testosterone esters chart

Efficacy and safety of the 2% formulation of testosterone topical solution applied to the axillae in androgen-deficient men. Testostetone enanthate is a fat-soluble, slow-acting, long-ester of Testosterone that is almost identical to Cypionate. A slower release means fewer testosterone injections per year. Before starting treatment, male hypogonadism should be documented with low morning testosterone levels on two occasions. TC is available both branded as Depo-Testosterone (Pharmacia and Upjohn Company, New York, NY, USA) and as a generic (41). Despite being an oral steroid, Anavar doesnt pose much risk to the liver, as it is metabolized differently (with the kidneys taking on more of the workload). Current FDA-approved testosterone products for injection are limited to three esters: testosterone cypionate, testosterone enanthate and testosterone undecanoate. In terms of Testosterone esters, theres no need to inject anything other than Enanthate or Cypionate; as theyre cheap, less troublesome and dont need to be injected regularly. Intramuscular injections should be given deep in the gluteal muscle. Pharmacokinetics, efficacy, and safety of a permeation-enhanced testosterone transdermal system in comparison with bi-weekly injections of testosterone enanthate for the treatment of hypogonadal men. To prevent this an effective SERM should be taken (Nolvadex) throughout the whole cycle. Users often take Testo-Max when bulking. Many esters of testosterone have been marketed, including the following major esters:[1][2], And the following less commonly used esters:[1][2], The following major testosterone ester has not been marketed:[1][2], And the following less commonly known testosterone esters have also not been marketed:[1][2], Several esters of dihydrotestosterone (DHT; androstanolone, stanolone) have also been marketed, including the following:[8][9], The following esters of DHT have not been marketed:[8][9], Testifenon (chlorphenacyl DHT ester) is a nitrogen mustard ester of DHT that was developed as a cytostatic antineoplastic agent but was never marketed.[10]. Staying on a low dose can quickly lead to plateaus, however by increasing the dose and length of the cycle; users can continue adding muscle and strength. The following esters of other natural AAS have been marketed: And the following have not been marketed: Sturamustine is a nitrosourea ester of dehydroepiandrosterone (DHEA) that was developed as a cytostatic antineoplastic agent but was never marketed.[12][13]. The review found inconsistent effects of testosterone therapy on lipids and no beneficial effect on reported angina.12, The effects of testosterone therapy on cardiovascular health remain unclear. However, Testosterone can be taken for lengthy periods of time. An aggressive PCT of hCG, Nolvadex and Clomid will also be required on this Test/Tren cycle to prevent an almost certain crash (and to help solidify gains). The unique element with this stack is that its very androgenic, thus there will be considerable fat loss; as well as exceptional strength/muscle gains. Their testosterone propionate contains 100 mg/ml of steroid, which equates to 830 milligrams of testosterone in total, and sells for $25. Other adverse effects reported with greater than 3% incidence during TU clinical trials included acne, injection site pain, and increased PSA (47). Delorimier AA, Gordan GS, Lowe RC, et al. AFP. The use of testosterone therapy is increasingly common in the United States, with an estimated 2.3 million American men receiving the therapy in 2013.1 More than one-half of testosterone prescriptions are written by primary care physicians.2 Most of these prescriptions are for middle-aged and older men with age-related declines in testosterone,1 despite inconclusive data on testosterone therapy's safety and effectiveness for this indication. Pharmacology of testosterone preparations. Testosterone propionate is a testosterone ester and kind of testosterone used to treat low testosterone levels in males. Because of circadian variations in testosterone levels, serum testosterone measurement should occur in the morning, or within two hours of awakening in shift workers (Figure 19 ). The primary difference between esters is the rate at which testosterone enters the bloodstream following an injection. No matter what cycle is used, a persons body is going to transform dramatically on Testosterone, with