Has anyone used Nebido? (Testosterone undecanoate)

[Mister Fixit]

Following my various threads on my 15 years of testosterone enanthate due to a pituitary cyst, I went to the Army hospital yesterday and they suggested I try Nebido.

 

It's expensive at 6,300 baht so I would like to know more because my enanthate shots cost me 260 baht a pop.  I was on a shot every 3 weeks but I decreased the interval to 2 weeks due to ED problems.

 

I believe the injections are quite painful but as they are only every 10-12 weeks I am sure I can cope!

 

Anyone know anything about the stuff and can give some advice?  @WaveHunter  @rcuthbert ??

[internationalism]

there is much cheaper Testos 40mg by JSP Pharmaceutical Manufacturing.

 

[Mister Fixit]

9 hours ago, internationalism said:

there is much cheaper Testos 40mg by JSP Pharmaceutical Manufacturing.

 

What variety?  I can get 3 x 250 mgs test enanthate for 540 baht for a box of 3 amps and that's what I have been using for 15 years.  Then the lady doc at the local clinic does the shot for 80 baht, so 260 baht a pop in total.  

 

Time for a change as I have got 15 years older and my test levels have fallen, don't you think?  The docs think so.  

Edited July 1, 2021 by Mister Fixit

[internationalism]

it's a capsule, 1-2 daily. About 450b per box of 30.

Might be difficult to find, but possible to get.

[jackdd]

49 minutes ago, Mister Fixit said:

Time for a change as I have got 15 years older and my test levels have fallen, don't you think?  The docs think so.  

You say you have been getting injections since 15 years, so your Testosterone level 15 years ago, after you started with the injections, and now are the same.

 

42 minutes ago, internationalism said:

it's a capsule, 1-2 daily. About 450b per box of 30.

Might be difficult to find, but possible to get.

Oral steroids damage the liver, which is why they are usually avoided, especially for long term use.

Edited July 1, 2021 by jackdd

[WaveHunter]

2 hours ago, internationalism said:

it's a capsule, 1-2 daily. About 450b per box of 30.

Might be difficult to find, but possible to get.

Nebido is injectable Test undecanoate, not oral.  Oral Test is available but not recommended due to potential liver toxicity.

[WaveHunter]

Personally I would not go for Nebido.  While it's true that Nebido has a significantly longer half-life than Enanthate (half life of around 30 days) so you only need to inject once a month or even once every 6 weeks, that is also its' main drawback for a new TRT subject.

 

The reason is that it will take significantly longer for your doctor to titrate to the optimal dosage since the titration schedule will be much longer due to the longer half-life.

 

Another issue is that the serum levels will fluctuate over the time between injections in sort of a sawtooth pattern which is not optimal compared with more frequent injections once or twice a week where the half life is only 4-5 days.

 

It's also significantly more expensive over the long run than Enanthate.

Edited July 1, 2021 by WaveHunter

[Mister Fixit]

2 hours ago, internationalism said:

it's a capsule, 1-2 daily. About 450b per box of 30.

Might be difficult to find, but possible to get.

 

No, the two docs I saw Tuesday say the injection is better.

 

However, I will look into it further.  If capsules are as effective and cheaper than the injection, I may well give them a go if I can find them.

[Mister Fixit]

18 minutes ago, WaveHunter said:

Personally I would not go for Nebido.  While it's true that Nebido has a significantly longer half-life than Enanthate (half life of around 30 days) so you only need to inject once a month or even once every 6 weeks, that is also its' main drawback for a new TRT subject.

 

The reason is that it will take significantly longer for your doctor to titrate to the optimal dosage since the titration schedule will be much longer due to the longer half-life.

 

Another issue is that the serum levels will fluctuate over the time between injections in sort of a sawtooth pattern which is not optimal compared with more frequent injections once or twice a week where the half life is only 4-5 days.

 

It's also significantly more expensive over the long run than Enanthate.

 

Oh yes, it's definitely a lot more expensive than the enanthate.  I can get the enanthate for 540 baht for 3 ampoules so 180 baht each, then my local clinic charges me 80 baht for the injection so a total of 260 baht per shot, or 520 baht a month.

 

The 2 docs told me that a shot of Nebido is 6,300 baht, which he says will need to be given in a few smaller doses until he has titrated my testosterone levels and can decide on what interval between shots 

I am prepared to pay that just to check how it goes.

 

I have about 8 amps of enanthate left so we decided I should use 4 of them for the next 8 weeks and leave the rest in reserve should I want to revert to enanthate at some stage.

 

I see him again on 13 July so I will discuss it further with him and the point made by @internationalism about capsules.  They did a lot on Tuesday with a physical exam and long discussions, and my wife was with me because I wanted her to talk to him about her menopause issues, so there was a lot to take in and I want to review things with him again in 12 days so I am clear.

