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Thread: :HRT therapy Nebido:

  1. #81
    Nofinshline is offline Junior Member
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    Hello Marcus, good thread! I'm thinking of switching from 100mg Test E x week to Nebido. My question is, do I have to wait until TE clears, say 2 weeks, then do bloodwork and then start nebido?

  2. #82
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    Quote Originally Posted by Nofinshline View Post
    Hello Marcus, good thread! I'm thinking of switching from 100mg Test E x week to Nebido. My question is, do I have to wait until TE clears, say 2 weeks, then do bloodwork and then start nebido?
    No need to wait for your TE to clear, go straight into the Nebido therapy you just wont need to do the loading phase
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  3. #83
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    I have 4x4ml amps. Was thinking of using it as base of cycle. From what ive seen it would need to look something like this:

    Week 1 12mls 3000mg
    Week 2 2mls 500mg
    Week 3 2mls 500mg

    This first phase should keep levels around 80nmol/l + for first 6 weeks. Then add in Test E:

    Week 7 100mg
    Week 8 150mg
    Week 9 200mg
    Week 10 250mg
    Week 11 300mg
    Week 12 350mg
    Week 13 400mg

    Test E should take up the slack as TU wears off

    Thinking of running Primo at 400mg/wk along side this.

    Week 16 begin PCT - 13 weeks after last TU. Maybe PCT would not be needed considering the long "tail" of the TU. I read somewhere that it allows Natty production to begin slowly without PCT, but would need that confirmed.

    I have not seen anyone post a cycle using TU. Front loading is the only way I can see to make use of the length of the ester, but a 3000mg shot on the outset, although clinically sound regarding release rates and nmol/l, feels a bit hairy.

    Comments please.

  4. #84
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    HRT Program prior to Nebido

    Marcus,

    Can you tell me what your doctor had you on prior to the Nebido? What was the hormone and weekley dose?

    I have been on HRT for 2 years now. I take Test cyp twice a week, 100mg per shot.

    I did have great improvement once I went on it. My memory came back, better libido etc. I had a bone density issue in my left hip and that is how I found out I was low test. I was 46, now 48.

    I still don't get morning wood frequently unless I use HCG , which I use from time to time. I only take .5mg Arimidex per week but was told by another Endo I don't need it.

    I am getting ready to go to a new doctor. I believe he is much more experimental as he mentioned me being on Test E for better levels. He can't tell me more till he sees me in 2 weeks.

    Any suggestions on what you think I should ask him etc. I am still trying to add size, so like being at the high end. My current doctor has let my total test stay around 1400 since I have better sexual response at this level. When I was around 1100 I could not always maintain but now I can. My free is high now per the lab test (marked high) I just don't remember the number.

    One thing I have not been able to overcome on this is my energy level. I get tired frequently but not sure this is test related or something else. Thus my reason for changing doctors, my current one is not doing anything. He just says all your levels look really good etc.

    Also, if on HRT and doing a cycle, is there really a need to to give the receptors a rest via a pct? I am getting conflicting input from two individuals. Thoughts?

    Thank You
    Last edited by toddbo01; 09-14-2011 at 11:17 AM.

  5. #85
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    Marcus 1000mg per 12 weeks is only 83mg per week. It would seem this would be too low. However you seem to say you even retain good muscle mass with this at the gym? The lowest ive seen is 100mg per week with E and CYP and a study I read says UNDEC is lower that cyp or E. I guess everyone is different.

    When you were on E how many mg per week were you taking?

    For frontloading, it would seem easier if the docs would just give test E 100mg/week for four weeks then start the long ester test. They could "tune" you up faster on this.


    Todd if you want help post up your blood work. That is the only way to tell where your Thyroid levels are (you feeling tired) and also if you aren't getting wood at 1100 that is the top level of test. Try taking 500 iu of HCG two day's before your shot split into 250iu the two day's before. Also look into your estrogen level's.
    Last edited by Brohim; 11-27-2011 at 11:01 AM.

  6. #86
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    Quote Originally Posted by marcus300 View Post
    Did you do the loading phase for the first 6 wks?

    Did your have bloodwork done?

    I know including myself around 5 people who are using Nebido and 4 of us are doing 1 every 12 wks and one is doing 1 every 10 wks, strange your having a rollercoast ride unless you didnt load correctly, but if for some reason your different than most 8 wks is still great but your the only one ive seen under 10 wks.

    Marcus what was your test levels with Nebidio?

  7. #87
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    I had been on gel for a year and was suffering badly, did not really understand just how bad I had been feeling until I started Nebido.

    It has only been a few weeks now but I feel SO GOOD, it is like a brand new me. And my girlfriend is over the moon, I am like a 21 year old again like you Marcus.

    I think the power of test is underrated when it comes to men´s well being, lets hope more and more doctors will start to understand that, because I met a lot of resistance when I started my quest. I even got "testosterone is useless to men and only abused by bodybuilders" yeah really !