their muscles blowing up and becoming stronger than ever before. Generally, if you experienced acne during puberty or currently have a receding hairline this cycle may aggravate either or both. Hair loss on the scalp, enlarged prostate and acne are all possible on Test/Tren; due to it being a highly androgenic cycle. Other steroids can have a much worse effect on BP, significantly increasing the risk of heart disease. This is partly due to Dianabol being a potent oral steroid, which is notorious for worsening cholesterol levels, as they stimulate hepatic lipase in the liver. Thus, androgenic side effects are significantly less on Dianabol; however, it has the edge over Testosterone for muscle/strength gains. Water retention is almost certain, causing users to feel bloated and muscles to look smooth. See permissionsforcopyrightquestions and/or permission requests. Do not prescribe testosterone or testosterone products to men contemplating or attempting to initiate pregnancy. It is recommended to start Vogelxo at a dose of 50 mg applied once daily to the shoulders or upper arms. This article discusses normal testosterone levels, tests, and treatment. Testosterone enanthate [package insert]. There is no ester attached, meaning every last milligram of the contained solution is the pure testosterone hormone. Most experts agree that the goal serum testosterone level should be in the midnormal range (i.e., 400 to 700 ng per dL [13.9 to 24.3 nmol per L]); values outside of this range require a dose adjustment.9 Most importantly, ongoing evaluation of treatment effectiveness is required. After receiving the last dose of the treatment period, testosterone levels were then measured more frequently. Should Older Men Take Testosterone Supplements? This ester is less popular due to its high cost. Mg for mg, Anavar is technically 6x more anabolic than Testosterone (6); however, in real life, this doesnt translate into more muscle gains. This before and after transformation is typical of a bodybuilders results after taking a low-dosed Testosterone cycle for the first time. 7 At-Home Testosterone Test Kits We Recommend in 2023, Testosterone - what it does and doesn't do, Salivary testosterone measurement by liquid chromatography tandem mass spectrometry in adult males and females, Testosterone therapy: review of clinical applications, Evaluation and treatment of women with hirsutism, The effects of short-term resistance training on endocrine function in men and women, Oral capsules, including Kyzatrex, Jatenzo, and Tlando, Implantable pellet (implanted under the skin), Possible risk for heart problems, cancer, and blood clots (though recent studies show that the risk for all of these is low or possibly not risky at all), Side effects such as breast enlargement (in males), skin reactions, changes in hair patterns, acne, and back pain. Thus, it requires very frequent injections (2x a day) in order to maintain peak serum testosterone levels in the bloodstream. Testosterone levels are likely to shut down post-cycle, thus an aggressive post-cycle therapy protocol is needed. Remember that because everyone's bodies have differing sensitivities to androgens, Bhasin S, Cunningham GR, Hayes FJ, et al. The testosterone ester determines how long it takes your body to dispose of the hormone in question and propionate is one of the shortest esters available with a testosterone base. No randomized controlled trial has demonstrated decreased cardiovascular events or mortality with testosterone therapy. If your testosterone levels are too low or high, you might develop symptoms that interfere with your daily life. The U.S. Food and Drug Administration warns that testosterone therapy may increase the risk of cardiovascular complications. In a 2015 advisory, the U.S. Food and Drug Administration (FDA) warned that testosterone use is possibly associated with increased cardiovascular risk and advised physicians to discuss this risk with patients before initiating testosterone therapy.38 This warning came after two observational studies39,40 and a meta-analysis of randomized controlled trials41 showed an increased cardiovascular risk, and the Testosterone in Older Men with Mobility Limitation (TOM) randomized controlled trial was stopped early because of concerns about a higher incidence of cardiovascular adverse events in the testosterone treatment group.42 However, other meta-analyses did not find an