Aug 12, 2020 · Patented synthetic hormones require extensive testing and funding, which helps keep the FDA in business. When looking at the safety of bioidentical hormones, several things stand out. As mentioned above, the risk of breast cancer is reduced using bioidentical hormones. FDA Approved Drugs. The following database contains a listing of drugs approved by the Food and Drug Administration (FDA) for sale in the United States. Drug information typically includes the drug name, approval status, indication of use, and clinical trial results. A. Bioidentical hormone therapy used to treat menopausal symptoms typically contains estradiol which is, in fact, identical to the estradiol used in traditional hormone therapy. Thus, the term bioidentical hormone therapy can be confusing; there are bioidentical hormones approved by the FDA, but there are also compounded bioidentical hormone ...These days, there are FDA-approved versions of bioidentical hormones, and there are alternative, custom-prepared varieties — like the one Foster uses — made in specialized "compounding ...Jul 1, 2020 · The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism — should be limited to the small number of patients who cannot benefit from an FDA-approved hormone therapy product, says a new report from the National Academies of Sciences, Engineering, and Medicine. Dec 7, 2020 · Compounding pharmacies should be aware of recent developments in the law surrounding bioidentical hormone therapy (cBHT). In the field of pharmacy, compounding (performed in compounding pharmacies) is preparation of a custom formulation of a medication to fit the unique need of a patient which cannot be met with commercially available products. Compounded drugs are not FDA-approved. The Food ... Jul 10, 2020 · The benefits of FDA-approved bioidentical hormone therapy stem from the nature of their creation. They are created at a molecular level in order to be as close a match as possible for their patients. On the other hand, since no conclusive study has yet been made, it can't be concluded that bioidentical hormones are any safer than synthetic ... 14 uses of U.S. Food and Drug Administration (FDA) approved hormone therapies include 15 replacement during menopause, oncology therapies, and for endocrine or genetic disorders. 16 Although oral contraceptives are a common use of hormones, their primary use for the preventionThe gap between a need for effective menopausal treatment and available therapies with a perceived acceptable risk/benefit ratio vastly expanded the use of non-Food and Drug Administration (FDA)-approved compounded hormone therapy (CHT), 6,7 which has been marketed as safer than HT and has been promoted as a superior alternative to HT. 6,8-10 ...The cost of hormone pellet therapy can vary depending on the provider, but an average cost may be close to $1,536 each year. Healthcare insurance may cover FDA-approved hormone therapy, but the extent of the coverage may vary among plans. Most insurance companies are unlikely to cover compounded bioidentical hormone therapy because it is not ...“The [widely available] FDA-approved bioidentical hormones produced in monitored facilities demonstrate a high quality of safety and efficiency in trials; therefore, there is no rationale for the routine prescribing of unregulated, untested, and potentially harmful custom-compounded bioidentical HTs.”by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses.Prescribers Should Restrict the Use of Non-FDA-Approved Compounded Bioidentical Hormones, Except for Specific Medical Circumstances. The National Academies of Sciences Engineering Medicine ...Bioidentical hormones are man-made hormones derived from plants, often soy and yams, that are chemically identical to those the human body produces. As such, they bind to the estrogen and testosterone receptors in the same way as women’s endogenous hormones have throughout their lives . The U.S. FDA has approved some forms of manufactured ...May 25, 2023 · Bioidentical hormones. These hormones come from plant sources. The term "bioidentical" implies the hormones in the product are chemically identical to those your body produces. There are some commercially available bioidentical hormones approved by the Food and Drug Administration (FDA). Read on to learn the definitions of compounded and bioidentical and what being “FDA-approved” tells you about a product. Compounded hormone therapy — sometimes called compounded bioidentical hormone therapy, abbreviated as cBHT — refers to the non-FDA-approved bioidentical options (pictured on the far-right branch of the decision tree ... October 17, 2019 | Filed under: Health, Menopause. I’m so thrilled to have Dr. Barbie Taylor a.k.a. “Menopause