My Experience On Jatenzo (Oral TRT) Log

[Fortunate]

Please post your lab results. Thank you for sharing. So I guess it’s like the creams and a blood test is required 4-6 hours after. Good to know. Honestly I think these short half life preparations are the best for trt long term. Jmo

I kinda agree with this sentiment (short half lives). But, I didn't do all that well with Jatenzo. In fairness, I never took it for enough time to reach a steady state. I noted a little GI distress while on it. Probably the biggest challenge is eating enough food and fat in the morning to make it work. I don't eat much in the morning.

Also, for the evening dose, I felt a little too amped up to go to bed, so I tried moving the second dose earlier than 12 hours after the first.

If I knew I could get to where @Systemlord is with Jatenzo, I'd put up with it a bit longer. The hard part is justifying going through difficulties and not knowing if it's gonna work well long term.

Tlando supposedly relies less on food intake. My doc has samples. Maybe I should grab some samples?

 

[Hyrulewarrior1978]

I kinda agree with this sentiment (short half lives). But, I didn't do all that well with Jatenzo. In fairness, I never took it for enough time to reach a steady state. I noted a little GI distress while on it. Probably the biggest challenge is eating enough food and fat in the morning to make it work. I don't eat much in the morning.

Also, for the evening dose, I felt a little too amped up to go to bed, so I tried moving the second dose earlier than 12 hours after the first.

If I knew I could get to where @Systemlord is with Jatenzo, I'd put up with it a bit longer. The hard part is justifying going through difficulties and not knowing if it's gonna work well long term.

Tlando supposedly relies less on food intake. My doc has samples. Maybe I should grab some samples?

Yea this was my concern with taking it so late. It’s the same as cream if I take it too late it disrupts my sleep.

 

[Fortunate]

@Systemlord, I know we have beaten this to death a bit, but can you give clarification on something for me? I have tried and stopped Jatenzo a few times. One of my concerns has been getting the dose in with enough food. You have (kindly) shared your food intake routine, but I am not 100% sure what you are doing with your dose. In one post you said, you use peanut butter to boost your fat intake. Are you saying that there are times when you use peanut butter alone, with no other food, when you take your dose?

I wonder if one can absorb the medication with a small amount of food, as long as the fat content were enough?

As an aside, I am considering getting samples of Tlando and trying for a week. If I can't get a week's supply, it may not make sense, but will find out soon. It's hard to tell if the lack of dose titration is a benefit (ie, they showed that various doses have similar efficacy) or a limitation (ie, they do not have enough clinical data on various doses)? In any case, If I end up trialing it, I will report back here.

 

[Systemlord]

You have (kindly) shared your food intake routine

One spoonful of peanut butter, that's it. I eat breakfast 2 hours later.

 

[Fortunate]

One spoonful of peanut butter, that's it. I eat breakfast 2 hours later.

Wow. Every day like this? What about the evening dose?

 

[madman]

@Systemlord, I know we have beaten this to death a bit, but can you give clarification on something for me? I have tried and stopped Jatenzo a few times. One of my concerns has been getting the dose in with enough food. You have (kindly) shared your food intake routine, but I am not 100% sure what you are doing with your dose. In one post you said, you use peanut butter to boost your fat intake. Are you saying that there are times when you use peanut butter alone, with no other food, when you take your dose?

I wonder if one can absorb the medication with a small amount of food, as long as the fat content were enough?

As an aside, I am considering getting samples of Tlando and trying for a week. If I can't get a week's supply, it may not make sense, but will find out soon. It's hard to tell if the lack of dose titration is a benefit (ie, they showed that various doses have similar efficacy) or a limitation (ie, they do not have enough clinical data on various doses)? In any case, If I end up trialing it, I will report back here.

Would not even waste your time trialing any of the oral T therapies unless you plan on putting in the time/effort.

As you know it will take 7 days to reach a steady state and even then one week in means jack-shit when looking at the bigger picture.

I would give it at least 4 weeks after you have achieved steady-state to see how you truly feel overall regarding energy, mood, libido/erectile function.

Need to give it enough time to see how your body reacts to the protocol.

Seeing as it is dosed twice daily (AM/PM) you will be experiencing 2 daily peaks/troughs.

Any T protocol (pellets, patches, oral, transdermal gels/creams, esterified injections) needs to be given enough time to truly gauge how you feel regardless of how fast you achieve steady-state.

Even Natesto which is the fastest acting needs to be given enough time to gauge how you will truly feel overall on the such protocol.

Jatenzo needs to be taken with a meal which could be a small snack as long as you are getting some fat with it.

If you feel that you are going to have a hard time sticking to this then forget fretting over such.

Bail out on that 1 week's TLANDO trial!

 

[Systemlord]

Wow. Every day like this?

Yes.

What about the evening dose?

With a spoon full of peanut butter and food.

 

[Fortunate]

Would not even waste your time trialing any of the oral T therapies unless you plan on putting in the time/effort.

As you know it will take 7 days to reach a steady state and even then one week in means jack-shit when looking at the bigger picture.

