Wondering if my TRT prescription schedule makes sense at all

[madman]

Wow. Thank you so much for taking the time to type out such a thoughtful and informative response. It is very eye opening and makes total sense. I am very happy to have a doctor that took pity on me and prescribed something for it as my family doctor simply didn’t care, but at the same time I’ve always kind of known he definitely doesn’t really know what he’s doing.

Like you said though as long as I have the prescription I can make the necessary changes.

So I actually proactively started splitting my dose on Monday - I injected 125MG rather than my prescribed 250MG, and I will be continuing with the 125MG injections weekly.

Understanding that even weekly I will have some hormone fluctuation, I honestly think it would be very hard for me to move to twice a week as the process of injecting is a very rough experience every time without fail.

I do injections into the glute with 1.5” 23 gauge needles and man it hurts sometimes. My wife actually does it for me thankfully cuz I don’t think I could do it myself haha. I did try a few 1” in the shoulder which wasn’t bad, but I wonder if I’m starting to build up any kind of scar tissue or something because sometimes it’s like the needle gets stuck half way and then she has to push past it and it finally goes in. It’s not very pleasant to say the least haha.

So with that being said, I will man up and keep going with weekly at least.

Finally, in regards to the topical 50MG - it seems to be a running theme from everyone who comments to say to stop using it. I have a few questions about that.

Is it simply because you think the 125MG weekly is enough, or is there additional reasons such as mixing 2 types of test?

I’m wondering - if my levels are still going to fluctuate with the weekly injections, wouldn’t the daily topical application then at least aid a bit in making sure the levels remain someone stable?

Again thanks so much for taking the time to respond. Everyone really. I didn’t expect to get such a great range of responses and I am so appreciative!

I do injections into the glute with 1.5” 23 gauge needles and man it hurts sometimes. My wife actually does it for me thankfully cuz I don’t think I could do it myself haha. I did try a few 1” in the shoulder which wasn’t bad, but I wonder if I’m starting to build up any kind of scar tissue or something because sometimes it’s like the needle gets stuck half way and then she has to push past it and it finally goes in. It’s not very pleasant to say the least haha.

Strictly sub-q or shallow IM using an LDS 27-31G (various needle lengths) insulin syringe with a fixed needle to draw/inject is where it's at.

You are causing yourself much more grief than need be.

Not only will you minimize any pain/scar tissue, especially when poking yourself frequently but you can also draw/inject using the same syringe (fixed needle) let alone minimize the loss of any wasted medication from using an LDS (low dead space) fixed insulin syringe.


“Fixed insulin type syringes have no void space at the point where the needle joins the syringe, and so are known as Low Dead Space Syringes, which is sometimes abbreviated in the literature to LDSS. They are made like this so that the full accurate dose is delivered, and there is no waste”

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...

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post#4

No drawing needles - is this normal and best practice for SubQ Testosterone?

Hello - I received my first batch of Testosterone Cypionate and HCG from Defy Medical. They sent 27 gauge 1/2" Easy Touch syringes for the Test (for SubQ), and 30 gauge for the HCG (for SubQ). These syringes do not have removable needles. They sent no alcohol wipes and no drawing needles. The...

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Finally, in regards to the topical 50MG - it seems to be a running theme from everyone who comments to say to stop using it. I have a few questions about that.

Is it simply because you think the 125MG weekly is enough, or is there additional reasons such as mixing 2 types of test?

I’m wondering - if my levels are still going to fluctuate with the weekly injections, wouldn’t the daily topical application then at least aid a bit in making sure the levels remain someone stable?

Choose one formulation.

IM or transdermal.

The majority prefer intramuscular injections.

Again the starting dose for IM is 100 mg T/week.

Always best to start low and go slow.

To be honest you would be far better off starting on 100 mg/week split into twice-weekly injections (50 mg every 3.5 days).

If you want to jump in on 125 mg T once weekly do what you feel is best for you.

If your goal is to minimize fluctuations then you would need to inject more frequently which will clip the peak--->trough and result in more stable blood levels throughout the week.

