Shallow Testosterone IM versus SubQ Injections - Lab Results

[MarkM]

Background: I have been on TRT for about 15 years. I've never really struggled with TRT but I was always tweaking my protocol like many do. The past several years I have been really dialed in well and have not messed with my protocol at all. That protocol has been injecting 24mg shallow IM ED with no HCG or AI. Prior to injecting ED I injected weekly, and E3.5D with various amounts of testosterone but could never get my HCT under control. That is what led me to try the ED protocol. So, all has been well under that protocol.

Me: 62 years old, 5'10", 190 lbs naked. Normally run about 10% body fat, sometimes as low as 8% but as high as 12%. I work out regularly but not obsessed with it. I am pretty solid and healthy looking for a 62 year old.

After reading numerous articles and opinions over the last year about the differences and variances in shallow IM verse SubQ it got me thinking maybe I should try the SubQ route. A study from UC showed increased testosterone, lower E2, and lower HCT injecting SubQ as compared to shallow IM. In the study there was no change in PSA.

I have attached a spreadsheet below comparing the lab results from June 7, 2021 on the shallow IM protocol and the lab results from October 20, 2021 using SubQ. I tested the same items in both labs to get a complete picture. You'll notice that my labs under the shallow IM were pretty good so one might ask why I would change if I was so dialed in........I guess curious to see if I could improve the numbers. I figured if the numbers did not impress me I would just go back to the shallow IM which I knew worked for me. A note on the testosterone testing. In June the labs did not use the LC/MS/MS for the Total Testosterone and did not use the Ultra Filtration on the Free T. Therefore, I did not use those assays on this round of testing so the testing would be apples to apples. I have numerous testosterone testing over the years use the most accurate assays but I wanted a good comparison. Plus, regardless of the number, it is about how I feel that is the most important and not a number.

I was on the SubQ protocol for 9 1/2 weeks to ensure there was no question about reaching a steady state. I did not change a thing about my protocol. I injected the same 24mg of testosterone ED and took all the same supplements I was taking previously.

You'll see below there was a nice decrease in HCT and Hb in the October testing on SubQ ......impressive. Total T and Free T dropped significantly on SubQ. Total T dropped 26.8% while Free T fell 47.2%. While the SubQ testosterone numbers are not terrible, they are much lower that the testosterone on shallow IM. There was not a big change on E2 with it going up slightly, 2.7%, on SubQ. Looking at all the other blood markers there wasn't much change at all. My DHT is high and over the range but it has always been that way and I'm not too concerned about it.

How do I feel? I feel pretty good but not as good as I felt on the shallow IM injections. I don't feel like I have quite the energy I had on shallow IM. I've never had an acne problem but I did notice some small acne on my chest and back that I did not have on the shallow IM. I didn't like that.

