Gold standard in the treatment of age-related androgen deficiency

February 19, 2022 Admin Home page » Pharmacology

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Instructions for use of Sustanon 250. Required dosages and side effects. Comparison of Sustanon 250 and Omnadren. Drug combination scheme.

For those who were interested in pharmacology, the name is familiar, but only a narrow circle of people know what the drug is and how to take it, so let’s expand the knowledge and identify plausible detailed facts about this drug of steroid origin.

Sustanon 250 instructions

The drug sustanon, or “sust” as it is called among chemists, includes testosterone, or rather its four esters:

The drug has its own name in the trade: Sustaretard-250 and Durandron-250

It is with the combination of the 4 above components that the drug quickly manifests its activity for a long period of time. In this connection, the “sust” has a pronounced anabolic result, gives a good increase in strength and muscle volume, but water retention and aromatization also occur, albeit in small sizes. Its advantage over other drugs is that even small dosages give visible results even on experienced “chemists”, who are difficult to surprise with anything.

Side effects of Sustanon -250

Taking the drug can cause phenomena that are similar to the use of testosterone:

• increased load on the liver;
• gynecomastia;
• fluid retention;
• increased hair loss;
• increased aggressiveness;
• increased sexual desire;
• the skin becomes oilier due to increased activity of the sebaceous glands;
• reducing the production of natural testosterone, since the body does not need it at this time, because it comes from outside in large quantities;
• the appearance of acne.

As the practical use of the drug shows, severe side effects occur as a result of exceeding recommended dosages. However, we must always remember that people who constantly experience swelling and fluid retention in the body must use atniestrogen while taking the “sust” course. For example, Proviron and Nolvadex are popular.

According to reviews from experienced chemists, the use of gonadotropin in PCT has not shown significant results in increasing natural testosterone production. In addition, it is worth noting that Sustanon is not recommended for women and beginners in the world of iron sports, especially amateurs.

To find out more information about the drug, read on...

Hormone replacement therapy for men with age-related androgen deficiency

Specialization: urology, andrology

Age-related androgen deficiency syndrome in men is a biochemical imbalance that occurs in adulthood due to insufficiency of androgens in the blood serum, often accompanied by a decrease in the body's sensitivity to androgens. As a rule, this leads to a significant deterioration in the quality of life and adversely affects the functions of almost all body systems. Naturally, the issues of androgen deficiency therapy are of great interest, since it poses a difficult task for the clinician: to choose from a wide arsenal of methods and drugs of hormonal therapy the most optimal one, combining quality, efficiency, and ease of use.

Currently, urologists and andrologists most often use testosterone replacement therapy. This method allows you to solve a number of problems: reduce the symptoms of age-related androgen deficiency by increasing libido and overall sexual satisfaction, reduce the severity or completely eliminate vegetative-vascular and mental disorders. In addition, if testosterone replacement therapy is used for more than 1 year, patients experience an increase in bone mass density, a decrease in the severity of visceral obesity, and an increase in muscle mass. Also, after a long course of treatment, laboratory parameters are normalized: there is an increase in hemoglobin levels or the number of red blood cells, a decrease in the level of VLDL (very low density lipoproteins) and LDL (low density lipoproteins) with an unchanged level of HDL (high density lipoproteins). Many authors believe that this effect can be achieved by restoring the concentration of testosterone in the blood to normal levels (10–35 nmol/l). It should also be taken into account that *17α-alkylated testosterone preparations fluoxymesterolone and methyltestosterone have pronounced hepatotoxicity, having a toxic and carcinogenic effect on the liver, and also negatively affect the lipid spectrum of the blood (a sharp increase in the level of atherogenic and a decrease in the level of antiatherogenic lipoproteins). Therefore, the use of these testosterone derivatives in clinical practice was discontinued. Currently, testosterone undecanoate (Andriol) is the preferred oral drug. This testosterone ester does not undergo primary hepatic metabolism, as it is absorbed into the lymphatic system, bypassing the liver. After hydrolysis of testosterone undecanoate in the lymphatic system, testosterone enters the systemic circulation, which has a therapeutic effect both on its own and through its main metabolites - dihydrotestosterone (DHT) and estradiol, which determine the full spectrum of androgenic activity of testosterone. Thus, testosterone undecanoate retains its activity when administered orally. At the same time, bypassing the portal vein system and passing through the liver, testosterone undecanoate does not have a hepatotoxic or hepatocarcinogenic effect. The half-life of the drug from plasma is 3–4 hours. In connection with this, the dosage regimen for testosterone undecanoate is 2 times a day, which is not always convenient for patients. Based on our own experience, we believe that Andriol is a fairly mild drug and helps only in cases of initial and minimal manifestations of age-related androgen deficiency.

