USA Endocrine Society hits compounded hormones and saliva testing

Posted 21 June 2016

The Endocrine Society has updated its statement on compounded “bioidentical hormones” and is urging clinicians not to prescribe them.

[Santoro N and others. Compounded bioidentical hormones in endocrinology practice: An Endocrine Society scientific statement. Journal of Endocrinology and Metabolism 101:1318-1343, 2016]

The document states:

“Much of the advertising associated with these custom-compounded preparations implies that naturally occurring hormones are superior to synthetic hormones and compounded formulations are better than FDA-approved formulations. In some instances, the purveyors . . . claim to produce combinations of hormones that mimic the circulating hormonal milieu of young adulthood and therefore prevent various ravages of aging. In the most extreme cases, advertisers imply that compounded natural hormones are risk-free when compared with conventional menopausal hormone therapy that uses bioidentical and/or synthetic hormones. . . . However, very few (if any) of these claims are supported by research, and in fact, many compounded natural hormones have been associated with risks and side effects

Overall, there is a general lack of standardization and quality control regarding how custom-compounded bioidentical hormones are produced and administered, leading to the possibility of overdosing, underdosing, or contamination. There is also recent evidence of patient harm and death associated with treatment, as seen with fungus-contaminated glucocorticoid preparations. With estrogen, progestin, and dehydroepiandrosterone treatments, the practice of baseline hormone measurements to replace “abnormal” hormone deficiencies has no basis in medical practice. Furthermore, there is no evidence that monitoring compounded hormone therapy with serial salivary or blood testing is effective, except in the case of thyroid hormone. Finally, no evidence supports the popularized notion that custom-compounded bioidentical hormones have fewer risks when compared with FDA-approved hormone treatments”. 

[Source: Consumer Health Digest #16-23, June 19,  2016]

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