Subcutaneous Testosterone Injections

[chaos]

I have been reading about these with great interest; it seems there was a study done which indicated its efficacy.

Is this an acceptable method of administration?

[DrMariano2]

@chaos 237 wrote:

I have been reading about these with great interest; it seems there was a study done which indicated its efficacy.

Is this an acceptable method of administration?

It is not the usual route.

Here is one study, however:

http://www.ncbi.nlm.nih.gov/pubmed/17143361?

There haven’t been repeat studies in the last three years that I know of, however.

Of concern is the risk for abscess.

[JanSz]

@chaos 237 wrote:

I have been reading about these with great interest; it seems there was a study done which indicated its efficacy.

Is this an acceptable method of administration?

I am on a third year of testosterone injections.
I do it EOD, EveryOtherDay.
I newer had problem, abcess or otherwise.
I use thise syringes for my T, HCG & B12 injections:

BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle–1/2 Unit Markings

I suspect that problems, if any, may lay in the usual descriptions of how SubQ injections are done.

I newer pinch, I use only one hand to do my injections.

When injecting T or HCG I do it at 45-90 degree angle.
When injecting B12 I use 10-30 degree angle.

I push needle in, untill tip of syringe makes about 1/4″ dimple in the skin then I press on plunger.
I newer aspirate to check for blood vessel penetration.

I inject into
upper outside quarter of glutes
delts
around navel

Injecting into side of thighs hurts me for couple days.

---

When injecting B12 I follow description as quoted, from the article in the link:

http://www.drneubrander.com/Files/READ%20ME,%20Injection%20Instructions%20for%20Methyl-B12%20Shots.pdf

Therefore, NEVER PINCH THE FAT to insure a subcutaneous injection. Instead, go as shallow as necessary, often just under the skin in order to deliver the methyl-B12 into subcutaneous tissue.

AT A 10-30 DEGREE ANGLE (this way it is impossible to go “too deep”) until it stops at the hub of the needle/syringe.

[JanSz]

My main reason for convenient injections is that they allow very frequent applications.

Very frequent applications are the only way to achieve repeatable levels of testosterone and (specially) estrodial.
Ideally, once a 24hr applications would allow accurate blood level measurements of TT and E2 and any required dose adjustments.
Many unusual results from blood test, specially of E2 can be easily explained by infrequent, weekly or even biweekly injections.

Difficulties with large long needle, infrequent injections, lead to preference of using transdermal testosterone.
90% of transdermal testosterone is wasted within close environment, specially on small children and women.

Testosterone injections need not be more difficult than multiple daily insuline injections.
Actually there should be a way to use insuline pens for T & HCG injections to make it even more convenient.

Good testosterone and E2 levels are delaying or preventing diabetis.
.

[DrMariano2]

What is interesting is that the dorsogluteal site – the site most people do an intramuscular injection actually has highly variable amounts of fat. Sometimes one has to use a 3-inch needle in order to hit muscle. Thus, if the needle is too short – e.g. a 1-inch needle in most people – this would cause the injection to be a subcutaneous injection not an intramuscular injection.

[DrMariano2]

@JanSz 252 wrote:

My main reason for convenient injections is that they allow very frequent applications.

Very frequent applications are the only way to achieve repeatable levels of testosterone and (specially) estrodial.
Ideally, once a 24hr applications would allow accurate blood level measurements of TT and E2 and any required dose adjustments.
Many unusual results from blood test, specially of E2 can be easily explained by infrequent, weekly or even biweekly injections.

Difficulties with large long needle, infrequent injections, lead to preference of using transdermal testosterone.
90% of transdermal testosterone is wasted within close environment, specially on small children and women.

Testosterone injections need not be more difficult than multiple daily insuline injections.
Actually there should be a way to use insuline pens for T & HCG injections to make it even more convenient.

Good testosterone and E2 levels are delaying or preventing diabetis.
.

What dose of subcutaneous testosterone cypionate do you use?

[JanSz]

@DrMariano 256 wrote:

What dose of subcutaneous testosterone cypionate do you use?

I am not sure if the shots I am doing (one handed) should be called subqutaneous.

