Tested my son for testosterone

[tareload]

If you’re trying to gauge how you’d feel with higher testosterone levels to determine whether injections or other long-term treatment would be a good option

I wonder what the transfer function is between nasal gel and even shorter acting Test ester like propionate in terms of symptom resolution. I notice you have tried injections, creams, and nasal gel. Comparison?

 

[TLawyer]

I wonder what the transfer function is between nasal gel and even shorter acting Test ester like propionate in terms of symptom resolution. I notice you have tried injections, creams, and nasal gel. Comparison?

I gave the nasal gel about 3-4 weeks. Definitely felt improvement in symptoms and better for the few hours after using it. Long-term compliance was going to be the issue, but it certainly let me know that my issue was low T levels and how I could feel with higher levels.

Cream on the scrotum puts me way too high. Only one click (along with injections) put my total T above 1,500 ng/dl and Free T above 50 pg/ml (the blood test wouldn't measure beyond that). In some ways, it felt good, but I noticed some sexual side effects, which now seem to be resolving themselves with just injections. DHT was about 115 ng/dl with the cream as well.

Injections seem to be best for me. I take every day. Feel level and stable and seeing improvements in symptoms. I actually did ok with Enclomiphene (which put me at total T of about 550), so I think for me I'll need to keep things maybe in the mid-range. I have low SHBG (low teens).

 

[tareload]

I gave the nasal gel about 3-4 weeks. Definitely felt improvement in symptoms and better for the few hours after using it. Long-term compliance was going to be the issue, but it certainly let me know that my issue was low T levels and how I could feel with higher levels.

Cream on the scrotum puts me way too high. Only one click (along with injections) put my total T above 1,500 ng/dl and Free T above 50 pg/ml (the blood test wouldn't measure beyond that). In some ways, it felt good, but I noticed some sexual side effects, which now seem to be resolving themselves with just injections. DHT was about 115 ng/dl with the cream as well.

Injections seem to be best for me. I take every day. Feel level and stable and seeing improvements in symptoms. I actually did ok with Enclomiphene (which put me at total T of about 550), so I think for me I'll need to keep things maybe in the mid-range. I have low SHBG (low teens).

I appreciate your response and methodical approach. Thank you and best wishes finding a treatment option that works for you short term and long term.

 

[FunkOdyssey]

All drugs have side effects. I already pointed that out. Care to share the frequency of the side effects that you pointed out about Wellbutrin/Bupropion? Or point out that the side effects in many cases dissipate after continued use? And just because you haven't experienced a side effect on TRT doesn't mean others won't. I think maybe you could have considered Wellbutrin for your son rather than jumping to TRT.

From: Side Effects of Wellbutrin (Bupropion Hcl), Warnings, Uses

Other Adverse Reactions Observed During The Clinical Development Of WELLBUTRIN​

The conditions and duration of exposure to WELLBUTRIN varied greatly, and a substantial proportion of the experience was gained in open and uncontrolled clinical settings. During this experience, numerous adverse events were reported; however, without appropriate controls, it is impossible to determine with certainty which events were or were not caused by WELLBUTRIN. The following enumeration is organized by organ system and describes events in terms of their relative frequency of reporting in the database.

The following definitions of frequency are used: Frequent adverse reactions are defined as those occurring in at least 1/100 subjects. Infrequent adverse reactions are those occurring in 1/100 to 1/1,000 subjects, while rare events are those occurring in less than 1/1,000 subjects.

Cardiovascular: Frequent was edema; infrequent were chest pain, electrocardiogram (ECG) abnormalities (premature beats and nonspecific ST-T changes), and shortness of breath/dyspnea; rare were flushing, and myocardial infarction.

Dermatologic: Infrequent was alopecia.

Endocrine: Infrequent was gynecomastia; rare was glycosuria.

Gastrointestinal: Infrequent were dysphagia, thirst disturbance, and liver damage/jaundice; rare was intestinal perforation.

Genitourinary: Frequent was nocturia; infrequent were vaginal irritation, testicular swelling, urinary tract infection, painful erection, and retarded ejaculation; rare were enuresis, and urinary incontinence.

Neurological: Frequent were ataxia/incoordination, seizure, myoclonus, dyskinesia, and dystonia; infrequent were mydriasis, vertigo, and dysarthria; rare were electroencephalogram (EEG) abnormality, and impaired attention.

Neuropsychiatric: Frequent were mania/hypomania, increased libido, hallucinations, decrease in sexual function, and depression; infrequent were memory impairment, depersonalization, psychosis, dysphoria, mood instability, paranoia, and formal thought disorder; rare was suicidal ideation.

