[1cc]

STABLE TESTOSTERONE LEVELS ACHIEVED
WITH SUBCUTANEOUS TESTOSTERONE
INJECTIONS
M.B. Greenspan, C.M. Chang
Division of Urology, Department of Surgery, McMaster University,
Hamilton, ON, Canada
Objectives: The preferred technique of androgen replacement
has been intramuscular (IM) testosterone, but wide
variations in testosterone levels are often seen. Subcutaneous
(SC) testosterone injection is a novel approach; however,
its physiological effects are unclear. We therefore investigated
the sustainability of stable testosterone levels using
SC therapy. Patients and methods: Between May and
September 2005, we conducted a small pilot study involving
10 male patients with symptomatic late-onset hypogonadism.
Every patient had been stable on TE 200 mg IM for
41 year. Patients were instructed to self-inject with
testosterone enanthate (TE) 100 mg SC (DELATESTRYL
200 mg/cc, Theramed Corp, Canada) into the anterior
abdomen once weekly. Some patients were down-titrated
to 50 mg based on their total testosterone (T) at 4 weeks.
Informed consent was obtained as SC testosterone administration
is not officially approved by Health Canada. T
levels were measured before and 24 hours after injection
during weeks 1, 2, 3, and 4, and 96 hours after injection
in week 6 and 8. At week 12, PSA, CBC, and T levels
were measured however; the week 12 data are still being
collected. Results: Prior to initiation of SC therapy, T
was 19.14+3.48 nmol/l, hemoglobin 15.8+1.3 g/dl, hematocrit
0.47+0.02, and PSA 1.05+0.65 ng/ml. During
the first 4 weeks, there was a steady increase in
pre-injection T from 19.14+3.48 to 23.89+9.15 nmol/l
(p¼0.1). However, after 8 weeks the post-injection T
(25.77+7.67 nmol/l) remained similar to that of week 1
(27.46+12.91 nmol/l). Patients tolerated this therapy with
no adverse effects. Conclusions: A once-week SC injection
of 50–100 mg of TE appears to achieve sustainable and
stable levels of physiological T. This technique offers
fewer physician visits and the use of smaller quantity of
medication, thus lower costs. However, the long term
clinical and physiological effects of this therapy need further
evaluation.

[jomi822]

interesting. i was under the impression only suspension could be injected subq, as fat tends to affect absorbtion.

the real question is what gives you more bang for your injection. will 100mgs of TE subq boost test levels as much as IM. stable levels is one thing, but i want to get the most out of my 900mgs of so of test

[1cc]

Originally Posted by jomi822

interesting. i was under the impression only suspension could be injected subq, as fat tends to affect absorbtion.

the real question is what gives you more bang for your injection. will 100mgs of TE subq boost test levels as much as IM. stable levels is one thing, but i want to get the most out of my 900mgs of so of test

According to the study, SubQ shots cause higher T levels than IM shots. I don't think it would be practical to do 900mg of T SubQ.

[pistonpump]

wow interesting post. I wonder who is going to or already has tried it this way.

[Heat Miser]

Just a reminder to some:

http://anabolicminds.com/forum/male-...ideration.html

[pistonpump]

i was wondering about that comment too.......

[Zero Tolerance]

How much oil could you inject subq though? My HRT prescription has me injecting 1ML intramuscularly and THAT gives me a lump for almost a week. Wouldn't the lump be much more obvious if it's just beneath the skin? Or would it spread-out evenly?

[Strateg0s]

What journal is this abstract from? I'm trying to find the full-text.

(yes, I'm still alive, just busy as all get out)

[1cc]

Originally Posted by Strateg0s

What journal is this abstract from? I'm trying to find the full-text.

The abstract is in this document.

[Random987]

I seem to recall that Dr. Shippen had some of his patients on Sub-Q T. I think he split it up into 3 30mg shots during the week. But I am not 100% sure. In any event, I know that it has been attempted by the Dr.'s in the know.

[Zero Tolerance]

Originally Posted by Zero Tolerance

How much oil could you inject subq though? My HRT prescription has me injecting 1ML intramuscularly and THAT gives me a lump for almost a week. Wouldn't the lump be much more obvious if it's just beneath the skin? Or would it spread-out evenly?

