Subq/IM differences and issues. Has anyone experienced this?

[DiegoG]

Having trouble dialing in due to one issue. I feel great on Subq injections and my dose is 70mgs a week split into EOD injections. This brings my total T - 729, free t - 156.7 and E2 - 38. My problem is that my constipation returns exactly after 4 weeks of doing subq. I had constipation before TRT and when I first started I was doing deep IM injections and after about 3 weeks my bowls cleared out like never before and my constipation issue disappeared completely, until I did subq. I switched because I could just not get dialed in on IM. I was having huge flucations on mood, energy, libido and ED all over the place no matter what I did. I tried 120mgs to 140mgs. 140mgs or more caused hot flashes, ED, acne, mood swings, insomnia, etc. and anything less than 120mgs brings back all my low t symptoms on deep IM. I was splitting my dose up into eod injections with IM also but it just felt like a constant roller coaster. When I switched to subq everything disappeared. Completely stable. No hot flashes, no ed, no mood issues, libido through the roof, slept perfect and then boom 4 weeks comes and my constipation returns exactly at 4 weeks. I've done this test now 3 times and waited 8 weeks each time before making changes.

My SHBG has stayed between 16-18 for the last year now. I've read a lot of mixed things about it and how it can affect your trt protocol. Has anybody experienced constipation with subq? were you able to remediate the issue? Anyone have any ideas? I've been researching as much as I can but can't find anything on this. Thanks.

@Nelson Vergel

 

[Systemlord]

Has anybody experienced constipation with subq?

First I’ve heard of it. I wouldn’t worry about SHBG.

 

[tropicaldaze1950]

Having trouble dialing in due to one issue. I feel great on Subq injections and my dose is 70mgs a week split into EOD injections. This brings my total T - 729, free t - 156.7 and E2 - 38. My problem is that my constipation returns exactly after 4 weeks of doing subq. I had constipation before TRT and when I first started I was doing deep IM injections and after about 3 weeks my bowls cleared out like never before and my constipation issue disappeared completely, until I did subq. I switched because I could just not get dialed in on IM. I was having huge flucations on mood, energy, libido and ED all over the place no matter what I did. I tried 120mgs to 140mgs. 140mgs or more caused hot flashes, ED, acne, mood swings, insomnia, etc. and anything less than 120mgs brings back all my low t symptoms on deep IM. I was splitting my dose up into eod injections with IM also but it just felt like a constant roller coaster. When I switched to subq everything disappeared. Completely stable. No hot flashes, no ed, no mood issues, libido through the roof, slept perfect and then boom 4 weeks comes and my constipation returns exactly at 4 weeks. I've done this test now 3 times and waited 8 weeks each time before making changes.

My SHBG has stayed between 16-18 for the last year now. I've read a lot of mixed things about it and how it can affect your trt protocol. Has anybody experienced constipation with subq? were you able to remediate the issue? Anyone have any ideas? I've been researching as much as I can but can't find anything on this. Thanks.

@Nelson Vergel

You're the only other person I've read who has/had issues with constipation related to testosterone dosing!

I was using test propionate in the morning. About 7 hours later I'd have a bowel movement. I continued with that protocol and it was predictable but I physically didn't feel good on test P(Empower). When I got back on rx test enanthate I experimented with the timing of my IM injection and found that if I take it at 6 pm I'd have a good bowel movement between 7 & 8 in the morning. To note; I've had bipolar disorder for 20 years and my HPA axis/body clock don't function the way they did before the onset of the illness.

 

[Vince]

I'm sure your testosterone levels has nothing to do with your constipation. Have you ever tried adding better food into your diet. Non-starchy vegetables and good, healthy nuts. I always try to eat both daily.

 

[NomDePlume]

A bit off topic, but I'm curious as to the difference (if any) of the half life using SubQ vs IM for, say Test E or Deca Durabolin.

 

[Vince]

A bit of topic, but I'm curious as to the difference (if any) of the half life using SubQ vs IM for, say Test E or Deca Durabolin.

Search results for query: SubQ vs IM

www.excelmale.com

 

[tropicaldaze1950]

I'm sure your testosterone levels has nothing to do with your constipation. Have you ever tried adding better food into your diet. Non-starchy vegetables and good, healthy nuts. I always try to eat both daily.

There is a connection between testosterone and gut motility.

