Injection frequency and labs

[haynewp]

I am new to TRT and started 10 weeks ago. I’m 50 yrs old and my labs from last week are attached. I think I was dehydrated, or the blood hemolyzed, for the initial labs in January because I redid them at my primary doctor 10 days later and the markers were much improved.

I go back to the TRT clinic tomorrow and they will likely want me to donate blood to get the hematocrit down. They have me on 200 mg cypionate once per week plus anastrozole 1mg per week. They also put gonadorellin in all their TRT shots there.

Should I ask about splitting the dose to take it twice per week to help future hematocrit labs? Also, they use a 23 gauge needle that is 1.5 inch long in glutes. What size should I use for putting it in my shoulder if I start doing the shots myself?

Thanks

 

[Systemlord]

They also put gonadorellin in all their TRT shots there.

If you have secondary hypogonadism, pituitary failure, gonadorelin won’t do sh**! Also 200 mg per week and 1 mg AI, looks like you found a clinic that is incapable of individualizing treatment and dishes out the same protocol to everyone that walks through the door.

Your hematocrit is not high, if you don’t like the lab range, go to a different lab company with a cut off is 52%. The hematocrit cut off for men on TRT is 54%. Even this is an arbitrary number chosen without any medical evidence that it is dangerous for someone without comorbid conditions.

If you haven’t tried TRT without the AI, I would recommend stopping it.

https://journals.sagepub.com/doi/10.1177/1557988314539000

Our study did not link high estradiol levels with diminished sexual performance. Paradoxically, patients with low estradiol below 42.6 pg/ml had more patients complaining of low libido as defined by ICD-9 of 799.81 in the problem list. Patients with higher estradiol levels above 42.6 pg/ml had less sexual dysfunction problems identified by their providers.

 

[Systemlord]

Also, they use a 23 gauge needle that is 1.5 inch long in glutes.

This provider is out to lunch, no reason you can’t use 30 gauge insulin syringes in the deltoids. You should be injecting yourself, because you’re a grown ass man!

 

[haynewp]

Thanks for the responses. I found out at my last visit that taking it home was an option instead of having to get it there every time. What is the length of a 30 gauge needle needed for deltoid injection?

 

[Systemlord]

What is the length of a 30 gauge needle needed for deltoid injection?

Half inch which is considered shallow IM injection.

 

[Westin]

200mg per week right out of the gate is extremely aggressive. Most docs in the know will start you off low 50-100 and get labs in 6 weeks, then adjust. It can take a while to get dialed in, but overshooting all targets in their hope you’ll (customer) see a result on the way down is a lazy approach.

Hitting everything with a bazooka dose can cause more side effects unnecessarily.

 

[madman]

I am new to TRT and started 10 weeks ago. I’m 50 yrs old and my labs from last week are attached. I think I was dehydrated, or the blood hemolyzed, for the initial labs in January because I redid them at my primary doctor 10 days later and the markers were much improved.

I go back to the TRT clinic tomorrow and they will likely want me to donate blood to get the hematocrit down. They have me on 200 mg cypionate once per week plus anastrozole 1mg per week. They also put gonadorellin in all their TRT shots there.

Should I ask about splitting the dose to take it twice per week to help future hematocrit labs? Also, they use a 23 gauge needle that is 1.5 inch long in glutes. What size should I use for putting it in my shoulder if I start doing the shots myself?

View attachment 42486View attachment 42487Thanks

Welcome to Nelsons domain.

Your starting protocol 200 mg T/week with an AI thrown in to boot is overkill!

Throwing in the gonadorelin is pure nonsense.

The reason the AI was thrown in is because the absurd starting dose of T will have your FT sky high which will drive up your estradiol and they think that this is a bad thing and needs to be kept in some so called magical range.

Much more going on here as healthy levels are needed.

The main issue here would be if one ends up driving it too low which can cause numerous issues.

Last thing one wants to due is crash their estradiol.

Many men end up crashing it from the overuse of an AI.

Cookie cutter protocol pushed by those dime a dozen T-mills.

Overmedicating men on T from the get go.

Most men on TTh are injecting 100-200 mg T/week.

The majority can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are those outliers that may need the higher-end dose but it is far from common!

When were your labs drawn?

We always want to test at the true trough (lowest pint) before your next injection.

Unfortunately you are missing one of the most critical blood markers free testosterone.

Although TT is important tp know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

Seeing as you are injecting once weekly if your labs were done at the true trough (7 days post injection) and you are hitting a high-end TT 821 ng/dL with a normalish SHBG 27.8 nmol/L then your trough FT would be high!

Shitkicker here is your peak TT, FT and estradiol will be much higher.

