Official Natesto Thread

[pyater]

Thank you for the help. I plan to wait about 6 weeks for a protocol change to have bloods done.

 

[TLawyer]

We want to test at peak when using Natesto.

Maximum concentration (Cmax) is achieved within approximately 40 minutes.

I would have blood drawn 1 hr post-dose.

Even then if you just started I would give it some time to see how your body reacts before rushing to get labs.


Figure 1: Mean Serum Total Testosterone Concentrations on Day 90 in Patients Following NATESTO 22.0 mg Daily Administered at 9 p.m. and 7 a.m. (N=122) and 33.0 mg Daily Administered at 9 p.m., 7 a.m. and 1 p.m. (N=151)
View attachment 19041


Recommended Dose and Dosage Adjustment

The recommended starting dose of NATESTO (testosterone) is 11.0 mg of testosterone (1 actuation per nostril) administered intranasally twice daily for a total daily dose of 22.0 mg.

To ensure proper dosing, serum total testosterone concentrations should be measured after initiation of therapy to ensure that the desired concentrations (300 to 1050 ng/dL) are achieved. The NATESTO dose can be adjusted at least 30 days after starting treatment based on the serum total testosterone concentrations from a single blood draw, taken 20 minutes to 2 hours after morning administration of NATESTO. If the total testosterone measurement is less than 300 ng/dL, the daily testosterone dose may be increased from 22.0 mg (twice daily administration) to 33.0 mg (thrice daily administration), as instructed by a physician.

Serum total testosterone concentrations should be checked periodically. The following rules should be applied:

* For patients on 22.0 mg (twice daily administration): If the measured serum total testosterone concentration from the single morning blood draw is less than 300 ng/dL, the daily dose of NATESTO may be increased from 22.0 mg (twice daily administration) to 33.0 mg (thrice daily administration);

*For patients on 33.0 mg (thrice daily administration): If the measured serum total testosterone concentration from the single morning blood draw is consistently less than 300 ng/dL, or if a desired clinical response is not achieved, NATESTO should be discontinued and an alternative treatment should be considered.

*If a post-dose morning total testosterone concentration consistently exceeds 1050 ng/dL, NATESTO should be discontinued.

What's your thought process on waiting until getting tested? If it's short-lived and doesn't build up in your system, it would seem like you could get tested after one dose and get an accurate read of what level you can expect to hit going forward.

 

[pyater]

I think just letting all of the hormones settle in with a protocol change.

 

[Willyt]

Having experimented with Natesto, I can certainly see its appeal as the most minimally disruptive form of TRT. And if it works for you great.

However, I keep coming back to the long-term challenges with Natesto or any nasal form of TRT. The recommended 3x daily (each nostril) means over 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.

My concern is not with the effort of 3x daily, but rather 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?

Here are the ingredients of Natesto:

• Testosterone (4.5% concentration)
• Castor oil (solvent)
• Oleoyl polyoxylglyceride (wetting agent)
• Colloidal silicon dioxide (viscosity increasing agent)

 

[CKO]

TLawyer, thanks for trying this combination. I've been considering going back on in enclomiphene and had wondered if they would allow someone to try nasal application at the same time. I'll be curious to watch your results and subjective outcomes. My labs always looked great on enclomiphene, but the subjective benefits were not there for me. Wondering if this is a viable option.

 

[TLawyer]

TLawyer, thanks for trying this combination. I've been considering going back on in enclomiphene and had wondered if they would allow someone to try nasal application at the same time. I'll be curious to watch your results and subjective outcomes. My labs always looked great on enclomiphene, but the subjective benefits were not there for me. Wondering if this is a viable option.

Well, I actually took my last dose of Enclomiphene 5 days ago and have been going just with the nasal gel (3 applications per day, 10 mg total each application). I just wanted to see what the nasal gel would do alone. So far, seems ok. I feel a little lower than when on the Enclomiphene as well, but normal. I'm going to try going with this for a few weeks, take labs, and then re-assess whether to add back in the Enclomiphene.

 

[TLawyer]

Having experimented with Natesto, I can certainly see its appeal as the most minimally disruptive form of TRT. And if it works for you great.

However, I keep coming back to the long-term challenges with Natesto or any nasal form of TRT. The recommended 3x daily (each nostril) means over 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.

My concern is not with the effort of 3x daily, but rather 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?

