BHRT vs Synthetic Hormones
Bioidentical hormones typically are discussed in regards to Testosterone, Estradiol, Progesterone, Thyroid, and cortisol. The term “bioidentical” means that these medications are molecularly the same as the hormones that are produced naturally in the human body. There are many variations of these hormones in which the pharmaceutical industry has manipulated the molecular structure of a hormone in order to achieve a certain effect or in order to be able to patent these medications. Since Bioidentical hormones are molecularly the same as those found in nature, they can not be patented. This means that any pharmaceutical company or compounding pharmacist can make them in various formulations for patient administration.
Are Bioidentical hormones safer than their synthetic counterparts?
This can be difficult to answer as this answer can be very patient specific but as a whole, it is my opinion, that they are. Particularly when discussing sex hormones and thyroid hormones. Often synthetic estrogens can have a more pronounced effect on the body and often can trigger more side effects or complications. Many times these synthetics can include other hormones that are not naturally occurring in the human body. One example of this is the commonly prescribed estrogen, Premarin®. This medication is derived from equine (horse) urine. Hence, the name Pre (pregnant), Mar (mare), In (urine). This has a significantly higher variety of estrogens that are not known to human body and thus can create issues with metabolism of these estrogens by the liver leading to a higher propensity for things like breast and endometrial cancer. Another example is with thyroid medication. Often, when a patient is diagnosed with hypothyroidism (low functioning thyroid), they are placed on a synthetic thyroid medication known as levothyroxine. Though, this may be beneficial for some and be an appropriate treatment option, often patients require a different approach to better manage their thyroid. Levothyroxine is synthetic T4 (stored thyroid). The theory is that by giving you T4, the body will convert T4 to T3 (active thyroid hormone) when it needs it. This makes sense in theory, but in practice, this is not always the case. Many patients do better with combination T4/T3 therapy and usually do well with porcine derived or bioidentical thyroid medication. Again, this is not to say that Bioidentical Hormones do not have some similar risks as their synthetic counterparts but as the body is more capable of recognizing and metabolizing BHRT, these risks can be lower and easier to monito with a skilled and knowledgeable hormone expert.
