So who is happy with TRT? Who wish they never started?
- Thread starter 42HRT
- Start date
-
- Tags
- testestone
Vince
Super Moderator
16 mg of testosterone cypionate daily, 500 iu of hcg twice weekly and no AI.
Pregnenolone 10 mg and 25 mg of DHEA.
My last injection before labs, about 28 hr.s.
Testosterone, Total, LC/MS, 1035.9 High ng/dL 264.0-916.0
Testosterone, Free 33.77 High ng/dL 5.00-21.00
% Free Testosterone 3.26% 1.50-4.20
DHEA-Sulfate01 499.0 High ug/dL 30.9-295.6 age adjust
Dihydrotestosterone 56 ng/dL
Estradiol, Sensitive 18.7 pg/mL 8.0-35.0
Sex Horm Binding Glob, Serum. 41.2 nmol/L 19.3-76.4
Hemoglobin. 16.7 g/dL 13.0-17.7
Hematocrit 47.7 37.5-51.0
tropicaldaze1950
Well-Known Member
No. As on this forum, some men have been on long term daily shots, either IM or subq, after trying other protocols, and have found success. There's a practitioner on there who does a weekly injection and prescribes that for many of his patients, though some have switched to 2X weekly. He prescribes doses between 140 and 200 mg. Some men on the forum micro dose, 50 to 70 mg.
tropicaldaze1950
Well-Known Member
I've been following your journey for a few years and it's great that oral T is working! I was reading an abstract on steroidogenesis and the authors stated that oral forms of testosterone closely mimic the daily peaks and troughs of endogenous testosterone.
I looked up the inactive ingredients in Jatenzo and not sure it or any other oral form is for me because of my many chemical sensitivities. I'm a walking disaster in that regard, LOL.
Mixed feelings. I started TRT after Clomid stopped working. I think I started with too high a dose because I had horrible acne and my hair started shedding, which led me to finasteride. Propecia caused severe damage that never fully healed. I wish I had tried adding hCG to Clomid rather than go on TRT.
How long were you on clomid before it stopped working? Was stopped working that your test levels fell again? Did you try upping the dose?
4 years. Yes my test levels dropped to hypogonadal levels (I have empty sella). I tried switching to enclomiphene for 3 months with no success. I wish I had kept trying though. I saw an interview with Dr. Mohit Khera where he said some men who dose Clomid daily will lose efficacy so it should be dosed every other day. I think maybe that happened to me.
What damage did propecia cause?
Golfboy307
Active Member
Been on it for over 8 years, now age 55. Pre -treatment was in the upper 300's with low free T. Make a huge positive difference for me in all facets. Hope I never have to go off!
madman
Super Moderator
If anything you are getting 2 daily peak/troughs 24/7.
T levels will be much lower before it is time for your second dose (12 hrs after 1st dose) let alone after you take your second dose you will hit a high Cmax 2-4 hrs later than T levels would rapidly decline and will be much lower overnight until your next dose in the early AM.
Even if dosed once daily which no one would do your T levels would be much lower in the evening/throughout the night until your next morning dose.
Many fail to realize that T levels gradually rise overnight reaching peak in the early AM.
*elevated and near peak TT level during nighttime sleep, peak TT level around the time of morning awakening
*T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
This is key:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
*The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
*As shown in the graphs of Figures 2 and 3, the PK of most FDA-approved PA-TRTs gives rise to TT 24 h patterns that deviate greatly from the normative one thereby failing to satisfy one or more of the five specified criteria.
*AndroGel® 1%, AndroGel® 1.62%, Xyosted®, and Striant®, which achieve relatively constant serum hormone concentration throughout the 24 h, seem to have been incorrectly conceptualized, perhaps because of the presumed necessity to maintain nonvarying, that is, homeostatic, TT concentration to achieve consistency of biological effects.
*The FDA-approved gel and solution PA-TRTs when applied as directed, that is, morning after awakening from nighttime sleep, while achieving TT levels within the normal range to remedy androgen hormone deficiency, fail to restore the normal physiologic TT circadian variation.
*The temporal patterns of these PA-TRTs differ from normal, either in the timing of the peak and/or nadir TT concentrations, by achieving the highest hormone levels generally between midmorning and noon and lowest (rather than near peak) ones during sleep (Figure 2A-2F).