I would give it at least 4 weeks after you have achieved steady-state to see how you truly feel overall regarding energy, mood, libido/erectile function.

Need to give it enough time to see how your body reacts to the protocol.

Seeing as it is dosed twice daily (AM/PM) you will be experiencing 2 daily peaks/troughs.

Any T protocol (pellets, patches, oral, transdermal gels/creams, esterified injections) needs to be given enough time to truly gauge how you feel regardless of how fast you achieve steady-state.

Even Natesto which is the fastest acting needs to be given enough time to gauge how you will truly feel overall on the such protocol.

Jatenzo needs to be taken with a meal which could be a small snack as long as you are getting some fat with it.

If you feel that you are going to have a hard time sticking to this then forget fretting over such.

Bail out on that 1 week's TLANDO trial!




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I hear you @madman. No question it needs to be given time. I am curious if it would be smoother than my Jatenzo trial. I got some G.I. side effects from that and I think the absorption was variable. Tlando may be worth trying to see if there are any differences. Obviously, one week won’t do the trick, but if I tolerate one week, maybe I can push it to several weeks and go from there.

Undecided at this point, but I am curious.

 

[greg smith]

Has anyone tried Tlando? My doctor wants to put me on it. I take 200 mg 1/2cc a week now

 

[Fortunate]

Has anyone tried Tlando? My doctor wants to put me on it. I take 200 mg 1/2cc a week now

Not yet. I was able to get a three week supply of samples. But, I don't think I am going to trial it quite yet. I plan to wait a bit. If/when I do, I will report back.

 

[Fortunate]

@Systemlord, have you ever gotten heartburn with Jatenzo?

 

[Systemlord]

@Systemlord, have you ever gotten heartburn with Jatenzo?

No, but I did get heartburn on injections when hormone levels were in flux.

 

[Systemlord]

I went in to Kaiser yesterday to test my vitamin D vitamin K levels, the person at the desk included Total T and SHBG by mistake and testing at 11 am, at 3 hours instead of at 4 hpura and my Total T was 772, so at 4 hours I would be right where I expect to be, which is 655 ng/dL.

This previous 1052 ng/dL result is either a fluke, inaccurate lab test or the dosage I took deviated from the 237 mg.

The SHBG result was 20 (pre-TRT 11), I knew it was only a matter of time!

 

[Nelson Vergel]

Two-Year Analysis of a New Oral Testosterone Undecanoate (TU) Formulation in Hypogonadal Men: Efficacy, Impact on Psychosexual Function, and Safety - PubMed

Oral TU offers a safe and effective long-term treatment option for men with hypogonadism. Honig S, Gittelman M, Kaminetsky J, et al. Two-Year Analysis of a New Oral Testosterone Undecanoate (TU) Formulation in Hypogonadal Men: Efficacy, Impact on Psychosexual Function, and Safety. J Sex Med...

pubmed.ncbi.nlm.nih.gov

 

[Fortunate]

@Systemlord, I have tried Jatenzo on a few occasions, but have never gotten past about three days (shocker, coming from me...). Thinking about trying again. Question: when you first started it, how long did you wait between stopping injections and starting Jatenzo? Did you "wash out" for a few weeks, or did you start Jatenzo within the same week as your last injection? Did you notice that you improved as the injected esters depleted over time? Are you aware of any medications that inhibit absorption of Jatenzo? I know I asked you this, but want to double check: when you started, did the evening dose interfere with sleep at all?

Thanks, man.

 

[Systemlord]

Question: when you first started it, how long did you wait between stopping injections and starting Jatenzo?

I completely forgot about this! When I started Jatenzo, I had only stopped the injections for a week. I felt great the first week, then felt like s*** for the next three weeks.

I think this could be why you’re having problems.

 

[Fortunate]

I completely forgot about this! When I started Jatenzo, I had only stopped the injections for a week. I felt great the first week, then felt like s*** for the next three weeks.

I think this could be why you’re having problems.

@Systemlord, do you mind giving clarification on this? I think I have read in a few different threads that when you started Jatenzo, you felt immediate success from the first dose, and never looked back. But, according to the post above, it sounds like you struggled for three weeks? Is that the case? In what way? If you reached steady-state at one week, what was going on on weeks two and three that dragged you down?

Thanks.

 

[JM Kane]

This is pretty remarkable considering some of the challenges you've faced in the past. IIRC you felt pretty awful, suffering from possible low iron?

Do not add iron supplements if you're male; talk to Dr. if you have questions.

 

[Fortunate]

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
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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
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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
View attachment 19827






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.

Time to beat this horse again! I just re-reviewed this article briefly and it appears that one of the conclusions is that any meal, regardless of fat content, is sufficient for Jatenzo absorption. And, the Jatenzo website simply states that you take your dose "with food".

So, our earlier conversation about fat content is moot? I thought I read that 30 grams of fat leads to better absorption than 15 grams, but I can't find the reference at the moment. Are we all on the same page in saying that fat content does not matter?

 

[Fortunate]

When I posted, I was on page 5 or 6 of this thread. I just realized that @madman has some of the information above on fat content!