The main reason one would choose transdermal over IM is fear/dislike of needles and those that have a better understanding of the PKs may prefer daily fluctuations in T levels as the daily transdermal application can somewhat mimic the natural endogenous 24-hour circadian rhythm of a healthy young male although you can poke holes in this.

Does Patient-Applied TRT Pose Risk for Blood Pressure Elevation?

Does Patient-Applied Testosterone Replacement Therapy Pose Risk for Blood Pressure Elevation? Circadian Medicine Perspectives (2022) Michael H. Smolensky, Ramon C. Hermida, Linda Sackett-Lundeen, *Ramon G. Hermida-Ayala, and Yong-Jian Geng ABSTRACT We reviewed medication package inserts, US...

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Figures 2A-2F depict the TT 24 h pattern achieved by the 6 different solution and gel PA-TRTs, and Figures 3A-3D depict the TT 24 h pattern achieved by the buccal tablet, oral capsule, transdermal patch, and subcutaneously injected PATRTs. There are substantial differences between the therapies in the derived TT 24 h pattern; moreover, all but one of them differs either somewhat or greatly from the normative one of diurnally active young adult males, which is defined by: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Based upon these criteria, only the Androderm® transdermal patch (Figure 3D), when applied in the evening (∼22:00 h) as recommended, closely mimics the TT circadian rhythm of normal young adult males.

*AndroGel® 1%, AndroGel® 1.62%, Axiron®, Fortesta®, and Testim® (and its biosimilar Vogelxo®) gel and solution preparations are recommended for application once daily in the morning to attain the highest serum hormone level 2 to 6 h following dosing and lowest, instead of highest, hormone level during sleep, that is, final hours of the 24 h dosing interval (Figure 2A-2E).




Accordingly, we characterized each PA-TRT according to its ability to simulate the normal TT circadian rhythm (Figure 1A). We developed five criteria for this purpose: (i) elevated and near peak TT level during nighttime sleep, (ii) peak TT level around the time of morning awakening, (iii) moderately elevated TT level during the initial hours of wakefulness, (iv) reduced TT level in the late afternoon, and (v) lowest TT level in the evening. Because at this time it is unknown whether any one of these criteria, for example, circadian time of highest or lowest TT level, is of greater biological importance than the others, we weighted each one of them equally.

*As shown in the graphs of Figures 2 and 3, the PK of most FDA-approved PA-TRTs gives rise to TT 24 h patterns that deviate greatly from the normative one thereby failing to satisfy one or more of the five specified criteria.

*AndroGel® 1%, AndroGel® 1.62%, Xyosted®, and Striant®, which achieve relatively constant serum hormone concentration throughout the 24 h, seem to have been incorrectly conceptualized, perhaps because of the presumed necessity to maintain nonvarying, that is, homeostatic, TT concentration to achieve consistency of biological effects.

*The FDA-approved gel and solution PA-TRTs when applied as directed, that is, morning after awakening from nighttime sleep, while achieving TT levels within the normal range to remedy androgen hormone deficiency, fail to restore the normal physiologic TT circadian variation.

*The temporal patterns of these PA-TRTs differ from normal, either in the timing of the peak and/or nadir TT concentrations, by achieving the highest hormone levels generally between midmorning and noon and lowest (rather than near peak) ones during sleep (Figure 2A-2F).

 

[Systemlord]

Most of the stuff I’ve found still is saying the things I’ve learned about IM and 1-1.5 and 23 gauge etc.

TRT is a new field of medicine, ignored for decades thanks to Charles Huggin. TRT is an infant compared to other areas of medicine, shocking few doctors are truly up to speed on everything TRT related.

 

[Blackhawk]

Super helpful. Keep up the great work

I am sorry you seem to have taken my comment in a negative way, and sorry to provoke you. Intended as humor, but not at your expense, rather a place of genuine care for your outcome. We see this all the time, the same stuff has been posted a thousand tomes here. Your whole story is a result of archaic protocol started for you by doctors who don't have a clue how to manage TRT. You are in a good place here on this forum.

Hope you have some relief from the harpoons. I really do wish only good for you as you join the modern world of Testosterone therapy.

