My notes on Empower nasal T gel experiment

[BigBeard411]

Very interesting. Your follow-up blood test looked similar to my experience. I too was surprised that nasal gel appears to bump up the natural production baseline for some guys. Nobody seems to how long the baseline stays elevated after you discontinue the Natesto. You could retest in 1-2 months to find out.

It sounds like you had better subjective results than I did though. Were you on Natesto only for two weeks? As you may know already, there is a bit of a honeymoon period with TRT - some of it physiological but also a placebo effect

There is much that won't shut you down if Natesto does not work.

You could consider hCG monotherapy or hCG with Natesto. This combination would be unconventional, but I did it for a long time.

Had you been on T previously? Maybe you experienced the classic TRT honeymoon period where nothing feels quite as good as those first couple of weeks.

As @Fortunate mentioned, even Natesto will eventually suppress your natural T production, although less than injections or cream.

I have not re-tested to see if my E2 normalized after stopping although it feels like it with injections. Let us know what you try next.

Well when i first began Natesto, I felt amazing. It was as if I was partially asleep for a decade and finally woke up. After a few weeks the effects diminished and I now feel absolutely the same as before I began TRT...maybe even worse because my short term memory is being affected (strange). I honestly feel like trash as I did before TRT. I really wish I would even feel 10% of the effects during the first few weeks of Natesto. I doubt it was a honeymoon because now I feel absolutely nothing when I use Natesto. Prior to this, I would feel it working within 5-10 minutes.

I got my results back from my latest blood work, about 3 or 4 months into TRT.
Doctor told me to dose Natesto 45minutes before the blood draw, which is that I did; blood was taken at 930am.


Here are my results:
TSH 2.996 (0.340-4.410 uIU/mL)
T4 Total 10.42 (6.1-12.2 ug/dL)
Free T3: 3.5 (2.5-3.9 pg/mL)
Free T4 0.99 (0.61-1.12 ng/dL)
LH: 3.03 (1.24-8.62 mIU/mL)
DHEA-Sulphate 447 (range 106-464 ug/dL)
Prolactin 12.3 (2.64-13.13 ng/mL)
Total Test 405.43 (198-679 ng/dL)
Test Free Calculated 66.06 (24.3-110.2%)
SHBG 21.3 (13.2-89.6 nmol/L)
DHT 411.6 (106-719 pg/mL)
Estradiol Sensitive <15 (<31.5 pg/mL)

What do you guys think? I was in the gym yesterday and had poor energy - same as pre-trt.

 

[Fortunate]

Well when i first began Natesto, I felt amazing. It was as if I was partially asleep for a decade and finally woke up. After a few weeks the effects diminished and I now feel absolutely the same as before I began TRT...maybe even worse because my short term memory is being affected (strange). I honestly feel like trash as I did before TRT. I really wish I would even feel 10% of the effects during the first few weeks of Natesto. I doubt it was a honeymoon because now I feel absolutely nothing when I use Natesto. Prior to this, I would feel it working within 5-10 minutes.

I got my results back from my latest blood work, about 3 or 4 months into TRT.
Doctor told me to dose Natesto 45minutes before the blood draw, which is that I did; blood was taken at 930am.


Here are my results:
TSH 2.996 (0.340-4.410 uIU/mL)
T4 Total 10.42 (6.1-12.2 ug/dL)
Free T3: 3.5 (2.5-3.9 pg/mL)
Free T4 0.99 (0.61-1.12 ng/dL)
LH: 3.03 (1.24-8.62 mIU/mL)
DHEA-Sulphate 447 (range 106-464 ug/dL)
Prolactin 12.3 (2.64-13.13 ng/mL)
Total Test 405.43 (198-679 ng/dL)
Test Free Calculated 66.06 (24.3-110.2%)
SHBG 21.3 (13.2-89.6 nmol/L)
DHT 411.6 (106-719 pg/mL)
Estradiol Sensitive <15 (<31.5 pg/mL)

What do you guys think? I was in the gym yesterday and had poor energy - same as pre-trt.

Is it possible your current tube is somehow bad? I know it sounds crazy, but I occasionally suspected that not every tube was the same.

 

[Willyt]

Well when i first began Natesto, I felt amazing. It was as if I was partially asleep for a decade and finally woke up. After a few weeks the effects diminished and I now feel absolutely the same as before I began TRT...maybe even worse because my short term memory is being affected (strange). I honestly feel like trash as I did before TRT. I really wish I would even feel 10% of the effects during the first few weeks of Natesto. I doubt it was a honeymoon because now I feel absolutely nothing when I use Natesto. Prior to this, I would feel it working within 5-10 minutes.

