Testosterone Pellets: Research Casts Doubt on Marketing Claims

The concept underlying testosterone pellets is a simple one—implant the time-release medication under the skin, and let your body do the rest.

For busy patients hoping to find relief for the symptoms of chronic low testosterone through Testosterone Replacement Therapy (TRT), an implant-and-forget approach can sound quite attractive when compared to other methods of treatment.

A male scientist in a white lab coat looks down into a microscope while researching the benefits and disadvantages of testosterone pellets.

The theoretical and highly-marketed advantages include:

  • A one-time implant intended to last 4-6 months would be more convenient than a regular schedule of testosterone injections
  • A pellet should cause less skin irritation than gels or creams
  • Each “dose” would last longer, and require only occasional replenishment

However, testosterone pellets fail the most important test.

Research shows that they actually don’t work very well.

Testosterone Pellets—Research Casts Doubt on Their Effectiveness

While testosterone pellets seek to maximize convenience, some studies report them to be highly ineffective.

In 2013, scientists studied the testosterone levels of men who had decided to discontinue pellet use.  These researchers found that there was no significant difference in the testosterone levels of the men who stopped using testosterone pellets and those who continued using them.

The logical conclusion is that patients’ bodies simply were not absorbing the supplementary testosterone medication—the pellets weren’t getting the job done.

Increased Risk of Polycythemia With Pellets

Research, including this 2018 study, also shows that the rates of polycythemia (an increase in solid red blood cells that thickens the blood) among patients receiving implantable pellet therapy may be considerably higher than previously reported.

The scientists concluded that increases in red blood cell count related to testosterone pellet implantation necessitated close, consistent monitoring to assure the highest levels of patient safety, even after prolonged administration.

Such stringent monitoring requires regular clinic visits to draw blood, which sharply reduces the advertised level of convenience—another way in which pellets don’t quite live up to the hype.

Additional Drawbacks to Testosterone Pellets

Testosterone pellet implants have more potential complications that further detract from their perceived convenience, including these:

  • The need for surgical implantation
  • Infection at the point of implantation
  • Pellet extrusion (Your body may discharge the pellet)

It’s entirely possible for pellets to turn into a painful and frustrating affair.

The Biggest Reason We Never Recommend Pellets

Assuming your body absorbs any of the supplementary testosterone supplied by the implanted pellet, the amount your body absorbs is impossible to control.

Once the surgical procedure required to implant the testosterone pellets under your skin is complete, you could experience a brief burst of unnaturally high testosterone levels followed by a rapid 3-4 month descent towards the threshold where low testosterone symptoms return.

During that early period of abnormally high levels, the risk for side effects significantly increases, which would likely explain the increased blood thickening found in the 2018 study we’ve also mentioned.

Other side effects exacerbated by testosterone levels above the optimum include:

  • High estradiol levels
  • Fluid retention
  • Mood swings

Our Highest Priority—Your Health

At TCT, we recommend testosterone cypionate injections over all other forms of TRT, especially testosterone pellets.

If you listen to the hype, testosterone pellets make good, logical sense because you can’t forget to take a dose of medication, and you don’t have to worry about juggling regular appointments.

However, keeping your hormone levels as stable as possible and minimizing fluctuation is the best way to provide relief from the symptoms of low testosterone while maximizing your safety.

Injections are simply the best way to accomplish that primary objective.

Unfortunately, too many people are making medical decisions, including whether to undergo TRT or what method of delivery to utilize, based on biased marketing and rumor.

That’s why we’ve put together a guide that answers the most common questions and presents the facts regarding Testosterone Replacement Therapy, including the overall benefits, the positives and negatives of the various treatment methods, a treatment timeline, and how we negate any potential side effects.

Read the Guide


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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.

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