Subcutaneous testosterone pellet therapy for reversal of male osteoporosis: a review and case report.

A 54-year-old male with a spontaneous fracture and osteoporosis had his osteoporosis reversed within one year on subcutaneous pelleted testosterone therapy.

• The patient had osteoporosis documented by DXA scan prior to treatment
• The patient experienced a spontaneous fracture associated with osteoporosis
• Reversal of the osteoporosis diagnosis was achieved within approximately one year of pelleted testosterone therapy
• The case represents a descriptive single patient case report

Consistent testosterone levels of 943 ng/dL were achieved with subcutaneous pellet therapy, compared to prior testosterone injections which did not provide physical or clinical benefit.

• Consistent levels of 943 ng/dL were achieved with pelleted testosterone
• The patient did not realize physical or clinical benefit on testosterone injections
• Both physical and clinical improvements were observed on pelleted testosterone
• The authors suggest pellet form provides more consistent testosterone levels compared to injections

The patient's testosterone level at diagnosis was considered within what many clinicians regard as a normal range, yet was associated with osteoporosis and testosterone deficiency syndrome.

• The patient presented with osteoporosis in the presence of 'what many consider a normal male testosterone level'
• Standard criteria for testosterone deficiency is commonly cited as below 300 ng/dL
• The authors note that testosterone deficiency 'is a clinical syndrome and osteoporosis can be found in levels above standard criteria of 300'
• This suggests clinical symptoms and bone density findings should be considered alongside serum testosterone levels

Subcutaneous pelleted testosterone therapy was associated with improvements in quality of life and sleep apnea in addition to bone density improvement.

• The patient experienced improvements in quality of life on pelleted testosterone
• Sleep apnea also improved on pelleted testosterone therapy
• These improvements were not realized on prior testosterone injection therapy
• Both physical and clinical outcomes improved on the pellet formulation

The authors conclude that subcutaneous testosterone pellet therapy should be further studied and considered for testosterone deficiency in men, particularly in relation to osteoporosis.

• The authors state this 'should be further studied and considered for TD in men'
• The paper is presented as a descriptive case report with a literature review component
• The authors suggest testosterone deficiency as a clinical syndrome may be underdiagnosed when relying solely on serum level thresholds
• The case highlights potential for pellet delivery method to achieve more consistent hormone levels than injections