 

[KJV1611]

So I had low test for quite a few years that was first tested when I was about 29. I have been on methadone since age 19. Though I have been on opiates for a long time, I was always a “functional addict” as I was a an athlete and was drafted into the QMJHL back in 2005. I always stayed in shape. But over the years since hanging up the skates I have become more and more sedentary.

When finally my blood work came back with very low test, Unfortunately my family doctor at that time was consistently not willing to prescribe me anything for it. I also have low thyroid. The combination of the two left me constantly exhausted and it was completely awful for a few years especially as I was in the middle of completing a computer science degree. Somehow I made it through. It was seriously torture living with such low test I got fat and had no sexual function pretty much whatsoever. It’s amazing my wife didn’t leave me.

Eventually I told my other doctor who prescribes my methadone about it. He immediately sent me for blood work and then started me on a very low dose of oral test. It was called “taro-testosterone”. 50MG a day. My levels didn’t move. Then I went to 2 a day and all the way to 4 a day. I did not respond at all to the pills.

Finally, my doctor who is such a great guy (but is a psychiatrist and it doesn’t seem like this is his specialty) took pity on me and said - were going to get this under control…. He then prescribed me 250MG of test enanthate every 2 weeks plus also 50MG of topical gel of “taro-testosterone” a day.

Within a few weeks it was just like total night and day. This was about a year ago and I have made SO many positive changes in my life since and I am becoming so much more proactive. I’ve started back to the gym recently (1 month) and am starting to see some real gains already.

The question I have is around my dosing and schedule. Sorry unfortunately I don’t have my test level information as my doctor hasn’t really told me the exact numbers , not that I’d understand them anyways… but anyways. So right now like I said I take 1 injection of 250MG enanthate every 2 weeks and then every morning I have a packet of 50MG taro-testosterone topical gel I use.

I’ve been reading about enanthate and I see that it’s half life is less than 2 weeks, so I’m wondering if I should be splitting my dose in half and taking it weekly rather than bi-weekly.

I know my Dr isn’t super knowledgeable on this as I overheard the conversation with the pharmacist the first time I filled it, he had way too much prescribed and the pharmacist had to tell him it was not normal.

I will 100% take what I can get though. I’m in Alta tic Canada and the Dr situation here is incredibly dire. I put myself on a list to see and endocrinologist but the wait list is like a year. So I’m just wondering if I should start splitting my dose in half or if there is anything else I should be considering.