I got my results back from my latest blood work, about 3 or 4 months into TRT.
Doctor told me to dose Natesto 45minutes before the blood draw, which is that I did; blood was taken at 930am.


Here are my results:
TSH 2.996 (0.340-4.410 uIU/mL)
T4 Total 10.42 (6.1-12.2 ug/dL)
Free T3: 3.5 (2.5-3.9 pg/mL)
Free T4 0.99 (0.61-1.12 ng/dL)
LH: 3.03 (1.24-8.62 mIU/mL)
DHEA-Sulphate 447 (range 106-464 ug/dL)
Prolactin 12.3 (2.64-13.13 ng/mL)
Total Test 405.43 (198-679 ng/dL)
Test Free Calculated 66.06 (24.3-110.2%)
SHBG 21.3 (13.2-89.6 nmol/L)
DHT 411.6 (106-719 pg/mL)
Estradiol Sensitive <15 (<31.5 pg/mL)

What do you guys think? I was in the gym yesterday and had poor energy - same as pre-trt.

Your experience sounds similar to mine - the positive effects seem to diminish over time, perhaps as our bodies adjust.

Have you considered moving to injectables? You can do similar low doses although you will lose the pulsing benefits of Natesto with its minimal suppression of HPTA.

 

[FunkOdyssey]

Have you considered moving to injectables? You can do similar low doses although you will lose the pulsing benefits of Natesto with its minimal suppression of HPTA.

That's usually the case but I'm not sure it has to be. I believe sufficiently low daily or EOD doses of test propionate would allow for some HPTA activity. I will be testing this myself with LH/FSH at trough.

 

[Fortunate]

Well when i first began Natesto, I felt amazing. It was as if I was partially asleep for a decade and finally woke up. After a few weeks the effects diminished and I now feel absolutely the same as before I began TRT...maybe even worse because my short term memory is being affected (strange). I honestly feel like trash as I did before TRT. I really wish I would even feel 10% of the effects during the first few weeks of Natesto. I doubt it was a honeymoon because now I feel absolutely nothing when I use Natesto. Prior to this, I would feel it working within 5-10 minutes.

I got my results back from my latest blood work, about 3 or 4 months into TRT.
Doctor told me to dose Natesto 45minutes before the blood draw, which is that I did; blood was taken at 930am.


Here are my results:
TSH 2.996 (0.340-4.410 uIU/mL)
T4 Total 10.42 (6.1-12.2 ug/dL)
Free T3: 3.5 (2.5-3.9 pg/mL)
Free T4 0.99 (0.61-1.12 ng/dL)
LH: 3.03 (1.24-8.62 mIU/mL)
DHEA-Sulphate 447 (range 106-464 ug/dL)
Prolactin 12.3 (2.64-13.13 ng/mL)
Total Test 405.43 (198-679 ng/dL)
Test Free Calculated 66.06 (24.3-110.2%)
SHBG 21.3 (13.2-89.6 nmol/L)
DHT 411.6 (106-719 pg/mL)
Estradiol Sensitive <15 (<31.5 pg/mL)

What do you guys think? I was in the gym yesterday and had poor energy - same as pre-trt.

In my above quote, I meant to say there "isn't" much that won't shut you down besides Natesto.

Your total and free T look similar to mine did an hour after Natesto earlier this year. I would consider one of the following: either stay the course or consider adding hCG. If you commit to this regimen, it is possible that over time, your natural production may creep back up. Won't know until you try. On the other hand, adding hCG makes zero sense from a physiology standpoint (it can suppress central nervous system signals to stimulate endogenous production), but you may simply feel better without suppressing leydig cell activity.

I see you drew a DHEA level. Are you also taking DHEA? If so, my advice: stop it. I took it for a along time and eventually realized it was making me really tired and put me in a bad mood. Are there any other supplements you are taking? Sometimes you can see addition by subtraction, and in my experience, this includes DHEA.

 

[Cataceous]

That's usually the case but I'm not sure it has to be. I believe sufficiently low daily or EOD doses of test propionate would allow for some HPTA activity. I will be testing this myself with LH/FSH at trough.

