Synthetic Testosterone vs. Bioidentical Testosterone

Testosterone replacement therapy (TRT) is a topic that lends itself to many areas of discussion. One, in particular, is that of comparison between synthetic testosterone and bioidentical or natural testosterone. If you are unsure of the difference, then this report is something you owe it to yourself to read. In this review, we cover the following topics:

• What is synthetic testosterone?
• What is bioidentical testosterone?
• The difference between synthetic and bioidentical testosterone
• Which types of testosterone are best?
• Side effects of bioidentical and synthetic testosterone

Before we begin to discuss taking synthetic testosterone, we want to clear up some confusion by answering a few frequently asked questions.

Is synthetic testosterone a steroid?

The primary difference between any form of testosterone and a “steroid” is the usage of the medication. Testosterone is an androgen steroid hormone. In its natural state, testosterone is derived from other steroid hormones in a series of chemical and hormone conversions. The term “steroid” often means the illegal use of testosterone and other androgen supplements for the sole purpose of athletic-related enhancement. We hear about steroid use most commonly associated with sports or bodybuilding – two illegal uses of testosterone. Is there a connection between synthetic testosterone and fertility problems? Yes, men who take either a bioidentical or synthetic form of testosterone have an increased risk of lower sperm count. The reason for this is that only testosterone produced inside the testes can act on the developing sperm cells to promote maturation. Supplemental or exogenous testosterone (that which comes from outside the body) does not enter the testes. As a result, the hypothalamus registers higher testosterone levels in the bloodstream, so it slows down and reduces natural testosterone production.

Is synthetic testosterone illegal?

Any type of testosterone, purchased without a doctor’s prescription, is illegal to use. The only legal way to buy testosterone supplements is with a valid authorization from a physician following a Low T diagnosis.

Synthetic testosterone is not the same as bioidentical or natural testosterone.

What Is Synthetic Testosterone?

People often think that how synthetic testosterone is made is what sets it apart from bioidentical testosterone. Both types of testosterone are “man-made,” meaning they are produced in a laboratory. A synthetic hormone differs from its counterpart that the body naturally produces. The molecular structure of synthetic testosterone is not the same as that of natural testosterone – C19H28O2. Chemical modification of the testosterone molecule is what makes it synthetic.

Why do pharmaceutical companies produce synthetic testosterone?

Pharmaceutical companies cannot trademark a natural substance as there is no unique formulation to it. By altering the molecular structure, they can patent the medication and have exclusivity to the product to increase profits. An example of synthetic testosterone is methyltestosterone – an oral form of testosterone that added a methyl group to the testosterone molecule at the c-17 alpha position.

Is synthetic testosterone bad for you?

In some forms, the answer is yes, oral testosterone (methyltestosterone) increased liver toxicity, which is why it is no longer in use for the treatment of Low T.

Synthetic testosterone has a chemical modification that is different from the natural testosterone molecule.

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What Is Bioidentical Testosterone?

Any bioidentical hormone has the same chemical molecular structure as the natural one produced in the body. Bioidentical hormones are still “man-made” as they are laboratory-produced. Many of the bioidentical hormones that we use today come from plant sources, such as yams or soybeans. These are natural substances that undergo chemical synthesis in a pharmaceutical laboratory to create both bioidentical and synthetic testosterone replacement therapy medications.

Are synthetic testosterone injections bioidentical?

Medications such as testosterone cypionate and testosterone enanthate are considered bioidentical even though they have a slight modification. These injectables consist of bioidentical testosterone with an added ester.

What is an ester, and what is its purpose?

The ester is a chemical compound that attaches to the testosterone molecule to slow its absorption into the bloodstream. Without the ester, the testosterone would rapidly enter the bloodstream, requiring frequent injections. Once in the body, esterase enzymes slowly cleave off the ester, returning the testosterone to its bioidentical and bioavailable state.

Bioidentical testosterone has the same molecular structure as natural testosterone.

The Difference Between Synthetic and Bioidentical Testosterone

When comparing synthetic testosterone vs. natural or bioidentical testosterone, it is crucial to remember that you can only buy legitimate testosterone medications from a licensed pharmacy. That requires you to have a prescription from a doctor. In addition to the similarity in molecular structure to natural testosterone, the primary difference between synthetic and bioidentical testosterone is how it will work in the body. A hormone that is bioidentical mimics the body’s natural compounds. Because synthetic hormones do not have the same molecular structure, they cannot work in the same way. To bind to the body’s androgen receptors, synthetic testosterone shots or other products would have to undergo some form of molecular change or conversion once inside the body. The outcome of that is what often increases the risks of side effects. Does synthetic testosterone work as well as bioidentical testosterone? The answer depends on the particular medication. For example, methyltestosterone may not work as well as its first pass is through the liver, where some of its benefits are destroyed by chemical reactions in the organ. Since the body tolerates bioidentical hormones better than synthetic, those are always the best option when available.

The primary difference between synthetic testosterone and bioidentical testosterone is its molecular similarity to natural testosterone and how it works in the body.

Side Effects of Bioidentical and Synthetic Testosterone

Adverse synthetic testosterone effects occur most often when the medication is taken orally. That is because it first enters the liver via the portal vein, where its metabolization can lead to significant health problems. A new form of oral testosterone – testosterone undecanoate – is not yet recommended for sale in the US. Marketed as JATENZO, warnings of dangerous blood pressure increases that can lead to major cardiovascular events, non-fatal stroke, and cardiovascular death have been reported. Injectable testosterone undecanoate (AVEED) carries significant side effects and warnings risks, including pulmonary oil microembolism (POME) and anaphylaxis. Bioidentical and synthetic testosterone side effects can occur when testosterone levels become too high in the bloodstream. That can lead to any of the following:

• Oily skin
• Acne
• Male breast enlargement (gynecomastia)
• Headache
• Nausea
• Worsening of sleep apnea
• Testicular shrinkage and infertility in men
• Increased red blood cell production

The most common cause of testosterone side effects is abuse. Taking testosterone as prescribed by a doctor to improve low testosterone levels rarely produces adverse reactions.

Oral synthetic testosterone poses significant risks due to liver toxicity.

Which Types of Testosterone Are Best?

The best synthetic testosterone to buy is one that is considered to be bioidentical in nature. Our doctors at Kingsberg Medical recommend testosterone cypionate and enanthate injections for men and compounded testosterone cream for women. You can buy synthetic testosterone (bioidentical) with a prescription from our physicians following the diagnosis of testosterone deficiency. We provide free consultations by phone (telemedicine) with our medical team to facilitate rapid diagnosis of your condition at a low cost to you. Local laboratories perform the necessary blood tests at predetermined prices to help minimize your out-of-pocket expenses. Please contact Kingsberg Medical today for more information or your free, confidential consultation.
Brian Leeber