I was using 175mg/week DepoTestosterone
EOD ( T & HCG) shots (shots on alternate days)
T-shot 50mg
HCG-shot=400iu
was not using Anastrozole

Blood drawn at Quest 5/23/08

TT=1117(250-1100)
BAT=584.6(46-575)
FreeT=303.5(46-224)
SHBG=18
Albumin=4.2
DHT=77(25-75)
E2=39(< or =29)
E2, Free=1.07(< or = 0.45)
E2,%Free=2.73(1.25 – 1.85)
===================================================
Started liquid Anastrozole

Blood drawn at Quest 8/02/08
Estradiol, Ultrasensitive, LMMSMS=15(<29pg/mL)

===================================================

In effort to get of dependendency on Anastrozole I changed to 140mg/week
EOD ( T & HCG) shots (shots on one day next day free)
T-shot 40mg
HCG-shot=400iu
no Anastrozole

Blood drawn at Quest 5/27/09

TT=764(250-1100)
BAT=320.7(46-575)
FreeT=166.5(46-224)
SHBG=21
Albumin=4.2
DHT=59(25-75)

---

Estradiol, Free, LC/MS/MS (36169X)
E2=20(< or =29)
E2, Free=0.54(< or = 0.45)
E2,%Free=2.7(1.25 – 1.85)

---

Estrogens, Fractionated, LC/MS/MS (36742X)
Estrone, serum=110(<OR=68)
E2,serum=23(<OR=29)
Estriol<0.1(0.2 or less)
—-
E2,Ultrasensitive(dr John favorite), LC/MS/MS=41(<OR=29)

I switched back to 175mg/week
I use 0.1mg Anastrozole on the day of my shots
===================================================

[chaos]

Janz, were you exhibiting any symptoms of high E2? Or did you add the anastrozole solely because of numbers?

Why liquid? Easy to dose small? Are you certain of the potency (then again, are we certain of the potency of a pill…)?

I, too, would like not to need this medication. Less is better. But on my current protocol, E2 is high and I get symptoms…irritability, mood swings, etc… New sympathy for my significant other 🙂

I am considering talking to my doctor about lowering my dose of T.

[hardasnails1973]

@chaos 264 wrote:

Janz, were you exhibiting any symptoms of high E2? Or did you add the anastrozole solely because of numbers?

Why liquid? Easy to dose small? Are you certain of the potency (then again, are we certain of the potency of a pill…)?

I, too, would like not to need this medication. Less is better. But on my current protocol, E2 is high and I get symptoms…irritability, mood swings, etc… New sympathy for my significant other 🙂

I am considering talking to my doctor about lowering my dose of T.

If the thyroid and adrenals are not in check then this can impair the body’s ability to detoxify estrogens in the proper pathways. From listening to alot of lecture from top dr’s it is noted that hypothyroidism can lead to increase in 4, 16 ohe resulting in one chances of cancer. This connection may explain why alot of people that have cancer have or are hypothyroid symptoms. Methylation is also altered in states of hypothyroidism which can have a huge pack on DNA and RNA replication. In many of the cases by properly manipulating ones hormones a person can get maximum benefit with the least side effects. This is the route when dealing with all patients and it has been working very successful. There are some instance that no matter how much one can manipulate the protocol it just is not possible to get all the desired results. When this occurs then using the least amount of medicine to get the desired results is the best over all out come.

[JanSz]

@chaos 264 wrote:

Janz, were you exhibiting any symptoms of high E2? Or did you add the anastrozole solely because of numbers?

Why liquid? Easy to dose small? Are you certain of the potency (then again, are we certain of the potency of a pill…)?

I, too, would like not to need this medication. Less is better. But on my current protocol, E2 is high and I get symptoms…irritability, mood swings, etc… New sympathy for my significant other 🙂

I am considering talking to my doctor about lowering my dose of T.

Going by my (very light) symptoms and then relief, I would say that my liquid Anastrozile actually works.
But it is not easy to prove case numerically, I was using different E2 tests.
As you can see from my most recent results, using same day blood draw, three E2 tests show widely different results.

From my above post you can see that after I started using my liquid Anastrozole
my E2 falled from 39 to 15.

39 from
Estradiol, Free, LC/MS/MS (36169X)

15 from
Estradiol, Ultrasensitive, LC/MS/MS (30289X)

---

but blood draw at 5/27/09 have given values 20, 23 and 41 on three different E2 tests.

---

I am sticking now to:
Estradiol, Ultrasensitive, LC/MS/MS (30289X)

.

[DrMariano2]

@JanSz 263 wrote:

I am not sure if the shots I am doing (one handed) should be called subqutaneous.

I was using 175mg/week DepoTestosterone
EOD ( T & HCG) shots (shots on alternate days)
T-shot 50mg
HCG-shot=400iu
was not using Anastrozole

An injection using a 5/16 inch needle in the upper outer quadrant of the buttocks will probably be subcutaneous even at a 90 degree angle, unless a person had very little fat.

I would usually prescribe at least a 1.5 inch needle if I wanted to hit muscle in the buttocks. Some people need 3-inch needles there, depending on the amount of fat they have in the buttocks.

