The needle length is the same (1/2 inch) and the only difference is that one is thinner (31g) and you have gone from 2 weekly injections to 3 weekly injections. Would only the diameter of the needle be able to make all this change? How long did you take the test in the lab after you started applying 3x / week? The time and day you collected the blood can also give this change.
Daily Sub Q TRT injection ?
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madman
Super Moderator
He switched from 29G 1/2"(12.7MM) needle length to 31G 5/16"(roughly 8MM).
The gauge would make no difference and the length of the needle is only changing from 12.7MM--->8MM.
He stated that by switching he was now injecting shallow IM as oppose to sub-q and achieved lower T levels.
Unfortunately, to make a true comparison his protocol dose T/injection frequency would have needed to be kept the same, stayed on each protocol for 4-6 weeks until blood levels stabilize (which he would have done),than tested at trough using the same lab, same assays (most accurate)!
I will add...I have plenty of bloodwork for sq injections. About a month ago, I switched to shallow IM in the delts, hoping to help with estrogen. Anyhow, I tested after 3 weeks because I felt like I had lower energy the following afternoon, just before my next dose, and since IM was new for me. I have low shbg, and I was worried I was consuming the T too quickly through IM...anyhow... Both my T and FT were higher than on long term SQ, after only 3 weeks. I tested 4 hours post injection and 24 hours post injection because I wanted to see how quickly the IM was effecting me and how quickly. So, that was my brief experience. Could have been a strange spike. I did "feel" the T when I switched to IM for the first and second dose, that is why I checked bloods after 4 hours. The blood work did not bear out my "feel" of the T, at least at that point. Maybe it was an initial burst from the shift? I am having full bloods completed next week, after 8 weeks on IM, same dosing amounts and frequency. So, I will know more then. While I feel like my estrogen impact has been lower, I much preferred the convenience and ease of SQ since I'm and ED guy, and I am thinking about switching back. However, I want to complete this blood work cycle with the IM.
ivankonst2017
Member
From my humble experience I wouldnt recommend anyone starting TRT with sub q. Absorbtion is variable, works great for some people but for some doesnt. IM works on everyone.
At least for me sub q produced very strange results in terms of how TRT should work. I guess on some esters sub q works better, also I can suppose it works better on people with less body fat percentage.
Another point is I think 95 percent wouldnt notice a differencr between cypionate on daily and every other day injections.
Not telling you what to do, just giving you points to consider. Cheers
At least for me sub q produced very strange results in terms of how TRT should work. I guess on some esters sub q works better, also I can suppose it works better on people with less body fat percentage.
Another point is I think 95 percent wouldnt notice a differencr between cypionate on daily and every other day injections.
Not telling you what to do, just giving you points to consider. Cheers
In my case this may be true. I used nebido for one year every 3 months deep IM and the hematocrits were controlled. I switched to subq cypionate since January 4 and the hematocrits are out of control and blood pressure goes up. I had to stop and when I can I will test the IM cypionate to see how it looks or to return to Nebidol
ivankonst2017
Member
I think with nebido things are very different than the rest of the esters. All people I know who tried nebido have issues getting optimal stable levels.
IM cypionate makes sense to me, why dont you try it EOD with a bit smaller dose maybe?
Also have you explored the most common cauees causing elevated blood counts - smoking or undiagnosed sleep apnea? Ive had total t of 1600 and even them my HCT was 48, HMGB - 165. Also most people I know who have issues with blood counts either smoke or turned out to have sleep apnea. Hope you manage to resolve your issues.
I have also tried the EOD cypionate. I know I snore a lot when I sleep, but this has been around for many years and when I started Nebido I already had this problem. With the ester change it didn't work ... I have to investigate further to resolve this. The fog on my TT and FT were high at the beginning. They are 1000 Mg at a time and this causes a large initial peak of 20mg of ester in the blood and decreases reaching 3, 21 at the end of 58 days. I am aware that the variation of testosterone between the peak and the valley in Nebido is around 2% per day and the ED cypionate would be 6.5% per day.
Tremonti22
Member
Ok jumping back on because it’s been a while. Been running 100mg spread over two doses every 3.5 days (60/40 mg) since I last posted. Been feeling ok, steady. Wondering if dose could go up. Couple things here. Got labs back yesterday (all except E2, Sensitive test takes longer) . I’ve got a two part
total test - 660
Free test - 179
SHBG - 15
thoughts on increasing to 120mg week?
