That sounds reasonable. How many months have you been on the ideal dose? It has been consistently helpful since being on the right dose?
My Experience On Jatenzo (Oral TRT) Log
- Thread starter Systemlord
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This thread is eye opening. Sounds like there are a ton of pitfalls with oral T. @Systemlord, what kind of meal do you typically eat when you take Jatenzo? I eat high fat, moderate protein, but it seems like a lot of work to get Jatenzo to absorb?
Systemlord
Member
A spoonful of peanut butter, avocado on toast and eggs. The days I don’t eat eggs I trade it out for oatmeal topped with fruit.
I always eat a spoonful (30+ grams/fat) of peanut butter with my Jetanzo even if I'm not going to eat anything, like at 8 p.m at night.
I'll sometimea eat a handful of walnuts with the peanut butter when taking Jatenzo.
All of my lab testing is done with only consuming peanut butter with my Jetanzo.
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Systemlord
Member
I've been on 237mg twice daily for 4 months. It's hard to fathom I was making progress with my diabetes on the lower doses even though I had no energy and absolutely no well-being improvements.
post #41
Better Libido/Sexual Function with different esters?
If your going to go that route, why not just try oral raw test base? Seeing esters are designed to be cleaved off in the blood, wouldn't they be useless orally?, might be able to get by with much less with the base. The Fda is just in it for the money, and cannot patent straight testosterone. I...www.excelmale.com
*In hypogonadal men with normal liver function, 400–600 mg testosterone must be administered daily if the patient is to be substituted by oral testosterone (Johnsen 1978; Johnsen et al. 1974), a dose exceeding the testosterone production of a normal man almost 100fold. Aside from being uneconomical, the possibility of adverse effects of such huge testosterone doses cannot be excluded, especially when given over long periods of time as required for substitution therapy. However, in a SMALL GROUP of patients treated for as long as seven years with oral testosterone, no serious side effects were observed (Johnson 1978). Nevertheless, oral administration of unmodified testosterone has not become a generally accepted method for therapeutic purposes.
*Historically, oral administration of physiological testosterone (Figure 1A) has been proven unsuccessful due to extensive first-pass metabolism through the liver despite having good gastrointestinal absorption. Ingestion of supra-physiological doses was required to overcome this and allow for measurable amounts in the serum
From a previous thread:
post #355
Progesterone Dose for Men
I just read through this entire thread and it was like reading a Thriller novel.. so many highs and lows... and at the end of this novel now I feel low.... smdh Since starting TRT about 11 years ago (currently 48 yrs old), I have never once had the great feeling. My sleep is horrible, I have...
You stated:
I’m currently not on estradiol. I’m not sure where my e2 sits but I presume it is on lower end. My most recent experiment involves 12mg of prop daily and 150mg of oral t base every 8ish hours (3 times daily)
Erectile quality skyrocketed for first time since being on trt. Still seeing whether or not this is honeymoon or not.
This study you posted to me speaks to the relative similar oral bioavailability of esterless testosterone. Jatenzo doses at 237 twice daily is around the middle of the above referenced 400-600mg daily which I believe reinforces the bioavailability claim. Jatenzo has terrible bioavailability but doesn’t mean it’s a terrible option. Test base does not need to be taken with a meal though. The half life is the next thing that we would need to pin down. The cost difference is obvious. Was I really far off base in my claims? Haha
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The formulation of a patentable esterless testosterone is difficult because testosterone is a raw hormone. It is not a drug. Pharma avoids common sense all over the place. This is why we all now live in pill land.
Not all, but a significant amount of the science that is completed is filtered through the lens of being able to commercialize the findings. The business side of science must not be left out in its analysis.
Not all, but a significant amount of the science that is completed is filtered through the lens of being able to commercialize the findings. The business side of science must not be left out in its analysis.
It's funny how oral esterless testosterone is put down because it requires 400mg daily, when Jatenzo (undecanoate) at the same high dose is all of a sudden "acceptable".
By the way, oral undecanoate is not invented by Jatenzo. It was available since mid 1970s as Andriol but was used at half the dose up to 240mg/day. It is currently available at various sites but reaching the dose is cost prohibitive. At that dose, split during the day, it does not achieve normal testosterone range but nevertheless "restores sexual functioning" (probably because it achieves above normal DHT and estradiol) without side effects:
A Ten-Year Safety Study of the Oral Androgen Testosterone Undecanoate 1994
By the way, oral undecanoate is not invented by Jatenzo. It was available since mid 1970s as Andriol but was used at half the dose up to 240mg/day. It is currently available at various sites but reaching the dose is cost prohibitive. At that dose, split during the day, it does not achieve normal testosterone range but nevertheless "restores sexual functioning" (probably because it achieves above normal DHT and estradiol) without side effects:
A Ten-Year Safety Study of the Oral Androgen Testosterone Undecanoate 1994
madman
Super Moderator
You missed the point which is the higher doses needed when using esterless T as it is metabolized through the liver.
