Importance of meals on oral testosterone undecanoate

[firefighterinNC]

Just checking for feedback for those that are on any of the oral TU. How important is what you eat with the medication for you? Have you had your labs checked while eating and dosed with healthy fat? I searched for this on here and it's not commonly discussed. My doctor and I have reverted back to oral TU and he says it's absolutely imperative I take it with food.

Feedback is welcome

 

[Vince]

Just checking for feedback for those that are on any of the oral TU. How important is what you eat with the medication for you? Have you had your labs checked while eating and dosed with healthy fat? I searched for this on here and it's not commonly discussed. My doctor and I have reverted back to oral TU and he says it's absolutely imperative I take it with food.

Feedback is welcome

I agree. Oral testosterone must be taken with a high fat meal, otherwise it will not be absorbed properly.

Usually with breakfast and dinner.

 

[madman]

Just checking for feedback for those that are on any of the oral TU. How important is what you eat with the medication for you? Have you had your labs checked while eating and dosed with healthy fat? I searched for this on here and it's not commonly discussed. My doctor and I have reverted back to oral TU and he says it's absolutely imperative I take it with food.

Feedback is welcome

As I already stated it needs to be taken with a small meal or snack that has some fat.

Again make it a priority to take each dose with a small meal that has some fat as this can easily make or break the effectiveness of the protocol.

Post in thread 'Where can I find Kyzatrex? Low cost options'

Jan 3, 2026

Nice congrats on retirement!

I'd say undoubtedly the hardest thing for me is taking it with food, my doctor who prescribed it said I'm not doing myself any good at all if i don't take it with food. So my best guess is it has to have food for absorption somehow. To me that's rough because I hate eating big meals or even anything when I first wake up and I try to be up by 5:30-6am every day I work and 7am on days i'm off. I usually take my 2nd dose around noon or shortly after, I also see some folks complain about burps and after taste but i haven't had much of that unless I...

• madman

 

[Systemlord]

Just checking for feedback for those that are on any of the oral TU. How important is what you eat with the medication for you? Have you had your labs checked while eating and dosed with healthy fat? I searched for this on here and it's not commonly discussed. My doctor and I have reverted back to oral TU and he says it's absolutely imperative I take it with food.

Feedback is welcome

I’ve taken my Jatenzo without food with zero issues. Just to play it safe if I’m planning on fasting that morning, I’ll just take a few ounces of avocado oil in a shot glass with my Jatenzo. That’s equivalent to 30 g of fat. I used to do the same thing when taking vitamin D supplements.

 

[firefighterinNC]

As I already stated it needs to be taken with a small meal or snack that has some fat.

Again make it a priority to take each dose with a small meal that has some fat as this can easily make or break the effectiveness of the protocol.

Post in thread 'Where can I find Kyzatrex? Low cost options'

Jan 3, 2026

Nice congrats on retirement!

I'd say undoubtedly the hardest thing for me is taking it with food, my doctor who prescribed it said I'm not doing myself any good at all if i don't take it with food. So my best guess is it has to have food for absorption somehow. To me that's rough because I hate eating big meals or even anything when I first wake up and I try to be up by 5:30-6am every day I work and 7am on days i'm off. I usually take my 2nd dose around noon or shortly after, I also see some folks complain about burps and after taste but i haven't had much of that unless I...

• madman

Yeah this time around, i’m really trying to focus on meal quality with the dose.

 

[firefighterinNC]

As I already stated it needs to be taken with a small meal or snack that has some fat.

Again make it a priority to take each dose with a small meal that has some fat as this can easily make or break the effectiveness of the protocol.

Post in thread 'Where can I find Kyzatrex? Low cost options'

Jan 3, 2026

Nice congrats on retirement!

I'd say undoubtedly the hardest thing for me is taking it with food, my doctor who prescribed it said I'm not doing myself any good at all if i don't take it with food. So my best guess is it has to have food for absorption somehow. To me that's rough because I hate eating big meals or even anything when I first wake up and I try to be up by 5:30-6am every day I work and 7am on days i'm off. I usually take my 2nd dose around noon or shortly after, I also see some folks complain about burps and after taste but i haven't had much of that unless I...

• madman

Yep I recalled. I was really wondering if someone had labs done with meal vs without. I know my numbers were low and I wasn’t eating breakfasts very well.

 

[madman]

Just checking for feedback for those that are on any of the oral TU. How important is what you eat with the medication for you? Have you had your labs checked while eating and dosed with healthy fat? I searched for this on here and it's not commonly discussed. My doctor and I have reverted back to oral TU and he says it's absolutely imperative I take it with food.

Feedback is welcome

Key point here!

