Author Topic: 4 weeks on Nebido  (Read 224 times)

andy

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4 weeks on Nebido
« on: December 30, 2017, 01:17:17 PM »
I hope everyone on here had a nice Xmas.

It's now just over 4 weeks since I had my first Nebido injection, having previously spent 5 months using Testogel which unfortunately did nothing at all to raise my low t.

For anyone unfamiliar with my history etc here is my previous thread:
http://www.androids.org.uk/forum/index.php?topic=1082.0

The first 2 1/2 weeks after the injection I noticed no changes at all. Then last week and over Xmas I did think there was a slight improvement, with a few nocturnal woodies and a reduction in tiredness. However this was short-lived as the last couple of days I feel dreadful. My brain feels awful, my concentration is practically non-existent and the woodies are not happening at all. I'm also irritable for no apparent reason. It's making me angry with myself feeling this way. I'm normally a happy go lucky type, I don't usually get moody and irritable and many times in my life it has been remarked I have very high levels of concentration and self-motivation. Well not today!! I slept for 9 hours last night and it was quality sleep. Yet today I just want to go back to bed and sleep again.

I've got another 12 days to wait until my 2nd injection so I know there is very little I can do until then. I also know it can take time for nebido to have an effect and that patience is key. Easier said than done!!

The one thing I am thinking about is oestradiol, as this has never been tested in any of the blood tests I've had done. Could my body be converting large amounts of testosterone into estogen? I'm sure I read something saying if you carry a little extra body fat you are more likely to be doing this. I weigh 230lb (104kg) although I am tall at 6ft 1in and have a rugby build. I did mention oestadiol to the endo when I last saw him in October. He said it's normal to convert some testosterone to estrogen and didn't say any more. I don't see him again until mid-March, although the nurses have said they will do another blood test on the day I have the 2nd nebido injection in mid-Jan. I think this is to assess t levels after 6 weeks of nebido. It was very low on the day I had the first jab, just 5.4. I feel far worse now than I did then! I am hoping they will wait to see the result of that blood test before deciding how many weeks to wait before the 3rd one. The nurse last time indicated it is a 13 week wait before the 3rd jab and each time afterwards. Should I be trying to persuade them to be testing oestradiol as well as T or is it more likely it's simply I haven't had enough nebido in my system to make much difference yet? If my oestradiol is high I know it's easy to fix with an aromatose inhibitor. I'm assuming this has to be via prescription, or are there supplements I could buy which would help?

I know it's speculation about oestradiol at the moment, as I don't know my levels. But is it possible that could be the cause of my low T in the first place? The endo says he can rule out primary hypogonadism as my LH, FSH, SHBG and Cortisol are all perfectly normal. He also doesn't think I have anything wrong with my pituitary, as a full MRI less than 2 years ago (for another issue) showed nothing amiss. I have had a pituitary scan 2 weeks ago just to be 100% certain (I'm awaiting results), but it sounds like secondary hypogonadism will also be ruled out. So if both are ruled out, what could have caused it to go so low in the first place? The letter the endo wrote to my doctor mentioned "gonatrophin deficiency cause unknown", which I read to mean the medical profession haven't got a clue what is causing my low T. I certainly can't think of anything in diet or lifestyle which would have caused it. I do think it has been a gradual process over a few years. I can trace the start of noticeable symptoms back to 2014 and it's possible my T had been dropping for a while before then. Is it possible to have significantly low t without any cause found?

Cheers for reading,
Andy
« Last Edit: December 30, 2017, 01:21:48 PM by andy »

Ashto70

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Re: 4 weeks on Nebido
« Reply #1 on: December 30, 2017, 02:52:09 PM »
Hi Andy. I'll keep this short because I'm busy visiting family over Christmas. However, what you've been diagnosed with is called Idiopathic Hypogonadism, which basically means the same as low testosterone from an unknown cause. A good proportion of blokes presenting with low testosterone are diagnosed with idiopathic hypogonadism because sometimes everything does look normal on the surface. That said, just because it seems idiopathic doesn't mean it's necessarily so. As you mention, it could be due to high oestradiol levels caused by increased aromatisation.

If you had a calculation of free T called the FAI (Free Androgen Index) then it's possible the result was unreliable, as it's a crude way of determining free T levels. Instead only a clinical measure of your free/bioavailable levels could be reliable, but the opportunity to have this tested properly are very low for cost and availability reasons.

If oestrogen levels are high then some endocrinologists will prescribe an AI for you. If/when that happens get back to us as there have been instances of doctors prescribing large doses of AI that can lead to your oestrogen levels crashing. If this happens, not only will you feel worse than you do with low T, but the effects can also be negative on your overall health.

