Sub-Q Testosterone Injections (study)

[kelkel]

Got this today from Michael Scally:

Subcutaneous Administration Of Testosterone

Al-Futaisi AM, Al-Zakwani IS, Almahrezi AM, Morris D. Subcutaneous administration of testosterone . A pilot study report. Saudi Med J 2006;27(12):1843-6. http://ipac.kacst.edu.sa/eDoc/2006/161440_1.pdf

OBJECTIVE: To investigate the effect of low doses of subcutaneous testosterone in hypogonadal men since the intramuscular route, which is the most widely used form of testosterone replacement therapy, is inconvenient to many patients.

METHODS: All men with primary and secondary hypogonadism attending the reproductive endocrine clinic at Royal Victoria Hospital, Monteral, Quebec, Canada, were invited to participate in the study. Subjects were enrolled from January 2002 till December 2002. Patients were asked to self-administer weekly low doses of testosterone enanthate using 0.5 ml insulin syringe.

RESULTS: A total of 22 patients were enrolled in the study. The mean trough was 14.48 +/- 3.14 nmol/L and peak total testosterone was 21.65 +/- 7.32 nmol/L. For the free testosterone the average trough was 59.94 +/- 20.60 pmol/L and the peak was 85.17 +/- 32.88 pmol/L. All of the patients delivered testosterone with ease and no local reactions were reported.

CONCLUSION: Therapy with weekly subcutaneous testosterone produced serum levels that were within the normal range in 100% of patients for both peak and trough levels. This is the first report, which demonstrated the efficacy of delivering weekly testosterone using this cheap, safe, and less painful subcutaneous route.

STABLE TESTOSTERONE LEVELS ACHIEVED WITH SUBCUTANEOUS TESTOSTERONE INJECTIONS

M.B. Greenspan, C.M. Chang
Division of Urology, Department of Surgery, McMaster University, Hamilton, ON, Canada

Objectives: The preferred technique of androgen replacement has been intramuscular (IM) testosterone, but wide variations in testosterone levels are often seen. Subcutaneous (SC) testosterone injection is a novel approach; however, its physiological effects are unclear. We therefore investigated the sustainability of stable testosterone levels using SC therapy.

Patients and Methods: Between May and September 2005, we conducted a small pilot study involving 10 male patients with symptomatic late-onset hypogonadism. Every patient had been stable on TE 200 mg IM for 41 year. Patients were instructed to self-inject with testosterone enanthate (TE) 100 mg SC (DELATESTRYL 200 mg/cc, Theramed Corp, Canada) into the anterior abdomen once weekly. Some patients were down-titrated to 50 mg based on their total testosterone (T) at 4 weeks. Informed consent was obtained as SC testosterone administration is not officially approved by Health Canada. T levels were measured before and 24 hours after injection during weeks 1, 2, 3, and 4, and 96 hours after injection in week 6 and 8. At week 12, PSA, CBC, and T levels were measured however; the week 12 data are still being collected.

Results: Prior to initiation of SC therapy, T was 19.14+3.48 nmol/l, hemoglobin 15.8+1.3 g/dl, hematocrit 0.47+0.02, and PSA 1.05+0.65 ng/ml. During the first 4 weeks, there was a steady increase in pre-injection T from 19.14+3.48 to 23.89+9.15 nmol/l (p¼0.1). However, after 8 weeks the post-injection T (25.77+7.67 nmol/l) remained similar to that of week 1 (27.46+12.91 nmol/l). Patients tolerated this therapy with no adverse effects.

Conclusions: A once-week SC injection of 50–100 mg of TE appears to achieve sustainable and stable levels of physiological T. This technique offers fewer physician visits and the use of smaller quantity of medication, thus lower costs. However, the long term clinical and physiological effects of this therapy need further evaluation.

[Times Roman]

Good read. this topic has been up for discussion before here, and the old timers are firm on IM, whereas blokes like me are more open to SubQ. My doc was pinning my trt SubQ. I asked him, and he said it was IM, but it wasn't.

