189 ng/dL. Small pituitary gland. Starting Nebido in four days. Bloods inside.

[markwilliams]

Any doc, particularly one claiming to be an Andologist, that says this needs to go back and review his/her class notes from reproductive physiology 101. Testosterone has a relatively short half life in the body, on the order of a few hours. When you provide supplemental T, even at low doses, it will shut down endogenous LH production and thus endogenous T production. The body will quickly (within days) strip away any reserve T it has in the SHBG pool. So, your baseline T is going to be gone in a matter of a day or two.

I'm pretty sure he meant that my baseline natty levels of 320 ng/dL weren't that bad, and that you do the booster only with people that start from zero. Again, he's the fourth person that gives me this explanation. And I drove 1 hour to meet this one. I'll probably have to change state at this point :P

He said that the would have waited before putting me on TRT. He would have liked to do more exams on the pituaritary gland, SHBG production, liver etc. He told me to do ultrasound to my liver in ten weeks, plus four pages of other exams.

But he also said: "you started Nebido, so keep going with it. I'll be happy to reduce your interval down to eight weeks if necessary, but let's start by removing one week from your eleven week protocol and doing the next injection at ten (nine full weeks)". He also suggested gels, but I kindly refused.

Anyway, five days after my third injection, I still feel like crap and sleep 12 hours a night. We'll see in the next few weeks.

I have a few questions:

1 - During the second week of my second injection, I tested 520 ng/dL. Isn't that low?
2 - At ten weeks of the same injection, I tested total test 3.43 ng/mL/free test 79 pg/mL. Are those natural levels or still provided by my Nebido injection? (LH was around 1.3)
3 - Reducing my interval to ten weeks with no booster will help me accumulate nebido and give steady levels over time or am I recovering my natural test at the end of every injection? (see question 2, my LH was 1.3 mUI/mL).
4 - I'm 40% body fat. Does it make a difference in how Nebido is absorbed? Does it have to be taken into account?

Cheers
M.

[markwilliams]

UPDATE ON MY THIRD INJECTION (the fourth is coming tomorrow at week nine)

I'm on week nine, and the I felt the positive benefits of this injection from the 2nd to the fourth week. After week five, back to normal.
Anxiety and mood swings were a constant in the whole nine weeks, even with the positive benefits.

It makes me wonder what the fuck is going on.

Fourth injection tomorrow, this time at week nine. Bloods taken in the morning before the injection.

I'll keep you posted. I found an andrologist, I'm going to ask him in a week if there's still time to do the booster and what the fuck is going on.

[Youthful55guy]

I'm very interested in you lab results and your progress. Thanks for posting. My personal belief is that the long intervals between injections of Nebido have been oversold by the manufacturer. Like all forms of exogenous T esters, more frequent, smaller doses will deliver a more constant level of T. The benefit to the Undecanoate is that it may stretch the optimal interval between injections from a 3-4 days to 3-4 weeks. So, monthly injections may be a reality if properly done.

The problem is that they have sold their 10 week protocols to the approving authorities (FDA, EMA, etc.) and to prescribing physicians. Reducing the interval will give them less of a market advantage over other forms of supplemental T. I think in the long run though, dissatisfaction of the 10 week protocols will drive patients to seek more time-proven treatments.

[markwilliams]

BLOODS - 9 WEEKS, before the fourth.

Test: 5.83 ng/mL (range: 2.7 - 10)
Free Test: 127.0 pg/mL (range: 75-124)
Estradiol: 43 pg/mL (range: 11-45)
Prolactin: 16 ng/mL (range: 4.0-15)

Are Estradiol and Prolactin normal? They look high.

As I said, I've experienced anxiety, in the first weeks of the third injection.

[Youthful55guy]

BLOODS - 9 WEEKS, before the fourth.

Test: 5.83 ng/mL (range: 2.7 - 10)
Free Test: 127.0 pg/mL (range: 75-124)
Estradiol: 43 pg/mL (range: 11-45)
Prolactin: 16 ng/mL (range: 4.0-15)

Are Estradiol and Prolactin normal? They look high.

As I said, I've experienced anxiety, in the first weeks of the third injection.

T looks good, particularly your Free T. Thanks for posting!

I wouldn't sweat the Estrogen. You're still in range and it is difficult to dose anastrozole with borderline cases like this. You might want to consider the vodka/eye dropper method, but keep in mind that men need E too for normal erections, libido, and GH secretion. I've seen way too many guys (myself included) get overly excited about borderline E and end up with a bad case of ED by throwing too much anastrozole and/or other AIs at it.

