used to monitor topical hormone therapy.

http://www.labrix.com/page?pageid=a0Y5000000072tsEAA&order=3&idMenu=a0f500000005TahAAE

Labrix Article: Progesterone & Traumatic Brain Surgery

2011-08-08T06:15:00.000-07:00

Progesterone & Traumatic Brain Surgery

As hormone replacement practitioners, we know the many benefits of progesterone therapy: mood and memory improvement, decrease in fibrocystic breast conditions, fewer hot flashes, less water retention…the list goes on. A preliminary study published in the Annals of Emergency Medicine shows promise for using the hormone progesterone in a new way: to treat traumatic brain injury (TBI). In the three year study, conducted at the department of emergency medicine at Emory University, 77 TBI patients received intravenous progesterone, while 23 received a placebo. A 50 percent reduction in the rate of death was found in the group treated with progesterone.
Progesterone is traditionally thought of as a pregnancy and/or female sex hormone, but it is also vital for brain cell health. It is a neurosteroid naturally present in small amounts in the brains of both females and males. During pregnancy, progesterone levels soar, leading researchers to hypothesize a relationship with brain development and maturation. With that in mind, study data suggests that the hormone has the ability to prevent neuronal loss, reduce brain swelling, and improve brain function in those with traumatic injuries.
Interestingly, the majority of damage (approximately 75%) suffered in TBI occurs hours and even days after the initial injury. Inflammatory and cytotoxic processes cause edema in the parenchyma and brain cells, causing further destruction. Modern medicine has yet to discover a treatment effective enough to reduce or even halt the cascade of events within the brain after injury, which is why the progesterone study is so meaningful. Extensive animal research has shown that progesterone significantly reduces cerebral edema, which in turn reduces further tissue and cell injury. The application potential for humans is obvious, which is what led Emory researchers to their study.
The study was designed to assess the safety of using progesterone for the treatment of TBI and became so promising that further clinical studies are planned. The study subjects that were given the hormone received amounts approximately three times higher than those seen during pregnancy within 11 hours of initial injury for three consecutive days. Significant improvement of functional outcome, level of disability and death rate was seen at a 30 day follow up. Another important element of the study results was the lack of adverse effects from the hormone administration: none were reported.
According to the study’s lead author, progesterone has potential in numerous situations, such as the one out of every three soldiers seen at Walter Reed Medical Center who suffered TBI, usually from improvised explosive devices. Eventually the hormone may be administered by paramedics at accident scenes, and there is promise for stroke victims and newborns affected by a traumatic birth. It is also suggested that premature senility and Alzheimer’s disease patients may benefit from progesterone as well.
While further clinical studies are pending, this research helps confirm what many of us already know: progesterone is a safe, effective, and beneficial hormone.

Retrieved from: http://www.labrix.com/page?pageid=a0Y5000000072tsEAA&order=3&idMenu=a0f500000005TahAAE

Andropause and Metabolic Syndrome

2011-08-05T05:59:00.001-07:00

Declining testosterone levels are commonly seen in men beginning in the fourth decade of life. Suboptimal or low testosterone levels in males are often associated with symptoms of aging and are referred to as andropause or male menopause. This is the equivalent of menopause in women when ovarian production of estrogens and progesterone begins to decline.

Testosterone is an important anabolic hormone in men, meaning it plays important roles in maintaining both physical and mental health. It increases energy, prevents fatigue, helps maintain normal sex drive, increases strength of all structural tissues such as skin/bone/muscle; including the heart and prevents depression and mental fatigue. Testosterone deficiency is often associated with symptoms such as night sweats, insulin resistance, erectile dysfunction, low sex drive, decreased mental and physical ability, lower ambition, loss of muscle mass and weight gain in the waist. The primary cause of this increase in girth is visceral fat, not excessive subcutaneous fat (fat under the skin).

The visceral fat cells are the most insulin resistant cells in the human body. They have excess hormone binding receptors for cortisol and androgens and decreased receptors for insulin (resistance to insulin). As a person ages hormone levels change in favor of insulin resistance. The cortisol and insulin levels rise while progesterone, growth hormone and testosterone decline. The visceral fat cell with its increased receptors, blood supply and innervation begins to collect more fat in the form of triglycerides. A vicious cycle is initiated, which if not interrupted with natural hormone balancing will lead to abdominal obesity, diabetes and high cholesterol levels. This phenomenon is known as metabolic syndrome. Stress management, exercise, proper nutrition, dietary supplements (particularly adequate zinc and selenium), and androgen replacement therapy (controversial in prostate cancer) have all been shown to raise androgen levels in men and help counter andropause symptoms. The “trick" is to know how much testosterone is required for each individual male. This is where knowing the salivary testosterone levels comes into play. Initial salivary testing and following salivary monitoring are crucial for determining the most optimal prescription.

Prior to initiation of testosterone therapy the PSA level needs to be within the expected range. There is no evidence that testosterone increases the risk of prostate gland cancer; however, if cancer has already developed testosterone may accelerate its growth. The PSA test is a good guide as to presence or absence of cancer and is a good indicator of inflammation within the prostate gland.

retrieved from: http://www.labrix.com/page?pageid=a0Y5000000072tsEAA&order=3&idMenu=a0f500000005TahAAE

Estrogen Dominance is Really Progesterone Deficiency

2011-08-04T08:01:00.000-07:00

The term "Estrogen Dominance" can be confusing at times because it is less related to the amount of circulating estrogen and more related to the ratio of estrogen to progesterone in the body. Contrary to popular belief, Menopause and PMS are not the result of estrogen deficiency although estrogen levels do decline during the latter phases of a woman reproductive cycle.
More relevant is that the estrogen levels drop by approximately 40% at menopause while progesterone levels plummet by approximately 90% from premenopausal levels. It is the relative loss of progesterone that causes the majority of symptoms termed estrogen dominance. The disproportionate loss of progesterone begins in the latter stages of a woman's reproductive cycle, when the luteal phase of the menstrual cycle begins to malfunction. The malfunction is initiated when the remnant tissue of the follicle (corpus luteum), the primary source of progesterone, begins to lose its functional capacity. By about age 35, many of these follicles fail to develop creating a relative progesterone deficiency. As a result, ovulation does not always occur and progesterone levels steadily decline. It is during this period that a relative progesterone deficiency, or what has become known as Estrogen Dominance, develops.
Typical symptoms of estrogen dominance are:

Mood Swings
Irritability
Depression
Irregular Periods
Heavy Menstrual Bleeding
Hot Flashes
Vaginal Dryness
Water Retention
Weight Gain: Hips, Thighs and Abdomen
Sleep Disturbance (Insomnia, less REM sleep)
Decreased Libido
Headaches
Fatigue
Short-term Memory Loss
Lack of Concentration
Dry, Thin, Wrinkly Skin
Thinning of Scalp Hair
Increased Facial Hair
Bone Mineral Loss (Osteoporosis)
Diffuse Aches and Pain

Patients experiencing a majority of these symptoms most likely will benefit from natural hormone replacement. The most effective way to assess hormone status is to test saliva for the appropriate hormone levels. Saliva is the best method for testing "functional" tissue levels of hormones.

The Progesterone/Estradiol (Pg/E2) reference ranges are optimal ranges determined by Dr. John Lee. While they are not physiological ranges, they are optimal values for the protection of the breasts, heart and bones in women, and the prostate in men. Salivary values within these ranges have been shown by Dr. Lee to decrease both breast and prostate cellular proliferation.

Retrieved from: http://labrix.force.com/page?pageid=a0Y5000000072tsEAA&order=3&idMenu=a0f500000005TahAAE

Vitamin D

2011-08-03T12:27:00.001-07:00

Article: Vitamin D

Vitamin D is a fat soluble vitamin and pro-hormone that exists in several different forms. Ergocalciferol (Vitamin D2) is not produced in the body and comes from plant sources whereas cholecalciferol (Vitamin D3) is found in cold water fish such as salmon, mackerel and sardines, is fortified in milk and is manufactured in the skin with adequate exposure to the suns UVB rays.
The New England Journal of Medicine estimated that 30-50% of children and adults in the US are at risk for vitamin D deficiency and 32% of healthy adults age 18-29 were measured as Vitamin D deficient at the end of a winter in Boston. This is likely a consequence of inadequate dietary intake that may be exacerbated by fat malabsorption coupled with insufficient exposure to UVB sunlight. Note: Synthesis from sunlight requires that the sun be greater than 45? above the horizon and most sunscreens block UVB rays. People with increased melanin (darker skin) require longer exposures to sunlight to produce the same amount of Vitamin D.

Effects

Bioactive vitamin D binds to specific receptors in the cell (known as VDRs or Vitamin D receptors) and induces the transcription of more than 50 genes that have far reaching effects in the body including:
Osteoporosis / Calcium Balance - Vitamin D increases intestinal absorption of dietary calcium, increases re-absorption of calcium filtered by kidneys and mobilizes calcium from bone when there is insufficient dietary calcium. We have long known the influence vitamin D had in formation of bone, as evidenced by the incidence of rickets with low Vitamin D levels.
Anti-Cancer – Vitamin D inhibits proliferation and stimulates the differentiation of cells when bound to VDR receptors. Vitamin D has also been shown to induce apoptosis (programmed cell death).
Immunity – There are a significant number of VDR receptor on T cells and macrophages and there is evidence that when bound to these receptors vitamin D acts as a selective immunosuppressant and can either prevent or significantly affect many autoimmune diseases including rheumatoid arthritis, SLE, type 1 diabetes and IBD. Vitamin D can also enhance innate immunity and has been shown to be beneficial against tuberculosis and through this mechanism may be useful against additional infectious agents such as influenza.
Diabetes – The bioactive form of Vitamin D has been shown to stimulate insulin production in the pancreas in type 1 diabetics and may play a role in the pathogenesis of type 2 diabetes through its ability to impair insulin synthesis and secretion.
Blood Pressure Regulation – Vitamin D can decrease the expression of the gene that codes for rennin, and therefore play a role in controlling hypertension.

Toxicity

Vitamin D is a fat soluble vitamin that is stored in the liver and fatty tissue and is eliminated more slowly than water-soluble vitamins. Excess levels of Vitamin D can cause hypercalcemia, hypercalciuria, hypertension, constipation, fatigue and more. While adequate levels of Vitamin D are very important, you can get too much of a good thing. Monitoring therapy is important to ensure adequate, but not excessive dosage.