Oral Complaints: Frequent was stomatitis; infrequent were toothache, bruxism, gum irritation, and oral edema.

Respiratory: Infrequent were bronchitis and shortness of breath/dyspnea; rare was pulmonary embolism.

Special Senses: Infrequent was visual disturbance; rare was diplopia.

Nonspecific: Frequent were flu-like symptoms; infrequent was nonspecific pain; rare was overdose.

Altered Appetite And Weight​

A weight loss of greater than 5 lbs. occurred in 28% of subjects receiving WELLBUTRIN. This incidence is approximately double that seen in comparable subjects treated with tricyclics or placebo. Furthermore, while 35% of subjects receiving tricyclic antidepressants gained weight, only 9.4% of subjects treated with WELLBUTRIN did. Consequently, if weight loss is a major presenting sign of a patient's depressive illness, the anorectic and/or weight-reducing potential of WELLBUTRIN should be considered.

Postmarketing Experience​

The following adverse reactions have been identified during post-approval use of WELLBUTRIN and are not described elsewhere in the label. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Body (General)​

Arthralgia, myalgia, and fever with rash and other symptoms suggestive of delayed hypersensitivity. These symptoms may resemble serum sickness [see WARNINGS AND PRECAUTIONS].

Cardiovascular​

Hypertension (in some cases severe), orthostatic hypotension, third degree heart block.

Endocrine​

Hyponatremia, syndrome of inappropriate antidiuretic hormone secretion, hyperglycemia, hypoglycemia.

Gastrointestinal​

Esophagitis, hepatitis.

Hemic And Lymphatic​

Ecchymosis, leukocytosis, leukopenia, thrombocytopenia. Altered PT and/or INR, infrequently associated with hemorrhagic or thrombotic complications, were observed when bupropion was coadministered with warfarin.

Musculoskeletal​

Muscle rigidity/fever/rhabdomyolysis, muscle weakness.

Nervous System​

Aggression, coma, completed suicide, delirium, dream abnormalities, paranoid ideation, paresthesia, parkinsonism, restlessness, suicide attempt, unmasking of tardive dyskinesia.

Skin And Appendages​

Stevens-Johnson syndrome, angioedema, exfoliative dermatitis, urticaria.

Special Senses​

Tinnitus, increased intraocular pressure.

The agitation and hostility side effects shouldn't be underestimated in terms of potential impact. For me, I believe it played a role in an uncharacteristic road-rage incident where I ran a biker off the road and was arrested for reckless driving. The biker could have easily died and life as I know it would have been over.

The dysphagia was what led to me stopping the drug though. Dysphagia is listed in the quote above as an infrequent gastrointestinal effect and it manifested for me as an inability to initiate a swallow. I would almost choke and panic as I tried to overcome the strange sensation of paralysis and swallow my food. Good times.

 

[TLawyer]

From: Side Effects of Wellbutrin (Bupropion Hcl), Warnings, Uses
View attachment 25270
View attachment 25271


The agitation and hostility side effects shouldn't be underestimated in terms of potential impact. For me, I believe it played a role in an uncharacteristic road-rage incident where I ran a biker off the road and was arrested for reckless driving. The biker could have easily died and life as I know it would have been over.

The dysphagia was what led to me stopping the drug though. Dysphagia is listed in the quote above as an infrequent gastrointestinal effect and it manifested for me as an inability to initiate a swallow. I would almost choke and panic as I tried to overcome the strange sensation of paralysis and swallow my food. Good times.

But what's the duration of these side effects? I experienced a few of these, but only for about a week or two. More a slight annoyance/inconvenience. Definitely wasn't a deal-breaker for me.

 

[FunkOdyssey]

I mean what do benzos, opioids, and testosterone all have in common? They’re all scheduled drugs and are notorious for having the worst withdrawals of any type or class of drugs. That’s the whole point of them being controlled substances (ie tightly regulated) because they cause dependency of the most extreme kind. I understand antidepressants also have their challenges. I’m not saying they don’t, but comparing one to the other is apples and oranges imo. Someone withdrawing from ad is likely to have weeks vs months of wd symptoms from scheduled drugs. I honestly thought this was common knowledge.