Taylor” with us today! She’s a retired OB/GYN who’s dedicated her 2nd half to educating women about menopause! If you’re a woman (of any age), this is a must watch video! I was a typical aging woman who had NO ….The agency has latched onto this false conclusion from a report it commissioned, and it is another direct threat to estriol and compounded bioidentical hormones’ future. Action Alert! The FDA’s announcement regarding bioidentical hormones came just hours after the National Academy of Sciences, Engineering, and Medicine (NASEM) released their report reviewing the “clinical utility” ofNov 8, 2022 · Bioidentical hormone therapy used to treat menopausal symptoms typically contains estradiol which is, in fact, identical to the estradiol used in traditional hormone therapy. Thus, the term bioidentical hormone therapy can be confusing; there are bioidentical hormones approved by the FDA, but there are also compounded bioidentical hormone ... Compounding pharmacies should be aware of recent developments in the law surrounding bioidentical hormone therapy (cBHT). In the field of pharmacy, compounding (performed in compounding pharmacies) is preparation of a custom formulation of a medication to fit the unique need of a patient which cannot be met with commercially available products. Compounded drugs are not FDA-approved. The Food ...The U.S. Food and Drug Administration (FDA) has approved some forms of manufactured bioidentical hormones, including bioidentical estriol (a weak form of estrogen) and progesterone.Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones.A wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ...The FDA requires manufacturers of FDA-approved products that contain estrogen and progestin to include a black box warning that reflects the findings of the Women’s Health Initiative. However, compounded products (including “bio-identical hormones”) are not approved by the FDA and have been exempt from having to provide patient package The following lists some basic information about the FDA-approved hormone medicines for menopause. Use this information to help you talk to your healthcare provider about whether hormone...However, there are also commercially available FDA-approved products that fit the definition of “bioidentical,” and some bioidentical hormones are derived from animal sources or made synthetically (Cirigliano 2007). These products are seldom marketed or prescribed by anti-aging and other alternative health practitioners, who instead favor ...FDA-approved. FDA does not have evidence that compounded “bioidentical hormones” are safe and effective, or safer or more effective than FDA-approved hormone therapy. FDA has approved drugs ...Read on to learn the definitions of compounded and bioidentical and what being “FDA-approved” tells you about a product. Compounded hormone therapy — sometimes called compounded bioidentical hormone therapy, abbreviated as cBHT — refers to the non-FDA-approved bioidentical options (pictured on the far-right branch of the decision tree ... Custom hormone treatments, called compounded bioidentical hormone therapies (cBHTs), are often promoted by celebrities as natural or safer than FDA-approved therapies.Jan 24, 2022 · Not all hormones made from natural sources are bioidentical. There are two types of bioidentical hormone products: pharmaceutical products and custom-made products. Pharmaceutical Products: These products have been approved by the U.S. Food and Drug Administration (FDA). Their quality and safety are regulated so it is the same high-quality ... Apr 29, 2011 · The term CBHT refers to hormone preparations that (1) have exactly the same chemical and molecular structure as the estrogens and progesterone produced within the human body, (2) are plant derived, and (3) are specifically compounded for an individual patient. Custom CBHT is not FDA-approved for treatment of menopausal symptoms. 16. Compounded drugs have long been part of the medical armamentarium. Through drug compounding, compounders may offer therapeutic alternatives for patients with unique medical needs that cannot be met by U.S. Food and Drug Administration (FDA)-approved drug products (FDA, 2017a). The Federal Food, Drug, and Cosmetic Act (FDCA) of 1938 is the primary source of FDA's authority over prescription ...Apr 14, 2021 · not currently available as an FDA-approved drug product” (p. 195). “The term ‘bioidentical hormone’ generally refers to sex steroid hormones, usually an estrogen, an androgen or progesterone, that has the same chemical and molecular structure [and Jul 9, 2020 · The agency has latched onto this false conclusion from a report it commissioned, and it is another direct threat to estriol and compounded bioidentical