    I will have my second shot in a couple of weeks (@ week 6) and I can´t wait

  8. #88
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    Quote Originally Posted by toddbo01 View Post
    Marcus,

    Can you tell me what your doctor had you on prior to the Nebido? What was the hormone and weekley dose?

    I have been on HRT for 2 years now. I take Test cyp twice a week, 100mg per shot.

    I did have great improvement once I went on it. My memory came back, better libido etc. I had a bone density issue in my left hip and that is how I found out I was low test. I was 46, now 48.

    I still don't get morning wood frequently unless I use HCG , which I use from time to time. I only take .5mg Arimidex per week but was told by another Endo I don't need it.

    I am getting ready to go to a new doctor. I believe he is much more experimental as he mentioned me being on Test E for better levels. He can't tell me more till he sees me in 2 weeks.

    Any suggestions on what you think I should ask him etc. I am still trying to add size, so like being at the high end. My current doctor has let my total test stay around 1400 since I have better sexual response at this level. When I was around 1100 I could not always maintain but now I can. My free is high now per the lab test (marked high) I just don't remember the number.

    One thing I have not been able to overcome on this is my energy level. I get tired frequently but not sure this is test related or something else. Thus my reason for changing doctors, my current one is not doing anything. He just says all your levels look really good etc.

    Also, if on HRT and doing a cycle, is there really a need to to give the receptors a rest via a pct? I am getting conflicting input from two individuals. Thoughts?

    Thank You
    I was on Test E before Nebido and was taking 125mgs weekly,
    I dont think you will need arimidex unless your bloods show elevated estrogen levels,
    You dont run a pct when on hrt if you go on cycle, just drop back down to your hrt dose,





    Quote Originally Posted by Brohim View Post
    Marcus 1000mg per 12 weeks is only 83mg per week. It would seem this would be too low. However you seem to say you even retain good muscle mass with this at the gym? The lowest ive seen is 100mg per week with E and CYP and a study I read says UNDEC is lower that cyp or E. I guess everyone is different.

    When you were on E how many mg per week were you taking?

    For frontloading, it would seem easier if the docs would just give test E 100mg/week for four weeks then start the long ester test. They could "tune" you up faster on this.


    Todd if you want help post up your blood work. That is the only way to tell where your Thyroid levels are (you feeling tired) and also if you aren't getting wood at 1100 that is the top level of test. Try taking 500 iu of HCG two day's before your shot split into 250iu the two day's before. Also look into your estrogen level's.
    Nebido therapy is the no1 therapy for hormone repla***ent or it is in my eyes and with all the studies ive posted in my first post you will see it outshines them all. Please read the studies if you require numbers and its performance when its up against Test E.


    Quote Originally Posted by Brohim View Post
    Marcus what was your test levels with Nebidio?
    My numbers are within mid range but ive not had them done for sometime now, I dont require any AI and I feel like when I was in my 20's and it maintains my size really well.

    Quote Originally Posted by BigIce View Post
    I had been on gel for a year and was suffering badly, did not really understand just how bad I had been feeling until I started Nebido.

    It has only been a few weeks now but I feel SO GOOD, it is like a brand new me. And my girlfriend is over the moon, I am like a 21 year old again like you Marcus.

    I think the power of test is underrated when it comes to men´s well being, lets hope more and more doctors will start to understand that, because I met a lot of resistance when I started my quest. I even got "testosterone is useless to men and only abused by bodybuilders" yeah really !

    I will have my second shot in a couple of weeks (@ week 6) and I can´t wait
    You will experience more changes as you go through the therapy, once the nebido is up and running at peak your life would of changed for the better
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    “Carrying a set to a point where you are forced to utilize 100 percent of your momentary ability is the single most important factor in increasing size and strength"--- Mike Mentzer

    “one set to failure is all that is required to stimulate an increase in strength and size – with no number of lesser sets having the same effect” – Mike Mentzer

  9. #89
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    Due to the pm's I've recently had, bump
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    “one set to failure is all that is required to stimulate an increase in strength and size – with no number of lesser sets having the same effect” – Mike Mentzer

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    My Doctor has changed my protocol from every 12 weeks to every 11, I was feeling a slight dip around wk 10 so we compromised
    Last edited by marcus300; 09-18-2012 at 08:37 PM.
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    “one set to failure is all that is required to stimulate an increase in strength and size – with no number of lesser sets having the same effect” – Mike Mentzer

  11. #91
    pugster is offline Associate Member
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    my protocol for nebido is now every 8 weeks , my last bloods at the end of week 8 showed TT at 17/nmol , hopefully this will go over 20 n/mol once ive had a few at the 8 week interval.