Does Patient-Applied TRT Pose Risk for Blood Pressure Elevation? - Excel Male TRT Forum
Does Patient-Applied Testosterone Replacement Therapy Pose Risk for Blood Pressure Elevation? Circadian Medicine Perspectives (2022) Michael H. Smolensky, Ramon C. Hermida, Linda Sackett-Lundeen, *Ramon G. Hermida-Ayala, and Yong-Jian Geng ABSTRACT We reviewed medication package inserts, US...
www.excelmale.com
*The US Food and Drug Administration (FDA), since the 1950s, has approved several physician-administered injectables and implantable pellets plus 10 unique (nonbiologically similar) patient-applied (PA) transdermal gel, intranasal gel, transdermal solutions, skin patches, buccal tablet, oral capsule, and subcutaneously injected TRTs. Intramuscularly injected and surgically implanted TRTs are administered by healthcare professionals at intervals of several weeks or months, whereas PA transdermal gel and solutions are dosed once daily at the commencement of the activity period, buccal tablet and oral soft gel capsule two times daily at approximately 12 h intervals, intranasal gel three-times daily at approximately 6 to 8 h intervals, and transdermal patch once daily before bedtime. As subsequently discussed, there is a substantial difference in the pharmacokinetics (PK) and attained T 24 h patterning between the 10 different PA-TRTs.
*LH pulses exhibit 24 h temporal patterning; they occur in greater number and higher amplitude during the sleep than wake span, suggesting the involvement of sleep-facilitating or sleep-dependent processes (10, 17, 57, 164, 175–177). Consequently, T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
*Figures 2A-2F depict the TT 24 h pattern achieved by the 6 different solution and gel PA-TRTs, and Figures 3A-3D depict the TT 24 h pattern achieved by the buccal tablet, oral capsule, transdermal patch, and subcutaneously injected PATRTs. There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
AndroGel® 1%, AndroGel® 1.62%, Axiron®, Fortesta®, and Testim® (and its biosimilar Vogelxo®) gel and solution preparations are recommended for application once daily in the morning to attain the highest serum hormone level 2 to 6 h following dosing and lowest, instead of highest, hormone level during sleep, that is, final hours of the 24 h dosing interval (Figure 2A-2E).
The Natesto® gel product applied to each nostril three times daily at approximately equal intervals results in highly variable serum TT concentration during the 24 h, showing three prominent peaks (Cmax), each occurring approximately 40 min after the administrations, and three prominent nadirs (Cmin) of 2 to 4 h duration, each occurring midway through the dosing intervals (Figure 2F).
The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
Xyosted®, a patient subcutaneously injected TRT at weekly intervals, has yet to be rigorously evaluated for its TT day-night pattern. Available data based upon rather infrequent blood sampling indicate Cmax occurs approximately 12 h following each weekly administration and that TT is maintained within the therapeutic range in a relatively stable manner, at least throughout the initial days of the 7-day dosing period (Figure 3C).
*The TT concentration produced by the Androderm® transdermal patch applied to the skin of the back, stomach, upper arms, or thighs nightly before retiring to sleep more closely reproduces the normative TT circadian pattern of young adult males than any of the other marketed PA-TRTs. Following application, TT concentration progressively rises during sleep and peaks around the time of morning awakening; it progressively declines during late morning and afternoon, reaching its nadir (Cmin) in the evening before the next scheduled patch application (Figure 3D).
I have been at this way too long!
A pill that could outsell Viagra: New testosterone Rx drug - Excel Male TRT Forum
https://www.americanbazaaronline.com/2022/10/11/testosterone-drug-kyzatrex-hits-market-451261/ Kyzatrex could be a potential blockbuster to treat testosterone deficiency, a severely undertreated disease. Testosterone has been historically perceived as a lifestyle issue for men who want to...
www.excelmale.com
Who Started TRT w/ "Normal" Levels @ What Age?
