Shallow Testosterone IM versus SubQ Injections - Lab Results

[xqfq]

Thank you for sharing this interesting information & data with us. I think I will do a similar experiment at some point as well. I notice no major difference between subQ and shallow IM, but I do think subQ takes longer to "kick in" (or it feels that way).

For me, the "direct" RIA free T tracks pretty well with my symptoms, much better than total testosterone or Tru-T. Vermeulen calculated free T tracks well too. I have recorded my symptom status daily in Nelson's TRT Analyzer app for the past couple of years.

I appreciate posts like this and I hope more people share similar. No one would assume this post is a comprehensive, definitive analysis of subQ versus IM - it is just someone providing some interesting information. There are many such posts on E2 changes with frequent injections, HCT, etc.

 

[tareload]

If his TT drops by 26% and his albumin, E2 and SHBG barely budge, isn't it likely that his FT also took a significant hit?

The point is we don't have an appropriate assessment of his TT levels for each case to allow a means comparison. We have n=1 and there's no ability to draw a statistically meaningful conclusion from these data. There is variability in the method and variability with the patient. My 7 day trough TT value is 600 ng/dl +/- 100 ng/dl after many replicates with same lab and assay and same protocol. So you would design a study to get replicates at SS for both cases which would allow a means comparison and determine...

1. Was his TT level different for the two cases? Use student t-test or other more sophisticated means comparison method.
2. Using accurate fT method or cfT calc, was his fT levels different?

But of course we shouldn't discourage our members from collecting and reporting these data. It's great just incomplete (again not knocking the OP unless he is a trained scientist).

 

[Willyt]

Highly doubtful his FT dropped drastically.

As stated previously I would even put more weight behind the cFTZ let alone cFTV over the piss poor direct immunoassay.

Even when using the calculated method his FT would not be cut in half.

Where did I say that his FT "dropped drastically"? Nor did I say it was cut in half. I merely said that there was a "significant" drop in TT/FT based on the fact that the guy experienced a 26% drop in TT with no change to albumin, E2 and SHBG. Are you disputing that his FT most likely decreased on subq? It's a simple yes or no answer.

 

[tareload]

Are you disputing that his FT most likely decreased on subq? It's a simple yes or no answer.

Yes. I would happily challenge that conclusion and I put forth a plan to test the hypothesis up above.

We don't have the information (yet) that is needed to conclude his fT was different for the two cases.

 

[Willyt]

The point is we don't have an appropriate assessment of his TT levels for each case to allow a means comparison. We have n=1 and there's no ability to draw a statistically meaningful conclusion from these data. There is variability in the method and variability with the patient. My 7 day trough TT value is 600 ng/dl +/- 100 ng/dl after many replicates with same lab and assay and same protocol. So you would design a study to get replicates at SS for both cases which would allow a means comparison and determine...

1. Was his TT level different for the two cases? Use student t-test or other more sophisticated means comparison method.
2. Using accurate fT method or cfT calc, was his fT levels different?

But of course we shouldn't discourage our members from collecting and reporting these data. It's great just incomplete (again not knocking the OP unless he is a trained scientist).

Who in their right mind would still want to post comparative test results on this forum? I've seen this nitpicking happen on several recent threads. The OP goes out of his way to contribute to the members' understanding of subq vs shallow IM and he gets shit on.
The fact is the OP confirmed what many of us have experienced first hand, regardless of what the studies may say.

 

[tareload]

Who in their right mind would still want to post comparative test results on this forum? I've seen this nitpicking happen on several recent threads. The OP goes out of his way to contribute to the members' understanding of subq vs shallow IM and he gets shit on.

Shit on? Speaking for myself, I shit on no one.

But to your point, no one said learning, science and all that is always fun and pleasurable. As someone or multiple people have said....the educational value of something is often inversely proportional to its entertainment value. Science is NOT here for our entertainment or convenience. It doesn't care in the slightest for your convenience, respectfully.

But it is fun to watch all those YouTube videos. Wonder what that says about their educational value?

 

[madman]

Where did I say that his FT "dropped drastically"? Nor did I say it was cut in half. I merely said that there was a "significant" drop in TT/FT based on the fact that the guy experienced a 26% drop in TT with no change to albumin, E2 and SHBG. Are you disputing that his FT most likely decreased on subq? It's a simple yes or no answer.

You stated.....Getting back to the original post, did you notice any effect on your libido when you switched to subq considering the significant drop in TT/FT?

My bad it should have said dropped significantly.

This is still going over your head.

His results show that TT and FT are lower on sub-q compared to IM.

FT was tested using the piss poor direct immunoassay which is known to be inaccurate.

I am not doubting that his FT is lower but highly doubt it was a significant drop let alone dropped drastically.


He stated:

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

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.


Again his FT was tested using an inaccurate assay.

He is claiming that his FT dropped significantly which is misleading, to say the least!

The piss poor direct immunoassay which is known to be inaccurate should not be used/relied upon when testing FT.

