Testosterone replacement therapy: Testogel vs Nebido injections

hi

applying gel everyday gives a good even amount of T daily

you don't achieve this with an injection

greetings

Hi,

I've had the pleasure (?) of recently having done 6 months of testogel, and then moving on to 6 months of nebido.

The first cycle of nebido is a short one, just 6 weeks, as the they seem to need to load your system - that suggest here is a start-up period. If it were me, I'd wean myself off the sachets EXCEPT if there is a blood test planned in the next week as I wouldn't want to skew the results of that. Thereafter its a steady 10~12 week cycle. I never got my 6 week injection and by week 11 of the first cycle I felt pretty low, and used some spare testogel sachets. My second cycle was better, and I've now just gone past the 7 week point in my 3rd cycle and feeling good. Given that I missed the short boost cycle I'm not surprised it's taken a couple of full cycles to even out completely.

The injection gives you steady levels of testosterone everyday, 24/7. The testogel gives you a daily boost that then needs to be repeated each day. So testogel gives you something more like the natural daily cycle of a peak in the morning, and then lower levels by the evening, whereas nebido gives you a steady level. I reckon the nebido does tail off towards the end of the 10 week cycle, but I go to the gym 4~5 times a week and record my cardio times and lifts - there's practically no difference at the end compare to the beginning. So no big peak at after the injection and no big dip at the end.

My endo says some people prefer the daily peak of T-gel, and others like me like the convenience of an injection just once every 10 weeks and a steady level.  That said, I'm holding on to my spare testogel sachets in case I feel I need a boost at the end of a cycle in the future.

Greg

Hi Greg,

Thanks very much for the advice. I just saw your private message too: thanks for taking the time.

I feel very slightly better today but still not right. I will hold off on the testogel top-ups until I've had a word with the endo early this week (he's usually good at emailing back). There is no imminent blood test planned but I'm guessing he will request one to see where I'm at.

The idea of the injections is so appealing, especially the convenience of having them once every 10 weeks or so. But I won't hesitate to return to the gels if I don't feel as good.

I'm not interested in walking around like Tommy Tripod and having a huge sex drive: it's all about feeling well, being able to concentrate at work, having enough energy to want to exercise and staving off the low moods. Anybody who has experienced symptoms of chronically low testosterone will understand what I mean.

The next Nebido is the booster in six weeks. I suppose topping up until then with gel sachets is a sensible option.

The dosage confuses me. I was on 1.5 gel sachets a day, which is 75mg (500mg a week). The Nebido injection as far as I know is a standard 1000mg for 10 to 12 weeks. I'm no Carol Vorderman but those figures don't stack up. So that's another question for the endo.

Take care and thanks again
Jason

Hi,

I agree its a mystery to me on how an injection can last 10 weeks, and also the dosages, so I'll do some investigation on that. I guess part may be that the absorption through the skin is less efficient than it being injected? i'll do some digging.

Greg

Speaking to your doctor sounds like a good idea. If the injection boosts your testosterone level higher than usual, this can also make you feel rough (people who take higher doses in the hope of boosting their sport performance sometimes report 'test flu') - so your symptoms could be an effect of higher as well as lower than usual levels.

Hi,

A brief investigation of the differences suggests that

long-lasting injections give a peak level after 72 hours, and decay from then over the cycle

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. C_max was 32.0 ± 11.7 nmol/L and half-life was 70.2 ± 21.1 days. The mean C_max of 32 nmol/L seen during steady-state with TU administration was lower than that achieved by Testogel^® (Bayer) 100 mg/day (37.5 nmol/L); however, it was higher than with Testogel^® 50 mg/day (28.8 nmol/L) and Androderm^® (Watson Pharmaceuticals, Inc.,) patch 5mg/day (26.5 nmol/L). Before the next injection, the serum levels for T and its metabolites DHT and estradiol were mostly within the normal (eugonadal) range and showed a tendency to decrease with increasing injection intervals. The study concluded that after initial loading doses at 0 and 6-weeks, injection intervals of 12-weeks establish eugonadal values of serum testosterone in almost all men. A later study (Yassin and Saad 2005) analyzing 58 hypogonadal men receiving TU treatment every 3 months did not report elevations of DHT levels exceeding the physiological threshold.

vs.

testogel, where levels rise 2x~3x after 2 hours, after 24 hrs, and only returning to baseline 4 days afterwards.

(Source: US national library of medicine)

hi

to comment about injections vs skin

injection goes through the liver, while skin absorption does not

this is also a factor too

daily applying to skin is controllable while an injection is not

i think it is best to go a few months with gel and see how it goes

only thing though is tat you need to well plan the morning, when you get up to apply and wait till it goes dry and then wear a shirt. besides that the gel is almost like the normal process that the body is expected to do.

i wouldn't try if the T levels are low, i would try taking ZINC before to try and boost the body to make more T. if all fails go to gel/injection

last but not least. external T does damage the semen manufacturing so if you are planning on kids, this is something to consider. 

greetings.

Hi,

That's useful information thanks - both deliver sufficient testosterone in their own way

I have the injection and its not too painful - warming the vial in your hands makes the oily fluid flow a lot more easily, and makes the injection easier. I cycle to and from the doctors, and other than an ache (mildly uncomfortable, nothing more) for 2 hours afterwards I have no pain - I reckon an ache for 2 out of 1680 hrs (10 weeks) in exchange for not having to do the gel everyday is a good result for me. For others who feel they need the circadian rhythm of higher levels in the morning, and who don't mind the daily regime, the gel is a good way - I used it for 6 months and it worked well, I just got fed up of the rigmarole.

Greg

Hi,

I've done a bit more reading on the testogel and the nebido, and the mystery of how we need 50mg+ of t-gel a day, but 1000mg of Nebido seems sufficient for 10 weeks.

Again from the US national library of medicine, they cite studies that show the bio-available testosterone available from the gel administered to the skin is 9~14%. So for ease of arithmetic call it 10%, that means we're getting ~5mg of testosterone we can use for every 50mg we apply.

I've yet to find equivalent data for the bio-availability of Testosterone from the injection - it would only need to have 35% bio-available (350mg) to mean it would last 70 days and deliver the same 5mg/day that we get from a single sachet of gel. That sounds plausible to me, but I haven't found any numbers yet.

What I did find was this graph showing how testosterone levels can vary when having Testosterone Undecanoate (TU) such as nebido. Looks like it can take a while to stabilise, but I'd like to have seen some more samples between month 9 and 12 in the graph.

For a long and detailed analysis of the topic see: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686335/#!po=38.2353

Greg

Sterling work Greg.

The dosage figures make more sense now. I intend to look into this in more detail myself this week so will let you know if I find anything useful.

Cheers
Jason