It seems that EC works well in increasing testosterone, no questions about it. These numbers look good, however, I don't feel any different and most of the issues I related above remain the same. I can tell you clomid blocks the effects of estrogen by attaching to the E2 receptors, it's one...
www.excelmale.com
Official Natesto Thread
Data point for anyone interested. Natesto has been the most tolerable form of TRT for me. Typically, I get headaches with other forms. I have also noticed a more forceful heartbeat than normal after injecting. I can even feel it in my abdominal aorta (I know, that sounds really weird). I have...
www.excelmale.com
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
ANDRODERM® (TDS)
https://www.androderm.com/about-androderm ANDRODERM® (testosterone transdermal system) is designed to deliver testosterone continuously for 24 hours following application to intact, non-scrotal skin (e.g., back, abdomen, thighs, upper arms). Four strengths of ANDRODERM® are available that...
www.excelmale.com
Water retention when I inject @ evening and less when @ morning, ideas why ? - Excel Male TRT Forum
I feel the best emotionally and get the best sleep as close to being natty when I inject ED around 12,5mg Test Prop in the evening prior to bed. Been experimenting for quite some time and indeed there is a very big difference. Wake up full of energy and feel calm during the day. Also this...
www.excelmale.com
Case Study: Absorption of Testosterone Cream via Scrotal Delivery
Case Study: Absorption of Testosterone Cream via Scrotal Delivery. Needham S1, Needham S2. 1Moses Lake Professional Pharmacy, Moses Lake, Washington. 2Alturas Analytics in Moscow, Idaho. Abstract Transdermal testosterone has been used for years to treat patients with low testosterone...
www.excelmale.com
Systemlord
Member
I would like to see a once daily extended release Jatenzo option, perhaps with similar half-life to Cialis.
It’s only a matter of time.
It’s only a matter of time.
madman
Super Moderator
Lipocine is already ahead of the game!
This is next in line.
*TLANDO XR (Testosterone Tridecanoate)
tropicaldaze1950
Well-Known Member
If anything you are getting 2 daily peak/troughs 24/7.
T levels will be much lower before it is time for your second dose (12 hrs after 1st dose) let alone after you take your second dose you will hit a high Cmax 2-4 hrs later than T levels would rapidly decline and will be much lower overnight until your next dose in the early AM.
Even if dosed once daily which no one would do your T levels would be much lower in the evening/throughout the night until your next morning dose.
Many fail to realize that T levels gradually rise overnight reaching peak in the earl AM.
*elevated and near peak TT level during nighttime sleep, peak TT level around the time of morning awakening
*T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
This is key:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
*The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
*As shown in the graphs of Figures 2 and 3, the PK of most FDA-approved PA-TRTs gives rise to TT 24 h patterns that deviate greatly from the normative one thereby failing to satisfy one or more of the five specified criteria.
*AndroGel® 1%, AndroGel® 1.62%, Xyosted®, and Striant®, which achieve relatively constant serum hormone concentration throughout the 24 h, seem to have been incorrectly conceptualized, perhaps because of the presumed necessity to maintain nonvarying, that is, homeostatic, TT concentration to achieve consistency of biological effects.
*The FDA-approved gel and solution PA-TRTs when applied as directed, that is, morning after awakening from nighttime sleep, while achieving TT levels within the normal range to remedy androgen hormone deficiency, fail to restore the normal physiologic TT circadian variation.
*The temporal patterns of these PA-TRTs differ from normal, either in the timing of the peak and/or nadir TT concentrations, by achieving the highest hormone levels generally between midmorning and noon and lowest (rather than near peak) ones during sleep (Figure 2A-2F).
Does Patient-Applied TRT Pose Risk for Blood Pressure Elevation? - Excel Male TRT Forum
Does Patient-Applied Testosterone Replacement Therapy Pose Risk for Blood Pressure Elevation? Circadian Medicine Perspectives (2022) Michael H. Smolensky, Ramon C. Hermida, Linda Sackett-Lundeen, *Ramon G. Hermida-Ayala, and Yong-Jian Geng ABSTRACT We reviewed medication package inserts, US...
*The US Food and Drug Administration (FDA), since the 1950s, has approved several physician-administered injectables and implantable pellets plus 10 unique (nonbiologically similar) patient-applied (PA) transdermal gel, intranasal gel, transdermal solutions, skin patches, buccal tablet, oral capsule, and subcutaneously injected TRTs. Intramuscularly injected and surgically implanted TRTs are administered by healthcare professionals at intervals of several weeks or months, whereas PA transdermal gel and solutions are dosed once daily at the commencement of the activity period, buccal tablet and oral soft gel capsule two times daily at approximately 12 h intervals, intranasal gel three-times daily at approximately 6 to 8 h intervals, and transdermal patch once daily before bedtime. As subsequently discussed, there is a substantial difference in the pharmacokinetics (PK) and attained T 24 h patterning between the 10 different PA-TRTs.
