Shaun Noorian
Appearances
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Coming up on this episode of The Doctor's Pharmacy. May utilize active pharmaceutical ingredients that have been FDA approved, but in order for a drug to be considered FDA approved, it has to go through the FDA approval process. And that process may take 10 plus years and billions of dollars. Well, that may not make sense for a small patient population that needs their medications today.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
They take more blood, see how their body has responded, and then adjusting therapy accordingly and sending that new compound to their compounding pharmacy to fill. Are you comfortable sharing other things that you use in your stack of things that you... Oh, so I use methylene blue, testosterone, of course.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
We make a topical hair product called Hair Restore Ultra that has minoxidil, azelaic acid, finasteride, and ketoconazole.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right, right, exactly. Combining multiple active ingredients, pretty much doing polypharmacy, but putting everything into a single dosage form. So it makes it much more convenient for the patient. It makes the patient more compliant and also makes it a lot more cost effective making, you know, providing one drug instead of having the patient apply four different drugs.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Yes, there's less absorption when the medication is applied topically than if a similar dose was taken orally. And so the patient, they get more of the local effects without it becoming systemic, becoming too systemic versus other dosage forms. And yes, drugs like finasteride can become debilitating for many men
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
not just causing erectile dysfunction, but a subset causing post-finasteride syndrome, which they never regain their libido after. And that's- That's a scary thing.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Yeah, my acne cream. So we have different forms of acne cream. One that I utilize has tretinoin, clindamycin, and niacinamide. I use that every three, four days. And then one that I use every night is what we call AcneDNS. It has dapsone, niacinamide, and spironolactone.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And by combining all these different drugs and vitamin together, it makes it much more convenient for the patient, applying one medication instead of three. And as I mentioned, because of Copping Pharmacy, we are kind of like a vertically integrated supply chain
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
We buy our drugs directly from the active pharmaceutical ingredient manufacturers that the rest of pharmaceutical manufacturers purchase them from. And because we don't have to, we probably don't work with insurance, we don't deal with carriers or PBMs, and we go directly to the patient working with the prescriber.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Exactly. And what we've done is we've become an FDA registered manufacturer. and 503b outsourcing facility. An outsourcing facility is a hybrid compounding pharmacy slash drug manufacturer that the FDA created in 2013 to meet the needs of practitioners that want to order products for office use. And then we have our pharmacy, our 503a compounding pharmacy.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
that makes medications at the bequest of a provider, but dispenses them directly to patients to self-administer. And then we've also become a wholesaler as well. So we are the manufacturer, wholesaler, and pharmacy, all vertically integrated into one. And by not accepting insurance, carriers and PBMs are out.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So it's a fully vertically integrated supply chain that works directly with every single pharmaceutical end user in this country. And you get the medications at a much lower cost because the lack of all these unnecessary middlemen.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Exactly.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
You know, I'm always experimenting with different forms of testosterone. There's testosterone cypionate and nanthate. You know, we actually make a combination of testosterone cypionate with a bit of testosterone propionate, which is a much faster-acting ester. The pharmacokinetic half-life of testosterone cypionate is about a week long. And the half-life of propionate is about two days.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so you can get a much different pharmacokinetic response and peak than you would be able to by just utilizing a single ester by itself.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Yeah, it's a good question. You know, compounding pharmacies, as I mentioned, they've been around since the beginning of time. And they've been around before big pharma was around. And they're governed by the state boards of pharmacy, as well as the FDA.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And the rules around making drugs, especially drugs that are destined to be injected into people, they are some of the strictest rules of any industry. And so state boards, they inspect compounding pharmacies every single year. And, uh,
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
ensure that the rules that are primarily the United States Pharmacopeia, the standard setting organization for all drugs that are made in pharmacies, the rules that they set are being abided by.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And then of course the FDA got jurisdiction of the practice of pharmacy in 2013 with the passage of the Drug Quality Security Act because of that fungal meningitis outbreak that happened in 2012 from a company called NECC or New England Compounding Centers. And that pharmacy made one bad batch, or I should say three bad batches, and killed 70 people and injured 700 or more.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so the FDA, so Congress then came in and said, how can we prevent this from happening again? And that is how the Drug Quality Security Act was passed. And this new category of 503B outsourcing facilities was created where the drugs that come from these facilities are made under good manufacturing practices or CGMPs, the same standards that the pharmaceutical industry uses.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