Sorry if I haven't responded to all your questions.
Have a great New Year.
Craig   

andy

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Re: 4 weeks on Nebido
« Reply #2 on: January 05, 2018, 03:57:44 PM »
Thanks Craig. A happy new year to you and everyone else on here.

I've now only got 6 days until my second nebido injection. Oddly (and thankfully) this week I feel slightly better than last and more like I did the few days before Xmas when there was a noticeable uplift. There are faint glimmers of libido trying to break through and I haven't felt as tired as last weekend.

I am definitely going to ask the endocrinology nurse to test my oestrogen levels as well as testosterone when I have the blood test just before the nebido injection. If my oestrogen is high then at least I can make an informed decision (after discussion with the endocrinologist) whether an aromatose inhibitor may benefit. If oetrogen is normal then I shall conclude my symptoms are all related to my low T. If the NHS refuses to test my oestrogen then I shall explore ways to get it tested privately.
« Last Edit: January 05, 2018, 03:59:21 PM by andy »

Ashto70

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Re: 4 weeks on Nebido
« Reply #3 on: January 10, 2018, 06:39:06 PM »
A couple of tried and tested online services for blood diagnostics in the UK:

Vitruvian Man does oestrogen tests for 59.00 each.
http://www.vitruvianman.org.uk/tests-fees/

Medichecks do a testosterone and oestrogen test together for 39.00
https://www.medichecks.com/testosterone-blood-tests/testosterone-oestradiol

andy

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Re: 4 weeks on Nebido
« Reply #4 on: January 11, 2018, 05:02:27 PM »
Thanks for the info Craig. Those services are very useful to know about.

I have today had my 2nd nebido jab, exactly 6 weeks after my first. The nurse did a blood test too, of which I will phone up to get the results next week. I'm expecting testosterone to be very low again, but we shall see. I have got to have another blood test after 6 weeks to see how my T levels are progressing. That seems ideal, as I have my next appointment with the endocrinologist a couple of weeks after then, and we can discuss the results.

The nurse has also booked me in for the 3rd nebido jab, in 12 weeks time. I did ask her if there is any flexibility in regularity. She said generally no (12 weeks is standard) but it is up to the endo to decide. So if worst case scenario my levels are low after 6 weeks and I have symptoms when I see the endo a couple of weeks later, I can then make the case for the 3rd injection to be sooner than 12 weeks. Hopefully I won't have to beg!! But I'm jumping the gun a bit here, I'm hoping my T levels are decent by then.

Regarding oestrogen, the nurse said it's not usual to test this when on nebido, but if I really feel there is a need to do so, I can raise it with the endo when I see him in March and it's up to him whether it's tested or not. So I am going to see how I get on the next few weeks and see what the 2nd jab does. If I still feel oestrogen is maybe playing a role in my symptoms then I will definitely consider getting a private test with Medichecks or Vitruvian Man. The nurse did point out it is most likely my symptoms are to do with low T and I have to give nebido time to build up in my system. I've now got to play the waiting game and see what happens in the next few weeks.

Ashto70

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Re: 4 weeks on Nebido
« Reply #5 on: January 11, 2018, 07:33:02 PM »
Hi Andy.

Well, it's good to hear you've overcome the first hurdle, getting your Nebido booster. Even though the package insert says you should have a six-week booster there's more than one member of this forum who's gone without due to practice incompetence. Hopefully, all will now go well for you. I personally feel that dosing at every three months over the long-term is probably not going to provide the steadiest and most strived for, healthful levels of testosterone. Your dose equates to 250mg every 21-days, which is the most commonly prescribed dosing interval for shorter life testosterone esters like Sustanon 250.

From the feedback you have likely read 250mg every three weeks results in wild surges and fluctuations of hormone in our body. On Nebido this fluctuation will be curbed due to it being administered every twelve weeks and not three, but the issue with Nebido is the dose and response in individuals. One gent on here has extended his Nebido stints to a shot every 16 or 17 weeks. Most Nebido users by far though need redosing much sooner than that, and sooner than 12-weeks too. I think straightforward common sense has aided the doctor's decision to put you onto three-month dosing and that's good from a starting stand-point and perspective. From a longterm perspective I would like to think your doctor is an open and considerate one, who will react and act upon the information that's presented to him by way of your comments, response, and blood tests.

I don't think now is the time to ponder nor dwell on oestrogen issues though. This is the time to focus, evaluate, and hopefully - if necessary - adjust your dose of Nebido should it be called for. Fair enough, if there's an obvious problem with oestrogen then sure, it needs addressing. My point really is not to over-think the subtleties of treatment and instead concentrate your thoughts and efforts on the big picture - for now at least.

