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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
IM versus Sub-q T Injections: Effect on TT, hematocrit, E2, and PSA
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<blockquote data-quote="madman" data-source="post: 191015" data-attributes="member: 13851"><p><strong>Comparison of Outcomes for Hypogonadal Men Treated with Intramuscular Testosterone Cypionate Versus Subcutaneous Testosterone Enanthate (2020)</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>Introduction</strong></p><p></p><p><em><span style="color: rgb(184, 49, 47)">Intramuscular testosterone cypionate (IM-TC) is the conventional treatment option for hypogonadal men with baseline serum total testosterone (TT) less than 300 ng/dL; however, significant peaks in testosterone cause adverse effects including polycythemia and a rise in estradiol (E2). </span></em><span style="color: rgb(44, 130, 201)"><em>Subcutaneous testosterone enanthate-autoinjectors (SCTE-AI) were designed with a lower testosterone peak-to-trough ratio of 1.8. </em></span></p><p></p><p></p><p><span style="color: rgb(0, 0, 0)"><strong>Objective</strong></span></p><p><span style="color: rgb(0, 0, 0)"></span></p><p><span style="color: rgb(0, 0, 0)"><em>This dual-institutional study compared the TT, hematocrit (HCT), E2, and prostate-specific antigen (PSA) response to treatment with IM-TC versus SCTE-AI.</em></span></p><p></p><p></p><p><strong>Methods</strong></p><p></p><p><em>263 hypogonadal men were treated with testosterone replacement therapy (TRT) via IM-TC or SCTE-AI. TT, HCT, E2, and PSA levels were obtained at baseline and 6- to 12-weeks post-treatment. Significant differences in baseline and post-treatment levels were identified by univariate analysis. Linear regression models determined whether treatment modality was independently associated with post-TRT levels of TT, HCT, E2, and PSA.</em></p><p></p><p></p><p><strong>Results</strong></p><p></p><p><span style="color: rgb(184, 49, 47)"><em>Patients treated with SCTE-AI were significantly younger and had lower baseline TT levels, and lower baseline E2 levels (Table 1). Post-TRT, the SCTE-AI cohort had significantly lower HCT and E2, while TT and PSA levels were not significantly different between the treatment arms.</em></span> <em><span style="color: rgb(44, 130, 201)">After adjusting for significant differences with linear regression, SCTE-AI was associated with a 14% greater increase in trough TT levels compared to IM-TC (p=0.027). Furthermore, SCTE-AI was independently associated with 41% and 26.5% lower post-therapy HCT (p<0.001) and E2 (p<0.001) levels, respectively, when compared to IM-TC.</span> </em><span style="color: rgb(26, 188, 156)"><em>Neither TRT modality was associated with post-therapy elevation of PSA (p=0.691).</em></span></p><p></p><p></p><p><strong>Conclusions</strong></p><p><strong></strong></p><p><strong><em><span style="color: rgb(184, 49, 47)">While IM-TC and SCTE-AI <u>provide a significant increase in testosterone, SCTE-AI is associated with lower levels of post-therapy HCT and E2 compared to IM-TC after adjusting for significant covariates</u>.</span></em></strong> <span style="color: rgb(44, 130, 201)"><em><strong>SCTE-AI is an effective testosterone delivery system with a preferable safety profile over IM-TC. </strong></em></span></p><p></p><p></p><p></p><p></p><p>[ATTACH=full]11735[/ATTACH]</p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/how-to-inject-testosterone-intramuscularly-shallow-im-or-subcutaneously.8858/[/URL]</p><p></p><p> </p><p></p><p></p><p></p><p><strong>Table 1. <span style="color: rgb(184, 49, 47)">Clinical demographics and treatment outcomes of intramuscular testosterone cypionate </span><span style="color: rgb(0, 0, 0)">(IM-TC)</span><span