This one sounds like an absorption issue, analogous to what's seen with lower-concentration topical products. Any true acclimatization or adaptation would be related to the modest HPTA suppression. I mentioned up front that Natesto seems less sustainable than troches, with anecdotes pointing to unpleasantness and perhaps reduced absorption over time as nasal tissue gets more irritated.
This also sounds like diminishing absorption. Serum levels were not very impressive.
That's a hefty dose, almost certainly suppressive, suggesting very low troughs with resulting issues.
This is a different animal. Scrotal cream is long-acting, implying full suppression. Absorption would only be an issue with lower-concentration products. Most guys on high-concentration products are using way too much, and it is reflected in serum testosterone and DHT.
He doesn't know what he's talking about. He's conflating this delivery method with older,
oral alkylated forms of testosterone.
No "fade pattern" is expected if you have consistent absorption of ~1 mg 2-3 times daily. Side effects of higher doses might be misinterpreted as such. Aside from HPTA suppression, if you're absorbing say 5 mg of testosterone in the space of a few minutes then you're likely experiencing extremely high, non-physiological serum levels, which could have negative consequences even if the duration is not long. I recall trying buccal absorption of sildenafil a few times and it was a guaranteed way to induce side effects when the dose wasn't scaled down appropriately.
I expect that properly-titrated buccal troches are likely to be sustainable indefinitely. The caveat is that solid research is lacking. A lingering concern I have is that they might be too fast-acting. If so then this would point to the need for smaller and more frequent doses.
As mentioned above, oral testosterone (capsules) is in between; somewhat more suppressive but easier to sustain.
I have been researching better alternatives. I had hopes that testosterone suspension would provide fast-acting results with the precision of injections. I have had great results with the protocol, but unfortunately suspension does not appear to be truly fast-acting. Instead it behaves as though it has both short- and long-acting components. It is less suppressive than any other injectable product I've tried, yet it is likely still much more suppressive than nasal gels or troches.
I also developed a water-based testosterone solution for injection. In theory it could be fast-acting, but the subjective results were not immediately promising. That could have been due to insufficient time for HPTA recovery. But it has deterred me from pursuing it for the moment.
There's lots of discussion in this thread:
I think if you get beyond a honeymoon / stabilization period of a few weeks then results should be sustainable. Unfortunately there are no clear-cut rules for titration. You'd have to rely on test results and how you feel.
The rub is that very few men are attempting to use troches as a Natesto substitute. The data just isn't there.
I believe the real issue is whether the desired amount of fast-acting testosterone can be absorbed consistently. There's no other reason for benefits to be lost after a stabilization period. In contrast, I suspect that some side effects of HPTA shutdown can emerge over a prolonged period, leading to a lot of confusion and unhappiness.
