Bioidentical Testosterone Pellets

Palermitano · Aug 27, 2015

Hello all,
It appears Im the only one here on pellet therapy. Much of the concern/debate has been the rate of testosterone decline over the 4-5 months until re-insertion. I have been curious about this myself and plan to test Total Testosterone, Free Testosterone and E2 (per discountedlabs of course) each month just to see whats going on. If there is interest, I will be happy to post my results.

ERO · Aug 27, 2015

yes, please do post your test results.

Have you been on the pellets long? How do you feel on them?

CoastWatcher · Aug 27, 2015

Please do keep us informed. The more knowledge pooled, the better informed all of us become. All the best.

Superman · Aug 27, 2015

i have some interest in your findings but not really for the purpose of switching to that type of protocol. Just curious if anyone actually has any success with it.

i was on pellets for a short time years ago. Aside from having a sore ass for a week, I felt great after about 3-4 weeks but that lasted all of a month. Then after the doctor added more of them I developed all sorts of issues like sleep apnea and crazy anxiety until they wore off. never again. The thing with shots and/or creams is it can easily be adjusted. Pellets are just a crapshoot from the start and adjustments aren't as easy.

Palermitano · Aug 27, 2015

The Dr looked at me at a pretty solid 220lbs, (I work out a lot) and said "17 pellets", which I believe was about 1700mg test. My T at the time just coming off of Axiron was about 425. The procedure was no big deal although I had some bruising for almost 4 weeks, not much pain at all. As I mentioned in another post, I tested after 30 days (peak time) and came in at 1475 Total test, Free Test 236, Bio Test 486, E2 (non sensitive) 88, DHT 88 (down from 108 w/gel) Hematocrit 51 (Ill donate at Red Cross soon).

I feel like a rock star, (I'm almost into 60 days now) although he wants to lower my dosage next time around, and I sadly agree. My only concern (and his) is my E2 at 88, (but I feel great) he wants me on Letrozole 2.5mg split in 2 doses per week, I'm not going there. Im trying Zinc, Liver Cleanse Supps and Calcium D Glucarate, Ill retest later.

Im retesting blood every 30 days so I will post more just after September 1st and be sure to use the "sensative" E2 test from now on.

CoastWatcher · Aug 27, 2015

My I ask, did you and your doctor consider other modes of therapy? Did you start, right out of the gate with pellets? Your E2 is high, but so is your testosterone - and you don't report any typical E2 symptoms. More support for the idea that it is the testosterone/estradiol ratio that is critical.

Palermitano · Aug 27, 2015

I started out several years ago with injections but did not like the roller coaster ride or having to deal with going into the office once a week. Tried Axiron, went on that for almost a year with decent results, but was a hassle. Someone told me about Bioidentical pellets (Sotopelle) so I thought I'd give it a try after much research. They will need some tweaking but so far (assuming/hoping levels don't drop too much in the coming months) I'm very pleased. Just need to get E2 in check.

CoastWatcher · Aug 27, 2015

Palermitano said:
I started out several years ago with injections but did not like the roller coaster ride or having to deal with going into the office once a week. Tried Axiron, went on that for almost a year with decent results, but was a hassle. Someone told me about Bioidentical pellets (Sotopelle) so I thought I'd give it a try after much research. They will need some tweaking but so far (assuming/hoping levels don't drop too much in the coming months) I'm very pleased. Just need to get E2 in check.

Have you read the threads here about the ratio of testosterone to estradiol? Nelson basically argues that the higher the total testosterone, the higher the estradiol should be. In other words, it isn't sensible to beleive that a man with testosterone measured over 1,000 would present with estradiol below 30 (using the 20-30 range that is regarded as something of a gold standard).

Healthy men, with solid testosterone typically have higher E2 - and have none of the symptoms of estrogenic dominance. The same holds true, particularly, for young, healthy men in early adulthood - awash in both testosterone and estradiol. Search and read the posts, it's convinced many of us.

Nelson Vergel · Aug 28, 2015

Palermitano

There are several types of testosterone pellets (Testopel and compounded pellets). Which one did your doctor use?

Testosterone Pellets, Sublingual and Buccal (Mouth)

Palermitano · Aug 29, 2015

Hi Nelson,
I'm on SottoPelle, I appreciate any feedback/opinions on this.

http://www.sottopelletherapy.com

Nelson Vergel · Aug 30, 2015

It is a fancy name for compounded testosterone pellets. Did you ask him how much testosterone each had and their cost?

Palermitano · Aug 30, 2015

Nelson Vergel said:
It is a fancy name for compounded testosterone pellets. Did you ask him how much testosterone each had and their cost?

