Krugerrs TRT Journey

[krugerr]

Sooooo... my doctors appointment this morning.

Dr - "So your results, I noticed that the LH was low. This could be the cause of your low testosterone , so I think we maybe stop the Nebido and investigate this further."
Me - "The LH is low because im using exogenous testosterone ...My Test levels are low because you didnt give me the booster shot at 6 weeks"
Dr - "Oh right, is that so?... Well we only give the booster shot if levels are low... I think I'll refer you to the Endo"

Im getting referred back, and hes given me script to give myself a shot. What a douche. I like the guy, but he clearly has never been taught a bloody thing about HRT.

[krugerr]

Just picked up my injection.
Going to inject it tomorrow morning, I've a blood test on Monday morning. That'll be 4 days after injection, so let's see what blood levels are saying then.

Sent from my iPhone using App

[IncreaseMyT]

Well your starting at 200 so they should be roughly what BB's table show. About 1200

If your trough was at say 800 you would be starting at 4x the blood concentration.

[krugerr]

Well your starting at 200 so they should be roughly what BB's table show. About 1200 If your trough was at say 800 you would be starting at 4x the blood concentration.

yep, interesting to see how high I peak, and how fast it drops weekly.

Sent from my iPhone using App

[krugerr]

Well I can tell me levels are unstable. Moody as fuck today.
Found myself slamming the phone down and swearing excessively in the office for no good reason.

[hammerheart]

I feel you. I have been running TRT without AI lately, was experiencing some joint pain, the problem was the UGL test being bunk, or just underdosed (swapped the vial now).

The issue now is though joint pain is going away I'm experiencing the worst brain fog ever, along with nervousness.


I need some AI right NOW, lol

[krugerr]

I feel you. I have been running TRT without AI lately, was experiencing some joint pain, the problem was the UGL test being bunk, or just underdosed (swapped the vial now). The issue now is though joint pain is going away I'm experiencing the worst brain fog ever, along with nervousness. I need some AI right NOW, lol

Ah mate I feel the brain fog. I can't concentrate at work. Last 3 weeks have been a haze!

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[hammerheart]

Both high and low E2 can trigger brain fog, but personally I found the former to be intolerable. I'm also having low grade fever, I feel like I'm going berserk mode at any time

[krugerr]

Both high and low E2 can trigger brain fog, but personally I found the former to be intolerable. I'm also having low grade fever, I feel like I'm going berserk mode at any time

I'm fine at high test or high TRT (self medicated). Low test those is debilitating.

<CALayer: 0xb221410>

[Mr.BB]

PHARMACOKINETICS

Absorption

Reandron 1000 is an intramuscularly administered depot preparation of testosterone undecanoate and thus circumvents the first-pass effect. Following intramuscular injection of testosterone undecanoate as an oily solution, the compound is gradually released from the depot and is almost completely cleaved by serum esterases into testosterone and undecanoic acid. An increase of serum levels of testosterone above basal values can already be measured one day after administration.

Distribution

In two separate studies, mean maximum concentrations of testosterone of 45 and 24 nmol/L were measured about 7 and 14 days, respectively, after single i.m. administration of 1000 mg of testosterone undecanoate to hypogonadal men. Post-maximum testosterone levels declined with an estimated half-life of about 53 days.In serum of men, about 98% of the circulating testosterone is bound to sex hormone binding globulin (SHBG) and albumin. Only the free fraction of testosterone is considered as biologically active. Following intravenous infusion of testosterone to elderly men, an apparent volume of distribution of about 1.0 L/kg was determined.

Metabolism

Testosterone which is generated by ester cleavage from testosterone undecanoate is metabolised and excreted the same way as endogenous testosterone. The undecanoic acid is metabolised by ß-oxidation in the same way as other aliphatic carboxylic acids.
Elimination
Testosterone undergoes extensive hepatic and extrahepatic metabolism. After the administration of radiolabelled testosterone, about 90% of the radioactivity appears in the urine as glucuronic and sulphuric acid conjugates and 6% appears in the faeces after undergoing enterohepatic circulation. Urinary products include androsterone and etiocholanolone.
Steady State Conditions
Following repeated i.m. injection of 1000 mg testosterone undecanoate to hypogonadal men using an interval of 10 weeks between two injections, steady-state conditions were achieved between the 3rd and the 5th administration. Mean Cmax and Cmin values of testosterone at steady-state were about 42 and 17 nmol/L respectively. Post-maximum testosterone levels in the serum decreased with a half-life of about 90 days, which corresponds to the release rate from the depot.