  12. #92
    dec11 is offline 'everything louder than everything else'
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    Quote Originally Posted by marcus300 View Post
    My Doctor has changed my protocol from every 12 weeks to every 11, I was feeling a slight dip around wk 10 so we compromised
    i squeezed the 10wk interval hehehe

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    dec11 is offline 'everything louder than everything else'
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    Quote Originally Posted by pugster View Post
    my protocol for nebido is now every 8 weeks , my last bloods at the end of week 8 showed TT at 17/nmol , hopefully this will go over 20 n/mol once ive had a few at the 8 week interval.
    holy shit, how'd you manage to talk 'em into that??!!!

  14. #94
    pugster is offline Associate Member
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    Quote Originally Posted by dec11 View Post
    holy shit, how'd you manage to talk 'em into that??!!!
    my doc said at the start he wanted to aim for low/mid 20's , tbh 8 weeks after my injections i started to feel a dip and by 10 weeks i felt as rough as hell , after telling him this he moved me to 8 weeks.
    tbh i think the lead time of 10-12 weeks by bayor for nebido is overstated and this time scale should be dropped to 8-10 weeks , i think a few docs know this now and are being more flexible with injection timescales , at 8 weeks its still by far the best treatment on the market atm (imo) as marcus says.

  15. #95
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    Quote Originally Posted by pugster View Post
    my doc said at the start he wanted to aim for low/mid 20's , tbh 8 weeks after my injections i started to feel a dip and by 10 weeks i felt as rough as hell , after telling him this he moved me to 8 weeks.
    tbh i think the lead time of 10-12 weeks by bayor for nebido is overstated and this time scale should be dropped to 8-10 weeks , i think a few docs know this now and are being more flexible with injection timescales , at 8 weeks its still by far the best treatment on the market atm (imo) as marcus says.
    Thats remarkable to get your Doctor to go outside the guidelines of the medication, never heard of that especially in the UK were I would say our doctors are behind the times with hormone therapy, well done.
    My dip use to come on around week 10 but it wasn't really bad just that I felt a slight dip so the 11 wk protocol should be just fine with me.

  16. #96
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    I don't think he's going to be on his own when I spoke to the doc he mentioned every 8-10 weeks and I think we share the same doctor

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    Quote Originally Posted by milky01623 View Post
    I don't think he's going to be on his own when I spoke to the doc he mentioned every 8-10 weeks and I think we share the same doctor
    naw i dont think we share the same doc as i get treatment on the nhs, tho it was me that recommended dr savage to you as ive spoken to him on the phone in the past (my own research led me to him when i was first looking into low testosterone and its symptoms), tho i get the impression a few TRT docs are becoming more flexible with dosage times so hopefully they will go on symptoms rather than fixed injection timing.
    Last edited by pugster; 09-19-2012 at 12:54 PM.

  18. #98
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    Sounds all good guys

    We have a nice Nebido gang here now lol
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  19. #99
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    Quote Originally Posted by pugster

    naw i dont think we share the same doc as i get treatment on the nhs, tho it was me that recommended dr savage to you as ive spoken to him on the phone in the past (my own research led me to him when i was first looking into low testosterone and its symptoms), tho i get the impression a few TRT docs are becoming more flexible with dosage times so hopefully they will go on symptoms rather than fixed injection timing.
    Sorry I got you mixed up with plunn lol
    Thanks for the info on leger clinic and what's more is because of dr savage I'm in the process of arrangeing an appt with an endo on the nhs
    I hope our little nebido gang doesn't want Xmas cards I'm skint and we're in recession lol

  20. #100
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    Yes good gang and very informative..

  21. #101
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    Hi guys. I have been lurking here for awhile and have learned a lot about TRT!
    Got my first Nebido injection today and I have been on Testogel with good results buy my endo and I decided to step up the game with injections.
    Looking forward to learn some more and to the second injection in six weeks...

  22. #102
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    Quote Originally Posted by dunder View Post
    Hi guys. I have been lurking here for awhile and have learned a lot about TRT!
    Got my first Nebido injection today and I have been on Testogel with good results buy my endo and I decided to step up the game with injections.
    Looking forward to learn some more and to the second injection in six weeks...
    Well your going to like no more bathing in the gel every day! And if your squeamish with a needle, then you are good to go with seeing your doc every 2 or 3 months for follow up injections for nebido. There are a lot of men I would estimate that want to be on injections but are scared, afraid, or just plain squeamish on doing it themselves, or even having someone else do it for them. So they stick to gels and creams to rub on them. One thing now though is that you won't need to worry about the transference factor of gels, where it can rub off on your wife or prepubescent children causing them to go into puberty early. That is if you have young children. But with the wife, she could have ended up with a fuller beard and lower voice than you over time. So now those possible worries are out the window. As they say in Australia..No Worries Mate!