increased cardiovascular risk,43,44 and several other observational studies have appeared to demonstrate decreased cardiovascular risk with testosterone therapy.4548 Additionally, one of the observational studies that showed increased risk was criticized for its statistical analyses,40 and many of the adverse events leading to the early stoppage of the TOM trial were of questionable clinical significance. The authors would like to graciously thank Joseph Kanasz, BFA, from the Cleveland Clinic Center for Medical Arts and Photography for creation of Figures 1-2 in this manuscript. Testosterone, various testosterone esters including long-acting or oral testosterone undecanoate, testosterone cypionate, enanthate, or mixed testosterone esters might be used depending on the medical indication as well as local and individual logistics. Equally, someone looking to keep their heart and liver in optimal condition may stack Testosterone with Deca Durabolin or Anavar (staying away from Trenbolone and Anadrol). It should not be given intravenously. Recent studies have shown that the use of TRT is increasing, and more than half of prescriptions for testosterone are written by primary healthcare providers. The study concluded that Vogelxo gel is better tolerated than transdermal testosterone patches, and can better normalize serum testosterone levels with titration (36). Available online: Bioavailability of albumin-bound testosterone. Also because Propionate injections are known to be painful, many bodybuilders opt for a different ester. There is a USA FDA Boxed Warning for the risk of POME and anaphylaxis; as a result, TU is only available through a restricted use program (Aveed REMS Program). In the 200 mg group, the average Cmax was also greater than 1,200 ng/dL and occurred 48 hours after the last dose. Testosterone - what it does and doesn't do. 2003;67(12):2565-2572. A total of 130 hypogonadal males received treatment, but levels were available for 117. A confirmed absolute PSA > 4.0 ng/mL at 12 months was observed in 1.9% of men in the testosterone group and 0.3% in the placebo group. Onset of effects of testosterone treatment and time span until maximum effects are achieved. The study was conducted over 90 days, with measuring of serum testosterone to assess 24-hour PK profiles on days 30 and 90. To try and keep blood pressure as low as possible, users are recommended to take 4g of fish oil per day, combined with clean eating and regular cardio. This significantly reduces the risk of gyno, without totally blocking estrogen at a cellular level (thus keeping HDL cholesterol and serotonin levels optimal). Treatments are available if your testosterone levels are abnormal. Part of the reason for this may be attributed to Decas low androgenicity, coupled with it lowering endogenous testosterone production. It needs to be dosed every day or every other day. Testosterone preparations are FDA Schedule III controlled substances that are subject to diversion and misuse. Depressed mood, fatigue, decreased strength, and a decreased sense of vitality are less specific to male hypogonadism. As part of the Choosing Wisely campaign, the American Urological Association says physicians should not prescribe testosterone therapy for men with erectile dysfunction and normal testosterone levels.20, Low testosterone levels (less than 200 ng per dL [7.0 nmol per L]) are associated with decreased bone density and unfavorable body composition changes.21 Testosterone therapy increases bone density at the lumbar spine but not at the hip in middle-aged men with testosterone deficiency.22 In older men, testosterone therapy increases bone density in the spine and hip.23,24 There is no evidence that testosterone therapy leads to decreased fractures or falls. HHS Vulnerability Disclosure, Help Enanthate and Cypionate are the two most popular forms of Testosterone, made up of longer esters that are slower to take effect. The suggested starting dose of Axiron is 60 mg applied once daily in the morning. Studies show significant increases in strength within 6 to 12 weeks . Since Testosterone Cypionate arrived on the scene, its been considerably more popular than Enanthate in the US due to its limited availability worldwide, consequently becoming a native favourite. Some studies have shown that saliva tests might also be used to accurately measure testosterone levels in the body. Testosterone enantate benzilic acid