The scheduling criteria is based on the relative abuse potential of a drug, as well as the severity of dependence when the drug is abused. If the criteria included "severe dependence that can occur simply by taking the medicine as directed", antidepressants would deserve to be scheduled. Spend some time on SurvivingAntidepressants.org if you don't believe me:

Introductions and updates

Natural case histories of individual progress in psychiatric drug withdrawal. New members, please start an Introduction topic about yourself here and update it often.

www.survivingantidepressants.org

 

[FunkOdyssey]

But what's the duration of these side effects? I experienced a few of these, but only for about a week or two. More a slight annoyance/inconvenience. Definitely wasn't a deal-breaker for me.

The first 6 weeks or so can be a rollercoaster when it comes to side effects, but that is pretty well known. Not an ideal antidepressant for those who are naturally anxious as it can make you more anxious with its stimulant effect. Sleep was hit or miss for me during those first 6 weeks, and I seemed to be very dehydrated. I am glad I stuck it out though as all of that literally disappeared around the 6 week mark.

The duration of side effects varies. Some disappear quickly, some not so quickly, some never. Some don't appear until many months into therapy like the dysphagia in my case. It really depends on the individual. Apparently, the duration of side effects can also vary within the same individual depending on which message you read (see quotes above).

 

[FunkOdyssey]

For me personally, I believe trt has caused depression. I’ve never been a depressed person in my life. I would get situationally depressed. And not feeling well all the time def gave me depressed feelings at times. But never felt defeated. On trt. I feel mentally and emotionally flat. I have no zest for life like I used to. I just go about my days like a damn robot. And I’m def not that guy. I’m the life of the party type guy. And now I just fight to feel any joy in things. Trt has helped me with a few issues I don’t want to give up. But being depressed is a very tough trade off. I seemed to do better on low dose ssri with my trt. Maybe it is damage from coming off the ssri 2 years ago. But who knows.

Can you elaborate on the SSRI use and how the timing overlapped with TRT? What led to the use of an SSRI if you were never depressed before?

 

[BigTex]

This nasal gel will go the same way as nasal hGH went. Most people get really sick of having to shove medication up their nose. Especially those who already have sinus problems.


Lewis AL, Jordan F, Patel T, Jeffery K, King G, Savage M, Shalet S, Illum L. Intranasal Human Growth Hormone (hGH) Induces IGF-1 Levels Comparable With Subcutaneous Injection With Lower Systemic Exposure to hGH in Healthy Volunteers. J Clin Endocrinol Metab. 2015 Nov;100(11):4364-71. doi: 10.1210/jc.2014-4146. Epub 2015 Oct 1. PMID: 26425883; PMCID: PMC4702464.

Intranasal Human Growth Hormone (hGH) Induces IGF-1 Levels Comparable With Subcutaneous Injection With Lower Systemic Exposure to hGH in Healthy Volunteers - PubMed

The study indicates that CP024 is a promising candidate for an efficacious nasal product for the treatment of GH deficiency due to induction of IGF-1 similar to that after a sc injection, despite the lower plasma hGH concentration obtained. A dose-response study is needed to evaluate the optimal...

pubmed.ncbi.nlm.nih.gov

They have been investigating this same thing since the early 1990's. Since 2015 when this study was published, nasal hGH has yet to make it to the market. The problems of intranasal delivery are: THE NEED FOR MUCH HIGHER DOSE: Only 8% bioavailability - means the need for a much higher dose versus subcutaneous delivery bioavailable. Pharma hGH is already way too expensive.

I know a very big UG lab that made nasal testosterone years back and still occasionally makes the creams. He tells me very few people are interested in buying the stuff. Occasionally someone who is burned out on needless will try but always go back. Most feel they are just not so effective. Like I said my wife tried the pump and absolutely hated and did not even finish it. I tried the nasal gel and absolutely tossed it.

 

[TLawyer]

This nasal gel will go the same way as nasal hGH went. Most people get really sick of having to shove medication up their nose. Especially those who already have sinus problems.


Lewis AL, Jordan F, Patel T, Jeffery K, King G, Savage M, Shalet S, Illum L. Intranasal Human Growth Hormone (hGH) Induces IGF-1 Levels Comparable With Subcutaneous Injection With Lower Systemic Exposure to hGH in Healthy Volunteers. J Clin Endocrinol Metab. 2015 Nov;100(11):4364-71. doi: 10.1210/jc.2014-4146. Epub 2015 Oct 1. PMID: 26425883; PMCID: PMC4702464.

