Troubleshooting ‘My pellets didn’t work last time’
Testosterone (T) release from pellet implants is very consistent. T and stearic acid are the ingredients in the implants. Both are found throughout the body. Neither compression pressure nor added ingredients changes the release of T. T effect is dose dependent. Higher doses correlate with a better clinical effect and relief of symptoms, but also more side effects like hair growth.
The most common reasons NOT to get the results you have experienced in the past
- STRESS: Increased stress, either physical or mental, will affect how you feel physically and emotionally. Stress can even cause hot flashes. Stress and intense physical activity (higher body temperature) can affect how long the pellets last. Symptoms may return sooner.
- MEDICATIONS: Anti-depressants, anti-anxiety medications, sleeping pills, blood pressure and other medications have side effects, can lower T levels and interfere with the effects of T therapy. Side effects include decreased libido and sexual performance, fatigue, anxiety, hot flashes, disruption of sleep patterns, memory problems, weight gain and depression (not feeling good).
- DIET: A diet high in refined foods and processed carbohydrates, and low in fat will definitely affect the result you get with T therapy. Fatigue, irritability and anxiety may be diet related. Whole foods, good fats and protein can elevate mood and increase energy. T increases lean muscle mass and decreases fat. Refined carbohydrates including whole grains can increase insulin (the storage hormone) and prevent weight loss. Whole fats lower insulin and help with weight loss.
- LACK OF CONSISTENT EXERCISE: Aerobic exercise is a remarkable stress reliever. It increases energy and metabolism and decreases anxiety. Exercise improves sleep patterns. The best results from T pellets are seen in people who exercise moderately.
- LACK OF SUNLIGHT: The lack of sunlight will affect mood, sense of wellbeing and physical energy. Lack of sunlight and subsequent low levels of Vitamin D are detrimental to health.
- HIGH ESTROGEN (Estrogen dominance): Fluid retention, weight gain, breast pain, anxiety, PMS, insulin resistance, and lack of ‘sense of well being’ are all symptoms of excess estrogen. Often women cannot lose weight or fat when they have high levels of estrogen. Also, it is the fat cells themselves that contain aromatase, the enzyme that converts T to estrogen. LOW ESTROGEN may cause hot flashes, sleep difficulties, hair thinning, and vaginal dryness.
- THYROID ABNORMALITIES: Too much thyroid hormone (low TSH) can cause many symptoms, which would not be relived with T therapy including fatigue, muscle weakness, anxiety, palpitations, etc.
Often complaints of ‘pellets not working’ occur during the winter months. The stress of the holidays, change in diets, lack of sunlight (especially in Ohio) and change in activity level can affect how you feel both mentally and physically. Some patients do much better with a higher dose of T in the winter months, especially those with ‘seasonal affective disorder’.
T can convert (aromatize) to Estradiol. This is how the body makes healthy levels of estrogen. However, if estrogen levels become too high, this can contribute to the symptoms of estrogen excess listed above and prevent T from working. Exercise, whole foods, fiber, losing weight and getting rid of refined carbohydrates can help lower estrogen levels. Anastrozole, an aromatase inhibitor, may be prescribed or combined with the T in the implant to reduce estrogen excess.
The amount of T you need to control symptoms, or the need for an estrogen blocker may change over the course of your therapy. Androgen levels decline with age, and you may need higher doses of T.
The factor that doesn’t change is the steady state release of T from the implant.