I believe they are a combination of 100 and 200mg pellets. I had 1700mg inserted (total t 1475) and I paid about $650 for the procedure/pellets. Of course, I want to wait as long as possible for reinsertion (to save money), but not at the expense of letting my test get too low, so I'm trying to figure this out. What would you think is acceptable test level to get down to before reinsertion? 400? 500? Or I can just reinsert every 4-5 months regardless.

Here is a little formula I'm working on, please tell me if you think this makes sense. I started out before insertion with my total test levels about 400, so that would be my base line for reinsertion. I was given 1700mg which jacked my test to 1475, so, 1475 divided by 17 = about 86. That means for every 100mg of test inserted, my Total T goes to about 86.

Optimal/top/safe range would be about 1100 for total T, (I want it as high initially as possible since there will be monthly decline) so if I wait till my T gets back to 400, then have 13 pellets inserted, 13 x 86 should (in theory) give me a total T of 1118, pretty much where I want to be. I did the same formula for my E2 and it should put me at about 67 (from my now 88). (non sensitive). Im have sensitive and retesting T in a few days.

Nelson Vergel · Aug 30, 2015

Palermitano

That formula is good for dosage calculation but obviously not for predicting when you will need reinsertion based on a 500 ng/dL endpoint. I would get my testosterone tested every 4 weeks during this first cycle to determine that. Do not let the doctor convince you that your dosage will last you 12 weeks since that means nothing without testing. Time and time again I see doctors waiting too long for reinsertion which allows T to drop down to the 300's.

If your doctor does not want to test every month, you can do it cheaply through DiscountedLabs.com

torrential · Aug 30, 2015

Another thought, T levels tend to respond to dosage change more rapidly than E2 levels. Towards the later stages in the lifetime of the pellets, as the the availability of new T declines your T levels will drop first. You may be left with high E unopposed by T

-Q as the T:E ratio becomes unfavorable. If that happens you'll be back on that rollercoaster you wanted to avoid.

You didn't mention HCG to support your therapy. Does this clinic offer HCG to offset the testicular shutdown that results from exogenous T administration?

Supplements: you mentioned a few to help reduce aromatization. That seems to work for some guys more than others. Another, complementary approach is to use DIM to help metabolize the estrogen that has already been created. Could be useful if the scenario I described above comes true and you need to get rid of E2 quickly towards the end of the pellet cycle. In my experience DIM works quickly - almost immediately - with less long term / slow cycle affect than an AI.

Palermitano · Aug 30, 2015

torrential said:
Another thought, T levels tend to respond to dosage change more rapidly than E2 levels. Towards the later stages in the lifetime of the pellets, as the the availability of new T declines your T levels will drop first. You may be left with high E unopposed by T -Q as the T:E ratio becomes unfavorable. If that happens you'll be back on that rollercoaster you wanted to avoid.

You didn't mention HCG to support your therapy. Does this clinic offer HCG to offset the testicular shutdown that results from exogenous T administration?

Supplements: you mentioned a few to help reduce aromatization. That seems to work for some guys more than others. Another, complementary approach is to use DIM to help metabolize the estrogen that has already been created. Could be useful if the scenario I described above comes true and you need to get rid of E2 quickly towards the end of the pellet cycle. In my experience DIM works quickly - almost immediately - with less long term / slow cycle affect than an AI.

Past experience has taught me that my E2 levels decline as my Test levels decline, the higher my T, the higher my E, the lower my T, the lower my E, Im just trying to find a good balance. Regarding my high E2, I've tried a very good DIM/Chrysin formula that has helped a bit, but not enough, now I am experimenting with weight loss, Zinc, a good liver cleanse and Calcium D Glucarate. Ill post my results when I retest in about 30 days.

Interestingly enough, I feel great, lots of energy, high sex drive, insane strength in the gym, morning wood, etc. even with E2 at 88! At my age though, Im still concerned about this high level, reading about possible strokes and heart attacks. The only thing I notice is constant abdominal bloat, and I hate it, Im not sure if its E2 related or not though.

Singinhawk · Dec 12, 2016

Did on search on pellets and saw your post. I have been on pellets for about three years compounded ones. I have noticed that my levels stay relatively stable for 16 weeks before I get a drop off. I usually get a new set at that time. That was observed by my labs. Of course everyone is different and many things can cause pellets to dissolve quicker.

There should be a section here for pellet users. It's growing in popularity from what I am observing. I am dealing with a crash in my E2 because my doc put me on a too high AI dose. Coming off it now but it's messing with sleep

ExcelFemale · May 31, 2017

Hi! I am a female that recently went on HRT including Testopel.
It has been amazing for me (& my husband). It's been 2 months & I am getting myself and my libido & marriage back. I'm in such a better mood, not cranky, have more energy, etc.
is this an appropriate forum for use of T in females. Is anyone interested?
If so, I will continue....

