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© 2018 by Tirpack Medical Procedures

  • What are Bioidentical Hormones

    • Bioidentical hormones are an exact structural replica of the hormones that are naturally produced by the body. The difference between bioidentical hormones and synthetic hormones is that, although both are created in labs, synthetic hormones are not identical to the hormones naturally created in your body while bioidentical hormones match human hormones molecule by molecule.

  • What are the ingredients of Bioidentical Hormones 

    • Bioidentical hormones are hormones derived from plants, such as soy or wild yams, and are designed to be structurally identical to the hormones produced naturally inside the human body.

  • Why SottoPelle

    • Dr. Gino Tutera, is recognized worldwide as a pioneer and leader in the field of bio-identical hormone replacement therapy. Made by a highly-respected pharmacy, the precision process used results in superior quality pellets every time; pellets that can perform reliably week after week, month after month. This ensures that each patient receives the full benefit of a steady, accurate dose.*

  • What is the difference between pellets, creams, patches, or T-Shots

    • Pellets work with the brain to regulate hormones. Pellet therapy is the only method of hormone therapy that gives sustained and consistent testosterone or estradiol levels throughout the day, for 3-5 months for females and 4-6 months for males, without any “roller coaster” effect.* Other forms of therapy simply cannot deliver such steady state of hormone levels. A patient does not have to remember to put a cream on daily or take a pill each day to sustain that constant level. Also the pellet is placed in the subcutaneous fat, it is not metabolized by the inside GI tract, liver or kidneys and any extra breakdown by the organs. Pellets are released through the capillaries, to match up with your hormone levels in your brain and are released as needed.

  • Any Disadvantages to the Pellet?

    • Hormones have to balance in your body. When the pellets are matching up with your own DNA there is a transition period that can take anywhere from a few days to 6 weeks. Everyone is different. Some patients get through the transition period faster than others. This usually takes the most time on the first pellet. If the next one is inserted in a timely manner, and your levels don’t drop, the transition will not be as significant the next time a pellet is inserted.

  • Any Side Effects of the Pellet?

    • As with any bio-identical hormone replacement therapy, some mild side effects can occur. Possible side effects include unwanted hair growth, acne, breast tenderness and mild water retention. In these cases, we will prescribe an antidote. To this day, there are no known serious side effects.

  • What Are The Advantages of Testosterone and Estradiol Therapy?

    • The advantage of the testosterone includes dilation of the coronary arteries which, with time, encourages decrease in the blood pressure, decrease in total cholesterol and LDL, decrease in fasting blood glucose, increase in bone density, exercise response to muscles, increased energy, less brain fog and decrease in joint aches. The advantages of estradiol include added hydration to the skin and hair, decreased vaginal dryness and sustained bone density.

  • How is a Pellet Inserted?

    • A pellet insertion is a short procedure that occurs here in our office. The pellets are inserted under the skin in the subcutaneous area of your buttock. It is like getting a shot. The area is cleansed with betadine or alcohol to keep the area sterile. The area is numbed using a local anesthetic, which is buffered with bicarbonate injectable to reduce the sting of the shot. A small ½ to 1mm incision is made and the pellet is inserted under the skin into the subcutaneous tissue. We then close the area with steri-strips, which is similar to a butterfly band aid. A small pressure dressing is applied.

  • What is the Pellet Insertion Post-Care?

    • Following the insertion, you can return to your daily routine. We suggest that patients ice the area for the next 12 hours to reduce swelling. If needed, you can take Tylenol or Ibuprofen for any discomfort for 24 hours after to prevent bleeding. The pellet must encapsulate in the subcutaneous area. In order for this to happen and to prevent the pellet from being expelled, certain activities are permitted for days following the insertion

  • What do I need to avoid and for how long?

    • Avoid submerging the area in a bath tub, hot tub, swimming pool, lake, etc. Showering is fine, just be careful not to submerge the area. (women 3 days, men 7 days).

  • Can I exercise?

    •  Avoid excessive lower body exercises such as cycling, horseback riding, lunges and squats. Anything that involves the gluteal muscle. How long? (women 3 days, men 7 days).

  • How Often Do I Need to Re-Insert Pellets?

    • At this time in technology, pellets are re-inserted at the suggested time before the hormone levels drop off. Typically they last 3-5 months in women and 4-6 week for men

  • Why do I Need Progesterone?

    • We recommend a progesterone pill for many of our female patients. Women who are menopausal, but still have a uterus are particularly recommended to receive progesterone to help protect against the development of uterine cancer or thickening of uterus lining. In addition, progesterone has a calming effect and helps promote a good night’s sleep.

  • Can I Get Pregnant When I Have a Pellet?

    • We do not suggest getting pellets if you are attempting to get pregnant. At this time, it is not proven whether pellets are safe in pregnancy. We ask that pellet patients who are in their childbearing years, have a birth control plan.

  • Will The Hormone Pellets Protect Me Against Bone Loss?

    • Will the hormone pellets protect me from bone loss? Yes. Estrogen therapy, especially when combined with testosterone, has been shown to maintain the mineral content and strength of bones after menopause. The consistent level of estrogen achieved by pellet therapy is especially effective in preventing bone loss.

  • Parkinson's Patients - Can This Help?

    • It has been found through some patient’s testimonials that their symptoms are reduced, and with time they have an increased level of stamina, balance, increased mobility, increased energy, more exercise tolerance and dexterity. Exercise helps build levodopa in the brain and the patient will have improved mental acuity, focus, and concentration. Both estradiol and testosterone accelerate dopamine activity in the brain that is lacking in Parkinson’s patients. It also helps neurotransmitters and neuronal cell growth.*

  • Does My Insurance Cover The Pellets?

    • The office visit/consult and lab work can be filed with your insurance. The pellet insertion is not covered by insurance. We do ask for payment up front prior to your pellet insertion. If you wish to request pellet insertion reimbursement from your insurance company, we can provide you with billing codes. Please note, we cannot contact your insurance company regarding pellet insertion reimbursement or coverage.