What to Test

Whether supplemented or manufactured in the skin, cholecalciferol (D3) is hydroxylated in the liver to form 25-hydroxycholcalciferol (25(OH) and this is the major circulating form of the vitamin. Though it goes through an additional hydroxylation (primary in the kidney) to form 1,25-dihydroxycholecalciferol before it is biologically active, the 25(OH) form is considered the most accurate measure of the amount of Vitamin D in the body, which is why testing 25(OH) is preferred.

The 25(OH) Vitamin D Blood Drop test from Labrix Clinical Services; this inexpensive, quick and painless test will enable you to test and monitor Vitamin D supplementation without the inconvenience of venipuncture.

References

1. Vitamin D Deficiency. Holick MF. N Engl J Med. 2007 Jul 19; 357(3):266-81.
2. Vitamin D: Importance in the Prevention of Cancers, Type 1 Diabetes, Heart Disease, and Osteoporosis. Holick MF. Am J Clin Nutr 2004;79:362-71.
3. Overview of General Physiologic Features and Functions of Vitamin D. DeLuca HF. Am J Clin Nutr 2004;80:169S-96S
4. Vitamin D: It’s Role and Uses in Immunology. Deluca HF, Cantorna MT. FASEB J. 2001 Dec; 15(14):2579-85.
5. Vitamin D and the Immune System: Role in Protection Against Bacterial Infection. Bikle DD. Curr Opin Nephrol Hypertens. 2008 Jul;17(4):348-52.
Health Disclaimer: All information given about health conditions, treatments, products and dosages are not intended to be a substitute for professional medical advice, diagnosis or treatment. This is provided only as a suggested guideline.

DHEA: A Commonly Overlooked Hormone

2011-08-03T12:16:00.001-07:00

Article: DHEA: A Commonly Overlooked Hormone

A commonly overlooked hormone in our testing menu is DHEA. It is an often misunderstood, yet very important part of the whole hormonal picture and is a key player in achieving hormone balance.
So what exactly is DHEA and why is it important to test?
DHEA (Dehydroepiandrosterone) is the most common steroid hormone in the body and is mainly produced by the adrenal glands, but smaller amounts are made elsewhere in the body. It is metabolized from pregnenolone and is a precursor to the sex hormones: namely testosterone, but also the estrogens. These features are why testing DHEA is a valuable part of dealing with hormone imbalance: the result will reflect how the adrenal glands are functioning, and a baseline DHEA level is important for dosing supplementation, as DHEA can raise testosterone and estrogen levels due to its precursor status. Female patients with low levels of DHEA and sex hormones having complaints of symptoms like low libido will be well served on DHEA, as they convert DHEA to testosterone more readily than men.
While DHEA is often seen in applications and discussions of anti-aging and adrenal function issues, it has also been found to be involved in many other processes in the body. Studies have shown that DHEA displays significant positive results in areas such as the regulation of insulin, cortisol and immune activities, cardiovascular protection, anti-dementia, bone stimulation, antibacterial activities, energy, and well being.

The potential promise of future applications of this hormone is leaking into the mainstream and increasing awareness, although not always with the best outcome. A simple internet search yields hundreds of sites touting the “magical" properties of DHEA, especially the feature of improving one’s feeling of well being. What they don’t say, of course, is how unwise the unmonitored use of this hormone is. As mentioned above, it can raise estrogen levels. This is not something a patient should do on their own. Someone who is feeling “blue" and has perfectly normal levels of DHEA and testosterone may start supplementing with over the counter DHEA and create a whole new set of problems by throwing their hormones out of balance. It is important to look at the whole picture when treating hormone imbalances, and DHEA is a critical part of that process.

Article retrieved from Labrix: http://www.labrix.com/page?pageid=a0Y5000000072tsEAA&order=3&idMenu=a0f500000005TahAAE

4- AP/ 4- Aminopyridine and MS/Multiple Sclerosis

2011-07-11T06:31:00.001-07:00

4- AP/ 4- Aminopyridine and MS/Multiple Sclerosis

If you are reading this article, you have probably already done your research and you know what this is and what the indications are for it.

Chances are you are looking for a compounding pharmacy and/or a practitioner to provide you with a customized option for this medicine.

But let us briefly review it: 4-aminopyridine (4AP) has been used for many years, prescribed for people with multiple sclerosis. It is a potassium channel blocker that, when used correctly, improves walking and other motor activities.

The key words are: “when used correctly”. There is a commercially available FDA approved version of 4-AP known as Ampyra. Ampyra comes in 10 mg strength only as a slow release oral tablet recommended to be taken twice daily. Yet the only available strength is, at the same time, the maximum allowed dose per day which may not be a proper dose for every patient. Furthermore the commercial tablet cannot be broken or chewed, which makes adjusting the dose very difficult.

A compounding pharmacy can prepare any adjusted strength customized for your unique needs in a capsule form with regular release mechanism.

To reach a better outcome using the 4-AP correctly, with minimal side effects, we suggest a titrating schedule:

5mg per day - in the morning - for 2 days
Then, 5mg twice daily (breakfast and late afternoon) for 3 days
Then, 5mg 3 times a day (every 5-6 hours while awake) for 4 days = 15 mg/day
Then, 5mg 4 times a day (every 4-5 hours while awake) for 5 days = 20 mg/day

You may not need the maximum allowed dose.

Please be advised that you should work with your doctor to choose the best option for your case.

Nurten Rasid, M.D.

Compounding Clinical Specialist

HM Compounding

http://www.hmcompound.com/

info@hmcompound.com

QSAC, Inc.

2011-07-01T08:07:00.000-07:00

QSAC, Inc.

PCAB

2011-06-16T08:50:00.001-07:00

Informed consumers should choose a compounding pharmacy that displays the PCAB Accredited™ Seal

Blog Subscribers Vitamin Discount!

2011-06-10T07:31:00.000-07:00

For special Blog subscriber discount on vitamins, visit our vitamin shop at:
http://wholesalevitaminsdirect.com/
Use blog promo code "hmcs2011" at checkout to recieve up to 20% off of vitamins.
FREE SHIPPING on orders over $49.00

June pet med specials

2011-06-07T12:28:00.001-07:00

Hormone Replacement Therapy for Men:

2011-06-06T08:25:00.001-07:00

Hormone Replacement Therapy for Men:

Approximately 30% of men aged 60-70 years and 70% of men aged 70-80 have low levels of testosterone in forms that the body can use (bioavailable; unbound; free).

Hypogonadism is a clinical condition in which low levels of serum testosterone (bioavailable testosterone less than 60 ng/dl) are found in association with specific signs and symptoms, including diminished sex drive and sense of vitality, erectile dysfunction, depression, anemia, reduced muscle mass and bone density, increased fat mass, frailty, and osteoporosis. A man may be considered hypogonadal at any age if total testosterone (bound and free) is less than 200 ng/dl. It is recommended that elderly men with symptoms of hypogonadism and a total testosterone level less than 300 ng/dl be started on hormone replacement.1
When hypogonadism occurs in an older man, the condition is often called andropause, or Androgen Deficiency of the Aging Male (ADAM), because testosterone is in a class of hormones known as androgens.

Bioavailable testosterone levels are significantly lower for depressed men, perhaps because an associated decrease in sexual function results in depression, irritability, and mood swings. Testosterone therapy might improve depressed mood in older men who have low levels of bioavailable testosterone.2,3

Osteoporosis-related fractures occur in 12% of all men over 50 years of age. Twenty-five percent of all hip fractures occur in men, and 33% of these patients die within one year of fracture. Gradual loss of testosterone is one of the major causes of osteoporosis in elderly men. Studies have reported beneficial effects of testosterone therapy on bone in older men, showing an increase in bone mineral density (BMD) and slowing of bone degeneration. Testosterone therapy in older men with low serum testosterone levels also increases lean body mass and decreases fat mass, improving physical performance and strength.4

Testosterone replacement therapy (TRT) has relieved symptoms and improved the quality of life for many men. TRT is well tolerated, and long term TRT appears to be a safe and effective means of treating hypogonadal elderly males, provided that laboratory values and clinical response are frequently monitored.

The only absolute contraindication to androgen replacement therapy is the presence of prostate or breast cancer. Guidelines recommend that TRT should not be initiated in older men with PSA serum levels above the normal range. Testosterone should be used with caution in men with severe heart, kidney or liver disease, increased red blood cell counts, and sleep apnea.5 Side effects of testosterone therapy can include mood swings, leg swelling, skin reactions, acne, alopecia, breast enlargement, and infertility. Liver toxicity has not been reported following testosterone administration using transdermal gels in physiologic doses.6 (Toxicity has occurred with methyltestosterone.)

Testosterone is well-absorbed from transdermal creams, gels, and lotions. Compounded preparations can be very advantageous because:
•   the exact amount of hormone needed by each man can be applied as a single dose
•   there is no need to shave the scrotum to apply one or more patches
•   there is no skin irritation from patch adhesive.

A healthy lifestyle is associated with higher hormone levels, and higher hormone levels seem to induce a more active, healthier lifestyle. For optimal results, it is vital that hormone replacement therapy be combined with adequate exercise, proper nutrition, and appropriate use of supplements.

References:
1 Am J Med. 2001 May;110(7):563-72.
2 J Clin Psychiatry. 2009 Jul;70(7):1009-16.
3 J Clin Psychopharmacol. 2009 Jun;29(3):216-21.
4 J Clin Endocrinol Metab. 2005 Mar;90(3):1502-10.
5 Ther Clin Risk Manag. 2009 Jun;5(3):427-48.
6 Expert Opin Drug Saf. 2004 Nov;3(6):599-606.

HMCompounding: June is Mens Health Month. Vitamins and TriMix Specials from HMCompounding

2011-06-03T06:46:00.000-07:00

HMCompounding: June is Mens Health Month. Vitamins and TriMix Specials from HMCompounding

June is Mens Health Month. Vitamins and TriMix Specials from HMCompounding

2011-06-03T06:43:00.000-07:00

TRIMIX & E.D.

The word “Trimix” became a well-known term for a large number of male patients with erectile dysfunction (E.D.) I want to clarify the meanings of this term and confusion it creates apparently both among patients and some health care practitioners.

Let’s talk semantics: “tri” stands for three and “mix” is mix. This is very simple, right? Tri-mix is a mix of three elements, no matter what they are.