Intranasal Human Growth Hormone (hGH) Induces IGF-1 Levels Comparable With Subcutaneous Injection With Lower Systemic Exposure to hGH in Healthy Volunteers - PubMed

The study indicates that CP024 is a promising candidate for an efficacious nasal product for the treatment of GH deficiency due to induction of IGF-1 similar to that after a sc injection, despite the lower plasma hGH concentration obtained. A dose-response study is needed to evaluate the optimal...

pubmed.ncbi.nlm.nih.gov

They have been investigating this same thing since the early 1990's. Since 2015 when this study was published, nasal hGH has yet to make it to the market. The problems of intranasal delivery are: THE NEED FOR MUCH HIGHER DOSE: Only 8% bioavailability - means the need for a much higher dose versus subcutaneous delivery bioavailable. Pharma hGH is already way too expensive.

I know a very big UG lab that made nasal testosterone years back and still occasionally makes the creams. He tells me very few people are interested in buying the stuff. Occasionally someone who is burned out on needless will try but always go back. Most feel they are just not so effective. Like I said my wife tried the pump and absolutely hated and did not even finish it. I tried the nasal gel and absolutely tossed it.

The difference is that HGH is intended to have the same effect whether administered nasally or via injections. It’s only a difference in administration, so one would opt for the easiest route of administration. Natesto and injections is not just a matter of different administration, but also of different intended effect/outcome. Natesto will not shut down you down while injections will. It may be less convenient than injections, but if you want the potential to experience higher testosterone levels without shutting down, it’s your only choice. If you don’t care about shutting down, then you do injections, creams or Jatenzo.

 

[Charliebizz]

The difference is that HGH is intended to have the same effect whether administered nasally or via injections. It’s only a difference in administration, so one would opt for the easiest route of administration. Natesto and injections is not just a matter of different administration, but also of different intended effect/outcome. Natesto will not shut down you down while injections will. It may be less convenient than injections, but if you want the potential to experience higher testosterone levels without shutting down, it’s your only choice. If you don’t care about shutting down, then you do injections, creams or Jatenzo.

But like big tex said. the kid has no money. And no insurance. natesto is dumb expensive. It’s just a waste of time. Injections will get him to a good place in a few weeks (if that’s what he needs) and if not he will go right back to baseline. Getting off of trt when you haven’t been on it that long isn’t as tough as everyone makes it out to be.

 

[Charliebizz]

Can you elaborate on the SSRI use and how the timing overlapped with TRT? What led to the use of an SSRI if you were never depressed before?

Dr Mariano (used to be big on the boards) said ssri use could help certain guys with hpta Dysregulation (aka adrenal fatigue). And I wanted to use it to see if I could tolerate trt. Back then test cyp used to crush my cortisol. For some reason test enanthate doesn’t.

 

[Systemlord]

like big tex said. the kid has no money. And no insurance. natesto is dumb expensive.

Also he's operating on only one testicle and no way is his son not getting short-changed on T.

This may have been the problem all along.

 

[TLawyer]

But like big tex said. the kid has no money. And no insurance. natesto is dumb expensive. It’s just a waste of time. Injections will get him to a good place in a few weeks (if that’s what he needs) and if not he will go right back to baseline. Getting off of trt when you haven’t been on it that long isn’t as tough as everyone makes it out to be.

Do you know the cost of proper blood tests and a consultation with Defy? Do you know the cost of the Empower version of Natesto? I would hope if he is committing to TRT and to see its benefits that he gives it more than just a few weeks. Someone here posted a recent study which shows that to realize some benefits (if you're going to realize them) it could take months after your levels are stabilized.

 

[TLawyer]

Also he's operating on only one testicle and no way is his son not getting short-changed on T.

This may have been the problem all along.

Maybe. It would have been good to approach it methodically and with proper blood tests to assess. It would have been nice to know what his Free T levels were.

 

[Charliebizz]

Do you know the cost of proper blood tests and a consultation with Defy? Do you know the cost of the Empower version of Natesto? I would hope if he is committing to TRT and to see its benefits that he gives it more than just a few weeks. Someone here posted a recent study which shows that to realize some benefits (if you're going to realize them) it could take months after your levels are stabilized.

yes I am a patient of defy. And some things can take a while on trt. That said certain things happen flvery quickly. I don’t know why your latching on to this natesto experiment. what if you do natesto and never get to good therapeutic levels because it’s an inferior way of delivering testosterone? Then the kid writes off trt? Natesto sounds great in theory. But compliance is a huge issue I would be willing to bet 99% of people wouldn’t even make a full year with that shit.

 

[Charliebizz]

Maybe. It would have been good to approach it methodically and with proper blood tests to assess. It would have been nice to know what his Free T levels were.