CLINICAL TRIALS

There were 4 pharmacokinetic studies, with 3 studies having open labelled extensions to support the dosage regimen, efficacy and safety of Reandron 1000 in the treatment of hypogonadism. The main pharmacokinetic and efficacy parameter was serum testosterone within the eugonadal range. The clinical studies included 72 men treated with Reandron 1000 (up to a maximum 36 weeks) while 60 men continued treatment longer term (range 18 – 33 months). Initially, the dosage regimen investigated was 6 weeks between injections (injected into the gluteal muscle) however this time interval between injections was found to be too frequent and resulted in accumulation. An optimal injection interval has not been defined and injections were administered in the extension phase of the clinical trials at intervals between 10 – 12 weeks. The possibility exists that supraphysiological serum testosterone levels may be attained even at the prescribed dosage regimen and the dosing interval may need to be titrated accordingly.

Results from the relevant clinical studies are summarised below.
Research Report No. A00315
This was a pharmacokinetic study conducted with Reandron 1000 in 14 hypogonadal men. The dosage interval between injections was 6 weeks and 4 intramuscular injections were administered. The primary efficacy parameter was the maintenance of testosterone levels within the eugonadal range after the 4th injection. Other secondary parameters investigated were adverse events, local intramuscular tolerability, status of the prostate and urine flow and standard clinical chemistry parameters including serum lipids and prostate specific antigen (PSA). The pharmacokinetic outcomes are presented below as Figure 1.
150729 Reandron 1000 DS 4
Figure 1. Time course of mean serum testosterone concentration (measured and net values) with SD during treatment of 14 hypogonadal patients with 4 x 1000 mg Reandron 1000 i.m.
It was found that at the end of the treatment period, all men had serum testosterone levels above the lower limit of the eugonadal range. The 6 week time interval between injections resulted in accumulation of testosterone suggesting that a longer time interval between injections was required. The implication is that serum testosterone levels should be monitored to determine the optimum interval between injections. Local tolerability at the injection site (gluteus medius muscle) was investigated with injection site pain reported 3 times at the time of injection and 3 times between injection intervals. Apart from injection site pain and leg pain associated with the injection, redness and tenderness at the injections site were also reported.
Research Report No. A01198
This was a comparative study with Reandron 1000 and testosterone enanthate (n = 20 per group) to investigate the efficacy and safety of treatment. Reandron 1000 was administered intramuscularly at 6 week intervals for the first 3 injections and then at a 9 week interval while testosterone enanthate was administered intramuscularly at 3 week intervals over the 30 week study duration. The primary efficacy variables investigated were erythropoiesis (haemoglobin, haematocrit) and grip strength, which were similar between the groups. Multiple secondary and safety parameters were investigated including serum testosterone levels and intramuscular tolerability (see Adverse Effects). The pharmacokinetic results for both treatment groups are presented below in Figure 2. The greater fluctuation in serum testosterone for the group treated with testosterone enanthate could be due to the longer dosing interval (3 weeks) between injections.
An extension of this clinical study (Research Report No. A05965) was allowed whereby all patients (n = 36 initiated the extension and n = 32 completed the extension phase) were administered a further 8 intramuscular injections of Reandron 1000 (84 weeks). The pharmacokinetic results for serum testosterone in the extension phase are presented in Figure 3.

****

Happy reading!

Really dont know what you expect from this, claiming ALL the studies Kruger and I already presented are wrong, Nebido has been studied throughly, and it is in application for years. So whatever is your reason to be against it, it is just dumb.