Intramuscular injections of long-acting testosterone esters are also a widely used method of replacement therapy in men with hypogonadism. The two most well-known testosterone esters, testosterone cypionate and testosterone enanthate, have similar pharmacokinetics. When these drugs are administered intramuscularly, a depot is created from which the drug is released into the bloodstream. During the first 2–3 days after administration, testosterone levels rise to supraphysiological levels, and then slowly decrease over the next 2 weeks to subnormal values. The positive side of these drugs is the duration of the therapeutic effect. Nevertheless, sudden changes in testosterone levels, often felt by the patient himself in the form of increases and decreases in libido, general well-being, and emotional status, are undesirable qualities of these drugs. In this regard, great hopes are placed on the new drug Nebido (Schering), the pharmacokinetics of which are significantly different from other testosterone esters. Nebido is testosterone undecanoate and is a non-peak drug. Over the past two decades, much attention has been paid to research into the benefits of transdermal use of testosterone preparations. Scrotal patches are effective and some patients find them the most convenient treatment option. Skin patches are most well accepted by patients and provide effective serum testosterone levels. However, there are some differences between the two types of patches regarding their allergenic potential: skin patches have a much higher incidence of allergic reactions and skin irritation than scrotal patches. Testosterone gel has all the benefits of patches and does not cause skin reactions. Its only drawback is the possibility of contact of the gel with a partner and the insufficient number of long-term studies on its use. The transdermal route of testosterone administration avoids its primary metabolism in the liver and inactivation, as occurs with the use of oral androgen drugs, and also allows it to simulate the circadian rhythms of release of physiological unmodified testosterone and its natural metabolites, estradiol and DHT. In addition, therapy using patches and gel can be easily interrupted if necessary. The positive aspects of this treatment method also include the low risk of drug dependence. The European drug 5-α-dihydrotestosterone gel (DHT), although found to be effective, is unknown whether the isolated use of a non-aromatized androgen, such as DHT, has the same effect as testosterone, due to the fact that testosterone metabolites include estradiol. According to many authors, the use of the drug is not recommended, since DHT, due to the inability to convert into estradiol, does not have the full range of therapeutic properties of testosterone (for example, effects on bone tissue and the cardiovascular system). Some of the replacement therapy drugs, such as testosterone undecanoate, DHT gel and scrotal patches, cause a significant increase in serum DHT concentrations. DHT is known as the main androgen of the prostate, and there has been much discussion regarding its ability to cause prostate disease. However, despite these assumptions, in the last 10 years there has been no evidence of an increase in the incidence of prostate pathology when prescribing DHT drugs.