It will be interesting to see your results. I'm not too optimistic, especially about the subjective outcome. We've had guys with primary hypogonadism successfully tune their TRT doses to achieve normal LH/FSH. But with typical secondary hypogonadism we apparently have hypothalamic hypersensitivity. This puts healthy testosterone levels well above the natural set point, making it a challenge to avoid suppression with longer-acting testosterone. Natesto works because it's in and out so quickly—the half-life is in the range of 10-100 minutes. Testosterone propionate has a half-life of maybe 0.8 days. Even with EOD dosing testosterone propionate may result in too much continuous time spent above the natural set point. Is it possible to lower the dose enough to avoid suppression without ending up back in hypogonadal territory?

 

[madman]

Not happening with daily/EOD prop.

Natesto PK profile vs prop let alone water-based suspension.....day and night!


*The 24-hour pharmacokinetic profile of testosterone for patients on TNG treatment has two or three discrete peaks (“pulses”) of testosterone provoked by LH secretions that occur on average every 2 hours. A maximal peak of testosterone appears at about 1h (Tmax) followed by a return to endogenous, pre-dose levels, 4-6 hours later (t1/2 ~1h). The nadir (trough) between doses correlates well with pre-treatment endogenous levels at diagnosis

*The unique, pulsatile, pharmacokinetic profile is believed to have a limited impact on the HPG axis with significant trough time preserving luteinizing hormone (LH), follicle-stimulating hormone (FSH), endogenous testosterone production, and sperm counts, while also limiting excess RBC production, estradiol, DHT and PSA in clinical trials

*In between NATESTO® doses, all patients in the phase 3 study maintained their natural testosterone at the same levels they had prior to entry into the study, indicating that NATESTO® does not suppress natural testosterone production. Based on the data, Acerus believes that the mechanism of action of NATESTO® is unique whereby the peaks in testosterone generated by NATESTO® dosing provide efficacy and improvement of symptoms, while the time between doses (4-8 hours) allows for the maintenance of testicular testosterone production and sperm production

*Nasal administration of T (4.5% testosterone nasal gel, Natesto) allows for rapid absorption through the nasal mucosa such that serum T levels reach a peak concentration in ∼40 min. Once in circulation, the T is quickly metabolized, with a return to near baseline T levels in 3–6 h (11). Therefore, multiple administrations of nasal T throughout the day (three times daily) maintain normal mean serum T levels over 24 h. The fluctuations in T levels potentially minimize the duration of exposure to exogenous T that is suppressive to the HPG axis, compared to other available T therapies

*Endocrine systems are regulated dynamically in response to positive or negative stimuli within a homeostatic environment. Modalities of T therapy evolved to extend the dosing interval and maintain sustained “steady-state” T levels. Long-acting TTh can inhibit the HPG axis, which in turn suppresses pituitary LH and FSH secretion, reducing circulating levels of LH and FSH and endogenous T production

*Short-acting T therapy, consisting of several doses of T with a shorter half-life throughout the day, minimizes inhibition of the HPG axis and reduces the impairment of spermatogenesis




post #55

Microdosing Enanthate

Thank you all for the responses. Even though my FT is mid-range and TT is high, I would be considered over dosed? You have no idea where your FT level truly sat as I highly doubt it was tested using an accurate assay. With a whopping TT 1420 ng/dL even with your high SHBG 53.4 nmol/L I would...

www.excelmale.com

post #8

Unorthodox "cycle" idea

Hey Gentleman! Im 29 yrs old (5'11, 210lbs and about 15-18%bf). Ive done several steroid cycles starting at 18 up until about 3 years ago with quite a lot of variation in terms of length of cycle, type of steroid, max dosage and stack combinations. Lately however, ive become more concerned with...

www.excelmale.com

post #68/70/72

Tips on how to blend propionate with enanthate (or cypionate)?

@Cataceous, as you know, I am interested in following your logic. I am currently not on either ester. I was planning on starting both esters simultaneously. As I read your post above, however, it sounds like you did this one ester at a time until you started the blend. Was this by design or were...

www.excelmale.com

 

[BigBeard411]

Is it possible your current tube is somehow bad? I know it sounds crazy, but I occasionally suspected that not every tube was the same.

I am considering that too, for a few reasons:

1. When I first tried Natesto, it was absolutely obvious that it was working. Every benefit of TRT appeared - even my driving improved (no longer having brain fog)
This rules out variation in nasal absorption that may be inherent in each individual and shows I can absorb it effectively (unless some unknown change occured)

2. I have mentioned in the past that variance in the tubes and volume of dispensed gel exists. Sometimes the tube would become very hard to depress and at the same time a very small amount of gel would come out, compared to when the tube has been used only a few times.
Is this a defect in manufacturing? Is it possible I am getting low-dose or defective tubes through the company's discount program? Is it even possible the pharmacy may be involved in this? I don't know, but the tubes are definitely not consistent.