*LH pulses exhibit 24 h temporal patterning; they occur in greater number and higher amplitude during the sleep than wake span, suggesting the involvement of sleep-facilitating or sleep-dependent processes (10, 17, 57, 164, 175–177). Consequently, T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
*Figures 2A-2F depict the TT 24 h pattern achieved by the 6 different solution and gel PA-TRTs, and Figures 3A-3D depict the TT 24 h pattern achieved by the buccal tablet, oral capsule, transdermal patch, and subcutaneously injected PATRTs. There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
AndroGel® 1%, AndroGel® 1.62%, Axiron®, Fortesta®, and Testim® (and its biosimilar Vogelxo®) gel and solution preparations are recommended for application once daily in the morning to attain the highest serum hormone level 2 to 6 h following dosing and lowest, instead of highest, hormone level during sleep, that is, final hours of the 24 h dosing interval (Figure 2A-2E).
The Natesto® gel product applied to each nostril three times daily at approximately equal intervals results in highly variable serum TT concentration during the 24 h, showing three prominent peaks (Cmax), each occurring approximately 40 min after the administrations, and three prominent nadirs (Cmin) of 2 to 4 h duration, each occurring midway through the dosing intervals (Figure 2F).
The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
Xyosted®, a patient subcutaneously injected TRT at weekly intervals, has yet to be rigorously evaluated for its TT day-night pattern. Available data based upon rather infrequent blood sampling indicate Cmax occurs approximately 12 h following each weekly administration and that TT is maintained within the therapeutic range in a relatively stable manner, at least throughout the initial days of the 7-day dosing period (Figure 3C).
*The TT concentration produced by the Androderm® transdermal patch applied to the skin of the back, stomach, upper arms, or thighs nightly before retiring to sleep more closely reproduces the normative TT circadian pattern of young adult males than any of the other marketed PA-TRTs. Following application, TT concentration progressively rises during sleep and peaks around the time of morning awakening; it progressively declines during late morning and afternoon, reaching its nadir (Cmin) in the evening before the next scheduled patch application (Figure 3D).
I have been at this way too long!
A pill that could outsell Viagra: New testosterone Rx drug - Excel Male TRT Forum
https://www.americanbazaaronline.com/2022/10/11/testosterone-drug-kyzatrex-hits-market-451261/ Kyzatrex could be a potential blockbuster to treat testosterone deficiency, a severely undertreated disease. Testosterone has been historically perceived as a lifestyle issue for men who want to...
Who Started TRT w/ "Normal" Levels @ What Age?
It seems that EC works well in increasing testosterone, no questions about it. These numbers look good, however, I don't feel any different and most of the issues I related above remain the same. I can tell you clomid blocks the effects of estrogen by attaching to the E2 receptors, it's one...
Official Natesto Thread
Data point for anyone interested. Natesto has been the most tolerable form of TRT for me. Typically, I get headaches with other forms. I have also noticed a more forceful heartbeat than normal after injecting. I can even feel it in my abdominal aorta (I know, that sounds really weird). I have...
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...
ANDRODERM® (TDS)
https://www.androderm.com/about-androderm ANDRODERM® (testosterone transdermal system) is designed to deliver testosterone continuously for 24 hours following application to intact, non-scrotal skin (e.g., back, abdomen, thighs, upper arms). Four strengths of ANDRODERM® are available that...
Water retention when I inject @ evening and less when @ morning, ideas why ? - Excel Male TRT Forum
I feel the best emotionally and get the best sleep as close to being natty when I inject ED around 12,5mg Test Prop in the evening prior to bed. Been experimenting for quite some time and indeed there is a very big difference. Wake up full of energy and feel calm during the day. Also this...
Case Study: Absorption of Testosterone Cream via Scrotal Delivery
Case Study: Absorption of Testosterone Cream via Scrotal Delivery. Needham S1, Needham S2. 1Moses Lake Professional Pharmacy, Moses Lake, Washington. 2Alturas Analytics in Moscow, Idaho. Abstract Transdermal testosterone has been used for years to treat patients with low testosterone...
You possess an extraordinary amount of knowledge. If doctors knew even a fraction of what you know...If anything you are getting 2 daily peak/troughs 24/7.
T levels will be much lower before it is time for your second dose (12 hrs after 1st dose) let alone after you take your second dose you will hit a high Cmax 2-4 hrs later than T levels would rapidly decline and will be much lower overnight until your next dose in the early AM.
Even if dosed once daily which no one would do your T levels would be much lower in the evening/throughout the night until your next morning dose.