 

 

[Mister Fixit]

2 hours ago, jackdd said:

You say you have been getting injections since 15 years, so your Testosterone level 15 years ago, after you started with the injections, and now are the same.

 

Oral steroids damage the liver, which is why they are usually avoided, especially for long term use.

 

Not necessarily the same - 16 years is a long time and I am a lot older.  Last month the level was quite low.  I'll be getting another blood test done in 12 days so let's see what it is then after 2 months of fortnightly shots instead of one every 3 weeks.

 

Good tip about the oral method though.  Thanks, I'll look into that further.

 

[WaveHunter]

17 minutes ago, Mister Fixit said:

 

No, the two docs I saw Tuesday say the injection is better.

 

However, I will look into it further.  If capsules are as effective and cheaper than the injection, I may well give them a go if I can find them.

Again I state, oral form can be highly liver-toxic, and if you try to order oral without an MD you will get scammed big-time by scammers with fake medication..."testosterone pills" are one of the biggest scams on the net.

[WaveHunter]

6 minutes ago, Mister Fixit said:

 

Not necessarily the same - 16 years is a long time and I am a lot older.  Last month the level was quite low.  I'll be getting another blood test done in 12 days so let's see what it is then after 2 months of fortnightly shots instead of one every 3 weeks.

 

Good tip about the oral method though.  Thanks, I'll look into that further.

 

Of course it's up to you to decide what's best for you but I would stay away from oral forms becuase liver toxicity in an older person is particularly dangerous.  As for undecanoate, I see no advantage over Enanthate for TRT at all. 

 

I don't understand why you would want to switch.  Are you saying your serum levels have dropped while on Enanthate, and that is the reason you want to switch to undecanoate ??  

[Mister Fixit]

6 hours ago, WaveHunter said:

Of course it's up to you to decide what's best for you but I would stay away from oral forms becuase liver toxicity in an older person is particularly dangerous.  As for undecanoate, I see no advantage over Enanthate for TRT at all. 

 

I don't understand why you would want to switch.  Are you saying your serum levels have dropped while on Enanthate, and that is the reason you want to switch to undecanoate ??  

 

Well, I certainly take on board about oral use, and perhaps that's why the docs suggested the injectable version.

 

I do not necessarily WANT to switch, I want to establish just what's going on after 16 years and, if the enanthate is no longer as effective, then consider an alternative.  
 

If you recall from my previous threads, my ED has worsened and from those threads, people such as your good self suggested that the enanthate had too short a half life for a shot every 3 weeks.  I decided not to have any shots for 7 weeks just to get a baseline and my level was way down, as you'd expect.

 

So then I reduced the interval to a shot every two weeks and have had 4 shots since 7 May and one today.  I have felt a reasonable increase in libido and have had some not very long lasting morning erections since then so something is happening.  I even managed a short morning bonk once about 2 weeks ago!  ????

 

I had a shot this morning and see the doc again on 12 July when I will ask him to check my levels again and we'll see where we are then.  He's a really approachable guy and we decided I would use up my stock of enanthate with a shot every 2 weeks over about 3 months and if nothing much has changed over that regime, then consider the Nebido.  So that's the current plan - as well as checking my PSA regularly to see if it rises.  It's always been excellent though, never more than 2.3 and mostly about 1.8 even after 16 years.  

 

 

[Mister Fixit]

21 hours ago, WaveHunter said:

Again I state, oral form can be highly liver-toxic, and if you try to order oral without an MD you will get scammed big-time by scammers with fake medication..."testosterone pills" are one of the biggest scams on the net.

 

Excellent point.  I will give those capsules a miss then.

If I am going to change the testosterone variety, then I will only do it via a hospital.

 

Since changing to a fortnightly shot in early May, I have had 4 shots over 2 months (plus one yesterday) and have noticed an increase in libido, although not huge.  I have also had a few morning erections, which I haven't had for a long time but they don't last long.  

 

[WaveHunter]

19 hours ago, Mister Fixit said:

 

Well, I certainly take on board about oral use, and perhaps that's why the docs suggested the injectable version.

 

I do not necessarily WANT to switch, I want to establish just what's going on after 16 years and, if the enanthate is no longer as effective, then consider an alternative.  
 

If you recall from my previous threads, my ED has worsened and from those threads, people such as your good self suggested that the enanthate had too short a half life for a shot every 3 weeks.  I decided not to have any shots for 7 weeks just to get a baseline and my level was way down, as you'd expect.

 

So then I reduced the interval to a shot every two weeks and have had 4 shots since 7 May and one today.  I have felt a reasonable increase in libido and have had some not very long lasting morning erections since then so something is happening.  I even managed a short morning bonk once about 2 weeks ago!  ????

