Pros and Cons of Sub-Q T

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  1. Pros and Cons of Sub-Q T


    How many here are doing their injects sub-q?

    Have you experienced any benefit over IM?

    What is the rationale behind it?


  2. Just Found this on another board:
    ---------------------------------------
    ---------------------------------------

    Saudi Med J. 2006 Dec;27(12):1843-6.

    Subcutaneous administration of testosterone. A pilot study report.Al-Futaisi AM, Al-Zakwani IS, Almahrezi AM, Morris D.
    Department of Medicine, College of Medicine & Health Sciences, PO Box 35, Postal Code 123, Al-Khod, Sultanate of Oman. Tel. +968 99475401. Tel/Fax. +968 24413419. E-mail: [email protected].

    OBJECTIVE: To investigate the effect of low doses of subcutaneous testosterone in hypogonadal men since the intramuscular route, which is the most widely used form of testosterone replacement therapy, is inconvenient to many patients. METHODS: All men with primary and secondary hypogonadism attending the reproductive endocrine clinic at Royal Victoria Hospital, Monteral, Quebec, Canada, were invited to participate in the study. Subjects were enrolled from January 2002 till December 2002. Patients were asked to self-administer weekly low doses of testosterone enanthate using 0.5 ml insulin syringe. RESULTS: A total of 22 patients were enrolled in the study. The mean trough was 14.48 +/- 3.14 nmol/L and peak total testosterone was 21.65 +/- 7.32 nmol/L. For the free testosterone the average trough was 59.94 +/- 20.60 pmol/L and the peak was 85.17 +/- 32.88 pmol/L. All of the patients delivered testosterone with ease and no local reactions were reported. CONCLUSION: Therapy with weekly subcutaneous testosterone produced serum levels that were within the normal range in 100% of patients for both peak and trough levels. This is the first report, which demonstrated the efficacy of delivering weekly testosterone using this cheap, safe, and less painful subcutaneous route.PMID: 17143361 [PubMed - in process]
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  3. Quote Originally Posted by rick055 View Post
    How many here are doing their injects sub-q?

    Have you experienced any benefit over IM?

    What is the rationale behind it?
    I think the Pro is that it's less painful since you're not going into a muscle.

  4. Quote Originally Posted by MarkLA View Post
    I think the Pro is that it's less painful since you're not going into a muscle.
    I use subQ T shots.
    At first I used 31ga 5/16" long needle (it is smallest and shortest that I could find).
    I found out tiny leakouts from time to time, nothing really big, most likely acceptable situation.
    I use now 30ga 1/2" long needle.
    They do not make 31ga 1/2" long.

    I never tried IM test shots but am hearing that they are painfull.
    There is absolutely no pain when doing SubQ shots, no leak outs (now with longer needle).

    I started my T shots on 6/19/07, using accelerated schedule (to get to steady levels faster).
    Blood draw 8/30/07
    results and dose adjustments shown on my post #62
    Jan's BloodTest April13/2007

    I use SubQ shots because of pain considerations,
    but I thing that there is additional benefit as I expect that testosterone
    fat--->blood transfer is slower than
    muscles--->blood transfer.

  5. Is it an "accepted" delivery method? (not the regular medical community, the anti-aging community)?
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  6. Quote Originally Posted by rick055 View Post
    Is it an "accepted" delivery method? (not the regular medical community, the anti-aging community)?
    I think dr John argued aginst subQ shots.
    I do them any way,
    and have blood test that show they are working.
    I try to avoid pain if I can help it.

  7. Quote Originally Posted by JanSz View Post
    I think dr John argued aginst subQ shots.
    I do them any way,
    and have blood test that show they are working.
    I try to avoid pain if I can help it.
    Dr j infered that 1/2 inch is not sub Q but IM ..
    I use my shoulders and quads..

  8. Quote Originally Posted by hardasnails1973 View Post
    Dr j infered that 1/2 inch is not sub Q but IM ..
    I use my shoulders and quads..
    I make sure that my shots are subQ.
    I pinch the skin on my belly and insert the needle 45 deg sideways.
    No questions, my shots are SubQ shots, needle does not touch the muscle.

    Sometimes I am curious how it would feel if I went 90 deg inti tihg musscle, but no thanks for the pain.

    Soon I will go to get flu shots.
    My doc does it with (probably) with 30ga 1/2" long needle to deltoid muscle straight 90 deg, not a big deal either but why bother.
  9. Most importantly, how do you FEEL on sub q shots?


    How do you feel? Notice any difference between the 2 methods?

    Quote Originally Posted by JanSz View Post
    I make sure that my shots are subQ.
    I pinch the skin on my belly and insert the needle 45 deg sideways.
    No questions, my shots are SubQ shots, needle does not touch the muscle.