Many fail to realize that T levels gradually rise overnight reaching peak in the earl AM.
*elevated and near peak TT level during nighttime sleep, peak TT level around the time of morning awakening
*T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
This is key:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
*The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
*As shown in the graphs of Figures 2 and 3, the PK of most FDA-approved PA-TRTs gives rise to TT 24 h patterns that deviate greatly from the normative one thereby failing to satisfy one or more of the five specified criteria.
*AndroGel® 1%, AndroGel® 1.62%, Xyosted®, and Striant®, which achieve relatively constant serum hormone concentration throughout the 24 h, seem to have been incorrectly conceptualized, perhaps because of the presumed necessity to maintain nonvarying, that is, homeostatic, TT concentration to achieve consistency of biological effects.
*The FDA-approved gel and solution PA-TRTs when applied as directed, that is, morning after awakening from nighttime sleep, while achieving TT levels within the normal range to remedy androgen hormone deficiency, fail to restore the normal physiologic TT circadian variation.
*The temporal patterns of these PA-TRTs differ from normal, either in the timing of the peak and/or nadir TT concentrations, by achieving the highest hormone levels generally between midmorning and noon and lowest (rather than near peak) ones during sleep (Figure 2A-2F).
Does Patient-Applied TRT Pose Risk for Blood Pressure Elevation? - Excel Male TRT Forum
Does Patient-Applied Testosterone Replacement Therapy Pose Risk for Blood Pressure Elevation? Circadian Medicine Perspectives (2022) Michael H. Smolensky, Ramon C. Hermida, Linda Sackett-Lundeen, *Ramon G. Hermida-Ayala, and Yong-Jian Geng ABSTRACT We reviewed medication package inserts, US...
*The US Food and Drug Administration (FDA), since the 1950s, has approved several physician-administered injectables and implantable pellets plus 10 unique (nonbiologically similar) patient-applied (PA) transdermal gel, intranasal gel, transdermal solutions, skin patches, buccal tablet, oral capsule, and subcutaneously injected TRTs. Intramuscularly injected and surgically implanted TRTs are administered by healthcare professionals at intervals of several weeks or months, whereas PA transdermal gel and solutions are dosed once daily at the commencement of the activity period, buccal tablet and oral soft gel capsule two times daily at approximately 12 h intervals, intranasal gel three-times daily at approximately 6 to 8 h intervals, and transdermal patch once daily before bedtime. As subsequently discussed, there is a substantial difference in the pharmacokinetics (PK) and attained T 24 h patterning between the 10 different PA-TRTs.
*LH pulses exhibit 24 h temporal patterning; they occur in greater number and higher amplitude during the sleep than wake span, suggesting the involvement of sleep-facilitating or sleep-dependent processes (10, 17, 57, 164, 175–177). Consequently, T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
*Figures 2A-2F depict the TT 24 h pattern achieved by the 6 different solution and gel PA-TRTs, and Figures 3A-3D depict the TT 24 h pattern achieved by the buccal tablet, oral capsule, transdermal patch, and subcutaneously injected PATRTs. There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
AndroGel® 1%, AndroGel® 1.62%, Axiron®, Fortesta®, and Testim® (and its biosimilar Vogelxo®) gel and solution preparations are recommended for application once daily in the morning to attain the highest serum hormone level 2 to 6 h following dosing and lowest, instead of highest, hormone level during sleep, that is, final hours of the 24 h dosing interval (Figure 2A-2E).
The Natesto® gel product applied to each nostril three times daily at approximately equal intervals results in highly variable serum TT concentration during the 24 h, showing three prominent peaks (Cmax), each occurring approximately 40 min after the administrations, and three prominent nadirs (Cmin) of 2 to 4 h duration, each occurring midway through the dosing intervals (Figure 2F).
The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
Xyosted®, a patient subcutaneously injected TRT at weekly intervals, has yet to be rigorously evaluated for its TT day-night pattern. Available data based upon rather infrequent blood sampling indicate Cmax occurs approximately 12 h following each weekly administration and that TT is maintained within the therapeutic range in a relatively stable manner, at least throughout the initial days of the 7-day dosing period (Figure 3C).
*The TT concentration produced by the Androderm® transdermal patch applied to the skin of the back, stomach, upper arms, or thighs nightly before retiring to sleep more closely reproduces the normative TT circadian pattern of young adult males than any of the other marketed PA-TRTs. Following application, TT concentration progressively rises during sleep and peaks around the time of morning awakening; it progressively declines during late morning and afternoon, reaching its nadir (Cmin) in the evening before the next scheduled patch application (Figure 3D).