ERO · Jun 1, 2017

Palermitano said:
Past experience has taught me that my E2 levels decline as my Test levels decline, the higher my T, the higher my E, the lower my T, the lower my E, Im just trying to find a good balance. Regarding my high E2, I've tried a very good DIM/Chrysin formula that has helped a bit, but not enough, now I am experimenting with weight loss, Zinc, a good liver cleanse and Calcium D Glucarate. Ill post my results when I retest in about 30 days.

Interestingly enough, I feel great, lots of energy, high sex drive, insane strength in the gym, morning wood, etc. even with E2 at 88! At my age though, Im still concerned about this high level, reading about possible strokes and heart attacks. The only thing I notice is constant abdominal bloat, and I hate it, Im not sure if its E2 related or not though.

You have no high e2 symptoms, so the smart move is to not chase a number, but go with how you feel. With your Total T where it is, your E2 numbers make sense and I would not consider it high. My 2-cents.

ERO · Jun 1, 2017

ExcelFemale said:
Hi! I am a female that recently went on HRT including Testopel.
It has been amazing for me (& my husband). It's been 2 months & I am getting myself and my libido & marriage back. I'm in such a better mood, not cranky, have more energy, etc.
is this an appropriate forum for use of T in females. Is anyone interested?
If so, I will continue....

Congratulations on finding success with TRT. My wife is post-menopausal and has zero libido now and has been low energy and putting on weight so I am interested in learning more about your protocol. I would love for her to feel better again. Since my TRT has been pretty much a failure, she is not interested though and I can see her point. She says, "You have been on TRT for over 5 years and it has not helped you at all..." not in a mean way but in response to any suggestion that she give it a try.

Nelson Vergel · Oct 4, 2021

Fertility and Sterility. VOLUME 116, ISSUE 3, SUPPLEMENT , E340, SEPTEMBER 01, 2021
PDF [88 KB]

pellets from Empower Pharmacy

PHARMACOKINETICS AND SAFETY OUTCOMES OF GENERIC VERSUS BRANDED TESTOSTERONE PELLETS IN MEN WITH TESTOSTERONE DEFICIENCY: A SINGLE-CENTER, OPEN-LABEL, RANDOMIZED TRIAL
Eliyahu Kresch, BA
Manuel Molina, MD
Thiago Fernandes Negris Lima, MD
Rohit Reddy, B.S.
Sirpi Nackeeran, BA
Ranjith Ramasamy, M.D

Objective

Testosterone deficiency (TD) is characterized by low serum testosterone (T) combined with symptoms such as low energy, fatigue, decreased libido and erectile dysfunction. One of the options to treating TD is with subdermal T pellets. Due to cost and cost and difficulty obtaining insurance reimbursement, we evaluated the pharmacokinetics and safety profile of generic pellets. We performed a single center, open-label, randomized clinical trial evaluating the market brand T pellet - Testopel (75mg) and compared it to generic pellets manufactured by an FDA-registered-outsourcing-facility.

Materials and Methods

We performed an open label randomized clinical trial with TD (at least one hypogonadal symptom + 2 testosterone level <300ng/dL or one low total T level combined with one low free T level). The participants were randomized to one of three groups: 10 pellets of 75mg (750mg), 8 pellets of 100mg/E100 (800mg) and 4 pellets of 200mg/E200 (800mg). Implantation was accomplished using a 3.5mm trocar for the 75mg and 100mg groups and 4.5mm trocar for the 200mg group. Serum testosterone levels, PSA, hematocrit (HCT) and estradiol (E) were measured at baseline before implantation and measured again at 2- and 4-months following implantation.

Results

A total of 73 participants have been enrolled in the ongoing trial (27 Testopel, 26 E100, 20 E200). At 2-month follow up the mean serum testosterone for the Testopel group was 682+/-290 ng/dL, the E100 group was 621+/-248 ng/dL and the E200 was 590 +/-285 ng/dL. At 4-month follow up the mean serum testosterone level for the Testopel group was 367 +/-275 ng/dL, the E100 group was 304 +/-248 ng/dL and the E200 was 387 +/-131 ng/dL. There were no statistically significant differences between testosterone levels of the three groups up to 4 months after implantation. Furthermore, side effects such as polycythemia, changes in E and PSA that can occur with T therapy are similar between men who received the market brand vs generic pellets. Notably, 3 patients in the 200mg group and zero patients in the other groups experienced pellet extrusion.

Conclusions

Market brand and generic testosterone pellets are similar in their ability to increase serum total testosterone to within the normal range (300 – 1000ng/dL) for up to 4 months.