Keep us in the loop dude.
Craig   

Patch

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Re: 4 weeks on Nebido
« Reply #6 on: January 11, 2018, 08:39:03 PM »
Hi andy, I think you must have started nebido not long before I did, and like you, with 10 days left before the six weeks are up I'm really not in a good place which is horrible because for a period of about a week my mood was right up where it hasn't been for years. Until starting this I had no idea of just how permanently irritated I am and how much of a glass half empty type person I had become. Unfortunately though for me, nebido didn't fully agree with me and I gained a stone virtually over night, could barely eat (and ive always had a huge apatite)  and had really hot flushes to the point I had to strip down to my pants Xmas night while watching tale. So I had blood tested and my oestrogen came back as 126 pmol/l I believe which my endo says is "reasonable" ,though I have no idea what the ideal is. So I now have to wait for another appointment at gp as he said nebido doesn't look good for me so now I'm to try weekly jabs of sustanon. But unfortunately I still have to see out the 6weeks which unfortunately means 2 unbearable weeks, not just for me, but also my family. I just hope I have better luck with sustanon, otherwise I don't know what my next move will be

andy

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Re: 4 weeks on Nebido
« Reply #7 on: January 12, 2018, 02:09:11 PM »
Craig - Thanks for the advice. Yes I agree it's now sensible to focus, evaluate and try to get the best regularity of nebido. My endo does indeed seem a decent and open guy, although I have only seem him twice in the 7 months since I was diagnosed with low T.  So I'm hoping we can plot the way forward together when I see him in March, based on my blood test results and how I am feeling then. You are right I do tend to overthink things sometimes, which doesn't always help! I must relax, chill out and give the nebido time to take effect.

Patch - I can definitely appreciate the irritability. I have suffered the same for a while now. Not all the while thankfully. But little things which would normally pass without much reaction or irritation can now become huge issues and a cause of far greater stress than they normally would. This in itself causes more irritation as I'm normally easy going and happy-go-lucky. I'm sorry to hear nebido didn't work for you. Hopefully sustanon will work better for you.

Ashto70

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Re: 4 weeks on Nebido
« Reply #8 on: January 12, 2018, 07:14:26 PM »
Hi Patch. If you've gained more than a couple of pounds on Nebido while eating much less then I'll almost guarantee the weight is 90%+ water. Reducing your intake of carbohydrates by 40% and lowering your salt intake by half should see you shed some of that. Make sure you're drinking at least two litres of water a day too to keep your hydration and water composition in check as this will balance things out too.

126pmol/L of oestrogen isn't high end but I'd say it's probably above where you want it. I'd bet the barn this is probably why your body is having such an easy time hoarding weight and the reason your appetite's poor. Higher than healthful levels of oestrogen tend to come with several unwanted effects not least of which is fat production, and where there's fat there's loads of water. Cutting your salt intake and carbs and drinking plentiful amounts of water - or weak fruit juices/ squash - will help combat any water retention. If things balance out and the weight falls then hopefully this will also mean a natural re-regulation of oestrogen hormone production. Definitely, natural regulation is the better option when considered against anti-aromatase medications as I'm sure you'll agree.

Did your doctor really say weekly shots of Sustanon? I'm hoping he misspoke or you misheard him. That's at least twice as much as any doctor should prescribe of Sustanon. 250mg a week or 1000mg per month would be considered by much of the medical community to be a supraphysiological dose of testosterone, or basically in layman terms: performance enhancing and cosmetic doses of the drug. For someone beginning a trial of Sustanon, I think 250mg every 21 days is a good starting point. This gives you room to manoeuvre in either direction. You may find your levels are too high on 21 days, and if that's the case you can extend to 28 days. If a 21-day cycle doesn't cut it, however, it's more probable you'll need to go the other way and increase the frequency to fortnightly injections.

I personally, don't have a fixed schedule. Since starting on Sustanon in 2002 I've come to notice when I'm due to redose - generally, it's around every 13 to 17 days.

Buzzwords I'm sure you'll be familiar with among the guys are: time, patience, monitoring, and waiting. Unfortunately, that's all we can do. We are all very different and unique in how our body's respond to testosterone therapy, if they respond at all, that is. It is indeed a waiting game. You are on therapy though and if you are hypogonadal, then recognition for this by a doctor is probably the biggest hurdle overcome. What is fortunate is the available forms of treatment we have from gels, injections, and now even antioestrogen medication, and Clomid to raise natural testosterone. So never think all is lost when it isn't. You will find something suitable...it just takes "time" bro.
 

