What needle length for IM TRT? Thinking of changing from subQ to IM to feel better

[GeorgieBoy]

What were you expecting as you approached this in the wrong way right off the hop increasing your dose every 2 weeks let alone preventing any chance of letting blood levels stabilize which will take 4-6 weeks?

You need to stay consistent with your protocol (dose of T/injection frequency) otherwise you are wasting your time!

I didn't realize it took so long to stabilize. Steroidcalc shows close to full stabilization after about 14-15 days, so I went with that.

Thanks for the feedback, I appreciate. I'll try to just be patient and ride it out.

 

[4:15amstreet]

I understand but right now I feel even worse than I did pre-TRT, and I keep reading about guys who say they feel better than they did when they were 20yo.

It is possible that the symptoms you are experiencing are not related to your testosterone levels. Having T levels optimized is just one aspect of being healthy and feeling good. I would recommend talking to your doctor and exploring other possible reasons as to why you are not feeling great.

That said, everyone is different and has a different level at which they feel best. My guess is you just haven't found it yet. 100/mg a week will put most guys in a mid range physiological T level. 200/mg a week will put most guys above physiological levels. Personally I feel best when my total T is in the mid 700s. I think that is most common, but some guys feel better at 500, some at 1100. So in short my advice to you would be try 120mg a week and stick with it for 6 weeks, get labs, honestly evaluate how you feel, talk to your doctor about depression and anxiety which are not necessarily related to T levels and can just be something you are genetically predisposed to suffer from, and while it sounds crazy, try to think less about your T levels and just make yourself do things you enjoy. Good luck.

 

[Blackhawk]

I didn't realize it took so long to stabilize. Steroidcalc shows close to full stabilization after about 14-15 days, so I went with that.

Thanks for the feedback, I appreciate. I'll try to just be patient and ride it out.

It is not as simple as achieving a certain blood level. Once steady state blood level is reached it still takes quite some time for your body to adapt to that "new normal" blood level. That adaptation takes time.

And this adaptation is not linear, homogeneous or fully predictable in all individuals. And there is much still to be learned. There are too many variables: what is SHBG?, how much is being converted into estrogen? How much is bound by albumin? How sensitive are your cell receptors, and how much will cell receptor number and function be affected by change in blood plasma level of Testosterone? How long does it take receptors to stabilize in response to the "new normal" level of blood testosterone? How are the downstream effects of the cellular uptake of testosterone affected and how long does it take for them to normalize? How do your cells vs my cells respond? What potential genetic polymorphisms may be involved? How does T affect protein synthesis as it interacts with DNAin cellular metabolism? What other cellular processes are affected?... etc etc...

 

[Wolverine]

Tons of energy, mood is great, strong libido, and never had any issues with erections other than pre-trt when I had low-t (no libido, lack spontaneous/nocturnal erections).

I am on a T only protocol and have never used hCG/AI or a PDE-5 inhibitor.

Never felt the need to try daily as I feel great overall.

Madman: Noted that you have never used HCG nor AI. Do you take any hormonal supplements (DHEA, Pregnenolone, etc)? Tx

 

[Another Great Day]

1/2 (12.7 mm) will be just fine for shallow IM.

I have been using 23 x 1 .5 cor Cypionate glut shots.

1/2 (12.7 mm) will be just fine for shallow IM.

For over 15 years I have been using 23 x 1 .5 for Cypionate glut shots. Is this too long of a needle?

1/2 (12.7 mm) will be just fine for shallow IM.

I do 27ga 1/2" needle for shallow IM and it seems to work. I do Im 3 days and sub q 4 days. I notice no difference

For over 15 years I have been using 23 x 1 .5 for Cypionate glut shots. Is this too long of a needle, 1/2 almost seems too short. You do not have any draw issues with a 27 gauge needle?

 

[madman]

Madman: Noted that you have never used HCG nor AI. Do you take any hormonal supplements (DHEA, Pregnenolone, etc)? Tx

No nothing else.

 

[madman]

I have been using 23 x 1 .5 cor Cypionate glut shots.

For over 15 years I have been using 23 x 1 .5 for Cypionate glut shots. Is this too long of a needle?


For over 15 years I have been using 23 x 1 .5 for Cypionate glut shots. Is this too long of a needle, 1/2 almost seems too short. You do not have any draw issues with a 27 gauge needle?

Depends on what area of the glute you are injecting.




