What is Troche?

 What is Troche?

So you and your doctor have decided to replace your decreasing hormones with natural bio-identical hormones instead of the synthetic alternatives.  Congratulations!  But don’t stop here.  The next piece of the puzzle is how to get these “new” hormones inside your body where they can be most effective.

And don’t be too quick to swallow a capsule or tablet.  The problem is many of the benefits of natural HRT (Hormone Replacement Therapy) will be lost as the hormones go through the process of digestion.

None of your circulating hormones are secreted into your digestive tract as a means of total body distribution.  Glands typically secrete hormones into the local circulation where eventually they reach complete systemic circulation. This is physiologically natural.  Delivery via the digestive tract is not.

When hormones are swallowed, they are exposed to digestive acids, bile salts, enzymes and metabolism as they are absorbed through the intestinal wall.  Then like everything absorbed by the digestive process, they are carried directly to the liver in what is called “first pass metabolism”.

As a total days’ amount of hormones reach the liver in a very short period of time, this does several things.

It adds to the livers burden and increases the risk of liver toxicity, injury and gallbladder disease—especially if other medications are also being taken.

The liver does not know that this sudden bombardment of hormones is temporary.  It operates on the basis that the hormone levels are way too high, and begins to make changes to counteract what it perceives to be a sudden increase in hormones.  The scenario is as follows:

  • You take the hormones by mouth
  • The digestion of those hormones  sends them to the liver
  • The liver interprets this as abnormal
  • The liver takes measures to lower the sudden increase in hormones

The net result is that it affects the way your body has access to the hormones.  It not only will affect the estrogen, progesterone or testosterone you may be taking but also other circulating hormones and chemicals as well.  These include thyroid hormone, cortisol and a substance called Anti-thrombin III that helps protect you from heart attacks and stroke.

These changes can increase your blood pressure and cholesterol; affect your mood; lower your thyroid and cortisol potential and increase your risk of heart attack and stroke.

At this time, viable options to swallowing your hormones include injections and transdermal (skin) delivery.  Injections have their drawbacks.

Transdermal delivery has gained rapid popularity during the last 10-15 years.  Hormones, nicotine, nitroglycerin and drugs for blood pressure and pain are just some of the different medications in a patch form that are applied to the skin for absorption.

Creams, suppositories and troches are other forms of transdermal absorption, all of which bypass the digestive system and first pass metabolism which is a good thing.

Creams can be very effective, but because of extreme variation in skin type (thickness, fat content, water content etc.) their absorption is erratic and unpredictable from one patient to the next.

Vaginal and rectal suppositories are very effective and dependable for drug delivery, but lack convenience.

TROCHES, however, offer the best of all worlds. A dosage form dating back to the 1800’s troches have regained tremendous popularity for the absorption of medications, especially hormones.

Troches are small lozenges that dissolve between the cheek and the gum over a period of 15-30 minutes.  They are very effective because the lining of the mouth is thin and rich in blood supply.

As it dissolves, the hormones are gradually absorbed into the blood stream, resulting in physiologically normal hormone blood levels.  Also because troches are Bio-Identical to the hormones your body naturally produces, they are efficiently recognized, utilized, metabolized and excreted by the body.

Since your own hormones last about 8-10 hours, your natural hormone replacement should be dosed about every 12 hours to insure adequate and balanced blood hormonal levels.

Because of the tremendous advantages in consistency, maximum absorbency and effectiveness, and the bypass of the digestive process, I strongly recommend troches as the primary dosage form for hormone replacement therapy for both men and women.

Note: Troches require a prescription from either an ND or MD.  Please choose a physician who understands the above process and knows how to read a saliva test for hormones.