[bass]

Great! More confirmation for me. Been doing SQ for quite a while now and it's working wonderfully. Pretty soon l be dropping the AI, I believe it's due to SQ.

[Times Roman]

Great! More confirmation for me. Been doing SQ for quite a while now and it's working wonderfully. Pretty soon l be dropping the AI, I believe it's due to SQ.

so you think less aromitization by SubQ?

[TheSpoonyBard]

so you think less aromitization by SubQ?

I wonder if it aromatazation would be similiar to SubQ pellets? I know with 200mg pellets, they typically release 1-3mg/day, which is a slow dose therefore less aromitization I assume? SubQ T is still getting dumped into your system via pin at 100mg/week vs say 10X200mg pellets releasing 3mg each on the high end equaling 30mg of test released into your system per week. So I would think that aromatase production would still be a good bit higher than pellets..Thoughts?

[Vettester]

I've been doing Sub Q now for at least 8 months; maybe more. I'm even running deca at the moment, 3x per week Sub Q.

IMO, it's the best way to go, unless you're into some hefty blast amount that would make more sense to go IM.

[J DIESEL3]

Great! More confirmation for me. Been doing SQ for quite a while now and it's working wonderfully. Pretty soon l be dropping the AI, I believe it's due to SQ.

Fantastic read kel! Bass how many SQ injections are you doing per week now?

[canesfan804]

What size needle would you use for a abdominal sub q injection? I have only run 1 cycle and alternated cheeks and it never hurt too bad. Actually no bother at all after first 2 or 3

[MuscleInk]

Bass/Vett what dose are you using at each injection? You mentioned dropping your AI. What dosing protocol and AI are you using?

I'm going to look into this further and see if any updated work has been done. The study Kel posted is a great reference but published in 2006 with a small subject sample and limited to 12 weeks. I'd be curious to see if any updated work is available with longer domain protocols and additional BW with more comprehensive markers.

I'm going to follow up on pubmed.

TR, you're right. IM is "old school" but even among the medical community it's still the designated protocol for most. I'd like to see where this kind of data could provide clinical validation for an alternate ROA with injectibles.

[TheSpoonyBard]

I've been doing Sub Q now for at least 8 months; maybe more. I'm even running deca at the moment, 3x per week Sub Q.

IMO, it's the best way to go, unless you're into some hefty blast amount that would make more sense to go IM.

How many mg's of deca per week, if I may ask? I'm curious to know how much can be used by someone who suffers from hypogonadism to see good gains?

[Vettester]

Bass/Vett what dose are you using at each injection? You mentioned dropping your AI. What dosing protocol and AI are you using?

How many mg's of deca per week, if I may ask? I'm curious to know how much can be used by someone who suffers from hypogonadism to see good gains?

My normal protocol consists of 120mg of cyp per week, which I usually break up 2x per week via sub q (.30 cc x 2), using a 31g x 5/16" x 1/2cc slim pin.

For my blast, I have switched up to test enanthate 300mg/ml, and nandrolone decanoate, which is also 300mg/ml. I alternate both compounds eod, and am pinning .40 cc sub q. So the test enanth is Mon, Wed, Fri and the Deca is Tues, Thurs, Sat. So, that would add up to 360mg per week of both compounds.

Since going Sub Q, I have not needed an AI. Actually, I was taking .25mg x 2/wk of Adex with my normal protocol, and at the first of the year my E2 was at 23. I stayed on the same maintenance protocol of Adex for my first 3 months of Sub Q only to find out that my E2 had dropped (I believe it was 18 pg). So, I've stayed of the AI since, and last month it was in the low 20's. I'll run another E2 sensitive assay at the end of the month, but I'm actually hoping to get it up in the high 20's/low 30's with this blast, then sustain it around that range for awhile.