hormones’ future. Action Alert! The FDA’s announcement regarding bioidentical hormones came just hours after the National Academy of Sciences, Engineering, and Medicine (NASEM) released their report reviewing the “clinical utility” of Estrogen, progesterone and testosterone are the most commonly used bioidentical hormones. Some prescription forms of bioidentical hormones are premade by drug companies. The U.S. Food and Drug Administration (FDA) has approved certain types of bioidentical hormones.Compounding pharmacies should be aware of recent developments in the law surrounding bioidentical hormone therapy (cBHT). In the field of pharmacy, compounding (performed in compounding pharmacies) is preparation of a custom formulation of a medication to fit the unique need of a patient which cannot be met with commercially available products. Compounded drugs are not FDA-approved. The Food ...Menopause is a normal, natural change in a woman’s life when her period stops. That’s why some people call menopause “the change of life” or “the change.”. During menopause a woman’s ...Bioidentical hormone therapy used to treat menopausal symptoms typically contains estradiol which is, in fact, identical to the estradiol used in traditional hormone therapy. Thus, the term bioidentical hormone therapy can be confusing; there are bioidentical hormones approved by the FDA, but there are also compounded bioidentical hormone ...The phrase bioidentical hormone therapy has been recognized by the FDA and the Endocrine Society as a marketing term and not one based on scientific evidence 4. Examples of compounded hormones include Biest (biestrogen) and Triest (triestrogen) preparations. The name Biest commonly refers to an estrogen preparation based on a ratio of 20% ...In contrast to FDA-approved drug products, compounded bioidentical hormone therapy (cBHT) preparations lack standardized production methods, potentially leading to state-by-state and even pharmacy-by-pharmacy variability in the medications dispensed to patients.Patented synthetic hormones require extensive testing and funding, which helps keep the FDA in business. When looking at the safety of bioidentical hormones, several things stand out. As mentioned above, the risk of breast cancer is reduced using bioidentical hormones.Hormone Route of administration Bioidentical brand name (active pharmaceutical ingredient) Non-Bioidentical brand name (active pharmaceutical ingredient) Estrogen: Oral: FDA-approved Estrace®, generics (17β-estradiol)Available compounded (not FDA-approved) Estradiol (E2), estriol (E3), biestrogen (E2E3), triestrogen (E1E2E3) FDA-approvedMay 25, 2023 · Bioidentical hormones. These hormones come from plant sources. The term "bioidentical" implies the hormones in the product are chemically identical to those your body produces. There are some commercially available bioidentical hormones approved by the Food and Drug Administration (FDA). Jul 10, 2020 · Bioidentical progesterone replacement therapy is commonly used by perimenopausal and postmenopausal women whose shifting hormone levels severely affect their well-being, causing symptoms such as irritability, hot flashes, difficulty concentrating, loss of libido, and more. However, women of reproductive age may also choose to take bioidentical ... Sep 12, 2012 · A long list of FDA-approved hormone products contain 17-beta estradiol and, therefore, are bioidentical. Examples include oral esterase, estradiol transdermal patches (Climara®, Vivelle®) and the vaginal ring (Estring®). Prometrium® is an oral FDA-approved bioidentical progesterone product. The next misconception is that progesterone ... The FDA requires manufacturers of FDA-approved products that contain estrogen and progestin to include a black box warning that reflects the findings of the Women’s Health Initiative. However, compounded products (including “bio-identical hormones”) are not approved by the FDA and have been exempt from having to provide patient packageThe cost of hormone pellet therapy can vary depending on the provider, but an average cost may be close to $1,536 each year. Healthcare insurance may cover FDA-approved hormone therapy, but the extent of the coverage may vary among plans. Most insurance companies are unlikely to cover compounded bioidentical hormone therapy because it is not ...FDA-approved. FDA does not have evidence that compounded “bioidentical hormones” are safe and effective, or safer or more effective than FDA-approved hormone therapy. FDA has approved drugs ...Compounded bioidentical hormone replacement therapy (BHRT) products such as progesterone and testosterone, are used at times instead of FDA-approved drugs for hormone replacement therapy.Bioidentical hormones are man-made hormones derived from plants, often soy and yams, that are chemically identical to those the human body produces. As such, they bind to the estrogen and testosterone receptors in the same way as women’s endogenous hormones have throughout their lives . The U.S. FDA has approved some forms of manufactured ...