What are bio-identical hormones, and how do they differ from synthetic hormones? 
Can you explain the process of preparing and customizing bio-identical hormones for individual patients? 
Sharon Higuchi: Bio-identical hormones (BHRT) are compounds that are structurally identical to the hormones naturally produced by the human body. They are typically derived from plant sources, such as soy and yams, and are processed to have the same molecular structure as endogenous hormones. 
 
How did you first become interested in bio-identical hormone therapy as a treatment for age-related issues?  
Sharon Higuchi: As a healthcare provider specializing in hormone replacement therapy (HRT) and neurodegenerative disease, my interest in bio-identical hormone therapy (BHRT) evolved from both clinical experience and personal health challenges. 
  For years, I watched patients struggle with fatigue, cognitive decline, metabolic dysfunction, and mood changes—symptoms that were often dismissed as “normal aging.” 
  Traditional medicine frequently offered band-aid solutions like antidepressants or statins, without addressing the underlying hormonal imbalances accelerating their decline.  
  My perspective changed when I personally faced health challenges that led me to explore hormone optimization, peptides, and regenerative medicine. Experiencing firsthand the transformative effects of BHRT—not just on energy and well-being, but on long-term disease prevention—solidified my passion for integrative and functional approaches to aging. 
  BHRT is more than symptom relief—it’s a powerful tool for preserving brain function, cardiovascular health, bone density, and overall vitality. Seeing my patients regain their mental clarity, strength, and confidence is what drives me every day. For me, hormonal health is foundational to longevity—and optimizing it is one of the most effective ways to enhance both lifespan and quality of life. 

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How Do They Differ from Synthetic Hormones? 
Sharon Higuchi:

 

Structure: Bio-identical hormones are identical in molecular structure to human hormones, whereas synthetic hormones have a slightly different chemical structure. 
Metabolism: Because they match natural hormones, bio-identicals are often metabolized in a way that mimics the body’s natural processes, potentially leading to fewer side effects.     
Administration: Bio-identical hormones are often compounded for individualized therapy, whereas synthetic hormones are typically available in standardized doses from pharmaceutical companies. 
Examples:  Bio-identical: Estradiol (E2), Estriol (E3), Progesterone, Testosterone.  • Synthetic: Ethinyl estradiol (found in birth control pills), Medroxyprogesterone acetate (Provera). 

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Customization of Bio-Identical Hormones 

Step 1: Patient Evaluation 
● Comprehensive Testing: Includes blood, saliva, or urine testing to evaluate hormone levels. 
● Symptom Assessment: Identifying symptoms related to hormone imbalance (e.g., fatigue, brain fog, insomnia, weight gain). 
● Medical History: Reviewing conditions like perimenopause, menopause, andropause, and other endocrine disorders. 

Step 2: Prescription Formulation 
● Custom Dosage: Unlike synthetic hormones, which come in fixed doses, bio-identicals can be tailored in strength. 
● Delivery Method: Bio-identical hormones can be prepared in various forms: 
● Creams/Gels: Absorbed through the skin. 
● Sublingual Troches: Dissolved under the tongue. 
● Capsules: Orally ingested. 
● Pellets: Implanted under the skin for sustained release.

Step 3: Compounding Process 
● Pharmacy Preparation: A compounding pharmacy formulates bio-identical hormones per the provider’s prescription, ensuring precise dosing. 
● Quality Control: Testing for purity and consistency is essential to maintain safety and effectiveness. 

Step 4: Monitoring & Adjustments 
● Regular Follow-Ups: Hormone levels and symptoms are reassessed regularly. 
● Dose Titration: Adjustments are made based on lab results and patient response. 

Why Choose Bio-Identical Hormones? 
● More Natural: Mimic the body’s hormones. 
● Flexible Dosing: Can be adjusted based on individual needs. 
● Potentially Fewer Side Effects: Lower risk of adverse effects compared to synthetic counterparts. 
● Age-Related Hormonal Changes 

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How do changes in hormone levels impact the aging process and overall health in men and women? What are the most common symptoms of hormone imbalances that you see in your practice? 
Sharon Higuchi: Hormones play a crucial role in maintaining homeostasis, and their decline is a major contributor to age-related deterioration. In both men and women, hormonal changes affect metabolism, cognition, cardiovascular health, bone density, and immune function. Understanding these shifts allows for targeted interventions to slow or mitigate the effects of aging. 

In Women: • Perimenopause/Menopause: • Hot flashes, night sweats • Mood instability, anxiety, depression • Brain fog, memory issues • Weight gain, slowed metabolism • Insomnia, fatigue • Vaginal dryness, decreased libido • Osteopenia/osteoporosis • Estrogen Dominance (low progesterone): • Breast tenderness, fibroids • Heavy, irregular periods • Irritability, anxiety • Low Testosterone/DHEA: • Loss of muscle tone • Reduced motivation, drive • Low libido, vaginal atrophy • Increased fat accumulation

In Men: • Low Testosterone (Andropause): • Decreased energy, motivation • Loss of lean muscle mass • Increased body fat, especially visceral • Erectile dysfunction, low libido • Depression, brain fog, irritability • Sleep disturbances • Cortisol Dysregulation (Adrenal Dysfunction): • Chronic fatigue, burnout • Increased belly fat • Sugar cravings • Poor stress resilience • Growth Hormone Deficiency: • Loss of muscle, increased frailty • Slow recovery from exercise • Sagging skin, wrinkles • Increased cardiovascular risk Indications for BHRT 

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How do you ensure that patients are fully informed about both the benefits and potential risks of BHRT? 
Sharon Higuchi:  BHRT is generally well-tolerated when properly prescribed and monitored, but like any medical intervention, it comes with potential risks and side effects. Since you have extensive experience in HRT, you likely approach these risks with a precision-based, patient-centered approach, ensuring safe and effective therapy.

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Public Perception and Education 

What do you think is the biggest misunderstanding people have about BHRT? 

 “BHRT and Synthetic Hormones Are the Same” 
False: Bio-identical hormones match human hormones exactly, while synthetics (e.g., Premarin, Provera) have altered structures with more risks. 

“BHRT Causes Cancer” 
False: The WHI study linked synthetic progestins—not bio-identical progesterone—to breast cancer. Transdermal estradiol does not increase clot risk. 

“BHRT Is Only for Menopause” 
False: It benefits men and women for bone, brain, cardiovascular, and metabolic health at any age. 

“Testosterone Therapy Is Dangerous for Men”
False: TRT does not increase prostate cancer risk; it improves muscle mass, cognition, and cardiovascular health when properly monitored. 

“Diet & Exercise Are Enough” 
False: Lifestyle helps, but hormonal decline accelerates aging—BHRT restores optimal function. 

“One-Size-Fits-All” 
False: BHRT requires personalized dosing based on labs, symptoms, and response. 

“You Can’t Stop Once You Start” 
False: BHRT isn’t addictive—it can be adjusted or discontinued as needed. 

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How long does it typically take to see noticeable results from BHRT?  

Improvement Area Expected Results Timeline:
● Energy & mental clarity 2-6 weeks 
● Mood & emotional stability 4-8 weeks 
● Libido & sexual function 2-8 weeks 
● Muscle tone & fat loss 8-12 weeks 
● Skin & hair health 3-6 months 
● Bone density & CV health 
● Safety and Risks 3-6 months+

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