Here are the ingredients of Natesto:

• Testosterone (4.5% concentration)
• Castor oil (solvent)
• Oleoyl polyoxylglyceride (wetting agent)
• Colloidal silicon dioxide (viscosity increasing agent)

Certainly a valid concern and one that is on my mind. One thought I have is to actually get the more concentrated gel from Empower that is 10 mg, or double the Natesto dosage. That would at least cut down on the amount of some of the gel. It’s currently 8 clicks with the 5 mg, so I should be able to go with 4 clicks with the 10 mg (unless I am thinking about it wrong). I think that’s cheaper as well.

 

[madman]

What's your thought process on waiting until getting tested? If it's short-lived and doesn't build up in your system, it would seem like you could get tested after one dose and get an accurate read of what level you can expect to hit going forward.

Of course, you can get blood work done right away to see what peak levels are achieved post-application.

Would rather wait a few weeks to see how you feel overall let alone get into a groove using the applicator.

 

[Fortunate]

@TLawyer, how's it going?

 

[TLawyer]

@TLawyer, how's it going?

I dropped the nasal gel after giving it another week. I think my T levels were fine on it, but the buildup in my nose was getting too much, and my throat was constantly sore. I would have liked to get some labs on it to see where it put me and realize the benefits, but the mode of application just doesn't make this a viable long-term option for me. I'm back to Enclomiphene only.

 

[Strengthandlibido]

I dropped the nasal gel after giving it another week. I think my T levels were fine on it, but the buildup in my nose was getting too much, and my throat was constantly sore. I would have liked to get some labs on it to see where it put me and realize the benefits, but the mode of application just doesn't make this a viable long-term option for me. I'm back to Enclomiphene only.

I just ordered a few of the pens, but Defy wouldn't release any enclomiphene; prescribed hCG instead. Maybe next time. I'm taking a break from cypionate injections after five weeks of injecting. Hoping I'll be recovered HPTA-wise a bit by the time the gel gets here. Will try the gel by itself for a while. It's 10mg/0.05ml, which is double the Natesto concentration, so I should be able to get by with half the applications. Can I expect more immediate effects with the gel, or creams for that matter, than with injections?

 

[Fortunate]

I just ordered a few of the pens, but Defy wouldn't release any enclomiphene; prescribed hCG instead. Maybe next time. I'm taking a break from cypionate injections after five weeks of injecting. Hoping I'll be recovered HPTA-wise a bit by the time the gel gets here. Will try the gel by itself for a while. It's 10mg/0.05ml, which is double the Natesto concentration, so I should be able to get by with half the applications. Can I expect more immediate effects with the gel, or creams for that matter, than with injections?

I do think that you can expect very quick effects. Some people feel it right away (within 90 minutes or so). I have heard of some people who use it to even treat depression, but that’s purely anecdotal.

 

[Strengthandlibido]

I do think that you can expect very quick effects. Some people feel it right away (within 90 minutes or so). I have heard of some people who use it to even treat depression, but that’s purely anecdotal.

Thanks! I see you are on nasal gel x 2/day + 100IU hCG daily. As noted, I got some hCG, but I'd been hoping for enclomiphene. I guess you are finding benefit to adding hCG. I wasn't going to use my hCG with the gel, so I'm really curious.

 

[Fortunate]

Thanks! I see you are on nasal gel x 2/day + 100IU hCG daily. As noted, I got some hCG, but I'd been hoping for enclomiphene. I guess you are finding benefit to adding hCG. I wasn't going to use my hCG with the gel, so I'm really curious.

I have typically done nasal three times a day.

hCG does not make great sense with Natesto. I started hCG in the past when I was on injections. I continue to use it simply because, subjectively, I believe I feel better on it.

Please report back!

 

[Strengthandlibido]

I have typically done nasal three times a day.

hCG does not make great sense with Natesto. I started hCG in the past when I was on injections. I continue to use it simply because, subjectively, I believe I feel better on it.

Please report back!

Sorry, I misread. I will let you know as soon as I feel anything working.

Any advice on application and avoiding discomfort or wastage?

 

[docc]

I just ordered a few of the pens, but Defy wouldn't release any enclomiphene; prescribed hCG instead. Maybe next time. I'm taking a break from cypionate injections after five weeks of injecting. Hoping I'll be recovered HPTA-wise a bit by the time the gel gets here. Will try the gel by itself for a while. It's 10mg/0.05ml, which is double the Natesto concentration, so I should be able to get by with half the applications. Can I expect more immediate effects with the gel, or creams for that matter, than with injections?

Why wouldn't Empower release any enclomiphene? FYI, Maximus prescribes it as a standalone, but can't be taken concurrently with TRT.