“The [widely available] FDA-approved bioidentical hormones produced in monitored facilities demonstrate a high quality of safety and efficiency in trials; therefore, there is no rationale for the routine prescribing of unregulated, untested, and potentially harmful custom-compounded bioidentical HTs.”The first will examine the clinical utility of treating patients with compounded bioidentical hormone replacement therapy (BHRT) products. ... instead of FDA-approved drug products for hormone ...(See Table for a list of FDA-approved bioi-dentical HT products.) Another hormone, testosterone (shown to improve sexual desire), is not currently available as an FDA-approved bioidentical product. Confusion and unsubstantiated claims surround the custom-compounded bioidentical hormone therapy products used to treat Sep 29, 2021 · Doses should be as low as possible to help ease the symptoms, and then taken for the shortest amount of time. For some women, this may be for a few months, for others, years. If you are taking HRT for serious menopause symptoms, you may be reluctant to stop taking HRT, for fear the symptoms will return. by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses.Sep 27, 2021 · The FDA wants to restrict compounded hormones to patients who are allergic to manufactured products or who need an unavailable specific dosage. People other than estrogen-deficient women use ... Dec 7, 2022 · The term "natural" means the hormones in the product come from plant or animal sources. They're not made in a lab. But many of these products still need to be commercially processed to become bioidentical. Traditional hormone therapies don't necessarily exclude natural hormones. Some FDA-approved products come from plants. Examples include ... “The [widely available] FDA-approved bioidentical hormones produced in monitored facilities demonstrate a high quality of safety and efficiency in trials; therefore, there is no rationale for the routine prescribing of unregulated, untested, and potentially harmful custom-compounded bioidentical HTs.” Estrogen, progesterone and testosterone are the most commonly used bioidentical hormones. Some prescription forms of bioidentical hormones are premade by drug companies. The U.S. Food and Drug Administration (FDA) has approved certain types of bioidentical hormones. The Endocrine Society has defined bioidentical hormones as “compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body.” 11 This broad definition does not address the manufacturing, source, or delivery methods of the products and thus can include non–FDA-approved custom-compounded ...An update in the fight to protect estriol and other hormones from an FDA ban. Action Alert! We’ve said before that the FDA is stacking the deck against bioidentical hormones; now it seems incontrovertible. Time is running out for the natural health community to mount an effective defense of estriol and other compounded, bioidentical hormones from an FDADec 12, 2022 · The U.S. Food and Drug Administration (FDA) has approved some forms of manufactured bioidentical hormones, including bioidentical estriol (a weak form of estrogen) and progesterone. Jul 1, 2020 · Compounded drugs have long been part of the medical armamentarium. Through drug compounding, compounders may offer therapeutic alternatives for patients with unique medical needs that cannot be met by U.S. Food and Drug Administration (FDA)-approved drug products (FDA, 2017a). The Federal Food, Drug, and Cosmetic Act (FDCA) of 1938 is the primary source of FDA's authority over prescription ... Apr 29, 2011 · The term CBHT refers to hormone preparations that (1) have exactly the same chemical and molecular structure as the estrogens and progesterone produced within the human body, (2) are plant derived, and (3) are specifically compounded for an individual patient. Custom CBHT is not FDA-approved for treatment of menopausal symptoms. 16. Compounded bioidentical hormone replacement therapy (BHRT) products such as progesterone and testosterone, are used at times instead of FDA-approved drugs for hormone replacement therapy.For example, one study found that only 1 of 10 compounding pharmacies provided progesterone vaginal suppositories that were all within the potency range required of similar FDA-approved products. 