BioTE Hormone Replacement

Susan (00:07):
My name is Susan M. I am a registered nurse with a baccalaureate degree. I presently work for Dr. Basu Aesthetics, and I have been a nurse for 40 years and specialized in plastics for 30 years. In one of my other employments with a gynecologist in 2015, she brought it on and it was life-changing for so many women at that time. They were exhibiting symptoms of anxiety, depression, fatigue, decrease libido, and it was a game changer for them. And that was very exciting for me as a healthcare professional to see this transformation occurs. So when I joined Dr. Basu in his practice in 2017, we brought it on board. We were making patients look younger, but they were not feeling at their best, at their optimal level. And that's when we brought in Biote hormone replacement therapy into the practice and have been very successful with offering this replacement therapy to both men and women.

(01:30):
If someone is interested in hormone replacement therapy, the first step is you would make a screening appointment with me and I would give you some paperwork and questionnaire to see if your signs and symptoms are aligned with hormone replacement therapy. That screening is of no charge, and I also make sure that mammogram, pap smears are up to date, et cetera. And if I feel that you are a candidate, then I would send you for screening labs, and that cost is $155 to the patient and it's very intensive. So we do CBC, a complete blood count, a comprehensive metabolic panel. We do T-S-H, T-P-O, T four, T three, those are all the thyroid levels along with a vitamin B12, vitamin D. For the men, we do PSA, and because one of the common side effects is fatigue, we want to rule out that someone is anemic or that they don't have an underlying medical problem that is giving them that symptom.

(02:53):
Biote hormone replacement therapy involves the insertion of into the hip area usually, and it's a cutaneous injection that is, for men, when that insertion occurs, depending with how many milligrams of testosterone, you would not come back to get hormone therapy for five months. Okay? So the best thing for the males and the females is that it lasts for several months. For the man, reinsertion of pellets occurs in five months, and for women it can be any time between three to four months, and that is driven by the patient. It's how you feel when you're feeling optimal. You feel fabulous, you have energy, you can feel it and you can feel it when it's leaving you. But patients will want to come back at like the two month mark because you can feel a decrease, but we cannot repellet women till the three months, three to four months timeframe.

(04:04):
Some women can go longer, maybe even five months, but we discourage that because we don't want you to empty out. And so basically for a male, he would be coming three times a year, so that saves on time. And for the women, it can also vary from three to four times a year, but it's driven by each individual. So men that are self-injecting either are going to clinic once a week or they're injecting themselves weekly. So this is a insertion that is given subcutaneously, a sterile technique for the males, and it takes about 30 minutes to do the insertion for the males and for the women, it can be done in 15 minutes. Does pellet insertion hurt? You feel a slight tingling or burning as we are numbing the area with bicarbon lidocaine, just like you would any type of injection, there's that little tingling, but with the medication that we're inserting, it's a numbing medication.

(05:18):
So after the area is numbed in a couple of minutes, we use a scalpel to insert our chocar and patients don't feel anything. If they do, we can administer more anesthetic to numb the area, but I've been doing that since 2015 and I would say the majority, like 99% of the patients just do fine. For the males, we do put a pressure dressing for one week, so we ask that no exercise or water activities be done for that one week timeframe. And the same goes for the women. They can remove their pressure dressing in 24 hours. We close everything up with Steri strips and it seems to just work great. We rotate injection sites every cycle. And I do want to say that when someone is initially thinking of hormone replacement and they do come in, I do like to tell them that I would say 90% of the patients do feel better with the first cycle of hormones, but sometimes patients have been depleted for years and are at very low levels that they'll feel better at second or third once we start increasing and stabilizing the hormone.

(06:43):
We will do labs at four weeks for the male and for the female at four to six weeks. Because this is a science, we are looking at each person's individual labs, so we know at baseline what their numbers were, and then we look at the results after they've had the hormone inserted in them. Then it's great to see how the numbers increase, and then at that point, if they are not at optimal levels, we can give them a booster at that first cycle at no charge. So once again, I think the great thing is that we're listening to the patients. We are looking at their labs so we don't overshoot them with hormones. So some of those side effects of too much hormone can be that they're hypersexual, they have an increase of acne, increase of hair growth, so having too much can also sometimes not feel great as too little, so we're trying to optimize their dose.

