Testosterone pellets sewed into men's skin are fast becoming a booming business in the healthcare industry - and 46-year-old actor Antonio Sabato Jr has offered Daily Mail TV an exclusive walk-through the treatment as he went under the knife himself.

The past decade has seen an increase in awareness about how men - like women - suffer a significant hormone dip in their 40s and 50s, which can cause fatigue, anxiety, listlessness, and erectile dysfunction, among other things.

As awareness has ramped up, prescriptions have boomed: a recent study showed the rate of men being prescribed testosterone has tripled since 2001, with the vast majority in their 40s.

Experts warn many of these men may be mis-prescribed, since low testosterone levels can be affected by other things, like protein levels and weight gain.

But for the right candidate who is properly screened, endocrinologists across the board agree it is an essential treatment, and that there is a need for a better alternative to the current mainstream options: a self-administered injection, or a gel, which could rub off on a partner or children.

Sabato Jr, who competed on Dancing In The Stars and is now an aspiring politician, falls into that 'right candidate' bracket - and he is among the first wave to try the increasingly-popular method of surgically inserting testosterone pellets under the skin.

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Antonio Sabato Jr, 46, pictured getting his testosterone pellet inserted into his buttock

His doctor, Dr Chris Asandra, administers the pellets, which are increasingly popular

The pellet - about the size of a tictac - is inserted 'right into the fatty tissue in the upper buttock or the hip area'. It then sits there for about five to seven months, before it needs to be replaced

EXPLAINED: WHAT IS TESTOSTERONE THERAPY FOR MEN? HORMONES SHIFT IN MIDDLE AGE Men suffer a significant testosterone dip by their 40s and 50s. Levels start declining after men hit 30. Typically, levels range from 300 to 1,000 nanograms/deciliter of blood. This fluctuates during the day - they are higher in the morning and lower in the afternoon. A deficiency is characterized differently depending on the age range. For men in their 20s and 30s, they should be around the 700-800 mark at least. In their 50s, the 400-500 mark is an appropriate ceiling. THERE IS A BOOM IN MEN GETTING HORMONE REPLACEMENT. DO MORE HAVE TESTOSTERONE DEFICIENCY? No. Around 30 percent of men over 30 have a testosterone deficiency, according to official estimates. The majority of those with a deficiency only feel mild effects, compared to the few who will suffer erectile dysfunction and sleeplessness. WHAT ARE THE SYMPTOMS? The symptoms are often subtle. Aside from low libido and erectile dysfunction, it can cause: fatigue

anxiety

listlessness

lack of energy

lack of stamina HOW IS TESTOSTERONE TAKEN? For those who are identified as having a testosterone-specific issue, there are three first-line options (in the US; there are three in the Europe). While oral testosterone tablets are taken in Europe, it is barred in America for fears of its impact on the liver. That leaves three alternatives: a gel, an injection, or the pellet. The injection is thought of as the most popular, since the gel runs the risk of rubbing off on the user's partner or children. However, not every patient is excited about self-administering a shot. The new pellet formulation is widely tipped as a balanced blend of the benefits of the injection and the gel. Advertisement

'People want to look good but they also want to feel good too,' Sabato Jr's doctor Dr Christopher Asandra, of NuMale Medical Center, told DailyMailTV.

As Dr Asandra explains, the pellet - about the size of a tictac - is inserted 'right into the fatty tissue in the upper buttock or the hip area'. It then sits there for about five to seven months, before it needs to be replaced.

Sabato Jr told Daily Mail Online he had been feeling increasingly tired with low energy.

The Italian-American model and actor, who was propelled to fame in a Calvin Klein ad in the early 90s, used to pump out hours in the gym willingly.

As he hit 40, everything became a lot more difficult.

His doctor referred him to Dr Asandra, who also performs anti-aging procedures all over the body.

According to Sabato Jr, he felt a significant change straight away.

'Once you find out for yourself where you need to be it's changing your life forever,' he told Daily Mail TV.

The pellets have been well-received by the endocrine community, but most caution that too many medics of other professions - including primary care doctors and urologists - are over-prescribing testosterone to men who don't necessarily need it.

