OK Total T , low Free T

[IncreaseMyT]

BTW yes we agree with Doctor Morgantaler's assessment on cardiovascular risk, prostate risk and HCT. We do not however agree with a single thing in that table above.

Just FYI it still says on a bottle of Watson test cyp to inject "50-200mg every 2-4 weeks"

Do you think that is also a good administration schedule?

And yes one of if not the top TRT clinic in the world sir.

[Mr.BB]

None of them know their ass from a hole in the ground if they are a proponent of every 10 week injections.

You obviously do not understand how TT levels rise and fall, and obviously neither do they.

1,000 mg in one shot? ARE YOU NUTS? haha I am seriously beside myself that you and whoever they are do not understand that TT levels will hit 7,000 ng/dl with a shot like that once steady state has been achieved. If you think thats not dangerous and reckless you have a lot to learn.

Like I said earlier you read way too much and don't realize there is a very small % of doctors in the world that understand the pharmacokinetics and pharmacologic attributes of the medicine they are discussing.

From: http://neaua.org/abstracts/2009/6.cgi

First Long Acting Testosterone Undecanoate Injection to Treat Male Hypogonadism:
21 Month Safety and Efficacy Outcomes
Abraham Morgentaler, MD1, Joel M. Kaufman, MD2, Ridwan Shabsigh, MD3, Martin M. Miner, MD4, Ronald S. Swerdloff, MD5, Christina Wang, MD5, Adrian S. Dobs, MD, MHS6.
1Harvard Medical School, Boston, MA, USA, 2University of Colorado School of Medicine, Denver, CO, USA, 3Maimonides Medical Center and Columbia University, New York, NY, USA, 4The Warren Alpert Medical School of Brown University, Providence, RI, USA, 5David Geffen School of Medicine at UCLA, Los Angeles, CA, USA, 6Johns Hopkins University School of Medicine, Baltimore, MD, USA.

BACKGROUND:
Pharmacokinetic data from a phase 3 study regarding testosterone undecanoate (TU) 750 mg injections for treatment of hypogonadism was previously reported for time points up to 24 wks. The purpose of this study was to report new, longer-term data with results up to 21 mo of treatment.

METHODS:
This was a multicenter, US based study of TU 750 mg injections given at baseline, at wk 4, and every 10 wks thereafter through 84 wks of treatment. Males ≥18 yrs of age with primary or secondary hypogonadism and a screening serum T concentration <300 ng/dL were eligible. Frequent blood sampling was collected during wks 14-24 (after 3rd injection) and wks 24-34 (after 4th injection). Trough T samples were collected at each injection visit. Extensive safety monitoring procedures included clinical laboratories, comprehensive prostate health, and adverse event (AE) assessments.

RESULTS:
130 patients were enrolled, with >75% completing all injections during the treatment period. Patients average 54 yrs of age. Average 10 wk T concentrations during wks 14-24 were 494.6 ng/dL (SD 141.46 ng/dL). T concentration profiles were similar for each injection interval (Figure 1), with peaks and nadirs nearly identical from one injection to the next, indicating consistent T replacement for these intervals. Average trough T concentrations were within normal range (300 to 1000 ng/dL) throughout the entire 21 mo treatment period.
Injections were well tolerated. AEs reported were minor and non-serious; 36.7% of patients experienced at least one possibly treatment related AE during the study, with acne and increased prostate specific antigen (PSA) the most commonly reported events, reported in 6.2% and 5.4% patients, respectively. There were 7 (5.4%) patients with increased PSA, 3 (2.3%) patients with increased hematocrit and/or hemoglobin, and 2 (1.5%) patients diagnosed with prostate cancer during the 21 mo study period.

CONCLUSIONS:
This study demonstrates that TU 750 mg every 10 wks for 21 mo effectively provides consistent T concentrations within the normal range, a favorable safety profile and high level of patient tolerability.
Figure 1: Mean (SD) serum total T concentrations after 3rd injection (wks 14-24) and 4th injection (wks 24-34) of TU 750 mg at steady state. (Horizontal lines are reference ranges for serum total T.)




There are dozens of studies about treating hypogonadism with testosterone undecanoate, specifically choosed one from the american society of endocrinology because it relates Aveed which is 750mg (nebido is 1000mg), and probably you will relate more to it.

Basically the study and the graph speak for it self, you are making yourself and your company look bad continuing this spectacle of ignorance.

It is not a crime or a big problem not to know everything, but it really looks bad not be humble enough to want to learn and discuss subjects without actually knowing the data. Again, you have no experience with nebido which is not FDA aproved, or Aveed which is the american version that I believe will be aproved soon, or has already been, so you dont know much about it, I get it, but be open to learn a bit more, it will make you look better.

