Thanks very much again @madman. You are a machine.
@Cataceous, I've thought quite a bit about this as once or twice weekly TC really does a number on my Hct.
From the paper above:
Reference 21:
Trough serum testosterone predicts the development of polycythemia in hypogonadal men treated for up to 21 years with subcutaneous testosterone pellets
Objectives Testosterone formulations that have more steady-state pharmacokinetics, such as subcutaneously implanted testosterone pellets, may cause less erythrocytosis than i.m. injections of shorter acting androgen esters. We, therefore, sought to define the prevalence, predictors, and...eje.bioscientifica.com
Seems to me you'd need something with a very short half life like Natesto or even the creams with crystalline testosterone (half life of hours) to really get the benefit here on reduced Hct.
Let's say you are doing 80 mg per week either 1 weekly injection or breaking it up daily:
View attachment 10306
Either way your trough never drops below physiological. Although AUC invariant, seems like these papers indicate you need time under physiological test levels in order to reap the benefit on your Hct. If I remember correctly trying to trace back the kinetics of testosterone on hepcidin suppression and to EPO, it's first order and you'd reach saturation, so whether you do Test Ester once a day (weekly dosage / 7) or once weekly (weekly dosage / 1) you run into the same problem (trough never drops below physiologic range). To turn off hepcidin suppression and slow down erythropoiesis in an interval fashion, you have to drop test levels intermittently below where they activate the chemical cascade.
Thanks to you guys for bringing this up. Curious your thoughts.
There is seldom a free lunch, bummer.
Very nice paper @madman, thank you.
Efficacy of Nasal Testosterone Gel (Natesto®) Stratified by Baseline Endogenous Testosterone Levels
Pharmacokinetic and efficacy data from a phase 3 testosterone nasal gel (TNG) study were stratified by baseline endogenous testosterone level in patients with testosterone deficiency. Total testosterone (TT), LH, and FSH levels, as well as erectile function, ...www.ncbi.nlm.nih.gov
For someone already shut down after esterified testosterone usage, would be interesting to see if they could restore HPG function (partial or complete LH recovery) while also providing symptom relief during the potential recovery period. This approach may be much more effective that the typical "PCT" methods used with a SERM? An eager expermentalist might vary the daily applications to spend more time below physiological to see if that provided more "driving force" for pituitary.
View attachment 10387
View attachment 10388
Also, I did pick up on this part of the discussion:
Thus, TNG’s ultradian profile is the means to maintain an active HPG. Despite modest Cavg, significant Cmax values may be sufficient for positive symptom outcomes. TNG has up to 12 hours of trough time at or below patients’ baseline (i.e., below the normal range), which is likely a factor in limiting unwanted anabolic effects on hematocrit [22].
Interesting proposition is whether you could use this tool to recover an active HPG as opposed to maintain using frequency modulation. Opens up a lot of potential options but I am probably down a rabbit hole here.
I appreciate it.
@readalot, I have wondered the same (can you use Natesto to wean off TRT without going through a formal restart protocol?)Very nice paper @madman, thank you.
Efficacy of Nasal Testosterone Gel (Natesto®) Stratified by Baseline Endogenous Testosterone Levels
Pharmacokinetic and efficacy data from a phase 3 testosterone nasal gel (TNG) study were stratified by baseline endogenous testosterone level in patients with testosterone deficiency. Total testosterone (TT), LH, and FSH levels, as well as erectile function, ...www.ncbi.nlm.nih.gov
For someone already shut down after esterified testosterone usage, would be interesting to see if they could restore HPG function (partial or complete LH recovery) while also providing symptom relief during the potential recovery period. This approach may be much more effective that the typical "PCT" methods used with a SERM? An eager expermentalist might vary the daily applications to spend more time below physiological to see if that provided more "driving force" for pituitary.
View attachment 10387
View attachment 10388
Also, I did pick up on this part of the discussion:
Thus, TNG’s ultradian profile is the means to maintain an active HPG. Despite modest Cavg, significant Cmax values may be sufficient for positive symptom outcomes. TNG has up to 12 hours of trough time at or below patients’ baseline (i.e., below the normal range), which is likely a factor in limiting unwanted anabolic effects on hematocrit [22].