Top it off that if you are gung ho f**king with a UGL source go nuts.
200-300 mg of esterless T taken twice daily (400-600 mg/day).
When ingested orally in its unmodified form testosterone is absorbed well from the gut but is effectively metabolized and inactivated in the liver before it reaches the target organs (“first-pass-effect”). Only when a dose of 200 mg is ingested which exceeds 30fold the amount of testosterone produced daily by a normal man, is the metabolizing capacity of the liver overcome.
Jatenzo 237 mg minus the undecanoate ester contains roughly 150 mg T.
Jatenzo bypasses the liver degradation as T is absorbed via the lymphatic system.
*SELF-EMULSIFYING DRUG DELIVERY SYSTEM (SEDDS)
TU has been formulated in a unique self-emulsifying drug delivery system (SEDDS) that was initially evaluated in multi-institutional placebo-controlled studies in Europe [27]. SEDDS formulations combine hydrophilic and lipophilic components that enable the solubilization of lipophilic molecules such as TU in the gut (Fig. 2). This promotes intestinal lymphatic absorption of lipophilic testosterone esters, thereby reducing first-pass hepatic metabolism. Furthermore, this formulation allows absorption after oral ingestion with a typical meal as opposed to high-fat content meals required for prior formulations. Yin et al. showed that this TU with SEDDS resulted in adequate serum testosterone levels within the physiologic range after dosing with just TU 200 mg twice per day in most hypogonadal men [28].
Even then you were clearly confused and had absolutely no clue until it was pointed out otherwise you would be dosing 200 mg at the bare minimum twice daily even then highly doubtful Cmax achieved using such dose would be high.
Much higher doses would be needed.
Get off the prop and get back to us on where your levels sit/effectiveness of such dose.
You stated:
I’m currently not on estradiol. I’m not sure where my e2 sits but I presume it is on lower end. My most recent experiment involves 12mg of prop daily and 150mg of oral t base every 8ish hours (3 times daily)
Erectile quality skyrocketed for first time since being on trt. Still seeing whether or not this is honeymoon or not.
madman
Super Moderator
They have been using this in Canada for decades!
An early oral TU formulation (ANDRIOL®) was approved for use in many countries but never in the United States. This formulation is heavily reliant on dietary fat intake as a means of increasing absorption and therefore leads to significant intra- and inter-patient variability in testosterone response [23, 24]. This results in the need to dose hypogonadal men with several capsules three or more times daily affecting compliance. Several studies have also demonstrated both gastrointestinal and liver adverse effects including severe cholestasis and jaundice [25, 26]. Consequently, these oral TU formulations have never been widely utilized to treat TD in the United States although they remain available in many countries
madman
Super Moderator
Some of the older studies from decades ago were done on a small number of patients (10) who used up to 400 mg unmodified T twice daily.
Madman, you are citing the manufacturer of Jatenzo, which has an obvious bias to trash the competition Andriol and convince us Jatenzo is much better.
I highly doubt one cannot achieve normal testosterone levels with 200mg Andriol twice per day, regardless of how many capsules that is and how much it will cost. I also highly doubt that Jatenzo has absorption much different from Andriol due to some imaginary "proprietary vehicle". There are claims that oral undecanoate is absorbed through the lymphatic system long before Jatenzo.
I highly doubt one cannot achieve normal testosterone levels with 200mg Andriol twice per day, regardless of how many capsules that is and how much it will cost. I also highly doubt that Jatenzo has absorption much different from Andriol due to some imaginary "proprietary vehicle". There are claims that oral undecanoate is absorbed through the lymphatic system long before Jatenzo.
madman
Super Moderator
It is already in the works as we speak!
post #56
My Experience On Jatenzo (Oral TRT) Log
Was ur energy at the same level as before donating blood, or was it higher than before? The energy levels are the same regardless of hematocrit and hemoglobin levels, however erections are better after the phlebotomy. This is the second time my erections have gotten better on day two after a...
www.excelmale.com
Haha I wouldn’t say I was clueless. I am taking 450mg a day!
