Episode 58 - Testosterone Pellets for Women

Speaker 1: 00:00 This is Dr Chad Edwards and you’re listening to podcast number 58 of against the grain.

Speaker 2: 00:05 Are you tired and fatigued? Are you frustrated with doctors because they just don’t seem to listen? Do you want to fix your pain without surgery? If you answered yes to any of these questions that we are the clinic for you, we offer prolotherapy prp or platelet rich plasma therapy and stem cell injections, ivy nutritional therapies, bioidentical hormone replacement therapy, and functional medicine to get you back on track to optimal health, call our clinic at nine one eight, nine, three, five, three, six, three, six, or visit our website@wwwdotrevolutionhealth.org. To schedule your appointment today. Welcome to against the grain podcast with Dr Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready because we’re about to go, go, go, go against the grain.

Speaker 1: 00:58 Hello. Hello. This is the Super Tall Marshall Morris and I’m back with Dr Chad Edwards and a Dr. Chad Edwards believes that 80 percent of medical recommendations are crap technically speaking. Here he is a board certified family physician. He served in the U s army, and he is the author of revolutionize your health with customized supplements. Dr Edwards, I’m pumped to be back with you, man. I’ll tell you how. Gosh, it seems like it’s been forever. It’s good. It’s good to be back soon and get our flow back. July. It was just, I don’t wanna say it was an awful man. That was a good month, but it was just crazy and hectic and chaotic. But we’re back. We’re back at it. It’s going to be consistent. We’re good. Okay. Okay. So I know that, uh, the listeners, they live for these hot topics. So what are we getting into today? Yeah. So you know, we’ve been, we’ve been talking about hormones in, in, at revolution.

Speaker 1: 01:49 We do a lot of hormone replacement therapy and we today where we’ve done a podcast on pellets in the past, and I think it was number 37 that we did. So go back and listen to that one if you haven’t listened to that podcast, but we’re going to talk about something a little bit different, but it’s still about a pellets for hormone replacement therapy. We’ve been doing this for awhile and there was just some things that I really just kind of needed to get out because there’s, some of it has to do with just hormone replacement in general. Some of it has to do with the pellet piece and I thought both of them were important and we’re going to focus this a little bit more for the women, uh, today. Uh, the, so the pellets and hormone replacement as it relates to women. Quick question here.

Speaker 1: 02:31 You hear testosterone and you immediately think men does that. Does that mean that women have testosterone too as well? Women should have testosterone. It, it’s, you know, and that’s a common thing. Women will come in, they’ll get their labs and I’m like, your testosterone, like packed his bag and left town and they’re like, why I need good. Right? And that’s simply not the case. And sometimes testosterone can get a bad rap rap for women because of a condition called pcrs or polycystic ovarian syndrome, uh, and that, that leads to a number of issues that many women have an issue with, but they’ll, they’ll have a elevated testosterone. So you might think that testosterone causes all of these problems. And that’s not necessarily the case. There’s testosterone isn’t an essential hormone, not only for men, but also for women. Uh, so I, you know, like I said, I’ve been managing hormones for a long time.

Speaker 1: 03:25 We’ve actually been using a testosterone, knows a little bit more sheepish about it until I started doing pellets. And the company that I use for my pellets is a company called [inaudible]. They’ve been around for several years. They do a fantastic job. They do a boatload of pellets and they’ve got an excellent track record. So just a little bit about my story on using pellets. And I don’t remember if I had addressed this in episode 37 for podcast 37, um, but basically, you know, using hormone replacement therapy, I would have these women come in and many of them came in from other clinics and they might’ve had pellets in the past and had a horrible experience and they’re like, I’m never doing that again. I feel awful, you know, that kind of stuff. And I had to clean up the mess and it can take awhile. It can take awhile because you put the pellets in and they are, they’re going to last awhile.

Speaker 1: 04:15 Uh, for women when you place pellets, most of the time it’s going to last in that three to four month kind of timeframe. So they get pellets, they feel the way they feel three to four months later, it starts to decline, get repetitive. That’s the way it should flow. So you get these pellets that are going to slowly release over time. And if it’s too much wrong dose wrong, you know, fill in the blank, they feel awful. And they’re coming to me saying, you’ve got to fix me. So I had this really bad negative perception about pellets because once you put them in there, you can’t go get them. And if anybody says, oh, I’ll go get your pellets out for you. It run. Uh, there, there are these little bitty, you know, grains of rice sized things and you don’t know exactly where they are and you’re going to go digging for that.