If we check Wikipedia, we’ll see that “Trimix may refer to:

· Trimix (breathing gas), a gas mixture used in deep-sea diving

· Trimix (injection), an injection containing alprostadil, papaverine, and phentolamine, used to treat erectile dysfunction”

Obviously in our discussion we refer to the second version on Wikipedia as I already connected the term “Trimix” to E.D. Your online search will take you to different sites that will give you a lot of detailed information about what Trimix is, what it contains, how can you use it, etc. And probably the more you read, the more you’ll get confused.

Why am I saying this? This is because one can easily notice the variation of the three ingredients in “Trimix” compositions. Furthermore, there is even more variety in the strengths of the three chemicals that make the composition of the “Trimix”, and you may wonder why.

The answer is a little more complex: “Trimix” is not a manufactured (made by a pharmaceutical company) product. While all three ingredients in “Trimix, no matter what they are, are FDA approved separate products, “Trimix” has to be made by a compounding pharmacy based on a doctor’s prescription. Because the name became so popular among E.D. sufferers and among Urologists who mainly prescribe it, some patients and even some practitioners are led to believe that there is only one “Trimix” and only one maker of it.

There is a compounding pharmacy that has even trade marked the name “Trimix” for urethral gel administration we want to be clear that in this article I am referring to Trimix injection.

Compounding means customizing a medicine based on a patient’s unique needs. Your doctor will write the combination and the strengths that work in your case, and it has to be a close collaboration between you, your doctor and your compounding pharmacist to adjust your medication for the best outcome.

The most commonly combined three ingredients are the ones mentioned above in Wikipedia quote:

Alprostadil strength between: 10-25 mcg/ml

Papaverine strength between: 18-25 mg/ml

Phentolamine strength between: 1-2 mg/ml

Some doctors prescribe “Bi-mix” or “Quad-mix” in various strength and ingredient combinations and the amount injected also varies from one patient to another or even from one time to another for the same patient. I want to leave you with one clear understanding: it is very important for you to collaborate with your doctor and your compounding pharmacist to find the most appropriate option that works for you.

For June, HM Compounding is featuring a special on TriMix injections for Mens Health Month. $79.99 for any strength of “TriMix”, up to a 10ml vial plus Free Shipping in the Tri-State area.

TriMix and ED

2011-05-02T09:48:00.001-07:00

TRIMIX & E.D.

Let’s talk semantics: “tri” stands for three and “mix” is mix. This is very simple, right? Tri-mix is a mix of three elements, no matter what they are.

If we check Wikipedia, we’ll see that “Trimix may refer to:

· Trimix (breathing gas), a gas mixture used in deep-sea diving

· Trimix (injection), an injection containing alprostadil, papaverine, and phentolamine, used to treat erectile dysfunction”

There is a compounding pharmacy that has even trade marked the name “Trimix” for urethral gel administration we want to be clear that in this article I am referring to Trimix injection.

The most commonly combined three ingredients are the ones mentioned above in Wikipedia quote:

Alprostadil strength between: 10-25 mcg/ml

Papaverine strength between: 18-25 mg/ml

Phentolamine strength between: 1-2 mg/ml

BHRT- Bio-identical Hormone Replacement Therapy

2011-05-02T09:31:00.001-07:00

BHRT- Bio-identical Hormone Replacement Therapy

A little talk about a big issue: our health and well-being

It’s not news, rather it’s an ongoing contoversial discussion. The amount of literature on the topic is growing, but apparently, so is the confusion. Yet a few things are clear: the term “bio-identical” is a proper and correct term. It is a proven fact that the molecular structure of the hormones used in Bio-identical Hormone Replacement Therapy (BHRT) are identical to the ones our human body makes. Actually there are commercially available and FDA approved bio-identical hormone products.

There is much to talk about on this topic as it is a very delicate and complex subject. I covered some aspects of it in previous articles, but in this article I would like to pick only one of the hormones that is part of the group of hormones mainly involved in the imbalance that occurs as we age: DHEA

About DHEA

DHEA is considered the "mother of all hormones." DHEA is the most abundant steroid in the human body and is involved in the production of testosterone, estrogen, progesterone, and cortisone.

DHEA is produced by the adrenal glands. The production levels rise up until age 25, then they start to decline quite rapidly.

By age seventy-five, DHEA levels are only 10 to 20 percent of what they were at age twenty.

Falling levels of DHEA together with the other hormones are closely associated with a number of very uncomfortable symptoms, as well as age-related diseases and disabilities.

Some scientists promote the idea of restoring the “young” age levels of these hormones in an attempt to recapture and maintain the youth. I believe that, as tempting as this may be, it can have very dangerous consequences, not to mention the legal considerations of applying such concepts into practice.

I think we need to take DHEA together with the other hormones that are declining with age, with the goal of restoring the balance, and only after a thorough and proper assessment. The main result would be the relief of symptoms. In other words, I support the concept that “less is better when it’s about hormones”, safety being paramount.

And definitely, customized is the right way to approach BHRT as each individual presents a unique combination, severity, and variety of troubling symptoms caused by hormonal imbalance. BHRT needs to be supplemented by a healthy lifestyle: exercise, proper nutrition, meditation, etc in order to reach the ultimate goal of well-being.

A customized approach means specific combination of hormones, in a specific ratio, strength, dosage, route of administration. It can be done only in collaboration with a professional compounding pharmacy.

Please educate yourself on this topic: read and find the right health care practitioner, the right compounding pharmacy, be prepared to ask the right questions and get the right answers for you. After all this is about your most precious asset, your health and well-being.

If you are interested in learning more about this topic browse our website, email us or call us. Thank you for reading.

Nurten Rasid, M.D.

Clinical Compounding Specialist

www.hmcompounding.com

nurtenr@hmcompounding.com

Makena Update

2011-04-20T06:44:00.000-07:00

FDA STATEMENT
For Immediate Release: March 30, 2011
Media Inquiries: Beth Martino, 301.796.7603, beth.martino@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA Statement on Makena

On February 3, 2011, the U.S. Food and Drug Administration approved the drug Makena (hydroxyprogesterone caproate) for the reduction of the risk of certain preterm births in women who have had at least one prior preterm birth. KV Pharmaceuticals, the drug’s owner, received considerable assistance from the federal government in connection with the development of Makena by relying on research funded by the National Institutes of Health to demonstrate the drug’s effectiveness. It also obtained seven years of exclusivity under the Orphan Drug Act, obtained approval under FDA’s accelerated approval program, and received expedited review.

For many years, a version of the active ingredient of Makena, which is a synthetic progestin, has been available to patients whose physicians requested the drug from a pharmacist who compounded the drug. Generally, FDA has exercised enforcement discretion with respect to most products made through traditional pharmacy compounding. This has included products made from the active ingredient in Makena, hydroxyprogesterone caproate.

Because Makena is a sterile injectable, where there is a risk of contamination, greater assurance of safety is provided by an approved product. However, under certain conditions, a licensed pharmacist may compound a drug product using ingredients that are components of FDA approved drugs if the compounding is for an identified individual patient based on a valid prescription for a compounded product that is necessary for that patient. FDA prioritizes enforcement actions related to compounded drugs using a risk-based approach, giving the highest enforcement priority to pharmacies that compound products that are causing harm or that amount to health fraud.

FDA understands that the manufacturer of Makena, KV Pharmaceuticals, has sent letters to pharmacists indicating that FDA will no longer exercise enforcement discretion with regard to compounded versions of Makena. This is not correct.

In order to support access to this important drug, at this time and under this unique situation, FDA does not intend to take enforcement action against pharmacies that compound hydroxyprogesterone caproate based on a valid prescription for an individually identified patient unless the compounded products are unsafe, of substandard quality, or are not being compounded in accordance with appropriate standards for compounding sterile products. As always, FDA may at any time revisit a decision to exercise enforcement discretion.

Retrieved from:

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm249025.htm

LDN (Low Dose Naltrexone) and Autoimmune Diseases

2011-04-18T13:40:00.000-07:00

LDN (Low Dose Naltrexone) and Autoimmune Diseases

Part 2 of 8 series

As a result of overwhelming number of stress factors we are exposed to in our modern-day life, a dramatically growing number and variety of autoimmune diseases affect more and more people.

A few examples of autoimmune diseases are:

· Systemic lupus

· Rheumatoid arthritis

· Crohn’s disease

· Celiac disease

· ALS ( Amyotrophic Lateral Sclerosis)

· Atopic dermatitis

· Psoriasis

· Grave’s disease

· Hashimoto’s thyroiditis

· Chronic fatigue immune dysfunction syndrome

· Myasthenia gravis

· Fibromyalgia

· …. And the list goes on and on

On a positive note, more and more health care practitioners are becoming aware of the growing variety of diseases included in this category, so they are prepared for a more thorough assessment in diagnosing these autoimmune disorders.

Unfortunately many of these licensed health care practitioners still do not know about the benefits of Low Dose Naltrexone (LDN) as a novel treatment option for so many of these cases.

Please read part 1 of 8 on LDN articles to re-acquaint yourself with the reason I started this series and also and visit the main website that contains all the information you need to know about Low Dose Naltrexone: www.lowdosenaltrexone.org/

Just keep in mind that the only way you can get a customized medication prescribed by your health care practitioner for your unique situation is from a professional compounding pharmacy.

Nurten Rasid, M.D.

Clinical Compounding Specialist

HM Compounding Pharmacy

www.hmcompounding.com

Medical News: AAPM: Hormone Tx May Relieve Intractable Pain - in Meeting Coverage, AAPM from MedPage Today

2011-04-01T09:02:00.000-07:00

Medical News: AAPM: Hormone Tx May Relieve Intractable Pain - in Meeting Coverage, AAPM from MedPage Today

http://myemail.constantcontact.com/PCAB-Applauds-Continued-Access-to-Compounded-Versions-of-17-hydroxyprogesterone.html?soid=1103447515829&aid=bcmZWcaMc14

2011-04-01T06:39:00.000-07:00

http://myemail.constantcontact.com/PCAB-Applauds-Continued-Access-to-Compounded-Versions-of-17-hydroxyprogesterone.html?soid=1103447515829&aid=bcmZWcaMc14

2011-03-31T07:21:00.000-07:00

FDA Allows De Facto Generic of Pricey Preemie Drug Makena

KV Pharma's Attempts to Invoke FDA Law to Stop Compounding Pharmacies Foiled

By COURTNEY HUTCHISON, ABC News Medical Unit

March 30, 2011

The Food and Drug Administration has no intention of enforcing a regulation that one drug company sought to exploit to drive out competitors, an FDA official told ABC News.

