Moving from Androgel to Cypionate with some questions

Under the guidance of my Dr. I am moving from Androgel to Cypionate had some questions to back up what my Dr. is advising.

Dosage:

I was using 1 packet of Androgel per day. My understanding is that this provides approximately 5mg Testosterone. I had previously used 2 packets per day, but that dosage brought me to around 1200 on the tests, and 1 packet brings me to about 400 so we want something in the middle.

5mg per day * 7 days = 35mg per week
1/2 CC of 200mg Cyp = 100mg per week

This seems like a big difference to me, even more than the 2 packets. Are my formulas correct? FYI - We decided to go with 1 injection per week to keep the levels as steady as possible.

Timing:

When should I stop taking the Androgel in regards to my first injection?

Cost:

This Cypionate is so much cheaper than the Androgel. It's even cheaper for me to buy it outright than have my insurance cover it (10ml vial is about $125 and lasts for 3 months vs. $40 month copay for insurance). I did find that this is my only option as my insurance covers androgel but not the cypionate. Is this common for insurance not to cover HRT with this medication?

with regards to the androgel being 5mg of testosterone/day=35mg over a week.
with 100mg of test cyp or enan/week you get approx 70mg/week as this is all the ester carries so although the injection is 100mg of test cyp there is actually only 70mg of testosterone.
yes this is still double what androgel will give you.however androgel being a transdermal does not usually need to be dosed the same as injection as transdermally more DHT is produced which makes up for the lower total test mgs.
use 1 andogel (5mg)pack up to when you get your first injection and put it on the day of injection(test cyp at 100mg) the following day use 1/2 packet(2.5mg) then discontinue the androgel and get your second injection(100mg) 1 week later.

check your PM's.

I'm not sure I understand why you are making the change.

I'm making the change primarily because my skin breaks out mildly with the Androgel, it is itchy. The secondary reason is that the 5mg packet is too low of a dose and the 10mg packet is too high (with the injectible we will be able to adjust easier). Also the injectible is more convienant for me (only 1x per week vs. dealing with it every day).

Thanks for the info toc67guru - I really appreciate it.

Also 1st injection done. It was quite awkward, but I got it done.

But androgel comes in a pump now. You use 4 pumps for 5gm, 6 pumps for 7.5, etc. It seems like you would have quite a bit of leeway with that.

Yes, my Dr. pointed out the pump option this visit (apparently it is new). If I have any problems with the cyprionate then I will go back to Androgel using the pump. I was on Androgel for about a year, but here is why I will use the cyprionate instead:

1) The androgel needs to be applied every day, the cyprionate is 1x per week. This is more convienant.
2) The whole avoiding contact and leaving androgel on for a certain number of hours thing. I used to put it on around 8AM and then would leave to go to the gym for lunch around 11:30 AM. I believe that is enough time for absorbtion, but there have been minor challenges here.
3) The cyprionate is much cheaper than the androgel and I'm not even using my insurance
4) I have to wait about 10 mins after applying the androgel before getting dressed or it will stick to my shirt. Another conveinance issue.

Now the downsides to the cyprionate:

1) You have to stick this huge needle in your leg or butt.
2) Getting over the injection fear/stigma
3) Disposing of used needles
4) Measuring out 1/2 CC in these 3CC syringes is kind of tough (Biggest problem I see so far).

I've only done it 2x now, but the injections weren't too bad. I scheduled a session with my Dr. and the nurse took about 20 mins to walk me through all of the steps the first time. The first time was awkward, but the 2nd time was much easier.

We'll have to see if Cyprionate is the right thing for me. My Dr. is concerned about spikes and valleys in my levels which is why we are doing 1x per week instead of 2x per week.

So far, I really like the convienance of the Cyprionate. The price is good also.

Does anyone know if they make a 1/2 CC or a 1CC syringe that uses a needle large enough for Cyprionate injection?

Also curious from your name - Are you a MD? Why the preference on Androgel over the Cyprionate? Just looking for more opinions since it looks like I'll be doing this for the rest of my life :)

I am a doc and I am also on HRT. I prefer the androgel just because of the better consistency of levels. On the other hand, if insurance wasn't paying for it-I, too, would be using weekly Cyp.