Element	Range	Measure	6/7/21	10/20/21
WBC	3.4 - 10.8	x10E3/ul	6.0	4.9
RBC	4.14 - 5.80	X10E6/ul	5.42	5.66
Hemoglobin	13.0 - 17.7	g/dl	15.9	14.8
Hematocrit	37.5 - 51.0	%	48.5	46.1
Ttl Cholesterol	100- 199	mg/dl	141	148
LDL	0 - 99	mg/dl	89	92
HDL	> 39	mg/dl	36	37
Triglycerides	< 150	mg/dl	82	92
VLDL Cholesterol	5 - 40	mg/dl	20	21
Ferritin	30 - 400	ng/ml	148	121
Iron	38 - 169	ug/dl	92	57
Iron Saturation	15 - 55	%	31	28
TIBC	250 - 450	ug/dl	280	261
UIBC	111 - 343	ug/dl	202	175
Glucose	65 - 99	mg/dl	96.0	97.0
Hemo A1C	4.8 - 5.6	%	5.2	5.3
TSH	0.45 - 4.50	uiu/ml	0.390	0.371
T3	.79 - 1.49	ng/dl	1.1	1.0
Free T3	2.0 - 4.4	pg/ml	3.7	3.5
T4	4.5 - 12.0	ug/dl	6.8	6.9
Free T4	0.82 - 1.77	ng/dl	1.29	1.22
Reverse T3	9.2 - 24.1	ng/dl	12.2	9.3
TgAB Antibody	0.0 - 0.9	iu/ml	<1.0	<1.0
TPOab Antibody	0 - 34	iu/ml	10	10
Vitamin D	30 - 100	ng/ml	69.0	57.7
Vitamin B12	> 231	pg/ml	962	846
Testosterone	264 - 916	ng/dl	1055	778
Free Test	7.2 - 24.0	pg/ml	31.6	16.7
% Free to Total	2.0 - 3.0	%	2.87%	2.15%
Bioavailable T	250 - 600	ng/dl	613	423
% Bio of Total	30 - 60	%	58.1%	54.4%
PSA	0.0 - 4.0	ng/ml	0.7	0.9
DHT	30 - 85	ng/dl	92	96
DHT % of Test	3.5 - 8.5	%	8.7%	12.4%
Prolactin	4.0 - 15.2	ng/ml	9.6	8.9
Estradiol, Sens	8.0 - 35.0	pg/ml	30.1	30.9
Free Estradiol E2	0.2 - 1.5	pg/ml	1.2	1.3
% Free E2 to Total	1.7 - 5.4	%	3.98%	4.21%
Estradiol (E2) % T	1.0 - 5.0	%	2.85%	3.97%
T:E Ratio	20 - 50	Ratio	35.0	25.2
SHBG	19.3 - 76.4	nmol/l	32.7	31.0
DHEA-S	49 - 344	ug/dl	331.8	287.2
Pregnenolone	< 180	ng/dl	81	70
Progesterone	0.0 - 0.5	ng/ml	0.3	0.3
T Cyp Per Week	150 - 200	mg/ml	168 mg	168 mg
Protocol		Daily	24 mg Daily	24 mg Daily
Peak/Trough		Peak/Trough	Trough	Trough
Method		IM/SubQ	Shallow IM	SubQ

I was surprised to be honest with you. I wanted the SubQ to come out on top. It did when it comes to HCT and Hb. That's a big deal, but my HCT and Hb on the shallow IM were fine, just not as good as the SubQ. I thought the E2 might decrease like in the study but that didn't happen. It actually went up as a percent of my testosterone. I did not expect the testosterone to drop like it did. I thought it might go up like in the study. Total T drop did not bother me as the Free T drop did.



So considering how I feel with less energy and some acne (minor) I will probably go back to the shallow IM. I probably don't need the 1064 Total Testosterone and Free T of 31.6 that I consistently get with the shallow IM injections of 24 mg a day. I could probably drop that a tad and have great results.

These were my results and yours may vary. I paid careful attention to keep everything exactly the same during the 9 1/2 weeks to eliminate any variable other than the injection type.

 

[Gman86]

This post is honestly amazing. Thank u so much for doing such a detailed experiment. It’s extremely impressive how well u kept all the variables the same. If only people conducting studies had ur brain. I would put much more weight into them. But anyways, obv ur results are exactly that, ur results, and they may vary person to person running this exact experiment. But at the same time, ur results are extremely important, and can really help the HRT community, especially if more guys ran this exact same experiment, and we found similar trends in others. Thanks again for doing this and making this post for everyone to see, I personally really appreciate it

 

[madman]

Background: I have been on TRT for about 15 years. I've never really struggled with TRT but I was always tweaking my protocol like many do. The past several years I have been really dialed in well and have not messed with my protocol at all. That protocol has been injecting 24mg shallow IM ED with no HCG or AI. Prior to injecting ED I injected weekly, and E3.5D with various amounts of testosterone but could never get my HCT under control. That is what led me to try the ED protocol. So, all has been well under that protocol.

Me: 62 years old, 5'10", 190 lbs naked. Normally run about 10% body fat, sometimes as low as 8% but as high as 12%. I work out regularly but not obsessed with it. I am pretty solid and healthy looking for a 62 year old.

