Support natural T instead of replacing?

[Tintin]

Hi guys,

I'm reaching out because I read about Natesto. It's a testosterone gel applied inside the nose, and supposedly it doesn't shut down natural T production. That's what I want. It's a little pricey, though, at roughly $400/m. Does anyone know what kind of testosterone is used in the gel? Right now, I'm guessing the shutdown doesn't happen because Natesto is applied 2-3 times per day - i.e., a smaller dose at a time. If that's what it takes to raise T and feel better without worrying about the side effects of shutting down natural T production, why not apply a 20% compounded testosterone cream 2-3 times per day instead? Shouldn't that produce the same effect with much less cost? It's more inconvenient, but personally, I wouldn't mind having a reminder on my phone and an applicator with me. Go to the bathroom, apply cream, wash hands, and that's it. Has anyone tried this?

Martin

 

[Vince]

Cream will completely shut down your T production. Natesto will not.

 

[Cataceous]

There's only one kind of testosterone, but perhaps you're asking if it has an ester attached in the Natesto product. The answer is no; it is pure testosterone. HPTA shutdown is reduced in part by the limited number of applications, but more importantly by the short duration of action. After an application, serum testosterone peaks within an hour and then drops relatively quickly, allowing significant time at lower levels before the next dose.

Transdermal products cause more HPTA suppression due to considerably longer half-lives. The skin acts as a reservoir for testosterone, releasing it slowly over many hours. Thus serum testosterone levels remain too high for too long to allow normal HPTA function.

Empower Pharmacy offers a testosterone nasal gel product that's supposed to be similar to Natesto and is less expensive. You should investigate this option. Currently the nasal gels are the only testosterone products known to minimize HPTA suppression.

 

[Tintin]

Thank you, that's exactly the information I was looking for. I didn't know the skin works as a buffer. I will contact Empower Pharmacy for pricing. I hope they are willing to ship internationally. Not sure how to get a prescription as I'm not a US citizen. How does that usually work?

 

[Systemlord]

worrying about the side effects of shutting down natural T production,

Most guys don't have issues even after several years and even decades. For the record on TRT you're not 100 percent shutdown as far as LH and FSH are concerned, that takes many decades.

 

[Tintin]

Most guys don't have issues even after several years and even decades. For the record on TRT you're not 100 percent shutdown as far as LH and FSH are concerned, that takes many decades.

It's a good point. 'Shut down' is commonly used in relation to the HPTA on TRT, but perhaps suppression is more accurate. I prefer as little suppression as possible. My main concerns are preserving fertility and minimizing estrogen issues to the extent it's possible. I'm also considering a transdermal cream, possibly combined with a bi- or tri-daily injection of HCG. Insulin needles are as far as I'm willing to go when it comes to injections. I noticed you are on Jatenzo. Those are testosterone pills as far as I know. How is that working out for you?

 

[Tintin]

Most guys don't have issues even after several years and even decades. For the record on TRT you're not 100 percent shutdown as far as LH and FSH are concerned, that takes many decades.

What made you decide to go with oral T?

 

[Cataceous]

.... I will contact Empower Pharmacy for pricing. I hope they are willing to ship internationally. Not sure how to get a prescription as I'm not a US citizen. How does that usually work?

Since you're not in the U.S. it seems unlikely you will be able to obtain Empower's product. The governing laws are draconian.

I think preserving HPTA function is a worthy goal. Just because many seem to do ok with suppression does not mean it's necessarily benign. Something like 20 or more other hormones can be disrupted by standard testosterone replacement therapy.

We typically see almost complete suppression with testosterone injections, and after only a month or two. There can be a little less suppression with oral and transdermal TRT due to lower serum testosterone and more intra-day variability.

 

[Systemlord]

I noticed you are on Jatenzo. Those are testosterone pills as far as I know. How is that working out for you?

I'm responding very well to Jatenzo! The best possible outcome.

 

[Systemlord]

What made you decide to go with oral T?

I started out with injections one to two times weekly, I had no response, no anabolic effects whatsoever.

As I moved injections closer together where I did start responding, I had some life threatening complications that I couldn't find out how to resolve.

I have concluded that the half-life is a problem, it's too long and produced too flat a hormone profile.

I didn't absord gels and creams, so Jatenzo was my last hope. I started responding to the first dose and felt steady at 7 days.

