T Nation

Help with Suggested Therapy - BioTE Pellets

Hello all, thanks in advance for responses. For the past couple of years I have suffered from very low concentration, low energy, low motivation, slight depression, slight anxiety, etc. Currently 34 years old. I was initially diagnosed with ADHD and have been on Adderall for the past couple of years. It worked great at first, then not so much. Very jittery, on edge, irritated, and stopped working for the most part. Then I voiced my concern about how tired I felt and couldn’t focus for the life of me, psychiatrist ordered blood work, and sure enough my testosterone total level came in at 225. Notably, vitamin D also came in low at 15.

I was referred over to the PA in their office which was trying to push this pellet treatment called BioTE - they’re bio-identical hormone pellets, injected every 3-4 months. I did some research and was a bit skeptical, as she made it sound like this was some wonder drug and that all my problems would go away.

Has anyone tried BioTE? I can’t seem to find enough reviews that seem legit. Would greatly appreciate any and all help. It has just gotten so bad with my energy levels, inability to focus and think, inability to be motivated, and it has really brought my life to a screeching halt. I also have the following questions:

  1. How do the pellets work in general in improving the symptoms I mentioned? How noticeable have the changes been for you? Again, the biggest struggles are feeling fatigued all day and have a really hard time thinking and learning new concepts.

  2. How long did it take before pellet TRT starting really working and improving your cognition/thinking and energy levels?

  3. Have you heard of or used BioTE TRT treatment? I’m thinking of making an appointment with a doctor that prescribes Testopel.

  4. Has anyone noticed that their ADHD symptoms went away after improving their T levels?

Here are my other blood work numbers:

Total T - 225
Free T3 - 3.8
TSH - 2.3
TPO - 2
SHBG - 21.7
Glucose - 88
Hgb A1c - 5.5
Ferritin 125
Vit B12 - 747
Vit D - 15
Cholesterol - 234
TGY - 258
HDL - 31
LDL - 151
WBC - 6.7
Hgb 14.9
Creatinine - 0.96
Potassium - 4.6
Calcium - 9.8
GFR - 103

Thank you in advance!

Gonna make a leap here. You do not have ADD, or ADHD. You do not. You felt better initially on Adderall because it’s a stimulant (generic is in fact amphetamine). It stopped working because you have down regulated the receptors, you feel jittery because you do not have ADHD. You do have low T and low D. Why is your vitamin D low? You really should know that first, as D plays a role in test production. Also, ranges are nice to go with the numbers as ranges are lab to lab, not standard.
The pellets are TRT. “Bio-identical” is fairly meaningless, all test is really bio-identical. Pellets work for some guys, but it is a commitment. You have to live with them for several months and it’s a cookie-cutter solution. Most guys prefer something we can adjust the dose on, be it scrotal cream or injections.
I think @travelling_man is on the pellets.

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You know, crazy that you mentioned that, I’ve been looking into the correlations of ADHD with low T, or at least the symptoms. Not much info, but the symptoms for me are definitely related.

Have you noticed much of a change with respect to your ability to concentration and really THINK? I capped “think” because I’m really trying to highlight my inability to think - it’s become a huge issue for me. And when noon rolls around? Fully fatigued. Say I take a nap sometime in the day, by 5-6 pm I’m done again.

Re the ranges:
Total T - 225
900-1100

Free T3 - 3.8
4.0 - 4.2

TSH - 2.3
0.5 - 1.0

TPO - 2
<34

SHBG - 21.7
17 - 66

Glucose - 88
<125

Hgb A1c - 5.5
<5.7

Ferritin 125
10 - 220

Vit B12 - 747

550

Vit D - 15

60

Cholesterol - 234
<200

TGY - 258
<150

HDL - 31

39

LDL - 151
<100

WBC - 6.7
4.0 - 11.0

Hgb 14.9
13.0 - 17.0

Creatinine - 0.96
<1.4

Potassium - 4.6
3.5 - 5.3

Calcium - 9.8
8.5 - 10.5

GFR - 103

60

Thanks again man!

I did a run with pellets when I was moving from one state to another. They were OK. They dissolve over time giving you a sustained release. The insertion is not the most pleasant thing and it takes a while for the incision to heal (they put them in your buttock) and I even had a pellet come out.

Injections are better in my opinion.

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Thanks for the response. My concern with the injections are the ups and downs I constantly read about here. Also, aren’t doctors going to want you to come to their office every time you need to inject?

Which process did you find worked the quickest?

There may be one or two people here that are trapped at some shady clinic forcing them to come in for.injections. everyone one else self injects. Im not gonna mention who i use cause it usually ends up with talk of paid advertisement but telemedical clinics are very convienient and cost effective. Read enough posts here and you will figure out which are good choices.

Thanks man! May be a stupid question, but what is a telemedical clinic? Do you need scripts? Do they provide scripts? And how do you know whether you’re using the right amounts?

Its a dr that you use over the phone/ internet. All scripts are shipped to you and you do blood work local that gets sent to them

No kidding, that’s crazy. Do they have to be based in the state you’re in?

I just completed my first year on BioTE pellets.

My journey is here
https://forums.t-nation.com/t/high-t-fsh-shbg-low-e2-no-libido-my-lab-results-pellets

That would be a bad choice.

I did some research and was a bit skeptical, as she made it sound like this was some wonder drug and that all my problems would go away.

Yet you want to go to testopel???