Not that my protocol is clinical, but I can definitely vouch that it is effective, and that it is much more manageable with controlling E2, at least from the need to include an AI in my program. At .25mg x 2/wk of Adex, I had never seen a decrease in E2, and if anything the AI would need a slight increase at times. My program has been pretty balanced over the past couple of years, but going Sub Q, I've had to make this slight adjustment with the AI.

[Vettester]

Forgot to mention, I am also still administering HCG at 250iu x 3/wk. I take the HCG on Sunday, Tuesday, and Thursday.

Plus, Pregnenolone, DHEA, and B12 methylcobalamin are cycled in every 3 months for 4 weeks. Adding Preg/DHEA helps back fill the pathways upstream, which I do believe has made a big difference with keeping my program balanced and stable. My thyroid is still kind of goofy, but that's another subject for another thread ...

[MickeyKnox]

Kel,

this is a terrific write up! thanks very much for sharing it.

im so tempted to try subcutaneous inj.

Vette,

how are you drawing the oil? with the same slin pin? must take a very long time, not that im in any real rush, simply an observation and clarification at this point.

thanks

[MuscleInk]

My normal protocol consists of 120mg of cyp per week, which I usually break up 2x per week via sub q (.30 cc x 2), using a 31g x 5/16" x 1/2cc slim pin.

For my blast, I have switched up to test enanthate 300mg/ml, and nandrolone decanoate, which is also 300mg/ml. I alternate both compounds eod, and am pinning .40 cc sub q. So the test enanth is Mon, Wed, Fri and the Deca is Tues, Thurs, Sat. So, that would add up to 360mg per week of both compounds.

Since going Sub Q, I have not needed an AI. Actually, I was taking .25mg x 2/wk of Adex with my normal protocol, and at the first of the year my E2 was at 23. I stayed on the same maintenance protocol of Adex for my first 3 months of Sub Q only to find out that my E2 had dropped (I believe it was 18 pg). So, I've stayed of the AI since, and last month it was in the low 20's. I'll run another E2 sensitive assay at the end of the month, but I'm actually hoping to get it up in the high 20's/low 30's with this blast, then sustain it around that range for awhile.

Not that my protocol is clinical, but I can definitely vouch that it is effective, and that it is much more manageable with controlling E2, at least from the need to include an AI in my program. At .25mg x 2/wk of Adex, I had never seen a decrease in E2, and if anything the AI would need a slight increase at times. My program has been pretty balanced over the past couple of years, but going Sub Q, I've had to make this slight adjustment with the AI.

Thanks Vett, this is useful to know. I'm actually starting some B12 with my protocol next week. I've heard and seen mixed opinions on benefits of B12 with some claiming little/no benefit while others stating it makes a considerable difference for many reasons.

I appreciate the further clarification. I'm going to search for more data in the SQ admin of test as the positive data from the referenced article was intriguing.

[Vettester]

Vette,

how are you drawing the oil? with the same slin pin? must take a very long time, not that im in any real rush, simply an observation and clarification at this point.

thanks

Mickey, yes, just slow and easy with the slim pin. It's not so bad though. .30cc of test takes usually 1 minute to 1-1/2 minutes. I'll just draw the pin to .30 cc, hold the bottle and let it fill. I can read a thread for a few minutes and then pull syringe out and pin The deca is slightly more viscous than the test, so right now it might take 3 minutes or so to get the .40cc. Like you said, I'm in no rush either, so I'd rather take a few extra minutes as opposed to IM and aspirating every time.

Thanks Vett, this is useful to know. I'm actually starting some B12 with my protocol next week. I've heard and seen mixed opinions on benefits of B12 with some claiming little/no benefit while others stating it makes a considerable difference for many reasons.

MI, I highly encourage to seek out the methylcobalamin B12, as opposed to the cyanocobalamin version. Cyan is the most common type of B12, and it's usually what you will find with the RC's and supplement stores. The methyl version is usually a bit pricier, but it is highly effective with being absorbed and retained within the body. I've used both, there's no comparison!

