Androgel to Injectable converstion

Sketch2000

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I"ve been using 2 packets of Androgel 1% daily with very good results.

I'm changing because of various reasons...

I just emailed my Endocrinologist (I've had subclinical hyperthyroidism and secondary hypogonadism for a decade or so...finally found an endo that knew what she was doing and willing to give me test as otherwise my test would fluctuate between low normal to low...doctors said it was "fine". I'm now 33).

Total T was 409 (1100 limit)
Free T was 90.4 (155 limit)

LH and TSH low....I"m assuming the LH was low because of the Androgel...TSH is low due to the sublicinal hyperthyroidism (all other thyroid hormones normal).

My endo emailed and said to try 1cc of Enanthate or cypionate every 4 weeks and then check my labs after 12 weeks...??
 
furion

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Are you using the 5g satchets or 2.5g?

In any case, in my experience, 5-10mg transdermal testosterone daily will produce higher more stable serum testosterone than 200-250mg monthly.
Your endo is being very conservative- bloods taken after a month will likely not best represent an accurate trough level. It also will take a very long time to reach steady state concentration if you are prescribed monthly intervals.
 

Sketch2000

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Sorry, using 2 5mg packs daily (1% gel).

She is being very conservative. I figure 1CC is typically 200-250mg (which isn't much at all), so it would likely break down to 50mg a week or so...

She is asking for labs to be done after 12 weeks (3 months) to check levels.
 

Sketch2000

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I wouldn't mind staying on the gel in all honesty. I feel great on 2 packets and I don't want to mess up a good thing having been thru problems associated with Low T for so long...so having to change and then (now) monitor to ensure that my levels at (the very) least stay where they are now (hopefully higher) is an issue...But its cheaper, easier to use, hassle free...If 200-250mg sounds a little low what would be a good conversion from the 10 mg daily. i.e. - 10 grams daily is approximately 100 mg of test daily (50 mg of test in each packet, how much of that really gets absorbed who knows...) so 10grams of test (transdermal) = how much mg via injectable....one could say she's being conservative (she is..) but for the reason that it likely evens out and via injection It may all be absorbed?
 
furion

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I wouldn't mind staying on the gel in all honesty. I feel great on 2 packets and I don't want to mess up a good thing having been thru problems associated with Low T for so long...so having to change and then (now) monitor to ensure that my levels at (the very) least stay where they are now (hopefully higher) is an issue...But its cheaper, easier to use, hassle free...If 200-250mg sounds a little low what would be a good conversion from the 10 mg daily. i.e. - 10 grams daily is approximately 100 mg of test daily (50 mg of test in each packet, how much of that really gets absorbed who knows...) so 10grams of test (transdermal) = how much mg via injectable....one could say she's being conservative (she is..) but for the reason that it likely evens out and via injection It may all be absorbed?
I have seen significant variances in blood levels between individuals using transdermal testosterone and there is more than just the absorption that influences this (lean body mass/aromatase expression, metabolic enzyme polymorphisms, ect)- so it would be difficult to quantify- I could probably do a quick calculation if you have some past blood levels.

You will get 100% bioavailability with the injection. In Australia, a less conservative endocrinologist would likely prescribe 250mg of a long acting ester (we only use enanthate over here) according to therapeutic guidelines which is every 10-14 days.

I hear you on the convenience of the injection- most common complaint I've heard is the potential transfer to a female spouse when in bed together.
 

Sketch2000

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I have seen significant variances in blood levels between individuals using transdermal testosterone and there is more than just the absorption that influences this (lean body mass/aromatase expression, metabolic enzyme polymorphisms, ect)- so it would be difficult to quantify- I could probably do a quick calculation if you have some past blood levels.

You will get 100% bioavailability with the injection. In Australia, a less conservative endocrinologist would likely prescribe 250mg of a long acting ester (we only use enanthate over here) according to therapeutic guidelines which is every 10-14 days.

I hear you on the convenience of the injection- most common complaint I've heard is the potential transfer to a female spouse when in bed together.
I can post some previous labs tomorrow. lol...I was born in Canberra (Australia)...but I"m on the East Coast in the U.S at the moment.