 

[madman]

Who in their right mind would still want to post comparative test results on this forum? I've seen this nitpicking happen on several recent threads. The OP goes out of his way to contribute to the members' understanding of subq vs shallow IM and he gets shit on.
The fact is the OP confirmed what many of us have experienced first hand, regardless of what the studies may say.

What using a garbage assay to test FT.

Is that truly a fair comparison?

Misleading if anything.

Where are you going with this?

No one was denying that his TT/FT are lower on sub-q.

Doubting his FT dropped significantly.

The s**t kicker of the trial was comparing labs using inaccurate assays especially FT.


post #16

 

[madman]

Who in their right mind would still want to post comparative test results on this forum? I've seen this nitpicking happen on several recent threads. The OP goes out of his way to contribute to the members' understanding of subq vs shallow IM and he gets shit on.
The fact is the OP confirmed what many of us have experienced first hand, regardless of what the studies may say.

I see Gman86 still gonna be left scratching his head!

Liking those posts out of spite.

We know what he is all about.

Funny how the herd is all of a sudden coming out of the woodwork hitting that like button.

They would all have you believing the OPzzz FT is in the gutter let alone injecting T strictly sub-q is a disaster!

This is classic.

 

[madman]

Where did I say that his FT "dropped drastically"? Nor did I say it was cut in half. I merely said that there was a "significant" drop in TT/FT based on the fact that the guy experienced a 26% drop in TT with no change to albumin, E2 and SHBG. Are you disputing that his FT most likely decreased on subq? It's a simple yes or no answer.

Hard to believe you would be asking such.

Unreal.


post #3

My reply:

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.

 

[bixt]

Liking those posts out of spite

Stop acting like an emo teenage girl. This aint instagram.

Condecending words like "piss poor" and "BRUH" are unbecoming of a moderator.

Please stick to the science, we all really do enjoy your writeups, which are top notch. But shooting down others ideas emotively is a big turn off. You will win way more people over with a soft and kind approach.

As to the whole subq/im FT/TT levels issue, a lot of fingers are absolutely pointing in the direction for further research. The books are not closed and the knowledge of TRT is not absolute and complete. Stop trying to be the final word on this issue.

Lets ignore the FT issue. There is def some TT "missing" which has been "lost", vanished into thin air, for some men. In those men, where has it dissapeared? There are lots of examples as I keep saying across various boards.

While on average the studies may show similar levels, they may not show the variabity for each sample between IM/subq. Im sure there are many such outliers. Perhaps these are the "special cases", and lets not forget its the special cases seeking help here!

Keep an open mind, this hypothesis is developing.

 

[GreenMachineX]

Hard to believe you would be asking such.

Unreal.


post #3

My reply:

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.

If you actually wanted to help people, using more tact would work very well.

 

[Willyt]

No one was denying that his TT/FT are lower on sub-q.

Fine we can actually agree on something instead of endlessly debating what "significantly" means lol.

For the record, I have become a fan of subq over the past several months despite the fact that it has resulted in a different subjective experience on Propionate. Subq has made prop a bit less intense and more even, which is a major positive. My guess is that the peak is lower. At some point, I will spend the $$ to test against IM results, but I sure as hell won't be posting my results on here anymore.

 

[tareload]

but I sure as hell won't be posting my results on here anymore.

Why? I appreciate the effort folks put in to share and I'd like to see them.

 

[madman]

Stop acting like an emo teenage girl. This aint instagram.

Condecending words like "piss poor" and "BRUH" are unbecoming of a moderator.

Please stick to the science, we all really do enjoy your writeups, which are top notch. But shooting down others ideas emotively is a big turn off. You will win way more people over with a soft and kind approach.

As to the whole subq/im FT/TT levels issue, a lot of fingers are absolutely pointing in the direction for further research. The books are not closed and the knowledge of TRT is not absolute and complete. Stop trying to be the final word on this issue.

Lets ignore the FT issue. There is def some TT "missing" which has been "lost", vanished into thin air, for some men. In those men, where has it dissapeared? There are lots of examples as I keep saying across various boards.

While on average the studies may show similar levels, they may not show the variabity for each sample between IM/subq. Im sure there are many such outliers. Perhaps these are the "special cases", and lets not forget its the special cases seeking help here!

Keep an open mind, this hypothesis is developing.

Emu girl.....had to look it up.....where are you hanging out?

Fetish?

Woodwork.....Nuff said!

Again no one was ever denying that some men may hit lower TT/FT level injecting sub-q let alone not feel good on such protocol.

This is coming from you in a previous thread.....Sadly every time this issue is observed - and the reported sample is large now - a really stubborn member called @madman persistently argues against it.

Again do you really think those that lurk on the forums represent most men on trt.....LMFAO

Another N=1 and you are jumping the gun.....Sadly every time this issue is observed - and the reported sample is large now - a really stubborn member called @madman persistently argues against it.

Let me guess.....injecting sub-q is inferior to IM.....LOL

9.5 weeks in the OP did state.....How do I feel? I feel pretty good but not as good as I felt on the shallow IM injections.




*Sadly every time this issue is observed - and the reported sample is large now - a really stubborn member called @madman persistently argues against it.

