@BigBeard411 Yes I concur Natesto is just unfortunately dead.
1. Most physicians claim testosterone doesn't cause tachycardia, palpitations, etc. but that seems directly AT ODDS with anecdotal reports on this forum alone, as well as online. In fact they seem more than common enough to warrant a listing as a side effect, at least. (Jatenzo for instance carries a BBW for BP elevation, though the cause is not known as to why that modality had that effect).
It's rarely mentioned in literature, and usually seems to happen at high HCT where blood viscosity is up which makes sense. It's also somewhat possible that people with HH MAY have become accustomed to slightly LOWER basal resting HR, and thus they may experience a slightly higher HR on T as palpitations (def varies by patient; skipped or extra ectopic beats and/or awareness that the heart is beating or too strongly).
And finally case reports show patients with elevated ferritin (and/or hemochromotosis) have not only had major tachycardia on T but significant cardiac damage over longer periods of time since it went undiagnosed - somewhat rare but worth noting as a clear connection mediated by ferritin and probably involving iron levels).
Either way - I also suspect patients online (like me prob) MIGHT be more sensitive to these hormone analogs in general, representing a selection effect. I do believe urologists who give TRT to thousands of pts when they say they rarely hear of 'tachycardia' or any cardiac s/s at all. So it may be that hypersensitivity is a factor here also.
2. I saw a cardiologist since I was concerned it didn't go away after 2 days, still doing basic cardiac tests, echo, Holter, but initials seemed normal (ECG, exam). Symptoms 99% gone now.
Now while I DO believe I had a small overdose of Natesto (and to be fair my fitness level has been terrible the past few years mostly 2/ to HH), apparently even those under normal doses DO report various noticeable cardiac s/s. So perhaps its hypersensitivity.
3. I do believe anecdotal reports of pts on here and other places saying that over time their resting HR basically DID rise (they think) and normalized, though they experienced some early adaptation.
It's also possible baseline fitness is poor (like mine) because of HH over time, and thus the cardiac response in healthier pts goes unnoticed or is better tolerated b/c bluntly their cardiac output is higher so the HR and BP don't increase noticably under elevated T spikes.
Natesto is a very low dose though so - aside from possibly overdosing on crystals I think that could point to VERY sensitive responses in some people.
4. I read through some Empower Nasal gel posts but didn't see any mention of cardiac issues. If there are none this would strongly support the crystal basis. Will likely try this once feel fully better.
5. Thank you to those posting above about Jatenzo. I have read some anecdotes there also. Of course I like the PO modality, not sure though about BP and/or potential cardiac s/s on Jatenzo if already getting them on Natesto.
Jatenzo has much longer halflife but - again anecdotally - seems to be good experience from what I've read; suppression similar to dermal gels (so more than Nasal gel, less than IM, but this basically makes sense). Jatenzo from what I've read can definitely get the serum T quite high in most pts, esp at its top titration, perhaps not always expected from PO.
Long term liver effects of Jatenzo et al. perhaps concerning (despite obv short term as expected there are none); arguably though LT effects of all TRT therapies on liver over decadal spans probably not that well mechanized.
1. Most physicians claim testosterone doesn't cause tachycardia, palpitations, etc. but that seems directly AT ODDS with anecdotal reports on this forum alone, as well as online. In fact they seem more than common enough to warrant a listing as a side effect, at least. (Jatenzo for instance carries a BBW for BP elevation, though the cause is not known as to why that modality had that effect).
It's rarely mentioned in literature, and usually seems to happen at high HCT where blood viscosity is up which makes sense. It's also somewhat possible that people with HH MAY have become accustomed to slightly LOWER basal resting HR, and thus they may experience a slightly higher HR on T as palpitations (def varies by patient; skipped or extra ectopic beats and/or awareness that the heart is beating or too strongly).
And finally case reports show patients with elevated ferritin (and/or hemochromotosis) have not only had major tachycardia on T but significant cardiac damage over longer periods of time since it went undiagnosed - somewhat rare but worth noting as a clear connection mediated by ferritin and probably involving iron levels).
Either way - I also suspect patients online (like me prob) MIGHT be more sensitive to these hormone analogs in general, representing a selection effect. I do believe urologists who give TRT to thousands of pts when they say they rarely hear of 'tachycardia' or any cardiac s/s at all. So it may be that hypersensitivity is a factor here also.
2. I saw a cardiologist since I was concerned it didn't go away after 2 days, still doing basic cardiac tests, echo, Holter, but initials seemed normal (ECG, exam). Symptoms 99% gone now.
Now while I DO believe I had a small overdose of Natesto (and to be fair my fitness level has been terrible the past few years mostly 2/ to HH), apparently even those under normal doses DO report various noticeable cardiac s/s. So perhaps its hypersensitivity.
3. I do believe anecdotal reports of pts on here and other places saying that over time their resting HR basically DID rise (they think) and normalized, though they experienced some early adaptation.
It's also possible baseline fitness is poor (like mine) because of HH over time, and thus the cardiac response in healthier pts goes unnoticed or is better tolerated b/c bluntly their cardiac output is higher so the HR and BP don't increase noticably under elevated T spikes.
Natesto is a very low dose though so - aside from possibly overdosing on crystals I think that could point to VERY sensitive responses in some people.
4. I read through some Empower Nasal gel posts but didn't see any mention of cardiac issues. If there are none this would strongly support the crystal basis. Will likely try this once feel fully better.
5. Thank you to those posting above about Jatenzo. I have read some anecdotes there also. Of course I like the PO modality, not sure though about BP and/or potential cardiac s/s on Jatenzo if already getting them on Natesto.
Jatenzo has much longer halflife but - again anecdotally - seems to be good experience from what I've read; suppression similar to dermal gels (so more than Nasal gel, less than IM, but this basically makes sense). Jatenzo from what I've read can definitely get the serum T quite high in most pts, esp at its top titration, perhaps not always expected from PO.
Long term liver effects of Jatenzo et al. perhaps concerning (despite obv short term as expected there are none); arguably though LT effects of all TRT therapies on liver over decadal spans probably not that well mechanized.
