The Prescription For A Pharmacy With One-To-One Care - WUTC

Designer Drugs Owner Randy Davis and Pharmacist Tanya Manoni, PharmD recently interviewed with WUTC’s Ray Bassett about what Designer Drugs Pharmacy is all about.

You can find that interview and listen to it here or read the transcribed version below!


Ray Bassett: Compounding Pharmacies make medicine for patients with specific needs that commercially available drugs cannot treat. They're responsible for about 3% of the drugs dispensed in this country. And here in Chattanooga, Designer Drugs Pharmacy has provided them for the past 20 years, starting hormones and hormone replacement therapy. Dr. Randy Davis is the owner and a pharmacist, and Dr. Tanya Manoni is a pharmacist and hormone expert.

Randy, Tanya, thanks for joining us.

Tanya: Thanks for having us.

Randy: We're just thrilled to talk.

Ray Bassett: You are a pharmacy, but you have a particular emphasis on very difficult problems, such as infertility.

Tanya: When you look at hormones in general, they play a role in everything. Every phase of life. Fertility is one of those, adolescents is another of course, and we've got perimenopause and menopause. With the manufactured hormones, a lot of them are completely synthetic. It's not a one size fits all. There might be three different levels, three different hormone strengths.

What we do here is a bio-identical hormone replacement. We're also able to look at the effects of these manufactured hormones if you've taken them your entire life because you are prescribed them at the age of 14 at the onset of menses.

And that's where that fertility piece comes in. But it's not just fertility. We're all stages of life.

When I moved back to Chattanooga in 2011, I saw Randy was doing HRT and this bio-identical hormone replacement therapy, and that he was known for it. I had done that in Utah, where I got my degrees, and I knew I was going to find my way to Randy eventually.

Randy: We're not out there trying to fit a person into the available drugs that are on the market. We're fixing a drug for that individual person. So that's what makes sense to us. And we have that ability. We have a lab, we have quality assurance, we buy the pure chemical, and we work with that. We have trained staff and all of these little stop-gap mechanisms to weigh this powder. It's recorded in the computer. And we have these lock numbers and logs and expiration dates, and everything is compliant with all the USP standard and guidances.

To build your business to be that level of compounder is the reason we're able to go ahead and get licenses in all 50 States. Everybody has their own little criteria and their checkpoints to check you and make sure that you're up to these standards. We want to be above the standards. And that's how we have this name across the nation, not just here in Chattanooga. It's amazing what you can do if you do things right and do things for the right purpose.

Ray Bassett: You still encounter stigma when you're talking about so many of these problems. How would you say that stigma has lessened in some ways, in the past few years and past few decades, and what's still out there as a stigma that needs to be tackled.

Tanya: I think that women are raised from the beginning to just think "this is my curse. I have to deal with it. I have to deal with this pain. I have to bear the children. I have to deal with these hot flashes. This is just being a woman," but it's not. We can absolutely ease that pain and help you embrace that cycle, embrace those hormones, and show you how to make them work for you. So I would say that it was and still is what we're trying to overcome.

But with the change of functional medicine and anti-aging medicine being catchphrases now, everyone's starting to hear about functional and comprehensive medicine, that's easing the stigma.

Now more providers, MDs, or DOs are wanting to get involved because this wasn't taught at pharmacy school or medical school. What we do here with regards to the hormones and the checking on labs and helping the prescribers prescribe. It's more off the beaten path, but that path is starting to become more mainstream.

Randy: The curse that people feel is the imbalance of hormones and hormones are so tiny, they're measured in nanograms or picagrams per decaleter in your blood chemistry. So they're tiny little particles that have a huge bang. But if they're out of balance, your estrogen to progesterone ratio, that's where we come in. We work with the provider to measure that imbalance then we talk with the patient just to see where that imbalance is. Is that imbalance just in the lab work? Or do you feel the imbalance? And so we want to treat the patient, but have the lab work to go along with it to see if we're doing the right things.

We can make a drug to create the balance, and if they feel good, and then we see that the balance is on the paper again, then we know we've done our job.

Ray Bassett: You have been helping people during this pandemic. And depending on people's situations, you've had to take into account what they might be dealing with when it comes to hormones and what they might be dealing with when it comes to other environmental factors.

Tanya: Absolutely. We carry two lines of supplementation that are practitioner grade. We are, at the end of the day, still a pharmacy, so we are trying to fill the community's needs and fill that need as fast as we can.

We did react quickly to the COVID pandemic with doing different compounding, whether it be with zinc and some of the others, and then making readily available and educating the community on supplements such as vitamin D and acetylcysteine, and just having them readily available to anyone who needs or wants those.

Randy: Vitamin D is the center hub of your immune system. Vitamin D levels are huge, and we want people to come in. And if they don't know their vitamin D level, please get it measured. Come here or go to your doctor and ask. Make sure that if they're going to draw labs, ask "can you get my vitamin D level? My pharmacist wants to know for me," and bring the labs here! We can give and titrate your vitamin D level to be optimal. Vitamin D has 1400 reactions in the body that they're responsible for -- all these metabolic pathways.

But the immune system's a big part of that. You want your immune system to kick in, but you don't want it on overdrive. So vitamin D is kind of a stop-gap. It's going to say, "okay, guys, calm down. We've got this handled. We don't need any more of you." Vitamin D is important. So we're just trying to get the word out.

Ray Bassett: What's something that this pandemic has reminded you about what you do that many people may not be aware of?

Tanya: I keep going back to the pharmacy as one of the most trusted professions. When we had to close our front doors and close our lobby and just operate in the drive-through, it took away that personal connection.

I did not realize how important that was to me, having that relationship with my patients. So we recently reopened our lobby doors and it's just been joyous here because there's something special about just making eye contact and smiling at another human that might be going through something.

Randy: Hormones are not just for women. Men have hormones, too. We measure them. We want to balance the estrogen to testosterone ratio as well. Men lose their hormones in a slow, gradual pace over a lifetime, where women seem to lose it very quickly.

Tanya: Yes. By hysterectomy or the process of menopause, men do go through Andropause. I have a tendency to focus mostly on the women because that's who want to talk more about that. But Randy always teases that that they will bring their husbands. So, absolutely.

Ray Bassett: If people want to reach out to you folks, how can they do it?

Randy: By our website -- you can always do that. You can just pick up the phone and call us, and someone's going to answer between the hours nine to six, Monday through Friday, and that's 423-954-2585. And our website is designerdrugs.us and you can request a consultation on there or just send us an email and we'll get back to you.

Ray Bassett: Tanya. Randy, thanks so much. Tanya: Thank you.

Randy: Thanks!

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