I recently undertook a very unscientific 10 week experiment with Empower's nasal testosterone gel (similar to Natesto) to see if such a short-acting form of T could increase my baseline natural production. The idea is consistent with some of the Natesto studies that @madman has cited.
NASAL T BACKGROUND
The main benefit of nasal T gel is minimal suppression of one's HPTA, meaning you continue to produce your own testosterone. You are supplementing, not replacing, your endogenous testosterone. There are many threads on the topic including these two longer ones:
INSPIRATION FOR THE EXPERIMENT
In early 2021, I ran a blood test about two weeks after discontinuing Nastesto (1x daily). My morning TT was over 500, which was significantly higher than my pre-TRT baseline of 250-300 (I tested in this hypogonadal range for 5 years straight pre-TRT for my annual physical).
I was very surprised by the result so I decided to try again following a long protocol of low dose Propionate. This time around I decided to use Empower's nasal gel pen instead of Natesto. Protocol was 2x applications daily (8am & 4pm). Dose per application is 5mg per nostril (so 10mg total).
BLOOD TEST RESULTS
I ran two blood tests: @ week 2 and @ week 10. Both tests were done in morning at trough (approx. 16 hours after last dose). Unfortunately the tests were done by different labs so not quite an apples-to-apples comparison.
Week 2 results: Tested 557 TT (300-890 range) at trough before morning application, nearly double my pre-TRT levels. In addition, my HPTA appeared intact with FSH of 3.2 (1.6 - 9.7) and LH of 4.5 (1.5 - 9.3). I felt pretty good at this early stage (honeymoon?).
Week 10 results: Results from the second test were less encouraging. HPTA was still intact with FSH of 2.7 (1.5 - 12.4) and LH of 4.0 (1.7 - 8.6). However, TT trough had decreased to TT 391 (264 - 916) which is still above my hypogonadal baseline of 250-300, but substantially lower than the first test above. My E2 also looked low at 14 (8 - 35). The Week 10 test results confirmed my suspicions because I was not feeling well by the end of my experiment.
SUBJECTIVE RESULTS
Here are some quick notes that I jotted down comparing the nasal gel to injectables
Pros: Zero TRT side effects - no water retention, no high E2 emotions, no heart palpitations, no sleep apnea, no ears ringing, etc. Hematocrit decreased from 50 to 45. Better sleep with fewer early morning awakenings. Plump nuggets (the boys are back!). Good nocturnal activity w/ excellent sensitivity. Less hangovers from alcohol (no idea why). Nice pre-workout energy boost (if timed right). Better cardio (because of weight loss?)
Cons: No libido boost ($^#&$!!), but then again, injections have not helped me either. Nose running like a coke addict - this could become a serious problem for long-term use. Felt low E2 symptoms by end of experiment. Disturbing mini-panic attacks in non-threatening situations (is there something in the gel? or maybe the low E2?). Diminished appetite with substantial weight loss (not in a good way). Inferior workout strength & recovery (although still better than pre-TRT years).
MY CONCLUSIONS
The fast acting nasal gel did appear to increase my natural production baseline although the effect seemed to diminish over time. However, I don't think nasal gel is a viable long-term solution.
The boost to natural production and minimal suppression of HPTA are potential advantages over more traditional forms of TRT, especially if you suffer from TRT side effects. But I keep coming back to the long-term challenges of any nasal form of TRT. As I mentioned in another thread, the recommended 2x or 3x daily (each nostril) means over 700 - 1,000 nasal squirts per nostril each year. TRT is a lifetime commitment. Taken over 20 years, you're looking at squirting that stuff into your nasal membranes over 20,000 times!
Think of the long-term health of your nasal membrane. Even after absorption, the membrane is bathing in that gel for 24/7. My intuition tells me that is probably not a good idea. Could this damage your smell or taste over a period of years? Hell, my nose was running like crazy after only 10 weeks.
Then there is the question of relief (or lack thereof) from hypogonadal symptoms. My guess is that most forum members would find the relief provided by nasal gel a bit underwhelming compared to injectables.
I certainly don't want to discourage anyone from trying nasal T. There are forum members such as @Fortunate who have done well on it. Experiment with it and see what you think.
ALTERNATIVE USES
In my experience, nasal T gel would be more much more useful in these two scenarios:
HPTA restarts - This has been mentioned by others on the forum. When stopping TRT, nasal gel could be used as alternative to going cold turkey in order to soften the post-TRT crash. Maybe you could even increase your natural baseline!
Daily variation - I've been pondering this one for a while. Build a steady state base with a medium-term ester like Enanthate to a moderate level like 600TT. Then use nasal gel to temporarily boost levels for several hours. For example, you could apply in the morning to add daily fluctuation. Or use as a pre-workout boost (which I have done with success here).
SIDE NOTE ON EMPOWER VERSUS NATESTO
After having tried both, I definitely prefer Empower. It's more of a cream than a gel with a pleasant smell. No nasty taste if/when it runs down your throat. You can easily microdose because the pen doses in clicks (8 clicks per nostril). (That said, I did have a problem with one of the pens not dosing correctly). The main advantage is cost. Empower's version is so much cheaper than Natesto ($65 versus $$$ for Natesto).
Empower also offers a stronger 10mg dose pen. This might be helpful because you could use less gel per application. I found that with both Empower and Natesto, a full dose is quite a lot of gel. The more gel you apply up your nose, the more likely it is to run down your throat.
The main drawback of Empower's gel is 29 non-medicinal ingredients. I called Empower and they explained that these ingredients make up the absorption base of the cream. It still gives me pause because you're putting that up your nose and occasionally ingesting it.