Thanks in advance

Mitch, Wow am I glad that this forum exist. Sometimes in life, you think or at least get the feeling you’re the only person on the planet with a specific issue. Take for instance, TRT, I found this platform while searching the Internet one day, and begin to read about others, with the same issues that I have. Just a small, quick backstory about myself, I was in a very physical, dangerous, although necessary occupation for 25 years, throughout those years, I was involved in the occupational hazards that come along with saving peoples lives every day. Due to several incidents, like most in this forum, I was prescribed a very strong opiates, at first I had no issues I was able to work and take my medication after work, (most days), unless I was off. A particular injury that involved the orbit of my and eye sinus cavity caused such severe pain that I stayed on the medication for several months. Up until this time I had never taken anything stronger than cough syrup. The eye area is an extremely sensitive/painful area anyway, however my injury finally healed, not knowing any better I stopped my medication, and started to work. Within a day, I was now in the middle of full blown withdrawals, shaking, very sensitive, sweating the whole 9 yards. I had no idea what was going on, and without getting too personal these things are not acceptable in my line of work. I spoke to my doctor via phone, he asked me to stop by as we were close friends and workout partners. He told me that I looked and checked out fine, he asked me of any changes I may have made in the past couple of days to my regular routine, I advised him “ no sir, all I’ve done is stop my pain medication is all that I can think of”, his eyes got as big as saucers. He explained that being on opiates for months was something that you couldn’t just stop doing. You have to remember this was almost 20+ years ago, like most doctors of the time he prescribed me a huge amount of opiates and advise me to taper off on a 10% schedule every two weeks, and I did. However, other than just being highly sensitive to opiates I had no understanding as to why, this wasn’t working, I took the medication exactly like I was told, and the same thing happened to me when it was time for me to get off of them. Withdrawals out the Ying yang, I had two options go to work in full withdrawals or find a clinic that could help. I chose the latter, and was put on Suboxone, four 8mg tablets a day, (which is ludicrous), now that I am educated on addiction. Like you stated yourself, this saved my job, which WAS my life. However, every year or so, I would taper against the clinicians orders to get off of these things, but because of the occupational hazards that come along with my job, I was frequently getting injured and having to go back up to the full amount, because I would NOT take any pain medication, because of surgeries, or injuries. Like yourself I have been on Suboxone since, like clockwork every month, I drive an hour to the clinic, where no one knows me due to the small town that I live. BEFORE these things took place, I had discovered in my early 20s that my testosterone was anywhere from 120 to the high 90s and was on injectable cypionate. My physician was somewhat educated on this issue and allowed me to inject myself, my prescription was around 300 MG’s every two weeks, and this worked wonders. My levels came up, and I felt like a brand new man, although I was still extremely young. I was ALREADY on testosterone for several years, when my injury occurred that caused me to be addicted to opiates. So I am in a similar predicament, however, after a devastating automobile accident in 2018 I could not for the life of me understand why my volume of ejaculate almost a drop if that wasn’t until a couple of months ago. This site that, not only was the volume extremely low, the (force) wasn’t there either. I spent almost 2 months after my accident WITHOUT TRT. I was advised, that due to the prolonged absence of TRT as well, as the amount of anesthesia that I had under during my surgeries, may have caused my issue. Then via this very forum I discovered HCG, and the benefits that it may have with someone that is only on TRT, in the hopes of bringing my testicles back to normal. I know this has been a quite long response, however, your post hit me like a ton of bricks, and I realized I was not alone and neither are you. Everything seems to be going well, the volume and force are still not Regular, I was told to hang tight and be patient. Sometimes the human body takes time to heal. Get well and God bless.

 

[mitcHELLspawn]

Thank you so much for everyone taking part in this discussion and also for the latest guy sharing his experience. This has been extremely informative and insightful.

I am now 10 weeks into a strict gym routine and switched to weekly injections from the advice on this forum.

I have not switched to sub-q yet however. (I’ll explain shortly)

when I started the gym I was 245 lbs. I carried it very well but was definitely overweight by a lot. As mentioned earlier I was in very good shape in my 20s and so carried all the muscle with me and with a layer of fat on top so my arms were always big and defined etc.

Anyways, I am now down to 223 while also very clearly and visibly also gaining new muscle. Things are going incredibly well. My strength has consistently just continued to grow.
For bench as a metric - upon first week or so I was only able to just barely bench 135 for 8-9.
I just had my latest chest day today and I was able to bench 225 for 8 - up an extra 2 reps from last week where I was able to do it for 6. So the strength continues to grow.

I’m so happy with what TRT has done for me. I have more energy, my health, looks, confidence and wellbeing is the highest it’s been in years.

So that was just an update.

Now - why haven’t I taken the sub-q advice ?

So, I am extremely new to all of this obviously. And I know everyone here is extremely knowledgeable, but of course it would be irresponsible of me to just take advice without first contacting my health professional. So I went to the pharmacy that I goto and discussed it with my pharmacist. She (as expected) didn’t really know much about it - but my pharmacy is a great little mom+pop run spot - and so she said to leave it with her and she would do some research.

Long story short, the next week I came in and she had been emailing back and forth with some health Canada company that manufactures test and other stuff. It wasn’t the exact company as mine, but they essentially said that it should be deep IM in the glute or thigh and no delt and they attached some clinical study on the efficacy of each and showed delt IM injections not as effective etc and then they outright said that the stuff I use should NOT be used subconsciously.

So… that’s where I am now - I obviously know yall know a ton about this stuff, but I also can’t verify any credentials etc and I feel it would be irresponsible of me to take advice from a forum when my direct health professionals are saying I shouldn’t…. This is really a crappy place to be in, because I’m so clueless about all of this stuff as well so I don’t even know enough and either way have to rely on a third party.