* must be taken with a normal meal/snack or breakfast with some fat to ensure absorption

A meal or snack with a moderate amount of fat would be ideal when using Jatenzo or Kyzatrex and a meal/snack with some fat will suffice when using Tlando.




KYZATREX®

Absorption

The KYZATREX® self-emulsifying drug delivery system is well absorbed from the gastrointestinal tract. Both testosterone undecanoate and the newly formed 5-alpha-dihydrotestosterone undecanoate are absorbed via the lymphatic system, circumventing first passage through the liver.

Following oral administration an important part of the active substance testosterone undecanoate is co-absorbed with the lipophilic solvent from the intestine into the lymphatic system, thus partially circumventing the first-pass inactivation by the liver. KYZATREX® must be taken with a normal meal or breakfast to ensure absorption.

KYZATREX® is expected to produce testosterone concentrations that approximate normal concentrations seen in healthy men.

When KYZATREX® was given with breakfast containing 16%, 33%, and 45% fat, the exposure (AUC 0- 24 hr) of testosterone was increased by 37%, 87%, and 94%, respectively, compared to when given under fasted conditions. The primary efficacy and safety study was conducted under fed conditions regardless of the type of meals and the primary efficacy endpoint of achieving testosterone C avg in normal testosterone range was met.

There was no effect on testosterone PK when KYZATREX® was administered with 20% alcohol along with a high-fat meal versus a high-fat meal alone.




Figure 1: Mean (±SEM) Concentration-Time Profile for NaF-EDTA Plasma Total Testosterone in KYZATREX® -Treated Patients at Day 90 Visit

JATENZO®

Absorption

JATENZO delivers physiologic amounts of testosterone, producing testosterone concentrations that approximate normal concentrations seen in healthy men.

The JATENZO self-emulsifying drug delivery system is well absorbed from the gastrointestinal tract. Testosterone undecanoate is absorbed via the lymphatic system, circumventing first passage through the liver.

Following oral administration an important part of the active substance testosterone undecanoate is co-absorbed with the lipophilic solvent from the intestine into the lymphatic system, thus partially circumventing the first-pass inactivation by the liver. JATENZO must be taken with a normal meal or breakfast to ensure absorption.

When JATENZO was dosed with different breakfasts containing various amounts of fat, the bioavailability with the 30 g fat, 45 g fat, and high-calorie high-fat breakfasts was comparable, but there was a food effect with the 15 g fat breakfast compared to the 30 g fat breakfast. The 15 g fat breakfast had a 25% decrease in testosterone exposure compared to the 30 g fat breakfast.




Figure 1. Mean (±SEM) Concentration-Time Profile for NaF-EDTA Plasma Total Testosterone in JATENZO Treated Subjects at Final PK Visit

TLANDO®

Absorption

Testosterone undecanoate is a lipophilic molecule that is primarily absorbed into the lymph system after oral administration and then released into the general blood circulation by the thoracic duct, avoiding absorption into the portal vein thereby circumventing first-pass metabolism in the liver. Testosterone undecanoate is converted to testosterone following absorption.


Effect of Food

Administration of TLANDO with moderate fat containing food did not significantly impact the pharmacokinetic parameters of testosterone compared to high or low fat. However, there is decrease in exposure when administered without food compared to fed conditions.

In studies with 13 to 14 hypogonadal males, mean testosterone Cmax and AUC were comparable when TLANDO was administered with food containing low, moderate or high fat amounts. Administration in fasting conditions resulted in approximately 65 % and 38% lower Cmax and AUC, respectively, compared to administration with food (high fat).




Figure 1: Mean (±SEM) Serum Total Testosterone Concentrations (ng/dL)

 

[firefighterinNC]

Key point here!

* must be taken with a normal meal/snack or breakfast with some fat to ensure absorption

A meal or snack with a moderate amount of fat would be ideal when using Jatenzo or Kyzatrex and a meal/snack with some fat will suffice when using Tlando.




KYZATREX®

Absorption

The KYZATREX® self-emulsifying drug delivery system is well absorbed from the gastrointestinal tract. Both testosterone undecanoate and the newly formed 5-alpha-dihydrotestosterone undecanoate are absorbed via the lymphatic system, circumventing first passage through the liver.

Following oral administration an important part of the active substance testosterone undecanoate is co-absorbed with the lipophilic solvent from the intestine into the lymphatic system, thus partially circumventing the first-pass inactivation by the liver. KYZATREX® must be taken with a normal meal or breakfast to ensure absorption.

KYZATREX® is expected to produce testosterone concentrations that approximate normal concentrations seen in healthy men.

