Testosterone Pellet Dose Comparison

[LVJR]

Nelson,

Good afternoon.

How would one compare a pellet implant dose to a IM weekly injection. For example, I had 1840 mg of Test implanted 2 weeks ago. Prior to that I was receiving 150 mg of Test C per week. I'm basing this on a 3 month re implant schedule.

Thanks for your assistance.

 

[Gene Devine]

I don't think you can compare how they metabolize as their delivery route is entirely different notwithstanding that we all metabolize at different rates anyway.

Only BW will tell you how you are metabolizing each mode of delivery LVJR.

 

[Nelson Vergel]

Nelson,

Good afternoon.

How would one compare a pellet implant dose to a IM weekly injection. For example, I had 1840 mg of Test implanted 2 weeks ago. Prior to that I was receiving 150 mg of Test C per week. I'm basing this on a 3 month re implant schedule.

Thanks for your assistance.

It depends on the pellet. Testopel, the only FDA approved pellet in the US, contains only 75 mg per pellet. Compounding pharmacies can legally make pellets up to 200 mg of testosterone per pellet. I am not sure which one you are using.

12 Testopel pellets were able to keep my total testosterone over 500 ng/dL for 10 weeks or so. The manufacturer swears it lasts longer than that, with promises of 3-4 months. They use 350 ng/dL as the cut off point to decide when to insert again, but we know that is not enough for most of us.

In this study using a 200 mg pellet, they found that "the estimated rate of release of testosterone from one pellet was 1.5 (95% confidence limits 1.3-1.6) mg/day as determined from direct measurement of residue in pellets recovered after extrusion and confirmed independently from percent absorbed-time plots."

A healthy man can produce 4-6 mg per day of testosterone.

Here is a graph that shows the blood level of testosterone (average) in 14 men who were administered 6 - 200 mg pellets (total of 1200 mg).


Since the graph uses metric units (nmol/l), we need to convert 500 ng/dL into nmol/l by dividing 500 by 28.82 = 17.4 nmol/l

This level was achieved in about 140 days (or 20 weeks or 5 months) after insertion of the 6 -200 mg pellets

Testopel has 75 mg of testosterone. For 1200 mg of total T dose, 18 Testopel pellets would be needed. As a guess estimate, 9-10 Testopel pellets could be sufficient to keep T levels above 500 ng/dL for 10 weeks (based on an assumption that a constant 1.5 mg per pellet would be released, which may be different for a smaller pellet like Testopel).






http://www.hormonebalance.org/images/documents/Pellets Pharma Clin En 96 Jockenhovel.pdf

More information on testosterone pellets can be found here:
Testosterone Replacement Treatment Options

 

[Nelson Vergel]

This information came from the package insert of Testopel (they do not show any graphs which surprises me from the FDA point of view). I must say that I strongly believe this information is not right after reading papers using 200 mg pellets. The dosage requirement is highly under estimated!

TESTOPEL DOSAGE AND ADMINISTRATION

The suggested dosage for androgens varies depending on the age, and diagnosis of the individual patient. Dosage is adjusted according to the patient's response and the appearance of adverse reactions. The dosage guideline for the testosterone pellets for replacement therapy in androgen-deficient males is 150mg to 450mg subcutaneously every 3 to 6 months. Various dosage regimens have been used to induce pubertal changes in hypogonadal males; some experts have advocated lower doses initially, gradually increasing the dose as puberty progresses, with or without a decrease in maintenance levels. Other experts emphasize that higher dosages are needed to induce pubertal changes and lower dosages can be used for maintenance after puberty. The chronological and skeletal ages must be taken into consideration, both in determining the initial dose and in adjusting the dose.

Dosages in delayed puberty generally are in the lower range of that listed above and, for a limited duration, for example 4 to 6 months.

The number of pellets to be implanted depends upon the minimal daily requirements of testosterone propionate determined by a gradual reduction of the amount administered parenterally.

The usual dosage is as follows: implant two 75mg pellets for each 25mg testosterone propionate required weekly. Thus when a patient requires injections of 75mg per week, it is usually necessary to implant 450mg (6 pellets). With injections of 50mg per week, implantation of 300mg (4 pellets) may suffice for approximately three months. With lower requirements by injection, correspondingly lower amounts may be implanted. It has been found that approximately one-third of the material is absorbed in the first month, one-fourth in the second month and one-sixth in the third month. Adequate effect of the pellets ordinarily continues for three to four months, sometimes as long as six months."

Comment: I have no idea what man only needs 25-50 mg per week of testosterone injections!! So, for a man using 150 mg per week, you would need 12 pellets for 3 months.

http://dailymed.nlm.nih.gov/dailyme...741a0b-3d4c-42dc-880d-a06e96cce9ef#nlm34090-1

 

[LVJR]

Thanks Nelson.

My dose was 16 pellets @ 100 mgs and 4 pellets @ 60 mgs

 

[LVJR]

Just received blood results back. After 1 month since pellets were implanted, Total T is 1122 and E2 is 15....I'm feeling great.

 

[Gene Devine]

Just received blood results back. After 1 month since pellets were implanted, Total T is 1122 and E2 is 15....I'm feeling great.

Excellent!!!