Ten in-person clinics across the Southeast and Texas doing one thing only: bioidentical hormone pellets, dosed off comprehensive bloodwork
Optimal Bio does hormone pellets and nothing else. No injections, no patches, no creams, no telehealth. Their treatments page lists three things: hormone therapy for women, hormone therapy for men, and a nutrition and supplement programme. Testosterone, estradiol and progesterone pellets, about the size of a grain of rice, are placed under the skin of the buttocks or lower back in the office. Women come back every three to four months, men every four to six. The intake is published and short. A 15-minute call with a patient coordinator, then a 30-minute consultation with a provider, then comprehensive bloodwork. You return about a week later to go through the results, and in most cases the first pellet goes in at that same visit. A four-week recheck follows to see where levels landed and adjust. No referral needed. Their argument for going outside insurance is that insurance dictates standardised dosing, and their pitch to patients whose labs came back normal is that normal is not the same as optimal. Greg Brannon, an OB/GYN who had practised in Cary for three decades, founded the company in 2012 and retired from clinical work in 2020. He died in July 2025, though parts of the company's own website have not yet been updated to reflect that. His daughter Tylar Brannon has run the business as CEO since 2018 and took it from a single office to ten. Cary Fishburne, MD, is now listed as medical director. One thing worth knowing about staffing: no physician is listed at any individual clinic. Day-to-day care at all ten sites is delivered by nurse practitioners and physician assistants, most of them nationally certified, and the company says providers train for several months before treating anyone alone. The pellets are compounded preparations rather than FDA-approved products, and the compounding pharmacy is not named publicly. Optimal Bio does no stem cell, exosome, PRP or IV work, and does not offer GLP-1 weight loss medication.
Board-Certified Physicians
Accreditations are records-based and do not imply endorsement of any treatment's safety or efficacy.
Starting from
On consultation
consult to quote
No price is published anywhere on their site, so the number comes at consultation. What they do commit to is that the quote is upfront and includes the initial comprehensive lab panel, and that follow-up appointments are part of the care rather than billed separately. Insurance does not cover the therapy itself, though your own plan may cover some of the lab work case by case. HSA and FSA funds are accepted, and Cherry financing is available.
Pricing is indicative and set by each clinic. Confirm the final cost directly before treatment.
3 reviews
Individual results vary and are not typical or guaranteed. Case studies and testimonials reflect one person's experience.
Experience
I receive pellets quarterly - it has been a life changing experience. The constant anxiety, feeling tired and depressed, inability to focus...gone! It's also nice not to mess with patches or creams. I see Rachel - she's awesome! She checks my levels, answers any questions and makes adjustments as needed. I've been on these pellets for many years and I highly recommend Optimal Bio.
Experience
Buyer beware. I was a moderately* content T pellet patient with Optimal Bio from May 2024 through early 2026. However, when I decided to start HRT (estradiol gel and progesterone capsules) through another provider in October 2025, Optimal Bio refused to provide my scheduled T pellet in January 2026. The decision felt abrupt and unexpected, and the explanations they offered didn't make scientific sense given my medical background. My impression is that they were simply unhappy I chose not to buy into their pellet-based E therapy.
Experience
Optimal Bio has been taking care of my testosterone and thyroid needs for well over 10yrs. They took me from constantly feeling tired and worn out, to having the energy to be active, get things done, and enjoy life. I'm 69yrs old. It keeps me stepping, but I can keep pace with my grandson, and I know he loved it.
Third-party sources, summarised by our editors and quoted where a reviewer said it best. These are not Optimal Bio's reviews on this site and are not counted in its rating here.
4.9out of 5 on Google from 742 ratings
The Cary listing carries a 4.9 rating across 742 Google reviews. Google's own topic tally shows reviewers mostly discussing bioidentical hormone replacement therapy, pellet placement and testosterone therapy, with frequent mention of lab work and results review, plus thyroid and menopausal symptoms. Doctor knowledge is the most cited staff theme.
Most-mentioned on Google
Checked . Figures on the source may have changed since. View the Google listing
Reddit discussion is very thin. One 2022 question, crossposted to r/NorthCarolina and r/raleigh, drew a single substantive reply: a self described patient said pellet therapy eased her menopause symptoms and rated the initial lab workup worthwhile. The original poster found the phone consultation noticeably sales driven.
Recurring points
Checked . Figures on the source may have changed since.
Cary Fishburne
Medical Director
MD, FACOG, FACS
Listed as medical director from July 2026. Optimal Bio publishes no biography for him, but he is externally verifiable as an obstetrician-gynecologist board certified by the American Board of Obstetrics and Gynecology in both OB/GYN and female pelvic medicine and reconstructive surgery, and a Fellow of the American College of Surgeons. He is licensed in North Carolina and South Carolina and practises in the Charleston area, where Optimal Bio has its Mount Pleasant clinic.
Tylar Brannon
Chief Executive Officer
JD, MBA
Took over as CEO in 2018 and grew the practice from a handful of offices to ten across the Southeast and Texas. She grew up in Cary, studied at NC State, took a joint law and business degree at the University of South Carolina and worked in Washington before joining the family business. Not a clinician.
Greg Brannon
Founder
MD
Founded Optimal Bio in 2012 after roughly thirty years as a board-certified obstetrician-gynecologist in Cary, North Carolina, having trained at Chicago Medical School and done his residency at USC Women's Hospital. He wrote two books on bioidentical hormones, Restore and The Hormone Health Handbook, and hosted the practice's podcast. He retired from clinical practice in 2020 and died in July 2025.
Tanya Nix
Nurse Practitioner, Greenville
DNP
Took her nursing degrees all the way to a doctorate at the University of Alabama at Birmingham and spent more than 25 years at UAB's University Hospital across orthopedics, geriatrics, intensive care, research and management. She also teaches nurse practitioner students as an adjunct.
Johnny Moody
Nurse Practitioner, Charlotte
MSN, NP
A Marine Corps and Army veteran who worked as a professional firefighter before qualifying as a nurse practitioner in 2013. ANCC board certified in North Carolina, with a background in emergency medicine, urgent care and primary care.
Candi Brown
Nurse Practitioner, Wilmington
NP
Board-certified family nurse practitioner, certified nationally through the AANP. Nursing degree from Winston-Salem State, master's from UNC Wilmington, and more than eleven years in adult and paediatric emergency nursing behind her.
Sabrina Kelley
Nurse Practitioner, 30A
DNP, CRNP
Twenty years in women's health. Nurse practitioner training at the University of South Alabama and a doctorate from Chatham University.
Irene Burns
Physician Assistant, Pinehurst
PA
Spent more than fifteen years as a certified medical assistant in women's health before going to PA school, and took both her degrees at Campbell University. She specialises in OB/GYN and works closely with the military community around Fort Bragg.
Misty Khandjian
Physician Assistant, Cary
MPAS, PA-C
Trained in Florida, including at Florida State University, with a background in women's health. Based at the Cary flagship.
Not yet verified
This clinic has not completed verification. Listings are still curated, but accreditation hasn't been confirmed.
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