Subcutaneous testosterone injections

[heavyiron]

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 1 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.

[DICE]

What do you think though?

[heavyiron]

I did a run with it back in April and here was my log;

I have been on a cruise dose of 280mg per week of Testosterone Cypionate and decided I would try injecting my testosterone subcutaneously. I have never injected testosterone any other way than Intramuscularly until today. I decided to use up some pharm grade propionate that has been sitting around so I loaded up a 29 guage slin pin with 40mg of prop. This was 40 units as the prop is 100mg/ml. I warmed up the testosterone in a cup of hot water and swirled it around until it was very warm. It took about 2 minutes to load the pin as the oil is somewhat thick. I injected 2 inches to the right of my belly button into a fold of skin. The injection took about 20 seconds. I felt nothing except the needle penetrating the skin. Several hours later I now feel a slight burning sensation at the injection site. I will pin 40mg/40 units every day and record my experience here.

[heavyiron]

If 40 units a day does not cause any problems with prop then using cyp at 200mg/ml that would equal 560mg per week. I still have some discomfort at the site and a small knot but time will tell how well this works.

My hope is to maintain very even blood androgen levels doing this. I hope those even androgen levels will reduce sides like acne. I also was thinking this would be an ideal way for ladies to use aas. Some adventursome women use Prop at 35-70 mg weekly.

[heavyiron]

There are several things I hope to find out doing this. The first is how much volume can comfortably be injected right under the skin. In the trial they shot as much as .5 ml once weekly. I will shoot .4 ml every day for a while and experiment with various volumes after that.

I also wonder how much this will slow down the release of the ester. I know HCG is reportedly slowed down when shooting sub q verses IM.

[DICE]

Thanks, it's def. a debate on a few sites.

[heavyiron]

I have taken hundreds of subcutaneous injections but never with aas. It definately feels different from shooting a water based medicine like HCG. I chose a 1/2 inch pin as that should be deep enough with the volume I am using. I will shoot 2 inches to the left of my belly button tomorow and see how it goes from there.

[heavyiron]

I will run this at various doses and using different esters until I feel I have answered my questions. I am interested to see how long the depot is felt under the skin and how painful this will compare to IM injections. I also would like to see if this frequent small dose administration reduces acne. There is also the issue of scar tissue with multiple IM injections so this may be a route for those who want to avoid scar tissue in the muscle. I also want to experience this so I can advise others on its use, particularly women. I imagine I can have a pretty decent working knowledge of this in a few weeks.


Day 2
Yesterdays injection site is still sore to the touch and I can feel a very small inflamed area. I injected 40mg of prop 2 inches to the left of my belly button subq this morning and felt no pain during the injection.

[heavyiron]

Day 3
Both sites are still a little sore and inflamed. It feels different shooting sub q vs IM. I shot another 40iu and I barely felt the inject a few minutes ago.

[-BLP-]

i do 3 cc a day a lately imagine how i will look like lol like bubble skin freak

[heavyiron]

A subq inject is a little different. The pin should never penetrate the muscle at all. Additionally, the volumes I am using are quite small, 4/10ths of a cc. Here is an illustration of a subq inject. I am using a 29 guage 1/2" pin.

[heavyiron]

I see, I don't have any redness at any injection sites. I have slight localized swelling though.

Day 4
Pinned another 40iu test P subq in my stomach. I still have some minor swelling but very little pain.

[heavyiron]

90 degree angle for injection, 45 degree angle if the pt has low body fat

[heavyiron]

The Procedure.

1. Inform patient of the procedure and obtain consent


2. Check the five Rights and prepare and check the medication. In most institutions both nurses must check and sign for the medications.

3. Subcutaneous injections can be given at a 90 degree angle or at a 45 degree angle

4. Normal practice is to give the shot straight in at a 90 degree angle if 2 inches of skin can be grasped between the nurses thumb and first (index) finger

5. However, if only one inch of skin can be grasped the it is safer and less painful to give the injection at a 45 degree angle

6. Remove the alcohol with from the container

7. Cleanse the area where you plan to give the injection. Allow the area dry.

8. Remove the cover of the needle from the syringe

9. Hold the syringe in your writing hand and pull the cover off with the other hand

10. For a 45 degree angle injection hold the syringe with your dominant hand

11. Then place the syringe between your thumb and your index and second fingers. The needle should be pointing to the skin at the 45 degree angle.

