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Home > Answers & Ideas > The Compounder Blog > No more saliva tests, no more consultations
Too many people take too many drugs. Larry's Blog

I am no longer offering saliva testing at our compounding pharmacy.

Yes, I know it's popular and common, and considered a step in the process of achieving hormone balance. That does not automatically equate to necessity. At least for me.

Just because we CAN measure levels of hormones in saliva (blood too), is not rationale for actually doing it, especially if the goal is to help determine a person's imbalance - and offer suggestions for correcting it.

Clinically, most of us are estrogen dominant. In fact, it would be extremely rare in the United States to find anyone who isn't. Estrogen dominance means we have an imbalance between estrogen and other hormones (mostly progesterone). It does not necessarily mean we have excess estrogen.

There are other substances that we don't measure that can also add to the estrogen load in our system. On some level, each of us is exposed to estrogen-like substances every day. Some of us experience the downside of this exposure more than others. When the symptoms become unbearable, the answer isn't to test and confirm something your doctor should already know.

A better approach is to save that money and do what seems to work well in the vast majority of cases - use physiologic amounts of progesterone, preferably as a transdermal (topical) cream or lotion. Some may suggest oral progesterone doses, but I think the chances of relief are greatly improved when doses can be adjusted to meet individual needs.

In addition to discontinuing the sale of saliva test kits, I no longer do formal hormone balancing consultations. After engaging hundreds of them I realized that I was saying practically the same thing to everyone - and charging for both the tests and my time.

Regardless of how hormone imbalance manifests in a person, the approach to relief is usually the same; better diet, modest exercise, clean water, vitamins/minerals, and a good progesterone supplement (without parabens). I decided I can no longer charge hundreds of dollars to regurgitate the same advice over and over again. But, if you ask me, I'll explain it to you in as much detail as I can - and there is no charge. I won't even expect you to buy anything from me. I want to tell you what I know, answer your questions, and allow you to decide what's best for you, all with no strings attached.

Yes, this a somewhat radical decision and I'm certain there are health providers lining up to chastise me for my decisions. If you're one of those, save your breath. Complain about me to someone else. I don't need to hear your criticism.

I am convinced that people can be healthy, have a good hormone balance, and live a vibrant life without drugs or extra estrogen. Everyone, however, needs additional progesterone and the dosing is simply basic - use a physiologic amount of a good progesterone cream that does not contain parabens.

Allow me to add one caveat.

I still order saliva testing for our staff. We order a baseline report upon hiring and then do repeat tests on a regular basis. The reason? I want one more measure that my staff are doing their jobs correctly and not inadvertently contaminating themselves due to poor technique or lack of equipment. The tests are accurate and valuable as a tracking tool, but of little help in diagnosing and treating hormone imbalance.

Comments  

 
0 #7 Mike L. 2012-05-29 14:09
One precaution regarding men using progesterone is that it's a 5-alpha reductase inhibitor--and thus will have a similar effect to finasteride (Propecia, Proscar) in lowering DHT levels.

This effect could well be useful, depending, but it could also cause lowered libido. I experienced this first hand in a pronounced way in experimenting with progesterone several years back after reading Dr. John Lee's comments about it. Being a male, I used a much smaller topical dosage than is recommended for women. Still, I had a major negative side effect.

In researching the scientific literature, I discovered why, as progesterone and various metabolites of it are effective 5-AR inhibitors. All soon returned to normal for me once I discontinued it.

I would say that, if used by men--and I'm not suggesting it shouldn't be used--the progesterone dosage will have to be very carefully titrated.

Of course, that's an obvious truth for any medication. But it's especially important that men don't just rush to slather on progesterone cream in an effort to counter estrogen without considering that there's a delicate balance when it comes to hormones and hormone manipulation. Side effects will need to be carefully monitored and adjustments made accordingly.
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0 #6 Larry Frieders 2012-05-29 09:23
Adrenal saliva testing, doctor, is in the same arena as all testing. It probably "says something", yet it is all but impossible to know what it means. First, adrenal hormones are lipid soluble and, from my perspective and experience, unreliable markers of imbalance. Levels can change from minute to minute in the body. They are a moving target.

Also, like all hormone tests, they are not diagnostic, even though most of us believe they are.

Tests are never clinical, but so many people - doctors included - mistakenly believe they are. Sometimes, a laboratory test can help confirm a diagnosis (their primary intent), but they cannot make one. If a person has the signs and symptoms of adrenal unbalance, what value is there in knowing numbers about it? Treatment must be decided upon clinically and not based on the values derived from the test results.

It would be NICE if we could diagnose disease and decide on treatment from simple tests, but that isn't the case.

I understand that my colleagues will certainly argue against my comments, but they can't disprove what I'm saying.

We need clinicians to help us overcome our health problems. There are very few of them around today. They've been replaced.
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0 #5 Regina Tobias 2012-05-29 08:58
What do you think of adrenal saliva testing?
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0 #4 Larry Frieders 2012-05-29 07:33
Paul, our protocol is for 20mg daily for days 1 through 12, then twice daily for days 13 through 28, then stopping until day 1. These can be days of a cycle or calendar days if no cycle is present. We have a progesterone cream in a pump container that delivers 20mg of Progesterone USP in each activation of the pumper.

Men use about 10mg daily, 6 days a week.

Monitoring is easy and BEST done by the person herself or himself.
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0 #3 Larry Frieders 2012-05-29 07:30
Yes, Glen, some men may need testosterone replacement, but probably not as many as the drug makers' advertising suggests. The key is always balance and everyone - men included - is living with the effects of estrogen dominance. The place to begin is with a progesterone supplements. It balances the impact of estrogen dominance AND is a chemical precursor for other hormones, including testosterone.

Before suggesting a testosterone supplement, I'd recommend a few weeks of progesterone - and a follow-up evaluation - NOT A LAB TEST - but a clinical conversation that begins with, "Well, how are you feeling?"

The marketing wizards have been making menopause a "disease" for decades. Now they'e turning their attention to men.
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0 #2 Paul Davidson 2012-05-29 07:26
Hi Larry,
Interesting idea. Will you recommend a woman start a regimen of 3% progesterone and suggest she monitor herself?

Thanks,
Paul
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0 #1 Glenn ODell 2012-05-29 04:55
Progesterone for men? I should think Testosterone would be more appropriate.
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