MD Custom Rx Logo

19035 W. Capitol Drive, Suite 102
Brookfield, WI 53045

Phone: 262-373-1050
The Mortar & Pestle
MD Custom Rx's monthly e-newsletter
March 2015   
Quick Links

PCAB


 
Like us on Facebook 
www.mdcustomrx.com
Thank you for entrusting in the compounding services at MD Custom Rx to help meet the unique medication needs of your patients.  We are excited to share with you our monthly newsletter and look forward to continuing to be your medication problem solvers.  Please don't ever hesitate to let us know how we can be of further assistance to you and your practice.
 
Sincerely,
John, Dan and Monica
Memory Loss Associated with Alzheimer's Reversed for First Time

   A broader-based therapeutic approach, rather than a single drug, may be feasible and potentially more effective for the treatment of cognitive decline due to Alzheimer's. In the first, small study of a novel, personalized and comprehensive program to reverse memory loss, nine of ten participants displayed subjective or objective improvement in their memories beginning within three to six months. Six patients were able to return to their jobs or continue working with improved performance, and their improvements were sustained for up to two-and-a-half years at the time the results were reported.

   The study was conducted Dr. Dale Bredesen of the UCLA Mary S. Easton Center for Alzheimer's Disease Research and the Buck Institute for Research on Aging. It used a complex, 36-point therapeutic program that included:
  • eliminating all simple carbohydrates, gluten and processed food from the diet, and eating more vegetables, fruits and non-farmed fish
  • meditating twice a day and beginning yoga to reduce stress
  • sleeping seven to eight hours per night, up from four to five
  • taking melatonin, methylcobalamin, vitamin D3, fish oil and coenzyme Q10 each day
  • optimizing oral hygiene
  • balancing hormones with appropriate hormone replacement therapy
  • fasting for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime
  • exercising for a minimum of 30 minutes, four to six days/week
   The results suggest that memory loss may be reversed and improvement sustained with the therapeutic program, but Bredesen cautioned that the results need to be replicated in a larger study.

Reference:
Estriol: Its Weakness is Its Strength

   Estriol is one of the three principal estrogens produced by the body. Studies suggest that estriol reduces symptoms of menopause, such as hot flashes and vaginal dryness, but with a better safety profile when compared to more potent estrogens and synthetic or horse-derived hormones. When estriol is administered topically, it does not increase the risk of hormone-dependent cancers of the breast or endometrium (uterine lining).

   Estriol offers a wealth of potential health benefits-it helps relieve menopausal symptoms while benefitting bone and urinary tract health. Estriol may also help improve cardiovascular risk factors and even shows promise in reducing the brain lesions of multiple sclerosis.

   Estriol offers breast protection; and several studies suggest that the use of topical natural progesterone cream may further reduce the risk to the endometrium. On the contrary, when testosterone is administered, it can aromatize to estradiol and the patient can experience the side effects of estradiol, including endometrial hyperplasia if progesterone is not administered.

References can be found on this link:
http://www.lef.org/Magazine/2008/8/Estriol-Its-Weakness-is-its-Strength/Page-01
Vaginal Hyaluronic Acid for Vaginal Dryness:  Comparison to Estriol

   In a multicenter, randomized, controlled, open-label, parallel- group trial, hyaluronic acid vaginal gel was compared to estriol vaginal cream in women with vaginal dryness due to various causes. A total of 144 postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. During telephone contact after the third administration, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream. At the final visit after the tenth administration (V2), the percentage improvement rates were 84 and 89 %, respectively. Improvement rates for vaginal itching, burning, and dyspareunia at V2 were about 86, 85, and 57 % for hyaluronic acid vaginal gel, and 82, 87, and 62 % for estriol vaginal cream, respectively. After treatment, vaginal pH was significantly lower in estriol-treated women compared to those having received hyaluronic acid. Endometrial thickness did not differ between groups. The proportion of women whose abnormal vaginal microecological results became normal was higher in women using estriol vaginal cream. Adverse events that were suspected to be related to the investigational compounds were minor and included vaginal infection and genital itching. The authors concluded that hyaluronic acid vaginal gel was not inferior to estriol vaginal cream in women presenting with vaginal dryness. They suggested using hyaluronic acid vaginal gel not only as an alternative treatment to vaginal estrogens, but also to consider its general use in women presenting with vaginal dryness of any cause.

Hyaluronic acid vaginal gel and estriol vaginal cream can be compounded by prescription.

Topical Melatonin:
Protective Effects Against UV Radiation


    Ultraviolet (UV) radiation is the main etiologic factor for skin cancer. The endogenous hormone melatonin has been proposed to have protective effects against sunlight and topically-applied melatonin has a protective effect against UV-induced erythema.  Four human studies and 16 experimental studies evaluated melatonin's protective effect against UVR-induced damage to cellular structures and pathways. Melatonin acts directly as an antioxidant, and indirectly by regulating gene expression and inducing a DNA stabilizing effect. The destructive effects of the UVR are significantly counteracted or modulated by melatonin in the context of a complex intracutaneous melatoninergic anti-oxidative system with UVR-enhanced or UVR-independent melatonin metabolites. Therefore, endogenous intracutaneous melatonin production, together with topically-applied exogenous melatonin or metabolites would be expected to represent one of the most potent anti-oxidative defense systems against the UV-induced damage to the skin. Treatment of the skin with melatonin 15 minutes before UV irradiation proved to almost completely suppress the development of an UV-induced erythema. In contrast, no significant protective effects of melatonin were observed when it was applied after UV irradiation. Free radical scavenging of UV-generated hydroxyl radicals and interference with the arachidonic acid metabolism are possible mechanisms of the melatonin action.

   Following topical application of 0.1% melatonin solution, plasma melatonin levels increased but did not exceed the physiological night peak.

Topical melatonin can be compounded by prescription.