Speaker 1: 05:02 Nope. I mean, that’s. Just, don’t, don’t do that. Don’t take that advice. That’s right, that’s, that’s bad. That’s one of those 80 percent of recommendations for. Okay, okay. Uh, so it, it’s in there, it will dissolve over time. You will get better, you know, those kinds of things. So I had this negative opinion about pellets for a long time and one of my, one of my colleagues was just a huge fan and kept telling me, you got to look at this, you got to look at this, you got to look at this. And there was a physician in Tulsa named Dr Jerry Block and he was an integrative functional medicine physician. And, uh, he died in November of 2015 and we had some similarities in our practice. Uh, we had some differences, but we had some similarities and I really respected him. Um, and he certainly missed, but a lot of his patients did really, really well.

Speaker 1: 05:51 And he did a lot of hormone pellets on a lot of these patients and they were coming to me saying, I’ve got to have pellets. I gotta have pellets, gotTa pellets, and I would talk to him and be like, Gosh guys, I just don’t know that that’s the best way to go. And they were like, well, I tried everything else and did awful. And I went to Belize and felt great. And I was like, well, I guess I gotta start doing pitches just for these people because I don’t want to. What are they going to go, you know? And um, I, I have this, this low level arrogance that says I can do it better than anybody else. So that I don’t, I don’t why I partially mean that. Um, I, I think I’m, I’m, I’m confident in my ability to do the procedure successfully safely.

Speaker 1: 06:27 And effectively, uh, and not everyone has that. Sometimes there’s just a moneymaking Gig for some docs and you know, I don’t, I don’t know their experience. And so why would I send them to someone else? So let’s, let’s, you know, do what I’m comfortable with. And so anyway, so I went to the training for Iot and they said some things that really kind of changed my perspective about pellets across the board. Uh, and, and I was like, uh, there’s some really interesting components and not all of it is just pellets, but just related to hormone therapy across the board. And I’ll tell you, you know, for men, testosterone pellets can be a really good idea. Uh, so this, I’m going to block out a section. This is just for the men. So men, men, men, men list. That’s right. So the, um, basically, uh, well this part’s for, for everybody.

Speaker 1: 07:14 This is just pellets in general. You can go back and listen to episode 30 podcasts already seven. But the, uh, the pellets that we use are bioidentical hormone and there’s two different kinds of pellets that we use. Estradiol, which is the primary estrogen during administrating years, and testosterone. Men will only get the testosterone. There’s only two ingredients in the pellets that we use. There’s the hormone, either estradiol or testosterone and a fatty acid called steric acid. And that’s just the binder that Kinda holds it all together and they’re pressed together under extremely high pressure and, uh, and it forms into this little pellets and those pellets are slowly released over time. The, uh, you know, the average duration for men is going to be about four to five months. So that’s. Now, this is where we’re talking about men. Uh, the procedure for men is a little bit more expensive because those pellets, you might get like 10, 12 pellets for women.

Speaker 1: 08:11 They’ll get one or two, maybe three a. So there’s a lot more testosterone that you give to men than to women. And there’s just a lot more pellets and it’s just more expensive to do that. There’s more chemicals, there’s more stuff, uh, so much more expensive for men. In fact, it’s double the cost as what it is for women, but the convey the benefits. There’s two primary benefits to using pellets for testosterone replacement. The first one is the convenience factor. You know, if you’re using a testosterone cream or gel, you got to put that stuff on everyday, at least once a day, sometimes twice a day, and if you’re using commercially available stuff like Andrew Gel or acts or on or test them, you have to you, you may have to put on a significant amount. I literally had one patient that would go from one wrist and slather himself up to the other risks, so all the way up his arm, across his chest and down the other side, use a hairdryer, dry it off, and then put on a second layer, two layers that exactly from wrist to wrist.

Speaker 1: 09:16 That’s how much he needed in order to get an effective amount. Remember, the commercially available topicals are about one percent. So you’re talking about 10 milligrams a day. It’s not a ton of testosterone. I’m the commercially available or the, uh, the compounded stuff, you know, we can get a much higher dose of that literally 30 times that in a smaller amount, but you still gotta use it everyday. If you get skin to skin contact, it can, you can get what’s called transference and the absorption is variable from person to person. So not a huge fan, but I mean some people will work. It works great if they don’t mind. It’s fine. We do a lot of testosterone injections, so we’re using testosterone, cypionate and most of the time that needs to be given at least once a week, if not two times a week. The half life of testosterone cypionate is about eight days.