[IncreaseMyT]

In two separate studies, mean maximum concentrations of testosterone of 45 and 24 nmol/L were measured about 7 and 14 days, respectively, after single i.m. administration of 1000 mg of testosterone undecanoate to hypogonadal men. Post-maximum testosterone levels declined with an estimated half-life of about 53 days.In serum of men, about 98% of the circulating testosterone is bound to sex hormone binding globulin (SHBG) and albumin. Only the free fraction of testosterone is considered as biologically active. Following intravenous infusion of testosterone to elderly men, an apparent volume of distribution of about 1.0 L/kg was determined.

Notice I highlighted estimated for you? The half-life is EXACTLY when HALF of the peak concentration was reached. From your previous chart that was clearly anywhere between 14-35 days. So I don't know where they got that "estimation"

Metabolism

Testosterone which is generated by ester cleavage from testosterone undecanoate is metabolised and excreted the same way as endogenous testosterone. The undecanoic acid is metabolised by ß-oxidation in the same way as other aliphatic carboxylic acids.
Elimination
Testosterone undergoes extensive hepatic and extrahepatic metabolism. After the administration of radiolabelled testosterone, about 90% of the radioactivity appears in the urine as glucuronic and sulphuric acid conjugates and 6% appears in the faeces after undergoing enterohepatic circulation. Urinary products include androsterone and etiocholanolone.
Steady State Conditions
Following repeated i.m. injection of 1000 mg testosterone undecanoate to hypogonadal men using an interval of 10 weeks between two injections, steady-state conditions were achieved between the 3rd and the 5th administration. Mean Cmax and Cmin values of testosterone at steady-state were about 42 and 17 nmol/L respectively. Post-maximum testosterone levels in the serum decreased with a half-life of about 90 days, which corresponds to the release rate from the depot.

Now your saying the half life is 90 days? lol Which is it 53 or 90?

If it takes 5 x 90 days to reach steady state, you mean your telling me you think its healthy to wait 450 days for steady state to occur? haha This is a joke right?

CLINICAL TRIALS

There were 4 pharmacokinetic studies, with 3 studies having open labelled extensions to support the dosage regimen, efficacy and safety of Reandron 1000 in the treatment of hypogonadism. The main pharmacokinetic and efficacy parameter was serum testosterone within the eugonadal range. The clinical studies included 72 men treated with Reandron 1000 (up to a maximum 36 weeks) while 60 men continued treatment longer term (range 18 – 33 months). Initially, the dosage regimen investigated was 6 weeks between injections (injected into the gluteal muscle) however this time interval between injections was found to be too frequent and resulted in accumulation. An optimal injection interval has not been defined and injections were administered in the extension phase of the clinical trials at intervals between 10 – 12 weeks. The possibility exists that supraphysiological serum testosterone levels may be attained even at the prescribed dosage regimen and the dosing interval may need to be titrated accordingly.
Happy reading!

Notice how they said originally the dosage schedule was every six weeks? This means they reached steady state faster, hence why less frequent injections are much better.

Notice how they said that it was too frequent? Please explain to me, in your own words, why it is logical to extend the dosage schedule, rather than reduce the dosage and titrate down?



Happy comprehending

PS half-life is STILL 14-35 days per the chart YOU posted lololol


Still waiting for those positive labs too...........

[IncreaseMyT]

"In a following study (Nieschlag et al 1999) 13 hypogonadal men received 4 intramuscular injections of TU at 6-week intervals. T serum levels were never found to lie below the lower limit of normal, and only briefly after the 3rd and 4th injection were T serum levels above the upper limit of normal (Figure 1) while values peak and trough levels increased over the 24-week observation period. Serum estradiol and DHT followed the same pattern, not exceeding the normal limits. In order to better establish (von Eckardstein and Nieschlag 2002) suitable injection intervals for TU, 7 hypogonadal men received injections at gradually increasing intervals between the 5th and 10th injection (starting with 6-weeks injection interval) and from then on every 12-weeks. Steady state kinetics were assessed after the 13th injection. Cmax was 32.0 ± 11.7 nmol/L and half-life was 70.2 ± 21.1 days."

So now we have - 21 days, 40 days, 53 days, 70 days and 90 days

hahahahahaha

I am confused, I am trying to figure something out. Why do all these studies have different half lives?

