What is Compounding?

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By Sheila Jiwan, Pharmacist and Certified Metabolic Anti-Aging Medicine Consultant

Simply put, compounding is the art and science of creating personalized medication. We take individual ingredients and mix together the exact strength and dosage required by the patient and prescriber. Unlike manufactured medications, where there are only a few different dosages strengths and forms, compounding allows for endless options.

Compounding’s history

Back in the days of your great grandparents, nearly all prescriptions were compounded. It wasn’t until the 1950’s and 60’s that mass drug manufacturing began to rapidly grow. Pharmacists quickly changed their role from manufacturer to dispenser. Unfortunately pharmacists were no longer trained to compound medication. However, the “one-size-fits-all” nature of many mass-produced medications meant that some patients needs were not being met. Fortunately, compounding has experienced resurgence as modern technology and innovation have allowed more pharmacists to customize medications to meet your specific needs.

What are the BENEFITS of Compounding?

We can help personalize medication for patients who need specific strengths, dosage forms, or ingredients excluded from medications due to allergies or other sensitivities.

  • When your medication is either discontinued or unavailable from the suppliers we can compound the medication for you so you don’t have to be without or switch
  • If you have allergies to the medication due to preservatives, dyes or fillers, we can customize your medication for you to avoid this problem
  • Tailored dosage strengths for patients with very specific needs such as a baby can be achieved through compounding when the strength required is not commercially available
  • If your doctor has prescribed a strength that is not available, we can compound it for you
  • If you have problems taking the medication; for example, if the pill is too large to swallow we can make the medication in an alternative dosage form such as a suspension liquid or cream.
  • Your option of having alternate dosage forms such as lozenges or gummies
  • We can combine several medications to increase compliance (ie. cream for your skin)
  • If a medication does not taste good, we can add flavor to make it more palatable for the patient, this is ideal for children. We can also flavor accordingly for your pets.
  • If you are prescribed one of many possible dosage forms for bioidentical hormone replacement therapy.

How does a compounding pharmacy work?

A compounding pharmacy uses state-of-the-art equipment, chemicals and advanced techniques to compound and ensure quality products. This method allows the compounding pharmacist to work with the patient and the prescriber to customize a medication to meet the patient’s specific needs. Other pharmacies do not have the time, equipment, chemicals, or education to ‘custom-make’ your medications.
Our trained pharmacists use the only sterile “clean room” in Burnaby to custom make your prescribed medications. Each compound is hand made from the highest quality chemicals and quality assured by the Pharmacist.

For more information on our compounding services, please contact us.

Sheila Jiwan is the Pharmacy Manager at Pharmasave-Canada Way Health Centre in the Summitview Medical Centre. She is American Board Certified in anti-aging medicine as a Certified Metabolic Anti-Aging Medicine Consultant. She leads the compounding pharmacy located in Summitview Medical Centre that prepares unique and highly individualized prescriptions.

What are hormones and what do they do?

Sarfaraz Comments Off on What are hormones and what do they do?

By Sheila Jiwan, Pharmacist and Certified Metabolic Anti-Aging Medicine Consultant

Bio-Identical Hormone Therapy

Hormones are natural substances produced in our body and act as messengers. They are produced by our glands, for example, ovaries, testes, thyroid, adrenal glands and the pancreas. The hormones released form the glands; then control essentially all our metabolic functions by acting on many different cells in the body and by giving the cell different commands as to what to do. As we go through our life our hormone levels change and eventually many of our hormone levels decline. It is the purpose of bio-identical hormone therapy to maintain hormones at their optimum level and to keep hormones balanced. Balancing hormones and maintaining them at a youthful level achieves not only a sense of well being but also slows down the development of many degenerative diseases.


Cortisol is a hormone produced by our adrenal glands. It is a hormone that allows our bodies to deal with situations that we perceive as being dangerous. In response to danger we increase our blood sugar, increase our blood pressure and suppress our immune system. Problems arise when we are under chronic stress and our cortisol levels remain chronically elevated. This can result in poor immune system function which makes us prone to infections. Chronically elevated cortisol levels are also associated with osteoporosis, diabetes, insulin resistance and breast cancer. Problems can also result when the adrenal glands become fatigued and cortisol levels remain chronically low. Good nutrition and supplements, proper sleep and stress reduction all have to be used to maintain healthy adrenal function.