Speaker 1: 10:04 So if your doctor is giving you testosterone and telling you you just need one injection a month, they don’t understand the pharmacokinetics and pharmacodynamics of testosterone, cypionate injections. Uh, it’s just, um, that’s just the fact if you’re getting it every two weeks, uh, there, there’s, there’s one testosterone type clinic, uh, that it, well, it’s a testosterone clinic and they put out this information about how often you should get testosterone injections. And they, they only presented half of the data and they were talking about how giving it every two weeks is better than giving it every week and they didn’t give the second half of the data. We’ll save that for another podcast, but it’s, you’re not going to be nice and consistent, uh, at, at every two weeks. You need to do it every week, if not twice a week. It’s going to vary from individual to individual, but it’s fairly inexpensive.

Speaker 1: 10:54 One of the pharmacies that we use, it’s $90 for a 10 milliliter vial, average guide between half and one milliliter. So you’re talking to a 10 to 20 weeks supply for 90 bucks. That’s as low as $18 a month. So we’re talking about really inexpensive stuff and properly managed on a patient that’s trustworthy and things like that. They can do them at home, they don’t need to come to the clinic and all those kinds of things. So we try to keep the cost down for patients, but you’re still giving yourself an injection every week. The. And the other thing with testosterone injections, excuse me, is that using testosterone Cypionate, uh, the, there’s a little tail on that that makes it non bio identical. It’s not the exact same testosterone that God put in our body, uh, so it’s not bioidentical testosterone pellets, all of the hormone pellets that we use, our bio identical.

Speaker 1: 11:43 So for men, the benefit is you get the, it’s a very simple procedure come in, you get numbed up, uh, in the, in it’s an area in your hip, make a little bitty incision. I mean it is little and a place the pellets and kind of phantom out in the tissue underneath the skin. And that’s going to last about four to five months. And the cool thing is, is all of the pellets are released based on cardiac output. The harder you work, the more hormones you need. When I say the harder you work, the more exercise, those kinds of more hormones you need. The cool thing is, is the more you’re going to get a, that just means it’s not going to last quite as long. So a pellets are a great way to go in that it’s very convenient because there’s nothing to do for four to five months when you feel like your levels are starting to decline, come back into the clinic and we’ll do another round.

Speaker 1: 12:29 So four to five months and there’s nothing to do if you’re going, if you travel a lot, you don’t have to take testosterone stuff with you. I mean it’s super convenient from that perspective and it’s bio identical. That was a long way of saying all of that stuff. And so it’s the exact same testosterone is the same hormone that your body is creating. That’s right, that’s right in these pellets. And additionally the body regulates itself and so that you don’t have to be measuring levels and constantly measuring. The more you need, the more your body will administer to itself from these pellets, it, we’ll use it up faster. That’s right. Okay. And so when you say, you know, four to five months, you know, if you’re doing a high activity day every single day, maybe it’s closer to four months, maybe if you’re, if it’s a less that you use, um, less exercise, you’re doing less exercise, maybe it lasts a little bit longer.

Speaker 1: 13:19 Exactly, exactly. And when you feel like you’re starting to climb, come back. And we do repeat the procedure. Um, so I mean, it’s, there’s a lot of convenience with it that it’s a great procedure, but it’s definitely more expensive. Uh, it’s, it’s definitely more expensive than the injection, so it’s a trade off a bit, but it’s a great way to go. So that’s the stuff for guys. Now let’s talk a little bit about, uh, about this stuff for women. I think I have a feeling we’re going to go long on this podcast. Hey, let’s do it. We’re going to do it anyway. So just pull up a chair, sit down or be ready to be hypnotized to sleep either way. Uh, so some people will talk about, you know, again, I’ve been doing hormones for a long time and for women I was exclusively using creams, creams and gels.

Speaker 1: 13:59 Now the hormones get deposited into the skin and the absorption get or you know, it goes across the scan and I often recommended what’s called a mucosal or a label application. So for women we were having them rub it on their Labia and the outer portion of their vagina because we got a more consistent absorption, not a lot of women like rubbing themselves with, uh, with creams and gels down there. So there was a convenience factor, uh, the base of the creams, there’s all different bases and some women react differently to them so they can have some itching and burning and all those kinds of things and you might do really well for awhile and then start to decline. So there was a lot of issues in regards to that for creams. I’m not anti cream, I just, we found a better way. Some people will talk about just hormone replacement in general and uh, you know, with some of the risks associated with that, like breast cancer and things like that.

Speaker 1: 14:50 And so we’re going to address a little bit of, of each of these, uh, so pellets, you know, first came around on the marketplace in 1938. So they’ve been around for a long time and there are, there’s lots of studies actually that show really good benefit and we’ve talked about these pallets and how they’re made and they’re a high pri, high high pressure. So if you’re a local compounding pharmacy is making pellets, they may not have the right equipment to make the same really high pressure compressed pellet. And if you put that pellet in and it starts to disintegrate or fall apart, uh, the hormones are all still there, but you, there’s more surface area. So it changes the absorption rate. And I think that’s one of the reason that many of the patients that I got in the past that had all kinds of problems was because of poor quality of pellets.

