Benefits of Capsules and Creams / Risks of Pellet Therapy

Comments: 0 | October 24th, 2018

By now, most people are aware of the health benefits of bioidentical hormones. Dr. Hotze visits with the Director of Hotze Pharmacy, Kim Bennett, R.Ph., to talk about the different delivery methods that are available, and the problems associated with pellet therapy and why you should avoid it. Discover the benefits of capsules and creams and the risks of pellet therapy.

Podcast Transcription:

Stacey: Welcome to Dr. Hotze’s Wellness Revolution. I’m Stacey Bandfield, here with Dr. Steven Hotze, founder of the Hotze Health & Wellness Center. And if you have not downloaded our podcasts, we have some great ones. We have some new ones on tap, as well, so go to, that’s H-O-T-Z-E podcast dot com. Now today, gosh, we get a lot of questions, Dr. Hotze, on this. It’s about hormone therapy. What are the best delivery options. Is it pellets, is it creams, is it pills? Pellets seem to be popular, but really is that the safest, best alternative?

Dr. Hotze: Thank you so much, Stacey, and thank each one of you for joining us today on Dr. Hotze’s Wellness Revolution. Today, we’re going to discuss the different ways that a person can receive bioidentical hormone therapy, and we’re going to be discussing this with Kim Bennett ,who is our pharmacist in charge at Hotze Pharmacy. I want to remind you what we believe. I believe that you and every individual needs a doctor and a staff of professionals who have the ability, the know-how, to coach you onto a path of health and wellness, naturally, so as you mature, you enjoy a better quality of life without using pharmaceutical drugs. One of our most important methods and treatment options to help you obtain and maintain health and wellness naturally is the use of biologically identical hormones which are known as bioidentical hormones.

Dr. Hotze: That means the hormones that are prescribed here are at the Hotze Health & Wellness Center and are prepared in Hotze Pharmacy are molecularly identical to the hormones that your body used to make in adequate amounts when you were younger, particularly the hormones that we use here in females are progesterone and estrogen hormones, a combination of estriol and estradiol. We also use testosterone in women, in smaller doses. But of course in males we use testosterone. We use cortisol which supports the adrenal glands. We also use pregnenolone which is a building block hormone of the adrenal glands and DHEA which is another adrenal hormone. These are the hormones that we use. We also use natural desiccated thyroid hormone. I will let Kim talk about the different methods that are used around the country to deliver the hormones to individuals.

Kim: Okay, thank you Dr. Hotze. There are several different methods to deliver bioidentical hormones. There are capsules, there are creams, that’s topical creams. Also there are vaginal creams available. And there’s sublingual tablet form. There’s also a troche available. And some of our guests may have heard of pellet therapy. I know that’s pretty popular out there now. I like to call that a fad, if you will.

Dr. Hotze: Right, and also some people use suppositories. At the Hotze Health & Wellness Center, our doctors, our physicians, our providers have historically used primarily slow-release capsules. We use capsules for all the hormones. We also use creams in some patients and it may be that an individual has some gastrointestinal problems and isn’t able to properly absorb their hormones. At that time we’ll use creams but creams are a little bit messy.

Kim: Right, not as convenient.

Dr. Hotze: Right, and talk about some of the, I mean we have used creams and used them effectively in people. But a lot of people just don’t like putting the cream, having to slather the cream on. It’s just a whole lot easier to take a capsule. We do use some sublingual therapy if a patient requests that. But what we’ve heard and seen in our practice is individuals that have come to see us because they tried the latest fad which is…

Kim: Pellet therapy 

Dr. Hotze: Pellet therapy. So describe to us what pellet therapy is for hormones and what its benefits might be and what would be detrimental about using it.

Kim: Okay. So what I’ve heard about pellet therapy is they place the hormones in a small cylinder that’s about probably just a little bit smaller than a grain of rice and it gets inserted into the abdomen or the buttocks, kind of the top of the hip area. And it depends upon the dosing that is used. They could have insertions of one to three to four to five pellets at a time inserted. Estrogens are inside of these pellets, as well as testosterone.