(07:55):
I think the advantages of coming to our center is Dr. Basu is the medical director. He does consult with each patient at the initial entry into our practice, and he does oversee all lab works that we get on patients. So he definitely is being consulted if there is a problem, if there does seem to be a pellet extrusion that can occur. We know how to deal with wound care. So I think the most important thing that patients need to seek when they are seeking hormone replacement is that there be a medical doctor on board overseeing all the patients. Patients want to feel great, so usually they are the ones that want to continue, and if anything, they want to come back sooner because they don't want to get that low. You definitely feel so great that you don't want to stop it. Same analogy I could say with exercise, once you get to feeling great with eating healthy, exercising, you want to maintain that feeling, that euphoria. It's all I can tell you. I think that's one of the things that I love about Biote, that it really transforms people, their mind, their marriages, patients physically. Yeah, we should be so thankful that we live in the 21st century with us living longer and having to work well into our seventies, this definitely helps. Yeah, it's a game changer.

(09:48):
Dr. Basu introduced semaglutide on February 3rd of last year, and we have over 400 patients, and I would say 95% of the patients have been successful in meeting their weight loss goals, and I believe the saying less is more. We try to find the sweet spot of you having energy, having a sense of fullness and achieving weight loss. So more isn't necessarily better. It is medication, it can create side effects, but I would say the majority of our patients that are on weight loss medications have the most common side effect can be constipation. We've had no patients with severe abdominal pain. Some have had slight nausea, but that was because they were then going to, they have been bad eating, high carbs, alcohol. We do have, since Dr. Basu is our medical director, if patients are losing weight but having a slight discomfort of nausea, what we can call prescription of Zofran for them.

(11:06):
But if you're having nausea because you're drinking and eating too many carbs, then we won't do that because then we're masking the side effects of the medication, which will bring you weight loss by giving you a sense of fullness. Dr. Basu likes to start one medical transition at the same time because if you start getting side effects and you start two things at one time, you don't want to bombard that person with too many new things at once because they do have a problem, then you have to be a detective to try to figure out, well, which one is doing it? Same thing with starting a lot of medications at the same time, so we like to implement one program at a time, and then after a month after we know that is they're having no side effects, then we can proceed. Because that goes for anything, whether it's skincare, semaglutide hormone replacement therapy, you can have side effects, and it's important to know which medical program is in the culprit or which medication.

(12:19):
The other thing I do like to preface is that sometimes patients will think that hormone replacement therapy is good for weight loss. I always like to preface to them that the hormones will give you energy so that you can now go to the gym so you can make smart food choices. Everyone thinks with hormone replacement therapy that it's going to do it all. Everything has its limitations, and even if I may just interject with the weight loss medications, it doesn't matter how much you're paying a month, but if you are not exercising, if you are not reducing your calories, if you are not making healthy food choices, you're not going to lose weight. And it's very important for patients to remember that and for them to take the time and energy to invest in themselves and also to do changes in their life that can maintain their desired results.

(13:26):
The first step is that you would call us and say you want a screening with Susan and it would take about 15 minutes. I'd ask you some questions. We could also do it over the phone, and if I feel that you needed to get your screening labs, if you were the age of a colonoscopy or needed a urology workup, then I would recommend that for you to get that in line. And then I would send you for labs and we would set up a consult with Dr. Basu. We get it takes about a week for us to get all the labs that I mentioned earlier into our office, and Dr. Basu would review all the labs, answer any questions you might have, and then at that appointment we would do a pellet insertion and then we see you back for follow-up labs.

Announcer (14:27):
Basu Aesthetics and Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basu plastic surgery.com/podcast on Instagram. Follow Dr. Basu and the team at Basu Plastic Surgery. That's BASU Plastic Surgery. Behind the Double Doors is a production of The Axis, THE AXIS. io.