I know what you mean with the gel...there's more to it than just absorption. So I understand what you mean when you say its hard to convert.

I would say that my levels that were just reflected in my labs (posted above) is what I"m aiming for...nothing outrageous (within limits).

But if your saying AUS guidelines reflect 250 mg every 2 weeks than I'd be using far far less....Based on my endo's recommendations I'd be using that over the period of a month.

My endo has said cypionate or enanthate, so whichever is stronger and would last longer i will use. It'll actually be prescribed by my PCP so I have some leeway...
 
furion

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I can post some previous labs tomorrow. lol...I was born in Canberra (Australia)...but I"m on the East Coast in the U.S at the moment. I know what you mean with the gel...there's more to it than just absorption. So I understand what you mean when you say its hard to convert. I would say that my levels that were just reflected in my labs (posted above) is what I"m aiming for...nothing outrageous (within limits). But if your saying AUS guidelines reflect 250 mg every 2 weeks than I'd be using far far less....Based on my endo's recommendations I'd be using that over the period of a month. My endo has said cypionate or enanthate, so whichever is stronger and would last longer i will use. It'll actually be prescribed by my PCP so I have some leeway...
Canberra, certainly the best place in Australia!

I would ask to have a peak blood level taken around 4-5 days after administration- then a trough level taken at 2 weeks (dose intervals are ideally calculated off trough levels). I would hedge my bets that after 2 weeks the trough would be around 290ng/dL, which is a level that would normally serve for ideal administration intervals for establishing a steady state concentration. If you have the peak level at least it'll serve as impetus for your physician to shorten the interval come time you get your trough taken.

Hope that arms you with a bit more info. Good luck with it.
 

kisaj

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If your option is to stay on the gel or use 200mg of test a month, stay on the gel. 50mg of test will crush you and is not even what we produce naturally when healthy (normal 7-9mg daily). In the states, the starting inject dose is generally 100mg weekly, divided into 2x weekly 50mg shots. It goes up from there.
 

Sketch2000

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If your option is to stay on the gel or use 200mg of test a month, stay on the gel. 50mg of test will crush you and is not even what we produce naturally when healthy (normal 7-9mg daily). In the states, the starting inject dose is generally 100mg weekly, divided into 2x weekly 50mg shots. It goes up from there.
I got ya man. Trust me I know...
But its not my only option. My endo is being really really conservative...but I'm also not seeing her...just emailing back and forth so I really can't be too strong about it...she's also not the one who's going to be dispensing it...I can get away with telling my PCP we communicated, just had labs done, and given I'm taking 2 packets daily we need to find the equivalent for that.

What you said (100mg weekly) is pretty much what Furion mentioned above per the guidelines in Australia (usually 250 every 2 weeks of enanthate).

Are there any (online) guidelines for RX usage? I'm going to run a quick search. It may be useful to take it in with me when I see my PCP.

If it comes down to 200mg monthly and/or the gel I'll stay on the gel...but I THINK (have to clarify, just received in the mail - literally) my insurance is dropping Androgel...that would be a huge problem - its like 1200 a month....That, and having to cover yourself in gel in the AM, having a partner, and when i said i live on the east coast I meant on the beach in Florida....so using gel (despite working now at 2 packets) is really really bothersome.
 

Sketch2000

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Canberra, certainly the best place in Australia!

I would ask to have a peak blood level taken around 4-5 days after administration- then a trough level taken at 2 weeks (dose intervals are ideally calculated off trough levels). I would hedge my bets that after 2 weeks the trough would be around 290ng/dL, which is a level that would normally serve for ideal administration intervals for establishing a steady state concentration. If you have the peak level at least it'll serve as impetus for your physician to shorten the interval come time you get your trough taken.

Hope that arms you with a bit more info. Good luck with it.
Thanks mate. I"m going to give it a go at telling my PCP to begin at 1cc every 2 weeks (so 100mg every week) and go from there after checking labs.
 