2. This article will focus on compounded bioidentical hormone preparations aimed at menopausal and perimenopausal women.The cost of hormone pellet therapy can vary depending on the provider, but an average cost may be close to $1,536 each year. Healthcare insurance may cover FDA-approved hormone therapy, but the extent of the coverage may vary among plans. Most insurance companies are unlikely to cover compounded bioidentical hormone therapy because it is not ...A wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ... Bioidentical hormones have the exact same chemical and molecular structure as hormones that are produced in the human body. Bioidentical hormones are available as FDA-approved hormone formulations. Nonapproved custom-compounded preparations are marketed as bioidentical, but content is uncertain.Sep 27, 2021 · The FDA wants to restrict compounded hormones to patients who are allergic to manufactured products or who need an unavailable specific dosage. People other than estrogen-deficient women use ... Compounded bioidentical hormone replacement therapy (BHRT) products such as progesterone and testosterone, are used at times instead of FDA-approved drugs for hormone replacement therapy.These types are approved and regulated by the FDA, and they are made by drug companies. Some bioidentical hormones are available in a compounding pharmacy. Compounded bioidentical hormones may be put into a capsule, a skin cream or gel, a tablet to dissolve under your tongue, a suppository, or a nose spray.For example, one study found that only 1 of 10 compounding pharmacies provided progesterone vaginal suppositories that were all within the potency range required of similar FDA-approved products. 2. This article will focus on compounded bioidentical hormone preparations aimed at menopausal and perimenopausal women.(See Table for a list of FDA-approved bioi-dentical HT products.) Another hormone, testosterone (shown to improve sexual desire), is not currently available as an FDA-approved bioidentical product. Confusion and unsubstantiated claims surround the custom-compounded bioidentical hormone therapy products used to treatMost of these hormones, except progesterone, are not approved by the FDA for use in women. Purchasing FDA-approved progesterone requires a medical prescription. Scientists report that FDA-approved progesterone BHRT products also adopt the name “body-identical” to avoid confusion with compounded bioidentical hormones (cBHRT). They are ...Jun 23, 2021 · The categories of hormones gets broken down into bioidentical versus synthetic, and FDA-approved versus non-FDA-approved. FDA-Approved Hormone therapy Numerous FDA-approved hormone preparations are available for the treatment of menopausal symptoms, gender-affirming therapy, birth control, and menstrual regulation. Source: goodtoknow.co.uk. On the other hand, many of these points may be directly treated with bioidentical hormone alternative therapy. Hormone preparations specially tailor made for patients by compounding pharmacies, often known as bioidentical hormones, are extensively touted as being safer and more natural than Food and Drug Administration (FDA) approved variations of hormones.14 uses of U.S. Food and Drug Administration (FDA) approved hormone therapies include 15 replacement during menopause, oncology therapies, and for endocrine or genetic disorders. 16 Although oral contraceptives are a common use of hormones, their primary use for the prevention"It is important that women understand what bioidentical hormones are and the differences between those that are FDA-approved and those that are compounded or "mixed" at the pharmacy level," said ...Compounded hormone products (e.g., pellets), including but not limited to compounded testosterone, estrogen, and progesterone pellets are not proven or medically necessary for any indication. Compounded drugs, including compounded testosterone, estrogen, or progesterone pellets are not FDA approved. 3. Applicable Codes14 uses of U.S. Food and Drug Administration (FDA) approved hormone therapies include 15 replacement during menopause, oncology therapies, and for endocrine or genetic disorders. 16 Although oral contraceptives are a common use of hormones, their primary use for the preventionThe term CBHT refers to hormone preparations that (1) have exactly the same chemical and molecular structure as the estrogens and progesterone produced within the human body, (2) are plant derived, and (3) are specifically compounded for an individual patient. Custom CBHT is not FDA-approved for treatment of menopausal symptoms. 