Your experience sounds similar to mine - the positive effects seem to diminish over time, perhaps as our bodies adjust.

Have you considered moving to injectables? You can do similar low doses although you will lose the pulsing benefits of Natesto with its minimal suppression of HPTA.

Considering how much TRT helped me when it did work, I am considering injectables, but only if I can take hCG to avoid HPTA shutdown - I need to preserve fertility. This will depend on what my doctor agrees to and what it would cost me. Currently paying $140 per month for Natesto.

In my above quote, I meant to say there "isn't" much that won't shut you down besides Natesto.

Your total and free T look similar to mine did an hour after Natesto earlier this year. I would consider one of the following: either stay the course or consider adding hCG. If you commit to this regimen, it is possible that over time, your natural production may creep back up. Won't know until you try. On the other hand, adding hCG makes zero sense from a physiology standpoint (it can suppress central nervous system signals to stimulate endogenous production), but you may simply feel better without suppressing leydig cell activity.

I see you drew a DHEA level. Are you also taking DHEA? If so, my advice: stop it. I took it for a along time and eventually realized it was making me really tired and put me in a bad mood. Are there any other supplements you are taking? Sometimes you can see addition by subtraction, and in my experience, this includes DHEA.

The doctor usually draws many markers during blood tests. I do not take any supplement other than Vitamin D. I realized I have to take 10,000 IU daily to maintain a level of 60 (forgot the units). Past few months I dropped the dosage to 5,000 IU and my levels fell to 40.

So you did not see any benefit in using Natesto too in terms of increasing Total and free T? What was your pre-TRT level of Total T and LH?

Before I began TRT, my total Test at 2PM was about 293 and my LH was 4.9
I also had slightly elevated prolactin so I went to an Endo and they had me come off Natesto for 2 weeks (3 weeks into it) and they retested my hormones in the AM. Prolactin came back normal, and Test came back at ~430, with LH at 2.9.
Now my latest results taken in the AM after 3 months on Natesto without interruption and dosing 45 minutes prior to blood-draw shows Total T at ~400 and LH at 3.0

It seems my LH suppression (can I even call it that?) stabilized, from 4.9 pre-TRT to 3.0. Is this a true suppression or can it be due to natural variation?
If it is indeed suppression, it is very possible in the first 2-3 weeks into TRT, my LH was higher, and therefore Total T was higher while using Natesto, which would explain why I felt so much better early on. Afterward, LH goes down and now Natesto is doing a poor job of elevating my T as there is less additive T from TRT + Natural production.

However, even this explanation makes no sense because my bloodwork with 2 weeks off of Natesto after the initial 3-week supplementation showed the same Total T as I had after dosing within 1 hour with Natesto, 3 months into TRT (430 vs 400, respectively), AND, I would argue that these are the same exact levels even pre-TRT when my LH was at 4.9 - the T that came back ~290, but blood was taken mid-day.

I just don't know how to make sense of any of this. The only rational conclusion is that Natesto does absolutely nothing?
Is it not weird my estradiol fell to 15 from 25 pg/mL after being on TRT for 3 months?
And that my total T levels are virtually unchanged even when adding exogenous testosterone?

 

[Fortunate]

But with typical secondary hypogonadism we apparently have hypothalamic hypersensitivity. This puts healthy testosterone levels well above the natural set point, making it a challenge to avoid suppression with longer-acting testosterone.

@Cataceous, hey, man, do you mind expanding on this? I am secondary and the sounds interesting, but I am not 100% sure what it means.

@BigBeard411, lemme digest some of what you wrote and get back to you. Without reading your numbers deeply, my sense is that in the beginning Natesto added to your endogenous level; over time, you shut yourself down a little bit. Not completely, but enough to now feel hypogonadal?

Thoughts: Try skipping a dose or two and see how you feel when you resume; also, you could consider Empower's version, which comes in a higher strength.

I have experienced the same with the tubes: sometimes more/less comes when when I dispense. In some cases, I even use an extra pump if it feels like I didn't get enough.

Full disclosure: I have at times felt under treated on Natesto, which is part of the reason I am trialing other things. That said, there have been times I have felt great on it.

 

[Willyt]

One of the best pieces of advice given to me on this forum was to ignore the first 2-3 weeks of going on TRT. Otherwise you spend your time chasing that wonderful honeymoon feeling, which in reality was a blissful one-off event that you cannot replicate.

 

[BigBeard411]

@Cataceous, hey, man, do you mind expanding on this? I am secondary and the sounds interesting, but I am not 100% sure what it means.