Thus, there are many drugs for androgen replacement therapy, but they all have certain side effects and also have an inhibitory effect on spermatogenesis. Recently, more and more studies have appeared demonstrating the secondary nature of age-related androgen deficiency. According to WHO materials, data were obtained on the preservation of the secreting function of Leydig cells in elderly men, which allowed scientists to propose a fundamentally new approach to the treatment of age-related androgen deficiency, based on stimulation of the synthesis of endogenous testosterone. However, we should not forget that along with absolute contraindications for androgen replacement therapy (breast and prostate cancer), there are also additional ones (benign prostatic hyperplasia with severe obstruction, prolactinoma, polycythemia). Relative contraindications include sleep disorders in the form of apnea, obstructive pulmonary diseases, and heavy smoking. Side effects of androgens include increased sleep apnea, polycythemia, gynecomastia, priapism, fluid retention, increased blood pressure, edema, increased prostate size, and inhibition of spermatogenesis. That is, today there are methods for treating age-related androgen deficiency, which can be divided into two groups, fundamentally different in their mechanism of action: replacement therapy with exogenous androgen drugs; therapy that stimulates the synthesis of endogenous testosterone. Thus, we can say that there is no optimal treatment for age-related androgen deficiency in men. And the choice of drug should be approached strictly individually, taking into account the patient’s age, body mass index, the need to preserve spermatogenesis, hematocrit values ​​and concomitant diseases.

Bibliography:

1. Kalinchenko S. Yu. Age-related androgen deficiency in men // Medical newspaper. – June 28, 2002 – No. 49.
2. Cunningham GR Management of male aging: which testosterone replacement therapy should be used? The Aging Male 2000;3:203-209.
3. Jordan WP Allergy and topical irritation associated with transdermal testosteron administration: a comparison of scrotal and nonscrotal transdermal systems. Am J Contact Dermat 1997;8:108-13.
4. Yu Z, Gupta SK, Hwang SS, et al. Testosterone pharmakokinetics after application of an investigational transdermal system in hypogonadal men. J Clin Pharmacol 1997;37:1139-45.
5. Gorpinchenko I. I., Miroshnikov Ya. O. Erectile dysfunction. – Lviv: Medicine of the World, 2003. – 80 p.
6. Duncan C. Gould Hypoandrogen-metabolic (HAM) syndrome: an important men's health issue//IMNG.– 2007. – V.2. – P. 174–178.
7. Shabsigh R. Testosterone therapy in erectile dysfunction and hypogonadism//J. Sex. Med. – 2005. – V.2. – P. 785–792.
8. Traish AM, Kim N. Weapons of penile smooth muscle destruction: androgen deficiency promotes accumulation of adiposities in the corpus cavernosum // Aging male. – 2005. – V.8. – P. 141–146.

The material was published in the specialized publication for doctors ProTest, issue 5, May 2016. When using materials, a link to the journal is required.

Comparison of Sustanon and Omnadren

If you have an idea about the drug Omnadren-250, then you know that you will not feel any strong differences in taking it instead of Sustanon. But there are still differences, if you take drugs together, you will immediately feel that the “sust” is softer than the “omna”. Why is this happening?

If we compare the two drugs, the content of testosterone esters is approximately the same and the rate of their involvement in work is also the same. However, what are these ethers?

Omnadren includes:

As can be seen from the list above, esters No. 3 and No. 4 are the same as sustanon, but esters No. 1 and No. 2 have several variations.

To put all the dots in this issue, you need to pay attention to the content of the drug from the famous Polish manufacturers - Jelfa or Dutch - Organon, what happened is provided below.

You don’t need to be very versed in chemistry or be an advanced pharmacist to see the different contents of components in drugs, but one thing is known that combining them gives better results, both in strength and mass. The question is the correct dosages.

Joint application scheme

You can hear many times that testosterone is the same everywhere and differs only in its duration of action, but practice shows different work of different testosterone esters and, accordingly, differences in effects. Especially if they also interact, like Omnadren or Sustanon. The instructions for the medications, of course, must be strictly followed.

That is why a scheme for connecting these funds as part of a general course was tested at one time.

The total dosage per week is no more than 500 milligrams, which minimizes possible side effects. In addition, thanks to alternate injections, the harsh influence of Omnadren is somewhat softened. Once again, it must be repeated that Omnadren and Sustanon are not very convenient for solo use.