When KYZATREX® was given with breakfast containing 16%, 33%, and 45% fat, the exposure (AUC 0- 24 hr) of testosterone was increased by 37%, 87%, and 94%, respectively, compared to when given under fasted conditions. The primary efficacy and safety study was conducted under fed conditions regardless of the type of meals and the primary efficacy endpoint of achieving testosterone C avg in normal testosterone range was met.

There was no effect on testosterone PK when KYZATREX® was administered with 20% alcohol along with a high-fat meal versus a high-fat meal alone.




Figure 1: Mean (±SEM) Concentration-Time Profile for NaF-EDTA Plasma Total Testosterone in KYZATREX® -Treated Patients at Day 90 Visit
View attachment 57029




JATENZO®

Absorption

JATENZO delivers physiologic amounts of testosterone, producing testosterone concentrations that approximate normal concentrations seen in healthy men.

The JATENZO self-emulsifying drug delivery system is well absorbed from the gastrointestinal tract. Testosterone undecanoate is absorbed via the lymphatic system, circumventing first passage through the liver.

Following oral administration an important part of the active substance testosterone undecanoate is co-absorbed with the lipophilic solvent from the intestine into the lymphatic system, thus partially circumventing the first-pass inactivation by the liver. JATENZO must be taken with a normal meal or breakfast to ensure absorption.

When JATENZO was dosed with different breakfasts containing various amounts of fat, the bioavailability with the 30 g fat, 45 g fat, and high-calorie high-fat breakfasts was comparable, but there was a food effect with the 15 g fat breakfast compared to the 30 g fat breakfast. The 15 g fat breakfast had a 25% decrease in testosterone exposure compared to the 30 g fat breakfast.




Figure 1. Mean (±SEM) Concentration-Time Profile for NaF-EDTA Plasma Total Testosterone in JATENZO Treated Subjects at Final PK Visit
View attachment 57030




TLANDO®

Absorption

Testosterone undecanoate is a lipophilic molecule that is primarily absorbed into the lymph system after oral administration and then released into the general blood circulation by the thoracic duct, avoiding absorption into the portal vein thereby circumventing first-pass metabolism in the liver. Testosterone undecanoate is converted to testosterone following absorption.


Effect of Food

Administration of TLANDO with moderate fat containing food did not significantly impact the pharmacokinetic parameters of testosterone compared to high or low fat. However, there is decrease in exposure when administered without food compared to fed conditions.

In studies with 13 to 14 hypogonadal males, mean testosterone Cmax and AUC were comparable when TLANDO was administered with food containing low, moderate or high fat amounts. Administration in fasting conditions resulted in approximately 65 % and 38% lower Cmax and AUC, respectively, compared to administration with food (high fat).




Figure 1: Mean (±SEM) Serum Total Testosterone Concentrations (ng/dL)
View attachment 57031

Quality of the meal and fat content sure seem to play a huge role. I know my doc called in a Rx for Jatenzo. He wants to see if I feel better on Jatenzo vs Kyzatrex, he said he's more open to how one feels on the medication vs their numbers but certainly wants to check them.

 

[madman]

Quality of the meal and fat content sure seem to play a huge role. I know my doc called in a Rx for Jatenzo. He wants to see if I feel better on Jatenzo vs Kyzatrex, he said he's more open to how one feels on the medication vs their numbers but certainly wants to check them.

Yes they need to be taken with food/fats otherwise you are wasting your time.

Keep in mind the newer oral TU formulations (Jatenzo, Tlando, and Kyzatrex) all deliver the same active hormone TU and if the doses are properly adjusted (Jatenzo/Kyzatrex) to achieve similar blood levels (peak, trough and overall exposure) they produce essentially the same effects.

Any noticeable difference after switching is usually due to slightly different absorption/meal effects, dose titration differences or individual variability (peaks/troughs).

The goal here would be to aim for a high-end or slightly supraphysiologic peak as it is fairly short-lived.

Trough would be much lower as in close to/back to baseline 8-12 hrs post-dose especially when your peak is not too high.

Last thing you want to be doing here is hitting an absurdly high peak especially when following the hybrid protocol (morning/noon).

Of course how one feels overall is what truly matters here but labs are still critical as you need to know where your peak TT and more importantly FT sit on said dose.

Would be wise to test at true trough (pre AM) dose too so you can see where you bottom out on said protocol whether following the standard BID (morning/evening) or Dr. Suns hybrid BID (morning/noon) protocol.

 

[Guided_by_Voices]

This all seems to argue in favor of troches that are absorbed through the mouth directly into the bloodstream, although perhaps the absence of an ester allows them to be cleared from the system too quickly, but they seem worth considering for those whose meals don't align with dosing.