Sketch2000

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Google is god...lol

http://www.drugs.com/dosage/testosterone.html

http://www.drugs.com/pro/depo-testosterone.html

This seems to be the most informative -

http://www.excelmale.com/showthread.php?1487-Testosterone-Replacement-Treatment-Options

I sent an email to my Endo after reading this info. Seems the standard is 200mg every fortnight (2 weeks) to begin. Perhaps she is starting lower becuase I'm transitioning from the Gel?

I'm going to be booking an appointment with my PCP to begin within the next few weeks.

Any recommendations on what RX to get written (generic Enanthate) - I want to get the cheapest available...
 

kisaj

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I use cypionate and I pay $15 through insurance for 10cc (2000mg) Just make sure they don't try to give you 200 e2w and understand you need a minimum of 100 ew.
 

Sketch2000

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I use cypionate and I pay $15 through insurance for 10cc (2000mg) Just make sure they don't try to give you 200 e2w and understand you need a minimum of 100 ew.
Yeah I get ya.
I'd rather get a larger bottle (and pay at once...or one price/copayment).
 

Sketch2000

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How much do you use ?
 

kisaj

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About 100mg wk now, but I may bump back up to 120mg. I dropped back for an experiment to see how it worked and I like my energy and mood better at 120.
 

Sketch2000

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I emailed my Endo and provided guidelines per Druglist and the articles I found.
She basically said I could "try" using 50mg injections 2x monthly...

I'm thinking to myself - that's pretty much the same as taking 100mg once monthly...

Upon reading this I can instantly tell that she's VERY inexperienced in injections....doesn't know the half life and that they have to be done on a certain regimen to keep blood levels stable. She is however a very good endocrinologist and i would still be impotent if it were not for her...

With all that being said tomorrow I see my PCP.

I'm going to tell her that my endo said "yes"....

That 2 packs of Androgel daily is 100mg of transdermal test at 1%

And the "guidelines" for injections are 100mg weekly.

I think thats a good general guideline (in Australia being 200-250 mg every fortnight, and here in the US the "norm" seems to be 100mg weekly).

So, I think that should be done with 2 shots per week (50mg) to keep levels stable.

So I"m keeping my fingers crossed and will post tomorrow on what happens....My PCP had mentioned injections to me during my first visit and said she treats many people with injections and knows the frustrations of androgel well (given I live 2 minutes from the ocean...lol) so she should be well aware of the guidelines.

My only last question is Enanthate or Cyponate....Enanthate is obviously a longer lasting Ester from what I've read....

What are the benefits / drawbacks of each?

I will also be requesting she give me the damn bottle I'm sure as sh-- not going in there to get shots twice a week! and to get the largest bottle (generic) possible so i can save as much money as possible.

Sketch
 

protrester

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find another doctor if you cant get what you want. they're a dime a dozen.
and i'd find a male doctor for this kind of thing. just sayin, what do you expect? trying to get this evil testosterone from a woman. lol
 

Sketch2000

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find another doctor if you cant get what you want. they're a dime a dozen.
and i'd find a male doctor for this kind of thing. just sayin, what do you expect? trying to get this evil testosterone from a woman. lol
lol...I feel ya.
My appt is in 2 hours...I'll keep you guys posted....hopefully there's no need for that...

Sketch
 

kisaj

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Something isn't adding up with this Endo. No way she is that clueless and out of touch with hormone treatment in her profession. Even a PCP would tell her she doesn't know what she is doing.

In any case, do not go back to her.
 

Sketch2000

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Something isn't adding up with this Endo. No way she is that clueless and out of touch with hormone treatment in her profession. Even a PCP would tell her she doesn't know what she is doing.

In any case, do not go back to her.
I feel ya Kisaj. I was so so surprised at her response! Its a shame because she did everything for me including HCG got me on Test etc...after so many doctors were unwilling because of me being in the normal range....(low normal)....neway, we'll see what happens in a few hours....

Sketch
 

Sketch2000

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About 100mg wk now, but I may bump back up to 120mg. I dropped back for an experiment to see how it worked and I like my energy and mood better at 120.
Do you split yours up into two weekly shots? (50mg each). If so what days?
 

