BioTE Frequently Asked Questions
How long have pellets been around?
Originally developed in 1939 for women who underwent radical hysterectomies. Widely used in Europe and Australia, they are the longest studied form of hormone replacement therapy (HRT) to date.
Why, until now haven't I heard more about bio-identical HRT?
Bio-identical HRT was very popular until a large pharmaceutical company Wyeth/ Ayerst developed Premarin in 1942.
What is the pellet made of?
Pellets are estradiol or testosterone and stearic acid is used to bind the “pellet”.
How big are pellets and can you feel them?
They are no bigger than a grain of rice. Occasionally pellets may be felt underneath the skin due to swelling, this will typically disappear within 24 hours or in some cases, although rare, up to a month. *Limited gluteal exercises after insertion for 72 hours in women and 7 days in men can reduce swelling.
Are pellets FDA approved?
The estrogen and testosterone in the pellet are FDA approved. The manufacturing of pellets 503B outsourcing facilities is under strict regulations by the FDA.
How often do patients need pellets?
3-5 months for women and 4-6 months for men.
After insertion, what happens to the pellets? Does BioTE "remove" pellets?
Over time, the pellets are completely dissolved into the bloodstream and eventually disappear. Patients will know it is time for their pellets to be replaced when symptoms begin to return. Patients will be able to estimate their own biological schedule for re-pelleting after the first few cycles of hormones.
What differentials pellets from other therapies?
Pellet delivery system allows your body to use the right amount of hormones as needed. Blood flows around the pellets and absorbs the hormones at exactly the right time.
Do patients need to stop taking any medications before getting blood labs?
No. If they are currently on some hormone replacement such as creams, patches or oral HRT, do not apply or take their hormones the day of getting their blood drawn. Once blood is drawn, patients may resume taking or applying as directed. For injectable hormones, BioTE recommends draw blood the morning they are supposed to receive their next shot before they receive their hormones. Once pelleted, women will stay on their existing hormone therapy for 3 days and then discontinue on day 4. Men should discontinue their existing hormone therapies 7 days after pelleting. This is often the best method to transition patients off of existing hormone therapies.
What about birth control?
Stay on your birth control. Pellets do not serve as a method of contraception. Premenopausal women need to remain on BC to avoid pregnancy.
Some other offices use saliva testing. Does the BioTE method do saliva testing?
A key hormone, to the BioTE method, FSH, cannot be detected in saliva. Most insurance companies DO NOT pay for saliva testing.
How long will it take for the pellets to get into my bloodstream?
Symptom relief can occur anywhere from 72 hrs to up to three weeks for first-time patients. Patients should expect to feel some degree of symptom relief within a month of pelleting or even sooner. Dosage and treatment plans may be adjusted if the patient has no symptom relief.
Are there any side effects of pellet HRT?
Some reported secondary responses are noticeable in the first two rounds during the initial balancing phase or re-optimization phase.
Mild fluid retention, acne or more hair growth as well could occur. Men may experience some testicular shrinkage, this is normal.
Fluid retention, especially in hot months, or some temporary swelling. This is temporary and most practitioners may call in a mild water retention pill if needed. Some women may experience some spotting if she still has her uterus, and was given Estrogen by her practitioner. Progesterone will be prescribed for those women to relieve this adverse effect. Progesterone should be taken in the evening with food as some women report it could make them drowsy. Acne can occur, and practitioners may prescribe Spironolactone for resolution. If your office has an esthetician, they can offer some acne topical treatments for the patient. Hair may appear to grow faster when hormones are optimized. Again, aesthetic treatments may be offered for those women. If secondary responses persist, dosage can be adjusted to help avoid the issues.
How long will it take for me to lose weight?
An exercise regime is essential in optimizing hormones, reducing fat mass and increase lean muscle mass.
Are pellets time released?
No. Pellets are released based on cardiac output. The more active you are, the more the hormone is released as needed.
Is there any pain experienced during the procedure?
Very minimal pain. Patients will feel the initial stick of the needle where the lidocaine/bicarbonate was injected. Most patients may feel pressure during the procedure. The insertion should only take about 3-5 minutes for women, a little longer for men.
Why Sodium Bicarbonate with Lidocaine?
Sodium Bicarbonate is not required to perform the pelleting procedure; however, it butters the lidocaine to reduce the sting of the initial needle stick.
Is there proof that pellets really work?
There is a significant amount of published scientific data on pellet therapy focusing on the heart, breast, bone and brain protection.
What is the cost for pellet HRT for patients?
Practitioners will determine the actual cost for you.
What if a patient can't afford pellet therapy?
Relatively the cost of pellet HT is less than other therapies.
Does insurance cover pellet HRT?
Most insurance providers WILL cover the lab work and consultation. It is up to the patient to contact their insurance provider to see if they could receive any reimbursement.
Can't my hormones be optimized by just diet and exercise alone?
Diet and exercise are essential components; however, it does not replace the loss of hormones the body experiences with the aging process, stress, toxins, obesity and many other factors.
What is cardiac output?
Cardiac output is the amount of blood that the heart ejects into the bloodstream per minute, exercise increases cardiac output.
Can breast cancer survivors receive pellet?
Yes. BC survivors may be treated with testosterone. They should not receive estradiol. Patients must be evaluated by a certified BioTE Practitioner to determine if hormone replacement therapy is appropriate. Studies show testosterone alone can address up to 90% of symptoms common in BC survivors such as fatigue, depression, bone loss, heart issues, libido loss, and many other health benefits.
Can prostate cancer survivors receive pellets?
Yes. After the prostate cancer has been treated or removed and the PSA blood test is negligible the patient can be pelleted. Studies show testosterone does not cause prostate cancer and has been shown to be good for the prostate.
Why doesn't BioTE have all the other "vitamins" I hear about?
Currently the nutraceuticals recommended are for optimization and balance, specifically for hormone optimization.
Why did our practitioner advise the patient to include iodine in their therapy?
It is beneficial and a great antioxidant. It improves thyroid function and is protective to the thyroid. There are studies that show iodine reduces the incidence of breast cancer. Iodine will reduce toxins in the body as well.
Why did our practitioner advise the patient to include DIM in their therapy?
DIM contributes to a better metabolism of testosterone and estradiol. It also increases the patient's free testosterone. Probiotic repairs and restores the good healthy bacteria in the GI tract. It allows better absorption of nutrients from the food we eat.
Why did our practitioner advise the patient to include ADK in their therapy?
It contains Vitamin A, Vitamin D, and Vitamin K2. The combination of these fat-soluble vitamins are key nutraceuticals in maintaining healthy bones and healthy blood vessels in our hearts.