 

[sammmy]

If you don't have access to a natesto nasal formulation, you may experiment with a testosterone gel applied in your nose or between your gum and cheek (and don't swallow as long as possible). The gel has alcohol in it though so it will burn, especially in the nose, and I am not sure what levels are achieved with just a 10-20 mins hold in your mouth. You won't be able to hold it longer due to saliva pooling.

 

[Guided_by_Voices]

Since you're outside the US, perhaps you have access pure injectable T (Testosterone No Ester, TNE). I assume that would require a much smaller dosage since you wouldn't have the loss that may occur in transdermal applications, but perhaps you could find a dosage that works for you.

 

[Tintin]

Since you're not in the U.S. it seems unlikely you will be able to obtain Empower's product. The governing laws are draconian.

I think preserving HPTA function is a worthy goal. Just because many seem to do ok with suppression does not mean it's necessarily benign. Something like 20 or more other hormones can be disrupted by standard testosterone replacement therapy.

We typically see almost complete suppression with testosterone injections, and after only a month or two. There can be a little less suppression with oral and transdermal TRT due to lower serum testosterone and more intra-day variability.

You're right. Here's what Empower replied:

'Empower Pharmacy is only licensed to dispense medication to the 50 United States. We are not allowed to ship our medications outside of the United States.'

Fortunately, I have a good friend in the US. I think I can make it work.

I agree with you on preserving HPTA function. To me, it's a great leap of faith to strongly suppress a system that is nothing short of brilliant and amazingly complex. As much as possible, I want to work with what I already have. I have been very stressed for years, and what I'm looking for is a pick-me-up to help me recover much faster and get out of this hole I find myself in. As I destress and recover, I'll gradually lower the amount of testosterone I supplement with. At least, that's the plan. Of course, I understand completely that some men need closer to replacement. At the moment, though, I have faith I can eventually feel great with less. I'm especially going to focus on building ass and legs. According to a coach I worked with for a while, there's strong correlation between lower body development and natural testosterone levels. He's well informed on the science so I trust is will pay off.

 

[Tintin]

I started out with injections one to two times weekly, I had no response, no anabolic effects whatsoever.

As I moved injections closer together where I did start responding, I had some life threatening complications that I couldn't find out how to resolve.

I have concluded that the half-life is a problem, it's too long and produced too flat a hormone profile.

I didn't absord gels and creams, so Jatenzo was my last hope. I started responding to the first dose and felt steady at 7 days.

That's incredibly brave of you to keep trying even after such adversity. If testosterone in the nose for some reason doesn't work for me, and I'm forced to try a different administration route, I will seriously consider an oral. It's so convenient, and you don't have to worry about rubbing the cream off on anyone. What is the impact on the liver? As I understand, if the ingested testosterone is methylated, it's hard on the liver. Are you experiencing any side effects?

 

[Tintin]

Since you're outside the US, perhaps you have access pure injectable T (Testosterone No Ester, TNE). I assume that would require a much smaller dosage since you wouldn't have the loss that may occur in transdermal applications, but perhaps you could find a dosage that works for you.

It's an interesting idea. TNE, is that what's used in testosterone suspension? It's quite painful, but it could be because of the amount and the size of the needle. It may be possible to use less and use a small needle several times per day, but for me personally, it's too much jabbing.

 

[Tintin]

If you don't have access to a natesto nasal formulation, you may experiment with a testosterone gel applied in your nose or between your gum and cheek (and don't swallow as long as possible). The gel has alcohol in it though so it will burn, especially in the nose, and I am not sure what levels are achieved with just a 10-20 mins hold in your mouth. You won't be able to hold it longer due to saliva pooling.

That's a creative idea. Perhaps I could find a local compounding pharmacy and ask them to create a gel with pure testosterone. What I'm unsure of is whether Natesto has added an agent to improve transdermal delivery, but it's worth a try. The biggest challenge I see with the long-term use of a nose gel is maintaining the integrity of the inside of the nose. I expect some TLC of my nose cavity between applications will be necessary. If I know the absorption happens in a couple of hours, I hope to be able to wash the remaining gel out of the nose to give the skin in the nose a chance to rest before the next application. Personally, I know alcohol is going to be prohibitive to long-term use. I'm sure I would get nosebleeds and snore like an angry lion.

 

[sammmy]

As I destress and recover, I'll gradually lower the amount of testosterone I supplement with. At least, that's the plan. Of course, I understand completely that some men need closer to replacement. At the moment, though, I have faith I can eventually feel great with less. I'm especially going to focus on building ass and legs. According to a coach I worked with for a while, there's strong correlation between lower body development and natural testosterone levels. He's well informed on the science so I trust is will pay off.

