Best TRT administration. Injectable vs Oral

[MyoPhilosopher]

Hi everyone,

I am helping a family member start TRT.
The doctor seems to be a fan of oral undecanoate.

Personally, I do not understand the reasoning.
From my experience and reading, administering test cypionate/enanthate a couple of times a week subcutaneously seems superior.

Does anyone have any experience with oral undecanoate. I feel like it should be avoided at all cost for men.
Sometimes it is frustrating asking such questions when doctors are "set in their ways".

Thanks in advance

 

[trtthings]

Honestly I thought the biggest problems with the orals was the liver. And to avoid that one might prefer gels or injections.

 

[madman]

Hi everyone,

I am helping a family member start TRT.
The doctor seems to be a fan of oral undecanoate.

Personally, I do not understand the reasoning.
From my experience and reading, administering test cypionate/enanthate a couple of times a week subcutaneously seems superior.

Does anyone have any experience with oral undecanoate. I feel like it should be avoided at all cost for men.
Sometimes it is frustrating asking such questions when doctors are "set in their ways".

Thanks in advance

Many doctors are uninformed when it comes to treating men for low-t let alone tend to be dead set on achieving mid-normal physiological levels.

Sticklers for prescribing big pharma transdermal (Androgel), intranasal (Natesto), or the newly approved oral testosterone undecanoate (Jatenzo) and the ones who tend to be brave and prescribe injectable esterified-T use those outdated stone-aged protocols (200 mg every 2 weeks).

If you get lucky you may even get one who prescribes injectable esterified T such as Xyosted (once weekly).....whoopee!

The goal of trt is to replace physiological levels through the use of exogenous T which results in relief/improvement of low-t symptoms and increased overall well-being while at the same time avoiding/minimizing and potential side-effects and keeping blood markers healthy long-term.

In order to achieve such healthy TT/FT levels are needed and depending on the individual some may do well with average TT/FT levels whereas others may need higher levels.

Many will not see improvement of symptoms until high enough TT/FT levels are achieved.

Although one can achieve higher T levels when using transdermal gels the doses needed are much higher when using big pharma brands as they are low strength and even then many can still have absorption issues.

Most would end up switching over to compounded T which are much higher strength.

Absorption when using transdermal is 9-14% at best.

Some end up using transdermal creams (scrotal application) as absorption is much higher.

Even then most are using injectable esterified T (cypionate or enanthate).

Very effective for attaining high T levels let alone a cost-effective method for treatment.

Forget the oral TU and tell your friend to convince his doctor to prescribe injections.

Otherwise, look into finding a reputable clinic.

 

[madman]

Honestly I thought the biggest problems with the orals was the liver. And to avoid that one might prefer gels or injections.

This would only be with orals that are c-17 alpha-alkylated (resistant to first-pass hepatic metabolism) such as methyltestosterone, anavar, stanozolol, methandrostenolone, oxymetholone, and fluoxymesterone.

Of those listed above, only 2 were prescribed for trt in men.

Methyltestosterone was the most commonly used oral for decades and in some cases, fluoxymesterone had been used but they are no longer in use due to possible liver toxicity and we have many safer options now.

These were replaced by non-17-alpha alkylated oral TU (testosterone undecanoate). The older formulation of TU (T-ester that is absorbed via the intestinal lymphatic system thus bypassing the portal circulation) replaced the c-17 alpha-alkylated orals.

The downfall of the older formulations was high amounts of dietary fat needed to be taken with the capsule to improve absorption which unfortunately resulted in significant variability in patients serum T level

They were again reformulated to try and reduce the effect of dietary fat but the low dose of TU in the capsule required the patient to take several capsules (3 or more daily) and even then some men were not able to achieve average T levels in the normal range.

Recently with the FDA approval of oral TU (Jatenzo) in the US the absorption issues of past formulations are no longer the case as TU was formulated in a unique self-emulsifying drug delivery system which allows the capsule to be absorbed when taken with food without the addition of high dietary fat but again, unfortunately, the main downfall is the blood levels achieved are modest at best.

 

[trtthings]

This would only be with orals that are c-17 alpha-alkylated (resistant to first-pass hepatic metabolism) such as methyltestosterone, anavar, stanozolol, methandrostenolone, oxymetholone, and fluoxymesterone.

Of those listed above, only 2 were prescribed for trt in men.

Methyltestosterone was the most commonly used oral for decades and in some cases, fluoxymesterone had been used but they are no longer in use due to possible liver toxicity and we have many safer options now.

These were replaced by non-17-alpha alkylated oral TU (testosterone undecanoate). The older formulation of TU (T-ester that is absorbed via the intestinal lymphatic system thus bypassing the portal circulation) replaced the c-17 alpha-alkylated orals.

The downfall of the older formulations was high amounts of dietary fat needed to be taken with the capsule to improve absorption which unfortunately resulted in significant variability in patients serum T level

They were again reformulated to try and reduce the effect of dietary fat but the low dose of TU in the capsule required the patient to take several capsules (3 or more daily) and even then some men were not able to achieve average T levels in the normal range.

Recently with the FDA approval of oral TU (Jatenzo) in the US the absorption issues of past formulations are no longer the case as TU was formulated in a unique self-emulsifying drug delivery system which allows the capsule to be absorbed when taken with food without the addition of high dietary fat but again, unfortunately, the main downfall is the blood levels achieved are modest at best.

Ahh okay, very enlightening. I wonder if they'll work on making it more efficient but I feel like maybe they're content with modest levels. Is this not something that can be improved by increasing the dose?

 

[madman]

Ahh okay, very enlightening. I wonder if they'll work on making it more efficient but I feel like maybe they're content with modest levels. Is this not something that can be improved by increasing the dose?

The minimum recommended dose is 158 mg twice daily. The maximum recommended dose is 396 mg (two 198 mg capsules) twice daily.

Depending on the individual and how they react to such dose high peak levels can be achieved but they are short-lived as levels start to decline soon after and can reach very low levels before the next dose as it needs to be taken twice daily.

You could increase the dose beyond the maximum recommended dose and drive levels up further but again the peak is short-lived as levels start to decline soon after let alone it needs to be taken twice daily.

Injectable esterified-T is the way to go if you are looking to achieve higher levels 24/7.

No no would waste their time trying to achieve very high levels with Jatenzo let alone the goal is to achieve T levels within the physiological range resulting in relief/improvement of low-t symptoms with the use of oral TU.

Jatenzo, an Oral Testosterone Replacement Therapy

Clarus Therapeutics Announces Commercial Launch and Availability of JATENZO® (testosterone undecanoate) capsules, CIII for the Treatment of Hypogonadism Clarus Therapeutics Announces Commercial Launch and Availability of JATENZO® (testosterone undecanoate) capsules, CIII for the Treatment of...

www.excelmale.com

 

[trtthings]

evels can be achieved but they are short-lived as levels start to decline soon after and can reach very low levels before the next dose as it needs to be taken twice daily.

You could increase the dose beyond the maximum recommended dose and drive levels up further but again the peak is short-lived as levels start to decline soon after let alone it needs to be taken twice daily.

Injectable esterified-T is the way to go if you are looking to achieve higher levels 24/7.

No no would waste their time trying to achieve very high levels with Jatenzo let alone the goal is to achieve T levels within the physiological range resulting in relief/improvement of low-t symptoms with the use of oral TU.

Thanks madman. It's my understanding that gel is similar in this regard right? It can peak early but then drifts off. I think I could use the stable mid-high levels 24/7 achieved by injections, am currently on the gel.