After reading numerous articles and opinions over the last year about the differences and variances in shallow IM verse SubQ it got me thinking maybe I should try the SubQ route. A study from UC showed increased testosterone, lower E2, and lower HCT injecting SubQ as compared to shallow IM. In the study there was no change in PSA.

I have attached a spreadsheet below comparing the lab results from June 7, 2021 on the shallow IM protocol and the lab results from October 20, 2021 using SubQ. I tested the same items in both labs to get a complete picture. You'll notice that my labs under the shallow IM were pretty good so one might ask why I would change if I was so dialed in........I guess curious to see if I could improve the numbers. I figured if the numbers did not impress me I would just go back to the shallow IM which I knew worked for me.

A note on the testosterone testing. In June the labs did not use the LC/MS/MS for the Total Testosterone and did not use the Ultra Filtration on the Free T. Therefore, I did not use those assays on this round of testing so the testing would be apples to apples. I have numerous testosterone testing over the years use the most accurate assays but I wanted a good comparison. Plus, regardless of the number, it is about how I feel that is the most important and not a number.

I was on the SubQ protocol for 9 1/2 weeks to ensure there was no question about reaching a steady state. I did not change a thing about my protocol. I injected the same 24mg of testosterone ED and took all the same supplements I was taking previously.

You'll see below there was a nice decrease in HCT and Hb in the October testing on SubQ ......impressive. Total T and Free T dropped significantly on SubQ. Total T dropped 26.8% while Free T fell 47.2%. While the SubQ testosterone numbers are not terrible, they are much lower that the testosterone on shallow IM There was not a big change on E2 with it going up slightly, 2.7%, on SubQ. Looking at all the other blood markers there wasn't much change at all. My DHT is high and over the range but it has always been that way and I'm not too concerned about it.

How do I feel? I feel pretty good but not as good as I felt on the shallow IM injections. I don't feel like I have quite the energy I had on shallow IM. I've never had an acne problem but I did notice some small acne on my chest and back that I did not have on the shallow IM. I didn't like that.

Element	Range	Measure	6/7/21	10/20/21
WBC	3.4 - 10.8	x10E3/ul	6.0	4.9
RBC	4.14 - 5.80	X10E6/ul	5.42	5.66
Hemoglobin	13.0 - 17.7	g/dl	15.9	14.8
Hematocrit	37.5 - 51.0	%	48.5	46.1
Ttl Cholesterol	100- 199	mg/dl	141	148
LDL	0 - 99	mg/dl	89	92
HDL	> 39	mg/dl	36	37
Triglycerides	< 150	mg/dl	82	92
VLDL Cholesterol	5 - 40	mg/dl	20	21
Ferritin	30 - 400	ng/ml	148	121
Iron	38 - 169	ug/dl	92	57
Iron Saturation	15 - 55	%	31	28
TIBC	250 - 450	ug/dl	280	261
UIBC	111 - 343	ug/dl	202	175
Glucose	65 - 99	mg/dl	96.0	97.0
Hemo A1C	4.8 - 5.6	%	5.2	5.3
TSH	0.45 - 4.50	uiu/ml	0.390	0.371
T3	.79 - 1.49	ng/dl	1.1	1.0
Free T3	2.0 - 4.4	pg/ml	3.7	3.5
T4	4.5 - 12.0	ug/dl	6.8	6.9
Free T4	0.82 - 1.77	ng/dl	1.29	1.22
Reverse T3	9.2 - 24.1	ng/dl	12.2	9.3
TgAB Antibody	0.0 - 0.9	iu/ml	<1.0	<1.0
TPOab Antibody	0 - 34	iu/ml	10	10
Vitamin D	30 - 100	ng/ml	69.0	57.7
Vitamin B12	> 231	pg/ml	962	846
Testosterone	264 - 916	ng/dl	1055	778
Free Test	7.2 - 24.0	pg/ml	31.6	16.7
% Free to Total	2.0 - 3.0	%	2.87%	2.15%
Bioavailable T	250 - 600	ng/dl	613	423
% Bio of Total	30 - 60	%	58.1%	54.4%
PSA	0.0 - 4.0	ng/ml	0.7	0.9
DHT	30 - 85	ng/dl	92	96
DHT % of Test	3.5 - 8.5	%	8.7%	12.4%
Prolactin	4.0 - 15.2	ng/ml	9.6	8.9
Estradiol, Sens	8.0 - 35.0	pg/ml	30.1	30.9
Free Estradiol E2	0.2 - 1.5	pg/ml	1.2	1.3
% Free E2 to Total	1.7 - 5.4	%	3.98%	4.21%
Estradiol (E2) % T	1.0 - 5.0	%	2.85%	3.97%
T:E Ratio	20 - 50	Ratio	35.0	25.2
SHBG	19.3 - 76.4	nmol/l	32.7	31.0
DHEA-S	49 - 344	ug/dl	331.8	287.2
Pregnenolone	< 180	ng/dl	81	70
Progesterone	0.0 - 0.5	ng/ml	0.3	0.3
T Cyp Per Week	150 - 200	mg/ml	168 mg	168 mg
Protocol		Daily	24 mg Daily	24 mg Daily
Peak/Trough		Peak/Trough	Trough	Trough
Method		IM/SubQ	Shallow IM	SubQ