B B B But the study said!!! ~ Mr BB

[IncreaseMyT]

KABLAM!!! And the hits just keep on coming. Add two more half life "estimations" to the list hahahah

Testosterone undecanoate (TU) provides testosterone (T) replacement for hypogonadal men when administered orally but requires multiple doses per day and produces widely variable serum T levels. We investigated the pharmacokinetics of a newly available TU preparation administered by intramuscular injection to hypogonadal men. Eight patients with Klinefelter's syndrome received either 500 mg or 1,000 mg of TU by intramuscular injection; 3 months later, the other dose was given to each man (except to one, who did not receive the 1,000-mg dose). Serum levels of reproductive hormones were measured at regular intervals before and after the injections. Mean serum T levels increased significantly at the end of the first week, from less than 10 nmol/L to 47.8+/-10.1 and 54.2+/-4.8 nmol/ L for the lower and higher doses, respectively. Thereafter, serum T levels decreased progressively and reached the lower-normal limit for adult men by day 50 to 60. Pharmacokinetic analysis showed a terminal elimination half-life of 18.3+/-2.3 and 23.7+/-2.7 days and showed a mean residence time of 21.7+/-1.1 and 23.0+/-0.8 days for the lower and higher doses, respectively. The area under the serum T concentration-time curve and the T-distribution value related to serum T concentration were significantly higher following the 1,000-mg dose than following the 500-mg dose. The 500-mg dose, when given as the second injection, yielded optimal pharmacokinetics (defined as mean peak T values not exceeding the normal range and persistence of normal levels for at least 7 weeks), suggesting that repeated injections of 500 mg at 6-8-week intervals may provide optimal T replacement. The mean serum levels of estradiol were normalized following the injections, and prolactin levels were normal throughout the study. Significant decrease of serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels was observed, with the decrease in LH levels being more pronounced. There were no significant differences in serum LH and FSH levels between the two doses. Sex hormone-binding globulin (SHBG) levels before any T therapy were near the upper limit of normal for adult men and were reduced by approximately 50% just prior to the second dose of TU. The decreased SHBG levels produced by the first TU injection could have led to lower peak total T levels and to a more rapid clearance of T following the second TU injection. We conclude that single-dose injections of TU to hypogonadal men can maintain serum T concentration within the normal range for at least 7 weeks without immediately apparent side effects. It is likely that this form of T would require injections only at 6-8-week or longer intervals, not at the 2-week intervals necessary with currently used T esters (enanthate and cypionate). This injectable TU preparation may provide improved substitution therapy for male hypogonadism and, in addition, may be developed as an androgen component of male contraceptives.

A pharmacokinetic study of injectable testosterone undecanoate in hypogonadal men. - PubMed - NCBI

[kelkel]

Guys, regardless of who anyone feels is "winning" this debate the information being put forth is extremely interesting and helpful to all who care to read it.
Minus some of the personal diatribes I think it's been great reading and interesting interaction between two very intelligent members.

So there.....

[Mr.BB]

Guys, regardless of who anyone feels is "winning" this debate the information being put forth is extremely interesting and helpful to all who care to read it.
Minus some of the personal diatribes I think it's been great reading and interesting interaction between two very intelligent members.

So there.....

You call this a intelligent conversation?!?!?!

Funny that only now you talk about the personnal name calling and harassment, or "personal diatribes" as you call it. This has been going on for weeks.

Kinda tired of the whole thing.

Bye.

[IncreaseMyT]

Mr BB I am not sure what you mean, I was not the one who started with the name calling.

You disrespected us in the first couple days we were here, PUBLICLY. I am not sure if your aware but being a sponsor here isn't cheap. Having a Vet member say we are incompetent on the open board without a solid reason is unacceptable. Especially when that Vet member is dead wrong.

BUT I didn't say anything, I figured if I showed you the truth that you would realize why I say the things I have said, and maybe even appreciate it.

Not only have you insulted us multiple times, you have even made mention MANY times that we are somehow against your injection protocol for "financial" reasons. Saying that we are going to lose business over it.

This couldn't be further from the truth. I guess I made the mistake of caring about your TRT protocol.

Now that I have posted ample evidence of why I said what I said, and have proven multiple times, you still just wipe away the facts and pretend they are not there. So I am wondering if your the one with a financial motivation.