Interesting proposition is whether you could use this tool to recover an active HPG as opposed to maintain using frequency modulation. Opens up a lot of potential options but I am probably down a rabbit hole here.
I appreciate it.
@readalot, I have wondered the same (can you use Natesto to wean off TRT without going through a formal restart protocol?)
Have you successfully stopped TRT? How did you do it? Do you have any additional thoughts on Natesto?
I haven't been able to tolerate creams and injections long term, but if on them long enough, I see certain benefits I don't see as much with Natesto. While I tolerate and even appreciate the benefits of Natesto, I also wonder if the effort is worthwhile? Stated another way: Do I get actual benefit from Natesto that I wouldn't feel if successfully weaned off TRT?
Currently, my options are: (1) Status quo = Natesto and daily hCG, (2) Try Empower's nasal option, hoping there may be some benefit over Natesto, or (3) Try a restart protocol to see how I feel compared to being on Natesto.
In any case, would love to hear if you or anyone else has leveraged Natesto to wean off TRT?
It’s an interesting city, but not totally clear what they are trying to answer. Are they trying to use a Natesto as a bridge to total cessation of TRT or as an alternative to whatever TRT they were on before? Also relevant is if you use a Natesto as a bridge, how do you get off of that eventually?Will have a better idea soon enough!
The Effects of Natesto For Treatment Of Hypogonadism
https://clinicaltrials.gov/ct2/show/NCT04717362 Sponsor: Baylor College of Medicine Information provided by (Responsible Party): Larry I. Lipshultz, Baylor College of Medicine Detailed Description: Testosterone replacement therapy (TTh) is becoming increasingly common among men of...www.excelmale.com
It’s an interesting city, but not totally clear what they are trying to answer. Are they trying to use a Natesto as a bridge to total cessation of TRT or as an alternative to whatever TRT they were on before? Also relevant is if you use a Natesto as a bridge, how do you get off of that eventually?
@readalot, I have wondered the same (can you use Natesto to wean off TRT without going through a formal restart protocol?)
Have you successfully stopped TRT? How did you do it? Do you have any additional thoughts on Natesto?
I haven't been able to tolerate creams and injections long term, but if on them long enough, I see certain benefits I don't see as much with Natesto. While I tolerate and even appreciate the benefits of Natesto, I also wonder if the effort is worthwhile? Stated another way: Do I get actual benefit from Natesto that I wouldn't feel if successfully weaned off TRT?
Currently, my options are: (1) Status quo = Natesto and daily hCG, (2) Try Empower's nasal option, hoping there may be some benefit over Natesto, or (3) Try a restart protocol to see how I feel compared to being on Natesto.
In any case, would love to hear if you or anyone else has leveraged Natesto to wean off TRT?
I tend to agree. I don't know how the ingredient list compares to Natesto, but I am a general believer that Less is More!Highly doubtful there will be any significant difference in absorption let alone effectiveness between Natesto and Defys compounded Nasal Cream.
Application site reaction.....hard to say.
Keep in mind that the non-medicinal ingredients listed in the compounded version are numerous.
post #13
My pre-workout Natesto experiment - Embrace your natural trough!
What if you could enjoy the benefits of exogenous testosterone - even if on a limited basis - while minimizing many of the usual side effects? I was determined to find out through a very unscientific experiment with Natesto, a short-acting nasal testosterone gel discussed numerous times on...www.excelmale.com
I tend to agree. I don't know how the ingredient list compares to Natesto, but I am a general believer that Less is More!
Boom! Great information, and I definitely feel lazy not pulling it myself.Testosterone Nasal Gel-cream
Non-medicinal ingredients: 29
View attachment 16306
What are the ingredients in NATESTO?
Medicinal ingredient: Testosterone.
Non-medicinal ingredients: Castor oil, colloidal silicon dioxide, oleoyl polyoxylglycerides.
* slightly yellow gel
NATESTO
Non-medicinal ingredients: 3