Prolactin is an episodic pituitary hormone. Granted, not as episodic as LH, but still it goes up and down. I've run the lab 4 times in the last year and was borderline high in one of the 3 labs. I think I just hit a peak that one time. Probably the same with you. I'd redo the lab before I got too excited about it.

[markwilliams]

UPDATE

Sixth injection, I'm officially more than one year on Nebid.

Bloods taken on the first and fourth week after my sixth injection.

Symptoms are pretty catastrophic: no libido (I mean, zero), no morning erections, difficulty mantaining an erection for more than a few seconds.

FIRST WEEK AFTER 6TH INJECTION

Estradiol: 86 ng/L (11-43)
Testosterone : 11.70 ug/L (2.49 - 8.36)

FOUR WEEKS AFTER 6TH INJECTION

Cortisol serum: 16 ug/dL (interv. 5-20)
Estradiol 53 ng/L (interv. 11-43)
SHBG: 33 nMol/L (interv. 13-71)
Testosterone: 6.70 ug/L (interv 2.49-8.36)
Free Testosterone: 149.9 pg/mL (75-124)

[Youthful55guy]

UPDATE

Sixth injection, I'm officially more than one year on Nebid.

Bloods taken on the first and fourth week after my sixth injection.

Symptoms are pretty catastrophic: no libido (I mean, zero), no morning erections, difficulty mantaining an erection for more than a few seconds.

FIRST WEEK AFTER 6TH INJECTION

Estradiol: 86 ng/L (11-43)
Testosterone : 11.70 ug/L (2.49 - 8.36)

FOUR WEEKS AFTER 6TH INJECTION

Cortisol serum: 16 ug/dL (interv. 5-20)
Estradiol 53 ng/L (interv. 11-43)
SHBG: 33 nMol/L (interv. 13-71)
Testosterone: 6.70 ug/L (interv 2.49-8.36)
Free Testosterone: 149.9 pg/mL (75-124)

Refresh my memory please. What is your protocol? I'm not very familiar with Nebedo protocols. Why are labs drawn after weeks 1 & 6?

Given that T levels will continually change over these long injection intervals, so will E conversion. Therefore, you E levels will slowly go up and down following T levels. That's going to make it very difficult to use an AI to control E. You will need to vary the dose over the injection cycle. An E of 86 is high by my standards, but I would not treat (or minimally treat) an E of 53.

I'm not sure if E conversion is the source of your libido problem, but it may be a place to start. Are you completely sold on Nebido? do you have other options? Just saying, I don't run into these problems when I keep a reasonable E3D T-cyp protocol.

[markwilliams]

Thanks for your answer.

My current protocol is Nebido (Testosterone Undecanoate sold in Europe) every nine weeks. The recommended protocol is every twelve, but I found out that I ended up with insufficient levels of Free and Total test.

I'm currently 40% body fat (DEXA).

My endo is pushing gels, but I don't want to and I refuse every time.

I'm not sold on Nebido but having a pin every nine weeks is a more attractive solution to me compared to pin weekly.

[almostgone]

Thanks for your answer.

My current protocol is Nebido (Testosterone Undecanoate sold in Europe) every nine weeks. The recommended protocol is every twelve, but I found out that I ended up with insufficient levels of Free and Total test.

I'm currently 40% body fat (DEXA).

My endo is pushing gels, but I don't want to and I refuse every time.

I'm not sold on Nebido but having a pin every nine weeks is a more attractive solution to me compared to pin weekly.

Just curious, why the aversion to injecting twice weekly or every 3 days with cyp or enanthate ? It takes very little time.

[Youthful55guy]

Just curious, why the aversion to injecting twice weekly or every 3 days with cyp or enanthate? It takes very little time.

I might add that most guys envision using 21G 1.5 inch harpoons for TRT injections. Indeed, many old school doctors still advise this practice. What they don't understand is that when you change the paradigm to injecting more frequently (E3D for example), you also decrease the needed volume to that which can easily be handled by a much smaller insulin syringe. I use a 28G half inch needle for my E3D protocol of 0.20 to 0.25 mL. I've been doing this for over 7 years. It works.

[markwilliams]

I just can't imagine having to pin every two/three days for the rest of my life. I apologize if this comes out as rude, it's not my intention.

[Youthful55guy]

I just can't imagine having to pin every two/three days for the rest of my life. I apologize if this comes out as rude, it's not my intention.

No, not rude at all, but many of us find this to be perfectly acceptable. I've been doing it for over 7 years. it simply becomes a routine. like taking any other medication. The trick is to make it sustainable. Small needles and small volumes go a long way toward that goal. The flip side of the coin is whether on not Nebido can deliver a result you can live with. It's a tough choice and an individual decision.