  23. #103
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    Quote Originally Posted by Shol'va View Post
    Well your going to like no more bathing in the gel every day! And if your squeamish with a needle, then you are good to go with seeing your doc every 2 or 3 months for follow up injections for nebido. There are a lot of men I would estimate that want to be on injections but are scared, afraid, or just plain squeamish on doing it themselves, or even having someone else do it for them. So they stick to gels and creams to rub on them. One thing now though is that you won't need to worry about the transference factor of gels, where it can rub off on your wife or prepubescent children causing them to go into puberty early. That is if you have young children. But with the wife, she could have ended up with a fuller beard and lower voice than you over time. So now those possible worries are out the window. As they say in Australia..No Worries Mate!
    I have no problem with needles and I actually looked forward to get the shot. The nurse that gave it to me was experienced with giving Nebido shots and I didn't felt any pain. However she complained a little about the thick oil and that she has to push the syringe so hard that she almost breaks her fingers...

  24. #104
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    Source: Testosterone Treatment and Mortality in Men with Low Testosterone Levels. Shores MM, Smith NL, Forsberg CW, et al. Testosterone. J Clin Endocrinol Metab 2012; Published ahead of print April 11, 2012



    Observational cohort study examined the association between testosterone replacement therapy and mortality in men with low testosterone levels compared with no testosterone treatment.
    This large retrospective observational cohort study of 1031 men with low testosterone (also known as hypogonadism) from seven Veteran Affairs medical centres in the US was the first to look for a link between testosterone treatment and mortality (death rate) in men with low testosterone. During the three and a half year study, 39% of the men received testosterone replacement therapy (intramuscular injections, testosterone patches or gel), and 61% did not. The mortality of treated men was compared with that of untreated men. The men in the study were aged 40 years or older (average age 62 years), with no history of prostate cancer, but they had a high number of other medical conditions, including diabetes (38%), sexual dysfunction (low libido; 36%) and heart disease (21%).Key Findings
    Overall during the study, one in ten men who received testosterone replacement therapy for low testosterone died, while one in five of those who had low testosterone but did not receive treatment died
    Treated men had a 39% lower risk of dying than untreated men when all the factors such as age, initial testosterone level, body characteristics and medical conditons, were taken into consideration
    Testosterone treatment appeared to be most beneficial in younger men, men with diabetes, and men without heart disease
    Source: Testosterone Treatment and Mortality in Men with Low Testosterone Levels. Shores MM, Smith NL, Forsberg CW, et al. Testosterone. J Clin Endocrinol Metab 2012; Published ahead of print April 11, 2012.

    Background information
    Low testosterone levels are common in older men, and have been linked to a number of conditions, including diabetes, obesity, cardiovascular problems, loss of muscle mass and strength, poor bone density, and low libido. A number of studies have found that men with low testosterone tend to die at a higher rate than men with normal testosterone levels.

    Although beneficial effects for testosterone treatment, including improvements in muscle mass and strength and increased bone density, insulin sensitivity and libido, have been shown in older men with low testosterone, this is the first study to specifically look at the link between testosterone treatment and mortality in middle-aged and older men with low testosterone. It is also interesting that men in this study often had a high level of other medical conditions that might make them more liable to harm or benefit from testosterone treatment.

    An observational cohort study is used to explore the possible effect of a treatment on a group of similar subjects (cohort). It can either be prospective (following subjects over time) or retrospective (looking at the medical records of subjects who have already undergone treatment). The results of this retrospective observational study do not allow us to say for certain that testosterone treatment was the cause of the longer survival of the men who received treatment for their low testosterone, as there may have been other factors to explain the reduced mortality in men treated with testosterone. The results are very interesting, all the same, and are likely to encourage further research into the effects of testosterone treatment for men with low testosterone.
    *Anyone wanting a source check from a willing vet/mod must first acquire 100 posts and 45 days of activity*

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    “one set to failure is all that is required to stimulate an increase in strength and size – with no number of lesser sets having the same effect” – Mike Mentzer

  25. #105
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    Source: Low testosterone is associated with an increased risk of MACE lethality in subjects with erectile dysfunction. Corona G, Monami M, Boddi V, et al. J Sex Med 2010;7(4 Pt 1):1557-1564



    Increased risk of dying from cardiovascular disease for men with erectile dysfunction and low testosterone
    Nearly 1700 men attending an andrology clinic for erectile dysfunction were monitored for an average of 4.3 years to find out whether those with low testosterone levels were more likely to suffer a major cardiovascular disease event, such as a heart attack or stroke.
    Key Findings
    At the start of the study, over 22% of the men had testosterone levels in the blood that were lower than the widely accepted lower limit for normal testosterone levels (the medical term for low testosterone is hypogonadism)
    Over the course of the study, 139 men had a major cardiovascular event, such as heart attack, stroke, sudden cardiac death or other major cardiac events
    For 15 of these men, the major cardiovascular event was fatal
    Although having a low testosterone level did not make men more likely to have a cardiovascular event, men with lower levels of testosterone who had a major cardiovascular event were seven times more likely to die than those with higher testosterone levels.
    Source: Low testosterone is associated with an increased risk of MACE lethality in subjects with erectile dysfunction. Corona G, Monami M, Boddi V, et al. J Sex Med 2010;7(4 Pt 1):1557-1564.