style="color: rgb(184, 49, 47)"> compared to subcutaneous testosterone enanthate-autoinjector </span><span style="color: rgb(0, 0, 0)">(SCTE-AI)</span><span style="color: rgb(184, 49, 47)">. </span></strong></p><table class='post-table ' style='width: 100%'><tr><td></td><td ><p>IM-TC</p></td><td ><p>SCTE-AI</p></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td ><p>n=188</p></td><td ><p>n=114</p></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td ><p>mean (SD)</p></td><td ><p>mean (SD)</p></td><td ><p><em>p</em>-value</p></td><td></td><td></td><td></td></tr><tr><td ><p>Age</p></td><td ><p>54.4 (13.4)</p></td><td ><p>49.7 (10.5)</p></td><td ><p><strong>0.001</strong></p></td><td></td><td></td><td></td></tr><tr><td ><p><em>Pre-Therapy</em></p></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td ><p>TT</p></td><td ><p>313.6 (263)</p></td><td ><p>249.6 (113)</p></td><td ><p><strong>0.006</strong></p></td><td></td><td></td><td></td></tr><tr><td ><p>HCT</p></td><td ><p>45.2 (4.2)</p></td><td ><p>44.8 (3.4)</p></td><td ><p>0.453</p></td><td></td><td></td><td></td></tr><tr><td ><p>E2</p></td><td ><p>30.4 (15.5)</p></td><td ><p>25.3 (9.2)</p></td><td ><p><strong>0.004</strong></p></td><td></td><td></td><td></td></tr><tr><td ><p>PSA</p></td><td ><p>1.4 (1.8)</p></td><td ><p>1.1 (0.8)</p></td><td ><p>0.072</p></td><td></td><td></td><td></td></tr><tr><td ><p><em>Post-Therapy</em></p></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td ><p>TT</p></td><td ><p>536.4 (295)</p></td><td ><p>552.5 (207)</p></td><td ><p>0.629</p></td><td></td><td></td><td></td></tr><tr><td ><p>HCT</p></td><td ><p>48.4 (4.4)</p></td><td ><p>46.3 (3.8)</p></td><td ><p><strong><0.001</strong></p></td><td></td><td></td><td></td></tr><tr><td ><p>E2</p></td><td ><p>46.6 (25.9)</p></td><td ><p>33.0 (15.4)</p></td><td ><p><strong><0.001</strong></p></td><td></td><td></td><td></td></tr><tr><td ><p>PSA</p></td><td ><p>1.3 (1.3)</p></td><td ><p>1.2 (0.9)</p></td><td ><p>0.565</p></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></table><strong><span style="color: rgb(184, 49, 47)">TT: </span>Total Testosterone;<span style="color: rgb(184, 49, 47)"> HCT:</span> Hematocrit; <span style="color: rgb(184, 49, 47)">E2:</span> Estradiol; <span style="color: rgb(184, 49, 47)">PSA:</span> prostate-specific antigen</strong></p></blockquote><p></p>
[QUOTE="madman, post: 191015, member: 13851"] [B]Comparison of Outcomes for Hypogonadal Men Treated with Intramuscular Testosterone Cypionate Versus Subcutaneous Testosterone Enanthate (2020) Introduction[/B] [I][COLOR=rgb(184, 49, 47)]Intramuscular testosterone cypionate (IM-TC) is the conventional treatment option for hypogonadal men with baseline serum total testosterone (TT) less than 300 ng/dL; however, significant peaks in testosterone cause adverse effects including polycythemia and a rise in estradiol (E2). [/COLOR][/I][COLOR=rgb(44, 130, 201)][I]Subcutaneous testosterone enanthate-autoinjectors (SCTE-AI) were designed with a lower testosterone peak-to-trough ratio of 1.8. [/I][/COLOR] [COLOR=rgb(0, 0, 0)][B]Objective[/B] [I]This dual-institutional study compared the TT, hematocrit (HCT), E2, and prostate-specific antigen (PSA) response to treatment with IM-TC versus SCTE-AI.[/I][/COLOR] [B]Methods[/B] [I]263 hypogonadal men were treated with testosterone replacement therapy (TRT) via IM-TC or SCTE-AI. TT, HCT, E2, and PSA levels were obtained at baseline and 6- to 12-weeks post-treatment. Significant differences in baseline and post-treatment levels were identified by univariate analysis. Linear regression models determined whether treatment modality was independently associated with post-TRT levels of TT, HCT, E2, and PSA.