Year

2014

Our HIV Pharmacist can Reduce Medication Errors and Optimize your Care

166842581Antiretroviral therapy (ART) is a combination of medications that treat HIV. The drugs do not kill the virus, but when taken in combination they can slow the progression of HIV. Antiretroviral drugs are referred to as ARV. Huge reductions in rates of death and suffering have been seen when use is made of a potent ARV regimen, particularly in early stages of the disease.

ART is complex and so medication errors and drug-drug interactions (DDIs) are common, especially when the drugs are prescribed by someone who is not an expert. Patients with HIV require additional attention when admitted to hospital because their antiretroviral regimens can be complicated. Medication errors have occurred when admission or discharge meds are prescribed by someone who is not an infectious disease specialist. In addition, surgical stress can affect drug absorption, metabolism, and excretion, which can in turn require changes in medication doses.

In one study of hospitalized patients with HIV, potential drug-drug interactions were observed in 58% of 200 patients, with 22 (9%) potential DDIs occurring with medication that was not previously recorded in the patients’ notes. Physicians sent 103 responses and 61.2% reported that the pharmacist consultation provided information they did not know, and pharmacist consultants led to change in management in 13.6% of cases.

With the growing number of antiretrovirals and increasing complexity of therapy, the pharmacist has an important role in optimizing care. Our HIV pharmacist can review your prescription for accuracy, and your medication history for potential drug-drug interactions (like with statin drugs) to promptly make changes and prevent potential problems.

RxUnlimited has been a provider of pharmacy services for people living with HIV/AIDS since 1994. Our mission is to help people living with HIV/AIDS or any other chronic illness to optimize their quality of life and maximize their health benefits. For more information, please call 877-877-DRUG (3784).

Reference:
Int J STD AIDS. 2013 Mar;24(3):237-41.

Carpal Tunnel and Your Thyroid

Trying to ignore tingling or numbness in your hand and wrist?

Ever have a sharp pain shoot through your wrist and up your arm?

It could be CARPAL TUNNEL SYNDROME.

   Carpal Tunnel Syndrome (CTS) is a painful progressive condition caused by pressure on the median nerve in the wrist. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though swelling is not visible. The symptoms often first appear during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to “shake out” the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to distinguish hot and cold by touch. Carpal tunnel syndrome may be due to repetitive strain and CTS is especially common in those performing assembly line work. There are also a variety of health conditions – including diabetes, arthritis and hypothyroidism – that can lead to CTS.

Carpal tunnel syndrome can be a symptom of untreated — or inadequate treatment of — hypothyroidism. If you have carpal tunnel syndrome and have not had your thyroid evaluated, you may want to discuss this with your doctor before you consider an invasive treatment like surgery.

In the U.S., the primary cause of hypothyroidism is Hashimoto’s disease — an autoimmune disease in which antibodies attack the thyroid gland, and eventually slow it down. Symptoms can start long before the slowdown is reflected by the Thyroid Stimulating Hormone (TSH) test but can be detected when a Thyroid Peroxidase Antibodies (TPO) test is included as part of a thyroid workup. Studies show that treatment of patients with normal TSH levels who have Hashimoto’s disease may help lower antibodies, and prevent progression to overt hypothyroidism. Research has shown that restoration of hormone balance, immune system support and dietary changes (such as a gluten-free diet) may lower antibodies, reduce inflammation, and help resolve symptoms in some patients.

The thyroid produces the two key hormones, T4 and T3. T4 is a storage hormone, and its function is to be converted into T3, the active hormone that delivers oxygen and energy to cells, tissues, glands and organs. In a thyroid test panel, the prescriber can choose to include TSH, Free T4, Free T3, and TPO. Thyroid hormone therapy is complicated when the active thyroid hormone T3 is not measured and deficiencies are not addressed. A patient can have a TSH in the “normal reference range” and yet still have low-normal or below-normal Free T3 levels, indicating that she does not have enough active thyroid hormone in her bloodstream. Patients often prefer combination treatments that include both T4 and T3.