Patch

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Re: 4 weeks on Nebido
« Reply #9 on: January 12, 2018, 09:50:34 PM »
Hi Craig, yeah it's going to be weekly jabs, but half a vial. Not sure how much is actually in a vial though. Initially he said to try the Jels, but due to the nature of my job it really isn't viable. So I asked about weekly injections (not knowing anything about other types or doses) so he said he agreed trying half doses weekly would be a good idea to try. I asked if it's worth persisting with nebido but he said it doesn't look good from his experience so wait till the six weeks are up and go straight onto the sustanon jabs. As far as I can tell from what I've read, this would mean a lower testosterone spike which should result in a lower oestrogen spike. Does this sound about right to you? It's strange, but now my moods down and simptums are back, the weight has decreased, my pit belly has gone back down and I can eat again. So would this be solely to do with the oestrogen dropping with my t levels, or is it possible these side effects were actually an adverse reaction to the testosterone itself? I really hope not. Now that I've had a taster of what life used to be like, the thought of not being able to take the testosterone in any firm would now be devestating. As it stands I'm really keen to get cracking with this other medication and get back to where I was a couple weeks back. I think my wife is too hahaha

Ashto70

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Re: 4 weeks on Nebido
« Reply #10 on: January 13, 2018, 02:10:08 PM »
If your doctor is willing and able to do weekly shots (125mg) of Sustanon then that's great. My only fear is that this is quite a high starting dose and if that's the case any problems with oestrogen will possibly remain. Still, you can it out and see how it goes. I do agree that any splits in dosing are a better option than taking the whole 250mg in one administration for the reason you say, namely to avoid oestrogen spikes and testosterone crashes.

By what you're experiencing with the onset of low-T symptoms, losing weight and regaining your appetite, it does sound like your oestrogen is ebbing-and-flowing with your testosterone levels. Hence the reason for suggesting the starting dose of Sustanon at 125mg per week is too high. If you are sensitive to oestrogen swings then it may end up with you using some form of anti-oestrogen medication such as Arimidex or Aromasin. More doctors are starting to realise the importance of anti-oestrogen meds in male hypogonadal therapy although few have the nouse or knowledge to prescribe it. Dosing for this is a ball game in itself, so if you do get prescribed any ensure it's an appropriate dose because we've heard from guys who are prescribed doses advised for women.

I'm glad your wife is benefitting from the new you.

Patch

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Re: 4 weeks on Nebido
« Reply #11 on: January 14, 2018, 09:12:20 AM »
Thanks for the advice. I'll post an update once I've got into sustanon a bit

andy

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Re: 4 weeks on Nebido
« Reply #12 on: January 18, 2018, 06:10:58 PM »
I've now been on Nebido for 7 weeks, having had my 6 week booster a week ago. There haven't been any noticeable positive changes in the last week, but I'm trying to stay optimistic. It's still early days.

The one thing that does concern me is I weighed myself today and was stunned to find I've put on over a stone in weight. There is nothing in my diet recently to have caused this. In fact I generally have a small appetite. I'm assuming this is caused by the nebido, as I spotted it mentions weight gain as a possible side effect in the package leaflet. Is weight gain something that is likely to continue or will it most likely drop as my system gets used to the nebido? I'm sure I read something somewhere indicating weight loss is probable when testosterone levels have normalised at a decent level, so I'm hoping the gain is an early side effect which will go. It's frustrating to get side effects without actual positive effects but hey ho! I'm already reducing carbs and increasing water intake as recommended by Craig to Patch earlier in this thread, in case it is to do with water retention. Although my skin (especially on my face) has been generally dry for a couple of years, and remains so now, presumably as a result of Low T. So surely if water levels are increasing in my body, the dry skin issue would be resolving?

I have spoken to my endocrinologist's secretary today and mentioned this to her. I've also asked for the results of the blood test I had last week (checking testosterone, FSH and LH). So she's going to speak to the endo and get back to me next week. I'm interested to see if the endo thinks the weight gain is just an side effect of nebido or if he thinks conversion to oestrogen is playing a part or not.
« Last Edit: January 18, 2018, 06:39:19 PM by andy »

Patch

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Re: 4 weeks on Nebido
« Reply #13 on: January 18, 2018, 10:09:27 PM »
Hi andy, as you've already seen i had the exact same issue and my urologist told me that although my oestrogen was reasonable, it didn't look good for me and nebido which is why I'm going onto sustanon on Tuesday. Fingers crossed I don't get the same negative response as the positive, though short lived was great. Keep us posted andy, I too would be very interested to see if it subsides in time

andy

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Re: 4 weeks on Nebido
« Reply #14 on: January 19, 2018, 03:40:41 PM »
Hi andy, as you've already seen i had the exact same issue and my urologist told me that although my oestrogen was reasonable, it didn't look good for me and nebido which is why I'm going onto sustanon on Tuesday. Fingers crossed I don't get the same negative response as the positive, though short lived was great. Keep us posted andy, I too would be very interested to see if it subsides in time

In my case, I think it is far too early to give up on nebido and switch to sustanon. I'm hanging in there and seeing what happens over the next few weeks.