Nope. Mine is in FL and i live in RI. Thats the whole point. If they were in your state it would probably be more practical to just see them in the office

I also did pellet therapy for a while but discontinued it in favor of injections. Let me tell you why.

  1. Extended dialing-in period.
    As anyone on TRT will tell you there are two processes that present the greatest amount of frustration. The first is finding the right dose of Testosterone to make you feel optimal…this period for some can be quite lengthy and find you and the Dr. jumping from one dosage to the next in an effort to find your sweet spot. With pellets you Dr. is going to want to wait until the first round dissolves before making any changes…this process takes on average 16 weeks for the pellets to dissolve. If you need to make 3-4 corrections to find your correct dose then potentially it would be a year before you got dialed-in. Wanna wait that long?
  2. Cost
    Ask you provider how much they charge for the insertion. I’m betting it’s 100’s of dollars.
  3. Risk
    Every insertion is a mini surgery. No, it’s not cardiac surgery, or rocket surgery, but’s it’s a risk of complications and dose leave a bit of a scar.
  4. Rejection / Extrusion
    It’s not uncommon for patients to extrude pellets from time to time either through poor insertion procedures or failing to follow post insertion protocols. I’ve lost 2 pellets on my final treatment. It’s not the end of the world but it’s aggravating considering the cost you pay AND now you know you won’t be getting all the medicine you need to feel good, so it’s doubly aggravating.

The biggest benefit to pellet therapy is convenience. It’s nice not to have to inject twice a week. It’s nice to be able to travel anywhere without having to worry about flying with syringes and stuff.

In my mind the absolute best method is subq injections. They’re safe, cheap, and easier to dial in.

Thanks for your response, but why a bad choice? I figured that would be much better since the actual product is the same from each treatment, consistent that is.

How happy are you with BioTE? Have you or will you do injections? How long did it take for your results?

Thanks for your response!

How long until you noticed a response on both pellets and injections? Which did you find was the method that kept you at a consistent optimal level?

Both methods provide consistent optimal levels once you get them dialed in…the trouble with my pellets experience was that I was almost a year into the dialing in process and wasn’t convinced I was going to get there! I forget where I started but remember 3 different procedures each one was a jump up in the pellet count. My final insertion was 9 pellets (and I ultimately extruded two of those) so I never really got there before I got tired of waiting for results. I switched to injections ASAP and was dial-in in a month or two.

With both forms you feel the results fairly quickly…faster with injections but again, your results may vary depending on how close your first dosing is to your sweet spot. I noticed that I felt better within a few weeks.

Is there a formula that Drs use to figure out find the optimum amount of either pellets or juice? Seems like these guys should at least have some sort of guidelines to follow that’s logically grounded.

Btw, did you notice a huge difference in your ability to think/concentrate/pick up material and energy levels? This is HUGE for me.

I can’t speak to whether there’s a formula or not…my assumption is that each Dr. approaches things differently. Some are good and some are not so good. I imagine that each will take into account your free and total T #'s as well as other health factors before selecting a starting dose. Some may be more conservative and others not so much. What you really want to hear is something to the effect of “I don’t aim for a certain # (referring to Free and Total T), I’m more interested in how you feel” Hearing this from a Dr. is music to my ears because it signals that they are more interested in my outcome than they are in simply getting my TT to 900. They are going to be more willing to look at other things related to my condition other than only low T and more apt to let me experiment with higher doses than the typical standard of care recognizes.

And yes, I noticed a day and night difference in mental clarity, and energy levels once I got dialed in. If low T is your only problem then this will change your life.

Your thinking will be a lot better once you are dialed in, it will probably improve even before everything is just right. If you have dopamine issues do not expect the “honeymoon” period many guys get, but things do improve. Energy, ambition, drive, clarity are all better.

Incorrect. My first pellet boost occurred within 30 days of first insertion. BioTE pellets are in your system within 48 hours. Get blood work done. If the levels didn’t go up, your doctor should give another insertion. Find a better doctor if he doesn’t.

Cost shouldn’t be the main concern for everything … otherwise, no one would own a $50,000 truck instead of a Ford Fiesta. Choose what is best for you if you can afford the difference.

I pay $750 for insertions. This cycle, I got 6 months out of it. That is $125 per month. I pay more than twice as much for labs than I do for pellets.

How much is it worth to feel good and alive again? You must decide.

Compare that to the risk of injecting yourself 2 or 3 times each week, without fail, for the remainder of your life. Traveling with needles. Disposing of used syringes and needles. Breaking a needle. I could go on …

Ask your doctor his extrusion record. Mine was clear - you don’t follow post insertion protocols I don’t treat you again.

As I said … you go in for an insertion, and other than to go for labs, you are done for months. NO needles, no injections, no traveling with syringes, nothing to do again for months. How much is the convenience worth to you?

The first cycle will likely not give you happy feet. You will feel good for a period of time, and depending on how fast your body aborbs the pellets, you might have a month where you don’t feel good until you re-schedule.

Getting your blood labs are the best way to teach your doctor what your body needs.

Before accepting “any” BioTE doctor, call around to the other BioTE doctors in your area. Find out which of the doctors is actually a BioTE patient as well.

Pellet users don’t post on these boards because they don’t have problems. These boards are for problems and people who are self-treating.

You are a good candidate for pellets based on your labs - except that I don’t see an Estradiol test.

Your fuzzy mind, fatique by noon, no interest in anything … my thread is long. But if you are serious, read it. I suffered with all of this and MORE.