    Sometimes I am curious how it would feel if I went 90 deg inti tihg musscle, but no thanks for the pain.

    Soon I will go to get flu shots.
    My doc does it with (probably) with 30ga 1/2" long needle to deltoid muscle straight 90 deg, not a big deal either but why bother.
  10. Dr J may not like sub q, but Dr. Shippen does.


    Quote Originally Posted by JanSz View Post
    I think dr John argued aginst subQ shots.
    I do them any way,
    and have blood test that show they are working.
    I try to avoid pain if I can help it.
    I trust Dr S and will go the sub q route when I ever so reluctantly start my routine. Would have started today, but there was no mail delivery today due to Columbus day. Seems stupid-the whole world works except the privileged few.

  11. Quote Originally Posted by anyman View Post
    I trust Dr S and will go the sub q route when I ever so reluctantly start my routine. Would have started today, but there was no mail delivery today due to Columbus day. Seems stupid-the whole world works except the privileged few.
    I just hope that when you start,
    you are going to do that full bore,
    instead of wasting more time.


    I am so glad that I am priviledged, I do not work.
    I tried to work but was newer succesfull at it, so I quit.
    What a country, beautifull USA.

    Between my son, daughter and son-in-law,
    son and daugher worked
    son-in-law had a free day, but he took my grandson to see his parents in Reading PA,
    so wife had a day off too.
  12. Just because I apparently need T cyp doesn't mean I have to like it.


    Quote Originally Posted by JanSz View Post
    I just hope that when you start,
    you are going to do that full bore,
    instead of wasting more time.
    I will be starting .6ml of 100mg T cyp (hope I have the terms right) and reducing my hcg to 300iu 2x/week as soon as the T is here. The first bottle should have been delivered today, but there is no mail today.

    Taking external T is akin to admitting defeat- I was unable to successfully ID the source of the problem and repair it. Now I'll be dependent on external meds, the supply of which can be cut off through no fault of my own (Remember Hurricane Katrina?). At the age of 44 I am saddened to be dependent on medicine at so young an age, but my options are, regrettably, few and far between. I resent my body's failure and inability to conduct basic repairs. We really are a poorly designed species, aren't we?

  13. Quote Originally Posted by anyman View Post
    I will be starting .6ml of 100mg T cyp (hope I have the terms right) and reducing my hcg to 300iu 2x/week as soon as the T is here. The first bottle should have been delivered today, but there is no mail today.

    Taking external T is akin to admitting defeat- I was unable to successfully ID the source of the problem and repair it. Now I'll be dependent on external meds, the supply of which can be cut off through no fault of my own (Remember Hurricane Katrina?). At the age of 44 I am saddened to be dependent on medicine at so young an age, but my options are, regrettably, few and far between. I resent my body's failure and inability to conduct basic repairs. We really are a poorly designed species, aren't we?
    Make sure that you take you (averege) weekly dose using E3D schedule.
    What is your SHBG?
    My last known SHBG=26
    my new dose =38units=177.3mg/week
    post #62
    Jan's BloodTest April13/2007

    Your goal is
    FreeT=300
    ============================== ==

    You say: "I will be starting .6ml of 100mg T cyp"
    The higher the SHBG the more T you need.
    Make sure that you use 200mg/ml Depo-testosterone.
    But if you are forced to use the 100mg/mL kind, remember to double the volume.
    ============================== ==



    The sooner you give up on "admitting defeat" the better for you.
    Just be gratefull that you have way out.

    Use it.
    .
    .
  14. I am starting at a lower dose at Dr S's directive. He wants to start low and work up.


    Quote Originally Posted by JanSz View Post
    Make sure that you take you (averege) weekly dose using E3D schedule.
    What is your SHBG?
    My last known SHBG=26
    my new dose =38units=177.3mg/week
    post #62
    Jan's BloodTest April13/2007

    Your goal is
    FreeT=300
    ============================== ==

    You say: "I will be starting .6ml of 100mg T cyp"
    The higher the SHBG the more T you need.
    Make sure that you use 200mg/ml Depo-testosterone.
    But if you are forced to use the 100mg/mL kind, remember to double the volume.
    ============================== ==

    My SHBG is quite low--around 12. Dr S wants me to start lower and work up as--and if-- needed. He is trying to keep as much of my testes working as is possible. We'll start at 6ml and work up after a 3 week blood test. He is of the opinion that my very low shbg allows for lower total and free levels. We'll see how it goes. Maybe I'll get lucky and start to feel a bit better. The weird part is that usually feel pretty good the later it gets. I am really irritable and even depressed in the earlyt morning, but get better as the day wears into evening.