 

I had a shot this morning and see the doc again on 12 July when I will ask him to check my levels again and we'll see where we are then.  He's a really approachable guy and we decided I would use up my stock of enanthate with a shot every 2 weeks over about 3 months and if nothing much has changed over that regime, then consider the Nebido.  So that's the current plan - as well as checking my PSA regularly to see if it rises.  It's always been excellent though, never more than 2.3 and mostly about 1.8 even after 16 years.  

 

 

My view...you need to find a better doctor to manage your TRT. 

 

Regardless of what your actual dosage is, if you are not injecting Testosterone Enanthate at least once a week, it will not work effectively.  A good TRT doctor would not prescribe Enanthate in the manner you are describing, so you need to find one that manages TRT better.

 

You need to understand that Testosterone enanthate has an elimination half-life of 4.5 days and a mean residence time of 8.5 days.  What this means is the injected testosterone is doing nothing at all for you after five days or so, as far as building up your serum levels of T. 

 

More simply, you must re-inject before you reach the end of the half-life.  Injecting higher doses less frequently won't extend the half-life of the drug, ya know?  If you only inject once every three weeks, you effectively will be going two weeks with no exogenous Test in your system.  Do you see what I mean?

 

My own doctor, and many other people I know that are successfully on TRT ALL inject at least once a week.  My doctor suggested once a week but when I asked him if a 4.5 day half life meant it should be more than once a week, we agreed that "technically" it should, but practically speaking it probably would not make a difference...but if I preferred to divide the weekly dose into two separate injections weekly that would be fine, and so that's how I've been doing it for 6 years now with fine results.

 

Bottom line, I think your dissatisfaction with Enanthate is simply you are not dealing with the half-life of the drug effectively.  Your doctor should understand this, and since he apparently does not, I'd find a better doctor to  oversee your TRT.

Edited July 2, 2021 by WaveHunter

[jackdd]

18 hours ago, WaveHunter said:

What this means is the injected testosterone is doing nothing at all for you after five days or so, as far as building up your serum levels of T. 

No, this is not what it means, you are wrong again.

https://books.google.co.th/books?id=mEgckDNkonUC&pg=PA442&redir_esc=y#v=onepage&q&f=false

 

 

I do agree though that more frequent injections are better to keep the level more stable.

[WaveHunter]

6 hours ago, jackdd said:

No, this is not what it means, you are wrong again.

https://books.google.co.th/books?id=mEgckDNkonUC&pg=PA442&redir_esc=y#v=onepage&q&f=false

 

 

I do agree though that more frequent injections are better to keep the level more stable.

Apparently you have no understanding of what "half-life" means, and more importantly you are NOT a doctor or even a TRT patient.  All of your knowledge seems to be from snippets of information you read here and there.  Most of it sounds like you've read it from outdated sources or from wacky YouTube health gurus.

 

Again, I'm not replying for your edification since you seem to have no interest in reality, or in putting in due diligence to really understand this subject.  I only reply so others are cautious of accepting anything you say without googling so they can see how far off-base all of your comments really are..

 

What's more you don't even understand what you are seeing in these graphs!  Anyone that understands about the half-life of Testosterone Enanthate, know that the LAST thing you want is a sawtooth pattern to occur in your serum T levels.  Achieving stable serum levels is a primary goal in TRT.

 

That is why doctors prescribe that injections occur at least once a week or that the patient splits the weekly dosage to two injections per week.  It is SPECIFICALLY to accommodate the very short half life of Test Ethanate. 

 

An experienced TRT doctor knows this.  Someone (like you) who is a self proclaimed expert but doesn't have a firm grasp of the applied science DOES NOT.  Your Nonsense is the perfect reason that people should consult a physician for TRT and not rely on self-proclaimed experts with no comprehensive understanding of the science and no practical or first-hand  knowledge of TRT whatsoever.

 

You really are a perfect example of the adage "A little knowledge is more dangerous than none at all"

Edited July 3, 2021 by WaveHunter

[jackdd]

6 hours ago, WaveHunter said:

Most of it sounds like you've read it from outdated sources or from wacky YouTube health gurus.

I provided the source for my information, stop trolling, thank you.

If you think it's wrong I recommend you just contact the authors of the book, Prof. em. Dr. med. Dr. h.c. Eberhard Nieschlag and Prof. Dr. med. Hermann M. Behre to inform them that their research is wrong and outdated and that you know better than them, they might then release an updated version of their book.

 

6 hours ago, WaveHunter said:

What's more you don't even understand what you are seeing in these graphs!

The graph clearly shows that it takes about 4 weeks until the effect of a Test E injection is close to zero.

Edited July 3, 2021 by jackdd

[WaveHunter]

37 minutes ago, jackdd said:

I provided the source for my information, stop trolling, thank you.

If you think it's wrong I recommend you just contact the authors of the book, Prof. em. Dr. med. Dr. h.c. Eberhard Nieschlag and Prof. Dr. med. Hermann M. Behre to inform them that their research is wrong and outdated and that you know better than them, they might then release an updated version of their book.

