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synthetic testosterone vs bio-identical testosterone

There is a lot of discussion about whether or not “bio-identical” testosterone is better than “synthetic” testosterone. Despite the fact that the term bio-identical certainly sounds good, the short answer is no. There are no scientific data supporting claims that it is safer, more organic, more personalized, or more effective as many clinics contend. I am definitely not discouraging use of bio-identical testosterone, as it is probably not inferior, but there is a fundamental chasm between the claims made by some clinics and actual scientific evidence. 

Here are some common misconceptions/claims made about bio-identical testosterone:

“BIO-IDENTICAL TESTOSTERONE IS NATURAL” – This is categorically false. Although the process of making it begins with a simple molecule derived from plants, that molecule undergoes a litany of chemical manipulations using synthetic reactants in a lab before taking on the chemical structure of human testosterone.

“BIO-IDENTICAL TESTOSTERONE IS SAFER” – There is no evidence that this is the case. Testosterone is testosterone in terms of risk. Those risks should be communicated to a patient in great detail before starting any form of testosterone therapy.

BIO-IDENTICAL TESTOSTERONE IS EASIER TO “PERSONALIZE”” I am not even sure what this means when I hear clinicians say this. Any testosterone therapy should be personalized–meaning achieving safe, reproducible levels with attention to clinical response. This is not difficult and is more dependent on the doctor’s protocol than the type of testosterone. Synthetic testosterone very dependably delivers easily measurable and adjustable testosterone levels. This can be achieved with bio-identical testosterone as well, although variability of bio-identical testosterone’s potency due to the extraction process has been demonstrated.

To summarize, at this time there is zero evidence to suggest that bio-identical testosterone is safer, more effective, easier to “personalize,” or more natural than synthetic testosterone. Although patients should feel comfortable with either if prescribed by a qualified doctor, truly scientific data would suggest that any claims that bio-identical testosterone is superior to synthetic testosterone are not supported by fact and such statements appear to be either misguided or for marketing purposes.