  15. I think Dr John doesnt reccomend it based on little reseach done about its effects and the fact that it is not common, and he doesnt want to push the envelope in the community

  16. I wondered what to expect as far as pain goes as well, but through my first 3 IM shots I have felt absolutely no pain. The only "pain" I feel is when the needle initially breaks the skin. It doesnt hurt at all when going into the muscle and there is no soreness the next day for me.

    By the way I'm using 25g, 1 inch needles into the quads.

  17. Quote Originally Posted by CF10 View Post
    I wondered what to expect as far as pain goes as well, but through my first 3 IM shots I have felt absolutely no pain. The only "pain" I feel is when the needle initially breaks the skin. It doesnt hurt at all when going into the muscle and there is no soreness the next day for me.

    By the way I'm using 25g, 1 inch needles into the quads.
    Agreed after my first 2 shots I havnt noticed pain since

  18. Quote Originally Posted by anyman View Post
    My SHBG is quite low--around 12. Dr S wants me to start lower and work up as--and if-- needed. He is trying to keep as much of my testes working as is possible. We'll start at 6ml and work up after a 3 week blood test. He is of the opinion that my very low shbg allows for lower total and free levels. We'll see how it goes. Maybe I'll get lucky and start to feel a bit better. The weird part is that usually feel pretty good the later it gets. I am really irritable and even depressed in the earlyt morning, but get better as the day wears into evening.
    To get FreeT~250-300
    With SHBG=12
    you need
    TotalT= 750-900

    To get that TT you need
    100-125 mg/week testosterone, best on E3D schedule.
    That 0.6mL testosterone may do the job if you use
    200mg/mL strenght.

    Since your SHBG is real low, you may be better off using E2D schedule, every other day.

    Assuming that you are going to be using 200mg/mL testosterone
    you weekly dose =120mg/week
    assuming E2D schedule,
    each shot=0.6/7*2=0.17cc=17 units on syringe
    at the same time do shots of hcg Novarel 250iu
    consider your estrodial status

    To arrive sooner at your average level of blood testosterone
    first four days do T shots each day and then continue on E2D schedule.

    Bottom line is blood test, T, E2 and DHT
    do these tests at Quest, draw blood on day of the shot, time of the shot, before shot.

    Estradiol, Free, LC/MS/MS (36169X)
    Testosterone, Free, Bio/Total (LC/MS/MS)
    Dihydrotestosterone, Free, Serum (36168X)

    there is many many other tests that you should consider.
    see my post #62
    Jan's BloodTest April13/2007
    I am describing my Test and Liquidex dose adjusment based on above tests.

    Looking at my chart, E2D schedule,
    you should be rather well stabilized at 3 weeks after change of schedule.
    Possibly there is no need to wait the usual 6 weeks.

    http://anabolicminds.com/forum/404im...eek-tcypionate

    Post #23 of
    Jan's BloodTest April13/2007

    Do not eat anything that is known to lower SHBG.
    Estrogen Metabolism
    To raise SHBG drink soy milk.

  19. Quote Originally Posted by anyman View Post
    My SHBG is quite low--around 12. Dr S wants me to start lower and work up as--and if-- needed. He is trying to keep as much of my testes working as is possible. We'll start at 6ml and work up after a 3 week blood test. He is of the opinion that my very low shbg allows for lower total and free levels. We'll see how it goes. Maybe I'll get lucky and start to feel a bit better. The weird part is that usually feel pretty good the later it gets. I am really irritable and even depressed in the earlyt morning, but get better as the day wears into evening.

    Increase fiber intake to 35-40 grams majoirty of 70% soluable SHBG will come up and lower fat intake a bit. Go on a vegan type diet shbg will rise..
    shbg is mainly driven by insulin and as i stated before insulin is a big factor...it makes sense more fiber reduces amount of insulin needed to handle the glucose. Less fiber speeds it up. am putting this theory to the test and my next blood report will reflect it.. shbg and insulin are antagonists. unless there is receptor damage give this a try and if it does not work then metformin may be necessary.

  20. Quote Originally Posted by CF10 View Post
    By the way I'm using 25g, 1 inch needles into the quads.
    Okay, so if one decides to go the IM route, you can inject solely in the quad? You can ignore the glutes?

    My worry is not about the injection; they don't bother me.

    But the glute shot seems kind of tricky to do by yourself.

    Any opinions?

  21. Quote Originally Posted by rick055 View Post
    Okay, so if one decides to go the IM route, you can inject solely in the quad? You can ignore the glutes?

    My worry is not about the injection; they don't bother me.