Ask our pharmacist or visit the following links for more information:

http://www.holtorfmed.com/carpal-tunnel-syndrome-thyroid/

http://www.holtorfmed.com/hashimotos-thyroiditis-and-your-immune-system

Natural Estrogens: Benefits for Postmenopausal Women

  When talking about a woman’s hormones, the term “estrogen” is frequently used. Estrogens are steroid hormones present in both men and women, but at significantly higher levels in women of reproductive age. But, do you know that there are three types of estrogens found in the human body? Estriol (E3), Estradiol (E2) and Estrone (E1) each have unique biological effects, benefits and side effects. Also, the different forms of estrogen have different affinities for certain body tissues (such as the brain, breast and vagina) and therefore it is important to select the most appropriate estrogen for optimal treatment or prevention of a specific problem.

   Estriol, coined the “weaker” of the three estrogens naturally made by the human body, has significant therapeutic benefits, and is commonly used to treat hot flashes, insomnia, and vaginal atrophy; to reduce the frequency of urinary tract infections; and for skin enhancement. Recently, estriol has shown the potential to treat individuals with autoimmune illnesses, including multiple sclerosis and rheumatoid arthritis.

Due to the well-known and documented risks associated with other forms of estrogen, estriol (E3) has attracted the interest of researchers and clinicians due to its protective and clinically beneficial actions. Estriol is not metabolized into other forms of estrogen, and hence does not result in an increase in the levels of either of the other two estrogens.

  After menopause, as estrogen levels fall, many women experience thinning, drying and inflammation of the vaginal walls, clinically known as vaginal atrophy. Multiple studies have demonstrated the benefits of a vaginal tablet containing an ultra-low-dose of estriol (E3) in combination with the probiotic Lactobacillus acidophilus for the treatment of vaginal atrophy.

Our compounding pharmacists will work with you and your medical provider to accurately test the specific hormone levels in your body, determine the best treatment strategy for you and compound the necessary hormones in individualized strengths and dosage forms to meet your unique needs. Our relationship with you and your provider is ongoing, to ensure that over time your dosages are adjusted to coordinate with your natural aging process.

Talk to your health care providers to discuss compounding as a treatment option and make sure to let them know you heard about prescription compounding from Rx Unlimited Pharmacy!

Men’s Health

International Men’s Health Week is June 9-15, 2014. “Recognizing and preventing men’s health problems is not just a man’s issue. Because of its impact on wives, mothers, daughters, and sisters, men’s health is truly a family issue,” said U.S. Congressman Bill Richardson. http://1.usa.gov/1rtXoY4 Knowing that on average, men smoke more, drink more, see doctors less, and die five years sooner than women, we want to encourage men to take care of their health. Many of the major health problems that men face, such as colon cancer and heart disease, have better outcomes with early diagnosis and treatment. We encourage all men (and women!) to schedule regular wellness checkups and know your cholesterol, blood pressure, and glucose levels.

Another important value that is not always measured is testosterone (“free” testosterone indicates the bioactive form). “Low T” or testosterone deficiency is strongly associated with common medical conditions including metabolic syndrome, obesity, diabetes, hypertension and atherosclerosis; as well as elevations in triglycerides (TGs), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C). Other signs and symptoms include:
• Diminished sex drive and sense of vitality
• Erectile dysfunction
• Depression
• Anemia
• Reduced muscle mass and bone density
• Osteoporosis
• Increased fat mass
• Frailty

Evidence indicates that appropriate therapy can relieve or partially reverse the progression of these problems in testosterone-deficient men. Transdermal therapy facilitates adequate absorption of testosterone to mimic the normal daily production. Testosterone can also be administered as a sublingual drop or a lozenge that dissolves in the mouth. Compounded preparations can be very advantageous because customized therapies increase compliance.

The presence of prostate or breast cancer is an absolute contraindication for testosterone replacement therapy, or use of other hormones in this class, known as androgens. Guidelines recommend that testosterone therapy should not be started 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.

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, weight management and treatment of other health problems.

Talk to our compounding pharmacist to learn how we can help in your journey to live well.

 

Adrenal Fatigue

Last month we used the analogy of the thyroid gland being the body’s “accelerator”. Continuing with that analogy, if the thyroid gland is the “accelerator”, the adrenal glands provide the “gas”.

The adrenal glands secrete hormones such as cortisol, estrogen, and testosterone that are essential to health and vitality AND significantly affect total body function. “Adrenal fatigue” can result when the adrenal glands function below the necessary level, and is most commonly associated with intense or prolonged stress. Adrenal dysfunction can also be caused by acute or chronic infections, including respiratory infections such as influenza, bronchitis or pneumonia.