Does anyone happen to have a study or information from a reputable source of using the standard IM based test solutions used in subcutaneous methods and the efficacy to go along with it etc? My pharmacist did mention that there are types of test out there made for that type of shallow injection, but said mine was not that type.

Sorry guys please don’t take this as me being combative or going against your clearly knowledgeable opinions. I’m just in a tough spot here. I want to make the best decision for myself. I would love to be able to start sub-q and move to twice a week injections but as it stands I’m still using what yall very elegantly referred to as “harpoons” haha and I couldn’t agree more. I’m using 1.5” 23G into the glute. Obviously great results but very inconvenient.

 

[madman]

Thank you so much for everyone taking part in this discussion and also for the latest guy sharing his experience. This has been extremely informative and insightful.

I am now 10 weeks into a strict gym routine and switched to weekly injections from the advice on this forum.

I have not switched to sub-q yet however. (I’ll explain shortly)

when I started the gym I was 245 lbs. I carried it very well but was definitely overweight by a lot. As mentioned earlier I was in very good shape in my 20s and so carried all the muscle with me and with a layer of fat on top so my arms were always big and defined etc.

Anyways, I am now down to 223 while also very clearly and visibly also gaining new muscle. Things are going incredibly well. My strength has consistently just continued to grow.
For bench as a metric - upon first week or so I was only able to just barely bench 135 for 8-9.
I just had my latest chest day today and I was able to bench 225 for 8 - up an extra 2 reps from last week where I was able to do it for 6. So the strength continues to grow.

I’m so happy with what TRT has done for me. I have more energy, my health, looks, confidence and wellbeing is the highest it’s been in years.

So that was just an update.

Now - why haven’t I taken the sub-q advice ?

So, I am extremely new to all of this obviously. And I know everyone here is extremely knowledgeable, but of course it would be irresponsible of me to just take advice without first contacting my health professional. So I went to the pharmacy that I goto and discussed it with my pharmacist. She (as expected) didn’t really know much about it - but my pharmacy is a great little mom+pop run spot - and so she said to leave it with her and she would do some research.

Long story short, the next week I came in and she had been emailing back and forth with some health Canada company that manufactures test and other stuff. It wasn’t the exact company as mine, but they essentially said that it should be deep IM in the glute or thigh and no delt and they attached some clinical study on the efficacy of each and showed delt IM injections not as effective etc and then they outright said that the stuff I use should NOT be used subconsciously.

So… that’s where I am now - I obviously know yall know a ton about this stuff, but I also can’t verify any credentials etc and I feel it would be irresponsible of me to take advice from a forum when my direct health professionals are saying I shouldn’t…. This is really a crappy place to be in, because I’m so clueless about all of this stuff as well so I don’t even know enough and either way have to rely on a third party.

Does anyone happen to have a study or information from a reputable source of using the standard IM based test solutions used in subcutaneous methods and the efficacy to go along with it etc? My pharmacist did mention that there are types of test out there made for that type of shallow injection, but said mine was not that type.

Sorry guys please don’t take this as me being combative or going against your clearly knowledgeable opinions. I’m just in a tough spot here. I want to make the best decision for myself. I would love to be able to start sub-q and move to twice a week injections but as it stands I’m still using what yall very elegantly referred to as “harpoons” haha and I couldn’t agree more. I’m using 1.5” 23G into the glute. Obviously great results but very inconvenient.

Long story short, the next week I came in and she had been emailing back and forth with some health Canada company that manufactures test and other stuff. It wasn’t the exact company as mine, but they essentially said that it should be deep IM in the glute or thigh and no delt and they attached some clinical study on the efficacy of each and showed delt IM injections not as effective etc and then they outright said that the stuff I use should NOT be used subconsciously.

Pure nonsense!

Although the majority on TTh are injecting strictly IM (shallow/deep) many men are injecting strictly sub-q.

Any esterified T whether (TC, TE, TP, mixed esters, or TU) can be injected subcutaneously.

My urologist is considered one of the pioneers in Canada when it comes to subcutaneous T injections.