@BigBeard411, lemme digest some of what you wrote and get back to you. Without reading your numbers deeply, my sense is that in the beginning Natesto added to your endogenous level; over time, you shut yourself down a little bit. Not completely, but enough to now feel hypogonadal?

Thoughts: Try skipping a dose or two and see how you feel when you resume; also, you could consider Empower's version, which comes in a higher strength.

I have experienced the same with the tubes: sometimes more/less comes when when I dispense. In some cases, I even use an extra pump if it feels like I didn't get enough.

Full disclosure: I have at times felt under treated on Natesto, which is part of the reason I am trialing other things. That said, there have been times I have felt great on it.

I am beginning to look into this variation more. My thoughts are that administration is not optimal, therefore absorption may fluctuate. We may be underestimating how far up the applicator/gel should go.

The Natesto applicator reaches the soft part of the nose under the bone, if pushed up as far as it can go. It is above this region that is most vascular - the respiratory and olfactory region. This is where the drug should go in order to be absorbed effectively.

I think this is the reason why we are told to squeeze our nose as opposed to spread it with an applicator - the squeeze pushes the gel further up, higher than the tip of the applicator reaches.

The nasal vestibule is the lower softer part of your nose, defined as:
The area just inside the nostril (nose opening) that leads into the nasal cavity. The nasal vestibule is supported by the cartilage of the nose and lined with tissue that contains small, course hairs. These hairs help filter dust, sand, and other particles to keep them from entering the lungs.

This region has the least vasculature and therefore natesto would absorb very poorly there.
The region just above the vestibule is the nasal atrium, this is defined as:
The anterior expanded portion of the middle meatus of the nose, just above the vestibule
This region is also very poor in drug delivery potential. The septum is also poorly vascularized, so application should be kept on the lateral walls of nasal cavity, but as deep inside as possible.

This contrasts with the nasal respiratory and olfactory region, which would be the optimal position, and are deeper in the nose
(NASAL DELIVERY - A Promising Route of Drug Delivery to the Brain: Scientific Considerations)

I'll try applying Natesto as deep as it can go, and then see if there is improvement. Maybe we were not applying deep enough by trying to avoid the plastic-chemical taste and smell. I am also not sure how clear instructions for application are.
The idea that the gel should be as deep as possible also puts sense into their instructions of blowing your nose before application, because most of the mucus is deeper in the nasal cavity. A mucus lining would hamper penetration into the capillary system.

One of the best pieces of advice given to me on this forum was to ignore the first 2-3 weeks of going on TRT. Otherwise you spend your time chasing that wonderful honeymoon feeling, which in reality was a blissful one-off event that you cannot replicate.

Not sure if this applies here. My testosterone levels are the same before and after TRT.

 

[Cataceous]

... But with typical secondary hypogonadism we apparently have hypothalamic hypersensitivity. This puts healthy testosterone levels well above the natural set point, making it a challenge to avoid suppression with longer-acting testosterone. ...

@Cataceous, hey, man, do you mind expanding on this? I am secondary and the sounds interesting, but I am not 100% sure what it means.
...

There are various negative feedback mechanisms in play in the hypothalamus to regulate testosterone production. The best known in these circles are the levels of free androgens and free estrogens. Among various other drivers is a starvation response. The starvation response is thought to lower hormones during periods of undernourishment so that energy is not expended on mating behavior. One hypothesized cause of secondary hypogonadism is a malfunction in the starvation response such that it is in effect even when calories are ample. This effectively makes the hypothalamus appear to be hypersensitive to the negative feedback of androgens and estrogens, resulting in a hormonal set point below what's normally considered healthy. Using exogenous testosterone to force serum testosterone above the lowered set point results in suppression unless the exogenous testosterone is very short-acting.

 

[BigBeard411]

I had a call with my doctor today about my above experience. So far she has not heard of people experiencing a decrease in effectiveness with Natesto. She will speak to a company rep on Tuesday.

in the meantime, she suggested I can start off at 50mg clomid weekly and continue with natesto. She claims she has success treating patients with clomid.

What do you guys think?

there doesn't seem to be long term safety data?

 

[Fortunate]

I had a call with my doctor today about my above experience. So far she has not heard of people experiencing a decrease in effectiveness with Natesto. She will speak to a company rep on Tuesday.

in the meantime, she suggested I can start off at 50mg clomid weekly and continue with natesto. She claims she has success treating patients with clomid.

What do you guys think?

there doesn't seem to be long term safety data?