I was surprised to be honest with you. I wanted the SubQ to come out on top. It did when it comes to HCT and Hb. That's a big deal, but my HCT and Hb on the shallow IM were fine, just not as good as the SubQ. I thought the E2 might decrease like in the study but that didn't happen. It actually went up as a percent of my testosterone. I did not expect the testosterone to drop like it did. I thought it might go up like in the study. Total T drop did not bother me as the Free T drop did.









So considering how I feel with less energy and some acne (minor) I will probably go back to the shallow IM. I don't probably need the 1064 Total Testosterone and Free T of 31.6 that I consistently get with the shallow IM injections of 24 mg a day. I could probably drop that a tad and have great results.

These were my results and yours may vary. I paid careful attention to keep everything exactly the same during the 9 1/2 weeks to eliminate any variable other than the injection type.

A note on the testosterone testing. In June the labs did not use the LC/MS/MS for the Total Testosterone and did not use the Ultra Filtration on the Free T. Therefore, I did not use those assays on this round of testing so the testing would be apples to apples.

When it comes to comparing blood levels you should have used the most accurate assays TT (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration) to see where your levels truly sat.

We can nitpick here on the TT as there should not be a significant difference between the standard and LC-MS/MS unless we get into the lower-end ranges.

Free T is a different story as the piss poor direct immunoassay is inaccurate and should not be used.....period!

Your trough TT(IM) 1055--->778 ng/dL (SUB-Q).....TT dropped 277 ng/dL which is a fair amount but far from drastic.

Not going to even compare the FT results as it means nothing seeing as you used the piss poor direct immunoassay.


Total T and Free T dropped significantly on SubQ. Total T dropped 26.8% while Free T fell 47.2%. While the SubQ testosterone numbers are not terrible, they are much lower that the testosterone on shallow IM

Your TT dropped 277 ng/dL and your SHBG barely budged.....highly doubtful your FT was cut almost in half.

Just to get a rough idea:

*After reading numerous articles and opinions over the last year about the differences and variances in shallow IM verse SubQ it got me thinking maybe I should try the SubQ route. A study from UC showed increased testosterone, lower E2, and lower HCT injecting SubQ as compared to shallow IM. In the study there was no change in PSA.

*You'll notice that my labs under the shallow IM were pretty good so one might ask why I would change if I was so dialed in........I guess curious to see if I could improve the numbers. I figured if the numbers did not impress me I would just go back to the shallow IM which I knew worked for me.

*Plus, regardless of the number, it is about how I feel that is the most important and not a number.

When it comes to how you feel.....most definitely but you have to admit that a big part of your trial was to compare NUMBERS!


How do I feel? I feel pretty good but not as good as I felt on the shallow IM injections. I don't feel like I have quite the energy I had on shallow IM. I've never had an acne problem but I did notice some small acne on my chest and back that I did not have on the shallow IM. I didn't like that.

