Mixtures Pharmacy
HRT for Women

Hormone replacement therapy (HRT) is the practice of correcting hormonal deficiencies that occur due to illness, aging, medication side-effects, etc. The hormones we compound with at Mixtures are of plant origin and are naturally occurring. Women suffering from hormonal imbalances may experience problems with their mood, energy, and libido, as well as a change in the consistancy of their skin, muscle, hair, and bones. HRT prescription compounds are commonly dispensed as lozenges/troches, creams, and capsules. We can work with your doctor to find the right hormone replacement prescription for you. Follow the link to the left to schedule a consultation and get started.

Estrogens

Women with low estrogen typically experience symptoms like night sweats, hot flashes, sexual dysfunction and discomfort, and some urinary disorders.

Progesterone

Progesterone is often used in HRT to prevent estrogen dominance and to treat insomnia and anxiety that can affect women experiencing menopause. It can also be used to regulate menstrual cycles.

Androgens

The most common androgens used in HRT are testosterone and dehydroepiandrosterone (DHEA), both of which typically decline as a woman enters menopause.
HRT for Men

Customized Hormone Replacement Therapy (HRT) is the replacement of deficient hormones with hormones that are identical to those that the body naturally produces. Hormone deficiencies can occur due to aging, illness, other medications, or environmental factors. Beginning at approximately 40 years of age, a man’s hormone levels, particularly testosterone, slowly decline. Approximately 30% of men aged 60-70 years and 70% of men aged 70-80 have low levels of testosterone, a condition often called “andropause” because testosterone is in a class of hormones known as androgens.

Testosterone

HRT for men primarily involves testosterone replacement therapy (TRT). However, it also may include other hormones such as DHEA and pregnenolone.

Why TRT?

Replacement of these hormones has improved the quality of life for millions of men who suffer from hormonal imbalance.

Maintenence

The ideal process for achieving hormonal balance includes an assessment of hormone levels through saliva or blood tests, then assessment of signs and symptoms, followed by replacement of the deficient hormones.
Skin Care

There are many skin conditions that can be addressed with compounded medication. From warts to toenail fungus to hair loss and skin care we can compound your prescription. If you need a higher percentage of active ingredients to lighten the dark spots on your skin, we can customize that for you. We can add other ingredients that help accelerate the turn over of your skin cells, reduce inflammation, and reduce melanin production which causes hyperpigmentation.

ACNE / ROSACEA / MELASMA

Acne may be caused by hormonal imbalances or bacteria. There are many options that can address your specific type of acne. Rosacea may also have small pimple-like pus filled bumps along with increased redness on cheeks, nose, chin and sometimes the chest or décolleté. Some patients may use ingredients like Azelaic Acid and Ivermectin that are helpful in reducing the inflammation and redness caused by rosacea. Some people are prone to spots or patches on the face that are darker than your natural skin color, known as Melasma. Many refer to this as a pregnancy mask since it typically affects women more than men and is commonly associated with the hormonal changes due to pregnancy.

SCARRING

Scars are the result of wound repair in the skin and are the body’s way to heal and replace lost or damaged skin. A scar is usually composed of fibrous tissue that has been formed as a result of infections, surgery, injuries, or inflammation of tissue. Scars may appear anywhere on the body, and the composition of a scar may appear flat, lumpy, sunken, or colored and may be painful or itchy. There are options that can help soften the fibrous tissue and reduce the tightness and appearance of the scar tissue.

Others:

Hair loss is an area where many patients are looking for solutions. Warts are not generally life threatening but can be bothersome and/or unsightly. Some examples of compounds that help eliminate the warts are Squaric Acid, or Salicylic Acid with or without Urea. Nail fungus has many options. Some choose topical options that don’t have the potential systemic effects like oral treatments.
Mouthwash