hydrazone, Testosterone 17-(1-((5-(aminosulfonyl)-2-pyridinyl)carbonyl)-, 11-Methyl-19-nortestosterone dodecylcarbonate, Androgen/anabolic steroid (as a medication), Dihydrotestosterone (DHT; androstanolone), Dehydroepiandrosterone (DHEA; prasterone), Prasterone (dehydroepiandrosterone, DHEA), Androstanolone (stanolone, dihydrotestosterone, DHT), Drostanolone propionate (dromostanolone propionate), Metenolone enanthate (methenolone enanthate), Oxabolone cipionate (oxabolone cypionate), Trenbolone hexahydrobenzylcarbonate (trenbolone cyclohexylmethylcarbonate), Metandienone (methandienone, methandrostenolone), Normethandrone (methylestrenolone, normethisterone), Adrenosterone (11-ketoandrostenedione, 11-oxoandrostenedione), DHEA (androstenolone, prasterone; 5-DHEA), 7-Methyl-19-norandrostenedione (MENT dione, trestione), Methylclostebol (chloromethyltestosterone), Andarine (acetamidoxolutamide, androxolutamide, GTx-007, S-4), Enobosarm (ostarine, MK-2866, GTx-024, S-22), https://en.wikipedia.org/w/index.php?title=List_of_androgen_esters&oldid=1122032190, Short description is different from Wikidata, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 15 November 2022, at 13:42. Thus, testosterone suppression is likely to be heightened post-cycle; as well as water retention/the risk of gyno, etc. The three IM preparations that are USA FDA approved are testosterone cypionate (TC), TE, and TU. Levels decrease gradually starting in the 20s or 30s. Nolvadex blocks estrogen specifically in the mammary glands, whilst keeping estrogen levels circulating throughout the body. Dose adjustments should be made based on serum testosterone levels measured 14 days after initiation, and drawn two to eight hours after dose application. Enanthate will release a steady (yet fluctuating as all esters are) level of hormone for approximately 10-14 days. Tulane University. Although Testosterone is relatively heart-friendly Dianabol is not. Furthermore, Cypionate injections may provide less irritation than Enanthate in some users. The formulation of TU contains a concentration of 250 mg/mL supplied in 3 mL vials, prepared in refined castor oil and is branded as Aveed (Endo Pharmaceuticals, Malvern, PA, USA) (46). However, it doesnt aromatize, thus taking an aromatase-inhibitor (AI) wont work to prevent gyno/water retention from Anadrol. However, its worth noting that Anavars antagonist effects on testosterone production are mild compared to other compounds. . Some bodybuilders think Propionate is cheap because its price is lower; however, Propionate is dosed at 100mg/ml instead of 250mg/ml (the usual test dosage). Ask your doctor to check for both total and free levels of testosterone in your system. TE is generically available in 200 mg/mL (5 mL vial) concentration, prepared in sesame oil (43). However, the Testosterone Trials were designed to assess only effectiveness and not the risks of testosterone therapy, including prostate cancer or cardiovascular disease. The dose of Vogelxo can be increased to 100 mg/day to achieve therapeutic serum testosterone levels (35). These products differ based on the carbon side chain esterified to the 17 position of testosterone (Figure 2). In women, testosterone is produced by the ovaries and adrenal glands, and by conversion of proandrogens in peripheral tissues. Esters of natural AAS [ edit] Testosterone esters [ edit] Matthew Wosnitzer, MD, is a board-certified urologic surgeon and physician scientist. Author disclosure: No relevant financial affiliations. Testosterone and Deca Durabolin is the exception to this rule, with both compounds not affecting the liver; and only having modest impacts on cholesterol. As cottonseed oil is the formulation vehicle, TC use is contraindicated in anyone with a known hypersensitivity to testosterone synthesized from soy. Development of polycythemia during treatment should lead to cessation of therapy, lowering of the dose, or switching to a lower-risk formulation to avoid increased risk of myocardial infarction, stroke, and venous thromboembolism. Dianabol, being an oral steroid, will cause liver toxicity; thus it shouldnt be taken for an extended period of time. Testosterone therapy should be considered for men with low testosterone levels and clinical symptoms of hypogonadism, particularly sexual dysfunction. Anavar is generally viewed as a cutting steroid, due to its powerful fat-burning effects. Fortunately, its