Downfall of injecting once weekly is that there will be a huge difference in the peak-->trough and blood levels will not be as stable throughout the week.

This can result in a roller coaster type effect for some and have a negative impact on mood, energy, libido and erectile function.

Injecting more frequently will clip the peak--->trough and blood levels will be more stable throughout the week.

Running a high/absurdly high FT is a surefire way to drive up your hematocrit/increase your chance of negative sides whether (blood markers, cosmetic, mood, libido, erectile function).

Unfortunately, most end up on the donating to frequently bandwagon let alone crashing ferritin which can open up another can of worms.

Bottom line here is if you feel great overall minus any sides and overall blood markers are healthy then do what you feel is best for you.

If you were struggling with sides (blood markers, mental/physical) then lowering ones FT would be the long-term solution here.

Keep in mind that when first starting TTh or tweaking a protocol (increasing dose of T) that it is a given hematocrit will increase within the first month and can take anywhere from 6-9 months or in some cases up to a year to reach peak levels.

Although I would not consider your hematocrit 51% absurdly high you are only 10 weeks in and where it sits now is not where it will end up 6-9 months let alone a year from now.

The cut-off is 54% and most doctors would recommend donating if it gets too high let alone many in the know would prefer to keep it <54%.

The cut off in Canada is 55%.

If you stay on your current dose it will be driven up further over the following months.

Many have no clue how this works and tend to overlook this.

Need to be kept an eye on such blood markers.

Again if these are your labs at the true trough (7 days post-injection) and you are hitting a high-end TT 821 ng/dL with normalish SHBG 27.8 nmol/L then your trough FT would be high as we can get an idea of where it sits using the calculated method.

Using the linear law-of-mass action cFTV with a high-end trough TT 821 ng/dL, normalish SHBG 27.8 nmol/L and Albumin 4.6 g/dL your would be hitting a high-end trough FT 19.9 ng/dL.

If anything you would be far better off lowering your weekly dose and injecting more frequently such as twice-weekly (every 3.5 days) and dropping the AI.

You can easily hit a healthy/high-end trough FT injecting a lower weekly dose of T split into more frequent injections.

Lowering your trough FT will bring down your hematocrit let alone you can drop the AI.

Yes you are far better off doing your own injections at home using a LDS (low dead space) insulin syringe 27-31G various needle lengths.

I would go with the Nelson Vergel special 27G x 1/2" shallow IM.

You have the option of injecting IM or strictly sub-q.

The majority would prefer IM.

No drawing needles - is this normal and best practice for SubQ Testosterone?

Hello - I received my first batch of Testosterone Cypionate and HCG from Defy Medical. They sent 27 gauge 1/2" Easy Touch syringes for the Test (for SubQ), and 30 gauge for the HCG (for SubQ). These syringes do not have removable needles. They sent no alcohol wipes and no drawing needles. The...

www.excelmale.com

 

[madman]

This provider is out to lunch, no reason you can’t use 30 gauge insulin syringes in the deltoids. You should be injecting yourself, because you’re a grown ass man!

Give the poor chap some options (27-31G)!

 

[haynewp]

Welcome to Nelsons domain.

Your starting protocol 200 mg T/week with an AI thrown in to boot is overkill!

Throwing in the gonadorelin is pure nonsense.

The reason the AI was thrown in is because the absurd starting dose of T will have your FT sky high which will drive up your estradiol and they think that this is a bad thing and needs to be kept in some so called magical range.

Much more going on here as healthy levels are needed.

The main issue here would be if one ends up driving it too low which can cause numerous issues.

Last thing one wants to due is crash their estradiol.

Many men end up crashing it from the overuse of an AI.

Cookie cutter protocol pushed by those dime a dozen T-mills.

Overmedicating men on T from the get go.

Most men on TTh are injecting 100-200 mg T/week.

The majority can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are those outliers that may need the higher-end dose but it is far from common!

When were your labs drawn?

We always want to test at the true trough (lowest pint) before your next injection.

Unfortunately you are missing one of the most critical blood markers free testosterone.

Although TT is important tp know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

Seeing as you are injecting once weekly if your labs were done at the true trough (7 days post injection) and you are hitting a high-end TT 821 ng/dL with a normalish SHBG 27.8 nmol/L then your trough FT would be high!

Shitkicker here is your peak TT, FT and estradiol will be much higher.

Downfall of injecting once weekly is that there will be a huge difference in the peak-->trough and blood levels will not be as stable throughout the week.

This can result in a roller coaster type effect for some and have a negative impact on mood, energy, libido and erectile function.

Injecting more frequently will clip the peak--->trough and blood levels will be more stable throughout the week.