Speaker 1: 15:43 You want to make sure that you’re using really high quality stuff and that’s what we’ve got a at revolution and so the more surface area means that you’re less, that your body’s in less control of the levels or you may absorb more than you need at any given time if, if they’re not the high quality pellets there. That’s exactly right. And I think the best way to understand surface area is my refrigerator has a cubed ice or crushed ice know you can, you can pick and if you get cubed ice it doesn’t cool off your water as quickly, but it lasts a whole lot longer because it doesn’t have as much surface area. But if you use crushed ice then it cools off really fast, but it doesn’t last very long. Uh, so I think it’s a good way to think about. So it’s the, it’s the surface area of that ice that coolest things off quickly, but it doesn’t last as long.

Speaker 1: 16:31 And the same thing can be true with the hormones. Okay? So we just lose some, some variability there. So we’re going to focus a little bit more on testosterone here because you know, there’s just a, there’s not that much thought about giving testosterone to women. I had a patient, um, and so this is our Hipaa compliant. I love this story for the day. So I had a patient that had been managing your hormones for about two years. She’s in her mid forties and for two years we had been using creams and gels or creams specifically, and she was doing much better than when she first came to see us. I believe she had had, if I remember right, she had had a hysterectomy, so had all of her female parts removed. And uh, so she, she had, she was not making hormones on our own and we were giving her a creams to replace the hormones that she had.

Speaker 1: 17:19 And she was doing pretty well, but she came to see me in and said, you know, I’m just kinda a little draggy a little bit. I’m just not feeling Kinda, you know, at my edge. So, you know, what do we need to do? So it looked at her labs and you know, at this, at this conference where they talked about some things that just a paradigm shift in the way I thought about some of the hormone things. I was like, Oh, you know what, we need to make some changes, but I think pellets would be a really good solution for you for women. And this is the, you know, from here on, we’re talking about the pellets for women. Her pellets were actually cheaper than her creams that she was getting into the pharmacy. So I’m getting ready to save her money and make her feel better than she had been feeling for two years when I was managing or other hormones and she doesn’t have to rub anything anywhere every day.

Speaker 1: 18:06 So this was like a no brainer for her and she was like, sign me up. So we did the procedure. Very simple. And by the way, I mean almost almost everyone says that they really don’t feel anything. How long does the procedure take a for women? Once they’re in position, you know, laid down and kind of in the right position for minutes. Wow. Yeah, it’s super simple. We make a little bit, so we. We numb the area up with it. It’s a little injection. You’ll feel a little bit of the burn with that. A little bitty bitty bitty incision. A, there’s a tro car, which is a little device where we put the pellets inside that trocar and slide it in, so we put the trocar in through the skin and then we placed the pellets in and push them in almost like a, like a plunger, like a Syringe, a push those things in and you’re done.

Speaker 1: 18:47 Then you put a dressing over it and that’s pretty much it. We don’t stitch it, we don’t glue it. We just use the stairs strip. Three days later they can go, you know, pretty much do whatever they want. There’s really no limitations after that. Very simple procedure and it only takes a couple of few minutes. So we did her pellets at that time. On that day I had all her labs and everything we needed and said, do this. She said, sign me up. We did it. Three weeks later she came into the clinic and talk to my front office girl and she said that she was almost in tears and just said, I’m a, I’m a new woman. Everything was way, way better. Her hair was better, her skin was better. She felt better. Her, uh, her energy was off the charts better, like way, way, way better. She felt amazing.

Speaker 1: 19:32 And the cool thing was my understanding is that we’re going to get a Christmas card from her husband because she initiated having sex with him for the first time in however long. So her sex drive was up and she was actually thinking about it on her own. We’re like, well, that’s a great success story and that’s someone that we had been managing your hormones with creams and then switched her over to pellets and she was just night and day better. So I’ve had multiple, countless stories very similar to that. And now I’m understanding why Dr. Block had so many patients who are like, I’ve gotta have my pellets. Uh, it just really for, for women, it’s the best thing out there, uh, for hormone replacement therapy without question in my experience. And so, you know, why is this such an against the grain topic? I mean, I hear you talk about it and is it the, is it the price?