[IncreaseMyT]

You can post all the nonsense you want to post, 600 mg injections got levels up to 2500 ng/dl in the testosterone dose relationship study its very clear, why on earth would you think a 1,000 mg shot of testosterone wouldn't make your levels of higher?

The only one that looks stupid here is your, because you have no idea how TT injections work.

Do you think "Nebido" has some magical power over the other T esters that it wont make your TT levels peak out 48 hours after injection?

I am sorry but I am going to step away from this comment and you can post any random published study you want in this thread, I know FOR A FACT a 1,000 mg shot will put your TT WELL OVER 5,000 ng/dl.

The problem is like you the author as no idea what true peak levels are and they are not testing peak levels, so you have no idea what they actually are. My guess is probably within 300ng/dl just FYI.

What is undecanoate fellas like 45% ester weight? So your injecting 550mg of raw T dude hahahah

[IncreaseMyT]

I guess the way they are doing they never reach steady state levels, and it looks to me like levels also trough at about 300ng/dl and below? So what would be the difference injecting TC every 2 weeks?

What exactly is the point of that? Do you not think its dangerous to have TT levels swing from 1200 to 300 ng/dl?

Why would it not be better to inject sub c and keep levels within a 100 point swing?

The point is no matter which way you look at the injection schedule you recommended, its reckless and doesn't work.

Would you like me to pull threads on it? On another board we sponsor same issues.

I mean look at the graph you posted, some of the patients were at 300ng/dl or less for 30 days? SOME OF THEM EVEN HIT 200 What is the point of injecting testosterone and have levels that are medically recognized as hypogonadism?

Nebido is no different than Sustanon , marketing BS

[Mr.BB]

You can post all the nonsense you want to post, 600 mg injections got levels up to 2500 ng/dl in the testosterone dose relationship study its very clear, why on earth would you think a 1,000 mg shot of testosterone wouldn't make your levels of higher?

The only one that looks stupid here is your, because you have no idea how TT injections work.

Do you think "Nebido" has some magical power over the other T esters that it wont make your TT levels peak out 48 hours after injection?

I am sorry but I am going to step away from this comment and you can post any random published study you want in this thread, I know FOR A FACT a 1,000 mg shot will put your TT WELL OVER 5,000 ng/dl.

The problem is like you the author as no idea what true peak levels are and they are not testing peak levels, so you have no idea what they actually are. My guess is probably within 300ng/dl just FYI.

What is undecanoate fellas like 45% ester weight? So your injections 550mg of raw T dude hahahah

So you went from calling me sir to dude

You are refusing to look at evidence even when they are presented to you, never seen such poor forum skills ffs.

Testosterone undecanoate peaks in 7 days, not 48 hours, and as shown on the graph posted above it peaks at an average 830 ng/dL with 750mg dose at 10 weeks interval.

Dont know why you are saying it will peak 5000 ng/dL, you are confusing with enanthate or cypionate . Well, I rest my case lol.

[IncreaseMyT]

Based on that graph looks like 300-400mg every 3 weeks would be the sweet spot.

[IncreaseMyT]

So you went from calling me sir to dude

You are refusing to look at evidence even when they are presented to you, never seen such poor forum skills ffs.

Testosterone undecanoate peaks in 7 days, not 48 hours, and as shown on the graph posted above it peaks at an average 830 ng/dL with 750mg dose at 10 weeks interval.

Dont know why you are saying it will peak 5000 ng/dL, you are confusing with enanthate or cypionate. Well, I rest my case lol.

I am not confused at all, your research is bunk buddy. Swinging your TT levels from 1200 to 200 is the way to go these days I guess haha

See my above post thanks.

[IncreaseMyT]

Testosterone undecanoate peaks in 7 days, .

Look at the graph YOU POSTED. lol obviously many men peaked at 3 days, your just looking at the average.

ALL ESTERS PEAK ROUGHLY THE SAME, it is the fall that is different.

[IncreaseMyT]

hmmm I wonder what kind of permanent damage they are doing to those guys. Basically they are suppressing these men, then letting their TT drop to 200 ng/dl and stay there for 30 days or more.

You do realize during this 30 day period they could have cholesterol build up and small adverse events to arterial walls due to decreased resiliency that could pose long term clotting problems?

[Mr.BB]

I guess the way they are doing they never reach steady state levels, and it looks to me like levels also trough at about 300ng/dl and below? So what would be the difference injection TC every 2 weeks?

What exactly is the point of that? Do you not think its dangerous to have TT levels swing from 1200 to 300 ng/dl?

Why would it not be better to inject sub c and keep levels within a 100 point swing?

The point is no matter which way you look at the injection schedule your recommended, its reckless and doesn't work.

Would you like me to pull threads on it? On another board we sponsor same issues.