Dr. Hotze: So they only use estradiol, they don’t use estriol and estradiol, so they only use estrogen hormones, estradiol and they only use testosterone. And because they’re placed in there for three to six months they have to have a very high dose to last that long because it is slowly dissolved in the subcutaneous tissue.

Kim: Right. It is slowly dissolved and once it’s in, it cannot be taken out. So that’s a problem we’ve seen, we’ve had some guests that have come to us that have had pellets inserted that have had extreme side effects after the insertion of the pellet. We had one gentleman that came in one time that had to take a leave of absence from work because he was so irritable and just could not function properly after the insertion of the pellet because it was such a high dose. What we do here with our hormones is we balance the natural, it’s called a physiologic or natural balance of the hormones. And what, Dr. Hotze you mentioned in the beginning was it brings your body back to where, it restores your levels back to where they were when you were younger. What the pellet therapy does is it’s what’s called supraphysiologic dosing.

Dr. Hotze: Which means a very large dose.

Kim: Right, very high dosing and which leads to very severe side effects. In addition to what I talked about with the gentleman, I’ve also heard of women experiencing facial hair growth to the point where they’ve actually had to start shaving their face, male pattern baldness, chest hair growth, things of that nature.

Dr. Hotze: Side effects that most women wouldn’t want.

Kim: Right. Why would you want to do that?

Dr. Hotze: So that’s the reason we began using capsules with slow-release formula so you take your almost twice a day. They don’t use progesterone pellets because it’s too quickly dissolved for some reason, I don’t know why it would be any different than estradiol or testosterone, but the problem is when you take a pellet you have it and you can’t get it out. It’s there whether you’re having side effects or not, it just stays there and is dissolved. Sometimes in some people it may be faster than others. That’s why you can get these high doses. And they have to give you high doses in the pellets because it’s supposed to last three to six months. That gives you no way to adjust the hormone. I always like to give hormones in doses that help individuals balance out and replenish their hormones, so the side effects… 

Dr. Hotze: Now let’s talk about the side effects that people have when their hormones decline. In females, women get premenstrual tension and syndrome. And that could be mood swings, weight gain, breast tenderness, migraines, headaches, moodiness, loss of romantic moods and inclinations, that’s very common and that can happen one to two days prior to a woman’s normal menstrual period or it could happen a week or two weeks, it can get worse and worse and that’s due to a decline in natural progesterone. A woman becomes estrogen dominant.

I talk about this in my book Hormones, Health, and Happiness. We talk about estrogen dominance, and when you have too much estrogen that adversely affects the way women feel when you don’t have the balance of progesterone, because it’s the proliferative hormone. So, inevitably, when women get estrogen dominance, not only do they get more severe premenstrual symptoms, but they also get dysfunctional uterine bleeding, they get heavier menstrual periods and then they get breakthrough bleeding, so the periods may be three to five days when they were younger than their five to seven day, seven to nine days, then they get breakthrough bleeding and then go to the doctor and they have fibroids.

Dr. Hotze: This is all caused by estrogen dominance. That’s why women need starting in midlife, as soon as you start having symptoms, you should begin to take natural progesterone day 15 through 28, and this goes back to the beginning of puberty. Some young girls come in and, you know once they hit puberty they just have all kinds of problems. Emotional problems, they have health problems and it’s all due to an imbalance in their hormones. And we can give just a little bit of progesterone to women that are young girls and teenagers, rather than giving them birth control pills which are counterfeit hormones, wet will give natural progesterone and that balances things out very, very nicely. And prevents them from having to go on lots of other drugs, because once you start on the birth control pills, those are counterfeit hormones, you don’t make progesterone that is attended by estrogen dominance, and estrogen dominance adversely affects a woman’s thyroid utilization and thyroid governs a woman’s and man’s energy production.