    Background information
    There is increasing evidence that erectile dysfunction may be a warning sign of a number of disease conditions, such as high blood pressure, metabolic syndrome, diabetes mellitus, depression and coronary heart disease.

    This study is important as it is the first to show that low testosterone increases the risk of men with erectile dysfunction dying from cardiovascular events
    Low testosterone is often a contributing factor to erectile dysfunction
    Seeking advice or treatment for symptoms of erectile dysfunction gives an opportunity for both the patient and his doctor, as a check-up may uncover other health issues that would benefit from early treatment or lifestyle changes
    It is known that testosterone replacement therapy benefits sexual function and improves the effectiveness of common treatments for erectile dysfunction in men with low testosterone
    Testosterone replacement therapy may also have benefits in preventing or slowing the development of atherosclerosis
    Screening for low testosterone may also be a worthwhile way of discovering those men most at risk from heart disease
    However, more study is needed to find out if testosterone replacement therapy can help prevent unnecessary deaths from cardiovascular disease in men with erectile dysfunction.
    *Anyone wanting a source check from a willing vet/mod must first acquire 100 posts and 45 days of activity*

    “Carrying a set to a point where you are forced to utilize 100 percent of your momentary ability is the single most important factor in increasing size and strength"--- Mike Mentzer

    “one set to failure is all that is required to stimulate an increase in strength and size – with no number of lesser sets having the same effect” – Mike Mentzer

  26. #106
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    Quote Originally Posted by marcus300 View Post
    Source: Testosterone Treatment and Mortality in Men with Low Testosterone Levels. Shores MM, Smith NL, Forsberg CW, et al. Testosterone. J Clin Endocrinol Metab 2012; Published ahead of print April 11, 2012



    Observational cohort study examined the association between testosterone replacement therapy and mortality in men with low testosterone levels compared with no testosterone treatment.
    This large retrospective observational cohort study of 1031 men with low testosterone (also known as hypogonadism) from seven Veteran Affairs medical centres in the US was the first to look for a link between testosterone treatment and mortality (death rate) in men with low testosterone. During the three and a half year study, 39% of the men received testosterone replacement therapy (intramuscular injections, testosterone patches or gel), and 61% did not. The mortality of treated men was compared with that of untreated men. The men in the study were aged 40 years or older (average age 62 years), with no history of prostate cancer, but they had a high number of other medical conditions, including diabetes (38%), sexual dysfunction (low libido; 36%) and heart disease (21%).Key Findings
    Overall during the study, one in ten men who received testosterone replacement therapy for low testosterone died, while one in five of those who had low testosterone but did not receive treatment died
    Treated men had a 39% lower risk of dying than untreated men when all the factors such as age, initial testosterone level, body characteristics and medical conditons, were taken into consideration
    Testosterone treatment appeared to be most beneficial in younger men, men with diabetes, and men without heart disease
    Source: Testosterone Treatment and Mortality in Men with Low Testosterone Levels. Shores MM, Smith NL, Forsberg CW, et al. Testosterone. J Clin Endocrinol Metab 2012; Published ahead of print April 11, 2012.

    Background information
    Low testosterone levels are common in older men, and have been linked to a number of conditions, including diabetes, obesity, cardiovascular problems, loss of muscle mass and strength, poor bone density, and low libido. A number of studies have found that men with low testosterone tend to die at a higher rate than men with normal testosterone levels.

    Although beneficial effects for testosterone treatment, including improvements in muscle mass and strength and increased bone density, insulin sensitivity and libido, have been shown in older men with low testosterone, this is the first study to specifically look at the link between testosterone treatment and mortality in middle-aged and older men with low testosterone. It is also interesting that men in this study often had a high level of other medical conditions that might make them more liable to harm or benefit from testosterone treatment.

    An observational cohort study is used to explore the possible effect of a treatment on a group of similar subjects (cohort). It can either be prospective (following subjects over time) or retrospective (looking at the medical records of subjects who have already undergone treatment). The results of this retrospective observational study do not allow us to say for certain that testosterone treatment was the cause of the longer survival of the men who received treatment for their low testosterone, as there may have been other factors to explain the reduced mortality in men treated with testosterone. The results are very interesting, all the same, and are likely to encourage further research into the effects of testosterone treatment for men with low testosterone.

    interesting.......... i need to go get tested!

    great work as always

    i think that new guidelines need to be made about the levels of test in males. i think that 400-900ng is way too broad and it needs to be broken down into smaller sections (for example 300-400ng would be on the really low side). what do you think about that?

  27. #107
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    A week ago I had my second shot of nebido after six weeks from the first one. The last couple of days I've been feeling pretty great.
    I haven't been in such a good mood since I don't know when, maybe seven years ago.
    I must say that I didn't feel much after the first shot and I was skeptical. But I aint no more.
    I just hope this will last 12 weeks to the next shot. To be continued...