Speaker 1: 20:25 Is that because it’s a more expensive procedure that it’s against the grain or walk me through that. Why is this an alternative type procedure for, for people? Sure. Well, first of all, the, um, the hormone pellets are not FDA approved. Now that sounds bad, like, oh, well, what am I doing? The only, there are some testosterone pellets that are FDA. I think we did a podcast this, uh, I think the flu, the nasal mist that are related, or maybe it was a subtopic in there, I don’t remember, but it’s that, that FDA approved thing. There are FDA approved a testosterone pellets test Testa pill and they were actually approved, gosh, in the eighties a, but they weren’t, um, they weren’t released and you know, for a long time, I don’t remember why the company didn’t want to do it. It was like this weird politics stuff, but they were FDA approved a long time ago and they just sat on them for a long time and finally they started using them, but there are 75 milligram pellets.

Speaker 1: 21:26 They’re only approved up to 450 milligrams, so that, you know, for, for men a 450 milligrams. And that means six pellets if you do seven pellets, it’s no longer FDA approved. So it has little to do with the actual pellet itself. Everything is based on the, the, the reported risks and benefits and the FDA when these pellets that we’re using are compounded, but they’re compounded by a pharmacy that has the equipment that they need to make a. I’m going to use the word commercially, but I’m not trying to mislead anyone. Uh, so it’s a, it’s a, uh, a commercial grade level, a pellet. So it’s, it’s not, you know, Billy Bob’s compounding pharmacy that just kind of pushed together with the monkeys in the back. I’m not trying to knock anybody, but, uh, there’s a difference in the quality. Um, so the, the, so the first piece with why is this a hot topic is because it’s not FDA approved.

Speaker 1: 22:26 Uh, the, the pellets are not fda approved, pellets themselves are, these pellets are not, and the only ones that are, are tested pell. But as soon as you go to seven pellets, you’re no longer FDA approved. I’ve never seen a single patient that was optimal at six pellets. They may be just inside the normal range, but then you can go back and listen to our podcast on episode number two, your podcast number two. Now you can listen to multiple of our other podcasts where we talk about normal versus optimal. Uh, you don’t want to be normal. You want to be optimal. You know, Dave Ramsey would say normal is broke, be weird, same, same, same concept. You don’t, don’t focus on normal. Um, so not FDA approved. Uh, the second thing is insurance doesn’t cover this. So there may be one out of 100 insurances out there that, that cover it, but many of the compounded creams, many insurance plans don’t cover those either.

Speaker 1: 23:24 So this is something that the patients have to pay for, so it’s against the grain because of that. Now, why should someone focus on this and listen very carefully. I had a patient came to me today, had she, and when I walked into the room, her hair was obviously thin. Uh, and I, I was, I was taken aback a little bit by how thin her hair was. That was one of her big concerns and she had gone to her doctor and I hear this story just about every day, you know, a 40 slash thirties to sixties year old woman that feels bad, goes into her doctor. They say, well, your thyroid maybe a little bit off, we’ll put you on synthroid. Uh, and then, uh, they don’t feel any better. And they say, well, you know, it’s, you’re depressed. Let’s put you on Lexapro or Wellbutrin or any fill in the blank with any of the antidepressants.

Speaker 1: 24:12 And most of the time these patients are like, I’m not depressed. I just feel like crap. And they’ll put them on an antidepressant. It doesn’t make any difference. Now they’re on an antidepressant and they’re on synthroid and they still don’t feel any better, and so this patient came to me today and she starts telling her story. She’s almost in tears and I’m almost laughing. I’m not laughing because I’m trying to laugh at the poor woman. It’s, I mean, I, I feel I feel bad for her. It’s laughable because I hear this story all the time and it’s the same thing. It’s, well, you know, you’re depressed. No, you’re not. You’ve got a hormone problem or a thyroid problem or nutritional problem or inflammation or any number of other things. Nutritional deficiencies are. That’s what’s going on that I can’t tell you how rare actual depression really is.

Speaker 1: 24:58 It’s, that’s not it. That’s something that another depression exists. Not trying to say, it doesn’t, it’s just not nearly as common as what I thought it was when I was practicing traditional medicine. So it’s fixed. The hormones fixed the thyroid, fixed the fill in the blanks. Listen to your patient, William Osler, you know, physician started, uh, a Johns Hopkins said, listen to your patient. He’s telling you the diagnosis. So when, when they are telling their doctor, I feel bad and their doctor says, well, let’s just increase your, you’re not listening to your patient, quit doing that. Your patient is telling you that they don’t feel well and you’re so stuck in a Rut that you’re saying what your labs are normal. Quit. Don’t treat patients that way. You don’t want to be treated that way. Don’t do that to them either. It’s crap. That’s where that 80 percent stuff, Canadians, Canadians have a whole 80 percent per se. Um, so anyway, um, let’s, we probably need to take a break. Yeah, we’ll take a quick break

Speaker 2: 25:54 and then, uh, we’ll come back and wrap it up. Vertical limit fitness, constantly strive for better, better mind function, fitness, capacity and community. They accomplish this through bodyweight bootcamp style classes in high intensity functional fitness classes from group classes to private training. Vertical limit fitness elevates your health and wellness while helping you become able to do anything and prepare you for everything that life may bring along. Call nine one eight four zero nine one six three, three, or visit their website@wwwdotverticallimitfitness.com for more information and to sign up for a week of classes.