Mouthwashes can be useful for a variety of reasons. The most common source of mucositis in the mouth and esophagus is due to chemotherapy and/or radiation. Oral infections can cause painful sores and inflammation and mouthwashes can give temporary relief. There is not a standard formula for mouthwashes so your compound can be changed to address your issues. Most mouthwashes use a combination of over the counter products and prescription medications. You will generally be directed to swish and spit or swish, gargle and spit the compounded mouthwash. We generally don’t suggest swallowing the ingredients because it may upset your stomach. If you do swallow the mouthwash, it isn’t a problem, just be cautious because most of them contain numbing agent(s). Your mouthwash may contain an anticholinergic or antihistamine to help ease your pain, a local anesthetic to relieve pain, and an antacid to spread the ingredients around and create a mucoadhesive to allow for longer contact of the ingredients. You might also have an antibiotic or antifungal to kill bacteria or stop fungal growth or a steroid for additional inflammation control in your compound.
Thyroid

Your thyroid is a butterfly shaped gland just below your voice box. This gland is very busy producing primarily T4(Levothyroxine) with some T3 (Liothyronine). If everything works like your body intends, a signal called Thyroid Stimulating Hormone (TSH) is sent from the pituitary gland in your brain asking for the thyroid gland to produce T4 and T3. When the TSH is elevated, that generally means your brain/pituitary gland isn’t happy and is asking for more production of thyroid. If the TSH is suppressed, then the brain/pituitary gland is getting sufficient feedback and doesn’t need additional production of thyroid hormones. There are many ways your body may feel an imbalance of thyroid hormones. There may be a production issue (not enough or too much), there may be an issue with getting the thyroid hormones into the cells (functional hypothyroidism), a conversion issue where the body doesn’t create enough active T3, or there may be an autoimmune condition where the body attacks the thyroid gland (Hashimoto’s). There are other thyroid disorders that a specialist may diagnose you with beyond these commonly diagnosed issues.

T4 - Levothyroxine /
T3 - Liothyronine

These thyroid hormones are considered “bio-identical” which means they are an exact chemical structure match of what your body produces. They are also considered “synthetic” since there isn’t a natural source to harvest these hormones, so they are bio-synthesized in a lab using tyrosine and iodine, both of which are natural products.

Thyroid USP

This glandular extract is generally porcine (pig) derived. The porcine glands are freeze-dried and the T4 and T3 are tested so the USP formulation contains 38mcg of T4 and 9mcg of T3 per every 60mg of powder. The benefit of the glandular comes from the combination of both T4 and T3 as well as the other factors that are not measured but found in the glandular powder. These factors include the glandular tissue, naturally occurring co-factors of T2 and T1, and minerals that support the glands like calcitonin and trace amounts of iodine. The drawback of Thyroid USP is the consistent relationship between the T4 and T3. When the dose is changed, both active ingredients change.

Hashimoto’s Disease

Hashimoto’s is generally diagnosed by your doctor or endocrinologist as a result of elevated antibodies, generally Thyroid Peroxidase Antibody (TPO) but sometimes Thyroglobulin Antibodies (TgAb). When the initial antibody attack begins there are elevated (hyperthyroid) levels of T4 and T3, which are generally due to the thyroid antibodies attacking the thyroid gland and releasing stored thyroid hormones. Once the body has run out of the stored thyroid hormone and has reduced the ability to make T4 and T3, the patient will convert to hypothyroid (low thyroid) due to Hashimoto’s. One of the effective treatment options is compounded Low Dose Naltrexone (LDN).
Pediatrics

Congratulations on your family addition! Unfortunately kiddos don’t come with an instruction manual. If a situation arises where your child is uncomfortable or as a new mom you are finding breastfeeding painful, we have options to help you.

Diaper Rash

It is so challenging seeing a little one in so much pain because of a rash in their diaper area. Once it is red and inflamed it takes special ingredients to create the barrier and to bind the bile salts that are continuing to irritate the area. Cholestyramine was developed to reduce cholesterol by binding to the bile salts and by using it topically we can neutralize the bile salts that are causing the diaper rash. When mixed with a barrier cream it will protect the skin and allow the area to heal. Your doctor will have you apply it to the rash after each diaper change. We find that one or two applications can reduce the pain so your little one isn’t so uncomfortable. Continue to use it until the rash has healed completely.