  28. #108
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    A study on the tolerability and effectiveness of injectable testosterone undecanoate for the treatment of male hypogonadism in a worldwide sample of 1,438 men




    Efficacy and safety of long-acting testosterone undecanoate in men with hypogonadism in daily clinical practice
    IPASS: a study on the tolerability and effectiveness of injectable testosterone undecanoate for the treatment of male hypogonadism in a worldwide sample of 1,438 men. Zitzmann M, Mattern A, Hanisch J, et al. J Sex Med 2012 [Epub ahead of print].

    This Research News article reviews article available in full from The Journal of Sexual Medicine, via Wiley Online Library.

    This prospective, observational, post-authorization surveillance study investigated the safety and efficacy of intramuscular injections of testosterone undecanoate (TU) in men with testosterone deficiency syndrome (hypogonadism) in a clinical practice setting.1 The study, conducted in 23 countries throughout Europe, Asia, Latin America and Australia, enrolled 1493 men (mean age 49.2 ± 13.9 years) with a diagnosis of primary or secondary testosterone deficiency syndrome (serum total testosterone 8–12 nmol/L for newly diagnosed treatment-naïve patients). The men received up to five injections of TU during an observation period of 9–12 months. Between the first and second injections of the agent there was an interval of 6–10 weeks, and subsequent injections were given at intervals of 12 ± 2 weeks.

    The study aimed to assess treatment outcomes of male patients with testosterone deficiency syndrome who received TU under ‘real-life’ conditions, and to assess the treatment continuation rate in such patients and further confirm the safety profile of TU. Parameters of erectile function, libido, vigor/vitality, mood and ability to concentrate were assessed by physician interview using items and five-point Likert scales. Certain physical and circulatory parameters, as well as other laboratory parameters, were also measured at each injection visit.

    Of the 1493 men enrolled, 72.5% were Caucasian, followed by 19.7% and 7.5% of Asian and Latin American descent, respectively. A total of 1438 and 1140 men were evaluable at baseline and at the time of the fifth injection, respectively. At baseline, mean body weight was 86.8 kg, and 54% of those enrolled had previously received androgen therapy. Mean serum testosterone (T) was 9.6 ± 7.5 nmol/L, and comorbidities included erectile dysfunction (ED), hypertension and dyslipidemia.


    Key Points
    Mean trough serum total T increased from 9.6 nmol/L at baseline to 17.3 nmol/L before the fifth injection (p<0.0001)
    At the time of injection 5, there was a significant improvement in the overall levels of sexual desire/libido compared with baseline


    A total of 64% of patients at baseline experienced very low/low sexual desire/libido compared with 10% at injection 5
    The proportion of patients with a high/very high libido increased from 10% at baseline to 61% at injection 5 (overall p<0.0001)
    Significant improvements over each injection interval were seen in the overall levels of vigor/vitality, mood and ability to concentrate (p<0.0001 for each)
    The proportion of patients reporting moderate, severe or extremely severe ED was significantly decreased from baseline at the time of the fifth TU injection, from 65% to 19% (p<0.0001)


    In those patients with some form of ED who did not receive concomitant phosphodiesterase type 5 (PDE5) inhibitor therapy, 56% reported a decrease from baseline in ED severity following TU therapy
    The proportion of patients reporting a high or very high response to PDE5 inhibitor therapy increased from 35.1% at baseline to 56.6% at injection 5
    Mean waist circumference decreased from 100 to 96 cm and the reduction was statistically significant whether or not patients had previously received androgen therapy (Figure 1)
    A total of 35.4% of patients each, reported being very satisfied or satisfied after treatment with TU
    Blood pressure, serum triglyceride, total cholesterol and LDL cholesterol levels were all significantly improved from baseline at injection 5 (p<0.02; Figure 2) whereas there was a slight increase in HDL cholesterol (not statistically significant)
    Adverse drug reactions (ADRs) related to TU therapy were rare (5.8%), and only 1 was considered serious (0.1%)


    The most common ADRs were increased hematocrit, increased PSA levels and injection site pain, all of which occurred in <1% of patients
    Overall, ADRs were associated with treatment discontinuation in 31 patients.


    What is known
    Hypogonadism (testosterone deficiency syndrome), which can be defined as serum total testosterone ≤12 nmol/L and a positive score suggestive of androgen deficiency on the AMS questionnaire, is increasingly recognized as a significant health problem in aging men.2-8 Testosterone deficiency syndrome adversely impacts physical health (including loss of physical strength, loss of muscle mass, increased visceral fat leading to a higher risk for metabolic syndrome and premature death), sexual function (loss of secondary sexual characteristics, decreased libido and erectile dysfunction) and psychological health (mood changes and sleep disturbances).5 Androgen replacement therapy is the principal treatment for testosterone deficiency syndrome, and involves the administration of T at doses which aim to reproduce normal blood T levels, in order to improve exposure of androgen-dependent tissues and organs to T. In general, the better the improvement in T levels after androgen replacement therapy, the better the clinical outcomes.1 TU is an intramuscularly administered, long-acting formulation of T used as an androgen replacement therapy for men affected by testosterone deficiency syndrome. As few large-scale post-marketing surveillance studies of TU have been conducted, and no large trials evaluating the agent in Asian and South American populations have been conducted at all, this trial aimed to confirm the safety profile of TU in men with testosterone deficiency syndrome, and to evaluate the efficacy of the agent in a ‘real world’ clinical setting throughout Europe, Asia, Latin America and Australia.