You don't supplement with testosterone, it replaces your natural or missing testosterone. Even Natesto will shut down partially your natural production, the part that it is replacing for. For a brief "honeymoon period" you may have super high levels of natural + external testosterone but then the body will start decreasing natural production.

Your plan is unrealistic:

• taking a little testosterone or a little anabolic steroid will shut you down enough so that the effect on your physique will be minimal - I've done anavar and transdermal and that was my conclusion
• after you stop taking T or anabols, you will revert to your previous state. You won't "keep the gains" without having high T levels.
• going on full blown TRT to replace your natural testosterone entirely will not achieve a big change, unless you were severely low on testosterone before TRT. Otherwise you are just replacing natural T with external T within physiological range.
• bodybuilders use super high amounts of T combined with anabolic steroids and suffer all kinds of side effects

 

[Tintin]

You don't supplement with testosterone, it replaces your natural or missing testosterone. Even Natesto will shut down partially your natural production, the part that it is replacing for. For a brief "honeymoon period" you may have super high levels of natural + external testosterone but then the body will start decreasing natural production.

Your plan is unrealistic:

• taking a little testosterone or a little anabolic steroid will shut you down enough so that the effect on your physique will be minimal - I've done anavar and transdermal and that was my conclusion
• after you stop taking T or anabols, you will revert to your previous state. You won't "keep the gains" without having high T levels.
• going on full blown TRT to replace your natural testosterone entirely will not achieve a big change, unless you were severely low on testosterone before TRT. Otherwise you are just replacing natural T with external T within physiological range.
• bodybuilders use super high amounts of T combined with anabolic steroids and suffer all kinds of side effects

It's an interesting perspective. I had the idea to cycle on and off nasal testosterone after watching this video where Leo and Lucy discuss supplementing with testosterone during difficult life circumstances:

YouTube search on Natesto lead me to this video:

I have gained almost 40 pounds since December 2021. My total T was around 350 when I was leaner, and interestingly, my free T was comparable to that of my personal trainer at the time, even though his total T was around 1000 naturally. Getting leaner has an enormous impact on my well-being and my sexual health. Right now, though, I struggle mightily to lose weight. It's really slow going, and my motivation and focus are poor. Fortunately, I'm not depressed, and I'm probably much better off than other men. Nevertheless, since men report an almost immediate effect on Natesto, I thought I could take it for a month to get myself going and establish a regular training routine. My hope is it will help me lose weight faster and make effort feel better. It might also preserve muscle as I lose fat. Then I don't mind stopping for a month to let my hormone system reset or possibly support it in other ways indirectly with supplements. It's possible that the risk is not worth the reward, but to me, it seems a month of use is an acceptable risk.

I was recommended enclomiphene citrate because it generally has fewer side effects compared to clomiphene, and I tried it a couple of months ago. 12.5 mg per day. The timing was bad, though, because I had peak stress. Unfortunately, my LH, free testosterone, T3, adrenaline, and noradrenaline shot outside the normal ranges. That was after just two weeks of use. It did give me insight into the difference in how I feel with higher testosterone, even despite stress hormones being higher than normal. I hammered out work on the computer and wanted more. It felt easy. I started having morning erections again. I felt more resilient. I also learned that my testies have the potential to produce enough testosterone to make me feel good. So, if I can have some of that without the increase in stress hormones, I welcome it. I may consider also using enclomiphene in a cyclic manner as well as I didn't experience any side effects aside from those coming from increased adrenaline and noradrenaline. For example, 6 mg first 2-3 days of the week for four weeks, then two weeks off. It has a long tail, and again I would give my system a break. I would also dial caffeine intake way down while taking the enclomiphene citrate. And definitely do weekly or bi-weekly blood tests.

 

[CKO]

If you try enclomiphene again, consider using it ever other day or twice a week. Most of us who had side effects from it were dosing daily. The side effects are most likely due to it binding to estrogen receptors and continually acting on them.

 

[Tintin]

If you try enclomiphene again, consider using it ever other day or twice a week. Most of us who had side effects from it were dosing daily. The side effects are most likely due to it binding to estrogen receptors and continually acting on them.

Thanks for the tip. I can see it as a valuable tool if used the right way. Based on what you are saying, I would try Monday and Wednesday, then nothing for the rest of the week. Are you using enclomiphene regularly?