You know, company pharmacies, you know, one – People, a lot of prescribers prefer to use a compounding pharmacy for a patient because they can be assured that they are getting exactly what the doctor ordered. What strength is labeled on that vial will be what that strength should be because of all the rules and regulations around the practice of compounding and manufacturing drugs in this country.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So that's really why we see practitioners utilize compounding pharmacies versus sending a patient to get maybe a topical progesterone cream that's maybe over-the-counter or a DHGA supplement from a supplement store. We have to test our products to meet these standards, especially if they're made at our 533 outsourcing facility.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Every single batch has to be tested for potency, sterility, endotoxin, a slew of other tests to ensure... safety.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Yeah, so when it comes to the utilization of one dosage form versus another, whether it's better for a patient to use a capsule, a topical cream, or an injection, it's really up to the prescriber to determine what is the best form of treatment to the patient for them to be compliant with their therapy, first of all, because for subcutaneous implantable hormone pellets,
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
you only have to do those about once every three months. And so a patient that travels a lot or may forget to take a daily or weekly cream or injection, that may be more convenient for that patient. But for patients that don't want or afraid to do injections, maybe a topical cream or a trochee is more appropriate. And so that's the beauty of utilizing a compounding pharmacy.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
We can make whatever you think is best for your patient.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Prescribers can utilize a drug for any indication, whether it's on-label or off-label. if he or she believes it will have a clinical effect for that patient. And so the practice of using medications for off-label use is perfectly normal and allowable.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And a lot of doctors, almost all medications in compounding are used for off-label use because no compounding pharmacy makes a drug that is FDA approved. We may utilize active pharmaceutical ingredients that have been FDA approved, but in order for a drug to be considered FDA approved, it has to go through the FDA approval process. And that process may take 10 plus years and billions of dollars.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, that may not make sense for a small patient population that needs their medications today. And so that's why doctors utilize compounders to make these medications for what may be considered off-label use for whatever they think is best for that patient.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Absolutely. We've seen sexual wellness come a long way over the past years, especially for men. Women, unfortunately, don't have many FDA-approved options out there. There are only two on the market.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right, right, yeah. You know, Addi, which was the first drug approved for female sexual hypoarousal disorder, it is an oral pill, generic name is fibanserin, and it may help increase feelings of desire. And then the second one that's FTE approved, which recently got approved several years ago, is known as bremalenatide, another brand named Bilisi.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so these are drugs that can be combined with each other by utilizing a compounding pharmacy to make a different dosage form, like the injection may be only available for melatonin, but a compounding pharmacy may be able to use it as a trochee for buccal or sublingual absorption. And combine other drugs like oxytocin, phentolamine mesylate. We can even combine- What's that? It's a vasodilator.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And it's actually used in intracavinosal injections as well. So for men that fail on oral PD-5 inhibitors like Viagra, Cialis, and Levitra. They can then utilize, they can work with a compounding pharmacy and a urologist to have prescribed a combination therapy of papavarin, phentolamine mesylate, and prostaglandin that can then be injected in the side of the penis in the corpora cavernosa.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Trimix, exactly. Yeah, and that's another option that patients have. Whereas if they fail on sildenafil, tidalafil, or vardenafil, they have another option before they have to go to a penile prosthesis. Yeah. And that's kind of less. That's a penile implant. That's right, exactly.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so that's an example of where practitioners can utilize a compounding pharmacy to create an effective drug that is not commercially available.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Oh, it's been used for decades.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So peptides are very powerful substances. You know, as we've seen.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Absolutely. And because they're so powerful, they are considered drugs. And in order for a compounding- So is your poop now, you know that?