[bp2000]

MI, I highly encourage to seek out the methylcobalamin B12, as opposed to the cyanocobalamin version. Cyan is the most common type of B12, and it's usually what you will find with the RC's and supplement stores. The methyl version is usually a bit pricier, but it is highly effective with being absorbed and retained within the body. I've used both, there's no comparison!

Vett I wished I knew this before I tried my B12. I used the Cyan version sold at RC shop and did 1000mcgs for 30 days only to notice a slight increase in hunger. I also read this version has cyanide in it as well. Sent PM

[MickeyKnox]

thanks Vette.

one last question, your opinions on oral methylcobalamin B12 as apposed to IM? obviously i don't have any problem with injections, its just one less compound to pin.

thanks again.

[lovbyts]

sublingual b12 is good.

[Vettester]

Vett I wished I knew this before I tried my B12. I used the Cyan version sold at RC shop and did 1000mcgs for 30 days only to notice a slight increase in hunger. I also read this version has cyanide in it as well. Sent PM

Yes, cyanocobalamin does have the cyanide molecule in it. Luckily, it's not enough to be toxic, but it is something the liver has to deal with when removing it. It's chemically synthesized, whereas the methyl is basically bio-identical to what's produced naturally in your tissues.

thanks Vette.

one last question, your opinions on oral methylcobalamin B12 as apposed to IM? obviously i don't have any problem with injections, its just one less compound to pin.

thanks again.

Actually, instead of going IM, just go Sub Q like the other compounds. You can easily stack 250mcg with 50mg of test to make it simple.

IMO on the oral B12 ... I'd stick to the liquids. They will get right into the tissue and get absorbed, without any of the first pass through the liver stuff.

[TraceMYD]

Vett, what sites are you doing your subq shots at?

I find that my subq hcg shots are more painfull and annoying then my IM test shots.

I even bruised myself pretty bad with my subq shot.

[MuscleInk]

Mickey, yes, just slow and easy with the slim pin. It's not so bad though. .30cc of test takes usually 1 minute to 1-1/2 minutes. I'll just draw the pin to .30 cc, hold the bottle and let it fill. I can read a thread for a few minutes and then pull syringe out and pin The deca is slightly more viscous than the test, so right now it might take 3 minutes or so to get the .40cc. Like you said, I'm in no rush either, so I'd rather take a few extra minutes as opposed to IM and aspirating every time.

MI, I highly encourage to seek out the methylcobalamin B12, as opposed to the cyanocobalamin version. Cyan is the most common type of B12, and it's usually what you will find with the RC's and supplement stores. The methyl version is usually a bit pricier, but it is highly effective with being absorbed and retained within the body. I've used both, there's no comparison!

Thanks Vett that's excellent input!

[bass]

so you think less aromitization by SubQ?

I truly believe so. I'm doing blood work in few days to see if I need the AI.

Fantastic read kel! Bass how many SQ injections are you doing per week now?

My current protocol is,
50 mgs test e3d
0.25 mg AI the day after each injection
500 iu one day before each injection

Last BW I was talking 0.5 mg AI after each injection and my e2 was still very low, I am suspecting it's still low.

Bass/Vett what dose are you using at each injection? You mentioned dropping your AI. What dosing protocol and AI are you using?

I'm going to look into this further and see if any updated work has been done. The study Kel posted is a great reference but published in 2006 with a small subject sample and limited to 12 weeks. I'd be curious to see if any updated work is available with longer domain protocols and additional BW with more comprehensive markers.

I'm going to follow up on pubmed.

TR, you're right. IM is "old school" but even among the medical community it's still the designated protocol for most. I'd like to see where this kind of data could provide clinical validation for an alternate ROA with injectibles.

Answer above. ^^^

[kelkel]

I know of a few members here now who have been able to get off of or lower their AI recently. So far it has related to twice a week injections as well as a reduction in body fat. SubQ, at least for the guys I know, was not a consistent factor.