    What this study adds
    This international, multicenter, one-arm, non-interventional, prospective, observational Post-Authorization Surveillance Study (IPASS) confirmed the safety profile of TU, and demonstrated its effectiveness in a large global cohort of patients, including those from Asia and South America.1

    Mental and psychosexual function scores (libido, vigor, overall mood and ability to concentrate) were all significantly improved over the course of the study, as were blood pressure and the majority of lipid parameters examined (Figure 1). After four injections of TU, the proportion of patients with low or very low sexual desire was significantly decreased, and 89% of patients declared themselves to be satisfied or very satisfied with TU therapy. The major limitation of this study was its potential for bias; however, the large sample size somewhat reduces the chance of this.








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    References

    1. Zitzmann M, Mattern A, Hanisch J, et al. IPASS: a study on the tolerability and effectiveness of injectable testosterone undecanoate for the treatment of male hypogonadism in a worldwide sample of 1,438 men. J Sex Med 2012 [Epub ahead of print].
    2. Ullah MI, Washington T, Kazi M, et al. Testosterone deficiency as a risk factor for cardiovascular disease. Horm Metab Res 2011;43(3):153-164.
    3. Wang C, Jackson G, Jones TH, et al. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes Care 2011;34(7):1669-1675.
    4. Bassil N, Morley JE. Late-life onset hypogonadism: a review. Clin Geriatr Med 2010;26(2):197-222.
    5. Wang C, Nieschlag E, Swerdloff R, et al. Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations. Eur Urol 2009;55(1):121-130.
    6. Kazi M, Geraci SA, Koch CA. Considerations for the diagnosis and treatment of testosterone deficiency in elderly men. Am J Med 2007;120(10):835-840.
    7. Traish AM, Miner MM, Morgentaler A, et al. Testosterone deficiency. Am J Med 2011;124(7):578-587.
    8. Saad F, Aversa A, Isidori AM, et al. Onset of effects of testosterone treatment and time span until maximum effects are achieved. Eur J Endocrinol 2011;165(5):675-685.
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  29. #109
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    Need to cover a few things here;

    1)I'm currently taking 150mg of Test E every 10 days. My level at this amount is between 900-1000. Marcus you refer to your levels being mid range at your protocol. Do you mind sharing exactly what Total Testosterone level you are?
    2)I will be traveling to California in 2 weeks to get a complete BW and than have my HRT doc evaluate the results. I will definitely be asking him about Nebido. However since it's not FDA approved and the economic angle I'm afraid I won't get a straight answer. Coupled with the fact that I currently live in a very remote place, I'll be on my own if I decide to switch over. I can get my blood tested to monitor my levels. Can you help me out with a protocol? Basically would like to stay in the 900-1000 range.
    3) would love to stop;
    a. having to do injections every 10 days
    b. taking arimidex
    c. eventually not having to worry about my Estrogen levels

    Thanks

  30. #110
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    Quote Originally Posted by fm2002 View Post
    Need to cover a few things here;

    1)I'm currently taking 150mg of Test E every 10 days. My level at this amount is between 900-1000. Marcus you refer to your levels being mid range at your protocol. Do you mind sharing exactly what Total Testosterone level you are?
    2)I will be traveling to California in 2 weeks to get a complete BW and than have my HRT doc evaluate the results. I will definitely be asking him about Nebido. However since it's not FDA approved and the economic angle I'm afraid I won't get a straight answer. Coupled with the fact that I currently live in a very remote place, I'll be on my own if I decide to switch over. I can get my blood tested to monitor my levels. Can you help me out with a protocol? Basically would like to stay in the 900-1000 range.
    3) would love to stop;
    a. having to do injections every 10 days
    b. taking arimidex
    c. eventually not having to worry about my Estrogen levels

    Thanks
    1, My levels were around 600 mark at a 12 week protocol, which was fine for me had no isses what so ever. Since them Ive been dropped down to 11 weeks but haven't had bw done since. The protocols are from 8 weeks to 12 weeks, so I am sure you will get a good solid range.

    2,Nebido isn't approved in the USA yet so doubt you will be able to get hold of it but around the 8 week protocol would get your levels at high range.

    3, I take one injection every 11 wks, I also don't take no AI, its not needed.
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  31. #111
    fm2002 is offline Associate Member
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    Thanks Marcus !

    Since I'm already a long time Test Ethanate user and will confirm soon, but sure my levels are between 900-1000, would I skip the front loading and just do 4ml ? Than wait how long; 6 weeks or 12 weeks for the next injection?