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Yeah, exactly. There's so many different therapies that the FDA has determined meet the classification of a drug and not a supplement, and therefore require the supervision of a prescriber to be able to ensure that the patient utilizes that medication safely and efficaciously.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And when it comes to the list of peptides that have names that contain letters and numbers like BPC-157 or CJC-1295 or AOD-96, exactly. Company pharmacies can only make drugs that have met one of three conditions. It has been a component of an FV-approved drug at some point in time. It has a USP or NF monograph.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And by the way, USP stands for United States Pharmacopeia and NF stands for National Formulary. These are the government bodies that oversee the practice of compounding. And if they've established a compendial certificate of analysis, you can show that that drug has been studied and that it's regarded as safe.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And then there's the third condition, which these drugs may have to be listed within what's known as category one of the 503 bulks list, which is a list of drugs the FDA has deemed safe and efficacious that neither have a USP or NF monograph and haven't been a component of an FDA-approved drug, but are considered safe and have been grandfathered in.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so these peptides have never been approved, don't contain a USP-NRF monograph, and aren't contained within category one of the five of the Bluxilis. So they've never been legal to be able to be made. Now, a lot of practitioners and company pharmacies have promoted these drugs over the years.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And now we see, finally, the states and federal regulators, the FDA, are taking action against compounding pharmacies for making these peptides because they were never supposed to be made in the first place.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Some of these peptides, while some are very safe and efficacious, others may not be. Some have failed clinical trials. Almost all of them have failed clinical trials, which is why they still have their letter and numbering system. For example, CJC 1295 stands for Conja Chemical, which is the name of the company that created the peptide and was studying it during clinical trials.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Now, those trials had to be ceased I believe in phase one for that drug because of patient death. And because of these drugs, they have significant effect, especially that one, on growth hormone release.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And this is why, you know, until these drugs become FDA approved, the FDA and state boards of pharmacy are not comfortable utilizing these drugs in a regulated... Do you think it's overreach or do you think that they're like, you know...
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Oh, pleasure to be on. Thanks for having me.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So to talk about peptides and the conspiracy theories, I've heard them all. And if you look at what the state and federal agencies are doing, all they're doing is the same thing they've always done, enforcing the rules and regulations that are currently in place. And so it's just a coincidence that peptides,
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
FDA is starting to put more attention to these peptides that weren't allowed to be made in the first place at the same time as semaglutide and terzapatide and other GLP-1s have been on backwater. It's really just about making sure that our drug supply chain utilizes drugs from regulated industries that are listed within that the FDA and state boards allow you to make.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Now, when we talk about other peptides like the GLP-1s, You know, company pharmacies have really stepped in and made a huge difference where there is a national and global shortage where Eli Lilly and Novo Nordisk, the makers of Wegovu, Wegovi, Ozembic, Zepound, and Mangiorno, the brand names for semaglutide and terzapatide, can't keep up with demand.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And during times where a drug is on shortage, the only other legal avenue for patients and prescribers to get access to these medications are through compounding pharmacies and outsourcing facilities. And that's one of the reasons why we exist, to be able to add additional supply to our country's supply chain during times of need.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Now, these drugs, yes, we pay a lot more for them in the United States than we pay anybody else.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
It's a good question. Because a lot of patients and prescribers, it's... They think that compounding pharmacies and outsourcing facilities, we get our active pharmaceutical ingredients off the street.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Nothing is further from the truth. We have to source, by law, we have to source our ingredients from the same exact places that pharma sources them from, FDA-registered active pharmaceutical ingredient manufacturing facilities. And so we get the same.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, the patent covers a certain dosage form, certain dosage strength, and certain indication.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