Effects of thickness of muscle and subcutaneous fat on efficacy of gluteal intramuscular injection sites


ABSTRACT

Intramuscular injections given at the dorsogluteal and ventrogluteal sites are intended for the gluteus maximus and gluteus medius muscles, respectively. However, little research has confirmed the reliability of these sites for the presence and thickness of the target and other muscles, and subcutaneous fat. This study characterized and compared these at the V-method and G-method ventrogluteal sites and dorsogluteal site (n=60). Gluteus maximus, medius and minimus were identified at each site, plus tensor fascia latae at ventrogluteal sites. Gluteus maximus and subcutaneous fat were significantly thicker and gluteus minimus significantly thinner at the dorsogluteal site than both ventrogluteal sites. Gluteus medius was the thickest muscle at each injection site, and thicker at the G-method than the V-method ventrogluteal site. Therefore, the dorsogluteal site reliably targets gluteus maximus, and the G-method ventrogluteal site was more reliable than the V-method ventrogluteal site to target gluteus medius in terms of presence and thickness.




KEY POINTS

■ Little research has confirmed the reliability of the gluteal intramuscular injection sites in terms of the presence or thickness of all the muscles and subcutaneous fat at these injection sites

■ Gluteus maximus was present in 100% of cases at the dorsogluteal site, and was thicker at this site than the ventrogluteal sites; therefore, the dorsogluteal site reliably targets gluteus maximus

■ Gluteus medius was present in 100% of cases and thicker at the G-method than the V-method ventrogluteal site; therefore, the G-method ventrogluteal site is more reliable than the V-method ventrogluteal site to target gluteus medius muscle

■ The V-method ventrogluteal site is less reliable and more variable, with gluteus medius present in 95% of cases and tensor fascia latae muscle present unilaterally in 20% of participants

■ An intended intramuscular injection given at the dorsogluteal site would be deposited in the subcutaneous fat or gluteus medius for 27% and 15% of participants, respectively






Conclusion

This study is the first to report on characterisation and comparison of the dorsogluteal and the two ventrogluteal intramuscular injection sites. Overall, the dorsogluteal site is reliable for targeting gluteus maximus and had a thicker muscle layer than both of the ventrogluteal sites. However, this site was also characterized by thicker subcutaneous fat and was associated with a higher risk of a subcutaneous, rather than intramuscular, injection. Therefore, it is recommended that, particularly for females who are overweight or obese, the ventrogluteal site be used instead of the dorsogluteal site.

The G-method ventrogluteal site is more reliable than the V-method ventrogluteal site in terms of gluteus medius presence, muscle thickness, and the likelihood of successful intramuscular injection. There was greater variability at the V-method ventrogluteal site, particularly in terms of muscles other than the target muscles, and more individuals were at risk of the needle reaching the bone here. Accordingly, it would be beneficial for nurses to become familiar with, and to practice, the G method of ventrogluteal site identification. The G method should be used over the V method for leaner individuals for a successful intramuscular injection without the risk of bone contact.

Overall, because of the significant influences of gender and BMI on subcutaneous fat thickness, these characteristics may be useful discriminators to assist with site selection and needle length for successful intramuscular injection outcomes. Nurses should base their site selection and needle size choices based on an assessment of patient characteristics, including gender and BMI. More research to support evidence-based decisions is warranted.

 

[madman]

Figure 1. A: Quadrant method for dorsogluteal site identification. B: V and G methods for ventrogluteal site identification: V method site between the index and middle fingers when the heel of the hand is on the greater trochanter; G method site at the centroid of the triangle formed between the greater trochanter, anterior superior iliac spine and iliac tubercle (adapted from Barry et al, 2014)

 

[Nik]

Wat is you shbg?

 

[buckeye22]

Speak for yourself and one can easily hit shallow IM using 1/2 needle length depending on muscle injected, how lean/muscular the individual.

Delts 1/2 inch needle length with ease!
View attachment 10578




T levels will peak 8-12 hrs post-injection!

That’s pretty much what I said... “lean/muscular” vs “skinny scrawny emaciated” either way there is less fat for subq. Same difference

 

[XXY47]

I am currently on IM TRT, and I have an appointment with a TRT specialist next week. My question is I currently inject using a 25g 1.5" needle in my thigh. Do I really need this long of needle? My Pharmacist recommended this needle length but I do not see why it needs to be so long.

I use a Union Medico Needle Guide Assistant to drive the needle in so that it is completely perpendicular and shrouds the needle. The guide has really helped with preventing needle anxiety and is practically pain free. But it never runs the needle right into the hilt so i was wondering on length because even thou the needle is not completely in I still feel the dosage of testosterone.

 

[Goel]

I am currently on IM TRT, and I have an appointment with a TRT specialist next week. My question is I currently inject using a 25g 1.5" needle in my thigh. Do I really need this long of needle? My Pharmacist recommended this needle length but I do not see why it needs to be so long.

I started off with a 22g 1.5" needle for injections but thankfully only did that once/week for about 5 weeks. I recently switched to 28g 1/2" and it's MUCH better with less muscle trauma. It does take a bit more patience to draw from the vial, but nothing drastic - maybe 20-30 seconds to draw and 10-15 seconds to inject. It's important to pressurize the vial before doing the draw and this is more so with a smaller gauge. A little more time than the bigger needle but easily more than worth the trade off to me.