Speaker 1: 26:30 Okay, we are back and we’re talking with Dr Chad Edwards here and we’re getting, we’re getting into the nitty gritty of testosterone pellets for women and it’s a pretty hot topic because there’s a lot that surrounds

Speaker 3: 26:44 it and there’s a lot of different, um, maybe alternatives to testosterone pellets, a lot of creams and uh, other ways to get your testosterone and hormones there. So I know that one of the big concerns around taking this extra hormones for women is the relationship to breast cancer. Okay. I know that’s something that you deal with quite, quite frequently. And so how would you maybe have that conversation with one of your patients? Uh, you know, we’re talking about specifically testosterone pellets for women, but why is that significant? Why, you know, how, how would you, uh, navigate that type of discussion?

Speaker 1: 27:28 Yeah. So first of all there is, there’s different kinds of breast cancer. They’ve got different estrogen receptors, progesterone receptors, different things like that. Uh, so there’s always a concern about using hormone replacement. And I had a patient this week, newly diagnosed with breast cancer, uh, that had considered a hormone replacement therapy. And she and I will, I will tell you that from a physiologic perspective, I believe that hormone replacement therapy is safe for breast cancer patients. However, I will not do it. I will not give a patient because there, there is a slight risk, but the evidence is not about estrogen or let me rephrase that. The estrogen or the, uh, the, the evidence that’s out there is primarily about Premarin, which is pregnant mare’s Geren, conjugated equine estrogens. These are horse estrogens, not human estrogens. I talk about this extensively in previous podcasts and probably multiple of them, uh, and how hormones are metabolized and you have estrone and Estradiol and how they bind to Alpha and Beta estrogen receptors.

Speaker 1: 28:36 And each one of those has a different function inside the body. And then you have hormone metabolism where you break down from a estrone estrodiol into four hydroxy estrodiol or two hydroxy or 16 hydroxy estrogen or estrogen, and then into four methoxy yesterday. This is hormone metabolism stuff. What the studies aren’t addressing is how these hormones are being metabolized and it’s affected by a number of things. So when you look at s drone, which is the primary estrogen that works in humans in Premarin and the way that stuff, it’s an oral pill, so you take this pill, liver gets first crack at it and it primarily gets metabolized through the four hydroxy, the bad pathway, and so of course you’re going to have an increased risk of breast cancer with something like that. That’s where the preponderance of the evidence lies. There are no studies that I’m aware of.

Speaker 1: 29:34 There may be not. I don’t think there are any studies on a bioidentical hormone replacement therapy and breast cancer. I tell you, there are numerous physicians out there that are using bioidentical hormones and they see absolutely no increased risk of breast cancer. There’s a endocrinologist out of beverly hills that has been using bioidentical hormones for over 15 years and has never seen a case of cancer in her practice. So there’s some anecdotal evidence, but it’s such a tumultuous topic. I don’t think that, I mean, it’s not worth the risk to me as a, as a physician, and certainly I don’t want to do anything that increases the risk of the patient and I just think that physiologically it hasn’t been, um, it, it doesn’t make sense and it actually makes sense that it may be protective, but that’s another podcast. So, so the estrogen part, we’re going to shelve that, but the testosterone part, there is actually a study, a testosterone delivered by subcutaneous implants.

Speaker 1: 30:33 Pellets does not increase the risk of breast cancer. And that was a study done by demoed trick caucus. He must be Greek and there’s an oral form of testosterone called methyl testosterone, uh, that, that does increase the risk of breast cancer. So again, you can’t lump all testosterone’s into the clump. Bioidentical testosterone is different than this other stuff. Your body does not make methyl testosterone, not good stuff. Pellets do not have the same risk of breast cancer as the synthetic progestins or synthetic methyl methyl testosterone. In fact, studies show a reduction in the incidence of breast cancer when the implantation of testosterone pellets with or without using the estrogen like estrodial. Um, even after 20 years of therapy, we’re using hormone pellets. Uh, the risk of breast cancer is not increased study showing that in breast cancer survivors, patients that have had breast cancer and, and their, they’re uh, uh, surviving it hormone replacement therapy with pellet implantation does not increase the risk of cancer recurrence or of death due to that cancer compared to estrogen in combined with synthetic progestins.