The active pharmaceutical ingredient, that is covered by a patent that covers a certain manufacturing process. If another API manufacturer uses a different manufacturing process, then it's not in violation of that.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right. And, you know, natural compounds, as you mentioned, insulin is a natural compound, but it is a drug. You know, anything that—what differentiates a supplement from a drug is that the drug has a significant effect biologically that needs a doctor's supervision for the patient to be able to safely take that medication. Right. Whereas a supplement, it's not going to have as much of an effect.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So it's considered safer for a patient to self-administer without the use or assistance of a prescriber.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so GLP-1s, they are very powerful when it comes to treating, as we know, type 2 diabetes, obesity, cardiovascular disease, you know, hepatic disease, addiction, and in some cases now there's some studies showing that it helped treat Alzheimer's, fertility issues, and the list just keeps going on and on.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right, because a lot of these other disease states are subsequent causes of obesity. And so obesity is one of the leading causes of death, because cardiovascular disease is the number one cause of death. Number two is cancer. Well, we know that obesity increases the risk of developing cardiovascular disease and cancer. Of course.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So by treating obesity, you really remove potential other comorbidities from happening in the first place or curing them.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
The dosing that the pharmaceutical companies have used, they have shown to the FDA and the panels of FDA experts that really decide whether a drug is safe and efficacious before it gets approved. They've proven that this dosing schedule and regimen will produce a certain effect. Now, that doesn't mean that prescribers have to use that exact dosing schedule and dose escalation.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
They can use whatever dose that they think is most appropriate for that patient. So for example, if a beginning dose that only comes in one strength with the commercial product causes nausea and some of these other side effects that you mentioned. They're stuck. They're stuck. Exactly. There's no other option. What are they to do? Well,
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
That prescriber can utilize a compounding pharmacy where a patient can get that medication instead of using the pen, take it out of a multi-dose vial using a syringe just like they would insulin or testosterone or any other medication that comes in the vial.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And administering a lower dose so that the patient doesn't have to experience that side effect. And then dose escalating slower than what the patient would do using a commercial product. Now, that's just an example. That's not always the case.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, the FDA-indicated use recommends once a week injections. Just like it's similar for testosterone. Testosterone is recommended to be dosed once a week, but we see prescribers dosing it, breaking that up into smaller injections, doing biweekly injections or injection twice a week. It's all dependent on what the prescriber thinks is best for their patient.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
A lot of these IV cocktails that these IV nutrition centers or mobile nurses are administering to patients, they are 100% bioavailable when infused. And some of these, you'd have to take tens of grams or hundreds of grams orally to be able to get an equivalent effect. And some of these, you can't take in those amounts.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
For example, vitamin C. If you take more than a gram, you're going to poop your brains out.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right. There's no way. You'd have to use it. You would poop your entire body out, I think, if you did that.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
It's not going to be an enjoyable experience, but it'll do the job. But, you know, if... For example, for oncology treatment, vitamin C has been known to be used off-label to potentially help the patient's immune system fight whatever disease. It's also been used to help fight viral or other infections.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right, right.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And we're starting to find out that natural vitamins, minerals, amino acids, they are the best form of medicine in a lot of cases. And by giving patients this medicine that they're typically lacking in their diet, we're almost all lacking the right amount of vitamins and minerals from the American diet.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
By infusing them, especially drugs that may be water-soluble, they are much safer than oil-soluble medications because the risk of overdose is lessened. And the body gets what it needs and typically passes out the rest.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Yeah, exactly. But for cases where the patient needs more hydration, like after a night of drinking, a hangover cocktail is very popular where it has a lot of the B vitamins, minerals, glutathione, maybe some Zofran for nausea, maybe, and of course, glutathione at the very end to help bring back the antioxidant.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right, exactly. Yeah, to help repair the liver after it's just gone through quite a battle. Yeah. with a very dangerous chemical. And so IV nutrition, we've actually seen it grow as the second largest area of growth in our company behind GLP-1s as that industry is growing about 25% a year.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
It is quite amazing. 25% more patients.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, it's never too late. I think one of the reasons why we see so many clinics doing this is because banana bags have been around in medicine forever. It's like the very first thing you pretty much give a patient whenever they come to a hospital.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
You're giving them B vitamins, riboflavin, which is what makes it yellow, and other minerals to help because almost all patients that introduce to the emergency center They all, they could benefit.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right, right. So you have immune cocktails with high doses of vitamin C. You have hangover cocktails with high doses of glutathione. You have beauty cocktails that have high levels of biotin. And then you have athletic cocktails that help with recovery by introducing amino acids like citrulline. to help patients improve the performance of their body.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And of course, getting it directly infused means that you're getting 100% of the drug bioavailable versus some amino acids you only absorb 5% when taking orally. So do you have a compound that you use called phosphatidylcholine IV? We made it before, but we no longer make it. I think it was used primarily for weight loss, spot reduction, but did not become very popularized