KV Pharmaceuticals gained exclusive rights in February to produce a progesterone shot used to prevent preemie birth, previously known as 17P, that it branded Makena. The shot had been offered by compounding pharmacies for between $10 and $20 per dose, but KV planned to sell it for $1,500 per dose.

The company then sent cease-and-desist letters to compounding pharmacies, saying the FDA would take action against them if they continued to synthesize the drug.

The FDA's official statement as of Wednesday is that "this is not correct" -- the FDA will not take action against these companies.

As a result of this official stance, many doctors will be able to bypass KV Pharmaceuticals and continue prescribing this progesterone shot at the affordable compounding pharmacy price women are used to.

ABC News' Lisa Stark contributed on this report

retrieved:

http://abcnews.go.com/Health/WomensHealth/fda-de-facto-generic-pricey-preemie-drug/story?id=13251025&page=1

Let’s talk again about bio-identical hormones!

2011-03-23T13:19:00.001-07:00

It fascinates me. …

If you are a woman, and going through “the change” and it is affecting the quality of your life, I sympathize with you. I’ve “been there, and done that”.

You probably were somewhat prepared for this, but hoping to go through it with ease. In modern and civilized countries such as ours, very few women are so lucky.

Why so, you would think. Well, let’s see:

· Do you work?

· Do you drive?

· Do you live in a big city?

· Do you breathe?

· Do you eat out?

· Do you drink bottled water?

· Etc……

These all sound like silly questions and I’m sure you are wondering where I am going with all this, but if you answered “yes” to at least one of these questions - and I know you did – I made my point. These are only a few of the factors that contribute to the quality of our life, throughout our life, yet we become more aware of them when we go through “the change” and we’ll refer to them later.

Just to be clear, you know I am referring to menopause here when I say “the change”, right?

OK, now let’s concentrate on the topic here and try to clarify a few things!

Bio- Identical Hormones - what are they and why should you know about them?

Before we begin, we have to understand a few terms related to menopausal changes.

Where do we start?

Let’s take a look at a common scenario:

Now that you have some of the life disrupting symptoms that come with menopause, and you realize that you are not your “old-self”, you decide that you have to do something about it. Do what should you do?

Go to your doctor. You do this just to hear your doctor tell you that your lab results are normal and you’re good to go.

What’s next? Try another doctor? Great! He just gave you a whole bunch of prescriptions for: depression, cholesterol, pain, etc., and told you to lose some weight. Sound familiar?

Sad, but true. This is what happens to many women going through menopause and seeking help from health care practitioners. Many health care practitioners do not know (or do not want to know) that you actually have so many options available to help you get relief from your symptoms. Your body is going through a dramatic change that has to do with severe decline in some of its hormones due to reaching a certain age.

Which major hormones do our bodies not produce anymore, or produce in very limited amount at this stage in life? We are talking about: Estrogen, Progesterone, and Testosterone.

Now there is one very important thing we all have to understand and keep in mind when we talk about hormones: in a healthy, young body, all hormones “work together in harmony”. Once one is affected, no matter which direction, it affects more or less the other s.

The occurrences of symptoms, which vary from one woman to another, and their level of severity, are consequences of differences in the changed/diminished production levels of these hormones. Therefore the harmony or the balance is broken, and once the balance is broken, the other non-sexual, “non-menopausal” hormones are affected as well most times.

It is also crucial for the healthcare practitioner to assess the function of thyroid gland, as well as adrenal gland when they assess your menopause related hormones. Of further importance is to take into consideration the lifestyle factors such as the ones mentioned above, because they are integrative parts of our well being, our quality of life.

Now you understand that there are many elements involved in maintaining harmony. Every woman has a unique set of symptoms that requires proper and thorough evaluation and then an individualized solution.

Yes, that is the key word: individualized. And I want you to keep that in mind when we talk about the options you have to get relief of your menopausal symptoms.

Let us go now through some of these options:

· Hormone Replacement Therapy (HRT). This refers to the conventional treatment most doctors used for decades for millions of menopausal patients both for menopausal symptoms and to prevent some diseases correlated with menopause. The most popular drugs prescribed were hormones extracted from pregnant horse urine for estrogen, synthetic – man created progesterone (properly termed: progestin), and a combination of the two.

This option suffered a severe decline in the last eight years because one of the largest studies done on these drugs revealed many negative side effects, that the study had to be interrupted and the doctors were advised to stop prescribing them, or dramatically reduce the dosage and the length of the treatment shows the severity of negative side effects.

· Symptomatic treatment = as a result of the outcome of the study mentioned in the previous paragraph, practitioners were advised to treat the symptoms as separate diseases, i.e.: anti-depressants, osteoporosis medicine, thyroid hormones, weight loss advice, or just “toughen up”.

· Phytotherapy = some doctors, mainly naturopathic, will recommend plant based therapy, such as “black cohosh”, which may or may not help much.

· Commercially available bio-identical hormones = yes, that’s right! Despite the controversy surrounding use of the terms bio-identical hormones, there are commercially available FDA approved products some doctors may choose to prescribe. The problem with them is that they come in a limited variety of strengths, dosages, routes of administration, not to mention lack of combinations. The estrogen products contain only one of the estrogen components our body makes, and it is the most dangerous one.

· Compounded bio-identical hormones = these are hormones synthesized in a lab from ingredients extracted from plants such as wild yams or soy beans. The final product has the same molecular structure as our own hormones; this is a scientifically proven fact.

The difference between compounded and commercially available bio-identical hormones is that the compounded ones are prepared only by a specialized compounding pharmacist. They are prepared only based on a doctor’s prescription. Your doctor will write an individualized, customized prescription after evaluating thoroughly your unique set of symptoms related to your hormonal imbalance and your lifestyle factors.

Therefore your estrogen prescription may contain the other estrogen components in different ratios, and they can be combined if need be with progesterone, testosterone, DHEA, etc.

If you already did your research on the topic, you most likely did not read anything new here. But you know there is still a lot of confusion and controversy (unfortunately even among “authorities”) on the matter.

That makes you “the boss”, the decision maker for your health and well-being. Educate yourself on the topic, listen to what your body is telling you, find the right practitioner who is willing to listen to you, and together choose what the best option for your situation is.

Nurten Rasid, M.D.

HM Compounding

nurtenr@hmcompounding.com

www.hmcompounding.com

Betahistine use in the US- interesting facts

2011-03-21T08:18:00.000-07:00

Betahistine has an interesting history in relation to the FDA, the latest standing being that it is considered an inert chemical, which means that FDA considered Betahistine as being an ineffective drug and removed it from the US market.

Yet, based on statistics, 94% of the ENT doctors in Europe/UK prescribe it for their patients with

Meniere ’s Syndrome.

The good news is that in the US one can get Betahistine by prescription from a compounding pharmacy.

More good news is that compared to other FDA approved drugs recommended for the same purpose, Betahistine has the mildest side effects.

Understanding of the intricate pharmacology and mechanism of action of the medicine is controversial in scientists’ views.

For more detailed information on this medication and its history you may want to check Dr. Timothy C Hain, MD’s compilation in the link bellow:

http://www.dizziness-and-balance.com/treatment/drug/serc.html

Betahistine is commercially available in many other countries under the name of SERC or BETASERC and bellow is a copy of the package insert for it:

http://www.menieres.org/martin.htm#package

More up-to-date info from Wikipedia:

http://en.wikipedia.org/wiki/Betahistine

As every individual is unique, so is the treatment option. Therefore only you and your doctor will decide if this medication will work for you and what will be the most appropriate strength for you.

Nurten Rasid, M.D.

Clinical Compounding Specialist

HM Compounding

http://www.hmcompound.com/

Dog in Sendai refused to leave injured friend

2011-03-18T12:23:00.000-07:00

Potassium Iodide

2011-03-17T07:20:00.000-07:00

HM Compounding is able to compound Potassium Iodide with a prescription from your health care practitioner. Call us today for any questions regarding Potassium Iodide. (800) 419-2804 or visit our website http://www.hmcompound.com/

Happy Saint Patrick's Day

2011-03-17T06:05:00.001-07:00

Always remember to forget
The friends that proved untrue.
But never forget to remember
Those that have stuck by you.

Irish proverb
Happy Saint Patrick's Day

http://www.bt.cdc.gov/radiation/ki.asp#

2011-03-16T06:53:00.000-07:00

Potassium Iodide (KI)

What is Potassium Iodide (KI)?

Potassium iodide (also called KI) is a salt of stable (not radioactive) iodine. Stable iodine is an important chemical needed by the body to make thyroid hormones. Most of the stable iodine in our bodies comes from the food we eat. KI is stable iodine in a medicine form. This fact sheet from the Centers for Disease Control and Prevention (CDC) gives you some basic information about KI. It explains what you should think about before you or a family member takes KI.

What does KI do?

Following a radiological or nuclear event, radioactive iodine may be released into the air and then be breathed into the lungs. Radioactive iodine may also contaminate the local food supply and get into the body through food or through drink. When radioactive materials get into the body through breathing, eating, or drinking, we say that “internal contamination” has occurred. In the case of internal contamination with radioactive iodine, the thyroid gland quickly absorbs this chemical. Radioactive iodine absorbed by the thyroid can then injure the gland. Because non-radioactive KI acts to block radioactive iodine from being taken into the thyroid gland, it can help protect this gland from injury.

What KI cannot do

Knowing what KI cannot do is also important. KI cannot prevent radioactive iodine from entering the body. KI canprotect only the thyroid from radioactive iodine, not other parts of the body. KI cannot reverse the health effects caused by radioactive iodine once damage to the thyroid has occurred. KI cannotprotect the body from radioactive elements other than radioactive iodine—if radioactive iodine is not present, taking KI is not protective.

How does KI work?

The thyroid gland cannot tell the difference between stable and radioactive iodine and will absorb both. KI works by blocking radioactive iodine from entering the thyroid. When a person takes KI, the stable iodine in the medicine gets absorbed by the thyroid. Because KI contains so much stable iodine, the thyroid gland becomes “full” and cannot absorb any more iodine—either stable or radioactive—for the next 24 hours.

Iodized table salt also contains iodine; iodized table salt contains enough iodine to keep most people healthy under normal conditions. However, table salt does not contain enough iodine to block radioactive iodine from getting into your thyroid gland. You should not use table salt as a substitute for KI.

How well does KI work?

Knowing that KI may not give a person 100% protection against radioactive iodine is important. How well KI blocks radioactive iodine depends on

how much time passes between contamination with radioactive iodine and the taking of KI (the sooner a person takes KI, the better),
how fast KI is absorbed into the blood, and
the total amount of radioactive iodine to which a person is exposed.