easy to find out if your testosterone levels are in the normal range. Note: Before taking Testosterone, get a check-up with your doctor to make sure your heart and liver are in good condition; and continue to get checked over regularly throughout your cycle to minimize any damage. Men receiving testosterone therapy should be monitored regularly for adverse effects and treatment effectiveness, including testosterone measurements, complete blood count to measure hematocrit, and prostate-specific antigen testing. The fluctuation in serum testosterone levels can result in mood swings or changes in libido, which is a formulation specific IM adverse effect that should be closely monitored. Anavar will worsen testosterone suppression post-cycle, requiring a more advanced PCT compared to a Test-only cycle. Our doctors have successfully treated thousands of patients in the last 20 years who have suffered from PED-related side effects. After a persons first Testosterone cycle, the above protocol can be utilized (with higher dosages). The effect of varying doses of TE on serum testosterone was evaluated in 23 males with primary hypogonadism (44). A retrospective study chart review was conducted in a single university-based transgender clinic. But for some reason, Test Cyp is favored over Enanthate. The goal of testosterone replacement therapy (TRT) is to return serum testosterone levels to within physiologic range and improve symptoms in hypogonadal men. Risks for a testosterone blood test are minimal but may include: If you and your healthcare provider decide to treat low testosterone levels, you may be a candidate for testosterone replacement therapy (TRT). Dr. Touliatos provides services to Inside Bodybuilding, in the form of online consultations. testosterone replacement therapy has been inconsistent, with some studies showing poor adherence (i.e., 15% by 12 months) and other showing high adherence patterns (e.g., 91% after 12 months). These preparations are widely used and have a good safety profile. It's produced by the adrenal cortex, a man's testicles, and a woman's ovaries. Accessibility Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus, Testosterone cypionate can be given at intervals of two to four weeks. Instead, a novice may want to run a 6-7 week cycle with lower dosages being 350mg/week for Testosterone and 15mg/day of Anavar for the first 3 weeks, followed by 20mg/day for the last 3 weeks. [9] [3] Along with testosterone cypionate, testosterone undecanoate, and . This Anavar/Testosterone cycle can also add significant amounts of lean mass when bulking, whilst simultaneously keeping fat gains at bay. Search dates: November 30, 2015; January 15, 2016; February 10, 2016; and March 17, 2017. Adverse events occurring in greater than 3% of subjects who received at least one dose included application site irritation (7%), application site erythema (5%), headache (5%), increased hematocrit (4%), and nasopharyngitis (4%). Testosterone esters are not biologically active until the ester group is cleaved off. Testosterone therapy may be considered for treatment of postmenopausal women with hypoactive sexual desire disorder. National Library of Medicine Ann Clin Biochem. Summary. United States Food and Drug Administration Orange Book [Internet]. Four men were diagnosed with prostate cancer. Your testosterone levels may be higher or lower based on your age, sex, medications you take, and other health conditions you have. Although not esters, the following ethers of natural AAS have been marketed as well: Many esters of the synthetic AAS nandrolone (19-nortestosterone) have been marketed, including the following major esters:[14][15][16], And the following less commonly used esters:[14][15][16]. 1 Additional testosterone esters have been prescribed as FDA-approved commercial products over the years but may now only be available through compounding pharmacies. A comparison of a novel testosterone bioadhesive buccal system, striant, with a testosterone adhesive patch in hypogonadal males. 