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Do Bioidentical Hormones Work? – What You Need To Know Before Starting Testosterone Pellet Therapy

Do bioidentical hormones work? Let’s discuss.

Are you being lured in by all the advertisements about “all natural,” “bioidentical hormone” treatment? Are you considering having your testosterone levels checked or treated? You may want to take a closer look at these “bioidentical” hormones.

Do bioidentical hormones workThe term “bioidentical testosterone” has been hijacked!

So we asked ourselves, do bioidentical hormones work the way marketers would have us believe?

Are they really any different than commonly-used hormones?

The manufacturers and providers of these treatment options would have you believe that they are offering an organic, non-pharmaceutical option for testosterone replacement therapy.

Their marketing uses the word “bioidentical” when referring to their medication, as if using that form of treatment is the only way to give your body something it recognizes.

The fact is, testosterone injections, topicals (gels/creams), and pellet implants all utilize such treatment. Let’s take a look at what this term really means.

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How Marketing “Bioidentical” Hormone Therapy Works

The buzzword “bioidentical” refers to how closely a medication matches its biological or naturally occurring counterpart on a molecular level.

So, in short, does the medication you take look exactly like what your body would produce? The answer is NO! So, do bioidentical hormones work? Not the way you expect.

This is quite possibly the one and only time you will ever find me agreeing with Dr. Oz, but don’t believe the bioidentical hormone myth.

The real question should be, “Will my body recognize and react to the medication that you prescribe in the same way it would react to naturally occurring hormones?” The answer to THAT question is: YES!

While the testosterone used in both standard prescription medications and compounded creams, gels, and pellets is more biomimetic (behaving like its natural counterpart) than bioidentical, the brain does identify and react to this testosterone the same way it would if you were producing the testosterone naturally.

The endocrine system functions on feedback loops that regulate internal hormone production. Therefore, this will have an effect on more than just your testosterone levels.

Understand that even with “bioTE” pellets, you are not receiving an “all natural” testosterone.

It is true that they use a natural source for the raw ingredients (plant sterols), but those ingredients must still be manipulated in a lab and then compounded in a sterile pharmacy to make it appropriate for human treatment.

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How Do “Bioidentical” Hormones in Testosterone Pellets Work Compared To Other TRT Options?

These compounded medications are not approved by the FDA and are therefore not covered by insurance.

Studies show that, with TRT by pellet implantation, your levels are not held consistent between implantations. When the surgical procedure that is necessary to implant the testosterone pellets under your skin is complete, all the medication that you have been given begins to absorb.

This procedure typically makes your testosterone levels go up higher than they ever would naturally for the first month. Thereafter, your levels begin to plummet.

This means that, while your levels are still barely normal 4-6 months after implantation, your body goes on a huge, and potentially dangerous, roller coaster ride to get there.

Instead of dealing with potentially-dangerous pellets or questionably-marketed “bioidentical hormones” that may not even work, click the button below to set up a FREE consultation with Testosterone Centers of Texas today!

During your free consultation, we will discuss both the benefits and the risks of any potential treatments, and we can get you your testosterone test results back in under 30 minutes.

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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.


  1. […] Testosterone injections are the most effective form of testosterone treatment: better than gels, better than creams, and certainly better than pellets. […]

  2. cheryl on 02/13/2016 at 10:07 am

    I am a post menopausal woman who has long suffered from a nonexistant libido. For many years I took testosterone injections as well as estrogen which worked great. Then I started having an irregular heartbeat (mainly PVC’s) which I eventually figured out was caused by the testosterone. Since I have stopped the testosterone the PVC’s have stopped, however, now I’m back to a nonexistant libido and a very unhappy husband! Have you every heard of this before? Is there anything else I can take (a different form of testosterone or something else) that will boost my libido?