Who should take KI?

The thyroid glands of a fetus and of an infant are most at risk of injury from radioactive iodine. Young children and people with low stores of iodine in their thyroid are also at risk of thyroid injury.
Infants (including breast-fed infants): Infants need to be given the recommended dosage of KI for babies (see How much KI should I take?). The amount of KI that gets into breast milk is not enough to protect breast-fed infants from exposure to radioactive iodine. The proper dose of KI given to a nursing infant will help protect it from radioactive iodine that it breathes in or drinks in breast milk.
Children: The United States Food and Drug Administration (FDA) recommends that all children internally contaminated with (or likely to be internally contaminated with) radioactive iodine take KI, unless they have known allergies to iodine. Children from newborn to 18 years of age are the most sensitive to the potentially harmful effects of radioactive iodine.
Young Adults: The FDA recommends that young adults (between the ages of 18 and 40 years) internally contaminated with (or likely to be internally contaminated with) radioactive iodine take the recommended dose of KI. Young adults are less sensitive to the effects of radioactive iodine than are children.
Pregnant Women: Because all forms of iodine cross the placenta, pregnant women should take KI to protect the growing fetus. However, pregnant women should take only one dose of KI following internal contamination with (or likely internal contamination with) radioactive iodine.
Breastfeeding Women: Women who are breastfeeding should take only one dose of KI if they have been internally contaminated with (or are likely to be internally contaminated with) radioactive iodine. Because radioactive iodine quickly gets into breast milk, CDC recommends that women internally contaminated with (or are likely to be internally contaminated with) radioactive iodine stop breastfeeding and feed their child baby formula or other food if it is available. If breast milk is the only food available for an infant, nursing should continue.
Adults: Adults older than 40 years should not take KI unless public health or emergency management officials say that contamination with a very large dose of radioactive iodine is expected. Adults older than 40 years have the lowest chance of developing thyroid cancer or thyroid injury after contamination with radioactive iodine. They also have a greater chance of having allergic reactions to KI.

When should I take KI?

After a radiologic or nuclear event, local public health or emergency management officials will tell the public if KI or other protective actions are needed. For example, public health officials may advise you to remain in your home, school, or place of work (this is known as “shelter-in-place”) or to evacuate. You may also be told not to eat some foods and not to drink some beverages until a safe supply can be brought in from outside the affected area. Following the instructions given to you by these authorities can lower the amount of radioactive iodine that enters your body and lower the risk of serious injury to your thyroid gland.

How much KI should I take?

The FDA has approved two different forms of KI—tablets and liquid—that people can take by mouth after a nuclear radiation emergency. Tablets come in two strengths, 130 milligram (mg) and 65 mg. The tablets are scored so they may be cut into smaller pieces for lower doses. Each milliliter (mL) of the oral liquid solution contains 65 mg of KI.
According to the FDA, the following doses are appropriate to take after internal contamination with (or likely internal contamination with) radioactive iodine:

Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution).
Women who are breastfeeding should take the adult dose of 130 mg.
Children between 3 and 18 years of age should take 65 mg (one 65 mg tablet OR 1 mL of solution). Children who are adult size (greater than or equal to 150 pounds) should take the full adult dose, regardless of their age.
Infants and children between 1 month and 3 years of age should take 32 mg (½ of a 65 mg tablet OR ½ mL of solution). This dose is for both nursing and non-nursing infants and children.
Newborns from birth to 1 month of age should be given 16 mg (¼ of a 65 mg tablet or ¼ mL of solution). This dose is for both nursing and non-nursing newborn infants.

How often should I take KI?

A single dose of KI protects the thyroid gland for 24 hours. A one-time dose at the levels recommended in this fact sheet is usually all that is needed to protect the thyroid gland. In some cases, radioactive iodine might be in the environment for more than 24 hours. If that happens, local emergency management or public health officials may tell you to take one dose of KI every 24 hours for a few days. You should do this only on the advice of emergency management officials, public health officials, or your doctor. Avoid repeat dosing with KI for pregnant and breastfeeding women and newborn infants. Those individuals may need to be evacuated until levels of radioactive iodine in the environment fall.
Taking a higher dose of KI, or taking KI more often than recommended, does not offer more protection and can cause severe illness or death.

Medical conditions that may make it harmful to take KI

Taking KI may be harmful for some people because of the high levels of iodine in this medicine. You should not take KI if
• you know you are allergic to iodine (If you are unsure about this, consult your doctor. A seafood or shellfish allergy does not necessarily mean that you are allergic to iodine.) or
• you have certain skin disorders (such as dermatitis herpetiformis or urticaria vasculitis).
People with thyroid disease (for example, multinodular goiter, Graves’ disease, or autoimmune thyroiditis) may be treated with KI. This should happen under careful supervision of a doctor, especially if dosing lasts for more than a few days.
In all cases, talk to your doctor if you are not sure whether to take KI.

What are the possible risks and side effects of KI?

When public health or emergency management officials tell the public to take KI following a radiologic or nuclear event, the benefits of taking this drug outweigh the risks. This is true for all age groups. Some general side effects caused by KI may include intestinal upset, allergic reactions (possibly severe), rashes, and inflammation of the salivary glands.
When taken as recommended, KI causes only rare adverse health effects that specifically involve the thyroid gland. In general, you are more likely to have an adverse health effect involving the thyroid gland if you

take a higher than recommended dose of KI,
take the drug for several days, or
have pre-existing thyroid disease.

Newborn infants (less than 1 month old) who receive more than one dose of KI are at particular risk for developing a condition known as hypothyroidism (thyroid hormone levels that are too low). If not treated, hypothyroidism can cause brain damage. Infants who receive KI should have their thyroid hormone levels checked and monitored by a doctor. Avoid repeat dosing of KI to newborns.

Where can I get KI?

KI is available without a prescription. You should talk to your pharmacist to get KI and for directions about how to take it correctly. Your pharmacist can sell you KI brands that have been approved by the FDA.

Other Sources of Information

Information retrieved from:
http://www.bt.cdc.gov/radiation/ki.asp

For infromation on prescriptions for Potassium Iodine, visit http://www.hmcompound.com/

4- AP/ 4- Aminopyridine and MS/Multiple Sclerosis

2011-03-08T08:04:00.001-08:00

4- AP/ 4- Aminopyridine and MS/Multiple Sclerosis

If you are reading this article, you have probably already done your research and you know what this is and what the indications are for it.

Chances are you are looking for a compounding pharmacy and/or a practitioner to provide you with a customized option for this medicine.

A compounding pharmacy can prepare any adjusted strength customized for your unique needs in a capsule form with regular release mechanism.

To reach a better outcome using the 4-AP correctly, with minimal side effects, we suggest a titrating schedule:

5mg per day - in the morning - for 2 days
Then, 5mg twice daily (breakfast and late afternoon) for 3 days
Then, 5mg 3 times a day (every 5-6 hours while awake) for 4 days = 15 mg/day
Then, 5mg 4 times a day (every 4-5 hours while awake) for 5 days = 20 mg/day

You may not need the maximum allowed dose.

Please be advised that you should work with your doctor to choose the best option for your case.

Nurten Rasid, M.D.

Compounding Clinical Specialist

HM Compounding
http://www.hmcompound.com/

Green Pharmacy

2011-03-03T10:21:00.001-08:00

HM Compounding takes steps for the future by recycling and using technology to reduce waste of products such as paper, and ink. Recycling and “green consciousness is strongly promoted throughout the organization.

We believe many of the things we do now are preparing us for doing business into the future and strive to stay “ahead of the curve" on a community and global level.

Why is choosing a PCAB Accredited pharmacy so important

2011-03-01T06:11:00.000-08:00

Compounding medications is an integral part of the practice of pharmacy, and with the demand of patient-specific compounded medications increasing each year, there is a need for an enhanced, profession-wide system of standards by which each compounding pharmacy can test its quality processes. While compounding pharmacy is regulated by the state, accreditation is an even more comprehensive way to ensure a compounding pharmacy is meeting the highest quality and safety standards.

Pharmacists also want to give patients and prescribers a way to select a quality pharmacy. The pharmacies seeking PCAB™ Accreditation want to be able to demonstrate that they are “the best.”

The Pharmacy Compounding Accreditation Board Process

The Pharmacy Compounding Accreditation Board (PCAB) is a not-for-profit corporation formed and lead by eight national pharmacy organizations that recognized the need for a national standards organization for compounding pharmacy. Together, these leading organizations developed the industry principles, policies and standards for the practice of compounding pharmacy, as well as the PCAB Accreditation criteria and processes.

Examples of specific quality and safety standards include:
PCAB Accredited compounding pharmacies can use only certain chemicals from highly reliable suppliers.
PCAB Accredited compounding pharmacists and their technicians must receive regular, specialized training.
PCAB Accredited compounding pharmacy facilities must meet design and other related standards to help ensure the area is clear and free of contamination.
PCAB Accredited compounding pharmacies must meet or exceed USP <795> standards for non-sterile compounding and/or USP <797> standards for sterile compounding.
PCAB Accredited compounding pharmacies agree to adhere to the PCAB “Principles of Compounding”
Pharmacies seeking accreditation must submit documented proof that they meet PCAB quality standards, submit their policies and procedures for regular review, and open their doors to regular physical inspections.
PCAB was founded by the American College of Apothecaries, American Pharmacists Association, International Academy of Compounding Pharmacists, National Alliance of State Pharmacy Associations, National Association of Boards of Pharmacy National Community Pharmacists Association, National Home Infusion Association and United States Pharmacopeia.
More detailed information about PCAB™ and the PCAB™ Accreditation process can be found on its Web site at http://www.pcab.org/.
or visit our site at www.hmcompound.com/pcab

HCG & Diet for weight reduction

2011-02-22T11:16:00.001-08:00

HCG & Diet for weight reduction

It has been a few years now since the American public was first introduced to Dr. Simeon’s protocol for weight reduction through treatment with HCG (Human Chorionic Gonadotrophin) and the 500 calories/day diet.

Since then a lot has been said, a lot has been written, and a lot has been done. Yet there is still a lot of interest by people who have failed so many other types of diets. Much of this confusion stems from these people not knowing where, how, and what to do in order to safely try this weight reduction program.

This leaflet is by no means a comprehensive information source for the ones who want to try Dr. Simeon’s protocol. It is merely a very simplified version of the original protocol.