Your right about the black market, as sad as it is that it’s the only way to get it. But regardless, for comparisons sake, let’s compare pharma grade test base to test undec.
It does appear delivery is significantly better with the delivery method created in jatenzo! But still, 300mg daily is still very low bioavailability. So I’d be down to stand by the fact that jatenzo bypasses a significant percentage of the liver degradation compared to esterless. However we cannot pretend it’s all of the degradation or that its a bioavailable option compared to injectable.
As far as the prop, your right, it will take a small set of balls to drop it from protocol. But that’s perfect since I do have a small set now since I’m on trt haha. This is also because I’d be one of the first people doing this around these parts.
So in summary of the oral test base
- high enough doses of esterless t will work to replace testosterone. It is higher than jatenzo. If we use natural production benchmarked at 10mg daily, albeit high, the liver would degrade 290mg of the testosterone received from jatenzo vs 490 of testosterone base.
-Test base needs not be taken with a meal.
-Test base is 25 dollars per month if it can sourced reliably. This is vs $1200 for jatenzo. The reliability is likely to be fine as far as getting what you ordered when it comes to test base. It’s not like primo. However purity may be of question due to manufacturing processes.
Due to these things and the cost of jatenzo, if it’s not covered by insurance (hoop jumping may be necessary), testosterone base is a cheap and potentially effective treatment that won’t break the bank and is likely to be tried by many men unless jatenzo becomes more obtainable for the common man.
The reduced bioavailability of testosterone base does not seem to burden the pathways of removal, rather it seems to upregulate liver function and is even effective in cases of cirosis.
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Potentially systemlords success with jatenzo is improved liver function. A known issue in every diabetic.
It wouldn’t be a far stretch to say that if I was to have started trying to rely solely on testosterone base orally as my only source of t, common sense thing would say to take 200mg-300mg 2 or 3 times daily. However I was not in that position due to wanting to run it alongside prop for the time being. Now I’m just taking 200mg in morning with prop. Next I will prob increase it to 300 in morning with prop. Or maybe try 5mg daily enanthate with 200-300mg base once. Or maybe I will start 50mg enanth every 5 days. Your guess is as good as mine.
By the way @madman thabk you for helping to refine the discussion herein concerning test base so we can all have a more precise set of expectations and therapeutic starting points. Test base is not rubbish. If one is to use bioavailability as the metric to determine therapeutic potential, then all oral testosterone is rubbish. If low bioavailability meant reaching toxic thresholds before therapeutic advantage then absolutely. But in this case it doesn’t seem to be an issue. The downsides are purity of test base (thank big pharma for having little interest as they likely won’t get 1200 for test base pills). from this convo, this is the only significant downside that can be drawn.
madman
Super Moderator
Look over some of the older oral TU (Andriol) studies.
Although it is still prescribed in Canada most doctors in the know would offer it as a last resort.
Gels let alone injections dominate.
The use of sub-q injections has skyrocketed.
Very few would waste their time with Andriol.
Definitely not a go-to drug!
A practical guide to diagnosis, management and treatment of testosterone deficiency for Canadian physicians (2010)
*Testosterone undecanoate is formulated in Canada in the convenience of an oral preparation (Andriol or pms-Testosterone). These products may induce supraphysiologic levels of dihydrotestosterone.32 To permit absorption, testosterone undecanoate must be taken with a high-fat meal. Absorption issues may lead to poor responses.
Table 2. Common testosterone formulations available in Canada
Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline (2015)
In Canada, the available products for testosterone therapy include short-acting injectable testosterone (testosterone enanthate, testosterone cypionate, and testosterone propionate), oral testosterone undecanoate, transdermal testosterone patches, transdermal testosterone gel 1% (hydroalcoholic gel, and hydroalcoholic gel with pentadecalactone), and axillary transdermal testosterone solution 2%. Intramuscular injection of testosterone propionate is used infrequently. Compounded testosterone products are available at many compounding pharmacies in Canada, but there are no published data on the safety and efficacy of these products.
The choice of product for testosterone replacement therapy should be a topic of discussion between the physician, the patient, and the patient’s caregiver, if appropriate. Factors affecting this choice include safety, efficacy, tolerability, availability, preference, and cost. More information on the advantages and disadvantages of available products, including costs, is outlined in Tables 7 and 8 of Appendix 1.