 

[Goel]

You do not have any draw issues with a 27 gauge needle?

I'm using a 28 gauge, so smaller still and no problems - just takes more patience and be sure to pressurize the vial first.

 

[XXY47]

I started off with a 22g 1.5" needle for injections but thankfully only did that once/week for about 5 weeks. I recently switched to 28g 1/2" and it's MUCH better with less muscle trauma. It does take a bit more patience to draw from the vial, but nothing drastic - maybe 20-30 seconds to draw and 10-15 seconds to inject. It's important to pressurize the vial before doing the draw and this is more so with a smaller gauge. A little more time than the bigger needle but easily more than worth the trade off to me.

I will have to look for alternatives that have smaller thinner needles, I'm not sure how this will work in Canada. I had a horrible time getting syringes, had to two two cases to get the needles and syringes I needed.

 

[Goel]

I will have to look for alternatives that have smaller thinner needles, I'm not sure how this will work in Canada. I had a horrible time getting syringes, had to two two cases to get the needles and syringes I needed.

Shouldn't be a problem; what you're looking for are commonly used one-piece insulin syringes.

 

[madman]

I will have to look for alternatives that have smaller thinner needles, I'm not sure how this will work in Canada. I had a horrible time getting syringes, had to two two cases to get the needles and syringes I needed.

Principles of Testosterone and hCG Injection Technique

Selecting the Devices There are many different syringes and needles, suiting many different procedures. It is important to choose the needles and syringes carefully according to the type of injection to be administered. For example, the length and gauge of the needle and type of syringe must...

www.excelmale.com

 

[DragonBits]

I am currently on IM TRT, and I have an appointment with a TRT specialist next week. My question is I currently inject using a 25g 1.5" needle in my thigh. Do I really need this long of needle? My Pharmacist recommended this needle length but I do not see why it needs to be so long.

I use a Union Medico Needle Guide Assistant to drive the needle in so that it is completely perpendicular and shrouds the needle. The guide has really helped with preventing needle anxiety and is practically pain free. But it never runs the needle right into the hilt so i was wondering on length because even thou the needle is not completely in I still feel the dosage of testosterone.

I looked at the Union Medico Needle Guide Assistant and it's made for insulin injection, the site recommended using 4-16 mm needles, that is 0.63 inch. Unless you have a different model, it's not surprising it doesn't run the needle into the hilt. Though with a 1.5 inch needle, I serious doubt you need to worry about that.

I have used a 1.5 inch 22 ga 5ml needle to do deep IM with nebido. Injecting 4 ml, it's really the only way.

But I use a 29ga 1/2 inch needle for testosterone cypionate.

As far as drawing, for TC I pressurize the vial, then set the needle with vial into a wine glass and a few minutes later it's full. Works for the 0.35 - 0.5 ml testosterone cypionate.

For nebido / testosterone undecanoate, I sometimes get an ampule, sometimes a vial, I usually change needles, one to draw and another to inject. The fact that it's slow to inject is a good thing, as slower it better as it lessens any post injection pain. Nebido bayer recommends taking 2 minutes for the injection.

I was interested in the Medico Needle Guide Assistant because one of the more difficult aspects of a deep IM in the glute is actually injecting. It's a little difficult to push the plunger in this position (reaching around to my butt). BUT it appears the needle assistant doesn't aid in pushing the plunger, at first it appeared it does, but then I realized the insulin needle they use has a button that injects a programmed amount.

I wonder what it costs, but it would do nothing for me.

 

[XXY47]

Shouldn't be a problem; what you're looking for are commonly used one-piece insulin syringes.

I inquired with my Pharmisist about change out to an insulin setup, and she said that would not be possible. The needles and Sryinges are on precription and I would have to have a special precription for a insulin needle which a doctor will not do because I'm not on insulin. I just can not walk into a medical depot and get needles and syringes, these things are controlled in Alberta. I will see if my new TRT specialist will prescribe something different.

 

[rayrock1]

DragonBits whats your injection time/rate, after the needle is in, with Test Cyp with the small gauge needles your using? 1ml per 5 seconds?

 

[Blackhawk]

I inquired with my Pharmisist about change out to an insulin setup, and she said that would not be possible. The needles and Sryinges are on precription and I would have to have a special precription for a insulin needle which a doctor will not do because I'm not on insulin. I just can not walk into a medical depot and get needles and syringes, these things are controlled in Alberta. I will see if my new TRT specialist will prescribe something different.

I know @madman is from Canada and uses tiny insulin needles. Despite what your pharmacist says, I am sure that their word is not the end of it. Here in the US 100 insulin syringes cost about $11-15 mail order, no prescription required.

Perhaps Amazon? Amazon.ca

or: where to buy syringes over the counter alberta canada - Google Search