Running a high/absurdly high FT is a surefire way to drive up your hematocrit/increase your chance of negative sides whether (blood markers, cosmetic, mood, libido, erectile function).

Unfortunately, most end up on the donating to frequently bandwagon let alone crashing ferritin which can open up another can of worms.

Bottom line here is if you feel great overall minus any sides and overall blood markers are healthy then do what you feel is best for you.

If you were struggling with sides (blood markers, mental/physical) then lowering ones FT would be the long-term solution here.

Keep in mind that when first starting TTh or tweaking a protocol (increasing dose of T) that it is a given hematocrit will increase within the first month and can take anywhere from 6-9 months or in some cases up to a year to reach peak levels.

Although I would not consider your hematocrit 51% absurdly high you are only 10 weeks in and where it sits now is not where it will end up 6-9 months let alone a year from now.

The cut-off is 54% and most doctors would recommend donating if it gets too high let alone many in the know would prefer to keep it <54%.

The cut off in Canada is 55%.

If you stay on your current dose it will be driven up further over the following months.

Many have no clue how this works and tend to overlook this.

Need to be kept an eye on such blood markers.

Again if these are your labs at the true trough (7 days post-injection) and you are hitting a high-end TT 821 ng/dL with normalish SHBG 27.8 nmol/L then your trough FT would be high as we can get an idea of where it sits using the calculated method.

Using the linear law-of-mass action cFTV with a high-end trough TT 821 ng/dL, normalish SHBG 27.8 nmol/L and Albumin 4.6 g/dL your would be hitting a high-end trough FT 19.9 ng/dL.

View attachment 42488

If anything you would be far better off lowering your weekly dose and injecting more frequently such as twice-weekly (every 3.5 days) and dropping the AI.

You can easily hit a healthy/high-end trough FT injecting a lower weekly dose of T split into more frequent injections.

Lowering your trough FT will bring down your hematocrit let alone you can drop the AI.

Yes you are far better off doing your own injections at home using a LDS (low dead space) insulin syringe 27-31G various needle lengths.

I would go with the Nelson Vergel special 27G x 1/2" shallow IM.

You have the option of injecting IM or strictly sub-q.

The majority would prefer IM.

No drawing needles - is this normal and best practice for SubQ Testosterone?

Hello - I received my first batch of Testosterone Cypionate and HCG from Defy Medical. They sent 27 gauge 1/2" Easy Touch syringes for the Test (for SubQ), and 30 gauge for the HCG (for SubQ). These syringes do not have removable needles. They sent no alcohol wipes and no drawing needles. The...

www.excelmale.com

Thank you for the extremely thorough response. The sample was in fact drawn at the trough, 7 days after my last shot of 200 mg.

Yeah I don’t know why they don’t check for free testosterone there, I can ask.

I actually feel very good. I can tell by the 5th and 6th day that my mood isn’t quite as high as earlier in the week as the shot starts to wear off. But it’s not drastic or anything. I’ve also noticed that I feel more aggressive the first couple of mornings after the shot which is why I also thought it was a little high a dose to start with.

 

[haynewp]

200mg per week right out of the gate is extremely aggressive. Most docs in the know will start you off low 50-100 and get labs in 6 weeks, then adjust. It can take a while to get dialed in, but overshooting all targets in their hope you’ll (customer) see a result on the way down is a lazy approach.

Hitting everything with a bazooka dose can cause more side effects unnecessarily.

I had come to the same conclusion on that 200 mg dose a few weeks ago.

 

[haynewp]

I would go with the Nelson Vergel special 27G x 1/2" shallow IM

Do you have a recommended manufacturer for these? Also, I read the link you posted on “no drawing needles” and it looks like I can draw with this gauge size as well.

I also asked today why free T was not checked and the guy said he didn’t know why the doctor there didn’t order it, but said I can request it next time. The doctor also wanted to increase the anastrazole to 1.5 mg but the nurse said he wouldn’t recommend that since estrogen looked okay. He also said I can choose not to take the 1mg pill at all in the future if I want. He also did not recommend dumping blood at this time based on my numbers.

However, he suggested starting Hemo-Flow supplement pills to help with blood viscosity and given that I have existing atherosclerosis. I’m also starting a daily low dose aspirin on my own. I think the thicker blood could stress my heart more since I already have some artery narrowing. I told my cardiologist a while back that I was doing TRT, but he didn’t mention any concerns in regards to blood thickening.

 

[madman]

Do you have a recommended manufacturer for these? Also, I read the link you posted on “no drawing needles” and it looks like I can draw with this gauge size as well.