    But the glute shot seems kind of tricky to do by yourself.

    Any opinions?
    I plan on rotating the glutes in there as soon as I get some larger needles. If it is too difficult I will just do quads only.

  22. Quote Originally Posted by rick055 View Post
    Okay, so if one decides to go the IM route, you can inject solely in the quad? You can ignore the glutes?

    My worry is not about the injection; they don't bother me.

    But the glute shot seems kind of tricky to do by yourself.

    Any opinions?
    I only do quads, its the only place I can see myself actually doing.

  23. Quote Originally Posted by JanSz View Post
    To get FreeT~250-300
    With SHBG=12
    you need
    TotalT= 750-900

    To get that TT you need
    100-125 mg/week testosterone, best on E3D schedule.
    That 0.6mL testosterone may do the job if you use
    200mg/mL strenght.

    Since your SHBG is real low, you may be better off using E2D schedule, every other day.

    Assuming that you are going to be using 200mg/mL testosterone
    you weekly dose =120mg/week
    assuming E2D schedule,
    each shot=0.6/7*2=0.17cc=17 units on syringe
    at the same time do shots of hcg Novarel 250iu
    consider your estrodial status

    To arrive sooner at your average level of blood testosterone
    first four days do T shots each day and then continue on E2D schedule.

    Bottom line is blood test, T, E2 and DHT
    do these tests at Quest, draw blood on day of the shot, time of the shot, before shot.

    Estradiol, Free, LC/MS/MS (36169X)
    Testosterone, Free, Bio/Total (LC/MS/MS)
    Dihydrotestosterone, Free, Serum (36168X)

    there is many many other tests that you should consider.
    see my post #62
    Jan's BloodTest April13/2007
    I am describing my Test and Liquidex dose adjusment based on above tests.

    Looking at my chart, E2D schedule,
    you should be rather well stabilized at 3 weeks after change of schedule.
    Possibly there is no need to wait the usual 6 weeks.

    http://anabolicminds.com/forum/404im...eek-tcypionate

    Post #23 of
    Jan's BloodTest April13/2007

    Do not eat anything that is known to lower SHBG.
    Estrogen Metabolism
    To raise SHBG drink soy milk.
    JanSz, you post on here a lot with a lot of useful info, but you never say how YOU are feeling with your TRT. So, I am curious, how is the routine you are on working for you?

  24. Quote Originally Posted by Hyde12 View Post
    JanSz, you post on here a lot with a lot of useful info, but you never say how YOU are feeling with your TRT. So, I am curious, how is the routine you are on working for you?
    I am satisfied by my mostly self treating method.
    It is working for me very well.
    I have been left for dead by head of sex department in major hospital in Manhattan NYC, at least the sex part.
    I described my story many times on this board.
    What I am advising to others is what I do for myself.

    I am looking for all kind of angles of good health so I am reluctant to call what I do TRT or HRT,
    anti-aging would be more like it..

    See my story/diary/research here:
    Jan's BloodTest April13/2007

    .

  25. Quote Originally Posted by TJack View Post
    I recall reading in a number of places on another forum where he used to be at (not sure he ever addressed this topic over there), but he did specify one concern. And that concern dealt with a belief on his part that injecting T subQ would lead to an increase of Total Es and E2 as the aromatase factor is much more heavily present in fat cells than in muscle cells... and that therefore one could have a strong potential for excessive aromatizing of T into E if using subQ injections.

    So... the study quoted above is great - except it does NOT address what happens with estrogen levels when the groups used IM injections versus subQ injections. I believe in a couple posts there that he pointed out that transdermal users usually have higher E levels as they are transferring the exogenous T directly into the dermal / fat layers below the skin and he believed that was due to the T in the fat cells converting more efficiently via aromatase into E...

    For subQ users, have you ever specifically charted E levels (specific blood test results) from when you did T via IM injections versus doing it as subQ injections.

    I currently inject IM (strictly quads - I draw with a 22-gauge 1 1/2" needle and then switch over to a 27 ga. 1 1/4" needle to inject - and only insert needle about 1"... I also find if I ice pack the injection area while I am setting everything up that when I go to actually inject it is totally painless).

    SubQ injections could be slightly more convenient (I could drop the icing procedure - plus I already inject HcG subQ), but I do have lingering worries over estrogen increases due to aromatase via fat cells where you are injecting directly into.

    Also for subQ users, do you draw from the vial directly with the subQ syringe & needle? And if so, doesn't that take quite a while with the thicker fluid of the T (as compared to HcG)? Or do you use another regular syringe to draw with and inject the T into the insulin type syringe?
    i know one person showed labs after switching to subq and his e2 stayed the same

    thats one person tho
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