I have no experience with Clomid, but I do have lots of experience with Natesto. This is purely anecdotal, but I feel like I have experienced what you are describing. I remember sitting in my doctor’s office and looking at her, telling her I feel like somehow I am absorbing less Natesto than I used to. that was a year or two ago. It is part of the reason that I have been wandering in the TRT wilderness, trying other protocols.

Please report back here.

 

[Fortunate]

I had a call with my doctor today about my above experience. So far she has not heard of people experiencing a decrease in effectiveness with Natesto. She will speak to a company rep on Tuesday.

in the meantime, she suggested I can start off at 50mg clomid weekly and continue with natesto. She claims she has success treating patients with clomid.

What do you guys think?

there doesn't seem to be long term safety data?

Also, I may have suggested this (I’m on my phone and too lazy to swipe up to look), but you could consider hCG instead of Clomid. It does not make great sense in terms of what you are trying to accomplish with Natesto, but it may provide you a therapeutic benefit and stimulate the testicles to continue making testosterone. I did this for a long time with pretty good results.

Clomid makes me nervous because of the eye side effects and supposed mood side effects that some people report.

 

[ZALEMAX]

Appreciate Excel Male site, Is always good to hear and read and share here for me,

All and @ Fortunate, Just to update, started the Natesto gel on or about 5/25/22. I took a minimal approach to the gel(1x 1/4 pump left side nostril of 2x daily) yes super small dose but its gel my application process goes like this:, I just paint it inside the nostril I do not even squeeze my nose together(going against the insert directions) I try just to leave it alone breath normally and do not lay down or sneeze. I am only trying just to get a feel of my body's reactions. I took this approach because my previous TRT protocol was IM injections had spiked my BP for 6-8 hours. and my BP was elevated 130z-140z for about two more days until normal 115z/. Even @ that low dose initially within approx. 15 min. had BP raised to upper 140z -150-160z got the feeling to take a walk to try and calm the new Netesto effects.,after 45 min I felt better and my BP seemed to stabilize. I also notice with the BP spike initially that I was burping a- lot and farting and my stomach kind of hurt in the center. Has anyone here experienced this? I also have a feeling my heart is working harder and just (possibly palpitations) but not sure about that. After about 35-45 min. these symptoms goes away. When I went to the clinic for my blood draw I showed the Dr. how I administer the Natesto medication he encouraged me further. He and I knew its a small dose so when my blood draw went like this on 6/23/2022 ..TT was 291ng/dl. and free is 58.58pg/ml-SHBG-69-Estrdiol 54pg/ml. PSA-0.76ng/ml

With that blood draw results Dr. wants to increase to half pump twice per day.

On 7/15/2022 I have adjusted up to 1 full pump one nostril right or left x2 times a day with residual on the other nostril and 1/4 bump opposite nostril.(7hours between doses) Most reactions negative's happen within 15 min. BP spikes, burps, heart beating faster, some pressure in the head. but those go away after 45-min.-1hour. Does anyone here have those side effects? All comments appreciated. Like other's have commented here, I have also noticed that sometimes the Natesto dispenses out less gel and have to add to it so I do not have a accurate dosage amount for that application. At first dose my Natesto cost 299. for one pen but my Dr. gave me a pharmacy my pay now discounted 140.00 for 3 like others here. As other here stated, sometimes I have minimal reactions from the Natesto no BP spikes, but the burps continue I also wonder if I am getting the therapeutic
TRT benefit when this occurs. Please comment?

The positives are more energy, (for about 4 hours) until next dose) lifting heavier weight in gyms slight increase in mass, erection are better, less brain fog,.

I often wander if somehow the Natesto is in someway damaging my heart upon initial 15 min. startup cause of the BP spikes. Again, all comments appreciated?

Current protocol:
1 baby aspirin daily
D3-2000
1 tab-magnesium
coq10-200mg
omega-1000mg
vitimin c-2000mg
Natesto 1 full pump left nostril x2 times a day residual on applicator right nostril with 1/4 bump.