I mean look at the graph you posted, some of the patients were at 300ng/dl or less for 30 days? What is the point of injecting testosterone and have levels that are medically recognized as hypogonadism?

Nebido is no different that Sustanon, marketing BS

It seems that Im responding to 2 persons, you seem a bit more knowledgeable than you colleague

Please notice that this graph is with Aveed (750mg), the guidelines suggest adjusting the interval so those out of range should reduce interval, but again with Nebido the dose is higher which would put them above those values.

Personnally everytime I inject testosterone subq got a inflammed bump under skin, so not really my favorite. But would like you to show data supporting this 100 point swing, this is pinning twice a week? do you have peak and bottom bloodwork?

Again for the general public, testosterone undecanoate is much easier with the big interval, not everybody like to self inject and to inject twice a week.

Nebido works for many, have no data about Aveed and frankly im a bit tired of having to proof everything I say to you, you can look it up yourself.

[IncreaseMyT]

You haven't proved a thing sorry.

Stand by every statement I made.

Nothing wrong with Nebido, if you had enough of a clue how to use it and reach steady state levels, from our conversations you may be a long way away though.

[IncreaseMyT]

You can look up what steady state means if you want, I too am tired of trying to explain it.

[IncreaseMyT]

Summary and Conclusion

(after these were done with threads on Nebido, if you want to risk your health with every 10 week injection schedules go for it)

1. Mr BB you claimed that every 10 week injections of Nebido were safe and effective. IMT highly disagrees. As we said earlier in the thread if one were to attain steady state levels and then do an injection of 1,000 mg your TT would hit 7,000 ng/dl. We stand by this statement.

2. Mr BB you posted a mapping table of TT levels of men on every 10 week TU injections. We did not realize you were never trying to reach steady state, that did not even come to mind because the whole goal of TRT is to attain and maintain steady state levels similar to eugonadal production. Your table clearly illustrates the negative effect of 10 week intervals. Patients falling into the 200 ng/dl range after being at 1200 ng/dl is a recipe for disaster. If you want this same effect simply inject TC 300mg every 3-4 weeks. Your peak and trough levels would be roughly the same as the table. (talk to a doc)

3. Mr BB earlier you posted an archaic table claiming to illustrate half-lives of certain esters such as testosterone enanthate . I am not sure if you are aware but the community has understood that is completely false for years now and we and the communities that allow us to post work tirelessly to educate men and the physicians that treat them, that enanthate and cypionate are actually 5-6 day esters. Spreading misinformation that these esters have 2 week half-lives plunges this community and TRT itself back into the stone age.

4. If one were to do TU injections IMT would guess that 300-400mg every 21 days would reach steady state and stay within optimal physiological range. (talk to a doc )

Before you showed that mapping table I had no clue anyone would be stupid enough to let someone bottom out like that before administering the next shot, but I guess that was the 1 thing we were wrong about here.

Not sure why you love Nebido so much and what your ulterior motive is, but if you really want to do something that is 12 week intervals you should try the pellets.

Not the pellets your insurance covers these are not strong enough and men and women run into the same problem as your mapping table, levels bottom out for the last 6 weeks and this is not good.

However, IMT uses compounded pellets that are stronger formulations that do last the entirety. We have some really cool ones that even have the anastrozole in the pellet. You can even get DHEA in them. These are bio-identical as well.

You also have creams as an option, or change your administration schedule.

Hope this helps.

[FakeLove]

Based on your comments you're obviously not qualified to make anything else than personal opinions about Nebido treatment. Nebido is the standard testosterone supplement in Europe that is prescriped for trt. And indeed the standard injection protocol is 1000mg every 10 to 14 weeks. In the states you have undecanoate supplement called Aveed 750mg/4ml which is injected at once. 750mg/4ml doesn't make sense to me since you have TE available, but 1000mg/4ml in a way does.

Now there can be a debate whether TT level fluctuation of the standard Nebido injection protocol is good or not. Based on my half life calculations 250mg every 2 to 2.5 weeks seem better, and based on my personal labs it is. I posted the results into the protocol thread, but that's naturally just my case. Some manage to stay between high and mid range of the TT scale for 10 weeks.

Why I'm using Nebido? Well Nebido and Sustanon are the only options in many European countries. I've been on it for almost two years and personally I'm okay with it. Injections every 2 and a half weeks makes life easier compared to 1 or 2 injections per week. Also all labs are in shape - cholesterol and everything. I've extended my protocol to two and a half weeks because due to my low SHBG free T gets quite high and my HCT was rising.

Would I use some different T supplement if available? Probably I would. Perhaps TE would be my choice to compare.

Nebido has been studied quite a lot and below is how the manufacturer (Bayer - Nebido® Prescribing Information - Nebido - Testosterone Undecanoate) tells about steady state conditions.

