Dr. Mary Claire Haver

It's very reasonable to start with five.

Now, the other way that people do it is some people do subcutaneous injections.

I'm familiar with people doing injections of testosterone because I take care of transgender people who do inject themselves.

And cis men inject themselves with testosterone at very high doses.

And then pellets...

Physiologically, I'm not here to demonize them.

I get why people like them.

Someone doesn't want to use the medication every day.

You say, okay, we're going to put an insert under your skin.

The problem with the pellets is you have no idea how they're going to be absorbed.

And so you will see people with incredibly high levels of testosterone coming in, losing their hair, covered in acne.

And we have to then give them spironolactone and other medications to counteract the effect of the testosterone they were taking.

So that's the problem with pellets.

Some people will argue, well, you can get pellets in these really low doses.

And I still say, again, you can't take it out once it's in.

You don't know how you're going to respond.

So I don't recommend pellets.

I understand why people use them.

I just don't recommend them.

So superphysiologic means that your level is above that target that we talked about earlier, right?