That is why we cannot emphasize enough the importance of reading the original protocol before you start your weight reduction program. You may have to read it several times and make sure you understand it as clearly as possible, what the program entails, and consequently be prepared to devote the appropriate amount of time one session will take..

The main purpose of this information is to objectively try highlighting the differences between this program and the other weight loss diets.

1. It is not the easiest method for weight reduction: it is time consuming and it requires very close cooperation between patient and physician.

2. It requires dedication as it is a restrictive diet.

3. Once these aspects are understood and accepted, the positives to the method become more evident.

4. Compared to any prescription weight loss medication, HCG + 500 calorie diet appears to have far less side effects, much is easier to tolerate.

5. Hunger control is achieved effortlessly in a short period of time.

6. Weight reduction is noticeable within days after starting the program.

7. If followed correctly, the results are well worth the effort and most importantly- majority of the patients keep off the lost fat for longer periods of time even though after treatment they re-start eating normal.

So, if after reading this, you still think you want to try this method, congratulations!

You are determined to take control of your weight issue. In that case keep reading, but please keep in mind that this is only a summarized version of Dr. Simeon’s original protocol and the information here will only help you visualize your program in a snapshot version.

So, here’s how it works:

First and foremost: to make your life easier, instead of injections - as in the original protocol - you’ll may take sublingual drops calculated to have the same effect: 125 IU/day

The number of treatment days for one session will be determined by your physician based on the amount of weight reduction you need.

First TWO DAYS of HCG drops: eat as much as you can, as unhealthy as you can (stuff yourself!)

The THIRD DAY of HCG: start the 500 calorie/day diet.

Here is your daily diet from now on for the duration of the session:

Breakfast: Tea or coffee in any quantity without sugar

Only one tablespoon of milk in 24 hours.

Artificial sweeteners may be used

Lunch: 1. 100 g of lean veal/beef/chicken breast/ fresh white fish/lobster/crab/shrimp

Weighed raw

Boiled or grilled

2. Only one type of the following vegetables:

· Spinach • Chard

· Chicory • Beet

· Green salad • Tomatoes

· Celery • Fennel

· Onions • Red radish

· Cucumber • Asparagus

· Cabbage

3. One Melba toast

4. An apple or an orange or a handful of strawberries or one-half grapefruit

Dinner: The same four choices as lunch.

· The juice of one lemon/day is allowed.

· Salt, pepper, vinegar, mustard powder, garlic, basil, parsley, thyme, marjoram, etc. may be used for seasoning. No dressing and no oil.

· Tea, coffee, water, mineral water allowed in any quantity at all times.

· Parts of lunch or dinner can be eaten as snacks between meals.

· No medicines or cosmetics allowed. (Ask us about custom-made cosmetics specific for this diet)

· Some adjustments may be made for vegetarians; please work with your physician on that.

After the last day of HCG continue three more days of 500 calories/day diet.

For three weeks after finishing a session, you have to refrain from carbohydrates in order to keep the weight off.

For all the detailed information in the original protocol highly recommended from the beginning, either go online: www.hcginfoonline.com/original_Dr_Simeons_Pounds_and_Inches

Or conveniently buy a copy from us for $15.00.

For any more questions you may have, please feel free to contact me. I’ll do my best to help you.

Nurten Rasid, M.D.

Veterinary Medicine

2011-02-18T10:12:00.002-08:00

Is your Human or Pet compounded prescription safe?

2011-02-16T12:16:00.001-08:00

Is your Human or Pet compounded prescription safe?

Your compounding pharmacy should be able to (at a minimum) answer to following questions, and demonstrate they comply to these critical safety and quality standards. For more information on compounding safety standards email info@hmcompound.com or visit www.hmcompound.com .

Questions to Ask Your Compounding Pharmacy

· Are you in compliance with USP <1075>, Good Compounding Practices?

· Are you in compliance with USP <795>, Pharmaceutical Compounding-Nonsterile Preparations?

· Do you have a checklist, a process, and a review process in place for acceptable strength, quality and purity?

· Does your staff take steps to minimize error and maximize the prescriber’s intent for the patient during the compounding process? Are these steps covered in your standard operating procedures and are they good practice standards to follow?

· Do your compounding records and documents contain the sources and lot numbers of the ingredients, calculations, processes used, results of any testing done, an assigned beyond-use date, identification numbers, name of the compounder, quantity of the preparation compounded, and other pertinent information?.

· Do you check to verify/insure that all the processes are appropriate and accurately performed?

· Do you counsel patients about use, storage and evidence of instability (visual changes, odor, etc.)?

· If you are compounding sterile preparations, do you conduct weekly and monthly independent lab tests of air and surface samples in your clean-room and other controlled environments?

· Is the air quality in your general compounding lab engineered for HEPA filtration to reduce particulates?

· Do you obtain independent, routine certifications of your clean-rooms and laminar airflow hoods?

· Do you perform daily monitoring and documentation of your clean-room for cleaning, pressure, temperature and humidity?

· Is your staff properly trained and evaluated in aseptic manipulation skills, gowning technique and clean-room use?

· Do you filter (0.2 micron) in a Class 100 (ISO 5) laminar airflow hood contained in a Class 1000 (ISO 6) clean-room, or autoclave where appropriate, to achieve sterility?

· Do you perform sterility testing on every preparation batch?

· Do you perform sterility testing according to USP <71> — Sterility Tests and USP <85> — Bacterial Endotoxin Test?

· Do you perform post-filtration filter-integrity testing?

· Do you have systems in place for handling complaints and investigating sterility failures and adverse events?

· In the event of a sterility failure, complaint or adverse event, do you have a procedure in place for determining and conducting a recall, if necessary?

· Do you purchase pharmaceutical-grade chemicals (USP, NF equivalent) from FDA-registered suppliers?

· Do you obtain Certificate of Analyses for all formula ingredients?

· Do you maintain both master formulas and lot-specific worksheets for all compounds?

· Can you immediately trace a prescription back to the original formula log sheet and the source of ingredients?

· Is every step of the compounding process from prescribing to compounding and labeling through dispensing reviewed and verified by a licensed pharmacist?

· Do you verify the potency of finished compounds through the weight, volume and yield checks?

· Do you perform pH testing on injections, ophthalmic preparations and other compounds?

· Do you perform HPLC verification on selected formulations?

· Are your pharmacists, technical and customer-service staff dedicated exclusively to compounding?

· Are you active members of the American College of Apothecaries and the International Academy of Compounding Pharmacists? Do you belong to any other professional organizations?

Menopause and Hormone Therapy

2011-02-15T08:06:00.001-08:00

Menopause and Hormone Therapy

Questions and answers with Dr Rasid.

What is menopause?

Menopause is a natural and normal transition in any woman’s life. It occurs when she ceases to have twelve consecutive menses. There also may be a “surgical menopause” that a woman goes through after a hysterectomy at an earlier age.

As natural and normal as it may sound, for many women (statistically for about 75% of North American women) menopause comes with many physical and emotional changes, sometimes very dramatic. More than 52% of the over 50 million women in the USA going through menopausal changes seek medical help because of many uncomfortable symptoms.

What kind of help is available for all these women?

The main answer coming from most of the health care practitioners will be: Hormone Therapy.

What is Hormone Therapy and why women need it?

First, we have to understand what happens in our body as we age and reach menopause. During our reproductive years our body produces, among others, two major steroid sexual hormones: estrogen and progesterone. While estrogen can be produced from a variety of sources within the body and externally, progesterone can only be produced internally. Estrogen’s main role during reproductive years is to replenish, prior to the ovulation, the inner lining of the uterus that was lost during the cycle. Progesterone further prepares the uterus and the breast for a potential pregnancy. Both estrogen and progesterone also affect other organs and systems in the body, such as: the brain, the endocrine system, the immune system, etc. When these hormones are present in the normal levels, they balance each other’s activity providing the body with harmonious functioning.

During and after menopause, as the ovulation stops, so does the production of progesterone, whereas estrogen is still available (from the adrenal glands that can convert other hormones into estrogen, in fat and other tissues). Also we are exposed to many chemicals in the environment that behave like powerful estrogens. So, during these menopausal years, women may have normal or elevated tissue levels of estrogen and very low levels of progesterone. The discrepancy in the production of these two hormones leads to hormonal imbalance, which, in light of latest data from the experts, appears to be the main cause of the menopausal symptoms.

Therefore the logical medical approach to help alleviate menopausal symptoms should be to re-balance the hormones through Hormone Therapy.

What kinds of Hormone Therapies are available and how are they different?

For the last four-five decades conventional Hormone Replacement Therapy (HRT) has been the default choice for menopause symptom management, consisting in powerful drugs manufactured by pharmaceutical companies, mimicking the functions of the two major hormones: estrogen and progesterone. A massive recent study revealed major shortcomings of conventional HRT, having researchers stop the study, before its intended end, as the negative effects outweighed the expected benefits.

As millions of women on the therapy were left helpless after these results had been exposed, the search for other options began. Having access to technology, many women started searching for literature and educating themselves, shortly afterward they learned that there is another alternative to conventional HRT: Bio-Identical Hormone Replacement Therapy (BHRT).

As controversial as it may be in the scientific world, BHRT is gaining more and more interest, prominence, and demand from patients. This perspective provides patients with customized solutions when re-balancing the hormones with products that have identical chemical structures to what the human body makes. These Bio-identical hormone products are synthesized in an FDA approved lab, from plants like wild yams or soy beans.

How does a woman get Bio-identical Hormone Replacement Therapy (BHRT)?

The first step would be to find a knowledgeable health care practitioner, who usually works within one of the following specialties: integrative medicine, functional medicine, holistic medicine, advanced medicine, anti-aging medicine, complementary and alternative medicine, internal medicine, and sometimes ob/gyn. For most of these practitioners the goal is to treat a patient as a whole so they address not only hormonal issues, but also other factors that will lead to balance and wellness, such as: diet, proper nutrition, exercise, relaxation techniques, etc.

Any of these practitioners work in close collaboration with a compounding pharmacy,

as this is the only way to get BHRT prescription products.

No two women undergo identical menopause experience; the combination of symptoms, the degree of the severity of the symptoms, the variety of hormones involved in the imbalance, the level of each deficient or dominant hormone, will be unique to each patient.

Only after a proper and thorough assessment, based on the symptoms and supporting lab tests (saliva testing), the practitioner will provide a plan that will include a customized hormone prescription with Bio-identical hormones to be prepared by the compounding pharmacist.