As you and many that have been on the forum long enough should very well know when comparing labs:

1. The protocol needs to be kept the same (ester/dose T/injection frequency)

2. 4-6 weeks for blood levels to stabilize before getting blood work done (6 weeks)

3. Testing is done at the true trough

4. Using the same lab

5. Using the same assays (most accurate) TT/e2 (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration)

6. 6. Each protocol needs to be given 12 weeks


Then and only then can you make a true comparison between injecting IM vs SUB-Q!

You were on point from 1-4 but out to lunch on 5 especially when it comes to FT and bailed out on 6.

At least you tried strictly sub-q and know that you do not feel as good overall when compared to IM.

Let alone injecting strictly sub-q has you hitting a lower TT 1055--->778 ng/dL which would result in a lower FT but highly doubtful your FT dropped significantly.

Good job overall but you should have known better not to waste your time using a piss poor known to be inaccurate assay when it comes to testing your FT.

 

[MarkM]

@madman Thank you for your input. I'm going to respectfully disagree with you a bit on the testosterone testing. I did state that I did not use the LC/MS/MS and the Ultrafiltration and why I did not. I chose to use the same assay as I had previous used for my study and not muddy the waters.

Back in 2018 using both the LC/S/MS and Ultrafiltration I had errors from the lab showing my Total T at 479 and Free T at 10.6 using the same protocol I am using today on shallow IM. Obviously using this most accurate method in this case did not work. I spoke to the lab and they agreed that those numbers did not look accurate based on my previous labs and they re-did the lab work at no cost to me one week later.

On the second set of labs the Total T was 979 and the Free T was 26.7. Everything was the same even the and I even took the labs the same time in the morning....7:30am.

So, errors happened even using the most accurate assays. Like you stated, the same assays should be used and that I did. It would not be a fair comparison had I not used the same assays and to me, would have been a waste of time. Now, had it been a test that was life dependent, I would have definitely used the most accurate method but we are just talking about testosterone which I have probably tested well over 50 times.

I have a home blood pressure machine and a home Hb/HCT monitor. I admit that these may not be as accurate as a device at a medical lab. But I still take my blood pressure every day and test my HCT/Hb once a month. I figure that while they might be off somewhat it gives me an idea of where I sit and, if off, likely consistently off. I don't forego monitoring them at home because the device being used is not the highest medical grade.

So, while you feel I was "out to lunch", it was a good lunch and I enjoyed it.

As always your input is much appreciated. Your knowledge is second to none.

Mark

 

[madman]

@madman Thank you for your input. I'm going to respectfully disagree with you a bit on the testosterone testing. I did state that I did not use the LC/MS/MS and the Ultrafiltration and why I did not. I chose to use the same assay as I had previous used for my study and not muddy the waters.

Back in 2018 using both the LC/S/MS and Ultrafiltration I had errors from the lab showing my Total T at 479 and Free T at 10.6 using the same protocol I am using today on shallow IM. Obviously using this most accurate method in this case did not work. I spoke to the lab and they agreed that those numbers did not look accurate based on my previous labs and they re-did the lab work at no cost to me one week later.

On the second set of labs the Total T was 979 and the Free T was 26.7. Everything was the same even the and I even took the labs the same time in the morning....7:30am.

So, errors happened even using the most accurate assays. Like you stated, the same assays should be used and that I did. It would not be a fair comparison had I not used the same assays and to me, would have been a waste of time. Now, had it been a test that was life dependent, I would have definitely used the most accurate method but we are just talking about testosterone which I have probably tested well over 50 times.

I have a home blood pressure machine and a home Hb/HCT monitor. I admit that these may not be as accurate as a device at a medical lab. But I still take my blood pressure every day and test my HCT/Hb once a month. I figure that while they might be off somewhat it gives me an idea of where I sit and, if off, likely consistently off. I don't forego monitoring them at home because the device being used is not the highest medical grade.

So, while you feel I was "out to lunch", it was a good lunch and I enjoyed it.

