Welcome everyone to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

Today’s podcast is a follow-up conversation with Congresswoman Diana Harshbarger about the state of compounding pharmacies (guidelines, regulations, drug shortages), and the confusion surrounding bioidentical hormone replacement therapy (BHRT). As I mentioned last week, Diana is not only a congresswoman, but also a licensed compounding pharmacist. What better person to be in congress than a compounded pharmacist? An agent of change! 

With that introduction, here are my Notes to help guide you through the podcast.  



Bioidentical Hormone Replacement Therapy (BHRT)


  • When the WHI (Women’s Health Initiative) came out, it really did a whole generation of women a disservice by denying them hormones. (1:44)
  • BHRT (Bioidentical Hormone Replacement Therapy) does not cause cancer or heart disease. It prevents it. (2:08)
  • Bioidentical hormones really got me into the world of functional medicine. It’s the cornerstone of anti-aging. (10:46)
  • There is no better treatment for osteoporosis than BHRT. (11:49)
  • You can’t patent a naturally occurring substance like your estrogen and progesterone. There’s no money in BHRT for pharmaceutical companies. (12:58)
  • In the eighties, the number one prescribed drug was Premarin. If you do a little research on Premarin and how it’s metabolized into equine horse estrogens, only one of them is remotely similar to what a woman makes, and it’s the one that can cause breast cancer. (13:30)
  • In general, when women come to see me, the major complaints are they can’t sleep, have no sex drive, and they are depressed. They are not deficient in Prozac. They are deficient in progesterone. (14:12)
  • Testosterone does not cause prostate cancer, or even prostate enlargement, but estrogen can. (15:56)
  • You really need to know what you’re doing if you do hormones. There are a lot of nuances to it. (16:46)
  • Infertility is huge. (18:10)


Compounding Pharmacies


  • I’m having a hard time getting some of the compounded medicines that I want because the FDA does not like compounded medicines or compounders. (2:40)
  • Compounding pharmacies require additional training. You need to be PCAB accredited by PCAB boards, and you have to go through extensive training. Sterile means IV products, and non-sterile means you can compound anything and formulate things that would benefit the patient. It could be capsules, or topicals. (3:19)
  • Compounders step in when there are drug shortages. (5:11)
  • Everybody uses compounded pharmacies. (6:10)




  • The FDA is putting barriers up to compounders and physicians wanting compounded medications for their patients because they say it’s “an inordinate amount”. When asked what is “an inordinate amount” they can’t give you a number. (19:53)
  • The sad fact is the FDA does not like compounded pharmacies. What’s happening with Ozempic and Monjouro is a great example of this. People can’t afford Ozempic or Monjouro for weight loss. 
  • FDA revolving door. When the head of the FDA is finished with the FDA, they go and sit on the board of one of the big pharmaceutical companies. When they are finished with that they come back to the FDA. (20:27)

The bottom line is you can’t understand medicine unless you practice it. That is why Diana Harshbarger is so valuable to our congress. She understands medicine. Her knowledge, experience, and passion for problem solving is helping to change the state of our country’s healthcare system. A huge thank you!

As always, do your research. Stay educated. Stay healthy.  

Till next week. 

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