I have been at this way too long!
A pill that could outsell Viagra: New testosterone Rx drug - Excel Male TRT Forum
https://www.americanbazaaronline.com/2022/10/11/testosterone-drug-kyzatrex-hits-market-451261/ Kyzatrex could be a potential blockbuster to treat testosterone deficiency, a severely undertreated disease. Testosterone has been historically perceived as a lifestyle issue for men who want to...
Who Started TRT w/ "Normal" Levels @ What Age?
It seems that EC works well in increasing testosterone, no questions about it. These numbers look good, however, I don't feel any different and most of the issues I related above remain the same. I can tell you clomid blocks the effects of estrogen by attaching to the E2 receptors, it's one...
Official Natesto Thread
Data point for anyone interested. Natesto has been the most tolerable form of TRT for me. Typically, I get headaches with other forms. I have also noticed a more forceful heartbeat than normal after injecting. I can even feel it in my abdominal aorta (I know, that sounds really weird). I have...
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...
ANDRODERM® (TDS)
https://www.androderm.com/about-androderm ANDRODERM® (testosterone transdermal system) is designed to deliver testosterone continuously for 24 hours following application to intact, non-scrotal skin (e.g., back, abdomen, thighs, upper arms). Four strengths of ANDRODERM® are available that...
Water retention when I inject @ evening and less when @ morning, ideas why ? - Excel Male TRT Forum
I feel the best emotionally and get the best sleep as close to being natty when I inject ED around 12,5mg Test Prop in the evening prior to bed. Been experimenting for quite some time and indeed there is a very big difference. Wake up full of energy and feel calm during the day. Also this...
Case Study: Absorption of Testosterone Cream via Scrotal Delivery
Case Study: Absorption of Testosterone Cream via Scrotal Delivery. Needham S1, Needham S2. 1Moses Lake Professional Pharmacy, Moses Lake, Washington. 2Alturas Analytics in Moscow, Idaho. Abstract Transdermal testosterone has been used for years to treat patients with low testosterone...
My day/night pattern is skewed. My 'peak', based on rise in libido and corresponding erection, occurs around 10 p.m. No nocturnal erections or morning wood. And it doesn't matter when I take my injection.(currently 34 mg EOD at 6 p.m.) This circadian change is due to bipolar illness, since my ability to naturally sleep has disappeared. I've needed medication to sleep for the past 18 years and that isn't even quality sleep.
A once a night erection would be fine if my wife and I slept together but bipolar and her ambivalence about sex put an end to that. She's now 16 months into rapidly progressing Alzheimer's, with me as her sole caregiver. And that's the story.
What is your TRT protocol, Madman?If anything you are getting 2 daily peak/troughs 24/7.
T levels will be much lower before it is time for your second dose (12 hrs after 1st dose) let alone after you take your second dose you will hit a high Cmax 2-4 hrs later than T levels would rapidly decline and will be much lower overnight until your next dose in the early AM.
Even if dosed once daily which no one would do your T levels would be much lower in the evening/throughout the night until your next morning dose.
Many fail to realize that T levels gradually rise overnight reaching peak in the earl AM.
*elevated and near peak TT level during nighttime sleep, peak TT level around the time of morning awakening
*T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
This is key:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by:
(i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
*The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
*The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
*As shown in the graphs of Figures 2 and 3, the PK of most FDA-approved PA-TRTs gives rise to TT 24 h patterns that deviate greatly from the normative one thereby failing to satisfy one or more of the five specified criteria.
*AndroGel® 1%, AndroGel® 1.62%, Xyosted®, and Striant®, which achieve relatively constant serum hormone concentration throughout the 24 h, seem to have been incorrectly conceptualized, perhaps because of the presumed necessity to maintain nonvarying, that is, homeostatic, TT concentration to achieve consistency of biological effects.
*The FDA-approved gel and solution PA-TRTs when applied as directed, that is, morning after awakening from nighttime sleep, while achieving TT levels within the normal range to remedy androgen hormone deficiency, fail to restore the normal physiologic TT circadian variation.
*The temporal patterns of these PA-TRTs differ from normal, either in the timing of the peak and/or nadir TT concentrations, by achieving the highest hormone levels generally between midmorning and noon and lowest (rather than near peak) ones during sleep (Figure 2A-2F).