As always your input is much appreciated. Your knowledge is second to none.

Mark

So, errors happened even using the most accurate assays.

They do now and then but it is far from common unlike the piss poor direct immunoassay which is known to be inaccurate let alone should not be used/relied upon when testing FT.


Like you stated, the same assays should be used and that I did. It would not be a fair comparison had I not used the same assays and to me, would have been a waste of time.

Again you used the wrong assay for FT.

The direct immunoassay should not be used.....period!

Your TT dropped 277 ng/dL (a fair amount) but far from drastic and it is highly doubtful your FT was cut in almost half let alone your SHBG barely budged.

I applaud you for putting in the effort overall but again the numbers are misleading due to using inaccurate assays especially when it comes to free testosterone.

Aside from the numbers when it comes to how you truly felt overall I am doubting you gave the protocol a full 12 weeks as you stated.....I was on the SubQ protocol for 9 1/2 weeks

You bailed early.

Even then after 9.5 weeks, you stated.....How do I feel? I feel pretty good but not as good as I felt on the shallow IM injections. I don't feel like I have quite the energy I had on shallow IM. I've never had an acne problem but I did notice some small acne on my chest and back that I did not have on the shallow IM. I didn't like that

At least you still felt pretty good even with a somewhat lower T level so injecting strictly sub-q was far from a disaster as many of those BRUHs would have you believe!

 

[MarkM]

Your right, I did not give the study 12 weeks, never intended to. Normal steady state on testosterone is about 40 days give or take about 6 weeks. I went well over that at 9 1/2 weeks. I kept the exact change protocol with only one variable, subq vs shallow IM. Didn't feel like I need to go 12 weeks and surely did not bail early as you state. How did I bail early?

 

[madman]

Your right, I did not give the study 12 weeks, never intended to. Normal steady state on testosterone is about 40 days give or take about 6 weeks. I went well over that at 9 1/2 weeks. I kept the exact change protocol with only one variable, subq vs shallow IM. Didn't feel like I need to go 12 weeks and surely did not bail early as you state. How did I bail early?

Much more to it than simply achieving a steady state!

As I have stated numerous times on the forum whether starting trt or tweaking a protocol hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks) and it is common for many to experience ups/downs during the transition as the body is trying to adjust.

Even once blood levels have stabilized it will take time for the body to adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.

Many fail to understand this and these are the individuals that end up tweaking their protocols every 6 weeks because they do not feel good.

Unless one's blood levels were absurdly low (highly doubtful) 6 weeks in then a protocol change needs to be given 12 weeks to truly claim whether it was a success or failure.

The first 6 weeks can be very misleading and mean nothing when looking at the bigger picture.

This is where many fail.

Yes, at least you put in 9.5 weeks!

 

[Willyt]

Great stuff. Appreciate you having the discipline to eliminate the variables, especially the supplements. Count me surprised by the subq TT number based on 24mg daily!

You could always alternate between subq and shallow IM every other day. With medium ester like Cyp the results would probably end up somewhere in the middle.

 

[MarkM]

Great stuff. Appreciate you having the discipline to eliminate the variables, especially the supplements. Count me surprised by the subq TT number based on 24mg daily!

You could always alternate between subq and shallow IM every other day. With medium ester like Cyp the results would probably end up somewhere in the middle.

I have considered that option.

 

[MIP1950]

I can only add my praise for your meticulous comparison analysis. Some, or many of us, wouldn't have the time or inclination to be so methodical. I also read the article on Testosterone Nation about the study at one of the medical centers in the University of California system. It never stated where, specifically, since I wanted to read the study, so you conducted your own study. Good job!

 

[Cataceous]

@madman
...
So, errors happened even using the most accurate assays. ...

I'd add that errors happen especially with the most accurate assays. The mass spectrometry-based tests are known to be temperamental and tricky to do right. I've had the sensitive estradiol test botched on a couple occasions, while the immunoassay test has remained consistent and useful, albeit a few percentage points higher.