Not to mention I have more experience than anyone on this board because of the luxury I have of seeing others labs and protocols first hand on their physician monitored TRT. Unless there is someone else here that does this every single day?

So I NEVER post anything without having good reason to do so, not just on some silly article I read either, actual experience and not just with myself with about 2,000 other people as well.

So please do not play the victim card.

[kelkel]

You call this a intelligent conversation?!?!?!

Funny that only now you talk about the personnal name calling and harassment, or "personal diatribes" as you call it. This has been going on for weeks.

Kinda tired of the whole thing.


Bye.

Yes, I do call it an intelligent conversation between two members, barring the name calling as i pointed out. You may not respect each others opinion but none the less you both have expressed some viable points that I at least respect. I'm sure others do as well. I saw no need to speak about the name calling as you are both adults and can choose whether to participate in a thread or to leave it alone.

So yes, I respect both points of view put forth.

[krugerr]

Yes, I do call it an intelligent conversation between two members, barring the name calling as i pointed out. You may not respect each others opinion but none the less you both have expressed some viable points that I at least respect. I'm sure others do as well. I saw no need to speak about the name calling as you are both adults and can choose whether to participate in a thread or to leave it alone.

So yes, I respect both points of view put forth.

Agreed here Kel.

As I said earlier in the thread, the only way to improve existing practice is to challenge it. This discussion has really covered a lot of ground and I think contains a lot of useful content. Id think you've both contributed some some very valid arguments.

[krugerr]

Latest results are coming in today.

So far these are shown below... obviously the vital ones arent in yet, but will add them as they do! Blood test was taken 4 days after injection of 1000mg/4ml Nebido (Test Undecaonate)


-----------------------------

LIPIDS

Name	Value	Range
Serum Cholestrol	5.3 mmol/L	< 5.2 mmol/L
Serum Triglycerides	2.26 mmol/L	0.28 - 2.2 mmol/L
Calculated LDL Cholesterol	3.2 mmol/L	< 3 mmol/L
Serum Cholestreol/HDL ratio	5	< 4

-----------------------------

H&H

Name	Value	Range
Haemoglobin Estimation	173 g/L	130 - 180 g/L
Haematocrit	0.48 L/L	0.38 - 0.54 L/L

-----------------------------

Testosterone

Name	Value	Range
Serum Free Testosterone	273 pmol/L	225 - 9999 pmol/L
Serum Testosterone	10.5 nmol/L	10 - 35 nmol/L
SHBG	19 nmol/L	10 - 70 nmol/L

[FakeLove]

Interesting thread. I don't by any means want to hijack, but just for the reference here's my comparable labs with Nebido since day one. Hope it helps.

Baseline values:

- Age at the time 32
- BF around 20%, not more at least
- TT 13-14 nmol/l (10-38)
- Free T 211-280 pmol/l (200-500)
- SHBG 18 (10-57)
- LH 6.7 IU/l (2.5-7)
- E2 0.1 nmol/l (<0,15)
- Hemoglobin 153 g/l (134-167)
- Hematocrit 0.45 (0.39-0.5)
- Cholesterol 5.6 nmol/l (<5)
- HDL 1.5 nmol/l (min. 1)
- LDL 3.6 nmol/l (<3)

18 days after the first 4ml injection:

- TT 30 nmol/l (10-38)
- FreeT 589 pmol/l (200-500)
- SHBG 17 (10-57)
- E2 0.16 nmol/l (<0.15) on Anastrozole 0,25mg e3d

A 4ml loading injection 6 weeks after the first one, blood work 11 days after:

- TT 47 nmol/l (10-38)
- FreeT 937 pmol/l (200-500)
- SHBG 16 (10-57)
- E2 0.19 nmol/l (<0.15) on Anastrozole 0.25mg eod (+ zinc 40mg / day)

Trough values 8 weeks after second 4ml (the loading shot) Nebido:

- TT 12 nmol/l (10-38)
- FreeT 204 pmol/l (200-500)
- SHBG 26 (10-57)
- E2 0.14 nmol/l (<0.15) on zero Anastrozole (surprisingly high compared to the T figures)
- Hematocrit 0.5 (0.39-0.5)
- Hemoglobin 170 g/l (134-167)