I am on Cyp. and it has been working great for me. I tried the Androgel first, but it actually made my levels go down. My test was at 222 before the Androgel and went down below 200 after one month of using it. Maybe I just have tough skin :unsure: .
I have been on the Cyp. for a year, and everything is good. I am taking two shots per week so I have no peaks and valleys. Last month I had my level checks and they were at 592.
Astrozombie, do you get sore from your shots?
When I first started I got very sore, but after doing some surfing here, I found out that the 21ga needle, that the pharmacy told me to use, was too big. Now I rarely have any soreness at all.

Astrozombie, If you dont mind me asking, what caused you to get on HRT in the first place?

I have no idea what caused me to go on HRT originally (what caused hypogonadism). It went undiagnosed for about 2-3 years, and I was really out of shape, which I thought was the problem. I started exercising and eating well and lost about 50 lbs. and still had all the symptoms and asked my Dr. to be tested. We had 3 tests done over 6 months and I came in just over 200 each time. I've been on HRT for about a year and things are much better.

Did you try the one shot per week before moving to two? I assume you are going with 1/4 CC per week then? That must be tough to measure out. I've only gotten a little sore on the shots, but it goes away in a couple of hours. Then again, I've only done two. Right now I am using 22g needles with 3CC syringes. This is the only tough part because my dosage is 100mg/week so I need to use exactly 1/2CC. I want to see if I can find a 20-22g needle with a 1/2CC or 1CC syringe, but I don't know if such a thing is made.

When I switched over to test Cyp, My dose was one shot of 200mg every two weeks. Which gave me a big peak and a big valley. My test levels stayed low, so I was moved up until I got to 400mg every week. Then my test levels got too high, and I dropped back down to 300mg every week. Now I stay in the 600-800 range. So now I take .75cc on Mondays and .75cc on Thursdays. I use a 23ga. 3cc pin. I always heat up the test before injecting it. Not hot, but just warm, it helps it come out of the smaller needle, and I dont get sore. I have always heard about hitting a vein, but havent had that problem until about three months ago. After putting the needle in, I pulled the plunger back to check for blood, and I got some, so I pulled the needle out and blood squirted out and ran down my leg. It was pretty crazy. A few times I have gotten some into a vein even though I didnt get blood in the pin when I checked, it makes you cough for a little while.

what causes a e2 spike shots or androgel im e sensetive ?

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Originally Posted by benrock

what causes a e2 spike shots or androgel im e sensetive ?

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Shots typically. The sudden flow (spike) of T in the system causes additional aromatase to be released into the system. Aromatase is the enzyme that converts T to E2.

Gel, for some, causes more DHT. Does for me for sure.

You can minimize the E2 by using a mild aromatase inhibitor like arimidex or a stronger one like Femera. Neither likely covered by prescription.

I am on HRT too. I tried a few different things... Patch then Gel and now injectables. I am taking 300mg every 2 weeks. I am thinking of starting a weekly dose. Is there a decernable diffeence between Enanthate and Cyponate? I have been using Enanthate for a year but my last prescription they gave me Cyponate.

cypionate and enanthate are interchangable.

Quote:

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Originally Posted by Astrozombie

Now the downsides to the cyprionate:

1) You have to stick this huge needle in your leg or butt.
2) Getting over the injection fear/stigma
3) Disposing of used needles
4) Measuring out 1/2 CC in these 3CC syringes is kind of tough (Biggest problem I see so far).

I've only done it 2x now, but the injections weren't too bad. I scheduled a session with my Dr. and the nurse took about 20 mins to walk me through all of the steps the first time. The first time was awkward, but the 2nd time was much easier.

We'll have to see if Cyprionate is the right thing for me. My Dr. is concerned about spikes and valleys in my levels which is why we are doing 1x per week instead of 2x per week.

So far, I really like the convienance of the Cyprionate. The price is good also.

Does anyone know if they make a 1/2 CC or a 1CC syringe that uses a needle large enough for Cyprionate injection?