Do you inspect your injection sites closely when injecting subcutaneously? Depending on the dose, the site and the how frequently the site is used, it's possible to have significant loss of the medication in the minutes after injecting. I'd assume this loss is more common with SC than with IM, making SC appear less effective in some cases.

 

[MarkM]

I'd add that errors happen especially with the most accurate assays. The mass spectrometry-based tests are known to be temperamental and tricky to do right. I've had the sensitive estradiol test botched on a couple occasions, while the immunoassay test has remained consistent and useful, albeit a few percentage points higher.

Do you inspect your injection sites closely when injecting subcutaneously? Depending on the dose, the site and the how frequently the site is used, it's possible to have significant loss of the medication in the minutes after injecting. I'd assume this loss is more common with SC than with IM, making SC appear less effective in some cases.

Yes sir, I would always inspect the site. I would move it around my entire midsection staying at least 2 inches away from the belly button. I was injecting a relatively small amount and never once had it whelp up like it would do when injecting much larger quantities years ago.

 

[madman]

I'd add that errors happen especially with the most accurate assays. The mass spectrometry-based tests are known to be temperamental and tricky to do right. I've had the sensitive estradiol test botched on a couple occasions,
while the immunoassay test has remained consistent and useful, albeit a few percentage points higher.

Estradiol sensitive LC/MS through Quest Diagnostics.....sure.

Through a lab such as Labcorp or any others certified through the CDC Hormone Standardization Program (CDC HoSt) Certified Estradiol Assays.....a botched test would be far from common.

The same could be said for TT and the same is going to happen for FT soon enough!

Looking forward to this as labs that are certified through the CDC Hormone Standardization Program (CDC HoSt) for Certified Free Testosterone Assays will be the only ones I will recommend.

Look over the “Individual samples pass rate”

Quest estradiol sensitive is not even certified through the CDC Hormone Standardization Program (CDC HoSt).

https://www.cdc.gov/labstandards/pdf/hs/CDC_Certified_Estradiol_Assays-508.pdf

• Certification is valid for one quarter (3 months) from the certification date. It is the responsibility of the participant to ensure that the results of the assay remain consistent, between lots, and over the measurement range reported.

 

[madman]

CDC STANDARDIZED TOTAL T and ESTRADIOL ASSAYS and soon to be FREE TESTOSTERONE!

How the CDC Clinical Standardization Programs Are Improving Hormone Tests - AACC.org WHAT PROGRESS HAS CDC MADE WITH STANDARDIZING TOTAL TESTOSTERONE AND ESTRADIOL TESTS? Since HoSt began in 2010, CDC has had more than 350 participants in 15 countries. Participants have shown measurable...

www.excelmale.com

Quest TT is certified.

Estradiol sensitive.....nowhere to be found.

 

[madman]

To all the newbies, men with their feet wet, OGzzz and yes I will include the BRUHs!


When getting blood work done let alone comparing labs it is critical that:


1. The protocol needs to be kept the same (ester/dose T/injection frequency)

2. 4-6 weeks for blood levels to stabilize (TC/TE) before getting blood work done (6 weeks)

3. Testing is done at the true trough

4. Using the same lab

5. Using the same assays (most accurate) TT/e2/DHT (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration)

6. Each protocol needs to be given 12 weeks


The most accurate assays for TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Most accurate assays for TT/FT (Labcorp, Quest Diagnostics, ARUP)

1. 500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp

2. 070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

3. Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

4. 070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

5. Testosterone Free and Total by ED/LC-MS/MS (Free) and LC-MS/MS (Total), Adult Males | ARUP Laboratories Test Directory

 

[madman]

This post is honestly amazing. Thank u so much for doing such a detailed experiment. It’s extremely impressive how well u kept all the variables the same. If only people conducting studies had ur brain. I would put much more weight into them. But anyways, obv ur results are exactly that, ur results, and they may vary person to person running this exact experiment. But at the same time, ur results are extremely important, and can really help the HRT community, especially if more guys ran this exact same experiment, and we found similar trends in others. Thanks again for doing this and making this post for everyone to see, I personally really appreciate it

Minus using/relying upon the piss poor known to be inaccurate assays especially when it comes to free testosterone.....most definitely!