I also asked today why free T was not checked and the guy said he didn’t know why the doctor there didn’t order it, but said I can request it next time. The doctor also wanted to increase the anastrazole to 1.5 mg but the nurse said he wouldn’t recommend that since estrogen looked okay. He also said I can choose not to take the 1mg pill at all in the future if I want. He also did not recommend dumping blood at this time based on my numbers.

However, he suggested starting Hemo-Flow supplement pills to help with blood viscosity and given that I have existing atherosclerosis. I’m also starting a daily low dose aspirin on my own. I think the thicker blood could stress my heart more since I already have some artery narrowing. I told my cardiologist a while back that I was doing TRT, but he didn’t mention any concerns in regards to blood thickening.

BD or Easy Touch!

I prefer BD.

Yes one of the advantages of using an LDS insulin syringe syringe (fixed needle) is you can draw/inject using the same needle let alone you are going to minimize any waste of medication due to the low dead space design.

No do not increase your AI dose and if anything the more sensible move would be lowering your weekly dose and injecting more frequently.

Again where your hematocrit sits as of now 51% at 10 weeks in is not where it will end up 6-9 months from now as it will take anywhere from 6-9 months or in some cases up to a year to reach peak levels so it will be pushed even higher if you stay on your current protocol seeing as your trough (7 days post-injection) FT 20 ng/dL would be on the high-end which means that your peak (12-24 hrs post-injection) and during the first few days of the week will be sky-high!

You could easily get away with lowering the weekly dose and injecting more frequently which will clip your peak--->trough while allowing you to still maintain a healthy trough FT.

This would bring down/minimize any further increase in hematocrit and allow you to drop the AI.

If you are dead set on sticking with your current protocol 200 mg T/week with an AI then make sure you keep an eye on your blood markers let alone how you feel overall in the long run and if you run into any issues with sides (blood markers, cosmetic, libido, erectile function, mood) then you easily have room to lower your weekly dose.

As I stated previously do what you feel is best for you.

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Amazon.com

 

[Melody68]

Welcome to Nelsons domain.

Your starting protocol 200 mg T/week with an AI thrown in to boot is overkill!

Throwing in the gonadorelin is pure nonsense.

The reason the AI was thrown in is because the absurd starting dose of T will have your FT sky high which will drive up your estradiol and they think that this is a bad thing and needs to be kept in some so called magical range.

Much more going on here as healthy levels are needed.

The main issue here would be if one ends up driving it too low which can cause numerous issues.

Last thing one wants to due is crash their estradiol.

Many men end up crashing it from the overuse of an AI.

Cookie cutter protocol pushed by those dime a dozen T-mills.

Overmedicating men on T from the get go.

Most men on TTh are injecting 100-200 mg T/week.

The majority can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes there are those outliers that may need the higher-end dose but it is far from common!

When were your labs drawn?

We always want to test at the true trough (lowest pint) before your next injection.

Unfortunately you are missing one of the most critical blood markers free testosterone.

Although TT is important tp know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

Seeing as you are injecting once weekly if your labs were done at the true trough (7 days post injection) and you are hitting a high-end TT 821 ng/dL with a normalish SHBG 27.8 nmol/L then your trough FT would be high!

Shitkicker here is your peak TT, FT and estradiol will be much higher.

Downfall of injecting once weekly is that there will be a huge difference in the peak-->trough and blood levels will not be as stable throughout the week.

This can result in a roller coaster type effect for some and have a negative impact on mood, energy, libido and erectile function.

Injecting more frequently will clip the peak--->trough and blood levels will be more stable throughout the week.

Running a high/absurdly high FT is a surefire way to drive up your hematocrit/increase your chance of negative sides whether (blood markers, cosmetic, mood, libido, erectile function).

Unfortunately, most end up on the donating to frequently bandwagon let alone crashing ferritin which can open up another can of worms.

Bottom line here is if you feel great overall minus any sides and overall blood markers are healthy then do what you feel is best for you.

If you were struggling with sides (blood markers, mental/physical) then lowering ones FT would be the long-term solution here.

Keep in mind that when first starting TTh or tweaking a protocol (increasing dose of T) that it is a given hematocrit will increase within the first month and can take anywhere from 6-9 months or in some cases up to a year to reach peak levels.

Although I would not consider your hematocrit 51% absurdly high you are only 10 weeks in and where it sits now is not where it will end up 6-9 months let alone a year from now.

The cut-off is 54% and most doctors would recommend donating if it gets too high let alone many in the know would prefer to keep it <54%.

The cut off in Canada is 55%.

If you stay on your current dose it will be driven up further over the following months.

Many have no clue how this works and tend to overlook this.