All comments appreciated

​

 

[Fortunate]

Appreciate Excel Male site, Is always good to hear and read and share here for me,

All and @ Fortunate, Just to update, started the Natesto gel on or about 5/25/22. I took a minimal approach to the gel(1x 1/4 pump left side nostril of 2x daily) yes super small dose but its gel my application process goes like this:, I just paint it inside the nostril I do not even squeeze my nose together(going against the insert directions) I try just to leave it alone breath normally and do not lay down or sneeze. I am only trying just to get a feel of my body's reactions. I took this approach because my previous TRT protocol was IM injections had spiked my BP for 6-8 hours. and my BP was elevated 130z-140z for about two more days until normal 115z/. Even @ that low dose initially within approx. 15 min. had BP raised to upper 140z -150-160z got the feeling to take a walk to try and calm the new Netesto effects.,after 45 min I felt better and my BP seemed to stabilize. I also notice with the BP spike initially that I was burping a- lot and farting and my stomach kind of hurt in the center. Has anyone here experienced this? I also have a feeling my heart is working harder and just (possibly palpitations) but not sure about that. After about 35-45 min. these symptoms goes away. When I went to the clinic for my blood draw I showed the Dr. how I administer the Natesto medication he encouraged me further. He and I knew its a small dose so when my blood draw went like this on 6/23/2022 ..TT was 291ng/dl. and free is 58.58pg/ml-SHBG-69-Estrdiol 54pg/ml. PSA-0.76ng/ml

With that blood draw results Dr. wants to increase to half pump twice per day.

On 7/15/2022 I have adjusted up to 1 full pump one nostril right or left x2 times a day with residual on the other nostril and 1/4 bump opposite nostril.(7hours between doses) Most reactions negative's happen within 15 min. BP spikes, burps, heart beating faster, some pressure in the head. but those go away after 45-min.-1hour. Does anyone here have those side effects? All comments appreciated. Like other's have commented here, I have also noticed that sometimes the Natesto dispenses out less gel and have to add to it so I do not have a accurate dosage amount for that application. At first dose my Natesto cost 299. for one pen but my Dr. gave me a pharmacy my pay now discounted 140.00 for 3 like others here. As other here stated, sometimes I have minimal reactions from the Natesto no BP spikes, but the burps continue I also wonder if I am getting the therapeutic
TRT benefit when this occurs. Please comment?

The positives are more energy, (for about 4 hours) until next dose) lifting heavier weight in gyms slight increase in mass, erection are better, less brain fog,.

I often wander if somehow the Natesto is in someway damaging my heart upon initial 15 min. startup cause of the BP spikes. Again, all comments appreciated?

Current protocol:
1 baby aspirin daily
D3-2000
1 tab-magnesium
coq10-200mg
omega-1000mg
vitimin c-2000mg
Natesto 1 full pump left nostril x2 times a day residual on applicator right nostril with 1/4 bump.

All comments appreciated

​

@ZALEMAX, sorry to hear you’re struggling a bit. I don’t know if my feedback will be helpful, but I will offer whatever thoughts I have.

I see your estradiol is pretty high for someone on Natesto. When is the last time you used any exogenous testosterone besides Natesto?

In the past, I used Natesto on a regular basis and don’t recall feeling any heart pounding. BUT, more recently, I have used Natesto a little here and there between trialing other protocols. In these circumstance, I actually have noticed periods when my heart feels like it is pounding harder than it should. There are a few explanations for this. First, it is possible that this happened in the past, but I never noticed it. Second, it is possible that it happened in the beginning, but I acclimated to it. Third, it is possible that the heart pounding is from supraphysiologic levels of T (doubtful). Fourth, it is possible that it is from dropping T levels, after having been elevated. Last, it is possible it is unrelated and/or from some other reason (I’d rank this first).

I personally noticed some very surprising side effects from Coq10. I realized that on days I took it, I had periods of lots of energy and mental clarity, but later in the day, I got crazy anxiety, maybe with heart pounding. I noticed this even with 100-200mg dose ranges, and I am very confident that it was the Coq10 causing it. As a little experiment, you might consider stopping Coq10 for a week or so, keeping everything else the same and watching what happens.

So, have you been on just Natesto from May to present, continuously? Is it possible you are taking one of your other supplements around the same time you are using Natesto, which could cause the GI symptoms? Magnesium can cause upset stomach. Not sure about Omega.

Lastly, you might consider getting levels drawn within an hour of your Natesto dose. That should give a better reflection of how high your levels are at their max. Ultimately, it may be the Natesto causing all that you are describing, but I am not quite there at this point.

 

[ZALEMAX]

@ZALEMAX, sorry to hear you’re struggling a bit. I don’t know if my feedback will be helpful, but I will offer whatever thoughts I have.

I see your estradiol is pretty high for someone on Natesto. When is the last time you used any exogenous testosterone besides Natesto?