It's all about balance he says let alone coming from a guy who still uses/relies upon inaccurate assays even when using ND.....who knew?

If it were only so simple.....LOL!



My takeaway on the IM vs SUB-q TRIAL:

As you and many that have been on the forum long enough should very well know when comparing labs:

1. The protocol needs to be kept the same (ester/dose T/injection frequency)

2. 4-6 weeks for blood levels to stabilize (TC/TE) before getting blood work done (6 weeks)

3. Testing is done at the true trough

4. Using the same lab

5. Using the same assays (most accurate) TT/e2 (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration)

6. Each protocol needs to be given 12 weeks


Then and only then can you make a true comparison between injecting IM vs SUB-Q!

You were on point from 1-4 but out to lunch on 5 especially when it comes to FT and bailed out on 6.

 

[MarkM]

@madman I get it that you totally disagree with me using the assays I did for my study. I explained why I made that decision. But you continually make reference, on numerous occasions, to the "piss poor" assays I used and I am about to take offense. It is almost like you are telling me I make piss poor decisions. You obviously would have done it differently and that's fine but don't continually slam me for my method of undertaking my study. You made your point initially so leave it alone, at least on my thread. Your an extremely intelligent individual but you need to learn to back off.

 

[Willyt]

3. Testing is done at the true trough

I am starting to question this logic. Why wouldn't you want to know the peak instead?

Often guys will see trough TT of 850 and think they are in range when in actuality they are spending at least half their time far above physiological levels. They are fooling themselves. From what I have experienced, the peak is what often drives the side effects, not the trough.

 

[madman]

@madman I get it that you totally disagree with me using the assays I did for my study. I explained why I made that decision. But you continually make reference, on numerous occasions, to the "piss poor" assays I used and I am about to take offense. It is almost like you are telling me I make piss poor decisions. You obviously would have done it differently and that's fine but don't continually slam me for my method of undertaking my study. You made your point initially so leave it alone, at least on my thread. Your an extremely intelligent individual but you need to learn to back off.

In no way is it fair to make the statement.....Total T and Free T dropped significantly on SubQ. Total T dropped 26.8% while Free T fell 47.2%. While the SubQ testosterone numbers are not terrible, they are much lower that the testosterone on shallow IM

The piss poor direct immunoassay is inaccurate.....plain and simple.

Again your TT dropped 277 ng/dL and SHBG barely budged.....highly doubtful your FT was cut in almost half.

Sick n tired of people on here claiming this and that yet they are not thorough with lab work.

Using accurate assays is critical.

Is it truly a fair assessment comparing results using inaccurate assays let alone 2 years strictly IM vs 9.5 weeks sub-q?

Would you have felt even better 3-4 months in?

Only time would tell.

 

[madman]

I am starting to question this logic. Why wouldn't you want to know the peak instead?

Often guys will see trough TT of 850 and think they are in range when in actuality they are spending at least half their time far above physiological levels. They are fooling themselves. From what I have experienced, the peak is what often drives the side effects, not the trough.

We always test at the true trough as we want to see where levels sit at the lowest point to make sure T levels are still in a healthy range to maintain the positive effects.


Why wouldn't you want to know the peak instead?

Often guys will see trough TT of 850 and think they are in range when in actuality they are spending at least half their time far above physiological levels. They are fooling themselves.

Most sensible people would know that the peak levels will be higher and in many cases much higher depending on the protocol (dose T/injection frequency).

It is critical to pay attention to your injection frequency and what trough level you are running as there is going to be a big difference between the peak--->trough injecting once weekly compared to injecting more frequently especially when injecting daily.


From what I have experienced, the peak is what often drives the side effects, not the trough.

Peaks play a role but it is somewhat short-lived and running too high an FT level is the key player.

Many are running absurdly high troughs meaning T levels are going to be very high throughout the week.

There are many men injecting daily which would clip/greatly minimize the peak--->trough yet they still continue to struggle with sides due to running too high an FT level.