    • Augie Galindo on 02/17/2016 at 10:38 pm


      I have never run into this before, but being that one potential side effect of testosterone replacement is an increase in blood viscosity (hematocrit), I could see how it could potentially exacerbate some other issue, like Mitral Valve Prolapse for instance, that could in turn cause PVC’s. There is a new drug on the market that was specifically developed to treat decreased sexual desire. The name of the medication is Addyi (flibanserin), and you can read more about it here: . I know very little about it, so I would encourage you to speak to your provider about its appropriate use and potential side effects.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  3. sharon on 02/14/2016 at 3:34 pm

    I had a pellet implant a couple of days ago. i still have the hot flashes, not as many, but they are decreasing. I sleep much better I noticed that right away, and on a scale of 1 to 10 do I fell better it’s about a 5, 10 being the worst. I paid 1200.00 for the whole thing pills and blood work and the pellet and i think that giving it a try was my only opinion . i was having 50 hot flashes a day they were non stop. No sleep at night. Crazzy maybe next time I will go for the shots because my hair is falling out i’m about 30 pounds over weight no energy so I will wait I think i would like the shots better 1200.00 is a bit prizie. I will see how it goes.. sharon

    • Augie Galindo on 02/17/2016 at 10:43 pm


      Best of luck to you! I do know some patients who swear by pellets, and I know others for whom the never really worked appropriately. A clinic that manages by injections, and that accepts insurance, would likely save you a significant amount of money.

      Best regards,
      Augie Galindo, MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  4. Maxwell on 12/08/2016 at 5:03 pm


    I am a 24 YO male and I have been on and off Test. Cyp. shots since I was 17 due to non advancing puberty that couldn’t be attributed to a pituitary tumor or any other known chromosomal or medical conditions. I was basically told that for whatever reason my testicles have the ability to produce testosterone but my brain wasn’t telling them to do it. The endo thought that maybe doing the shots for a few months would “kick start” my puberty and I would be able to get off the shots once my body started naturally producing. After approx 2 years off the shots I had my levels tested again and not surprisingly my levels were extremely low. I say not surprisingly because for me it’s easy to tell when I’m low (no sex drive, decreased erections, moodiness, etc.). My PCP started be back on test. cyp. shots and I began to feel better. I have another endo appt. in January but it’s looking more and more likely that I will have to remain on TRT for the rest of my life if I want to maintain a sexually active lifestyle and keep my body in balance. I am afraid that constantly injecting my body with synthetic hormones will damage my body in unforeseen ways. Do you have any advice for someone who is looking down the barrel of long term (like decades) of synthetic TRT on how to stay healthy and avoid negative health affects or of any other options on how to help my body stay in balance without TRT?

    • Augie Galindo on 12/08/2016 at 6:17 pm


      Thank you for reaching out. I agree that with the limitation of where we are at in treating hormonal deficiency, at least for now, it does appear that this will be a life-long need for you. One option to consider is hCG monotherapy, I would recommend against Clomid/clomiphene just in case that is ever debated as a possible solution.

      While all injectable testosterone is synthetic, there have been no significant findings that would indicate that this this poses any particular problems. Testosterone therapy has been around since the 1940’s, and though there have been no solid, long-term, proscpective studies I see no indication of a looming threat.

      The safest management of therapy will require close monitoring of your estradiol, hematocrit (blood thickness), and PSA levels over the course of treatment.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Cheryl on 07/01/2017 at 3:23 pm

        There is one potential side effect of long term use of any steroid and that is steroid induced glaucoma. It happened to me. Research it and and have your eye pressure checked yearly!

        • Augie Galindo on 07/03/2017 at 1:55 pm


          Thank you for bringing this up. I actually have researched this before. I know several optometrists and one of them brought it up to me. The literature shows this to be an issue with corticosteroids (which testosterone is not), and it also requires some other factors. One is an anatomical predisposition to glaucoma, and the intra/periocular use of corticosteroids; either topically, inhaled, or applied to nearby anatomical structures. However, annual eye exams are always recommended.

          Best regards,
          Augie Galindo MPAS, PA-C
          Testosterone Centers of Texas | Founding Partner

  5. heather on 02/15/2017 at 9:40 pm

    what forms of testosterone do you use for women? enanthate? cypionate?