In the past, I used Natesto on a regular basis and don’t recall feeling any heart pounding. BUT, more recently, I have used Natesto a little here and there between trialing other protocols. In these circumstance, I actually have noticed periods when my heart feels like it is pounding harder than it should. There are a few explanations for this. First, it is possible that this happened in the past, but I never noticed it. Second, it is possible that it happened in the beginning, but I acclimated to it. Third, it is possible that the heart pounding is from supraphysiologic levels of T (doubtful). Fourth, it is possible that it is from dropping T levels, after having been elevated. Last, it is possible it is unrelated and/or from some other reason (I’d rank this first).

I personally noticed some very surprising side effects from Coq10. I realized that on days I took it, I had periods of lots of energy and mental clarity, but later in the day, I got crazy anxiety, maybe with heart pounding. I noticed this even with 100-200mg dose ranges, and I am very confident that it was the Coq10 causing it. As a little experiment, you might consider stopping Coq10 for a week or so, keeping everything else the same and watching what happens.

So, have you been on just Natesto from May to present, continuously? Is it possible you are taking one of your other supplements around the same time you are using Natesto, which could cause the GI symptoms? Magnesium can cause upset stomach. Not sure about Omega.

Lastly, you might consider getting levels drawn within an hour of your Natesto dose. That should give a better reflection of how high your levels are at their max. Ultimately, it may be the Natesto causing all that you are describing, but I am not quite there at this point.

@Fortunate thanks for your reply, to answer your question I started the minimal dosage of Natesto (5 /15/22) No, on other exogenous testosterone, I was back to base line 270z-288z when starting out. Yes my Estrdiol raised that was higher than I have ever seen in 2 years. I spoke to my Dr. about that he not concerned, he did not feel to prescribe a estrogen blocker but could be on the table if required. The only recommendation was to adjust higher dosage of the Natesto. In June I made the adjustment to 1 full dose left nostril and residual right with a 1/4 bump in right.x2 times daily (alternating nostrils each day) till present.

Adding that my BPH is slightly worse at times with that dosage, but tolerable. I had that even before TRT. Dr. willing to prescribe medication for that but I refused for now mainly because of possible side effects of the drug.

Have been using the CO-q10 for albeit 10 years.. I try to take that several hour (2 hours) after Natesto dose. As you suggested I will stop the cq-10 and see what happens ..In my Pre -TRT days I used more like 400mg.

I hope as you suggest that my body will get more acclimated to the Natesto cause I would like to increase the dose to 1 full pump each nostril x2 daily.

Really do not understand the GI problems after taking the Natesto? Do you think its heart issue ? Also, do you think the Natesto is someway damaging the heart?

For me, there are benefits of Natesto.
Making a plan to do the Natesto and get a blood draw and see how my blood panel sits..
That's what I did on 6/23/22.

All responses appreciated thanks @ Fortunate post back to me.

 

[Fortunate]

@Fortunate thanks for your reply, to answer your question I started the minimal dosage of Natesto (5 /15/22) No, on other exogenous testosterone, I was back to base line 270z-288z when starting out. Yes my Estrdiol raised that was higher than I have ever seen in 2 years. I spoke to my Dr. about that he not concerned, he did not feel to prescribe a estrogen blocker but could be on the table if required. The only recommendation was to adjust higher dosage of the Natesto. In June I made the adjustment to 1 full dose left nostril and residual right with a 1/4 bump in right.x2 times daily (alternating nostrils each day) till present.

Adding that my BPH is slightly worse at times with that dosage, but tolerable. I had that even before TRT. Dr. willing to prescribe medication for that but I refused for now mainly because of possible side effects of the drug.

Have been using the CO-q10 for albeit 10 years.. I try to take that several hour (2 hours) after Natesto dose. As you suggested I will stop the cq-10 and see what happens ..In my Pre -TRT days I used more like 400mg.

I hope as you suggest that my body will get more acclimated to the Natesto cause I would like to increase the dose to 1 full pump each nostril x2 daily.

Really do not understand the GI problems after taking the Natesto? Do you think its heart issue ? Also, do you think the Natesto is someway damaging the heart?

For me, there are benefits of Natesto.
Making a plan to do the Natesto and get a blood draw and see how my blood panel sits..
That's what I did on 6/23/22.

All responses appreciated thanks @ Fortunate post back to me.

If the estradiol was not an ultra sensitive test, you might do that next. It’s really odd that it’s that high on Natesto. Some foods can raise your estradiol, but I wouldn’t think by that much.

It is possible you are under treated, instead of over treated, but your observations that your BP goes up right after Natesto is pretty compelling.

I guess gather as much data (personal observations and labs) as is feasible and look for patterns. Please keep us updated.

 

[Fortunate]

@BigBeard411, any updates? How’s it going?