12. For a 90 degree angle injection hold the syringe with your dominant hand

13. Then place the syringe under your thumb and first finger. Let the barrel of the syringe rest on your second finger. Some people hold a pen in this manner.

14. Hold the skin with the hand not holding the syringe. Holding the syringe barrel tightly using your dominant hand, use your wrist movement to inject the needle. Sometimes the needle goes in easily. At other times people have tougher skin and a little more pressure or force is used.

15. Push the plunger down to inject the medication into the patient

16. Gently withdraw the needle at the same angle you put it in...also release the pinched skin as you remove...better yet release it right before you remove the needle

17. Finally, wipe the area with the dry sterile gauze 2 x 2 pad

18. Dispose the syringe and needle in the sharps container, or in a used container of MUSCLETECH WEIGHT GAIN HARDCORE. =)

[heavyiron]

Day 5
skipping administration today

[heavyiron]

Originally Posted by heavyiron

Day 5
skipping administration today

lol, I have 4 little sore spots that are slighty inflammed on my belly. I think I will switch to cyp tomorow, that way I will shoot only 20iu as it is twice the concentration as prop.

[heavyiron]

Ok, I decided to switch over to cyp. I shot 20iu/40mg of TC in my left side above my hip about 2 minutes ago. It was painless to shoot but I will see if there is any pain later.

[heavyiron]

I have had blood work that showed 250mg per week put me at the high end of the range for Total T but everyone is different so I imagine it varies from person to person.

[heavyiron]

Ok, cyp was way better. Zero pain or discomfort!

Day 6
Shot 20iu/40mg of cyp sub q in my abdomen fat. zero pain during the inject other than slight pain when the needle broke the skin.

[heavyiron]

Day 7 Subcutaneous Cypionate Injection.

More of the same. Test Cyp is painless subq and at 20units/40mg I feel no oil under the skin. My shot last night was good. Zero problems. I may experiment with larger volumes =)

[heavyiron]

The feedback I have recieved from others doing this has all been positive. This practice is not approved in some countries so it may be a while before it becomes more widespread but the evidence for its effectiveness is good. I will have blood tests in a couple months to see how my hormones measure using subcutaneous injections. My doctor is so interested he is giving me the tests for free.

[heavyiron]

Day 8

I shot another 40 units of cyp. Everything is good.

[heavyiron]

So far so good but the real test will be seeing how much volume you can comfortably shoot. I am hoping for 1/2cc per inject at some point.

[heavyiron]

Man, if I can tolerate larger volumes I will. In the trial they shot 1/2 cc once weekly SC, so 1/2cc sounds doable. If I shoot 1/2cc every day with cyp I can get 700mg per week which would be decent. I think what I will do next is increase the volume and shoot every other day and see how the depot feels. If the depot does not build up as a lump under the skin too bad I will go every day.


Day 9
20 units cyp no problems SC.

[heavyiron]

Day 10
30 units, 60mg subcutaneous cypionate injection. I have increased the volume 10 units to see how the depot feels. Still no problems.

[heavyiron]

I cannot see anything unusual at the 10 injection sites around my abdomen. I can feel a very slight inflamation about the size of a dime under the skin in a few places. It is very small and only detectable when I gently press on the injection site. It is only in a couple of them and the rest are not inflamed at all. I like the protocol and will experiment with it some more.

[heavyiron]

I skipped yesterday's administration so I could experiment with larger volumes of Cypionate. I shot 40 units/80mg subcutaneously this morning with no problems so far.

[heavyiron]

In the first post the trial used 1/2 cc every week. Based on this I think that is a totally appropriate volume. I am still experimenting but I am guessing that's about as much as will be comfortable.

I have been reading various methods for SC injects and it seems 3 injects a week is common with doctor recommendations but I have gone every day to see for myself. I also have been in contact with others who are using higher concentrations of aas. One patient is using 300mg/ml enanthate for his SC injections so that a larger mg can be injected with a smaller volume.

[heavyiron]

Pinned 50 units of cypionate subcutaneously today. Largest volume so far. No problems.

[heavyiron]

50 units is 1/2cc or 1/2ml.