Been doing this since the early 2000s and has treated 100s of men who do well when it comes to symptom relief let alone achieving high/very high TT/FT levels.

Far and few would be hitting sub-par T levels on such.

Are there outliers who may not achieve stellar T levels?

Sure but it is far from common.

Are there men who do not do well or feel worse off injecting strictly sub-q?

Most definitely!

If anything the main disadvantage would be for those individuals that tend to develop nodules/lumps.

Subcutaneous Testosterone Injection Studies

Subcutaneous Testosterone: An Effective Delivery Mechanism for Masculinizing Young Transgender Men (2014)

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TRT with Subcutaneous Testosterone Injections: A Safe, Practical and Reasonable Option

Abstract Context: Injections with intramuscular testosterone esters have been available for almost 8 decades and not only result in predictable serum testosterone levels but are also the most inexpensive modality. However, they are difficult to self-administer and associated with some...

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The contribution of the in-vivo fate of an oil depot to drug absorption

ABSTRACT Sustained release of lipophilic compounds can be achieved with oil depots. These parenteral formulations are generally injected into the vastus lateralis and deltoid muscle. It is known that the absorption rate differs between these two muscles. The reason for this is not fully...

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Daily Intramuscular injections.

Hey guys I'm currently on m-w-f injections. Ive actually started to feel way better on shot days on Im vs sub q. However through years of testing my t levels drop off quite a bit 24 hrs post injection. I respond very well to lower doses. 90mg a week has my ft slightly over range. And TT around...

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Sub Q injections quit working

... This subq vs IM issue has nothing to do with areas under the curve. Its some other issue causing low levels over long periods of time. Self-contradictory statements. Low levels over time would mean lower areas under the curve for SC injections, which is not the case when studied under...

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Comparison of Testosterone Blood Concentrations from Different TRT Products Versus Normal Diurnal Variations

Abstract Background: To improve symptoms associated with testosterone deficiency (TD), many testosterone therapies (TTh) are available that aim to restore serum testosterone (T) levels to the normal physiologic range. The magnitude, frequency, and duration between peak and trough T...

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Xyosted Question

Hello fellas, My primary retired and I started up with a new PCP. She was okay with my TRT protocol. I didn’t know this before I left her office but she refilled my testosterone script with Xyosted. I did a search on this forum but didn’t find too much on it. It’s expensive. With insurance, it...

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SubQ vs IM (E2)

Anyone get higher e2 from subQ injections? Is it because of estrogen in fat?

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SUB-Q TESTOSTERONE INJECTIONS IN HYPOGONADAL MEN

SUBCUTANEOUS TESTOSTERONE INJECTIONS IN HYPOGONADAL MEN (2022) Rodney L Dennis MD Testosterone Therapy may be administered in various ways. But, one delivery route not often considered is a subcutaneous injection. Some reasons for this may include a lack of familiarity with the technique, a...

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Test E sub Q?

Can Testsosterone Enanthate be injected sub Q. My weekly Inj dose is currently 210 mg, so what would that be ?30mg daily? .o3 on insulin pin

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Subcutaneous TRT injections reduce the number of men with high hematocrit

Erythrocytosis in Subcutaneous Testosterone Replacement Therapy Author links open overlay panel (2022) TWilliamson, JTrussler, AMcCullough Introduction Intramuscular (IM) testosterone replacement therapy (TRT) is commonly administered to treat symptomatic male hypogonadism and can result in...

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Most Patients Liked Being Switched to Subcutaneous Testosterone Injections

Early Experience with Subcutaneous Injection of Non-Proprietary Testosterone as an Alternative Approach for Testosterone Replacement (2022) KAlter, DRoadman, CAmarasekera, LLevine Introduction Testosterone replacement therapy (TRT) has been demonstrated to benefit men with a diagnosis of...

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subcutaneous injection into stomach

Is 80mg injected into my belly every 4th day to much? Meaning is 80mg to much to inject at one time into belly?