Bass, that would be great if you could get off the AI as well!

kel

[Vettester]

Vett, what sites are you doing your subq shots at?

I find that my subq hcg shots are more painfull and annoying then my IM test shots.

I even bruised myself pretty bad with my subq shot.

For starters, try the 31g if you're not using that yet.

I stick with pinning around the naval area; probably within 2" of the naval.

One trick ... After wiping the area with alcohol, take the pin and slightly prod on an area. You can feel the nerve ending pretty quick. If so, prod another space close thereof til you don't feel the sharp pain. I find more stability of the pin being inserted in the skin by holding it close to the bottom at the base, near the needle, then proceed to inject at a slow pace. I usually take at least 1 minute to complete the injection.

I virtually don't have any pain unless it hits a nerve ending. Try the prodding technique a few times. Just make sure to keep thoroughly cleaned with the alcohol wipe.

[TheSpoonyBard]

Thanks Vette. So thorough.

[Brazensol]

Good to hear subq seems to be working well.

I was pinning twice a week (60 mgs Monday AM and 60 mgs Thursday PM) but noticed that large of an amount caused the injection site to get very tender about a day or two later. I started to break each 60 mg injection into 2 30 mg injection about an inch apart and this has fixed the tenderness issue but... I had blood drawn on 20 Sep (a Thursday) before my labwork and on my Monday AM pin I reduced the amount of t to 50 mgs (as prescribed by the doctor) and my Total T was 1420 (250-1100) and Free T was 434 (35-155). Compared to previous bloodwork these numbers are fairly high and was wondering if using two injections sites instead of one allows more T to enter into the system? I have been doing this for about a month now. Any thoughts?

By the way I am now only pinning 50mgs total each injection day now and will have blood drawn again this Thursday to see what's going on.

[Hackamaniac]

I've also been doing subq for around 7 months... Started out doing 60 mg twice a week and now doing 60 mg 3 times a week... Subq is just so damn easy... I do my injections in my quads and haven't had any problems..

[MickeyKnox]

Yes, cyanocobalamin does have the cyanide molecule in it. Luckily, it's not enough to be toxic, but it is something the liver has to deal with when removing it. It's chemically synthesized, whereas the methyl is basically bio-identical to what's produced naturally in your tissues.

Actually, instead of going IM, just go Sub Q like the other compounds. You can easily stack 250mcg with 50mg of test to make it simple.

IMO on the oral B12 ... I'd stick to the liquids. They will get right into the tissue and get absorbed, without any of the first pass through the liver stuff.

thanks again Vette.

[SEOINAGE]

Good to hear subq seems to be working well.

I was pinning twice a week (60 mgs Monday AM and 60 mgs Thursday PM) but noticed that large of an amount caused the injection site to get very tender about a day or two later. I started to break each 60 mg injection into 2 30 mg injection about an inch apart and this has fixed the tenderness issue but... I had blood drawn on 20 Sep (a Thursday) before my labwork and on my Monday AM pin I reduced the amount of t to 50 mgs (as prescribed by the doctor) and my Total T was 1420 (250-1100) and Free T was 434 (35-155). Compared to previous bloodwork these numbers are fairly high and was wondering if using two injections sites instead of one allows more T to enter into the system? I have been doing this for about a month now. Any thoughts?

By the way I am now only pinning 50mgs total each injection day now and will have blood drawn again this Thursday to see what's going on.

Wow I wish I could get those high of test levels, I'm miles away from that with IM and 200 mg a week. I tried subq and got a nasty massive bump that lasted a long time. I would like to try it again but a higher dose, because the time I tried it was 75x2 a week. and any less than 200 a week I feel like crap even IM.

Even IM at 100x2 a week I don't have high E2.

[Brazensol]

Both the doc and me both question the accuracy of the last test which is why I am going to repeat it again Thursday. BUT... if it is accurate then I do wonder as to whether or not the same dose of T delivered to two different sites, at the same time, somehow allows more T to enter into the body. Perhaps more surface area for the T to diffuse in?