J Clin Invest. 2022 Jan 18; 132(2): e150789.
Published online 2022 Jan 18. doi: 10.1172/JCI150789
PMCID: PMC8759776
PMID: 34847080

Diminished androgen levels are linked to irritable bowel syndrome and cause bowel dysfunction in mice​

Daniella Rastelli,1,2 Ariel Robinson,1 Valentina N. Lagomarsino,1 Lynley T. Matthews,2 Rafla Hassan,3 Kristina Perez,1 William Dan,4 Peter D. Yim,4 Madison Mixer,1 Aleksandra Prochera,1 Amy Shepherd,1 Liang Sun,5 Kathryn Hall,6 Sarah Ballou,3 Anthony Lembo,3 Judy Nee,3 and Meenakshi Rao[IMG alt="corresponding
author"]https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/corrauth.gif[/IMG]1,2

Importance of Testosterone for Proper Digestive Health Brooklyn NY

Gastroenterologist Dr Alexander Shapsis explains the importance of testosterone for proper digestive health. Visit Atlantic Gastroenterology in Brooklyn NY

www.atgastro.com

 

[tropicaldaze1950]

Vince, I would not have made the connection, either, if I didn't experience it. And I eat fruits, vegetables, beans and nuts. Not even high dose vitamin C or magnesium was helping. It's an odd one, even for me! I've just started back on desiccated thyroid, taking it at night, in an attempt to improve my sleep and slowly get off of clonazepam.

 

[Vince]

Vince, I would not have made the connection, either, if I didn't experience it. And I eat fruits, vegetables, beans and nuts. Not even high dose vitamin C or magnesium was helping. It's an odd one, even for me! I've just started back on desiccated thyroid, taking it at night, in an attempt to improve my sleep and slowly get off of clonazepam.

The article says low testosterone causes gut issues. So what you telling me is you need to increase your testosterone levels?

I have no gut issues. I'll show you my levels.

Vince's Labs for October 2023

I haven't changed 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 1/2 hrs. Labs are from LabCorp. Testosterone, Serum 1417 ng/dL range 264-916 Free Testosterone 47.8 ng/dL...

www.excelmale.com

 

[tropicaldaze1950]

The article says low testosterone causes gut issues. So what you telling me is you need to increase your testosterone levels?

I have no gut issues. I'll show you my levels.

Vince's Labs for October 2023

I haven't changed 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 1/2 hrs. Labs are from LabCorp. Testosterone, Serum 1417 ng/dL range 264-916 Free Testosterone 47.8 ng/dL...

www.excelmale.com

I can't explain it. All I've observed is that my gut works fine if, minus the ester, I'm deriving at least 20 mg or more of testosterone, irrespective of injection frequency, though I was doing 100 mg E5D, then went to 70 mg twice a week. I know your total and free T are good. I've told my urologist. He and I agree that I'm a puzzle.

 

[Vince]

I can't explain it. All I've observed is that my gut works fine if, minus the ester, I'm deriving at least 20 mg or more of testosterone, irrespective of injection frequency, though I was doing 100 mg E5D, then went to 70 mg twice a week. I know your total and free T are good. I've told my urologist. He and I agree that I'm a puzzle.

Reduced testosterone levels have been linked to the onset and severity of irritable bowel syndrome. As a result, low testosterone levels can actively damage the gut, leading to increased inflammation and even lower testosterone levels – a vicious cycle that can gradually erode health and encourage disease.

Men’s Health Clinic Near Me | American Male Medical › ...

Can Low Testosterone Cause Digestive Problems? - American Male Medical​

 

[Vince]

Now I wonder if gut issues causes low testosterone or contributes to it?

 

[tropicaldaze1950]

Now I wonder if gut issues causes low testosterone or contributes to it?

The microbiome has emerged as major factor in human health and function. Though I do have a long history of IBS, a comorbidity of bipolar illness, bipolar is a neuroendocrine disorder. From the brain to the gut to the immune system to the endocrine system to the autonomic nervous system; there's no there. A psychiatrist/molecular geneticist I once emailed told me the genomes of patients with bipolar show system wide damage. It's discouraging. Additionally, on my late father's side, there's trauma, depression, addiction and suicide.

"Life is not a matter of holding good cards, but of playing a poor hand well."

Robert Louis Stevenson

 

[Vince]

The microbiome has emerged as major factor in human health and function. Though I do have a long history of IBS, a comorbidity of bipolar illness, bipolar is a neuroendocrine disorder. From the brain to the gut to the immune system to the endocrine system to the autonomic nervous system; there's no there. A psychiatrist/molecular geneticist I once emailed told me the genomes of patients with bipolar show system wide damage. It's discouraging. Additionally, on my late father's side, there's trauma, depression, addiction and suicide.

"Life is not a matter of holding good cards, but of playing a poor hand well."

Robert Louis Stevenson

I believe the best place to start is with a person's diet.

 

[tropicaldaze1950]

I believe the best place to start is with a person's diet.

No disagreement, Vince. There are three cutting edge psychiatrists in the Boston area, all who place a major emphasis on diet; tending mostly to a keto diet. But they also use medications. I do wish that most physical and/or mental illness was resolved by diet, alone but I've yet to see it. People with mastocytosis have to follow a strict, low histamine diet. Some can only eat two or three foods. And they use medication(s) also. IMO, if there was overwhelming evidence that diet, alone, could manage or even eliminate illness, particularly mental illnesses, I believe even conservative doctors would be on board.