Third Nebido shot ever was 2ml (after calculations decided to start splitting). Labs three weeks after the shot:

- TT 23 nmol/l (10-38)

After almost two years with steady 1ml every 2.5 weeks Nebido protocol trough values are:

- TT 20 nmol/l (10-38)
- FreeT 367 pmol/l (200-500)
- SHBG 21 (10-57)
- E2 0.07 nmol/l (<0,15) on Anastrozole roughly every 36 hours, labs taken 10 hours after the dose.
- Hematocrit 0.46 (0,39-0,5)
- Hemoglobin 153 g/l (134-167) - keeping the frequency in 2.5 weeks keeps my hemo in check, with every two weeks it increases too high
- Cholesterol 4.8 nmol/l (<5)
- HDL 1.2 nmol/l (min. 1)
- LDL 3 nmol/l (<3)

[krugerr]

Fakelove - thanks, nice to have some comparable results. If i get time later I may well plot your levels on a graph, just for visual reference.

[FakeLove]

Fakelove - thanks, nice to have some comparable results. If i get time later I may well plot your levels on a graph, just for visual reference.

No worries. Started smiling after the comments from your last visit with the doc. Sounded so familiar. I was lucky enough eventually to find a very good doc, but before that I had multiple similar conversations. At the time I had already studied quite a bit, but it was so frustrating when doctors were clueless. I still remember one who was curious to see what would happen to my LH on T when AI would be added. The she got mad at me when I said nothing will happen Then she wanted me off T and said Tamoxifen would help. I told her that when my baseline LH was already on top of the scale it wouldn't help. Of course she didn't believe. It's amazing what one can experience being a trt patient in Europe...

[krugerr]

No worries. Started smiling after the comments from your last visit with the doc. Sounded so familiar. I was lucky enough eventually to find a very good doc, but before that I had multiple similar conversations. At the time I had already studied quite a bit, but it was so frustrating when doctors were clueless. I still remember one who was curious to see what would happen to my LH on T when AI would be added. The she got mad at me when I said nothing will happen Then she wanted me off T and said Tamoxifen would help. I told her that when my baseline LH was already on top of the scale it wouldn't help. Of course she didn't believe. It's amazing what one can experience being a trt patient in Europe...

Agreed, frustrating! I dont get mad with him though, by his very definition hes a general practitioner. Hes there to deal with the day to day stuff, or refer you if needed. I dont expect him to have expert knowledge on every topic. But if I were him, and a patient had a condition I knew nothing about, I would want to learn about it. If only to satisfy my own curiosity.

[krugerr]

Updated. Testosterone results in above post. 4 days after injection. Levels are WAY lower than predicted i think.

<CALayer: 0xd769a60>

[IncreaseMyT]

Interesting thread. I don't by any means want to hijack, but just for the reference here's my comparable labs with Nebido since day one. Hope it helps.

Thank you for posting. Your lab work depicts everything i have been stressing. Nice work on educating yourself and switching to 2.5 weeks.

Seems like you have a good protocol going

[krugerr]

So, plotting the latest results, the graph really doesnt spike like we've been speculating. My Free came up 3 points, and my total came up 70 points. Really not much of a jump.
Ive booked a further blood test for 19th Aug, which will be 15 days after injection. Not sure whether I expect levels to be up or down from here?!

Images attached for those like me that prefer visual versions.

[IncreaseMyT]

Honestly it looks like your not even taking testosterone .

[krugerr]

Honestly it looks like your not even taking testosterone.

Agreed. But it's 1000mg Nebido which I personally collected with a script from a pharmacy.

(
d,
2,
0,
d
)

[krugerr]

Honestly it looks like your not even taking testosterone.

I'm going to get several tests before my 6 week booster.

Any thoughts though? I'd have assumed a bigger spike regardless!

Sent from my iPhone using App

[hammerheart]

I guess it could take more than a week for the ester to be released from depot.

[krugerr]

I guess it could take more than a week for the ester to be released from depot.

That could possibly be it. Although I'd still have expected higher than 273 by now!

