Bioidentical - who cares, right? Actually, the difference between bioidentical testosterone and non bioidentical is all the difference in the world. Bioidentical simply means that a molecule matches exactly in shape, structure and atomic quantities the molecule utilized in the body.
Testosterone is not a horrendously complex molecule: it has 19 carbons, 28 hydrogens and a couple of oxygen molecules arranged in four "chicken wire" ringlets. And, oh, what a powerhouse bioidentical testosterone is for the male: as I have documented in my Symptoms page, it controls brain, muscle, sexual, libido, bone and blood functions for us guys. It is the elixir of life for men and I ask the question, "Why would you use anything other than the original bioidentical testosterone that works so perfectly and powerfully??"
But the problem (originally) was money: drug companies can't patent testosterone. So they will remove a carbon here or add a methyl group there to make it similar but not identical and then slap a patent on it. Bye bye bioidentical. As a side note, probably the ultimate story of greed and corruption occurs in the female hemisphere: women actually do not have access (from Big Pharma) to bioidentical estrogens. Trust me - this bioidentical issue has caused many of the females in your life a host of issues that you should be aware of, including loss of sexual desire. You can read more in my link on Female Libido.
This same issue has surfaced for males who use steroids, which are essentially mock testosterones that are not bioidentical. The pharmaceutical manufacturers of many of the common steroids have made their steroids sound like bioidentical testosterones (or DHT), when, in fact, they are nothing of the sort. The bottom line is that all of these are testosterone with something modified just so the drug company could get a patent. And artibrarily screwing with Mother Nature is not a good idea and the side effects of steroids are numerous:
1) Liver damage, particularly from the oral steroids, is quite common.
2) Liver tumors, usually benign, are not uncommon.
3) Atrophy of the testes are not uncommon with certain steroids, especially with those who "stack", i.e. use more than one steroid at a time.
4) Negative lipid changes are common with some steroids: chol4Kscoreol is increased and HDL decreased.
5) Hypertension, i.e raised blood pressure.
6) Enlargement, or hypertrophy, of the left ventricle (heart chamber) which results in less blood to the heart.
This list could go on and on, but brings up a very important point: these side effects are notably absent when using bioidentical testosterone. The tragedy is that attacking your lipids, your liver, your heart are all going to eventually adversely effect one's sexual function and performance. Contrast that with bioidentical testosterone, which will, except in certain relatively unusual circumstances, helps the heart and sexual function. Good, clean bioidentical testosterone (at a reasonable dosage of course) can build muscle, including those at the base of your penis, and improve libido and brain function without destroying your heart or liver! So why bother with anything else??
Another big problem is many guys use steroids without proper supervision, which is not the case for a guy who receives bioidentical testosterone from his doctor, who almost always monitors PSA, liver function and lipids. Elite athletes have the same luxury with their steroids, but that is not the case with the typical guy in the gym cycling steroids on the side and on his own.
That's why many on-the-street guys are slowly damaging their health. I have seen bodybuilding sites recommending to guys to back off a steroid when their "nipples start tingling". This is madness and is too late, because their estrogen levels are obviously grossly elevated. Going too high with any testosterone can lead in some cases to an overproduction of estradiol and DHT, leading to bizarre feminization and hair loss/acne effects, respectively. Remember that both estrogen and DHT are converted from testosterone, so if you pump too much testosterone, whether it is bioidentical or not, into your system, you end up with an excess of these downstream hormones.
My wife knew of a guy who grew such large man boobs from steroid abuse that he could grab his chest and squirt milk. Yes, he had to have the breast tissue surgically removed. Again, stick with bioidentical testosterone at a reasonable dose!
Contrast all of these problems with doctor-prescribed, bioidentical testosterones such as Androgel and Testim: they have been extensively studied and issues good and bad are well known. Compounded testosterone are almost always bioidentical as well (and much cheaper). (Yes, anyone can have side effects: read my link on HRT (Hormone Replacement Therapy) for details.)
So, if your testosterone is low, most doctors are willing to provide you with bioidentical testosterones, such as Androgel and Testim. You can also your doc if you can use a compounding testosterone instead: testosterone is not actually that expensive. Androgel and Testim cost more, because the drug companies were able to get a patent on the delivery system of these bioidentical testosterones.
ESTERS: What about the injectable esterized testosterones such as testosterone cypioante, enanthate, undecanoate and propionate? (Undecanoate now comes in an oral form in some countries.) These appear to be are safe because, while an ester has been attached to a bioidentical testosterone, it is quickly broken off by the body. And the key point is that once the ester is broken off, then you are left with bioidentical testosterone.
CONCLUSION: Again, I cannot think of any good reason not to use the same stuff your body uses: bioidentical testosterone.