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December 2, 2019

Dr. Mistry and Donna Lee Discuss Testosterone Pellets as an Affordable, Reliable Treatment Option

Speaker 1: 0:09
Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 0:18
Welcome back to the Armor Men’s Health Hour, I’m Dr. Mistry, your host here with my cohost Donna Lee…So in our last segment, Donna had brought up this issue of testosterone therapy using pellets.

Donna Lee: 1:24
I always have questions about that.

: 1:25
Yeah. And this week we had a wonderful visitor to our office from Bio T. Bio T is the name of the product that we use to be our pellet supplier. Now a lot of urologists will put in pellets and they’ll use a pellet called Testopel, which is paid for by some insurances and others will have pellets made up by a compounding pharmacy. People wonder what’s the difference between them. And sometimes people will say that I got pellets put in and they didn’t work. And I just feel like there’s a lot of mixed reviews when it comes to pellets. And so I thought, you know, I would use a little bit of time to kind of give you my impression of what pellet therapy is like for testosterone and what the difference between those things are.

Donna Lee: 2:05
And let’s talk about the size, because I’ve never seen an insertion and I’m always curious about that. I hear that our patients are 99.9% happy with the pellets. I’ve never had a patient complained to me that was terrible and I want my money back. It’s always like, “Oh my gosh, the pellets are so easy and convenient and I don’t have to worry about it for six months.”

Dr. Mistry: 2:22
That’s right. So like if you are on testosterone replacement therapy or you are considering testosterone replacement therapy, the pellets offer several benefits over injections or creams. So number one, it’s just something, it’s a little procedure done in the office every six months. We make a small incision less than a centimeter in the skin of your buttock. And then we tunnel under the skin and insert these pellets. We use up to 2000 milligrams of testosterone. That milligrams is what and how it gets leached or absorbed by your body is what determines what your level is going to be. And a lot of our patients will end up with levels in the 800 to 900 level. And that stays consistent, which is different than injections in which when you inject, you get a high level and then you get a low than a high than a low. So this up and down nature of the testosterone curve when you get injections is something we’re trying to avoid with pellets.

Donna Lee: 3:13
Oh, gotcha. So this is, you said a centimeter. So…

Dr. Mistry: 3:16
It’s tiny. We numb it up.

Donna Lee: 3:20
We’re making a face, I know you can’t see it.

Dr. Mistry: 3:21
That Donna’s going to be on our female to Bio T soon. So she’s, I think she’s just trying to just kind of psych herself up, you know?

Donna Lee: 3:28
Oh boy. So how does this stay consistent so well?

Dr. Mistry: 3:31
Well, it gets, it gets absorbed by the body in kind of a more consistent level. So there’s not, there’s not a big bolus or a big injection of medicine at once. And so this allows a more consistent dosing. Now because of that, we find that certain side effects are a lot less than pellet patients, namely something called Polycythaemia where your red blood cell count gets too high. So if you’ve been on testosterone in the past and they’ve asked you that you have to go and like get blood taken off because your blood count got too high, pellets may offer an option that kind of avoids the development of that Polycythaemia. Pellets also are nice because you don’t have to deal with them because you know, even if you were injecting your testosterone on the same day every week, people invariably miss and then their numbers go too low and then they have to catch up and the pellets offer consistency in your dosing, which allows you to get the benefits of testosterone replacement therapy. We use a product called Bio T. We use that because over the years we tried to obtain testosterone pellets from a number of compounding pharmacies and you just couldn’t get great quality. When a company’s just making pellets just for you or a few other doctors, they’re just not making them in high enough numbers and we just weren’t getting great quality. By going to a supplier that has thousands of testosterone pellet inserters, they’re making millions of pills every year or millions of pellets, and so we’re just getting great consistency. And so that’s kind of what we’re looking for. The dosing is much higher than what Testopel provides, so a lot more patients get a benefit. It’s just something that we’re really proud of doing is this testosterone pellet therapy.

Donna Lee: 5:05
And it’s not as expensive as you would think.

Dr. Mistry: 5:07
That’s right. It comes, it comes out to about a hundred dollars a month, which I will tell you that after talking to so many people that go to you know, bioidentical wellness centers here in Austin, people are spending upwards of $2,000, $4,000, $6,000 a year for therapy that we do. Not only is it a routine part of our practice, so covered by your insurance in many cases, but also at a much lower price. So if you’re a patient at one of these places and you want to get a second opinion, we’d welcome to see you and kinda tell you what we can do for you. Because if you’re looking at spending, you know $4,000 or $5,000 a year for the rest of your life, I think that it just kind of reduces compliance and makes you not as excited about doing it.