I was very surprised with those numbers and if true I sure don't feel any better with them... Prior to this I was only a bit above mid-range.

[Brazensol]

Wow I wish I could get those high of test levels, I'm miles away from that with IM and 200 mg a week. I tried subq and got a nasty massive bump that lasted a long time. I would like to try it again but a higher dose, because the time I tried it was 75x2 a week. and any less than 200 a week I feel like crap even IM.

Even IM at 100x2 a week I don't have high E2.

Did you pin the whole 200mgs at one time? I can imagine it would make a rather large bump if you did. Mine wasn't to large a bump but it really got sore.

[bass]

Both the doc and me both question the accuracy of the last test which is why I am going to repeat it again Thursday. BUT... if it is accurate then I do wonder as to whether or not the same dose of T delivered to two different sites, at the same time, somehow allows more T to enter into the body. Perhaps more surface area for the T to diffuse in?

I was very surprised with those numbers and if true I sure don't feel any better with them... Prior to this I was only a bit above mid-range.

Yup, more is not always better. Balance is they key when it comes to TRT.

[SEOINAGE]

Did you pin the whole 200mgs at one time? I can imagine it would make a rather large bump if you did. Mine wasn't to large a bump but it really got sore.

no it was 75 mg, and it reacted really bad, the bump was enormous and stayed for a week or so, then the big red spot stayed for months, still a mark from where it was.

[TraceMYD]

I'm loving my new IM 2xweek Test protocol.

Test E, 125mg on Monday AM and 125mg Thursday PM

HCG MWF 250iu

And since the switch, I'm only having to taking .25mg anastrozole one time a week(Tuesday)!

I feel pretty soon I won't need the ai at all!

Thanks to all the Vets on here... learning so much since I started.

[MickeyKnox]

I'm loving my new IM 2xweek Test protocol.

Test E, 125mg on Monday AM and 125mg Thursday PM

HCG MWF 250iu

And since the switch, I'm only having to taking .25mg anastrozole one time a week(Tuesday)!

I feel pretty soon I won't need the ai at all!

Thanks to all the Vets on here... learning so much since I started.

wow, that's great news! sounds like youre dialed in and have found your sweet spot. good for you! im jealous

[Vettester]

I'm loving my new IM 2xweek Test protocol.

Trace, did you mean Sub Q, or is it indeed IM?

[Hackamaniac]

I'm loving my new IM 2xweek Test protocol.

Test E, 125mg on Monday AM and 125mg Thursday PM

HCG MWF 250iu

And since the switch, I'm only having to taking .25mg anastrozole one time a week(Tuesday)!

I feel pretty soon I won't need the ai at all!

Thanks to all the Vets on here... learning so much since I started.

Why anastrozole one day a week?? That doesn't make much sense..

[TraceMYD]

Trace, did you mean Sub Q, or is it indeed IM?

IM for the test shot
Sub Q for the hcg


Prior to the 2x week test shot switch I was doing
Test E 250mg one time a week
HCG 500iu MWF
and taking .25mg anastrozole every third day.

Big time rollercoaster and when I tried to stop the ai
my E2 shot up to 70!


I'm so glad I did the switch and now I see they maybe
even more options to explore with TEST Sub Q

[TraceMYD]

Why anastrozole one day a week?? That doesn't make much sense..

Because thats all it took to get rid of the itchy nips and emotional roller coaster feeling.
And No more crying when I watch bambi with my daughter lol

In a couple more weeks I'll be getting more BW done to see where the .25mg/week anastrozole
puts me.

[kelkel]

Because thats all it took to get rid of the itchy nips and emotional roller coaster feeling.
And No more crying when I watch bambi with my daughter lol

In a couple more weeks I'll be getting more BW done to see where the .25mg/week anastrozole
puts me.

Come on Trace. You can tell us the truth....