Injecting test cyp eod/ed IM

[canatct]

51 years young. 6' and 265 lbs, but not obese at all but could lose around 40 lbs. I walk by a gym and grow muscle lol. I actually started riding a bike to get away from the muscles and now my quads are huge.
I've been on prescribed test cyp for over 1 year now. IM e4d for the most part. Tried eod subq for a while but total and free T plummeted while e2 went up. (I started a thread with bw results last summer). I got on board with DEFY and added HCG daily. I also use Anastrozole for e2. My numbers from the last 2 blood draws look ok, but I'm still chasing e2 symptoms.
I just had blood drawn 2/12 so those results should be in by mid week.
I have a follow up with DEFY in a couple weeks and thinking about asking about going to eod our even ed IM. I have seen where some of you are doing this.
I read where one member tried eod and the half life stacked up on him. I understand half-life but can someone explain how the half life can "stack up"?
I also have read where guys are doing test and hcg in one syringe. Is it ok to mix the 2?
Also, I have been using 25g 1" for delt and quad IM with no problem, but I wouldn't want to use it for eod or ed.
I have 27g 1/2" needles that I can use.
Would shallow IM be the same as deep IM?
Thanks folks

 

[CoastWatcher]

I inject test enth, 16mg, daily, very shallow IM. Steady testosterone levels (total +- 910, and free +- 23), and I've never taken an AI. I went from injecting every 3.5 days to daily because my e2 was climbing very slowly. If you lost some of the 40 pounds you mentioned that could have a significant impact on lowering your estradiol. I know when I lost six pounds last summer it contributed to my e2's decline.

 

[canatct]

I saw where you posted before you used a 29g 5/8 needle. Is that a one piece or just the needle? I've called the local pharmacies and non can even find that size.

 

[ERO]

That is a standard insulin syringe size. Get them here very inexpensively.

 

[tumbleweed]

Regarding half life "stacked up".
For simple math if you inject 50 mg cyp eod, that would be 250 mg in 9 days. Let's call half life 9 days.
Again for simple math day 9 you will have 125 plus another 250 for next 9 days, that's 375. Next 9 day period it will be 75+125+250= 450. And it keeps building like that.

Again, this is a simple example to demonstrate. With eod injections it's a bit more complicated to get exact numbers without an algebraic formula.

 

[canatct]

That is a standard insulin syringe size. Get them here very inexpensively.

Thanks for the link but those are 1/2". Does anyone have a link to the 29g 5/8"?

 

[ERO]

Let me Google that for you....

 

[canatct]

Let me Google that for you....

Lol. I just know you would love me if we met in person.
I thought I read a couple posts where guys were using 29g x 5/8" needles. I googled and found nothing. Maybe it was a typo and/or I'm over thinking this stuff.

 

[CoastWatcher]

Lol. I just know you would love me if we met in person.
I thought I read a couple posts where guys were using 29g x 5/8" needles. I googled and found nothing. Maybe it was a typo and/or I'm over thinking this stuff.

I am in Canada and my doctor provides them. Don't get too hung up on the needle size; an insulin syringe will do the trick (I have used them before).

 

[Jackie Treehorn]

I also have read where guys are doing test and hcg in one syringe. Is it ok to mix the 2?

That's Nelson's technique. I know there are some guys on this forum (Vince?) that are using it, and are very happy with it. I personally don't mix the two, and hate pinning into my deltoids...so it's a no-go for me.

Also, I have been using 25g 1" for delt and quad IM with no problem, but I wouldn't want to use it for eod or ed.
I have 27g 1/2" needles that I can use.
Would shallow IM be the same as deep IM?
Thanks folks

You must be a glutton for punishment. I've said this many times before...there's no need to harpoon yourself in the quad (or deltoid, for that matter) with a 1"/25ga needle. I use a 1/2"/29ga insulin pin, and it works like a champ. I really don't have any fat on my quads, so the 1/2" needle is probably going shallow IM. No leakage/pain. Just take your time loading the syringe (takes me about 75-90 seconds), inject slowly, and apply immediate pressure for a minute immediately after needle removal.

 

[ERO]

Lol. I just know you would love me if we met in person.
I thought I read a couple posts where guys were using 29g x 5/8" needles. I googled and found nothing. Maybe it was a typo and/or I'm over thinking this stuff.

The hyperlink will take you to the results- lots of sources for them and you can get them on Amazon.com as well, although their prices for them is often higher than other sources.