Sketch2000

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Cool. Thx bra. At the doctors now. Nervous as ****
 

Sketch2000

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Got 100mg of cyponaite weekly. 10ML BOTTLE!! (1ml = 100mg) !! With 50mg injections twice weekly. FYI after speaking to the pharmacist (who was cool as ****) she androgel just came out with a generic (useful info for those that use, and have been stuck paying heaps or insurance paying heaps)...she said my insurance would need the doc to call (needs pre authorization to justify even tho i use androgel) but without insurance it's 50 bucks for a 10ml bottle (2 1/2 month supply!!) Picking up tomorrow!!
 

Sketch2000

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I'm not strict with it, but generally Mon and Thur.
I just got my cyponaite. Got a 2,000mg bottle. 10ML (1ML is 200mg...so I'll be doing 100mg 1/2 ML weekly...) I was supposed to get the 10ML 1,000mg bottle but that's what was sent in inadvertently so i just took it...90 bucks...

I read about people splitting up into 2 shots....50mg 2x weekly...

But given the fluctuations after 10 days people are injecting weekly. So why twice a week? I would much rather inject once (100mg weekly)....

Sketch
 

kisaj

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Once a week is fine, just not as stable twice a week. Using me as an example. 100mg ew has me at about 1000-1100 level and then the day before inject 7 days Iater I am at low 500s. If I inject 50mg, I am at about 800 and by the time I inject again, I am at low/mid 600s. Less up and down.

Remember that it isn't linear, so you don't double up.
 

Sketch2000

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Okay. Gotcha. Thanks man.

Sketch
 

Sketch2000

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Your insurance will cover a new bottle after 28 days with a multi dose vial, it's good to stock up...
Completely agree with you on stocking up...

I didn't run it thru my insurance...90 bucks was the actual cost.

Would have had to wait to have my insurance pre approve it and then they would have probably only given meone months worth (400mg)..

On top of it all my doc has prescribed me 100mg a week but she wrote for a 10ml 1000mg bottle so i could pay a flat rate (compayment) and get more..

I ended up getting double that, but again my doc won't let me just stock up and the pharmacy knows my dosage.

Despite adjusting the dose which will likely be done after month to probably go slightly higher I doubt ill get another bottle like this. My doc is fine prescribing it as long as i don't abuse it.

As long as my levels stay high normal I'm good...but now that i know how the ester will work i can do my labs with little to none in me to get my dosage as high as possible...

So yeah...if and when i will get as much as i can..

Unbelievable that at the current recommended dose two and a half months worth costs 90 bucks and androgel costs 1200 monthly..
 
LMuscle

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How long does cyp keep for sealed? Exp says 2016
 

Sketch2000

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Just took my first shot (50mg) in the left delt.

The syringes my PCP prescribed were wrong....

to draw the test out she gave me a 3ML Syringe...21Gx 1 1/2

Then to inject she gave me a 3ML 25G x 1

After watching all the videos reading all the posts and knowing you draw from the "big one" then switch the needle to the other syringe...that's what I did...problem was is the needle from the "injecting syringe" wouldn't fit on the other one (the one used to draw).

So I just ended up re-injecting what I had pulled out....then pulling it out from the syringe used for injecting....took about the same time to draw out...maybe a little longer....but I got up to .25 ML (200mg a ML) and injected...

Now my shoulder hurts like a bitch...

Its Saturday...So I figure I'll do again on Wednesday...

Then I'd like to slowly push back/forward days so i can get on a Monday/Thursday regimen.

Sketch
 

kisaj

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You are brave. I've been doing this for 4 years and only ever shoot my glutes. No pain at all ever.
 
GreenMachineX

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Your insurance will cover a new bottle after 28 days with a multi dose vial, it's good to stock up...
Doesn't the doctor know your stocking up? Aren't they notified every time you get a refill?
 

Sketch2000

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Doesn't the doctor know your stocking up? Aren't they notified every time you get a refill?
My doc doesn't know I'm "stocking up"....she's playing it by the books...given what I've been thru just to get the damn injectable I don't want to ruin that. Trust me when I tell you If I can get more I will...but the instructions are 100mg weekly and I just picked up a 2000 mg bottle....not via insurance - via self pay.

So its not really the insurance but the pharmacy that knows at my current dosage that's about 2 months worse...that and its a "controlled substance"...