Now, why is that?

All those N=1 scattered on the bro forums are on point when it comes to 1-6.....right?

LMFAO!

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. Each protocol needs to be given 12 weeks


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




*Lets ignore the FT issue.

Let's not especially when it comes to point 5!

 

[madman]

Fine we can actually agree on something instead of endlessly debating what "significantly" means lol.

For the record, I have become a fan of subq over the past several months despite the fact that it has resulted in a different subjective experience on Propionate. Subq has made prop a bit less intense and more even, which is a major positive. My guess is that the peak is lower. At some point, I will spend the $$ to test against IM results, but I sure as hell won't be posting my results on here anymore.

Bring your A-game....use the most accurate assays!

 

[solothesensei]

This is the problem here.

You are going to have newbies let alone people who still use/rely upon inaccurate assays thinking that injecting strictly Sub-q caused his FT to drop drastically.

Misleading, to say the least!

Hi madman,

I think you misunderstood what I said.

Do you notice I used a qualifying statement on the drop in FT? I said - "if the labs are directionally accurate".

I'm not ruling out the assay method which is what you're arguing for (I actually agree that is a huge issue!).

I'm sure you'll agree with me on this - even if the assay is imperfect, the results can be directionally accurate.

 

[solothesensei]

Respectfully,

no, no, and no on these 3 bullet points.

Just as an example, box plot or table your own Trough TT readings from last 5 blood tests on the same protocol. Mean +/- SD?

What does this tell you?

While the OPs data is appreciated and respected, there's much more work you'd have to do to chase down the TT story and of course the fT story going on here.

Look at bullet point 1....making a transient argument for a SS result. OP is injecting every day. Nice setup by the way, @MarkM

Thanks for your comment, I stand corrected that my TT explanation is logically insufficient.

I'd like to point out an issue with the study you quoted on the 14 transgender males though.

Looking at the actual study, I notice that the IM readings were taken on week 3, but the SC readings were taken on week 11. This is hardly fair for comparison. If anything, the correct IM measurements (if done on week 11) should be significantly higher, statistically.

Here's the excerpt: During the intensive pharmacokinetic testing weeks, total testosterone exposure, as measured by the mean ± S.D. AUC after i.m. injection (during week 3) (1.9 ± 0.6 nmol·days/L/mg), was not significantly different from that during the subcutaneous regimen (week 11) (1.7 ± 0.6 nmol·days/L/mg)

 

[tareload]

Thanks for your comment, I stand corrected that my TT explanation is logically insufficient.

I'd like to point out an issue with the study you quoted on the 14 transgender males though.

Looking at the actual study, I notice that the IM readings were taken on week 3, but the SC readings were taken on week 11. This is hardly fair for comparison. If anything, the correct IM measurements (if done on week 11) should be significantly higher, statistically.

Here's the excerpt: During the intensive pharmacokinetic testing weeks, total testosterone exposure, as measured by the mean ± S.D. AUC after i.m. injection (during week 3) (1.9 ± 0.6 nmol·days/L/mg), was not significantly different from that during the subcutaneous regimen (week 11) (1.7 ± 0.6 nmol·days/L/mg)

Methods: In a prospective, open-label, crossover study, adult participants already on stable i.m. testosterone gender-affirming therapy self-injected testosterone cypionate or enanthate i.m. for 3 weeks followed by subcutaneous injections for 8 weeks. Trough serum testosterone concentrations were determined weekly, and serial total serum testosterone (TST) concentrations were determined on postinjection days 1, 3, and 5 of weeks 3 and 11. Hemoglobin and alanine transaminase (ALT) levels were measured at week 3 (the first visit), with repeat measurements at week 11 (the final visit). The dose-normalized area under the time-concentration curve (AUC) was calculated during weeks 3 and 11.


They were already at SS with IM prior to study starting. So 3 weeks or 11 weeks, wouldn't matter for the intensive sampling.

 

[solothesensei]

Methods: In a prospective, open-label, crossover study, adult participants already on stable i.m. testosterone gender-affirming therapy self-injected testosterone cypionate or enanthate i.m. for 3 weeks followed by subcutaneous injections for 8 weeks. Trough serum testosterone concentrations were determined weekly, and serial total serum testosterone (TST) concentrations were determined on postinjection days 1, 3, and 5 of weeks 3 and 11. Hemoglobin and alanine transaminase (ALT) levels were measured at week 3 (the first visit), with repeat measurements at week 11 (the final visit). The dose-normalized area under the time-concentration curve (AUC) was calculated during weeks 3 and 11.


They were already at SS with IM prior to study starting. So 3 weeks or 11 weeks, wouldn't matter for the intensive sampling.

Much appreciated on the clarification.

If I may further tap on your knowledge - is it at all possible to monitor E2 or FT levels if there are no laboratories in my country that performs the LC-MS (for E2) and Equilibrium Dialysis (for FT)?

For example, I've heard the ECLIA test for E2 confounds with C-reactive protein. Would it be feasible then, to take the ECLIA reading and deduct the CRP reading to get the true reading for E2?