Speaker 1: 31:43 It’s the synthetic hormones, and I’ll say it until I’m blue in the face, it’s the synthetic crap that causes the problem. But that’s where the studies have been done. You cannot patent a, a bio identical hormone. Your body is naturally occurring. You can’t patent that if you can’t patent it. You can’t make money if you can’t make money. You can’t do a study unless it’s government funded, you know, some, some other kinds of pharmaceuticals or who, who does most of the studies and they’re expensive. So you’re not going to get studies. Would that be kind of like saying, you know, I’m going to lay a patent, the utility patent on air? Yeah. Just kind of like a naturally occurring thing. It’s like sunlight. I’m staking claim to sunlight. Right. You know, you can’t do it because everybody creates their own version of that. That’s where the body has its own ability to create it.

Speaker 1: 32:37 Right. And you the, when you look at statens. So Merck, uh, I don’t remember if they came up with a new. They bought the patent for it, but uh, when, when you’re looking at statens and how they found them, they actually found that a population of Asian people had lower cholesterol than everybody else. And they started looking at it and they found that there were eating a lot of red yeast rice. So they’re eating this rice that was tainted with red yeast and the red yeast to produce a chemical that inhibited a chemical called HMG Coa reductase. That’s the rate limiting step in the production of cholesterol. So they had to alter that chemical just slightly so that they can patent it. And then they called it mevacor and that was the first staten and mark eventually bought that. So because you can’t patent an air or water or anything else, uh, so that plays a role with this.

Speaker 1: 33:30 Um, so there was a paper published in the journal Menopause in 2004 and it said breast cancer incidence in postmenopausal women using testosterone. And in addition to usual hormone therapy, um, the, uh, the women were referred for testosterone supplementation for the following indications, complications of emotional liability. So we’re talking about that depression stuff. They were, they were here, fatigue or loss of stamina. How many patients, how many people listening have fatigue or loss of stamina? Impaired concentration and memory. Real common. So common. I can’t remember how common it is. Sorry. A breast tenderness, loss of sex drive. Extremely common. You can listen to one of the podcast by Courtney, uh, you know, way early where we’re talking about sex drive and things. Sleep disturbance, again, so common a muscle weakness, these female patients receive testosterone implants that contained 50 to 150 milligrams of testosterone every five months, so a little less frequent than what we recommend for, uh, for our pellets in addition to the estrogen or progesterone therapy, the addition of testosterone that were given by pellets a was shown to reduce the incidence of breast cancer in women treated with conventional hormone therapy in women not on synthetic progesterone therapy, which is known to increase the risk of breast cancer.

Speaker 1: 34:50 And the relative risk of that, by the way, is one point six nine to two. So it doubles your risk. Synthetic progestins double your risk of breast cancer. Uh, the incidents of breast cancer was lower than no hormone therapy at all. So we’re talking about something that’s very protective against breast cancer when it’s natural, natural bioidentical testosterone. I’m extremely low. Incidence of side effects with hormone replacement therapy, uh, with pellets and a high compliance rate. In fact, I don’t remember the numbers, I think it’s like 97 percent or something in patients that get pellets that they’re on their third round. Ninety seven percent is greater than 90 percent of those patients come back time after time after time. They’re very happy with the results. It’s been shown to be extremely effective in the treatment of migraine headaches as well. So you’ve got a lot of potential benefits. It can help with all these things like emotional liability, fatigue and loss of stamina, impaired memory and concentration, breast tenderness, loss of Libido, sleep disturbance, muscle weakness. You know, I, I see this all the time. This is one of the benefits of using testosterone and why using pellets is I believe superior for women.

Speaker 3: 36:00 So you talk about all these added benefits, um, and how it relates to maybe some of these symptoms in different parts of the body. I’m one of the previous podcast that we talked about were, was about osteoporosis. What, how, how do pellets effect bones? How does, how does this, how do these hormones affect the bones?

Speaker 1: 36:20 Man, I am so glad you asked that because it had an incredibly powerful what testosterone does and even with my mom, she’s in her mid seventies and I remember when she was younger and went through menopause, her doctor, primary care, normal standard inside the box doc, he put her on, I remember her being on Premarin. In fact, I remember her being on Prempro, which was provera, which that’s that synthetic progestin that we’re talking about a that shows increased risk of cardiovascular events that were shown in the women’s health study and increased risk of cancer. And I remember her being on this and then switched to premarin and um, and I know part of the reason was because of he was concerned about bone loss. So, uh, you know, nobody wants to have osteopenia osteoporosis, your bones getting thin and wasting away as we age. So hormone replacement therapy can be very beneficial for maintaining the, the, uh, the bone density.

