5-aminolevulinic acid is an endogenous precursor of protoporphyrin IX, which is a photosensitiser. The medication ALA is used topically in conjunction with blue light illumination for the treatment of some grades of actinic keratoses of the face and scalp. ALA solution is applied topically. It is not intended for application by patients or unqualified practitioners. Application should involve either scalp or face lesions, but not both simultaneously. Contact your cosmetic dermatologist for more information.


A large proportion of our community don’t receive enough exposure to sunshine to sustain recommended levels of Vitamin D in the body, especially during the winter months. Oral supplementation with higher-dose capsules is common place now, and there is a huge body of evidence showing the many health benefits of this vitamin.

Vitamin D is a steroid hormone that assists with calcium homeostasis and absorption in the gut, assists with the conversion of T4 to T3, helps the pancreas release insulin and is even necessary for blood clotting.

The 25-hydroxy D is the form that is tested by pathology labs – with a normal range of 50 to 140 nmol/L. Aiming for levels in the top one-third of this normal range is ideal.

A prescription is required for this medication for doses over 1,000IU.

Contact your chemist for more information.



Tryptophan is an essential amino acid and precursor of serotonin. CNS depletion of serotonin is considered to be involved in depression, and tryptophan has a role in the treatment of some cases. Compounding Chemists will compound L-tryptophan or 5-HTP according to individual patient prescriptions, where commercial products are not available. Prescriptions are required for this medication.


Tryptophan is readily absorbed form the gastrointestinal tract and is extensively bound to serum albumin. It is metabolised to 5-HT then to serotonin and eventually excreted in the urine. Pyridoxine and ascorbic acid are involved in its metabolism.


Concomitant administration of tryptophan and a MAOI may enhance the effects of the MAOI.

Concomitant administration of tryptophan and melatonin or serotonin reuptake inhibitors may cause serotonin syndrome.


Nausea, headache, light headedness and drowsiness have been reported.

Occasional: sexual disinhibition, reversible dyskinesias, reversible Parkinson-like rigidity in patients taking tryptophan with or after phenothiazines or benzodiazepines.

5-hydroxytryptophan, an intermediate in the conversion of tryptophan to serotonin, has central stimulant activity as well as reported neurotoxic effects.



Troches may contain a wide range of medicines designed to be absorbed from the lining of the mouth (buccal mucosa).

The medication is delivered straight to the blood stream, avoiding gut absorption and liver first-pass metabolism.

HRT troches contain estrogen, progesterone, testosterone, dhea, pregnenolone as per prescription.

Contact your physician or chemist for more information.


The medication Triest is usually prescribed as a mix estriol, estradiol and estrone.

Chemists make creams and troches containing the strength prescribed, with or without other hormones.

Prescribers seeking more information on BHRT hormones, including common starting doses and benefits of each dosage form are encouraged to contact their pharmacist.

Sample troche trays (without hormones) are used to assist in patient counselling and flavour selection.