 

The graph clearly shows that it takes about 4 weeks until the effect of a Test E injection is close to zero.

I'm not criticizing their research; I am criticizing your interpretation of what they were researching!  It's obvious that you did not even bother to read their study enough to even know what it was about or you wouldn't be misinterpreting the significance of these graphs.

 

Those sawtooth patterned graphs represent exactly what you do NOT want to happen in TRT.  Again, since you don;t even bother to read what I write, I'll say what should be obvious to any reasonably informed person when it comes to TRT: Achieving stable serum levels is one of the primary goals in a well conceived TRT protocol.

 

Secondly, the graph does NOT show that the "effects" of Test Enanthate are close to zero at the end of four weeks. The valleys of the graph only show when the drug has reached trace amounts in the body, and BTW the mean number of days for that to occur at standard TRT dosages is 8.5 days, not two weeks.

 

There is a difference between when physiological effects diminish and when the drug has left the system....they are two different things ENTIRELY.

 

You obviously do not understand what I've now made clear TWO TIMES now:  Testosterone enanthate has an elimination half-life of 4.5 days and a mean residence time of 8.5 days.  Why don't you read up on what these two terms mean, and then maybe you won't continue to say foolish things.

 

At any rate, I've said all I am going to say to you.  I have better things to do than argue with someone who doesn't even take the time to understand what he's talking about.

 

Edited July 3, 2021 by WaveHunter

[jackdd]

25 minutes ago, WaveHunter said:

Those sawtooth patterned graphs represent exactly what you do NOT want to happen in TRT.  Again, since you don;t even bother to read what I write, I'll say what should be obvious to any reasonably informed person when it comes to TRT: Achieving stable serum levels is one of the primary goals in a well conceived TRT protocol.

I already agreed with this two posts ago, with who are you arguing?

Only one person here doesn't bother to read, and it's not me.

 

[WaveHunter]

1 hour ago, jackdd said:

I already agreed with this two posts ago, with who are you arguing?

Only one person here doesn't bother to read, and it's not me.

 

Look, first of all the book you are referring to has nothing to do with modern TRT protocols.  It was written over 20 years ago when TRT was barely even a recognized treatment.

 

FYI, I know this book you refer to well and have it in my library. It is indeed a recognized text on Male reproductive health but t is not up to date AT ALL on modern TRT protocols.

 

However, If you had bothered to actually read what the authors had to say about administration of Test Enanthate, you'd realize that what they have to say about the undesirable effects of the "saw tooth pattern" on serum levels is exactly what  I've been talking about in my posts!

 

The only difference is that today, modern TRT protocols are designed to greatly reduce the saw tooth pattern and thus eliminate those undesired side-effects of treatment,

 

That is the goal of every competent TRT physician, including mine, which you so smugly criticize without even knowing anything about her credentials or experience.

 

Now, regarding the graphs you refer to... they actually have nothing to do with modern TRT!.  No doctor today is going to prescribe 250mg per week for TRT, so those graphs are completely meaningless, and prove nothing (unless you are illicitly using Test as a performance enhancing drug).

 

Just as a benchmark and nothing more, my weekly dosage is 120mg, divided into two doses per week of 60mg each.  That protocol, along with other metabolic considerations like low-carbohydrate nutrition/avoidance of processed foods, and a very active athletic lifestyle keep my serum Test at around 850-1,000 ng/dL, which for me not only keeps me feeling at my best but also has no negative effects on any of my other blood panels.  In fact, test results are almost always not just "in the acceptable range" but in the optimal. range....and that's going on six years of TRT now.

 

So if you wish to criticize my doctor or me or any of the other men undergoing a similar TRT protocol, go for it, but you can't argue with the numbers on my blood tests or how I feel.

 

The whole goal in titrating a proper dosage is to boost the serum level to an acceptable value and have it stay there (with as little fluctuation as possible).  Having your serum levels jumping all over the place is not desirable at all, and that's what happens if you exceed the half-life between injections.

 

That's why the concept of a drug's "half life is so important, and so you should appreciate that simple fact instead of ignoring it.

 

You can believe anything you wish, but you might try reading up from a science based source that is related to TRT and is up to date, instead of a textbook that is over twenty years old, completely unrelated to modern TRT, and that you're not even willing to take the time and comprehend.  But that is up to you.

 

Once again, my disclaimer:  I am not saying this for your benefit becuase it's obvious you don't really want to know about TRT.  I only say what I have to say so that other people who read your silly criticisms of me will doubt what you have to say enough to find a real doctor who they can trust for the real truth, instead of being misled by your self-proclaimed  yet totally unfounded "wisdom" on this topic

 

So, good luck with your life, and we are done with this bizarre conversation now.

Edited July 3, 2021 by WaveHunter