Again, none of what I wrote is to dismiss the role of diet in health and wellness, but because of how doctors are trained and how little they learn about nutrition, as well as hormones, unless he or she makes an effort to learn, once they've completed their residency, we end up with more doctors who only know the 'sick care model' of medicine, as @Systemlord always reminds us. So then, it's up to each person to be their own physician; to research, to experiment on themselves and hopefully, improve their health and their life.

 

[Vince]

No disagreement, Vince. There are three cutting edge psychiatrists in the Boston area, all who place a major emphasis on diet; tending mostly to a keto diet. But they also use medications. I do wish that most physical and/or mental illness was resolved by diet, alone but I've yet to see it. People with mastocytosis have to follow a strict, low histamine diet. Some can only eat two or three foods. And they use medication(s) also. IMO, if there was overwhelming evidence that diet, alone, could manage or even eliminate illness, particularly mental illnesses, I believe even conservative doctors would be on board.

Again, none of what I wrote is to dismiss the role of diet in health and wellness, but because of how doctors are trained and how little they learn about nutrition, as well as hormones, unless he or she makes an effort to learn, once they've completed their residency, we end up with more doctors who only know the 'sick care model' of medicine, as @Systemlord always reminds us. So then, it's up to each person to be their own physician; to research, to experiment on themselves and hopefully, improve their health and their life.

Sugar and processed foods can lead to inflammation throughout the body and brain, which may contribute to mood disorders, including anxiety and depression. When we're feeling stressed or depressed, it's often processed foods we reach for in search of a quick pick-me-up.

Sutter Health | Doctors and Hospitals | Northern California › health

Eating Well for Mental Health | Sutter Health​

 

[tropicaldaze1950]

Sugar and processed foods can lead to inflammation throughout the body and brain, which may contribute to mood disorders, including anxiety and depression. When we're feeling stressed or depressed, it's often processed foods we reach for in search of a quick pick-me-up.
View attachment 41653
Sutter Health | Doctors and Hospitals | Northern California › health

Eating Well for Mental Health | Sutter Health​

Vince, I've had mental health problems since I was a child. As to diet, in 1970 or '71 was diagnosed with multiple food sensitivities. Cut out sugar, gluten, eggs, chicken, dairy, tomatoes, onions. Followed that elimination diet for about 20 years. Benefits: zero. Continued to have migraines, gastro problems, anxiety, panic attacks, depressive episodes, suicidal feelings. What never changed was my high libido and ever ready erectile function. Those began to disappear after bipolar re-emerged in 2005. That, and my wife's verbal/emotional abuse/gaslighting/non-empathy buried my sex drive and function.

In retrospect, since I've had a lot of time on my hands, I never should have married; not to the woman I'm with nor anyone. I never had any interest in marriage and thankfully, never fathered any children. And the woman I married turned out to have far more emotional problems than me. I've written about this before.

But regarding all the recommendations about eating clean and avoiding sugar; been there and it didn't help. Yes, that's me. For many others, those recommendations might have brought about significant physical and mental improvements. I don't know if there's an answer for me. I just go down my own path of exploration.

 

[Vince]

Vince, I've had mental health problems since I was a child. As to diet, in 1970 or '71 was diagnosed with multiple food sensitivities. Cut out sugar, gluten, eggs, chicken, dairy, tomatoes, onions. Followed that elimination diet for about 20 years. Benefits: zero. Continued to have migraines, gastro problems, anxiety, panic attacks, depressive episodes, suicidal feelings. What never changed was my high libido and ever ready erectile function. Those began to disappear after bipolar re-emerged in 2005. That, and my wife's verbal/emotional abuse/gaslighting/non-empathy buried my sex drive and function.

In retrospect, since I've had a lot of time on my hands, I never should have married; not to the woman I'm with nor anyone. I never had any interest in marriage and thankfully, never fathered any children. And the woman I married turned out to have far more emotional problems than me. I've written about this before.

But regarding all the recommendations about eating clean and avoiding sugar; been there and it didn't help. Yes, that's me. For many others, those recommendations might have brought about significant physical and mental improvements. I don't know if there's an answer for me. I just go down my own path of exploration.

You should check out siggi's yogurt. It's pasteurized before it's fermented that way it keeps all the good active cultures.

 

[tropicaldaze1950]

You should check out siggi's yogurt. It's pasteurized before it's fermented that way it keeps all the good active cultures.

Familiar with it. Dairy is strangely problematic. Aside from gastro problems, my right nostril starts bleeding. Yes, just my right nostril. Maybe if I slowly added yogurt or kefir by the teaspoon or tablespoon I can avoid or even eliminate that.

 

[DiegoG]

So I took anatrazole low dose and within a few hours I started peeing out a ton of water. Within the next day I started moving my bowls again after 7 days of not going. I stopped the anatrazole and the constipation came back immediately. So it seems high estrogen is causing the constipation from water retention.

Bloodwork confirmed elevated estrogen.