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[FakeLove]

Four days might be too early to see the peak, but I guess at this point it already should show signs of improvement. There are few individuals who do not respond to Nebido though. All of them who I know the situation improved over the next shots, but their patience (understandably so) ran out and they all switched to Sustanon . Then again few individuals have been non responders to Sustanon as well. It remains mystery why this happens to some.

Even when one is a high responder like me, it can be that T metabolises very quickly as you can see from my labs. The big downside of Nebido is that the accumulation can continue / continues until a year or year and a half.

Then there's the average who do great on it and it works like designed.

I'd say there are few options:

1. If possible take labs again 10 days after the initial injection and shoot the booster earlier if there's no signs of significant improvement. Total T should get around 30 nmol/l +-5 after the first shot at its peak (based on studies day 7). This of course requires that you get the upcoming vials bit earlier to avoid a gap later on.
2. Same as above, but inject the booster splitted in four. I understand there's no benzyl alcohol in the vial, but there's already enough practical evidence that is quite safe to say the infection risk is the same as in any injection. Nobody of us haven't had any. The upside is that even based on pharmacokinetics it works way better that way, which is also proven in real life. If I was about to start Nebido right now I would split event the first vial. This naturally will not ever be supported by any doc.
3. If you have the possibility switching to Sustanon could be a quick fix. If this would be a possibility and your choice I wouldn't recommend even to try if the injection frequency is over 14 days. And even with 14 days I would split in two or three.

[IncreaseMyT]

There is no way you injected 1,000 MG of T and your levels only went from 200-273

Literally impossible.

[krugerr]

There is no way you injected 1,000 MG of T and your levels only went from 200-273 Literally impossible.

Well I promise that's what's happened. Unless the NHS are selling bunk gear, I injected all 4ml, 1000mg.
I've been here long enough that I'm sure a few can vouch I'm not here on a windup.

FakeLove mentioned nonresponders which isn't something I'm familiar with.

Sent from my iPhone using App

[krugerr]

Four days might be too early to see the peak, but I guess at this point it already should show signs of improvement. There are few individuals who do not respond to Nebido though. All of them who I know the situation improved over the next shots, but their patience (understandably so) ran out and they all switched to Sustanon. Then again few individuals have been non responders to Sustanon as well. It remains mystery why this happens to some. Even when one is a high responder like me, it can be that T metabolises very quickly as you can see from my labs. The big downside of Nebido is that the accumulation can continue / continues until a year or year and a half. Then there's the average who do great on it and it works like designed. I'd say there are few options: 1. If possible take labs again 10 days after the initial injection and shoot the booster earlier if there's no signs of significant improvement. Total T should get around 30 nmol/l +-5 after the first shot at its peak (based on studies day 7). This of course requires that you get the upcoming vials bit earlier to avoid a gap later on. 2. Same as above, but inject the booster splitted in four. I understand there's no benzyl alcohol in the vial, but there's already enough practical evidence that is quite safe to say the infection risk is the same as in any injection. Nobody of us haven't had any. The upside is that even based on pharmacokinetics it works way better that way, which is also proven in real life. If I was about to start Nebido right now I would split event the first vial. This naturally will not ever be supported by any doc. 3. If you have the possibility switching to Sustanon could be a quick fix. If this would be a possibility and your choice I wouldn't recommend even to try if the injection frequency is over 14 days. And even with 14 days I would split in two or three.

Thanks for your feedback. I've never heard of a non-responder. I wouldn't have thought it was weight or height related? Just a genetic thing?

I'm going to take the booster at week 6. I had that blood test on day 4 and I have another booked for day 14.

I hope that levels will pick up, and that you're right and the peak is just a little bit delayed.

Sustanon is a no go. I don't want to inject several times a week. I would consider though changing protocol for Nebido. Assuming Endo approves haha.

[macmathews]

Well I promise that's what's happened. Unless the NHS are selling bunk gear, I injected all 4ml, 1000mg.
I've been here long enough that I'm sure a few can vouch I'm not here on a windup.

FakeLove mentioned nonresponders which isn't something I'm familiar with.

Sent from my iPhone using App

on another note..
That's a fuck lot of test to inject all at once ..
Is that several pins ? Sounds like a sore spot to me..

BTW - I got my popcorn..

