Starting TRT/Pellet Therapy: Advice?

[jamin26]

Hi LVJR..
I came across a post re Pellet Therapy, and I have a consultation in about a week for similar TRT using pellets using BioTe Test. therapy here in Colorado. As a newbe, I want to learn what the "watch-out-fors" should I decide to try out this type of TRT? Any bad side effects I should be aware of? Or any adjustments to your protocol that smoothed out the therapy for you? Any concern for long term use? Are you taking the HCG? About me; I'm 56 and have low libido, sluggish energy, brain fog and not much pep in my step.. Any advice on the TRT Pellets is appreciated (are you taking Sotto Pelle pellets?) Thanks in advance!

 

[Jackie Treehorn]

Guys,

After much research and unhappiness with my doc, I decided to switch from weekly shots of Test C(150 mg) to pellets. Last Friday, I had the pellets implanted and the process was a piece of cake. I had 1840 mg of Test pellets implanted. In addition, some of the pellets were mixed with Arimidex(16mg). Its been a little over 5 days and I feel some benefit(killer workout) as well as some mood elevation and overall just a better feeling. It generally takes close to 2 weeks to notice a difference. I'll get labs done in one month to review my numbers. The doc said I will more than likely be back in 3 to 3 1/2 months. I'll keep you posted.

IMHO, you made a bad choice. Pellets are an ancient protocol...if you need to titrate down, how do you do it now? Answer: you don't. Also...excuse me, 16mg of Adex were mixed in with the pellets?? Oh, this should be interesting. Everyone here would love to see your labs in a couple of weeks, if that is possible. I know I would.

I'd also love to hear Dr. Saya's opinion of your protocol, if he has the time.

 

[ERO]

The big issues with pellets are twofold. 1) It is next to impossible to adjust your dosage. Say you get injected and then tested 3 weeks later and your T is too low? Or it is too high? What can you do? Pretty much nothing...Additionally E2 is mat be hard to control. 2) Quite often the Doc can only give you new pellets every 12 weeks, but often T levels drop to the "Low T" range for the last 4 to 5 weeks of the 12, but you are stuck feeling like crap because you have to wait the full 12 weeks.

 

[Dr Justin Saya MD]

There is a place, albeit a limited one, for pellets in very select patients for various reasons (poor transdermal absorption for topicals and unwillingness to self-inject), but it does suffer from the exact drawbacks listed. I agree it is not the ideal method for most. We may, in fact, offer pellets on a limited basis in the future for patients that fall into the above two categories, but that's about it. The much BIGGER problem is ANASTROZOLE 16mg...enough said!

 

[CoastWatcher]

Were other modes of therapy discussed? Though it fails in a significant number of men, topical testosterone (gels or compounded creams) is something that should have been considered, along with, what here at EM, is the preferred treatment method, injections. Were the pros and cons of all these approaches reviewed?

 

[Dr Justin Saya MD]

We're other modes of therapy discussed? Though it fails in a significant number of men, topical testosterone (gels or compounded creams) is something that should have been considered, along with, what here at EM, is the preferred treatment method, injections. Were the pros and cons of all these approaches reviewed?

Not to speak for OP, but I believe the entire business model of BioTe is based on pellets...so from experience they typically "talk down" on other methods (transdermal, injections) and "talk up" pellets. The initial meeting with most of these type of clinics is often with a sales person to "sell the patient" on pellets, which most often is the only mode of TRT the clinic will offer. The example here may be different, just commenting on the majority.

 

[johndoesmith]

Not to speak for OP, but I believe the entire business model of BioTe is based on pellets...so from experience they typically "talk down" on other methods (transdermal, injections) and "talk up" pellets. The initial meeting with most of these type of clinics is often with a sales person to "sell the patient" on pellets, which most often is the only mode of TRT the clinic will offer. The example here may be different, just commenting on the majority.

Unless I'm completely misunderstanding esters, I never understood how anyone can claim that testosterone cypionate isn't functionally "bioidentical".

The cypionate ester is simply cleaved off in serum(probably, unless most of it is cleaved off in the depot when the oil comes into contact with blood, then the pure testosterone is absorbed via the vascular system) leaving PURE testosterone.

How is that not bioidentical?

 

[Dr Justin Saya MD]

Unless I'm completely misunderstanding esters, I never understood how anyone can claim that testosterone cypionate isn't functionally "bioidentical".

The cypionate ester is simply cleaved off in serum(probably, unless most of it is cleaved off in the depot when the oil comes into contact with blood, then the pure testosterone is absorbed via the vascular system) leaving PURE testosterone.

How is that not bioidentical?

At that point, it IS bioidentical.

The term "bioidentical" is only really a topic of discussion with female BHRT treatments. Virtually all commercially and pharmaceutically available testosterone preparations for male TRT are bidoidentical in that regard. Anabolic/androgenic steroids (AAS) are the equivalent of "non-bioidentical" in this context.

 

[C-YA]

I used Biote pellet therapy done in Mexico several times. I have also never have had an issue. I went in and had blood drawn for all my markers needed for this treatment. I came back less then a week later and the doctor went over my results and gave me options. I never have had an issue in to much or too little as he figured out the math and gave me the correct dosage. Nothing like shots up and down and back and forth.

I have great results, lost my belly and man boobs. I slept better no night sweats. My work outs increased and felt over all better down below. all this happened with in 3 weeks and lasted almost 6 months. Going in for my 4th treatment next week. Oh yes

 

[MIP1950]

I did try Testopel years ago. Though the labs looked great, zero response. But I'm not negative about pellets. My urologist, with decades of experience, added pellet therapy to his practice but still prescribes injections, gels, compounded creams. I talked with men six years ago on peaktestosterone.com who had excellent response to pellet therapy and that included taking an ai to manage E2, which improved one man's response. I find many men sharing their problems 'dialing in' their injection protocols, forever tweaking it, changing it, stopping it or adding ancillaries and supplements. There are many abstracts and personal experiences regarding subq but for me, I don't feel it and I've tried it several times.

We don't always hear success stories, whether on IM, subq, cream or pellets. On here, we do hear success stories, which are wonderful to read. It gives those of us who are treatment outliers, hope. And I tend to suspect there are more success stories with pellets than we know. Dr. Kathy Maupin in St. Louis found personal success with pellet therapy and then devoted her whole practice to pellets, exclusively, for men and women. Yes, it's surgery. Yes, if you pay out of pocket, pricey, but if you have insurance, it's covered. If Medicare approves something, private insurers follow suit. The one gripe I've heard is how much money a doctor makes from the procedure. So what? If it helps you, you're not going to gripe. You'll be glad your insurance covered it. And if you can afford to pay out of pocket and get some reimbursement from your insurance, icing on the cake. Being down in the mouth about pellets doesn't help someone seeking advice. And even if it failed to help you, it doesn't mean it won't help someone else.