That's beside the issue of naturopaths and wellness therapists, who are not qualified in medicine, handing out testosterone prescriptions.

'It's a great option for the right patient who is screened correctly,' Dr Aren Skolnick, an endocrinologist who is currently training to use the pellets at Northwell Health in Great Neck, Long Island, explained to Daily Mail Online.

'As we age, testosterone levels tend to go down as well, but there are so many other reasons for low-testosterone levels, which their doctor may have already checked for,' Dr Skolnick says.

'It could be to do with the pituitary gland, or sleep apnea, or obesity, or they checked their testosterone levels in the afternoon when the levels go down.

'They shouldn't just be started on testosterone, they should be worked up befoe they commit to it, because it is a commitment.

'It's at least a few pellets inserted next to the belly button or on the thigh under the skin. It lasts anywhere from five to seven months before they need to be replaced.'

He breaks down the step-by-step approach to determining whether or not patients need testosterone-replacement therapy, which can be arduous, with side effects.

'Before they commit to the pellet therapy, the patient should have a repeat testosterone level check in the morning,' he says.

'In addition, we check their levels of SHBG (sex hormone binding globulin), the protein which testosterone binds to. That can show if it really is a testosterone issue or a protein issue.

'The pituitary gland should be check to determine if it's a pituitary issue, along with a check of prolactin, which can be high in men, and would be an easy fix with medication - easier than testosterone.'

For those who are identified as having a testosterone-specific issue, there are two first-line options (in the US; there are three in the Europe).

While oral testosterone tablets are taken in Europe, it is barred in America for fears of its impact on the liver.

That leaves two alternatives: a gel or an injection. The injection is thought of as the most popular, since the gel runs the risk of rubbing off on the user's partner or children. However, not every patient is excited about self-administering a shot.

According to Dr Skolnick, the new pellet formulation is a balanced blend of the benefits of the injection and the gel.

'It's a steady dose of testosterone every day, without having those peaks and troughs of the injection,' he said

'Like the gel, it's nice and steady and balance without having to think about putting on a sticky substance that could rub off on your clothes, your partner or even your children.'

They are expensive - running up to $1,300 for insertion every six months - but according to Dr Skolnick, it looks set to become the most popular form within a few years.

The pellets have been well-received by the endocrine community, but most caution that too many medics of other professions - including primary care doctors and urologists - are over-prescribing testosterone to men who don't necessarily need it

For those identified as having a testosterone-specific issue, there are two first-line options - a gel or an injection. But Sabato Jr says the new-fangled pellet form did wonders for him

Sabato Jr performed on Dancing With The Stars in 2014 and is now an aspiring politicia

'I heard about the pellets two or three years ago as an alternative testosterone therapy,' he said.

'I think testosterone therapy has evolved over the years, partly because of more marketing. People didn't seek it out as much before as they do now.

'Stigma, maybe, but also people now hear more about the benefits for libido, fatigue - etc - from testosterone therapy.'

The biggest issue with the surge in testosterone prescriptions is that many patients receive their prescriptions based on symptoms alone, rather than having a full testosterone work-up.

'Usually it's really non-specific symptoms that lead men to get their testosterone levels checked,' Dr Skolnick explains.

'You could have fatigue, low energy levels, difficulty concentrating, depression, decreased endurance. Men who could typically spend a couple of hours in the gym may find they can't any more.

'Most of the men come when it starts to affect their libido, fertility, or they have erectile dysfunction.'

The danger, he says, is that putting a man straight on testosterone to cure those issues means the clinician can no longer reliably test their testosterone levels.

As such, monitoring their health for all kinds of issues may become skewed and complicated.

Another issue is that we still don't have much research on its long-term impacts.

'We have more on hormone-replacement therapy for women during menopause,' he explains.

'But it's only been in the last 10 to 15 years that men's hormone replacement therapy has been getting more popular.'

Studies have shown HRT for men could have a myriad of down-sides, from increasing the red blood cell count (which could affect the patient's stroke risk) to causing depression and anxiety.

'A lot more research is needed,' he says.