Mac

[krugerr]

on another note.. That's a fuck lot of test to inject all at once .. Is that several pins ? Sounds like a sore spot to me.. BTW - I got my popcorn.. Mac

Nebido is a 4ml/1000mg shot. It's not so bad in glutes or quads.

I've done 5ml shots before without issue!

[krugerr]

So a little light reading this morning, a lot of posts referring to TRT and 'Non-Responders' all mention Low SHBG, which I do have. Could this be because of my current HRT? Or due to underlying thyroid problems?

Many men have learned that SHBG binds to a little over half of their testosterone molecules and renders them "inactive". Because of this, as SHBG goes up, unbound testosterone goes down. Many physicians like to focus on free testosterone, which is your T that is not bound to SHBG or another protein called albumin. And the rule is simple: as SHBG goes down, free testosterone goes up. And free testosterone is considered the form of testosterone that is active and available to act on tissues.


NOTE: It is actually a little more complicated than that as testosterone bound to albumin can be easily unbound and used as well. But the point remains the same.
So clearly a man wants low SHBG, since it indicates that his free testosterone would be improved, right?
Wrong! As it turns out, low SHBG is often a sign of many of the worst chronic diseases that we face in modern, civlized societies.



*1. Obesity and Being Overweight. Low SHBG is associated with obesity. [1] The reason is probably due to a loss of insulin sensitivity as we'll discuss below.


*2. Lower Insulin Levels. There is evidence that increasing insulin lowers SHBG. [2] Studies have found this both in vitor and in vivo as well, i.e. on human subjects and male ones at that. [3] Therefore, SHBG is often a flag or warning signal of insulin and blood sugar issues. In other words, SHBG does not cause insulin resistance but does indicate it.

*3. Cardiovascular Disease, Diabetes, Metabolic Syndrome and Decreased Longevity. Due to #1 and #2, mumerous studies have shown that low SHBG can actually indicate decreased longevity. For example, one study found:
"Low SHBG and IGFBP-1 were both associated with an increased prevalence of abnormal glucose tolerance and the metabolic syndrome, but only SHBG was associated with diabetes mellitus. SHBG was less influenced by body mass index than IGFBP-1. Low SHBG indicated increased cardiovascular and coronary disease mortality; the association remained after adjustment for abnormal glucose tolerance, but not after adjustment for prevalent cardiovascular disease." [1]

This is about as ugly as it gets. Low SHBG is correlated with three of the biggest killers of men: heart disease, diabetes and Metabolic Syndrome. A more recent and larger scale study verified the above results but did find that all mortality risk was due to its association with diabetes, lowered HDL and weight gain. So SHBG does not seem causative, but rather often a sign that something else is wrong. By the way, it was "ischemic heart disease" risk that was associated with lowered SHBG in this case, which basically means accelerated arteriosclerosis and decreased blood supply to the heart.

*4. Apnea. I document in my link on Apnea and Testosterone how apnea can affect your baseline testosterone levels by 30 percent or more. Other studies have shown that apnea significantly lowers SHBG as well. [7] So if you have low testosterone and low SHBG, this is something to consider.

*5. Obesity. Because weight gain can lead to loss of insulin sensitivity, low SHBG values are correlated to extra weight.

*6. Inflammation. One study (in women) found that lowered SHBG was associated with elevated CRP (C-Reactive Protein), one of the "gold standard" markers of systemic inflammation that is linked to heart disease, dementia and autoimmune disorders. [8]

*7. Hypothyroidism. One study found that low SHBG was associated with hypothyroidism and could even be reversed by correcting the underlying thyroid issue. [9]

*8. Elevated Triglycerides. Several studies have found that elevated triglycerides, which are a risk factor for both heart disease and erectile dysfunction, are also tied in with low SHBG. [10] Of course, this should be no shock since elevated triglycerides usually come from eating meals with an overly high glycemic load and refined carbohydrates.

source: http://www.peaktestosterone.com/Low_SHBG.aspx

[hammerheart]

Low SHBG means you metabolize test faster, hence the need for more frequent injections.

[krugerr]

Low SHBG means you metabolize test faster, hence the need for more frequent injections.

19nmol/L

Well I guess that could possibly account for something.