What is a compounding pharmacy?

Pharmacy compounding is the art and science of preparing customized medications based on a doctor’s prescription, to meet a patient’s unique needs. Based on practitioner’s preferences, the compounded formulation can be made in any combination, form, shape, strength, or route of administration, whether it is a tablet, capsule, sublingual drops, cream, gel, solution, suppository, etc. Meeting the uniqueness of the need and the preference, compounding improves compliance, therefore improves the outcome.

Is BHRT indicated only for menopause?

No, both men and women can encounter hormonal imbalances at any age.

A few examples of female hormonal imbalance at other ages would be: PMS, migraine, acne, heavy bleeding, depression, mood swings, irritability, sleep disturbances, weight gain, fatigue, etc.

Men go through similar hormonal changes mainly noticeable during andropause, the male equivalent for menopause.

Nurten Rasid, M.D.

HM Compounding

http://www.hmcompound.com/

I Love NYC Pets Month

2011-02-15T07:19:00.000-08:00

I Love NYC Pets Month

Potential Signs of Autism

2011-02-14T07:16:00.000-08:00

The difficulty of getting children to take their medication can become even more challenging when the child suffers with Autism.
Medications can be prepared in the following forms:
  Oral
  Topical
  Injectable
  Nasal Spray
  Suppository
If your baby shows any of these signs, please ask your pediatrician or family practitioner for an immediate evaluation:
No big smiles or other warm, joyful expressions by six months or thereafter
No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months or thereafter
No babbling by 12 months
No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months
No words by 16 months
No two-word meaningful phrases (without imitating or repeating) by 24 months
Any loss of speech or babbling or social skills at any age

boob-olution

2011-02-14T05:55:00.001-08:00

http://www.youtube.com/watch?v=7SM7Hvjqny4

2011-02-09T08:19:00.001-08:00

http://www.youtube.com/watch?v=TZYo7UbvspI

Women and hormones

2011-02-07T07:59:00.001-08:00

Women and hormones

So much has been written about hormones; especially about women and hormones. What has been written has come mostly from licensed health care practitioners and scientists, but not exclusively. The media has transmitted to the public, many times purposefully misleading information to be by some not so scientific sources. The main interest of those sources, sometimes the only interest, is financial gains.

I believe this is one of the reasons there is so much confusion on this topic, both among patients and even many health care practitioners, despite so much talk and so much literature.

Sadly, even the long-time reliable medical journals practitioners were considering as their practicing “bibles” are becoming less reliable due to the same greedy financial goals of some authors/companies that publish those articles/studies.

But, let’s get back to the topic of our article. I just want to re-iterate some of the basics related to women and hormones and emphasize that the power to control any issues related to this topic consists in knowledge, the right knowledge.

I know, more and more women are getting educated about their hormones; some learn so much that they may feel they know more than their health care practitioners. The key question though is where are the really reliable sources?

OK now: let us start with the basics! When it is about women and hormones these are a few basic things we need to keep in mind:

· First: I am referring here to the major sexual hormones: estrogens, progesterone, testosterone; and a few others very closely “connected” to them: cortisol and thyroid.

· Second: we need all these hormones (and others) to work in perfect harmony in our body in order for us to feel good. In other words our hormones have to be well balanced to keep us feeling well.

· Third: when one (or more) of these hormones is in excess or deficient, imbalance occurs leading to many unpleasant symptoms.

· Fourth: hormonal imbalance can occur at any age from early puberty to long past menopause. It is true that most commonly reported unpleasant symptoms that require medical attention occur a few years before menopause and after.

· Fifth: causes for imbalance? Too many to count here, but I’ll mention just a few: birth control pills, environmental estrogen-like products in foods, drinks, clothing, etc.

And, of course, for peri-menopausal symptoms the main cause is natural aging that comes with the decline in these hormones.

· Sixth: no matter the age the imbalance occurs, the symptoms and the real causes of them will be unique for each individual female patient, and requires a thorough assessment and individualized treatment plan.

· Seventh: here is where we need to educate ourselves and have the power to control our hormonal imbalance- learn about Bio-identical Hormones (identical to the ones our own bodies make) and synthetic hormones made by drug companies.

· Eighth: with the knowledge acquired from learning about the difference between bio-identical and synthetic hormones, the next step would be to find a practitioner who uses a PCAB™ Accredited, compounding pharmacy. Only a compounding pharmacy will prepare individualized bio-identical hormone prescriptions for our unique individual needs, and a pharmacy bearing the PCAB™ seal of accreditation has been proven to have the highest quality and safety standards.

· Last but not least: I invite every woman who wants proper knowledge on this topic to read the articles in the link bellow. I have a great respect for the author of these articles and I do believe they present a purely scientific and unbiased perspective with regards to the information provided. The site contains biographical information about its author: Dr. Ray Peat.

http://www.raypeat.com/articles/articles/natural-estrogens.shtml

Thank you for reading my article and have a pleasant and very educational lecture.

Nurten Rasid, M.D.

HM Compounding

http://www.hmcompound.com/

2011-02-07T06:16:00.001-08:00

Check out the new look of the site.

New York Podiatric Clinical Conference

2011-01-27T12:54:00.000-08:00

Tomorrow HM Compounding will have our booth at the New York Podiatric Clinical Conference. http://www.nyspma.org/ Booth E3 on the 5th floor right off the elevators! See you there.

Pediatrics: Rectal Suppository Antibiotics.

2011-01-26T10:03:00.001-08:00

Drug absorption in the rectum

Before prescribing any antibiotics to be compounded into a rectal suppository, it would be good to consult with a knowledgeable pharmacist, and use only a PCAB™ Accredited compounding pharmacy.

Pharmacist Society of the State of New York IV, Nuclear & Compounding Academy

2011-01-26T06:22:00.001-08:00

This last weekend HM Compounding attended PSSNY's Mid winter conference where Alfonse Muto PharmD of Pine Pharmacy was elected Chairman of the IV, Nuclear & Compounding Academy and our own Alex Chervinsky, RPh was elected Vice Chairman. We look forward to the Academy being reinvigorated and the exciting things to come in 2011

HCG and Weight Loss

2011-01-20T08:12:00.000-08:00

There are volumes of information on the internet about HCG and weight loss. In NYC its important for providers and pharmacies to understand the legal and safe way to prescribe HCG for patients. We have put together a providers assitance manual for safe and legal prescribing of HCG in New York State. If you as a prescriber are interested in recieving this information free of charge, or if you are a patient that would like more information on proper HCG diet programs, call us at (800) 419-2804 or email us at info@hmcompound.com.

Valentines TriMix Special

2011-01-19T09:11:00.000-08:00

Tri-Mix Special

2011-01-17T13:26:00.000-08:00

For this February coming up, HM Compounding will be running a special! Valentine’s day is coming up in February and we are running a special from now until the end of the February. All orders for "TriMix" Injection (alprostadil, papaverine, and phentolamine) will $79.00, any strength your doctor prescribes, and up to a 10ml vial! We will have more info coming up regarding this special so stay tuned. For more info call us at (800) 419-2804 today!

Topical Anesthetics

2011-01-17T06:08:00.001-08:00

Analgesic gels and sprays can be compounded to reduce pain and bleeding secondary to lacerations. The search for a "topical anesthetic that affords painless, safe application, does not contain narcotics or controlled substances, and has a maximum safety with complete anesthesia" revealed that LAT gel (lidocaine, adrenaline, tetracaine) is superior to preparations containing cocaine for topical anesthesia in laceration repair. Epinephrine (adrenaline) in the gel helps to stop bleeding secondary to injury.
Pediatrics 1995 Feb;95(2):255-8
Lidocaine adrenaline tetracaine gel versus tetracaine adrenaline cocaine gel for topical anesthesia in linear scalp and facial lacerations in children aged 5 to 17 years.Click here to access the PubMed abstract of this article.

DMAE

2011-01-11T07:50:00.001-08:00

DMAE (2-dimethylaminoethanol, deanol), when applied topically to the skin, may improve the appearance of sagging skin, boost the effects of other antioxidants, increase smoothness, reduce fine lines and give facial muscles a leaner look. In a randomized clinical study, 3% DMAE facial gel applied daily for 16 weeks has been shown to be safe and efficacious in the mitigation of forehead lines and periorbital fine wrinkles, and in improving lip shape and fullness and the overall appearance of aging skin.
Br J Dermatol. 2007 Mar;156(3):433-9.
The antiwrinkle effect of topical concentrated 2-dimethylaminoethanol involves a vacuolar cytopathology.
Click here to access the PubMed abstract of this article.
Am J Clin Dermatol. 2005;6(1):39-47.
The role of dimethylaminoethanol in cosmetic dermatology.
Click here to access the PubMed abstract of this article.

HCG & Diet for weight reduction

2011-01-06T07:15:00.001-08:00

This leaflet is by no means a comprehensive information source for the ones who want to try Dr. Simeon’s protocol. It is merely a very simplified version of the original protocol.

The main purpose of this information is to objectively try highlighting the differences between this program and the other weight loss diets.

1. It is not the easiest method for weight reduction: it is time consuming and it requires very close cooperation between patient and physician.

2. It requires dedication as it is a restrictive diet.

3. Once these aspects are understood and accepted, the positives to the method become more evident.

4. Compared to any prescription weight loss medication, HCG + 500 calorie diet appears to have far less side effects, much is easier to tolerate.

5. Hunger control is achieved effortlessly in a short period of time.

6. Weight reduction is noticeable within days after starting the program.

So, if after reading this, you still think you want to try this method, congratulations!

So, here’s how it works:

First and foremost: to make your life easier, instead of injections - as in the original protocol - you’ll may take sublingual drops calculated to have the same effect: 125 IU/day

The number of treatment days for one session will be determined by your physician based on the amount of weight reduction you need.

First TWO DAYS of HCG drops: eat as much as you can, as unhealthy as you can (stuff yourself!)

The THIRD DAY of HCG: start the 500 calorie/day diet.

Here is your daily diet from now on for the duration of the session:

Breakfast: Tea or coffee in any quantity without sugar

Only one tablespoon of milk in 24 hours.

Artificial sweeteners may be used

Lunch: 1. 100 g of lean veal/beef/chicken breast/ fresh white fish/lobster/crab/shrimp

Weighed raw

Boiled or grilled

2. Only one type of the following vegetables:

· Spinach • Chard

· Chicory • Beet

· Green salad • Tomatoes

· Celery • Fennel

· Onions • Red radish

· Cucumber • Asparagus

· Cabbage

3. One Melba toast

4. An apple or an orange or a handful of strawberries or one-half grapefruit

Dinner: The same four choices as lunch.