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NEW INSIGHTS INTO DRUG ABSORPTION FROM OIL DEPOTS

A very interesting read for anyone who wants to develop a better understanding of drug absorption from a parenteral oil depot. Long read but very informative. Spatial distribution of oil depots monitored in human muscle using MRI. The shape and surface areas of oil depots after injection is...

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[madman]

Thank you so much for everyone taking part in this discussion and also for the latest guy sharing his experience. This has been extremely informative and insightful.

I am now 10 weeks into a strict gym routine and switched to weekly injections from the advice on this forum.

I have not switched to sub-q yet however. (I’ll explain shortly)

when I started the gym I was 245 lbs. I carried it very well but was definitely overweight by a lot. As mentioned earlier I was in very good shape in my 20s and so carried all the muscle with me and with a layer of fat on top so my arms were always big and defined etc.

Anyways, I am now down to 223 while also very clearly and visibly also gaining new muscle. Things are going incredibly well. My strength has consistently just continued to grow.
For bench as a metric - upon first week or so I was only able to just barely bench 135 for 8-9.
I just had my latest chest day today and I was able to bench 225 for 8 - up an extra 2 reps from last week where I was able to do it for 6. So the strength continues to grow.

I’m so happy with what TRT has done for me. I have more energy, my health, looks, confidence and wellbeing is the highest it’s been in years.

So that was just an update.

Now - why haven’t I taken the sub-q advice ?

So, I am extremely new to all of this obviously. And I know everyone here is extremely knowledgeable, but of course it would be irresponsible of me to just take advice without first contacting my health professional. So I went to the pharmacy that I goto and discussed it with my pharmacist. She (as expected) didn’t really know much about it - but my pharmacy is a great little mom+pop run spot - and so she said to leave it with her and she would do some research.

Long story short, the next week I came in and she had been emailing back and forth with some health Canada company that manufactures test and other stuff. It wasn’t the exact company as mine, but they essentially said that it should be deep IM in the glute or thigh and no delt and they attached some clinical study on the efficacy of each and showed delt IM injections not as effective etc and then they outright said that the stuff I use should NOT be used subconsciously.

So… that’s where I am now - I obviously know yall know a ton about this stuff, but I also can’t verify any credentials etc and I feel it would be irresponsible of me to take advice from a forum when my direct health professionals are saying I shouldn’t…. This is really a crappy place to be in, because I’m so clueless about all of this stuff as well so I don’t even know enough and either way have to rely on a third party.

Does anyone happen to have a study or information from a reputable source of using the standard IM based test solutions used in subcutaneous methods and the efficacy to go along with it etc? My pharmacist did mention that there are types of test out there made for that type of shallow injection, but said mine was not that type.

Sorry guys please don’t take this as me being combative or going against your clearly knowledgeable opinions. I’m just in a tough spot here. I want to make the best decision for myself. I would love to be able to start sub-q and move to twice a week injections but as it stands I’m still using what yall very elegantly referred to as “harpoons” haha and I couldn’t agree more. I’m using 1.5” 23G into the glute. Obviously great results but very inconvenient.

Some take-home points here:


*To date, limited data suggest that SC administration of testosterone enanthate and cypionate results in stable and predictable on-treatment concentrations has good acceptability among patients, and can be self-administered more easily than IM injections. Furthermore, localized adverse effects at the injection site are mild and transient. Although long-term studies with a larger number of patients are needed to evaluate the safety and compliance of SC testosterone (in particular for testosterone undecanoate), clinicians should be aware of this route of testosterone administration, as it has the potential to increase patient adherence to therapy of a formulation that is relatively inexpensive and results in comparable on-treatment serum testosterone concentrations.


*As the lymphatic drainage from SC tissue is largely dependent on intrinsic pumping, while IM lymphatic flow is also substantially influenced by extrinsic pumping during physical activity (43), these drainage patterns suggest that testosterone esters administered SC likely have more stable absorption kinetics compared to IM administration.


*On the contrary, after SC administration, the drug is delivered to the hypodermis (adipose tissue underlying the dermis), which is not only less vascularized compared to skeletal muscles, but the flow in this region does not increase significantly with physical activity. Since the blood flow at the site of drug administration influences the pharmacokinetics of the administered drug, SC injections display a more stable vascular absorption pattern compared to IM injections.