NASAL T BACKGROUND
The main benefit of nasal T gel is minimal suppression of one's HPTA, meaning you continue to produce your own testosterone. You are supplementing, not replacing, your endogenous testosterone. There are many threads on the topic including these two longer ones:
Official Natesto Thread
Welcome to the Natesto thread. I have used Natesto on an off for several years, but it seems to be one of the less popular TRT options here. That said, I have seen a few readers mention it, and I thought it would be good to start a dedicated thread on Natesto where people can share their...
www.excelmale.com
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
INSPIRATION FOR THE EXPERIMENT
In early 2021, I ran a blood test about two weeks after discontinuing Nastesto (1x daily). My morning TT was over 500, which was significantly higher than my pre-TRT baseline of 250-300 (I tested in this hypogonadal range for 5 years straight pre-TRT for my annual physical).
I was very surprised by the result so I decided to try again following a long protocol of low dose Propionate. This time around I decided to use Empower's nasal gel pen instead of Natesto. Protocol was 2x applications daily (8am & 4pm). Dose per application is 5mg per nostril (so 10mg total).
BLOOD TEST RESULTS
I ran two blood tests: @ week 2 and @ week 10. Both tests were done in morning at trough (approx. 16 hours after last dose). Unfortunately the tests were done by different labs so not quite an apples-to-apples comparison.
Week 2 results: Tested 557 TT (300-890 range) at trough before morning application, nearly double my pre-TRT levels. In addition, my HPTA appeared intact with FSH of 3.2 (1.6 - 9.7) and LH of 4.5 (1.5 - 9.3). I felt pretty good at this early stage (honeymoon?).
Week 10 results: Results from the second test were less encouraging. HPTA was still intact with FSH of 2.7 (1.5 - 12.4) and LH of 4.0 (1.7 - 8.6). However, TT trough had decreased to TT 391 (264 - 916) which is still above my hypogonadal baseline of 250-300, but substantially lower than the first test above. My E2 also looked low at 14 (8 - 35). The Week 10 test results confirmed my suspicions because I was not feeling well by the end of my experiment.
SUBJECTIVE RESULTS
Here are some quick notes that I jotted down comparing the nasal gel to injectables
Pros: Zero TRT side effects - no water retention, no high E2 emotions, no heart palpitations, no sleep apnea, no ears ringing, etc. Hematocrit decreased from 50 to 45. Better sleep with fewer early morning awakenings. Plump nuggets (the boys are back!). Good nocturnal activity w/ excellent sensitivity. Less hangovers from alcohol (no idea why). Nice pre-workout energy boost (if timed right). Better cardio (because of weight loss?)
Cons: No libido boost ($^#&$!!), but then again, injections have not helped me either. Nose running like a coke addict - this could become a serious problem for long-term use. Felt low E2 symptoms by end of experiment. Disturbing mini-panic attacks in non-threatening situations (is there something in the gel? or maybe the low E2?). Diminished appetite with substantial weight loss (not in a good way). Inferior workout strength & recovery (although still better than pre-TRT years).
MY CONCLUSIONS
The fast acting nasal gel did appear to increase my natural production baseline although the effect seemed to diminish over time. However, I don't think nasal gel is a viable long-term solution.
The boost to natural production and minimal suppression of HPTA are potential advantages over more traditional forms of TRT, especially if you suffer from TRT side effects. But I keep coming back to the long-term challenges of any nasal form of TRT. As I mentioned in another thread, the recommended 2x or 3x daily (each nostril) means over 700 - 1,000 nasal squirts per nostril each year. TRT is a lifetime commitment. Taken over 20 years, you're looking at squirting that stuff into your nasal membranes over 20,000 times!
Think of the long-term health of your nasal membrane. Even after absorption, the membrane is bathing in that gel for 24/7. My intuition tells me that is probably not a good idea. Could this damage your smell or taste over a period of years? Hell, my nose was running like crazy after only 10 weeks.
Then there is the question of relief (or lack thereof) from hypogonadal symptoms. My guess is that most forum members would find the relief provided by nasal gel a bit underwhelming compared to injectables.
I certainly don't want to discourage anyone from trying nasal T. There are forum members such as @Fortunate who have done well on it. Experiment with it and see what you think.
ALTERNATIVE USES
In my experience, nasal T gel would be more much more useful in these two scenarios:
HPTA restarts - This has been mentioned by others on the forum. When stopping TRT, nasal gel could be used as alternative to going cold turkey in order to soften the post-TRT crash. Maybe you could even increase your natural baseline!
Daily variation - I've been pondering this one for a while. Build a steady state base with a medium-term ester like Enanthate to a moderate level like 600TT. Then use nasal gel to temporarily boost levels for several hours. For example, you could apply in the morning to add daily fluctuation. Or use as a pre-workout boost (which I have done with success here).
SIDE NOTE ON EMPOWER VERSUS NATESTO
After having tried both, I definitely prefer Empower. It's more of a cream than a gel with a pleasant smell. No nasty taste if/when it runs down your throat. You can easily microdose because the pen doses in clicks (8 clicks per nostril). (That said, I did have a problem with one of the pens not dosing correctly). The main advantage is cost. Empower's version is so much cheaper than Natesto ($65 versus $$$ for Natesto).
Empower also offers a stronger 10mg dose pen. This might be helpful because you could use less gel per application. I found that with both Empower and Natesto, a full dose is quite a lot of gel. The more gel you apply up your nose, the more likely it is to run down your throat.
The main drawback of Empower's gel is 29 non-medicinal ingredients. I called Empower and they explained that these ingredients make up the absorption base of the cream. It still gives me pause because you're putting that up your nose and occasionally ingesting it.