Does Patient-Applied TRT Pose Risk for Blood Pressure Elevation? - Excel Male TRT Forum
Does Patient-Applied Testosterone Replacement Therapy Pose Risk for Blood Pressure Elevation? Circadian Medicine Perspectives (2022) Michael H. Smolensky, Ramon C. Hermida, Linda Sackett-Lundeen, *Ramon G. Hermida-Ayala, and Yong-Jian Geng ABSTRACT We reviewed medication package inserts, US...
*The US Food and Drug Administration (FDA), since the 1950s, has approved several physician-administered injectables and implantable pellets plus 10 unique (nonbiologically similar) patient-applied (PA) transdermal gel, intranasal gel, transdermal solutions, skin patches, buccal tablet, oral capsule, and subcutaneously injected TRTs. Intramuscularly injected and surgically implanted TRTs are administered by healthcare professionals at intervals of several weeks or months, whereas PA transdermal gel and solutions are dosed once daily at the commencement of the activity period, buccal tablet and oral soft gel capsule two times daily at approximately 12 h intervals, intranasal gel three-times daily at approximately 6 to 8 h intervals, and transdermal patch once daily before bedtime. As subsequently discussed, there is a substantial difference in the pharmacokinetics (PK) and attained T 24 h patterning between the 10 different PA-TRTs.
*LH pulses exhibit 24 h temporal patterning; they occur in greater number and higher amplitude during the sleep than wake span, suggesting the involvement of sleep-facilitating or sleep-dependent processes (10, 17, 57, 164, 175–177). Consequently, T production occurs in the greatest amount during sleep as recurring pulses at approximately 90 min intervals in healthy young males and approximately 140 min in healthy middle-aged males (91).
*Figures 2A-2F depict the TT 24 h pattern achieved by the 6 different solution and gel PA-TRTs, and Figures 3A-3D depict the TT 24 h pattern achieved by the buccal tablet, oral capsule, transdermal patch, and subcutaneously injected PATRTs. There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.
AndroGel® 1%, AndroGel® 1.62%, Axiron®, Fortesta®, and Testim® (and its biosimilar Vogelxo®) gel and solution preparations are recommended for application once daily in the morning to attain the highest serum hormone level 2 to 6 h following dosing and lowest, instead of highest, hormone level during sleep, that is, final hours of the 24 h dosing interval (Figure 2A-2E).
The Natesto® gel product applied to each nostril three times daily at approximately equal intervals results in highly variable serum TT concentration during the 24 h, showing three prominent peaks (Cmax), each occurring approximately 40 min after the administrations, and three prominent nadirs (Cmin) of 2 to 4 h duration, each occurring midway through the dosing intervals (Figure 2F).
The serum TT concentration generated by the Striant® mucoadhesive buccal tablet system applied to the upper gum above the incisor of either side of the mouth twice daily at equal intervals displays 12 h-like patterning, with the Cmax following closely after each application and the overall 24 h Cmin occurring during sleep (Figure 3A).
The Jatenzo® oral soft gel capsule formulation ingested twice daily at equal intervals also gives rise to variable TT levels of distinct 12 h patterning, with prominent Cmax following 2 to 4 h after each ingestion and rapidly declining levels thereafter (Figure 3B).
Xyosted®, a patient subcutaneously injected TRT at weekly intervals, has yet to be rigorously evaluated for its TT day-night pattern. Available data based upon rather infrequent blood sampling indicate Cmax occurs approximately 12 h following each weekly administration and that TT is maintained within the therapeutic range in a relatively stable manner, at least throughout the initial days of the 7-day dosing period (Figure 3C).
*The TT concentration produced by the Androderm® transdermal patch applied to the skin of the back, stomach, upper arms, or thighs nightly before retiring to sleep more closely reproduces the normative TT circadian pattern of young adult males than any of the other marketed PA-TRTs. Following application, TT concentration progressively rises during sleep and peaks around the time of morning awakening; it progressively declines during late morning and afternoon, reaching its nadir (Cmin) in the evening before the next scheduled patch application (Figure 3D).
I have been at this way too long!
A pill that could outsell Viagra: New testosterone Rx drug - Excel Male TRT Forum
https://www.americanbazaaronline.com/2022/10/11/testosterone-drug-kyzatrex-hits-market-451261/ Kyzatrex could be a potential blockbuster to treat testosterone deficiency, a severely undertreated disease. Testosterone has been historically perceived as a lifestyle issue for men who want to...
