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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Natesto: large shards UPDATE- batch is all bad.
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<blockquote data-quote="trax123" data-source="post: 278733" data-attributes="member: 46508"><p>My urologist seems to just order it for $30/each directly from Empower? They claim to have done this for other pts? I don't actually know anything about Defy.</p><p></p><p>Re: [USER=45577]@granger[/USER] lol yeah probably. Interesting that you had higher residual levels like that - I still think the nasal route (nevermind crystals) leads to very uneven absorption from anatomy, spreading of the gel, moisture, how much of it you swallow, etc. it's a good concept but perhaps meh in practice. And yeah I'm sort of suspecting that people online seem to be selected for hypersensitivity. I remember patients (I'm still shocked to think about AAS users!) who would take massive doses of T while on 3 other drugs and never seemed to have any adverse effects (on short time scales anyway). </p><p></p><p>It makes sense too - millions of prescriptions... if you have no adverse effects you're a lot less likely to go discuss on a forum.</p><p></p><p>**I've also more or less confirmed significant numbers of anecdotal reports (including on here) of palpitations and ectopic heartbeats (flutter, skipped beats, stronger beats, variants) usually a few weeks after starting TRT (including IM and gel modalities). This is fascinating because it appears in almost none of the trials, in the writeups, or even on many of the inserts (which usually list all manner of bizarre freak possibilities), and yet its OBVIOUSLY common enough.</p><p></p><p>Even more interesting (and contra basically every medical book or physician I've asked), pts confirm that combining TRT with any vasodilators (like tadalafil) will absolutely worsen palpitations and tachycardia, which is what I assumed happened to me. It also makes perfect physiological sense at a high-school biology level so I'm incensed that all professional clinical sources claim the drugs don't interact which is nonsense. </p><p></p><p>Another interesting finding I surfaced from anecdotes (and I think I can add myself) is that TRT may potentiate the effects of epinephrine and caffeine - so basically could become more sensitive to caffeine re cardiac; I believe that ALSO happened to me. </p><p></p><p>Many report (I was on Reddit... lol) that sometimes lowering the dose helps resolve cardiac s/s, other times not. Some also note it 'fades' as treatment progresses. A surprising number went through the exact process as me - going to cardiology, finding nothing (couldn't even catch an ectopic beat on a Holter monitor in most cases), restarting TRT... and then getting it again and not sure if they should continue.</p><p></p><p>I do wonder if an oral modality (TU Jatenzo/Tlando), despite some possible BP (+/- even more theoretical liver issues) provides a cleaner consistent dosing regime and perhaps helps with cardiac s/s. I have NOT seen any reports of palpitations on the PO route interestingly enough, though it doesn't seem very popular either. It will suppress LSH/FH a LOT more than the nasal gel, but interestingly enough I wonder if in borderline hypogonadal pts (like me) that could actually be GOOD in that instead of randomly potentiating baseline production (recall changes in E2 endogenous plus E2 via aromatase are well-known causes of arrythmias/palps) you basically hand over T levels much more to the drug potentially reducing the spiking not of T (PO data still show similar but longer half life spikes as nasal gel) but of E2, which - IF it were true - could explain why PO TRT in theory could be better for cardiac s/s sensitivity. </p><p></p><p>***Also a note - this site's founder I think was reviewing the two big long-term TRT studies and one of them DID find arrhymias were significantly higher in the TRT treated population long-term... which isn't great... but I'd also caveat that many of those patients had varying levels of cardiac disease so it wasn't well designed to detect an effect.</p></blockquote><p></p>
[QUOTE="trax123, post: 278733, member: 46508"] My urologist seems to just order it for $30/each directly from Empower? They claim to have done this for other pts? I don't actually know anything about Defy. Re: [USER=45577]@granger[/USER] lol yeah probably. Interesting that you had higher residual levels like that - I still think the nasal route (nevermind crystals) leads to very uneven absorption from anatomy, spreading of the gel, moisture, how much of it you swallow, etc. it's a good concept but perhaps meh in practice. And yeah I'm sort of suspecting that people online seem to be selected for hypersensitivity. I remember patients (I'm still shocked to think about AAS users!) who would take massive doses of T while on 3 other drugs and never seemed to have any adverse effects (on short time scales anyway). It makes sense too - millions of prescriptions... if you have no adverse effects you're a lot less likely to go discuss on a forum. **I've also more or less confirmed significant numbers of anecdotal reports (including on here) of palpitations and ectopic heartbeats (flutter, skipped beats, stronger beats, variants) usually a few weeks after starting TRT (including IM and gel modalities). This is fascinating because it appears in almost none of the trials, in the writeups, or even on many of the inserts (which usually list all manner of bizarre freak possibilities), and yet its OBVIOUSLY common enough. Even more interesting (and contra basically every medical book or physician I've asked), pts confirm that combining TRT with any vasodilators (like tadalafil) will absolutely worsen palpitations and tachycardia, which is what I assumed happened to me. It also makes perfect physiological sense at a high-school biology level so I'm incensed that all professional clinical sources claim the drugs don't interact which is nonsense. Another interesting finding I surfaced from anecdotes (and I think I can add myself) is that TRT may potentiate the effects of epinephrine and caffeine - so basically could become more sensitive to caffeine re cardiac; I believe that ALSO happened to me. Many report (I was on Reddit... lol) that sometimes lowering the dose helps resolve cardiac s/s, other times not. Some also note it 'fades' as treatment progresses. A surprising number went through the exact process as me - going to cardiology, finding nothing (couldn't even catch an ectopic beat on a Holter monitor in most cases), restarting TRT... and then getting it again and not sure if they should continue. I do wonder if an oral modality (TU Jatenzo/Tlando), despite some possible BP (+/- even more theoretical liver issues) provides a cleaner consistent dosing regime and perhaps helps with cardiac s/s. I have NOT seen any reports of palpitations on the PO route interestingly enough, though it doesn't seem very popular either. It will suppress LSH/FH a LOT more than the nasal gel, but interestingly enough I wonder if in borderline hypogonadal pts (like me) that could actually be GOOD in that instead of randomly potentiating baseline production (recall changes in E2 endogenous plus E2 via aromatase are well-known causes of arrythmias/palps) you basically hand over T levels much more to the drug potentially reducing the spiking not of T (PO data still show similar but longer half life spikes as nasal gel) but of E2, which - IF it were true - could explain why PO TRT in theory could be better for cardiac s/s sensitivity. ***Also a note - this site's founder I think was reviewing the two big long-term TRT studies and one of them DID find arrhymias were significantly higher in the TRT treated population long-term... which isn't great... but I'd also caveat that many of those patients had varying levels of cardiac disease so it wasn't well designed to detect an effect. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Natesto: large shards UPDATE- batch is all bad.
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