Simply put, a compounding Pharmacy is a special type of Pharmacy where prescription medications are formulated or produced pursuant to a written prescription by a licensed medical provider and made by a licensed Pharmacist qualified in product formulation sciences. The guiding principles for compounding a medication are outlined in specific guidelines set forth by the United States Pharmacopeial convention and regulated by the various State Boards of Pharmacy and the FDA in some cases. Compounding is accomplished by either changing an existing dosage forms such as tablets, capsules, creams, gels etc. into a new dosage forms usually to be administered through the same or different route of administration depending on each patient’s specific circumstances. By reformulating some medication dosage forms, compounding pharmacies have the capability to change the flavor of an otherwise very bitter medication to one that is palatable, by adding either sweeteners or flavoring agents according to the patient’s specific needs. Compounding Pharmacies also have the unique ability to use approved raw material otherwise called active pharmaceutical ingredients to produce unique patient specific formulations from scratch in other to give patients a unique experience using the “one size does not fit all phenomenon”. A particularly good example in this category is bio-identical Hormone Replacement treatments in Creams, gels, suppositories, oral lozenges and Troches, sustained release Oral Capsules, Medication filled oily capsules such as progesterone, oral disintegrating tablets, sublingual sprays, nasal sprays etc. The rational for formulating Hormones through compounding Pharmacies is simple. Every human being on earth has a hormonal symphony which is overly complex especially when it comes to the choice between using solely all-natural Bio-identical Hormones. There is a huge difference between bio-identical and synthetic derivatives. Many patients want natural formulations with ingredients made from natural sources. Such ingredients usually are made from sources such as wild yam and soy. These natural Hormones fit into the same receptors in the body just like the hormones that we were born with. Several bio-identical formulations also exist in retail pharmacies around the country. Ask your local Pharmacist. When it comes to thyroid medication; I have found compounding to be an absolute game changer for a lot of patients with Thyroid gland abnormalities such as Hypothyroidism, Hashimoto disease, autoimmune conditions etc. Several combination Thyroid medications are available in the market from Levothyroxine, to Liothyronine, to Amour Thyroid, Porcine Thyroid, and others. However, many combination dosage forms are being made by compounding Pharmacies based on evidence-based studies showing that a simple change in the ratio of these hormones has a tremendous impact on the health of our patients. An exceptionally good example is a mere change from Liothyronine immediate release to sustained release only available through compounding Pharmacies. Most patients have found such a change to help their palpitations, nervousness, headaches often associated with Immediate release dosage forms. Also, when thyroid medication is compounded, other ingredients or supplements, which are crucial for absorption and conversation of T4 to the active T3 can be added such as selenium, Iodine, and Vitamin D. More so, for patients who are on fixed dose Amour Thyroid or Porcine Thyroid, there does exist a great chance that they might not be getting optimal results. Simple reason being that such formulations exist in a fixed ratio (4 parts T4 to one-part T3). Studies have shown that such a ratio is not perfect for every patient. Hence, it is crucial for such patients to receive a different ratio of T3 and T4 preferably in a Sustained release capsule. These compounded dosage strengths are only available through a compounding pharmacy.