So I'll likely not be getting any more until my labs are drawn in a month and my dosage is (hopefully upped). I'd like to be on 150 a month.
 

Sketch2000

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Once a week is fine, just not as stable twice a week. Using me as an example. 100mg ew has me at about 1000-1100 level and then the day before inject 7 days Iater I am at low 500s. If I inject 50mg, I am at about 800 and by the time I inject again, I am at low/mid 600s. Less up and down.

Remember that it isn't linear, so you don't double up.
Took my first shot on Saturday. Its now Tuesday so this afternoon will be 3.5 days...then again on Satuday. I'd like to slowly taper to Monday and Thursday. I'd rather be shooting during the week then the weekend...

Should I wait until tomorrow (Wednesday) to get closer to a Monday, Thursday pin?

Sketch
 

kisaj

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Yeah, then just extend a day next week. A day is no big deal.
 

Sketch2000

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Thanks. I'm going to pin tomorrow. (Wednesday) than wait until Monday (that's be 4 days instead of the 3.5 on both shots) but I doubt it'll be that big of a deal. Then I can just do Monday and Thursday.
 

Sketch2000

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Thanks. I'm going to pin tomorrow. (Wednesday) than wait until Monday (that's be 4 days instead of the 3.5 on both shots) but I doubt it'll be that big of a deal. Then I can just do Monday and Thursday.
Actually, Monday to Thursday is - Monday pin, Tues, Wed, Thurs (Thursday being the 3rd day after pinning)...Thursday pin - then its Fri, Sat, Sun...Monday being the third day after pinning...okay...yeah that sounds good...as long as i can keep a steady regimen....I'll do both shots in the AM...so it'll be 3 days (actually pinning on the 4th day though) this okay?

Its a shame this week (my first) is a little off...but only be one day (or .5) but I'd much rather pin during the week than on Satuday....

This way my test levels are good and manageable during the weekend...
 
GreenMachineX

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My doc doesn't know I'm "stocking up"....she's playing it by the books...given what I've been thru just to get the damn injectable I don't want to ruin that. Trust me when I tell you If I can get more I will...but the instructions are 100mg weekly and I just picked up a 2000 mg bottle....not via insurance - via self pay.

So its not really the insurance but the pharmacy that knows at my current dosage that's about 2 months worse...that and its a "controlled substance"...

So I'll likely not be getting any more until my labs are drawn in a month and my dosage is (hopefully upped). I'd like to be on 150 a month.
That question about stocking up was to Emantest.
 
emantest

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That question about stocking up was to Emantest.
If you have a prescription and are receiving a multi dose vial, at or about 28-30 days you can request another bottle. The reason is potential for bacteria growth with the vial being contaminated.
 

kisaj

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Huh? When do you suspect bacteria growth and contamination occurs in a vial of test?
 

kisaj

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That is just silly. So you get your 2,000 mg/10 mL vial and toss it every 28 days? If this is actually true, then you must be going to a clinic as no doctor or endo I have every dealt with or talk to would ever allow that.
 
emantest

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That is just silly. So you get your 2,000 mg/10 mL vial and toss it every 28 days? If this is actually true, then you must be going to a clinic as no doctor or endo I have every dealt with or talk to would ever allow that.
Do I discard no do I get another bottle yes
 

kisaj

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Ok, I misunderstood. But, back on topic- your doctor will actually allow you to get a new bottle of test every 28 days?? My insurance, UHC, doesn't even allow a prescription to be filled under 90 days.
 
emantest

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Ok, I misunderstood. But, back on topic- your doctor will actually allow you to get a new bottle of test every 28 days?? My insurance, UHC, doesn't even allow a prescription to be filled under 90 days.
I utilize an Advanced Practice nurse who has her own hormone clinic. I'm also a nurse who uses the power of best practices and hospital standards to get the bottle every 28 days. My pharmacy labels the vial as best discarded within 28 days.
 

kisaj

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Haha, OK. So it should be noted that your situation is not one that 99% of people on TRT will ever be in, so advice on getting a new bottle every 28 days needs to be understood as such.
 

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