The Pitfalls of Pellets

Exhausted. Gaining weight. Suffering from Insomnia…. Anxious. Retaining water. Irregular periods and pelvic pain. What a joy it is to face another day.

You’ve been to three doctors already and been told it’s all normal or “you’re just getting older.” You’ve even tried to convince yourself – maybe they’re right? But surely, there has to be a reason why you just don’t feel like you anymore.

And then finally, someone recommended they could put you on a wonderful new thing called a hormone pellet. Here’s a disclaimer; I will refrain from mentioning brands of pellets as I’m certain this will please companies or providers that make and use them. Let’s suffice it to say, the pellets are presented to you in the light of hormone balance and feeling better; bioidentical and wonderful. I’m here to put an end to the nonsense of hormone pellets and here are the reasons why:

1.THEY’RE EXPENSIVE (WAY TOO EXPENSIVE) – Pellets are somewhere between $300 – $400 / every three months (that’s somewhere around $100 – $125 / month). Bioidentical creams and troches at reasonable compounding pharmacies are around $45 / month and if you buy three months at a time are usually closer to $39 / month. Pellets, delivering the same medicine, cost about three times the amount of compounded creams.

2.HORMONE LEVELS TOO HIGH (Dangerously High) – Pellets will be explained (sold even) as maintaining a level hormonal balance. But if you really think about it, there is absolutely no way this can be true. There is not guarantee that the same amount of hormone will be released on a daily basis for three months. Absolutely none. Most commonly, what I see is the first month of pellets levels will go dangerously high; for many times 3-4 times the high end of normal for a woman. Then two months of a steep fall. So women initially feel good when they are prescribed because your levels are surging and super high. Then levels fall to the point where you start having withdrawal and you think “shit I need my pellets again”. The problem; many women feel these withdrawal symptoms, not because their levels are low but because they were so high that even a small drop can make them feel symptoms. I have seen hundreds of women who still have super high levels of hormones but have symptoms of low levels because they were so high that the small drop they’ve had gives them symptoms.

3.IT’S A SURGICAL PROCEDURE – pellets have to be put under your skin every three months. The provider has to dig a pocket in the fat of your butt cheek to get that pellet in. This results in bruising, infection, pellets popping out, and pain. I can’t tell you how many infected butt cheeks I’ve seen over the years……. It’s a lot. How many infections, bruises, and pain happen with creams? None.

4.ONCE THEY’RE IN THEY DON’T COME OUT – Well, that’s not totally true, sometimes they actually do pop out, but the reality is they aren’t made to come out and if you are having side effects, then you’re stuck with them for 3-6 months. If you have side effects from the levels being too high like pain, bleeding, headache, weight gain, water retention, lethargy, clitoromegaly (yes enlarged clitoris which is permanent), deepening of the voice (permanent), mood swings, irritability, anxiety, and high blood pressure, then you’re likely stuck with them for 3-6 months and sometimes longer.

5.EVERY THREE MONTHS – You are told you have to go the office every three months to have new pellets put it. Simply put, why would you do anything that required you to go to the office every three months to have a small surgical procedure. It makes absolutely no sense whatsoever. The costs alone should have been a derailment but the idea of digging a pocket in your butt cheek every three months if we think logically, should be enough of a reason for you to say no.

6.ABSORPTION RATES (IRREGULAR) – Pellets are promoted as being the ultimate in stability and stable absorption rates, but as I’ve explained, that simply isn’t true. They aren’t made with some genius device that releases stable levels every day and in fact, I have seen quite the opposite. The medication is released as a high dose initially then slows over time. I haven’t seen one study that shows stable hormone levels with pellets that is either legitimate or reproducible. The reason, there aren’t any.

7.SHOW ME THE MONEY – I’m gonna be honest here, if I put in pellets in my practice, I’d be rich. The vast number of women I have in my practice that are receiving hormones is in the thousands and if I was doing pellets on them, I’d make a ton of money. This is a cash cow for doctor’s offices. Every three months hundreds of women have to come in to have hormones pellets placed and they are all paying up. You do the math and realize that the offices placing these, in my opinion, aren’t doing them because they think it’s an amazing thing, they have seen the bottom line.

8.WHO IS PUTTING THEM IN? – If I haven’t made friends to this point then here is where they hate me. Simply put, overall, the people putting them in have absolutely no idea what they are doing. Why do I say this? Because the majority of providers putting them in are armchair quarterbacks. Physicians who dabble in hormones or physician extenders like many Practitioners that took a weekend course in hormone therapy. You see, the companies that sell the pellets, they have courses that you go to for a weekend and then magically you are a hormone expert. I just think this is a horrible recipe for failure. Expertise comes years of study coupled with years from patient encounters not because you went to a weekend course and learned hormones from another non-expert. Yeah it’s harsh, but I’m not one to sugarcoat things and the reality is pellets are being inserted by people that simply don’t have the expertise. If they were a hormone expert, they wouldn’t be using them.

9.IT’S A CLUB – The offices putting them in have to pay to play. They have to pay a monthly fee to use the company name and they have to buy the pellets. Because they are invested, they are obviously blinded by this and in my opinion, are going to push pellets.

10.YOU’RE A NUMBER – If and when these practitioners draw your blood, they take the results and feed the numbers into a program from the company and then they are told by a protocol of what to do with the dosage, experts don’t use protocols and we also don’t treat you like you’re a formula of numbers. Hormones never work this way and they never will, and the reason for this is that we are all different. To try and simplify our vast hormonal network into a series of protocols is a serious detriment to you as an individual. Hopefully you can see this.

I know this is a lot to consume, and the sad thing is I have more reasons, but I’ll stop here. I’m sure I will catch some resistance on this, but I can thoroughly defend myself and I would ask any provider out there who espouses the safety of hormones to chime in here. If you have pellets, let them dissolve and switch over to a cream or sublingual troche and take back control of your hormonal balance. Don’t be sold a trojan horse (which is what these are). Will they make you feel better? Maybe initially, but at what cost? With levels so high they can have side effects and withdrawal symptoms that make you want to use them again?

Pellets? NO.

You as an individual? YES.

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