Natesto has a half-life of 10-100 minutes, while enclomiphene's half-life is 10.5 hours, while testosterone cypionate is 8 days. Generally, faster half life compounds that achieve a higher peak level of testosterone are 'felt' more, but the unique advantage of enclomiphene is that because its stimulates your own T production, its released in a much more 'natural' rhythm since the testes are still regulating its production.

 

[Strengthandlibido]

Why wouldn't Empower release any enclomiphene? FYI, Maximus prescribes it as a standalone, but can't be taken concurrently with TRT.

Natesto has a half-life of 10-100 minutes, while enclomiphene's half-life is 10.5 hours, while testosterone cypionate is 8 days. Generally, faster half life compounds that achieve a higher peak level of testosterone are 'felt' more, but the unique advantage of enclomiphene is that because its stimulates your own T production, its released in a much more 'natural' rhythm since the testes are still regulating its production.

Because I mentioned testicle size as a concern, and I was told enclomiphene was for fertility, not testicular size. I also had to choose between nasal gel and scrotal cream. It looks like they think I'm using the gel as an occasional boost as opposed to a solo therapy.

I also mentioned to her that penile sensitivity was becoming more of a problem with the injections. That may be another reason for the hCG. I am hoping switching up the delivery method to allow for more of a natural daily trough will clear up some sexual issues that injecting T cypionate doesn't seem to be helping. But per the post below, maybe nasal gel will help with that.

Lack of Penis Sensitivity

Hey Guys, I'm having issues with penis sensitivity. Long story short, I started TRT in August 2018 after being diagnosed with Low T (Test in Aug showed T @ 187ng/dl and Free T @ 3ng/dl). Since starting the treatment I have had great results in terms of the way I feel, weight loss and getting...

www.excelmale.com

"As it turns out I solved my penis sensitivity issues by moving to testosterone delivery systems with a much shorter half life - first Test cream applied to the scrotum and now Natesto. I believe my incredibly high trough levels - typically 1000-1200 were causing it. Now I have much more natural trough levels and my penis sensitivity and overall enjoyment of intimacy have returned to my pre low T levels. If you don't want to come off of injections I agree that a lower does of T may accomplish the same thing."

 

[docc]

Because I mentioned testicle size as a concern, and I was told enclomiphene was for fertility, not testicular size. I also had to choose between nasal gel and scrotal cream. It looks like they think I'm using the gel as an occasional boost as opposed to a solo therapy.

I also mentioned to her that penile sensitivity was becoming more of a problem with the injections. That may be another reason for the hCG. I am hoping switching up the delivery method to allow for more of a natural daily trough will clear up some sexual issues that injecting T cypionate doesn't seem to be helping. But per the post below, maybe nasal gel will help with that.

Lack of Penis Sensitivity

Hey Guys, I'm having issues with penis sensitivity. Long story short, I started TRT in August 2018 after being diagnosed with Low T (Test in Aug showed T @ 187ng/dl and Free T @ 3ng/dl). Since starting the treatment I have had great results in terms of the way I feel, weight loss and getting...

www.excelmale.com

"As it turns out I solved my penis sensitivity issues by moving to testosterone delivery systems with a much shorter half life - first Test cream applied to the scrotum and now Natesto. I believe my incredibly high trough levels - typically 1000-1200 were causing it. Now I have much more natural trough levels and my penis sensitivity and overall enjoyment of intimacy have returned to my pre low T levels. If you don't want to come off of injections I agree that a lower does of T may accomplish the same thing."

That's incorrect guidance. Topical TRT decreases testicular volume, while enclomiphene increases testicular volume significantly (compared to both placebo & TRT).

Intranasal TRT will have less LH/FSH suppression (on the order of 20-30% compared to 80-90% with injectable TRT), so it reduces testicular shrinkage compared to other forms of TRT, but it won't maintain or increase testicular volume like enclomiphene does.

 

[Strengthandlibido]

I do think that you can expect very quick effects. Some people feel it right away (within 90 minutes or so). I have heard of some people who use it to even treat depression, but that’s purely anecdotal.

I have typically done nasal three times a day.

hCG does not make great sense with Natesto. I started hCG in the past when I was on injections. I continue to use it simply because, subjectively, I believe I feel better on it.

Please report back!

Nothing from initial dosing. I even popped half of a Cialis.

 

[Fortunate]

Nothing from initial dosing. I even popped half of a Cialis.

It would be interesting to see your levels after a dose. I did mine about 60 minutes after a dose and posted results above. Levels were not as high as expected. Could be because I was either pre- or post peak.

As a Natesto user for several years, I also suspect that dosing may not be always be consistent. I think the nasal route may be less exact than injections.