Steady-state conditions

After the 1st intramuscular injection of 1000 mg testosterone undecanoate to hypogonadal men, mean Cmax values of 38 nmol/L (11 ng/mL) were obtained after 7 days. The second dose was administered 6 weeks after the 1st injection and maximum testosterone concentrations of about 50 nmol/L (15 ng/mL) were reached. A constant dosing interval of 10 weeks was maintained during the following 3 administrations and steady-state conditions were achieved between the 3rd and the 5th administration. Mean Cmax and Cmin values of testosterone at steady-state were about 37 (11 ng/mL) and 16 nmol/L (5 ng/mL), respectively. The median intra- and inter-individual variability (coefficient of variation, %) of Cmin values was 22 % (range: 9-28%) and 34% (range: 25-48%), respectively.

It's been confirmed in many studies that these figures more or less apply. Also my personal labs followed these figures quite accurately. Things get way better by injecting 250mg at once though.

[hammerheart]

Why I'm using Nebido? Well Nebido and Sustanon are the only options in many European countries. I've been on it for almost two years. Personally I love it. Injections every 2 and a half weeks makes life easier compared to 1 or 2 injections per week. Also all labs are in shape - cholesterol and everything. I've extended my protocol to two and a half weeks since due to my low SHBG free T gets quite high and my HCT has been rising..

How do you split injections? Vials aren't intended for multi-dose.

I have been on nebido on more than a year and couldn't even get my beard growing steadily on it.

It's also grossly overpriced... I guess Ba**r made a good marketing job, it's funny to notice how makes its appearance as a sponsor at every damn endocrinology meeting; it's everywhere. My former endo too was sponsored as well as the whole Italian endos association. He did even publish a couple of studies on how great nebido is and I wasn't surprised he reacted negatively when I asked for a change - nebido is the most advanced TRT available he said - unless it was for another b***r product.

[FakeLove]

How do you split injections? Vials aren't intended for multi-dose.

I have been on nebido on more than a year and couldn't even get my beard growing steadily on it.

It's also grossly overpriced... I guess Ba**r made a good marketing job, it's funny to notice how makes its appearance as a sponsor at every damn endocrinology meeting; it's everywhere. My former endo too was sponsored as well as the whole Italian endos association. He did even publish a couple of studies on how great nebido is and I wasn't surprised he reacted negatively when I asked for a change - nebido is the most advanced TRT available he said - unless it was for another b***r product.

Naturally they're not officially multi-dose vials, but the rubber stopper seems exactly the same as in official multi-dose vial. So I just draw through it as I would in any multi-dose vial. I of course follow the basic aseptics and keep the vial in a minigrip bag in an upright position. Haven't experienced any problems ever. Based on my experience I highly recommend it since I'm not convinced that best possible result would be achieved by injecting at once. For many it just metabolises too fast. And when you play around with the half life in an excel it's quite clear that 250mg at once provides the best of both worlds. Most stable and high enough TT values with a decent pinning frequency. I'm not alone, there are also others doing it.

It is overpriced for sure. For me it's covered by the insurance so I'm personally not bothered about it. The situation in the Europe in terms of available supplements and doctor's general knowledge is horrible though. I could switch to Sustanon if I would want to, but that again generally would require 125mg every five days and I would really like to keep pinning frequency at least in two weeks. Makes travelling and everyday life so much easier.

Keep in mind though that the beard growth ain't a very good measurement if trt is working or not. It's all good for me and my bear growth hasn't changed. There's many other factors affecting to it than T.

[hammerheart]

I definitely agree about regimen, if I were to obtain TU (which itself, it's great) 250mg every two weeks would be my way to go.

Notice that nebido vials lack the benzyl alcohol, a preservative added to multi-dose vials. It acts as a bacteriostatic agent, preventing overgrowth of bacteria. You are running an health risk there.

[FakeLove]

There's benzyl benzoate still so don't think it's nothing to worry too much about.

[IncreaseMyT]

. Based on my half life calculations 250mg every 2 to 2.5 weeks seem better, and based on my personal labs it is. I posted the results into the protocol thread, but that's naturally just my case.

Just staying between high and low is not good enough. Dropping tt levels down to 320 would not be healthy for the patient either. It is the swing that is bad, not the actual number. (kind of like going through puberty, same sides)

We do agree with you on your injection schedule, and that has been our point, Nebido is not bad, the every 10 week injection schedule is.

So thank you for confirming our post's.

[Mr.BB]

It's also grossly overpriced...

Agreed it should be cheaper.

Still much MUCH cheaper than all TRT clinics in the US.

[IncreaseMyT]

Agreed it should be cheaper.

Still much MUCH cheaper than all TRT clinics in the US.

How do you know that? Just FYI I bet money JUST testosterone from IMT would be a lot cheaper than Nebido.

I could be wrong but now I am curious to know.