*As discussed, SC administration of testosterone esters should result in a more stable absorption and release of testosterone into the circulation due to less fluctuation of lymphatic flow in the hypodermis with physical activity. This was confirmed by pharmacokinetic studies that assessed the Cmax and Tmax of testosterone in the serum, and the average serum total testosterone concentration during the steady-state. These data are summarized below.

TRT with Subcutaneous Testosterone Injections: A Safe, Practical and Reasonable Option

Abstract Context: Injections with intramuscular testosterone esters have been available for almost 8 decades and not only result in predictable serum testosterone levels but are also the most inexpensive modality. However, they are difficult to self-administer and associated with some...

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*Subcutaneous vs Intramuscular Routes

The IM and SC routes present a defined phase of absorption, in which the serum concentration of the drug administered progressively increases to a maximum (Cmax) and then decreases according to its elimination half-life. For testosterone esters, the time corresponding from administration to the Cmax, i.e., time of maximum concentration (Tmax), is determined by the rate at which absorption occurs, since systemic elimination of testosterone is the same regardless of the route of administration. Therefore, the formulation and the injection site influence the speed and magnitude of absorption.

After IM or SC administration of a testosterone ester, absorption occurs first by diffusion from the depot into the interstitium (Figure 2B). The physiology of the IM and SC milieu determines the patterns of absorption after administration. Molecules smaller than 1 kDa, such as testosterone, are preferentially absorbed by the blood capillaries due to the high rate of filtration and reabsorption of fluid across vascular capillaries (39). However, the hydrolysis of testosterone esters by tissue esterases is a slow process due to their high lipophilicity, with negligible spontaneous hydrolysis in water (40). This results in some of the esterified testosterone entering the lymphatics, thus prolonging the secondary absorption phase.

The interstitial fluid consists of plasma ultrafiltrate and proteins derived from tissue metabolism and is drained by the lymphatics (41). Because of their lipophilicity, testosterone esters are unlikely to have significant diffusion into the tissues; they likely associate with small proteins and are drained via the lymphatics into the central circulation, with the hydrolysis of these esters likely occurring in the central circulation (40). Therefore, the pharmacokinetics of testosterone esters administered via the IM versus SC route will vary according to the lymphatic circulation of the tissue. Lymphatic drainage is dependent on intrinsic and extrinsic pumping. Intrinsic pumping is dependent on the contraction of lymphangions (muscular unit of the lymphatics with unidirectional valves) that transport lymph by mechanisms analogous to that occurring in the cardiac chambers (42). Extrinsic pumping results from intermittent external pressure exerted by skeletal muscle contractions on the lymphatics (42). As the lymphatic drainage from SC tissue is largely dependent on intrinsic pumping, while IM lymphatic flow is also substantially influenced by extrinsic pumping during physical activity (43), these drainage patterns suggest that testosterone esters administered SC likely have more stable absorption kinetics compared to IM administration.

Similar to lymphatics, the hemorheological differences of the vascular compartments of the SC and IM tissues play a role in the pharmacokinetics of testosterone esters. As different muscle groups have variable blood flow (e.g. the blood flow to the deltoids is higher than the glutei) (44), which further varies with physical activity (45), serum on-treatment testosterone concentrations after IM injections are dependent on these characteristics. On the contrary, after SC administration, the drug is delivered to the hypodermis (adipose tissue underlying the dermis), which is not only less vascularized compared to skeletal muscles, but the flow in this region does not increase significantly with physical activity. Since the blood flow at the site of drug administration influences the pharmacokinetics of the administered drug, SC injections display a more stable vascular absorption pattern compared to IM injections.




*Pharmacokinetics of Testosterone Esters Injected Subcutaneously

As discussed, SC administration of testosterone esters should result in a more stable absorption and release of testosterone into the circulation due to less fluctuation of lymphatic flow in the hypodermis with physical activity. This was confirmed by pharmacokinetic studies that assessed the Cmax and Tmax of testosterone in the serum, and the average serum total testosterone concentration during the steady-state. These data are summarized below.