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Do a web search and see if you can find some TB syringes... I think they are 1cc with luer-lock (twist on / twist off) tips. Insulin syringes generally have fixed needles, I think, so no good, there. With a luer-lock type syringe you can order needles seperately in whatever guage and length you like.

Don't use a huge needle. Use a 21ga or whatever for drawing up into the syringe. Then change to a fresh needle for your injection. A fresh, sharp needle goes in slicker than frog snot. 23ga is popular. Good compromise between too small (hard to get the gear to pass through a needle that is too small) and too big (well, too big hurts and leaves more scar tissue). I have been using 25ga but I admit it is slow going, pushing the gear through that small of a pin.

The fear of needles will quickly go away. You will look forward to your shots, soon enough.

You can buy a sharps container at walgreens for about three bucks. Ask your doc about disposal of the full container. Most hospitals, some fire departments will take care of it for you. Maybe your doc will take it off your hands, since he already has to dispose of his own medical waste / biohazard stuff, and you are his patient. At one shot per week, that's two needles per week, and it will take probably 2 or 3 years to fill up your sharps container. The syringe itself you can just toss in the trash. Only the pin needs special disposal precautions.

Dosing is not so critical that .45cc or .55cc is gonna make or break you. But for more accurate dosing (and less waste) with a 3cc rig, see if your pharmacy will compound your gear at 100mg/ml for you. That would give you a bigger shot for the same dose of actual testosterone.

Oh, two shots per week will give you MORE stable levels than once per week. It is splitting hairs, anyway, but spikes and valleys should not be cause to shoot LESS often... au contraire.

Welcome... to the dark side.

I have also just switched from androgel 10mg to cypionate. As far as the question of cost goes... the androgel is covered by most medical (pharmacy) plans. Injectables are not normally covered by the pharmacy plan BUT can be covered under the medical part. What i mean is check with your medical insurance provider, if your doctor recommends that you take testosterone, it is then considered medical in nature and can be covered by your plan. In my case 2 boxes of Androgel per month cost me 20 dollars in copay. Cypionate was not covered. My doc signed and faxed a form provided by my medical insurance stating it was necessary, and now it is covered by medical. My cost is 0. (it pays to ask questions of your insurance).
The reason i switched was the 2 packs of androgel was giving me a little nausea. Other than that worked great. The injections, now 200mg every two weeks has just started, but i don't see any results yet. Hopefully it will be adjusted on my next visit.

Sorry for double posting, but I forgot some things.. Regarding the insurance part. Medical should pay for the cypionate if you have the doctor do the injection. (I know what your thinking.. that gets old). But as long as you go for the first shot.. the doc can show you the proper way to do it, you can then do it yourself at home.

Just wondering how you rate the various patches with the gels (both being transdermal). I currently use 7.5 grams AndroGel and am still under 400 Total T. (Around 375). Would like to bump up to two 5 gram packets... or the equivalent in one of the patches. Have problems with several granschildren who visit freuently and always worried about transferrence and also just the conveneience factor with working out, swimming, showering at different times, etc.

But then I have also read that the gels provide a lot more "bang for the buck" as far as relates to asorbability as compared to the pacthes.

Finally, had read some info about a nasal spray delivery system for testosterone delivery but seems like it's disappeared off the radar screen.

Thanks for any info.

Larry

Quote:

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Originally Posted by darmadoc

I am a doc and I am also on HRT. I prefer the androgel just because of the better consistency of levels. On the other hand, if insurance wasn't paying for it-I, too, would be using weekly Cyp.

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I tried the patch and it ate up my skin. went to cypionate 1 ml every 2 weeks, thinkin I need a higher dose though cause I do not feel the same energy as in the beginning.. Barron gave good advice on the injections and have been thinkin myself of 1 a week shots, My doc had be doing 2 ml'400 mg once a month, seemed like a waste so I broke it up into 2x a month.

Go to 1ml once a week. You will be happy. Gels and patches irritated my skin. Gel worked good.. just didn't like having to put on every single day, and worried that if I went on vacation, I couldn't go in the water for 6 hours. Not to mention that skin to skin contact it could transfer (according to directions).
Once a week cyp injections are a snap. Took a bit longer to get the noticeable results, but well worth it.