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And we saw that sales were decreasing over time as more and more providers were using other therapies.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
One, have so much respect for the academics that are doing all this research and introducing compounded therapies to show that they may treat indications outside of the indicated use. For example, nangelone decanoate, also known as decadrabilin, it's starting to be known that it helps treat osteoporosis and joint injuries.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
I'm very lucky to have been introduced to this industry that gives us the ability to help millions of patients get access to quality, affordable medicine. And if you think about compounding, compounding has been around since the beginning of time. Before big pharma existed, everything was compounded.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Right, right. And so we see a lot more prescribers getting comfortable with this medication that was primarily used to treat anemia, you know, several decades ago, also treating wasting syndrome for patients with AIDS, but also being now utilized for other indications. And so there's, you know, utilizing accompanying pharmacy
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
You can, because a lot of the medications that we prescribe don't have indicated uses or their prescribers utilizing it for a use that may not, the FDA approved drug may not have been studied under, they can use it for whatever treatment that they deem would have a clinically significant benefit to that patient.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so we've actually sponsored several studies utilizing compounded medications to see whether a patient, it'll work in a patient that the FDA-approved drug may not have worked for a different use. So we kind of are an experimental ground, if you want to call that, for prescribers that want to utilize a product that hasn't been on the market for one reason or another.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Please send me the formulation. I'd love to dig into it. I will.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
You can visit our website at empowerpharmacy.com, where we have a knowledge base and a drug catalog that lists everything you would need to know about the medications that we manufacture and produce. And also to educate prescribers on how to utilize some of these compounded medications in their practice. Also, if patients want to learn more about compounding, they can go to compounding.com.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
They can also ask their practitioner how they utilize compounded medications in their practice. And that's typically an indication if that practitioner is really a specialist at what they do. Because specialists, they will make something that is special. for that individual patient. And that's really where we see the future of medicine headed.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So I think compounding has a very important part to play in the future of our healthcare system. And we're very lucky to be able to benefit tens of millions of patients and soon hundreds of millions of patients across the globe. As we're not just sick here in the United States, there's a whole crisis, healthcare crisis that's going on globally that these types of medications can't address.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
I'm sure you can imagine pictures of an old apothecary where they're making a concoction at the bequest of the practitioner. and using mortars and pestles. Well, that is compounding. And before the industrialization of manufacturing for the pharmaceutical industry, everything was compounded.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Can't wait. I love being a mad scientist in my spare time. But thank you for what you do to bring access, knowledge, and different point of view to how medicine could be done in this country, because there needs to be a change as there is a crisis going on right now with healthcare costs and outcomes, given a certain amount of cost for that specific therapy.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So thank you for educating all of us and bringing us into the future of healthcare.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Pleasure's all mine. Thank you.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And it wasn't till the early 1900s where we saw that get transferred into factories away from the local apothecary or druggist. And by the 1930s, we saw about 75% of medications were compounded. Fast forward to the 1975, where it became only about 25% of prescriptions were compounded.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And then you fast forward to today, where only about 1% to 3% of compounded medications are prescribed in this country. Compounding has kind of gone the wayside over the past 150 years, but now we're seeing a resurgence because more patients and providers are becoming more knowledgeable about compounding pharmacies and the use that compounding pharmacies have when customizing dosage forms.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
So compounders like us, let's say you have a medication that contains a dye from a commercial product or is back-ordered, discontinued, orphaned, or just not available in a certain dose of strength, form, or combination.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, a prescriber can work with a compounding pharmacy to give that patient exactly what the doctor ordered and optimize that patient's treatment so they can have the best outcomes. Exactly.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Exactly. And this is why we see functional medicine providers such as yourself utilizing compounding pharmacies because all of us patients, we have a different amount of biomarkers within our serum. And when a pharmaceutical company only makes a single product, it can't help the entire patient population that is differing in their comorbidities as well as their health status.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so by working with a compounding pharmacy, doctors can really fine-tune these therapies so that patients can receive the best outcomes.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