Need to be kept an eye on such blood markers.

Again if these are your labs at the true trough (7 days post-injection) and you are hitting a high-end TT 821 ng/dL with normalish SHBG 27.8 nmol/L then your trough FT would be high as we can get an idea of where it sits using the calculated method.

Using the linear law-of-mass action cFTV with a high-end trough TT 821 ng/dL, normalish SHBG 27.8 nmol/L and Albumin 4.6 g/dL your would be hitting a high-end trough FT 19.9 ng/dL.

View attachment 42488

If anything you would be far better off lowering your weekly dose and injecting more frequently such as twice-weekly (every 3.5 days) and dropping the AI.

You can easily hit a healthy/high-end trough FT injecting a lower weekly dose of T split into more frequent injections.

Lowering your trough FT will bring down your hematocrit let alone you can drop the AI.

Yes you are far better off doing your own injections at home using a LDS (low dead space) insulin syringe 27-31G various needle lengths.

I would go with the Nelson Vergel special 27G x 1/2" shallow IM.

You have the option of injecting IM or strictly sub-q.

The majority would prefer IM.

No drawing needles - is this normal and best practice for SubQ Testosterone?

Hello - I received my first batch of Testosterone Cypionate and HCG from Defy Medical. They sent 27 gauge 1/2" Easy Touch syringes for the Test (for SubQ), and 30 gauge for the HCG (for SubQ). These syringes do not have removable needles. They sent no alcohol wipes and no drawing needles. The...

www.excelmale.com

The Madman truly knows a helluva lot about TRT . . .

 

[jnde207]

If you have secondary hypogonadism, pituitary failure, gonadorelin won’t do sh**! Also 200 mg per week and 1 mg AI, looks like you found a clinic that is incapable of individualizing treatment and dishes out the same protocol to everyone that walks through the door.

Your hematocrit is not high, if you don’t like the lab range, go to a different lab company with a cut off is 52%. The hematocrit cut off for men on TRT is 54%. Even this is an arbitrary number chosen without any medical evidence that it is dangerous for someone without comorbid conditions.

If you haven’t tried TRT without the AI, I would recommend stopping it.

https://journals.sagepub.com/doi/10.1177/1557988314539000

25 gauge 1 inch is as thin and short as I'd go with a syringe, anything thinner and then it'll take 15 mins to inject 1ml of cyp, lol.

 

[Systemlord]

The Madman truly knows a helluva lot about TRT . . .

Madman is the human version of an encyclopedia for men's health.

 

[jnde207]

I am new to TRT and started 10 weeks ago. I’m 50 yrs old and my labs from last week are attached. I think I was dehydrated, or the blood hemolyzed, for the initial labs in January because I redid them at my primary doctor 10 days later and the markers were much improved.

I go back to the TRT clinic tomorrow and they will likely want me to donate blood to get the hematocrit down. They have me on 200 mg cypionate once per week plus anastrozole 1mg per week. They also put gonadorellin in all their TRT shots there.

Should I ask about splitting the dose to take it twice per week to help future hematocrit labs? Also, they use a 23 gauge needle that is 1.5 inch long in glutes. What size should I use for putting it in my shoulder if I start doing the shots myself?

View attachment 42486View attachment 42487Thanks

Do you have a recommended manufacturer for these? Also, I read the link you posted on “no drawing needles” and it looks like I can draw with this gauge size as well.

I also asked today why free T was not checked and the guy said he didn’t know why the doctor there didn’t order it, but said I can request it next time. The doctor also wanted to increase the anastrazole to 1.5 mg but the nurse said he wouldn’t recommend that since estrogen looked okay. He also said I can choose not to take the 1mg pill at all in the future if I want. He also did not recommend dumping blood at this time based on my numbers.

However, he suggested starting Hemo-Flow supplement pills to help with blood viscosity and given that I have existing atherosclerosis. I’m also starting a daily low dose aspirin on my own. I think the thicker blood could stress my heart more since I already have some artery narrowing. I told my cardiologist a while back that I was doing TRT, but he didn’t mention any concerns in regards to blood thickening.

I would suggest if YOU want larger veins/arteries, try some winstrol oral/pills, they will drastically enlarge your veins for better blood flow, and the good thing about winstrol is that it's on the same level as Anavar as mildness goes, in other words it's about the safest oral you can take, and it'll actually boost your immune system unlike other AAS, and the reason I suggest oral is because it's because you would have to pin every dang day, and that gets old before the cycle is over with. I started at 50mg/day but you don't have to do that, 50mg/day is an intermediate dose.
If you give it a try, let me know how it goes, cause either way you'll look shredded up in no time.