As the name suggests, the primary symptom of “adrenal fatigue” is tiredness that is not relieved by sleep. In more serious cases, individuals suffering from adrenal fatigue may have difficulty getting out of bed for more than a few hours per day. The body will make alterations to compensate for the decrease in adrenal hormones, but at a price. Changes occur in carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and can even affect a person’s sex drive.

Adrenal hormones like cortisol help to minimize autoimmune disorders. These hormones closely affect the utilization of carbohydrates and fats, the conversion of fats and proteins into energy, and cardiovascular and gastrointestinal function. Ask the pharmacists at RxUnlimited Pharmacy about hormone replacement therapy and to recommend supplements for adrenal support.

Thyroid Deficiency

Is your “accelerator” slow?

It is estimated that as many as 59 million Americans have a thyroid problem. The thyroid is a butterfly-shaped glad located in the neck and is the master gland of metabolism. To use an analogy, this gland works as the body’s “accelerator”. When your thyroid doesn’t function properly, it can affect every aspect of your health including weight, mood and energy levels.

Here are some of the most common signs that you may have a thyroid condition:

  • Muscle and Joint Pains
  • Neck Discomfort
  • Hair/Skin Changes
  • Depression and Anxiety
  • Weight Changes
  • Fatigue

Thyroid hormone exists in two major forms, an inactive form called Thyroxine (T4) and an active form called Triiodothyronine (T3). A drop in T4 and T3 levels can lead to hypothyroidism which is the second leading cause of high cholesterol. When levels drop, the liver no longer functions properly and produces excess cholesterol, fatty acids, and triglycerides, which increase the risk of heart disease.

Call us today to learn how we can work with you and your practitioner regarding testing and customized dosing of thyroid hormones to help get you back to feeling yourself again.

February is American Heart Month

February is American Heart Month and February 7th is National Wear Red Day, a reminder to women and those who love them to take action against the #1 killer of women – heart disease. Nearly 1 in 3 American women has high blood pressure, and 80% of women ages 40 to 60 have one or more risk factors for heart disease. Taking good care of your heart means controlling those risk factors, such as high blood pressure, high blood cholesterol, diabetes, smoking, physical inactivity, and being overweight.

A woman’s natural estrogen supply may also reduce her risk of developing heart disease. A study by researchers from University Medical Center, Utrecht, the Netherlands, found that women who were 52 or older when they entered menopause saw an 18% decrease in cardiovascular disease, when compared to women who entered menopause at age 44 or younger. This suggests that the longer a woman holds onto her natural estrogen supply, the less likely she is to suffer from cardiovascular disease.

Here at RxUnlimited Pharmacy, we specialize in hormone replacement therapy. Our compounding pharmacists will work with you and your doctor to compound the necessary hormones in individualized strengths and dosage forms to meet your unique needs.

Stop in today and speak with one of our compounding pharmacists or fill out our online consultation form to set up an appointment for a personal review of your symptoms and health history. http://www.rxunlimited.com/female_health_history.html

New Year, New You!

If one of your New Year’s resolutions is having healthier skin, then RxUnlimited Pharmacy can help! Our experienced compounding professionals create customized therapies to help combat a vast array of dermatologic conditions. Your complexion is the face you meet and greet the world with, and we can help make it the face (and body) you are excited to have the world see. Medications can be added to novel bases to improve the appearance of old or new scars, keloids, or stretch marks. We precisely compound the proper dose of each medication into cosmetically appealing topical creams, sprays, and powders. In addition, we can compound medications such as numbing creams, skin-whitening formulas, facial masks and acne preparations.

Melasma, or discolored skin, is a common hyperpigmentation disorder that affects mostly women. The actual cause of melasma is unknown, but experts believe the condition is hereditary. Sometimes called the “mask of pregnancy”, melasma causes brown or grayish-brown patches to appear on the cheeks, nose and forehead. The culprit is hormones, which fluctuate wildly during pregnancy. Other melasma-triggering factors include birth control pills, hormone therapy, certain medications or cosmetics, and the sun. Melasma usually fades on its own, either after delivery or once you stop taking hormones or birth control pills. But if discolored skin does not lighten, ask your dermatologist about treating the area with topical steroid creams, chemical peels, microdermabrasion, or laser treatments.

If you struggle with facial and body acne, unsightly scars, rashes, eczema, dry or painful skin, scars, cuts, and/or wounds, contact us today to see how we can partner with you and your practitioner to offer customized care for all of your needs.