2014;51(Pt 3):368-378. doi:10.1177/0004563213506412. A PK study evaluated serum levels of testosterone periodically for 14 days after administration of TC 200 mg IM in 11 hypogonadal men (42). Testosterone/Trenbolone will produce similar size gains, as the Testosterone/Dianabol cycle but without the additional water retention. Testosterone and estrogen are two of the most well-known hormones. Testosterone is produced by Leydig cells in the testes, in response to luteinizing hormone produced by the pituitary gland. The active substances of Sustanon 250 (see section 6 "What Sustanon 250 contains") are turned into testosterone by your body. The Endocrine Society/American Association of Clinical Endocrinologists, Decreased total serum testosterone, increased LH and FSH, Chromosomal abnormalities, cryptorchidism, FSH/LH receptor gene mutations, Klinefelter syndrome, myotonic dystrophy, Chemotherapy, hypothyroidism, orchitis/epididymo-orchitis (from mumps, gonorrhea, or chlamydia), radiation/trauma to testes, testicular torsion, Decreased total serum testosterone, normal or decreased LH and FSH, Kallmann syndrome, Prader-Willi syndrome, other genetic abnormalities, Chronic opioid use, hyperprolactinemia, pituitary tumors, sellar radiation, sleep deprivation, surgery, trauma, Decreased total serum testosterone, variable LH and FSH, Aging, cancer, chronic glucocorticoid use, chronic kidney disease, chronic obstructive pulmonary disease, cirrhosis, diabetes mellitus, hemochromatosis, human immunodeficiency virus infection, obesity, Diminished bone density, low-trauma fractures, Diminished energy, sense of vitality, or sense of well-being, Incomplete or delayed sexual development (in cases of prepubertal onset), Sexual symptoms (decreased libido, decreased spontaneous erection), Prostate-specific antigen > 4 ng per mL (4 mcg per L) or presence of nodules/induration on digital rectal examination (referral to a urologist is required before considering testosterone therapy), Desire for fertility (testosterone therapy suppresses spermatogenesis), Testosterone cypionate (Depo-Testosterone), 200 mg per mL: $115 ($130) for one 10-mL vial, 200 mg per mL: $80 ($100) for one 5-mL vial, Serum levels tend to have peaks and troughs, 750-mg initial dose and another 750 mg four weeks later, then 750 mg every 10 weeks, Two doses four weeks apart, then every 10 weeks, Special prescriber registration required because of risk of anaphylaxis and pulmonary oil microembolism, 33 mg; one actuation (11 mg) in each nostril three times daily, Adverse effects include headache, nasopharyngeal and upper respiratory symptoms, Possible to transfer from one person to another; risk of virilization of exposed women and children, Skin rash common; patients should be advised to rotate application sites, Applied to axillary area similar to deodorant; risk of transfer to others as with gel forms, Three to six months following initiation of therapy, then annually, Baseline; three to six months after initiation of therapy, then annually if stable, Goal is to increase level to midnormal range, although there is no clear target level, Endocrine Society recommends levels between 400 and 700 ng per dL (13.9 and 24.3 nmol per L) one week following injection with testosterone cypionate or enanthate, or at any time with other formulations, If hematocrit is > 54%, therapy should be stopped, or dose lowered or changed to different formulation; it can be restarted at a lower dose once levels decrease, Baseline; three to six months after initiation of therapy, then discuss risks/benefits of ongoing screening with the patient given the evidence against routine screening, Only men older than 40 years with baseline PSA > 0.6 ng per mL (0.6 mcg per L) should be screened, Refer to a urologist if PSA increases by > 1.4 ng per mL (1.4 mcg per L) over 12 months or there is an abnormality on DRE, One to two years after initiation of therapy, In men with osteoporosis or low trauma fracture history, Recommended only for treatment of hypoactive sexual desire disorder, Diagnosis is clinical; there is no established cutoff level of testosterone to indicate treatment, There are no formulations readily available in the United States that provide the recommended treatment dosage for women (300 mcg per day), necessitating the use of compounding pharmacies, Adverse effects may include virilization (acne, hirsutism, deepening of the voice) and adverse lipid changes; the effect of testosterone on breast and endometrial tissue is not well studied, although there is currently no evidence of cancer risk, Treatment should begin with a six-month trial period, and continued only if the patient is responding favorably at that time; there are no safety and effectiveness data beyond 24 months.

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