DHEA is a hormone produced by our adrenal glands and like testosterone it is an androgen. As we age our DHEA levels decline. DHEA is a precursor to other hormones made by the adrenal glands including testosterone and estrogen. This is especially important in post menopausal women. DHEA plays an important role in immune function and our ability to handle stress. Good nutrition and supplements can be used to naturally improve DHEA levels.


Estrogen is a term given to a family of hormones. We actually make three different types of estrogen in our body; Estriol, Estradiol and Estrone. Bio-Identical hormone therapy can include any one or all of the estrogens. Maintaining optimum balance of estrogen protects against heart disease, osteoporosis and dementia. Symptoms of Estrogen deficiency include hot flushing, night sweats, mood swings, depression, memory loss, vaginal dryness, decreased libido, skin dryness and fine facial wrinkles.


Insulin is a hormone produced by the pancreas. Insulin is secreted from our pancreas in response to increase in our blood sugar. Insulin then allows our cells to process blood sugar and use it or store it for energy. Excess weight and obesity causes our cells to become insulin resistant; the cells need more and more insulin to process the same amount of sugar. When we do not have adequate insulin our blood sugar stays high and diabetes can develop. Elevated levels of sugar in our blood cause premature aging in many of our organs, leading to kidney damage and cardio vascular disease. Weight management, physical activity, diet and nutritional supplements should all be used to maintain a healthy insulin and glucose balance throughout our entire life.


Progesterone is a hormone that balances estrogen in our bodies; it thus protects us from developing uterine and breast cancer. Progesterone also prevents osteoporosis, helps to treat fibrocystic breast disease and endometriosis. It is progesterone that frequently is lacking, even in the peri-menopausal years, and causes many unwanted symptoms such as anxiety, irregular periods, breast swelling and tenderness, fluid retention and weight gain.


Testosterone is primarily a male hormone but it has many important functions in both men and women. It maintains muscle mass and protects against osteoporosis. In both men and women low testosterone can result in loss of sex drive, decrease in energy level, depression, loss of muscle strength and hot flushing. In men symptoms also include increased abdominal fat, development of fatty breasts and problems with erections.


Thyroid hormone controls almost all aspects of our metabolism. Hypothyroidism, or under production of thyroid hormone, is a common condition as we age. Thyroid hormone acts as a thermostat in our body, when too low, all processes and metabolism slows down; when too high, the processes speed up. Common problems associated with suboptimal thyroid function include: feeling cold, even when others are warm, cold hands and feet, fatigue, especially in the morning; weight gain, dry skin, constipation, hair loss and high cholesterol. Sometimes standard tests do not reveal subtle deficiencies. It is important to accurately asses thyroid function, replace thyroid hormone and optimize its levels by using natural thyroid replacement and by using supplements that support thyroid gland function.

Bio-Identical Hormones

Bio-Identical hormones are identical and have the exact same molecular structure as those produced by our body. Bio-Identical hormones are made from natural plant compounds that are similar in structure to human hormones. Estrogens and progesterone are made from compounds derived from yam and soy. Unfortunately, most commonly prescribed hormones and hormones used in large studies have been synthetic. The synthetic hormones are structurally different from human hormones and therefore have unwanted effects on our bodies. Some of the synthetic hormones, for example, were derived from pregnant horses’ urine and the product then contained horse estrogens which are unnatural and harmful to humans. When considering the risks and benefits of hormone therapy it is crucial to keep in mind that bio-identical and synthetic hormones are not the same and at times have completely the opposite effects on the human body. When bio-identical hormones are prescribed correctly they can treat many symptoms and prevent diseases associated with aging. Bio-identical hormone preparations or creams are made at special pharmacies called compounding pharmacies. Compounding Pharmacies make each preparation on a case-by-case basis for each patient to meet their specific needs.

Sheila Jiwan is the Pharmacy manager at Pharmasave Health Centre in the Summitview Medical Centre. She is American Board Certified in anti-aging medicine as a Certified Metabolic Anti-Aging Medicine Consultant. Sheila speaks to groups about healthy aging and the positive effects of Bio-Identical Hormone Replacement Therapy (BHRT). She leads the compounding pharmacy located in Summitview Medical Centre that prepares unique and highly individualized bio-identical hormone prescriptions.