[/I] [B]Results[/B] [COLOR=rgb(184, 49, 47)][I]Patients treated with SCTE-AI were significantly younger and had lower baseline TT levels, and lower baseline E2 levels (Table 1). Post-TRT, the SCTE-AI cohort had significantly lower HCT and E2, while TT and PSA levels were not significantly different between the treatment arms.[/I][/COLOR] [I][COLOR=rgb(44, 130, 201)]After adjusting for significant differences with linear regression, SCTE-AI was associated with a 14% greater increase in trough TT levels compared to IM-TC (p=0.027). Furthermore, SCTE-AI was independently associated with 41% and 26.5% lower post-therapy HCT (p<0.001) and E2 (p<0.001) levels, respectively, when compared to IM-TC.[/COLOR] [/I][COLOR=rgb(26, 188, 156)][I]Neither TRT modality was associated with post-therapy elevation of PSA (p=0.691).[/I][/COLOR] [B]Conclusions [I][COLOR=rgb(184, 49, 47)]While IM-TC and SCTE-AI [U]provide a significant increase in testosterone, SCTE-AI is associated with lower levels of post-therapy HCT and E2 compared to IM-TC after adjusting for significant covariates[/U].[/COLOR][/I][/B] [COLOR=rgb(44, 130, 201)][I][B]SCTE-AI is an effective testosterone delivery system with a preferable safety profile over IM-TC. [/B][/I][/COLOR] [ATTACH type="full" alt="injections.jpg"]11735[/ATTACH] [URL unfurl="true"]https://www.excelmale.com/forum/threads/how-to-inject-testosterone-intramuscularly-shallow-im-or-subcutaneously.8858/[/URL] [COLOR=rgb(44, 130, 201)][I][B] [/B][/I][/COLOR] [B]Table 1. [COLOR=rgb(184, 49, 47)]Clinical demographics and treatment outcomes of intramuscular testosterone cypionate [/COLOR][COLOR=rgb(0, 0, 0)](IM-TC)[/COLOR][COLOR=rgb(184, 49, 47)] compared to subcutaneous testosterone enanthate-autoinjector [/COLOR][COLOR=rgb(0, 0, 0)](SCTE-AI)[/COLOR][COLOR=rgb(184, 49, 47)]. [/COLOR][/B] [TABLE][TR][TD] [/TD] [TD] IM-TC [/TD] [TD] SCTE-AI [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] [/TD] [TD] n=188 [/TD] [TD] n=114 [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] [/TD] [TD] mean (SD) [/TD] [TD] mean (SD) [/TD] [TD] [I]p[/I]-value [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] Age [/TD] [TD] 54.4 (13.4) [/TD] [TD] 49.7 (10.5) [/TD] [TD] [B]0.001[/B] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] [I]Pre-Therapy[/I] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] TT [/TD] [TD] 313.6 (263) [/TD] [TD] 249.6 (113) [/TD] [TD] [B]0.006[/B] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] HCT [/TD] [TD] 45.2 (4.2) [/TD] [TD] 44.8 (3.4) [/TD] [TD] 0.453 [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] E2 [/TD] [TD] 30.4 (15.5) [/TD] [TD] 25.3 (9.2) [/TD] [TD] [B]0.004[/B] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] PSA [/TD] [TD] 1.4 (1.8) [/TD] [TD] 1.1 (0.8) [/TD] [TD] 0.072 [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] [I]Post-Therapy[/I] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] TT [/TD] [TD] 536.4 (295) [/TD] [TD] 552.5 (207) [/TD] [TD] 0.629 [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] HCT [/TD] [TD] 48.4 (4.4) [/TD] [TD] 46.3 (3.8) [/TD] [TD] [B]<0.001[/B] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] E2 [/TD] [TD] 46.6 (25.9) [/TD] [TD] 33.0 (15.4) [/TD] [TD] [B]<0.001[/B] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] PSA [/TD] [TD] 1.3 (1.3) [/TD] [TD] 1.2 (0.9) [/TD] [TD] 0.565 [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR] [TR][TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD] [TD] [/TD][/TR][/TABLE] [B][COLOR=rgb(184, 49, 47)]TT: [/COLOR]Total Testosterone;[COLOR=rgb(184, 49, 47)] HCT:[/COLOR] Hematocrit; [COLOR=rgb(184, 49, 47)]E2:[/COLOR] Estradiol; [COLOR=rgb(184, 49, 47)]PSA:[/COLOR] prostate-specific antigen[/B] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
IM versus Sub-q T Injections: Effect on TT, hematocrit, E2, and PSA
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