You know, it's a story of luck, I think. You know, so I've always been into cars, and my father owned a go-kart track, so I've been racing and building go-karts and fixing them since I was five years old. And so I wanted to go get a degree in mechanical engineering with an emphasis on automotive engineering.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And when I got my degree from UT Austin in December 2007, I couldn't get a job working for any car companies.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, not the one that I wanted to work at, unfortunately. And the car industry wasn't doing very well. No, very few industries were. It was the beginning of the recession.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Exactly. And so I did what most engineers in Texas do. I got a job working for oil and gas. And I was very lucky to get a job working for a great company, Schlumberger, doing hydraulic fracturing as a fuel engineer. Now, working out in the fields is hard work. I have so much respect for the men and women out there that put their lives at risk to be able to give us energy that powers our society.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so when I was out there, I saw so many injuries. And it was nine months in when my number was up. And I was lifting a heavy piece of pipe. And I lifted it the wrong way and ended up hemorrhaging several of my lower vertebrae in the process. So I couldn't work out in the field anymore, so I went into physical therapy.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And one of the chiropractors that was working with me noticed that I was very skinny for my age. Keep in mind, I'm 25 years old at the time, 5'10", and I weighed about 125 pounds. Just always been skinny my entire life. No matter how much I worked out, how much I ate, I couldn't gain any muscle whatsoever. I thought, that's the way it is. Those are my genetics.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, when this doctor took my blood, he noticed that I had the testosterone level of an 80-year-old man, which kind of described why I was so skinny my entire life, and why I couldn't get any muscle, and why I probably got injured, because I was lifting a very large piece of mass that my body could not support.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so he sent me to a specialist in Houston, which is also another very lucky part of my story. Houston being the largest medical center in the world had some of the best specialists in the world that specialized in my condition. And so the term, I had low testosterone because I was born with a pituitary disorder. my body doesn't create luteinizing hormone or follicle stimulating hormone.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Yeah, yeah. And for men specifically, luteinizing hormone works on the leydig cells to produce testosterone and follicle stimulating hormone works on the serotoli cells within the testicle to produce sperm. And so I was hypogonadal and I was infertile. Yeah. And well, it became fun afterwards. Once I got my first medication from a compounding pharmacy, and this is another very lucky part.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
My doctor just happened to be very wise and knew that in order for his patient population to be able to be compliant with their therapies for the rest of their lives, they would have to utilize a compounding pharmacy. One, because Big Pharma increases prices on average by 11% a year.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And if a patient is going to be on these medications for 50, 60 years, a large portion of the population will lose access. And second, he knew that in order for his patients to get the best outcomes, that he would want to customize these treatments for those patients and use products that may not be on the market commercially, but could be made by a compounding pharmacy.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And so that was my introduction to compounding. I got my prescriptions filled at a compounding pharmacy in Houston. got my first injection of testosterone, and it completely changed my life for the better. I became normal. And becoming normal is an amazing feeling.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Exactly, exactly, yeah. The symptoms of hypogonasm, depression, low libido, low stamina. I'd take a nap at 5 o'clock every single day. You know, I was sleepy all the time, even though I'd get good enough sleep if you broke it up in enough periods. But, you know... I didn't realize that all this stuff could be fixed just by normalizing the level of testosterone in my body.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And since then, I've been working and learning about this space and integrating more and more therapies into my treatment protocol to be able to optimize myself so I can be the best version of myself that I can be.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Well, every patient is unique. And so we manufacture 600 different drugs. And the primary ones that we see functional medicine providers utilizing, as you said, as the base, we have the hormones, testosterone, estradiol, progesterone, estriol, estrone, whatever DHCA, whatever is out there that the patient may be deficient in.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
And then on top of that, then we see some providers utilizing growth hormone replacement therapy to improve immune function, hair, skin, nails, sleep, and also help repair injury. And then we see additional therapies like nootropics, methylene blue, for example, being utilized for patients that want better mental clarity. Maybe ketamine for patients that have depression.
The Dr. Hyman Show
What Is A Compounding Pharmacy? The Science Behind Medications Customized Just for You | Shaun Noorian
Maybe patients are obese, so they're utilizing a lipotropic injection or a B12 injection, or they're also utilizing a GLP-1. And so, you know, you see all these different areas of treatment being integrated into a patient's profile so that they can become better. And then, of course, they go back and see their doctor on a quarterly, biannual, annual basis.