    Than I suppose to adjust your level you would toggle between 9-12 weeks of a 4 ml injection?

    Lastly if one wanted to do hcg when would you do this?

  32. #112
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    Every 11 weeks now and feeling good, estrogen in check and levels between 600-700mark
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  33. #113
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    hello Marcus; I read all of your posts about Nebido ,.Just want to ask about LOADING PHASE.Can you explain how should it be?

  34. #114
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    Quote Originally Posted by DelTurco View Post
    hello Marcus; I read all of your posts about Nebido ,.Just want to ask about LOADING PHASE.Can you explain how should it be?
    It tells you on the first page of this thread, thanks
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  35. #115
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    Product Name: Nebido® (Reandron® in Spain, Reandron®1000 in Australia, Nebid® in Italy)

    Indications: hypogonadism

    Disease or condition: Typical signs of testosterone deficiency, known as hypogonadism, may include: Increased irritability or depression, fatigue, decreased concentration, noticeable decrease in lean body mass and increase in fat mass, particularly abdominal fat, decreased libido and sex drive, erectile dysfunction and decreased frequency of morning erections, reduced muscle mass and strength, loss of body hair, osteoporosis.

    Drug mechanism: Nebido® provides testosterone to men whose testes do not produce enough testosterone.

    More detailed: Nebido® is the first registered testosterone undecanoate preparation for intramuscular injection. One ampoule contains 1000 mg of testosterone undecanoate in 4 ml of oily vehicle and is available in a corresponding individual packaging.

    Nebido® is an intramuscularly administered depot preparation of testosterone undecanoate. Following intramuscular injection of testosterone undecanoate as an oily solution, the com-pound is gradually released from the depot and immediately cleaved by serum esterases into testosterone and undecanoic acid. An increase in serum levels of testosterone above basal values may be seen immediately after administration. The muscle serves as a depot for the sustained release of testosterone into the systemic circulation.

    Circulating testosterone is chiefly bound in the serum to sex hormone-binding globulin (SHBG) and albumin. The albumin-bound fraction of testosterone easily dissociates from albumin and is presumed to be bioactive. The portion of testosterone bound to SHBG is not considered biologically active. The amount of SHBG in the serum and the total testosterone level will determine the ratio of bioactive and non-bioactive androgen. SHBG-binding capacity is high in prepubertal children, declines during puberty and adulthood, and increases again during the later decades of life. Approximately 60 % of testosterone in plasma is bound to SHBG, 2 % remains unbound (free) and the rest is bound to albumin and other proteins1.

    Product characteristics (package/color/durability/dosage):
    Nebido® Ampoule vergrößern Nebido® is the first registered testosterone undecanoate preparation for intramuscular injec-tion. One ampoule contains 1000 mg of testosterone undecanoate in 4 ml of oily vehicle and is available in a corresponding individual packaging.

    As stability tests have shown that Nebido® is stable at a temperature of 30°C for at least 24 months and at a temperature of 40°C for at least 6 months, there are no particular precau-tions for storing the product. It is recommended to store the product at room temperature. Shelf life is 5 years in most countries. The medicinal product must be used immediately after first opening.

    Nebido® is injected in intervals of 10-14 weeks. It is advisable to reduce the first interval to six weeks in order to reduce the time until steady state conditions are reached. (During the initial time of treatment the mean concentration of testosterone is slowly increasing with each injection. Steady state is reached when the amount of testosterone supplied with an injection replaces exactly what has been metabolized from the intramuscular depot). Individualization of therapy is required and should be based on serum testosterone levels achieved under Nebido® treatment and clinical symptomatology.



    For what is Nebido® licensed?
    Nebido® Packshot vergrößern In the countries where it is licensed, Nebido® is authorized for testosterone replacement therapy of primary and secondary male hypogonadism, i.e., if testosterone deficiency has been confirmed both by clinical and by laboratory tests. Nebido® is licensed in more than 80 countries worldwide.
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  36. #116
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    "Product Name: Nebido® (Reandron® in Spain, Reandron®1000 in Australia, Nebid® in Italy)"

    Does this mean it is available in the US now?

  37. #117
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    "Product Name: Nebido® (Reandron® in Spain, Reandron®1000 in Australia, Nebid® in Italy)"

    what from this statement says anything about US?!

  38. #118
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    Quote Originally Posted by bass
    "Product Name: Nebido® (Reandron® in Spain, Reandron®1000 in Australia, Nebid® in Italy)"

    what from this statement says anything about US?!
    I was thinking the exact same prior to reading your comment lol.

  39. #119
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    Duhhhh............your right.

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    Quote Originally Posted by ctenosaura View Post
    "Product Name: Nebido® (Reandron® in Spain, Reandron®1000 in Australia, Nebid® in Italy)"

    Does this mean it is available in the US now?
    No it doesn't otherwise it would state available in the US
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