 

[Dr Justin Saya MD]

Regarding half life "stacked up".
For simple math if you inject 50 mg cyp eod, that would be 250 mg in 9 days. Let's call half life 9 days.
Again for simple math day 9 you will have 125 plus another 250 for next 9 days, that's 375. Next 9 day period it will be 75+125+250= 450. And it keeps building like that.

This is a commonly missed question/topic on the USMLE (US Medical Licensing Exam)...so don't feel bad about this clarification. It is a generally applicable pharmacologic phenomenon that a med/drug will reach a RELATIVE steady state after approximately 4-5 half lives. Thus, for T cyp assuming a half-life of 7-8 days, a relative steady state will be reached after approximately 35 days (give or take). This DOES NOT mean that your levels will be steady and not fluctuate after 35 days (as they will fluctuate after that point primarily as a function of injection frequency), but it does mean that the "stacking" or "stepwise increase" due to half life will stop after that point as long as the dosage remains the same (i.e. Your levels will not continue "stacking" indefinitely). Of note, THIS is the reason why I often encourage folks to wait AT LEAST 5 weeks after making changes to recheck their labs (and also why folks who make too frequent of changes get stuck chasing their tail).

Now if you've read my previous commentary on TRUE steady state with daily injections you will note that, with daily injections, you would also achieve the relative steady state after ~35 days (i.e. no more climbing/stacking), but ALSO benefit from a TRUE steady state of minimal fluctuation in daily levels (or levels across days) when compared to weekly, BIW, TIW injections due to the frequency of administration. Hope this makes sense.

 

[tumbleweed]

I don't fell bad about your clarification of my post. It's great to have real doctors on here to help people with facts and information.

 

[canatct]

Thanks for the post Dr Saya.

When switching from e4d to ed injections should a guy expect to feel some low T symptoms until a steady state is achieved?

 

[CoastWatcher]

Thanks for the post Dr Saya.

When switching from e4d to ed injections should a guy expect to feel some low T symptoms until a steady state is achieved?

Speaking only for myself, I noticed my body adjusting for about ten days when I went from injecting every 3.5 days to daily injections. I didn't necessarily feel "bad", but certainly less focused. It took about six weeks before I achieved, subjectively, what I had set out to achieve.

 

[canatct]

Speaking only for myself, I noticed my body adjusting for about ten days when I went from injecting every 3.5 days to daily injections. I didn't necessarily feel "bad", but certainly less focused. It took about six weeks before I achieved, subjectively, what I had set out to achieve.

Thanks for your reply. I know that we all respond differently but it's good to hear from others like yourself.

 

[Dr Justin Saya MD]

Thanks for the post Dr Saya.

When switching from e4d to ed injections should a guy expect to feel some low T symptoms until a steady state is achieved?

Coastwatcher summarized it pretty well. An "adjustment" period is expected...now whether or not low T symptoms are experienced is variable. After ANY changes to the regimen, balance/steady state takes a solid ~5 weeks.

 

[canatct]

Coastwatcher summarized it pretty well. An "adjustment" period is expected...now whether or not low T symptoms are experienced is variable. After ANY changes to the regimen, balance/steady state takes a solid ~5 weeks.

Thanks Dr Saya. I'm due for a follow up in March so we'll discuss what I should do then.

 

[canatct]

Another question.
I understand the e2 fluctuations with days or weeks between injecting.
If your T reaches a steady state with ed injections that means your e2 should as well. What if that number or state causes high e2 symptoms? One would still have to use an ai, right?
I have no trouble with My total and free T. It's the e2. My baseline e2 before trt was 16 on the sensitive test, but that was with total T <300 on a 300-1000 scale. And I know how you feel trumps a number but I feel sometimes like I'm chasing Bigfoot.
I catch a glimpse every once in a while but that's about it.

 

[Vince Carter]

A baseline number means nothing at all, it has zero bearing on your care once you start TRT.
The E is the part toughest to manage, once you achieve that steady state, get re-tested (TT/FT/Sens E2), and make SMALL changes from there. If you're doing EOD or ED injections, you shouldn't need an AI at any point on that kind of schedule, it's just about a "rule" unless there's another medical issue driving it, that no AI is needed with EOD/ED. People make the very common mistake of taking big swings at their meds, they feel this or they feel that and coupled with any anxiety, muck things up without ever getting to the steady state. Or lack the committment to the dosing and schedule.
There's a real fallacy to the notion that "I feel bad TODAY, so I have to do SOMETHING, TODAY, to fix it!", and that's just a path to failure with TRT.