Donna Lee: 5:47
Right. And I know that the patients that are coming in for their injections…I think we’re not making money there, sir. We are hardly charging people for their testosterone–which is great for the patient. But I would like to tease you as your practice manager that there are other offices in town that are probably more expensive.

Dr. Mistry: 6:04
Yes, I think you’ve probably right about that. So if you are interested in getting pellets before the end of the year, please give us a call. Or if you want to make this a great Christmas gift for yourself or for your spouse, give us a call.

Donna Lee: 6:17
Is it the same for women and men? I think it’s, it’s six months for men.

Dr. Mistry: 6:21
That’s right. And women, the pellet therapy usually only lasts about three months. But that’s just because the dosing is so much smaller and it all, and sometimes it takes a little bit more kind of manipulating or getting an idea of what dosing is exactly perfect for you. But if you’re a woman suffering from perimenopausal symptoms, low libido, vaginal dryness, you’re having issues with your skin, hair, and nails, you know, getting your hormones checked and making sure that we get you righted-up is a great treat for yourself and your partner.

Donna Lee: 6:51
That’s right. Merry Christmas to both of you. I think too, I wanted to debunk a myth. I had a patient who was very upset the other day because I told him he had to come in for his lab work every three months per the doctor for our doctor. And he was convinced it was just because I wanted to make money on him somehow. And I said, no, we don’t even benefit from, we just need your lab results. We don’t make any money on the labs, we have a lab in house lab. But, remind patients why they should come in though. You talked about the red blood counts.

Dr. Mistry: 7:19
Well, testosterone therapy is not without some side effects.

Donna Lee: 7:22
Right. He thought he should get his lab work once a year and he just wanted to be done with it.

Dr. Mistry: 7:26
I understand. And I think that there are people that can do that for that patient. And if you want to get therapy with us, which I think is extremely high quality, low side effect kind of therapy, then at least initially for the first 6 to 12 months you are going to get lab work every 3 months. And if you’re stable and on a treatment program that, that you are happy with and compliant, then you go to every 6 months. And then, and then some patients, we do have low dose testosterone patients on for many years. We will put them on yearly labs. But it also gives us an opportunity to kind of talk to you, make sure that therapy is doing what you want it to. We take a lot of people off testosterone, too, because it’s not doing what they thought it was supposed to do for them. And so we don’t want to continue with treatment just to treat a number. We want to treat you as the patient. But I think that a number of patients feel like doctors do certain things to be able to, you know, continue to charge and get money from you. And I guess I can understand that on some level, but you can’t call a plumber to give you a diagnostic on your toilet and expect not to charge them for their time or ask a lawyer to give you an update on their business or their filings or an accountant or anyone really who is a professional. If you’re going to take their time to review your labs or to keep you safe or to do your refills and take liability for that drug, that’s what they’re doing when they do the prescription. If there’s a liability, there’s somebody out there who’s in charge of having given you that drug and taking responsibility for you being responsible for it.

Donna Lee: 8:57
And testosterone is a controlled medication. So we can’t just give it out willy-nilly.

Dr. Mistry: 8:59
That’s right. And I get it. I get it. You know, I think that when you have 3,000 or 4,000 testosterone patients like we do, you’re bound to get, you know, some patients that simply don’t want to tow the line of what we think is safe medicine. But fortunately the vast, vast majority of patients are very happy with what they’re getting and what I think we provided a very, very inexpensive price, especially for our testosterone injection patients. It can cost less than $30 a month for labs and for their drugs. And so, I certainly don’t think that there’s a lot of room to complain for providing cost-effective care.

Donna Lee: 9:40
Right. Gotcha. Good answer.

Dr. Mistry: 9:42
Well, great. Well this was a great show today.

Donna Lee: 9:44
That’s was a good show. If you have any questions for future shows or want to hear about a certain specialty that falls under men’s wellness, reach out to us at Armormenshealth@gmail.com. That’s our men’s health@gmail.com. Our website is Armormenshealth.com. Y’all have a wonderful, wonderful rest of your day.

Dr. Mistry: 10:00
Absolutely. See you next week.

: 10:01
The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin. For questions or to schedule an appointment, please call (512) 238-0762 or online at Armourmenshealth.com.

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