Speaker 1: 37:23 But we, I, as a physician, as a Family Medicine Board, certified physician, I thought estrogen alone, I was like, we gotta get that estrogen up to maintain the bone health. The thing is, his testosterone is incredibly beneficial for bone density, hormone replacement therapy with testosterone pellets is superior to oral and topical, both the Patch and gel hormone replacement therapy for bone density, so testosterone implants better than topical testosterone patches and Gels, so the implants were superior in that in a, in a study done by a Saba Davis and Henderson and the, uh, there were consistent and adequate levels of testosterone delivered by appellate implantation. Um, and that was important for maintaining bone density and was, uh, also available as a substrate for the production of Estradiol and estrone. Dial comes from testosterone so it can help with some of the estrogen balance as well as hormone replacement therapy with pellets has an extremely low incidence of side effects, which you’ve already talked about.

Speaker 1: 38:31 Uh, the pellets not only prevent bone loss, but they also actually bone mineral density. And I want to say it’s like eight percent per year at some incredible amount. It’s a really high number, eight percent per year. You’re talking about there’s a supplement, you know, most of the medications focus on reducing the loss of bone and there is a supplement that we use in our clinic that is, has been shown in randomized controlled trials to increase bone mineral density by two percent, which is extremely profound. So that’s a supplement that we offer and we’re getting our online store up and running and we’ll have that available in the next few months. Uh, you know, if somebody is interested in that and that, great for bones, skin, hair, all those things, so the uh, but adding testosterone too, that can make a profound difference and it may be a completely alleviate the need for some of those bisphosphonates like fosamax or some of these others have all these potential problems and side effects and jaw problems, all this stuff.

Speaker 1: 39:37 And so you talk about the ability to completely change the energy level within women and solve all of these other, uh, maybe symptoms or problems along the way. You know, you talk about low sex drive, just energy level throughout the day. Confidence, I mean, the value of just being more confident because you’re not constantly battling headaches or, or worrying about, you know, going into the clinic every single week to get a, you know, in an injection that has to be huge. Yeah. So what else, what are we missing here with a testosterone pellets for women? Yeah. So let me, I’m gonna send it out because I know we need to, we need to end pretty quick because I’m going to rapid fire some things here. Okay. Uh, so, um, hormones by the subcutaneous implant. So pellets, they bypass the liver, they don’t effect clotting, blood clotting, risk for clots a and don’t increase the risk of thrombosis.

Speaker 1: 40:35 So clots, testosterone delivered by pellets is cardio protective. Unlike the oral stuff. So we’re talking about reducing cardiovascular disease risk. A testosterone delivered by Pella implementation does not have a problem, does not adversely affect hypertension, blood pressure, lipids. So your cholesterol, which that’s another whole multiple podcasts, a blood sugar, glucose or liver function. It does not affect the menstrual cycle and it has been used to treat endometriosis and uterine fibroids. It’s superior to oral and topical Hormone Replacement Therapy in respect to menopausal symptoms. Uh, it’s been shown to improve insomnia, so inability to sleep, improve sex drive libido, hot flashes, palpitations, headaches, irritability, depression, aches, pains, vaginal dryness, lethargy, so just that extreme fatigue, uh, this isn’t another steady loss of libido hot flashes as well as cardiac and lipid profiles. Another study show that it was successfully treated it severe premenopausal syndrome, unresponsive to other forms of therapy without adverse effects.

Speaker 1: 41:43 So you’re talking about a substance that it can increase or improve multiple problems that I hear every day. If you’ve got fatigue, low libido, a blood sugar problems, liquid problems, all those things, uh, you gotta, look at your testosterone and pellets without question, gives consistent results without a lot of negative effects that can come with others. Wow. For all the listeners out there that are like, Yup, I need to know more about this. This is sounds exactly like what I need. What would you suggest that they do? I would call our clinic nine, one, eight, nine, three, five, three, six, three, six, schedule and appointment. That’s the, you know, for anybody in this area, if you’re in Oklahoma, it’s worth the drive, you know, it’s, you don’t have to do this all that often. Come see us, you know, it’s, it’s easy to do if you’re outside the state, fly to us.

Speaker 1: 42:32 I mean, do you want to live with these symptoms or do you want to get rid of it? Come see us. I mean, it’s, it’s not that hard. If you wanted to find a physician in your area, I can’t vouch for, for any of them in anywhere else. Uh, the company that I recommend for hormone replacement therapy is bio t b I o t e a, and so you can just Google Bot and you’ll, you’ll find if you go to our website, you’ll find it. And so they’ve got a list of recommended physicians, uh, and, and just seek one of those app. Dr Edwards, thank you so much for joining us today. Always a pleasure. Thanks Marshall. Thanks for listening to this week’s podcast with Dr Chad Edwards. Tune in next week where we’ll be going against the grain.