    • Augie Galindo on 02/24/2017 at 1:33 pm


      For injections, which is the modality I prefer, we use testosterone cypionate.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  6. Ryan on 04/20/2017 at 5:20 pm

    Hello, I’m 24 and tested my levels which came back low (240). I had always assumed that I was low in testosterone but never looked for resources to confirm that self diagnosis until I started talking to someone from a clinic and said I can get a test. He provides BioTE as a solution and I’ve read good reviews but haven’t seen much for a 20 year old, can I get some advice? This article has me wondering what the next step is. Thanks

    • Augie Galindo on 04/24/2017 at 4:35 pm


      I may not be the best source here. I pretty much categorically recommend against pellet therapy. BioTe has fantastic marketing, but bad science. You can’t give six months worth of medication, dosed through pellets without time-released properties, and have it deliver consistent levels over time. What you see with pellets is an extreme elevation of testosterone levels for the first month or so after implantation, then a precipitous drop over the next two to three. This creates a troublesome roller coaster effect of symptoms, but a dangerous roller coaster of risks.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

      • Ryan on 04/24/2017 at 4:55 pm

        So obviously this isn’t something you recommend by that statement, which is unfortunate. Now I am definitely not sure what to do

  7. Kage on 05/21/2017 at 10:09 am

    My wife did the Bio Tee Pellet and loved the energy, positive mood and increased libido. However, she began to have periods again. So her Doctor put her on estrogen. The Doctod did another exam and and said that it was causing her uterus wall to thicken and took a biopsy that proved negative for cancer. Her Doctor took her off the pellet but has her on Protesteron. It is all very confusing. Any comments?

    • Augie Galindo on 05/25/2017 at 7:13 pm


      I typically don’t recommend the isolated use of testosterone in women unless you are at least monitoring (if not treating) the estrogen/progesterone balance. This is a much more complex task than TRT for men. I am glad that the biopsies were negative. I always evaluate symptoms, testosterone, estradiol, progesterone, and thyroid hormones in my new female patients.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  8. H. Dezile on 07/27/2017 at 7:51 pm

    I had bioRE HRT pellets inserted 8 days ago. I had a hysterectomy at age 35, my ovaries have atrophied to nothing (I’m now 63) and I had all the symptoms of post-menopause for years such as dry skin, chronic insomnia, depression, zero libido.
    On the 3rd day after insertion I developed the beginning signs and symptoms of a vag yeast infection. The itching and excessive moisture worsened by the day.
    The doctor who prescribed the pellets after testing my P, E and T levels said the yeast infection wasn’t from the pellets; however he prescribed a 5 day course of Diflucan tablets and told me to “double my Progesterone capsules” for 3-4 nights (from 200 to 400 mg’s every night to 400 mg’s). I am still itching and burning like crazy despite doing everything “right” to avoid/stop these symptoms. I am scared because these pellets are in my body for the next 4-6 months and I already wish I’d never had them put in. There are countless papers online about post-menopausal women getting yeast infections after HRT. But my doctor says the bioTE pellets have no connection to this unusual occurrence of my getting a yeast infection for the first time in well over a decade. My breasts are also very tender, much like they felt at the beginning of my two full term pregnancies. Your thoughts/suggestions are welcomed!

    • Augie Galindo on 08/03/2017 at 4:42 pm

      H. Dezile,

      You are correct, increased estradiol levels (especially when not appropriately balanced) can contribute to an overgrowth of Candida; the microbe responsible for yeast infections. Your symptoms, and moreover the probability of their prolonged persistence, is precisely one of the reasons I recommend against pellet therapy. All of the side effects you have listed appear to be related to hyperestrogenism/estrogen dominance. This is, no doubt, secondary to the pellets.

      The good new is that the pellets rarely have a significant effect beyond 3-4 months past implantation vs. the 4-6 that is often quoted. Management of your subsequent aromatization of testosterone and the resultant surge in estrogen would help with what you are experiencing.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

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