Why does any of that matter? To be honest, most people that I know personally that do very well on trt, don’t even know about free t or shbg and all that shit. Labs are a great starting point but not the end all be all. all the over thinking, studying and fretting about lab work is probably why a lot of us guys don’t feel great. I hate to say it but I always feel best when I get away from the forums. But then I wonder if anything changed in the world of trt get back on, try the new flavor of the week and end up fucking myself up again lol.

 

[Systemlord]

It would have been nice to know what his Free T levels were.

Sure this info while not completely useless, my research into T levels has hinted levels below 550 ng/dL increase the risk of heart attacks by 30% and desirable healthy testosterone levels are much higher than what doctors consider normal.

Studies show loss of vigor and libido starts <500. The fact he's only got one functioning testicle makes for a stronger case notwithstanding for what is suboptimal T.

 

[FunkOdyssey]

Dr Mariano (used to be big on the boards) said ssri use could help certain guys with hpta Dysregulation (aka adrenal fatigue). And I wanted to use it to see if I could tolerate trt. Back then test cyp used to crush my cortisol. For some reason test enanthate doesn’t.

I was on a forum called MindandMuscle.net when the Dr. Mariano low dose SSRI craze swept through. It was thought to be almost a panacea and people were trying it for everything: chronic fatigue, stress, allergies, autoimmune disorders, and other inflammatory conditions, in addition to the usual suspects like anxiety and depression.

One thing is for sure: SSRIs produce strong effects at doses far lower than they are typically prescribed. The normal starting doses are very much like beginning TRT at 200 mg weekly.

 

[BigTex]

yes I am a patient of defy. And some things can take a while on trt. That said certain things happen flvery quickly. I don’t know why your latching on to this natesto experiment. what if you do natesto and never get to good therapeutic levels because it’s an inferior way of delivering testosterone? Then the kid writes off trt? Natesto sounds great in theory. But compliance is a huge issue I would be willing to bet 99% of people wouldn’t even make a full year with that shit.

I couldn't agree with you more @Charliebizz. Natesto is absolutely out of the question. It's over $200 at GoodRx. I know a UG lab that makes it for $100 (still to much) but having to put this crap up you nose 3 times a day for the rest of your life is not feasible. My whole family has sinus problems and there is no way that will work. Nor is it financially feasible. I paid $45 for 10g of test enanthate and already made it made with GSO. As I said, I was sent a free sample of a nasal gel by a UG lab to test, I absolutely hated it and gave it a week and tossed it in the trash can.

Here, right out of GoodRX : Natesto (testosterone nasal gel) can cause nasal side effects such as a common cold, runny nose, nosebleeds, nasal discomfort, and nasal scabbing. Natesto is not recommended for use in patients with a history of nasal disorders; history of nasal or sinus surgery; history of nasal fracture.​

I'll go sub-q or even deep IM any day over this. It's worse that having to use nasal spray. IMHO, it is definitely an "inferior" way to deliver testosterone. I would much rather use test base in BA/DMSO 3 x/d

I guess for some it is hard for some of us to understand someone being financially unable to do things. Maybe for some of us money grows on trees? I have no problem keeping the kid supplied with testosterone and insulin syringes until he gets his feet on the ground, can get insurance and pay for his own. Speaking of that he is still doing very well. My wife and I are both happy with the progress, he is on his 3rd week I guess of going to the gym....5 days a week. Not so bad since he has not been to the gym in 8 years.

@Systemlord - "Studies show loss of vigor and libido starts <500. The fact he's only got one functioning testicle makes for a stronger case notwithstanding for what is suboptimal T."

Absolutely, which is why my wife and I made the decision to help him. Especially when old norms show a guy this age at 700-900. Doesn't take a million and 1 blood test to figure out this equation. Just like it didn't take my doctor long to figure my case out. Long term testosterone use....no doubt I was competely shut down and didn't want to be at 320 because I did not feel normal. Again, the co-pay for my doctor was $5 and after my insurance approved me the test was $5. Had he done none of this, I would have taken care of the issue myself like I have been doing for years. Now I am legal and can get on a public board and talk about it.

Kind of hard to believe @TLawyer is still going on and on about this. If other young guys came to this board they would be absolutely scare to death to talk about it and would no doubt go to their gym steroid dealer for advice. Keep on sniffing that nasal spray and believing that blood testing like @Charliebizz mentioned is the end all. The word hypochondriac comes to mind. I feel bad because my blood test show I do, therefore I feel bad.

Yea, @Charliebizz it is common for even PRO bodybuilders to completely come clean and go to baseline after a contest cycle. Atheletes figured our how to do this a long time ago. Most drug test are passed this way.