16.Oct 18, 2017 · The good news for women who make this choice is that there are many FDA-approved bioidentical hormone products that supply estradiol that you can buy...with a prescription, of course...at any neighborhood pharmacy. They have names such as Estrace, Alora, Climara, Estring and Vagifem. However, there are also commercially available FDA-approved products that fit the definition of “bioidentical,” and some bioidentical hormones are derived from animal sources or made synthetically (Cirigliano 2007). These products are seldom marketed or prescribed by anti-aging and other alternative health practitioners, who instead favor ...May 27, 2022 · There are FDA-approved bioidentical hormone products available, including estradiol ... Compounded bioidentical hormone replacement therapy (BHRT) products such as progesterone and testosterone, are used at times instead of FDA-approved drugs for hormone replacement therapy.products are FDA approved for use in the U.S. (Moskowitz, 2006). Custom compounded HT formulations may include any combination of P4, E1, E2, or E3 (Stanczyk et al., 2021). FDA approved 17-beta estradiol is available in the U.S. in oral, transdermal, and vaginal formulations; under generic and brand names such as Estrace, Alora patch, and Vagifem
Apr 29, 2011 · The term CBHT refers to hormone preparations that (1) have exactly the same chemical and molecular structure as the estrogens and progesterone produced within the human body, (2) are plant derived, and (3) are specifically compounded for an individual patient. Custom CBHT is not FDA-approved for treatment of menopausal symptoms. 16. . Spider man no way home full movie reddit
The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism — should be limited to the small number of patients who cannot benefit from an FDA-approved hormone therapy product, says a new report from the National Academies of Sciences, Engineering, and Medicine.A wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ... by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses.“The [widely available] FDA-approved bioidentical hormones produced in monitored facilities demonstrate a high quality of safety and efficiency in trials; therefore, there is no rationale for the routine prescribing of unregulated, untested, and potentially harmful custom-compounded bioidentical HTs.” Compounded “bioidentical hormone therapy” (BHT) products, such as progesterone and testosterone, are used by some providers and patients instead of FDA-approved drug products for hormone therapy.FDA-approved. FDA does not have evidence that compounded “bioidentical hormones” are safe and effective, or safer or more effective than FDA-approved hormone therapy. FDA has approved drugs ...The use of compounded bioidentical hormone therapies (cBHTs) — an increasingly popular approach to relieve symptoms of menopause and male hypogonadism — should be limited to the small number of patients who cannot benefit from an FDA-approved hormone therapy product, says a new report from the National Academies of Sciences, Engineering, and Medicine.Apr 14, 2021 · not currently available as an FDA-approved drug product” (p. 195). “The term ‘bioidentical hormone’ generally refers to sex steroid hormones, usually an estrogen, an androgen or progesterone, that has the same chemical and molecular structure [and A wide variety of FDA-approved bioidentical hormones are currently available. New transdermal biodentical estradiol gels have been approved by the FDA for menopausal symptoms. In the future, new ...BIOIDENTICAL HORMONE THERAPY WHAT ARE BIOIDENTIcAL HORMONES? “Bioidentical” means identical in molecular structure to endogenous hormones. Howev-er, as we will see, a better distinction should be made between products that are approved and regulated by the US Food and Drug Ad-ministration (FDA) and those that are not.“The [widely available] FDA-approved bioidentical hormones produced in monitored facilities demonstrate a high quality of safety and efficiency in trials; therefore, there is no rationale for the routine prescribing of unregulated, untested, and potentially harmful custom-compounded bioidentical HTs.”by DonnaWhite | Oct 11, 2019. The quick answer is yes, bioidentical hormones are FDA approved but hold on, this is a very controversial and somewhat complex topic that requires more explanation. Some bioidentical hormones are manufactured by drug companies, are approved by the FDA, and sold in standard doses.Compounded bioidentical hormone replacement therapy (BHRT) products such as progesterone and testosterone, are used at times instead of FDA-approved drugs for hormone replacement therapy.Bioidentical progesterone replacement therapy is commonly used by perimenopausal and postmenopausal women whose shifting hormone levels severely affect their well-being, causing symptoms such as irritability, hot flashes, difficulty concentrating, loss of libido, and more. However, women of reproductive age may also choose to take bioidentical ....