Since I have extra Cypionate that I'm worried about Potentially going bad - I MAY consider giving this a shot just to see what would happen. But then this would probably be the wrong area to discuss that possibility.. Can we have this discussion moved?

[pmgamer18]

Originally Posted by Zero Tolerance

How much oil could you inject subq though? My HRT prescription has me injecting 1ML intramuscularly and THAT gives me a lump for almost a week. Wouldn't the lump be much more obvious if it's just beneath the skin? Or would it spread-out evenly?

Are you using 100mgs/ml that is a big dam shot not dose wise. I use 200mgs/ml and did .32mls with a 27g x 1/2" lg. needle into my thigh with no problems. The T comes out slow so I pull the plunger all the way down and hold it there until I get my dose. I read from one of Dr. Shippen's men that he give's him self a subQ shot but does it half on one side and the other half on the other side of his belly. So is doing .18mls on each side every 3 days = .36mls or 72mgs every 3 days.
Phil

[Zero Tolerance]

I'm currently using 300mgs/ml per week of Cypionate. Actually, I just cut down to a 1/2 ml so that would be 150mg per week. But, when injecting into my thigh, I use a 25g 1" needle.

I just injected 1ml of Methyl B12 subcutaneously into my stomach. That seemed to go well.. I just don't know how Cypionate would react there.. Plus, I don't think the oil would go through the 29g slin pins I have..

Like I said, I'm considering giving all this a try but I'd like to see more feedback on it first.. Opinions, criticisms, etcetera...

[SilentScream27]

wait until the study comes out and they report the AUC (area under [the] curve) for both methods... I assume they will do this, as it would be retarded not to.

[SilentScream27]

Originally Posted by Dr. John

"stable on TE 200 mg IM for
41 year."

What does that mean? Were they on 200mg every other week? if so, then merely going to weekly injections would even things out greatly.

I don't know why thye draw a conclusion that this would result in "fewer physician visits"? Why would an untried technique be prefrable in tis respect to standard IM injections? Patients can easily do either.

I readily admit, we may be looking at the shape of things to come, though.

Dr. John, I am sure you know this as well as anyone, but it annoys me to no end to hear that testosterone injections are problematic because they result in uneven levels of T. THAT'S BECAUSE THEY REFUSE TO INJECT MORE OFTEN THAN ONCE A FORTNIGHT! When, and why, the hell did that become common practice for something with a 5-6 day half-life? They are simply injecting once T falls below baseline, instead of acknowledging the widespread anecdotal evidence showing that falling/rising levels are hell for patients. I am glad that you are one of the only docs who will inject EW. I am sure there could be benefit from injecting twice EW for patients who can self-administer, as well.

200mg EOW (for the IM) is almost certainly what they are talking about. I suppose the study is far less useful than it could have been now... who reviews these things before they go to trial?

EDIT: And yes, I actually have no idea how one would go about sticking a 23g needle into abdominal fat... do you go close to parallel to the surface to avoid stabbing your liver or god knows what else?

[Random987]

Doc,

Did Dr. Shippen tell you why he does it? Is it just ease of use (no telephone pole injections)?

Thanks

Originally Posted by Dr. John

Dr. Eugene Shippen uses this technique exclusively. He likes ot tease me, privatley and publicly, because I do not. He says "John, when are you going to GET WITH IT??!!"

I think it's weird being considered behind the times in my field of medicine. LOL.

[Random987]

I am not sure which is worse, one huge shot per week (and 2 hcg shots), or 3 subq T shots (I believe that is what Dr. Shippen uses) and 2 hcg shots. I imagine it will be a lot more complicated as you will be dealing with 3 different half-lives of a smaller dose (or maybe it will be more like a gel).

Originally Posted by Dr. John

If I remember right, he believes it prodcues more stable serum levels. It may very well be.

I may be completely wrong about this, and subQ oil-based TRT injections may be the way to go, but I'm just not ready to go there yet. In my little midwestern community, believe me, TRT is considered pretty radical even when it is admistered by IM or TD.