Who Started TRT w/ "Normal" Levels @ What Age?
It seems that EC works well in increasing testosterone, no questions about it. These numbers look good, however, I don't feel any different and most of the issues I related above remain the same. I can tell you clomid blocks the effects of estrogen by attaching to the E2 receptors, it's one...
Official Natesto Thread
Data point for anyone interested. Natesto has been the most tolerable form of TRT for me. Typically, I get headaches with other forms. I have also noticed a more forceful heartbeat than normal after injecting. I can even feel it in my abdominal aorta (I know, that sounds really weird). I have...
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...
ANDRODERM® (TDS)
https://www.androderm.com/about-androderm ANDRODERM® (testosterone transdermal system) is designed to deliver testosterone continuously for 24 hours following application to intact, non-scrotal skin (e.g., back, abdomen, thighs, upper arms). Four strengths of ANDRODERM® are available that...
Water retention when I inject @ evening and less when @ morning, ideas why ? - Excel Male TRT Forum
I feel the best emotionally and get the best sleep as close to being natty when I inject ED around 12,5mg Test Prop in the evening prior to bed. Been experimenting for quite some time and indeed there is a very big difference. Wake up full of energy and feel calm during the day. Also this...
Case Study: Absorption of Testosterone Cream via Scrotal Delivery
Case Study: Absorption of Testosterone Cream via Scrotal Delivery. Needham S1, Needham S2. 1Moses Lake Professional Pharmacy, Moses Lake, Washington. 2Alturas Analytics in Moscow, Idaho. Abstract Transdermal testosterone has been used for years to treat patients with low testosterone...
I’ve been on TRT for about 7 years. No regrets.
I’ve tried enanthate, cypionate, cream, and propionate and like them in roughly that order. Tried just about every injection protocol too, eventually settling on EOD enanthate.
If I have any complaints, it’s that I’m jealous of the guys that benefit from low doses and normal levels. I find that I don’t get much benefit from TRT until my levels are in the upper part of the range or higher, and what goes with that are side effects like poor sleep and some acne.
Be aware that if you choose to try it, you will likely feel fantastic for a few days immediately upon starting. That is a dopamine response and is not indicative of how you’ll feel on TRT long term.
Also know that there is very little risk in trying it out. So many guys think that if you try it, you’re “stuck on it for life”. Using sensible doses, you could try it out for a few months then very likely go right back to your natural levels if you decide it’s not for you.
I’ve tried enanthate, cypionate, cream, and propionate and like them in roughly that order. Tried just about every injection protocol too, eventually settling on EOD enanthate.
If I have any complaints, it’s that I’m jealous of the guys that benefit from low doses and normal levels. I find that I don’t get much benefit from TRT until my levels are in the upper part of the range or higher, and what goes with that are side effects like poor sleep and some acne.
Be aware that if you choose to try it, you will likely feel fantastic for a few days immediately upon starting. That is a dopamine response and is not indicative of how you’ll feel on TRT long term.
Also know that there is very little risk in trying it out. So many guys think that if you try it, you’re “stuck on it for life”. Using sensible doses, you could try it out for a few months then very likely go right back to your natural levels if you decide it’s not for you.
Certainly give it a try! If it doesn’t work for you then stop and you will quickly go back to baseline. I’ve been on TRT for about 10 years, and following this forum 3 years. One factor to consider when reading other people’s experiences here is that many of them are taking way more T than what is considered normal. When it comes to T I found that more is not better! More does not give you more libido, but it will give you elevated red blood cell counts, acne,and a short temper. The only positive is more muscle mass and definition, but in my opinion that’s not worth the long list of negative side effects. I inject 40 mg twice a week and all systems are go. I added HCG a few months ago to see if my testicles would come back, and that worked. The hcg may have also presented an uptick in my libido, which was already very good. So try TRT, but go in baby steps, and do regular labs. You don’t need total T of 1500+ when everything works better at 750.
tropicaldaze1950
Well-Known Member
How much EOD?
36mg (126mg/wk)
Similar threads
Share this page
Sponsors
Online statistics
- Members online
- 3
- Guests online
- 537
- Total visitors
- 540
Latest posts
-
-
-
-
-
-
-
-
-
-
-
Is it possible to get a prescription for test these days?
- Latest: tropicaldaze1950