TREATMENT OPTIONS
Table 7. Testosterone Products for the Treatment of TDS
Canadian Urological Association guideline on testosterone deficiency in men: Evidence-based Q&A (2021)
Ethan D. Grober, MD; Yonah Krakowsky, MD; Mohit Khera, MD; Daniel T. Holmes, MD; Jay C. Lee, MD; John E. Grantmyre, MD; Premal Patel, MD; Richard A. Bebb, MD; Ryan Fitzpatrick, MD; Jeffrey D. Campbell, MD; Serge Carrier, MD; Abraham Morgentaler, MD
13. What are the current treatment options for TD in Canada?
Table 3 summarizes the testosterone treatment formulations currently approved by Health Canada.
Compounded testosterone products are available at many compounding and online pharmacies in Canada, however, published data have demonstrated significant variability of testosterone concentrations within such products, leading to concerns regarding the efficacy and safety.30
The choice of testosterone therapy and route of administration should be a topic of discussion between the physician and the patient using a shared decision-making approach. Factors influencing this choice include safety, efficacy, tolerability, availability, preference, and cost/insurance coverage.
Table 3. Testosterone treatment formulations currently approved by Health Canada
A new oral testosterone undecanoate therapy comes of age for the treatment of hypogonadal men (2020)
*Historically, efforts to administer oral T have taken two primary paths: alkylation of T at the C-17 position to create T analogs that are resistant to first-pass hepatic metabolism (exemplified by methyltestosterone);2 or fatty-acid esterification of T to create a T-ester (exemplified by TU) that is absorbed via the intestinal lymphatic system thus bypassing the portal circulation.3 Oral methyltestosterone, originally discovered and used clinically in the mid-1930s,1 is the only oral TRT ever approved for use in the US, but has been associated with serious hepatotoxicity such as cholestasis, peliosis hepatis, and hepatic adenocarcinoma4–6 and therefore is not recommended for clinical management of male hypogonadism. Conversely, while oral TU has not been associated with liver toxicity, an early oral TU formulation approved for use in many countries but never in the US (Andriol®) was highly influenced by dietary fat, thus leading to significant intra- and inter-patient variability in T response and questionable clinical utility.7,8 Reformulation of this product to reduce the effect of dietary fat did not address the low TU content of the capsules, thus resulting in the need to dose hypogonadal men with several capsules three or more times daily. Even then, reported serum T response would not result in average serum T levels in the normal range9 and therefore would not pass current-day regulatory scrutiny for efficacy. Consequently, these oral TU formulations have never been widely used to treat T deficiency although they remain available in many countries.
madman
Super Moderator
As long as one does not jump in headfirst!
Ah yes, the other item that is a downside, multiple daily uses. A dealbreaker for a few. Many guys do use supplements anyways. I guess it depends. The disproportionate dht conversion is a concern and questions about all of the estrogens come to mind. I wonder if it influences estriol or estrone disproportionally.
However, the test base will not be affected by diet which is a huge plus.
Lastly, the road less traveled is not always a bad road. If it is not common practice, then it sometimes pricks my curiosity. Of the list of factors influencing “popularity”, who knows why it’s not really used as primary source.
Money and availability are usually pretty intimately tied together. It is a very human thing to want something special. Plain test base is not sexy. It must not be good “I can deliver testosterone deep into my body with a needle and make sure it absorbs” -random old guy that wants to feel better.
there is more than just pure objectivity that goes into the magnitude and diversity of human preference. Psychology and money drive how things play out in the marketplace. Not always what is the most common sense.
I’m not saying it’s the missing link or all of the other advances we’ve made in trt are rubbish. I’d just like to say that based on what we have looked into, it’s not necessarily rubbish. After all oral testosterone has helped system lord, a hard case, start to thrive.
How many times do us humans take a while to find something that was in our pocket all along. It’s happened to most of us.
Regarding Andriol vs Jatenzo: the max dose of Andriol is 240mg/day, which is split in 2-3 daily doses. Clearly this is 50% of the daily dose in Jatenzo. I suspect Andriol is equivalent to Jatenzo when the same dose is used.
Meal increases absorption of both Andriol and Jatenzo. Their bases both use hydrogenated castor oil as an emulsifier, so I again doubt there is difference between them. I wonder why FDA didn't simply repurpose Andriol with higher doses and larger capsules.
As often happens in US, approval is given to an old drug, just because it is in a "novel and better" formulation, which leads to milking more money from the insurance.
Meal increases absorption of both Andriol and Jatenzo. Their bases both use hydrogenated castor oil as an emulsifier, so I again doubt there is difference between them. I wonder why FDA didn't simply repurpose Andriol with higher doses and larger capsules.
As often happens in US, approval is given to an old drug, just because it is in a "novel and better" formulation, which leads to milking more money from the insurance.
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