Testosterone Enanthate Appetite & Cravings Changes: What the Evidence Shows

Does Testosterone Enanthate Change Appetite?

The enanthate label's adverse reactions section lists nausea and fluid and electrolyte disturbances, but not appetite change [1]. What it says about food is indirect. Androgens 'have been reported to increase protein anabolism and decrease protein catabolism,' and the label adds that nitrogen balance is improved only when calorie and protein intake is sufficient [1]. That describes how the body handles protein, not how hungry a person feels.

What the Label Lists That Touches Eating

The listed gastrointestinal reaction is nausea. The label also lists fluid and electrolyte disturbances, including retention of sodium, chloride, water, potassium, calcium and inorganic phosphates [1]. On fluid, the label warns that 'due to sodium and water retention, edema with or without congestive heart failure may be a serious complication in patients with preexisting cardiac, renal, or hepatic disease' [1].

On blood sugar, the label states that in diabetic patients the metabolic effects of androgens may decrease blood glucose and insulin requirements [1].

Craving appears in the label in one context: withdrawal. It states that people taking supratherapeutic doses of testosterone may have withdrawal symptoms lasting weeks or months that include craving, anorexia, fatigue, restlessness, irritability and depressed mood [1]. The same section states that drug dependence at approved doses has not been documented [1].

What the Trials Actually Measured

A 2005 meta-analysis of 29 randomized trials (1,083 men, mean age 64.5) found testosterone treatment reduced total body fat by 1.6 kg and increased fat-free mass by 1.6 kg, with no change in body weight [3].

A 2016 meta-analysis of 59 randomized trials (3,029 men on testosterone, 2,049 controls) found no significant change in body weight, waist circumference or BMI. It also found a reduction in fat mass, an increase in lean mass, and lower fasting glucose and insulin resistance [4].

A 2001 dose-response study gave 61 healthy eugonadal men aged 18 to 35 a GnRH agonist plus weekly testosterone enanthate at 25, 50, 125, 300 or 600 mg for 20 weeks. Energy and protein intakes were standardized. Fat-free mass rose by 3.4, 5.2 and 7.9 kg at the 125, 300 and 600 mg doses, and fat mass was negatively correlated with testosterone concentration [5].

Do These Trials Show Whether Cravings Change?

The trials above report body composition and metabolic measures, not hunger or food cravings. In the enanthate dose-response study, energy and protein intakes were standardized [5]. Across the pooled trials, body weight tended to stay flat while fat and lean mass moved in opposite directions [3][4].