2nd question - after 4 month waiting period I did go see Dr. Larry Lipshultz in Houston and he’s recommending I start on 200mg week injected once weekly with a 1mg dose of anastrozole per week. I have to admit I was shocked to hear him say this, that doesn’t seem like the right step considering he is supposed to be a leader in the field. Any thoughts on him / his recommendation?
total test - 660
Free test - 179
SHBG - 15
thoughts on increasing to 120mg week?
2nd question - after 4 month waiting period I did go see Dr. Larry Lipshultz in Houston and he’s recommending I start on 200mg week injected once weekly with a 1mg dose of anastrozole per week. I have to admit I was shocked to hear him say this, that doesn’t seem like the right step considering he is supposed to be a leader in the field. Any thoughts on him / his recommendation?
madman
Super Moderator
Not sure why you are splitting your dose T 100 mg/week (60/40) as it will make no difference and I would just stick with 50 mg every 3.5 days.
Have no idea where your FT level truly sits as you did not post-lab reference ranges let alone the testing method used.
As I have stated numerous times on the forum that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.
The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration.
If these are labs at the trough and you are hitting a TT 660 ng/dL and SHBG sits at 15 nmol/L than your FT levels would be descent and something you need to keep in mind is that your peak levels will be much higher.
If you feel well overall and blood markers are healthy then you can either leave it be or try increasing your dose slightly if you feel that there is room for improvement.
Forget the 200 mg/week protocol with the added AI.
Such dose will have your TT/FT level through the roof let alone the peak--->trough will be extreme and can have a negative impact on energy/mood/libido/erections.
Top it off that your SHBG 15 nmol/L is on the lower end.
You already tried a higher dosed T protocol and it did not work out so well.
On your current protocol of 100 mg/week split 60/40 every 3.5 days you are hitting a robust trough TT almost 700 ng/dL let alone FT level will be descent as your SHBG is on the lower end.
Keep in mind that increasing your dose T from 100--->120 mg/week may not seem like a big jump that 20 mg esterified T will most likely drive your trough TT >1000 ng/dL let alone have your FT very high as you have low SHBG.
madman
Super Moderator
My Most Recent Labs. - Excel Male Health Forum
My protocol, 16 mg of testosterone cypionate daily, 500 iu of hcg twice weekly and no AI. Pregnenolone 10 mg and 25 mg of DHEA. My last injection before labs, about 28 hr.s. Labs are from LabCorp. Testosterone, Serum 1319 ng/dL range 264-916 Free Testosterone 47.9 ng/dL range...
www.excelmale.com
Sit back and take a close look at how high Vince's FT sits with TT 1300 ng/dL and that is with an SHBG of 48.2 nmol/L.
It was tested using one of the most accurate assays Equilibrium Ultrafiltration.
Most men on those other forums let alone some on here would have you believe that they need to run those absurdly high TT levels 1500-2000 ng/dL to achieve a healthy FT level due to highish/high SHBG.....LMFAO!
Testosterone, Serum 1319 ng/dL range 264-916
Free Testosterone 47.9 ng/dL range 5.00-21.00
% Free Testosterone 3.57 range 1.50-4.20
DHEA-Sulfate 449.0 H ug/dL range 30.9-295.6 (age adjusted)
Estradiol, Sensitive 24.0 pg/mL range 8.0-35.0
Sex Horm Binding Glob, Serum 48.2 nmol/L range 19.3-76.4
Hematocrit 46.8 % range 37.5-51.0
Hemoglobin 16.0 g/dL range 13.0-17.7
Albumin 4.2 g/dL range 3.8-4.8
Tremonti22
Member
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Tremonti22
Member
I hear ya. Yea I was very disappointed in Dr. Lipshultz, he seemed like he was more interested in bulking me up than he was in getting my levels right. He said he always starts his guys off at 200mg weekly and 1mg of AI weekly. He was also nodding off as I was speaking to him. Very disappointed in that experience.
madman
Super Moderator
Again if you feel well overall and blood markers are healthy then leave it be.
madman
Super Moderator
Unfortunately, some in the know are dishing out these generic protocols..... high-end dosed T injected once weekly with an AI to boot!
Your body still experiences the extremes between the peak--->trough, especially when injecting strictly IM let alone such a dose would put most men's FT let alone estradiol through the roof and can easily have a significant impact on driving up your RBCs/hemoglobin/hematocrit.
Top it off that everyone is caught up on their trough without taking into account how high peak levels can really be depending on the dose T/injection frequency used.
Most men can easily achieve a healthy FT let alone an absurdly high FT on 100-150 mg/week.
