Testosterone pellet surface area relates to effectiveness more than dose
Abstract
INTRODUCTION: Hypogonadism, while common, can be devastating with long-term ramifications. There are multiple treatment options, but most are burdensome leading to poor compliance. Administration of testosterone (T) pellets offers consistent blood levels based on the implantation of pellets that dissolve over months. Guidelines for pellet dosing has been absent and often men are overdosed with T. The goal of the study was to evaluate the effect of pellet dose versus surface area on blood levels over 3 months in healthy men.
METHODS: One group of men were administered small individual pellets that resulted in higher surface than the other group, but at a lower dose.
RESULTS: Within 2 weeks the T levels had risen over two times the baseline level in both groups, but the cohort administered the lowest T dose (but highest surface area) had the greatest response whether calculated as peak change or when analyzed according to age-adjusted values. Increasing the pellet surface area resulted in fewer extrusions, no adverse events, and higher serum T levels compared to subjects that received a higher dose with a lower surface area.
CONCLUSION: Presently there appears to be no negative consequences of administering T pellets using methods that maximize the total pellet surface area.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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