Tummy Trouble

Just like adults get heartburn, so can little ones. Probiotics are available OTC and may help by providing the correct flora for their gut. If that isn’t enough your pediatrician may recommend a compounded medication that can help address the acid production. These are dosed and flavored per your little one’s needs.

Breast Feeding

If you are trying to breastfeed and have sore and/or cracked nipples, your doctor can write for a compound we call All Purpose Nipple Ointment (APNO). This has several ingredients to ensure you don’t have a bacterial or fungal infection mixed in a barrier cream. Your doctor will generally have you apply it to the nipples after each feeding and not wipe or wash off before the next feeding.
Pain Relief

Pain can have many sensations such as neuropathy, inflammatory, burning or itching. Topical pain management was commonly referred to as transdermal pain therapy. We now refer to it as permeation-enhanced topical pain therapy (PETPT) because “transdermal” is now primarily associated with manufactured patches like fentanyl, not compounded creams or gels. Because we can get a large amount of active ingredients directly to the affected area in a permeation enhancing base, this is a major benefit to compounding and applying topically. Oral doses must be absorbed and then distributed systemically. Which results in a relatively low dose ultimately arriving at the affected site. The oral dose needed to achieve therapeutic activity at the affected site often manifests as unwanted side effects (gastric distress, sedation, hypotension, etc.). As a result, the use of topical pain medications using a permeation enhancing base may be considered a viable alternative to oral pain therapies in many patients. There are a multitude of studies to show the active pharmaceutical ingredients we use have merit and clinical relevance today. The best pain medication is the one that addresses your pain.

Acute vs Chronic Pain

Acute pain happens quickly and once the underlying issue is fixed will go away. Chronic pain is defined as pain lasting longer than 6 months and can continue after the underlying issue has been fixed. Chronic pain serves no biologic function as it is not a symptom of a disease process but is a disease process itself. There are two types of chronic pain: inflammatory nociceptive pain and neuropathic pain.

Neuropathic Pain

People describe nerve pain as a shooting, burning pain. This pain may be constant or happen intermittently. Sometimes it can feel sharp and sudden like an electric shock. It can sometimes occur as a result of touch that would normally not be painful, like something lightly brushing your skin. Neuropathic pain is produced by damage to the neurons in the peripheral and central nervous systems and involves sensitization of these systems

Inflammatory Pain

Inflammatory nociceptive pain is associated with tissue damage and the resulting inflammatory process. It is adaptive in that it elicits physiologic responses that promote healing. Based on visual observation by Celcius in De Medicina self published in A.D. 25 he characterized inflammation by five cardinal signs, namely redness (rubor), swelling (tumor), heat (calor; only applicable to the body' extremities), pain (dolor) and loss of function (functio laesa). These 5 signs still apply today.
Veterinary

At Mixtures Pharmacy, we compound customized medications and utilize novel delivery systems to meet specific needs of pets, exotics, wildlife, and zoo animals. We can prepare formulations containing the precise dose of active ingredient(s) which will be most effective, in dosage forms that can be conveniently administered, well tolerated, and are appropriately flavored. Our state-of-the-art equipment, specialized training and extensive support network, combined with years of experience, make Mixtures Pharmacy unique. We will work together with the veterinarian and client, integrating your knowledge of the animal’s preferences (and the animal’s response) to formulate creative compounds which can improve compliance, maximize the potential for therapeutic success, and potentially reduce the overall cost of animal care.

Dogs

We can help with hard-to-find medications for urinary incontinence, valley fever medication, pain management, gels for ear infections, liver/gallbladder medication, and anti-anxiety medication to name a few

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Cats

Cats can be notoriously difficult medicine takers. We can compound a permeation-enhanced topical therapy (PETT) as an alternative delivery system to apply to the inner ear of your feline friend, commonly for hyperthyroid or anxiety. We can make a tasty suspension for their inflammation and GI issues.

Other Pets

We work with all your feathered, furry and scaled friends. We can make concentrated solutions for birds, turtles and reptiles. We work with ferrets, rabbits, hedgehogs, guinea pigs and many other pets.