Some even when using <100 mg/week.
Where your TT/SHBG sits is critical as it will have a significant impact on what FT level is achieved on such protocol (dose T/injection frequency) let alone can dictate what injection frequency may suit you best!
madman
Super Moderator
Variance in Peak and Trough T Levels in Men Using Intramuscular T Injections - Excel Male Health Forum
MP85-14 VARIANCE IN PEAK AND TROUGH TESTOSTERONE LEVELS IN MEN USING INTRAMUSCULAR TESTOSTERONE Bruno Nascimento*, Helen L Bernie, Elizabeth Schofield, John P. Mulhall, New York, NY INTRODUCTION AND OBJECTIVES In men using intramuscular testosterone (IM T), clinical experience shows us that...
www.excelmale.com
Since no one has said it outright - it was the switch to subq. That and nothing else is the reason for the dramatic drop. You are not absorbing the subq injections for reasons not understood. There are now tons of such examples on this and other forums. In such cases the solution is simple - daily shallow IM to the thighs / delts.
madman
Super Moderator
Really?
Strong chance.....sure!
If anything he would have had to have blood work redone to rule out the possible chance of lab error in order for one to truly claim such.....it was the switch to subq. That and nothing else is the reason for the dramatic drop.
Post #77 (my reply):
As I stated previously going from 160 mg/week--->98 mg/week is a significant drop in T but even then hard to believe that one would experience such a drastic drop in levels 1500--->254!
Bad lab test......possible as it is known to happen.
If anything you can retest TT to rule out but you already know where your FT/e2 truly sit as both were tested LC/MS-MS.
Mind you as stated your feeling horrible.
*No wonder I’ve been feeling bad. Extreme insomnia, constipation & no libido. Probably because my test dropped down to where I was when I started.
*I know crazy right
Can’t believe it would be the test
Don’t think the lab was wrong / no libido and insomnia and constipation confirm levels were low.
Highly doubtful it was bad testosterone seeing as you stated that it is being prescribed by your doctor.
Even if it was not pharma grade and instead compounded there would not be such a drastic drop in T.
Sure.....if it was UGL (highly underdosed/bunk)!
Poor injection technique/procedure causing leakage.....doubtful unless it was happening frequently as you are injecting daily.
Would be rare that one would have excess leakage at the injection site frequently and in most cases anytime one experiences any leakage it is minimal.
*If you are concerned that injecting sub-q may be causing absorption issues then switch to IM.
Regarding the absorption/effectiveness of T should be no difference between sub-q vs IM mind you there are some men who do not feel well injecting sub-q let alone claim they hit much lower numbers but I would be suspect in most cases unless they are :
*following the same protocol (dose T/injection frequency)
*staying consistent and waiting the full 4-6 weeks for blood levels to stabilize
*getting blood work done at 6 weeks
*using the same lab, same assays (most accurate), and testing at the true trough.
Only when the above steps have been followed and labs from the sub-q and IM protocol can be fairly compared then one can truly state such!
Your TT/FT/e2 levels are at the bottom end of your current protocol as you can see from your blood work.
Top it off that you feel horrible.
If you feel more comfortable injecting IM then make the switch and decide whether you want to stick with dailies or jump into 120 mg/week at 60mg twice weekly (every 3.5 days).
Post #79 (Cataceous):
It's easy enough to check your injection sites a few times to rule out leakage. Just leave them untouched for a few minutes and then shine a flashlight so the light reflects off of your skin. It's easy to see if you've got an oil slick there. At these tiny doses a mere 0.05 mL of loss each time would account for your low total testosterone.
Don't rule out the lab either until you have a retest. It's possible to get side effects from any significant dose reduction, even when serum testosterone stays in a healthy normal range. It takes time to adapt.
madman
Super Moderator
Some may have issues let alone not do well when injecting strictly sub-q but this is far from common.
Regarding the absorption/effectiveness of T there should be no difference between sub-q vs IM mind you there are some men who do not feel well injecting sub-q let alone claim they hit much lower numbers but I would be suspect in most cases unless they are :
*following the same protocol (dose T/injection frequency)
*staying consistent and waiting the full 4-6 weeks for blood levels to stabilize
*getting blood work done at 6 weeks
*using the same lab, same assays (most accurate), and testing at the true trough.
Only when the above steps have been followed and labs from the sub-q and IM protocol can be fairly compared then one can truly state such!
Trust me when I tell you that some of these same individuals making such claims as poor absorption/lower T levels have slipped up on one of the points stated above.
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