Dr. Hotze: So if you don’t have enough thyroid in your cells, no matter how much you have in your blood, then you have a problem and estrogen dominance causes the liver to produce high levels of thyroid-binding globulin which bind the thyroid hormone. It can’t get into the cells. You may have it in the blood, but it doesn’t get into the cells in the active form, so you have low energy production. You have low energy, you have low metabolism, difficulty with weight, don’t sleep well, can’t think clearly, have mood swings, depression, irregular menstrual cycles, joint, muscle aches and pains. Maybe your bowels don’t function well, maybe they’re constipated, recurring chronic infections and just feel unhealthy at a young age. And that’s due to a decline in your naturally occurring hormones, which occurs as a woman marches through her menstrual life.  The hormones are going to decline. They peak in their early 20s and then they’ll decline

Dr. Hotze: And there are plenty of hormone disruptors that we have in our lives that disrupt this, and their petrochemical products and what we breathe in the air, the food we eat, what we drink and the lotions you slather on the body full of petrochemicals which disrupt the normal production of your hormones. So that’s why it’s all the more important to supplement and replenish your hormones. As a woman goes through the change a life, she’ll need some estrogen, because when you have estrogen decline what happens is you’re going to get hot flashes and you get night sweats, you get mood swings or vaginal dryness and a host of other problems that afflict a woman as she loses her natural estrogen. So you have to balance these out.

Dr. Hotze: Men have the same problem ass they lose their testosterone, which declines. They peak in their 20s and that declines by the time they’re 40, it’s about two thirds to one half what it was in the early 20s. By the time they’re 50, it’s about a third, by the time they’re 60, it’s a fourth of what they used to make. And testosterone has a positive effect on helping with initiative, assertiveness, sense of well-being, self-confidence, mood, goal orientation, drive, directiveness, decisiveness and analytical ability. Those are all brain functions. Remember, the hormones affect your brain’s neurotransmitters so you can think right and you can feel good. And testosterone, of course, governs male pattern behavior and as men lose their testosterone, well they lose their attentiveness, their decisiveness, their goal orientation, their drive, their muscle mass shrinks, they get cardiovascular problems, they have romantic moods and inclinations that are dramatically declined and their abilities are declined. So it’s a host of problems.

Dr. Hotze: So that’s the reason we supplement with bioidentical hormones and we have found here at the Hotze Health & Wellness Center, after treating over 31,000 people since 1989 most of whom are adults, we have found that when you replenish and balance your hormones naturally, you can have a tremendous improvement in your overall health and sense of well-being and many of the symptoms that you’ve had will resolve. We’ve found the best way to treat is using capsules by mouth orally, and creams when indicated, when needed. That’s what we do.

Dr. Hotze: And in testosterone we also use capsules, creams. We also use injectable testosterone in males and that can be very helpful, as well. So that’s what we use, but we have found in individuals that have come and saw us after seeking pellet therapy, that they had problems on pellet therapy, and that doesn’t mean everybody has problems on pellet therapy, but there was absolutely no way you can balance the hormones. Once you put a pellet in, you’re stuck with that dose whether it’s too low or too high and you can’t adjust it. Whereas when you’re taking your oral on a daily basis, and as you walk through your life your hormones need to be adjusted over time. We can do that very simply and orally or using a , but primarily orally, and that is the simplest, safest way to do it without having to worry about effects of high, high doses and the adverse effects you can have with that.

Kim:    Or going under even local anesthesia and having scars and having the pellets pop out and you know, things like that.

Dr. Hotze: So we recommend using capsules for hormones and secondarily creams, and in males, if you’d like to, you can use injectable therapy, as well. So that’s the story about bioidentical hormones and the different methods that are used to get these hormones into patients. We think capsules and creams are absolutely the best, and injectables for testosterone can be very helpful.

Dr. Hotze:   Thank you for joining us today. We look forward to having you back with us on our next podcast. Let me mention to you that youcan go to to our Symptom Checker and see if you have any problems, and if you do, don’t hesitate to give us a call at 281-698-8698 and visit with one of our new guest consultants who will be glad to help you do a 180 and take charge of your health.




Written By: STEVEN F. HOTZE, M.D.

Steven F. Hotze, M.D., is the founder and CEO of the Hotze Health & Wellness Center, Hotze Vitamins and Physicians Preference Pharmacy International, LLC.

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