[naam4all]

I’ve recently been diagnosed with moderately severe Sleep Apnea (OSA) following a sleep study. After a week of experimenting with mouth/nasal masks on the CPAP, I have found the Nasal Pillow to be the most comfortable and it appears to be dramatically reducing my apneas and providing me with some much needed sleep.

I also received a low Total Testosterone (181) result following recent blood tests (I am a 56 year old male, and I “feel” like I’m 15-20 years older than I really am, with out the drive & vitality to function optimally with good cognitive function. My conventional MD prescribed intra-muscular T injections (every two weeks) which I have not yet begun. I have read up a bit on the subject (Abraham Morgentaler’s new book “Testosterone for Life”) and reviewed info on the BodyLogicMD sites related to Bioidentical hormone replacement.

My question is this: there is evidence to show that my lack of sleep may be contributing to my low T results. From what I understand, without the necessary sleep, my body can’t produce enough Human Growth Hormone (HGH) to produce adequate levels of testosterone. Am I better off waiting 2-3 months to see if the CPAP machine has the indirect effect of raising my bioavailable Free T, at which point I can have an Analog Free T blood test; or will it be too long a wait before my T reaches normal levels (if indeed, this actually is a common response)?

Should I just go ahead and take the T injections? Or, if moving forward with some kind of Testosterone Replacement Therapy is called for (rather than waiting), what are the advantages of taking a bioidentical cream vs. the injection. What are the possible risks with both these avenues?

Thanks! (DJC)

[pmgamer18]

First let me say I am not a Dr. but I have been on TRT for over 27 yrs. Don’t go on this until you know why your low. I work on the forums helping men and been at it for many yrs. You can read my story at this link and the update to it.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=9239
http://www.medibolics.com/ArimidexBoostsTestosterone.htm

I have talked a many men that had low testosterone from sleep Apnea and not one had levels as low as yours. So doing the CPAP might not bring them up high enough. I do see a lot of men with levels this low that have a low LH and FSH this is the messages sent to the testis from the brain to tell them to make more testosterone. Most Dr.s don’t test this and your Dr. telling you to do shots every 2 weeks tells me he is not up on this. Doing shots every 2 weeks is old and does not help most men. Your doing a big shot every 2 weeks your levels will shoot up very high in 4 days and start falling to a very low level by the next shot.
So you feel like your on a roller coaster ride up after the shot only to be very low by the next one. Plus doing big shots drive up your Estradiol levels this takes away any good the Testosterone does.

If your Dr. did not test your LH and FSH with your Estradiol levels and if your Estadiol levels are high your brain will think it’s Testosterone and slow down the LH and FSH messages to make more testosterone. This happens to older men because we have more fat Estradiol is made from Testosterone and the brain can’t tell the difference. So do get the labs done in this link, I have for Men at my thyroid forum.
Adding to the Thyroid labs Total T3 and T4.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=7059

Men that find there Estradiol levels very high have ED, Hives, Rush’s, can’t reach an orgasm easy, no night time and morning wood and feel panic or have panic attacks. With some Prostate problems and slow voiding. Getting your Estradiol down if to high to about 20 pg/ml fixes your problems and they will be gone and your Testosterone levels will come back up read this link.
http://jcem.endojournals.org/cgi/content/full/89/3/1174
And this link on how to treat this.
http://www.medibolics.com/ArimidexBoostsTestosterone.htm

Now you can have all the above bottom line is testing and doing this with a Dr. not an Endo that treats a lot of men for low testosterone. Dr. M is one of the best at this.

As for Apnea I had it but no way I could use that CPAP machine. I used a nose strips at bed time to help with breathing and sowed a tennis ball into a tee shirt so I could not sleep on my back and when I lost weight my Apnea stopped.

Don’t go on TRT with out knowing why your so low it can be more then one thing and if you fix them your levels will come back up. If not then go on TRT but It’s for life try the Gels first like Androgel or Testim this works the best and if you have a drug care plain that pays for this go for it if not the lowest cost of TRT is shots but don’t do them every 2 weeks do them every week start with a 200 mgs shot to jump start you then do them every week shooting 100 mgs a week.

To feel better get your total testosterone levels up into the upper 1/3 of your labs range and keep your Estradiol down to about 20 pg/ml. In time doing this your body will start to undo the damage done by low testosterone and you will start to feel better a little at a time everyday.

Read the AACE Guidelines page 11 it states to do shots every 7 to 10 days.
http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

A good site to read and watch is Dr. Gordens.
http://www.thehiddendisease.com/
Phil

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