· The juice of one lemon/day is allowed.

· Salt, pepper, vinegar, mustard powder, garlic, basil, parsley, thyme, marjoram, etc. may be used for seasoning. No dressing and no oil.

· Tea, coffee, water, mineral water allowed in any quantity at all times.

· Parts of lunch or dinner can be eaten as snacks between meals.

· No medicines or cosmetics allowed. (Ask us about custom-made cosmetics specific for this diet)

· Some adjustments may be made for vegetarians; please work with your physician on that.

After the last day of HCG continue three more days of 500 calories/day diet.

For three weeks after finishing a session, you have to refrain from carbohydrates in order to keep the weight off.

For all the detailed information in the original protocol highly recommended from the beginning, either go online: www.hcginfoonline.com/original_Dr_Simeons_Pounds_and_Inches

Or conveniently buy a copy from us for $15.00.

For any more questions you may have, please feel free to contact me. I’ll do my best to help you.

Nurten Rasid, M.D.

Palliative Care

2011-01-05T08:44:00.001-08:00

Palliative Care is "the active total care of patients whose disease is not responsive to curative treatment." The goal of palliative care is the achievement of the best possible quality of life for patients and their families.

Symptom Control involves therapies for nausea & vomiting, dry mouth & stomatitis, excessive pulmonary secretions/death rattle, radiation mucositis and proctitis, and wound care.

We work together with patient and practitioner to solve problems by customizing medications that meet the specific needs of each individual. Please contact our compounding pharmacist to discuss the dosage form, strength, and medication or combination that is most appropriate for your patient.

Topical Treatment for Chronic Venous Leg Ulcers, Irritation around Stomas, and Diaper Rash

2011-01-03T07:20:00.001-08:00

Topical Treatment for Chronic Venous Leg Ulcers, Irritation around Stomas, and Diaper Rash
Daily application of sucralfate gel to non-infected post-phlebitis/vascular ulcers for 42 days led to complete healing in 95.6% of patients compared to only 10.9% of cases that used placebo.1
A 10% aqueous solution of sucralfate, administered twice daily as a rectal enema or vaginal douche, was also used successfully to treat radiation-induced rectal and vaginal ulcers. 2, 3

Topical sucralfate represents a safe, inexpensive and effective therapeutic intervention, particularly for those patients with high output or short stomas where repeated stoma leakage may be unavoidable.4

1 Int J Mol Med. 2008 Jul;22(1):17-23.
Topical treatment of chronic venous ulcers with sucralfate: a placebo controlled randomized study.
Click here to access the PubMed abstract of this article.

2 Arch Dermatol. 2000 Oct;136(10):1199-200.
Topical sucralfate for erosive irritant diaper dermatitis.
Click here to access the PubMed abstract of this article.

3 Ann Pharmacother. 1999 Dec;33(12):1274-6
Treatment of radiation-induced proctitis with sucralfate enemas.
Click here to access the PubMed abstract of this article.
4 Clin Exp Dermatol. 2000 Nov;25(8):584-8.
Topical sucralfate in the management of peristomal skin disease: an open study.
Click here to access the PubMed abstract of this article.

Hormone Replacement Therapy for Men:

2010-12-29T10:58:00.001-08:00

Website

2010-12-29T10:56:00.001-08:00

Our website should be getting a facelift soon, stay posted!

2010-12-28T11:01:00.001-08:00

http://www.nydailynews.com/lifestyle/pets/2010/12/27/2010-12-27_top_winter_safety_tips_for_pets_keep_your_dog_and_cat_safe_from_snow_hazards_.html

Low-Dose Naltrexone Improves Active Crohn's Disease

2010-12-28T06:48:00.001-08:00

Low-Dose Naltrexone Improves Active Crohn's Disease

Endogenous opioids and opioid antagonists have been shown to play a role in healing and repair of tissues. Low-dose naltrexone (LDN) therapy appears effective and safe in subjects with active Crohn's disease.

Am J Gastroenterol 2007;102:1-9
Low-dose naltrexone therapy improves active Crohn's disease.
Click here to access the PubMed abstract of this article.

Dentistry

2010-12-23T06:23:00.001-08:00

Upon a prescription order, we can compound:

lip balms for viral lesions
topical muscle relaxants/analgesics
topical anesthetics
non-staining antibacterial rinses
oral sedation in lollipops and freezer pops
lollipops for oral thrush
mouth rinses for aphthous ulcers or chemotherapy-induced stomatitis
mouth rinse to stop oral bleeding during dental procedures for patients who take anticoagulants
dry socket preparations
"mucosal bandages" to cover ulcerated, infected, or tender mucosa
lozenges that help to prevent gagging
and many more unique preparations and novel delivery systems

Medications are manufactured in a limited number of strengths and dosage forms that will satisfy the needs of most patients due to stability concerns, and the cost of stocking and distributing numerous formulations of each drug. Using pharmaceutical grade chemicals and specialized equipment not found in most pharmacies, we can compound medications in doses and dosage forms that are not commercially available. We want to optimize the care of every patient. Just let us know what you need!

Press Release

2010-12-22T06:39:00.001-08:00

http://www.i-newswire.com/first-new-york-city-based-pharmacy/80462

Wound Care

2010-12-20T05:50:00.001-08:00

Per a prescription order, a formulation can be compounded to contain the proper combination of active ingredients, in the most appropriate base, to treat a specific type of wound. We customize medications to meet each individual’s specific needs.

For example, the choice of cream, ointment, or gel can be clinically significant. Each time a wound needs to be cleaned, there is the potential for disruption of new tissue growth. Gels, which are more water soluble than creams or ointments, may be preferable for wound use because a gel can be rinsed from the wound by irrigation. Ointments may contain polyethylene glycol (PEG), which can be absorbed from open wounds and damaged skin. If the wound is quite large and too much PEG is absorbed, it can lead to renal toxicity.

Another useful dosage form is the “polyox bandage” - which can be puffed onto a wound and will adhere even if exudate is present. A polyox bandage can be compounded to contain the active ingredient(s) of your choice.

Sports Medicine

2010-12-17T09:32:00.001-08:00

Athletes, coaches, trainers, team physicians, physical therapists, and even the “weekend warrior” are faced with problems including inflammation and muscle spasms. We work together with these individuals and other health care professionals to customize medications which meet specific needs. Our compounding specialists can help to solve medication problems using customized preparations that contain the most appropriate ingredients in the best vehicle to most efficiently provide the needed drug to the affected area. Please contact our compounding pharmacist for more information.

Podiatry

2010-12-17T06:06:00.001-08:00

Podiatrists and other health care professionals encounter numerous problems that may be helped with compounded medications.
We commonly prepare unique formulations that prescribers develop to meet specific needs of their patient population, or "tried and true" formulas acquired during professional training. Penetrant enhancers can be added to improve the extent of absorption of topically applied medications. Numerous compatible medications can be combined into a single dosage form for ease of administration. Also, a synergistic effect can be achieved when certain medications are used concomitantly.

Dermatology

2010-12-16T14:37:00.001-08:00

Our compounding professionals can prepare individualized therapies for a myriad of dermatologic problems. Compounding pharmacists continue to improve both the aesthetic and therapeutic aspects of customized medications, offering alternatives and advantages for dermatology. We can compound medications into cosmetically appealing creams, topical sprays and powders, as well as create customized oral dosage forms (such as flavored troches or lollipops) and various preparations for other routes of administration. Compatible drugs can be combined into a single dosage form to simplify a medication administration schedule and improve compliance. USP approved chemicals can be utilized to enhance the absorption of topically applied medications. We commonly prepare unique formulations that physicians develop to meet specific needs of their patient population, or "tried and true" formulas acquired during medical training.

2010-12-16T06:56:00.000-08:00

HM Compounding

2478 McDonald Ave

Brooklyn, NY 11223

August 5, 2010

Dear Providers:

Recently there has been a great deal of interest in Human Chorionic Gonadotropin (hCG) for weight loss. We currently are providing hCG in oral sublingual drops, nasal spray, injections, and topical creams. We do advocate the following though for anyone considering using hCG and the corresponding diet:

1. Patients should have a physical exam done before any weight loss program. While on the program, they should be monitored to ensure safety.

2. Patients can only get HCG with a prescription from a physician. Many websites state they sell HCG, doing so without a prescription is considered illegal.

3. Some websites sell “homeopathic” HCG, which is simply diluted preparation that contain very little active HCG. We do not recommend participating in any HCG program without proper medication from a local, licensed pharmacy.

Show your patients you care. When prescribing HCG, use proper medication and proper monitoring.

Sincerely,

Anthony Phillips

Director of Business Development

Pharmacists Helping Vets and Pets

2010-12-15T13:33:00.001-08:00

Our "specialty service should not be viewed as competition with local veterinarians; rather, compounding allows veterinarians to broaden their prescribing abilities and to offer [dosage] forms that are patient-specific in strength and formulation. Therefore, the goal of compounding for the veterinary patient is to enhance the veterinarian's ability to treat patients in a more effective and efficient manner...
"Compounding can make medicating animals easier if the pharmacist prepares flavored chews that animals accept readily. For example, tranquilizing a feral cat with a liver-flavored chew eliminates the possibility of over- or underdosing. If a chew contains 10mg acepromazine and the dose fails to gain a response, a second flavored chew can be given to the animal. Furthermore, the amount of medication incorporated into the chews, capsules, [topical or transdermal], or liquid preparations can be formulated to the specific request of the veterinarian, thereby eliminating the need to cut-up tablets and divide the contents of commercially prepared capsules... As manufacturers decide that certain products are no longer economically rewarding to market, the list of commercially prepared veterinary medication becomes smaller. At present, the armamentarium of medications available for animals is less than perfect. Cherry-flavored amoxicillin or orange-flavored cephalexin may not be [appealing to a cat or monkey]..."

Veterinary Forum October 2002, (pp. 62-65)
Our compounding pharmacy can prepare:

Flavored medication
Medicine in ideal size, strength, and dosage form
Unavailable medications
Combinations to improve compliance
Novel devices and delivery systems

Compounding is actually a means to an end. We work together with veterinarians and their clients and patients to solve medication problems by compounding specialized medications that meet the unique needs of each animal - pets, exotics, horses, or zoo animals. Let us know how we can help you and the animals in your care.