Commercial for Low-T

Watching television with my daughter we saw repeated advertisements for this website:

http://www.isitlowt.com/do-you-have-low-t

I also came across a study here in Denver that suggests T is safe and estrogen is not unsafe in the context of stroke risk. Sounds like I should continue T-Replacement but consider a switch to sub-q administration.

Testosterone may reduce risk of stroke in men; Estrogen levels not related to stroke.

http://www.scienceblog.com/community/older/2002/G/2002127.html

Intramuscular is best - gel will aromatize more than shots and end up screwing you over.

Estrogen does have risks in men for CV health [clots, heat attacks and strokes], prostate, fat, diabetes and mood. But the major problems are mostly restricted to those with low T where the E can drive deep estrogen dominance. For those on TRT, increased estrogen lowers libido and affects mood and energy. Studies will not explore those differentials. There are no large longitudinal studies for men on TRT. Many studies exist where T, E and DHEA have been checked in blood samples of men who have heart attacks.

E dominance causes endothelial dysfunction in men and women. T is CV protective in men just as progesterone is CV protective for women. [Hence the danger in estrogen only HRT for women.]

We will never see TV adds for injected T, there isn’t enough money to support the message. And injectables are all generic, so it is impossible to drive viewers to consume your product.

There is a good thread in this sticky that explores these issues:

[quote]KSman wrote:
y. Studies will not explore those differentials. There are no large longitudinal studies for men on TRT. Many studies exist where T, E and DHEA have been checked in blood samples of men who have heart attacks.

[/quote]

I recall it saying only people never having received HRT were allowed entry into the study.

Just got this back from the Doc:

“The oil based testosterones are not made to be injected SUB Q. The doctor does not recommend you to inject the testosterone SUB Q. Please inject your medication IM.”

From the WWW:

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 ethanate (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
(p�0.1). 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 50â??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.

Quote:
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: alfutaisi@squ.edu.om.

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, Montreal, 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 ethanate 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.

Thanks again KSman.

Sounds from the study like I can try abodmonal fatty area instead of my fatless legs. I have seen this discussed in other posts. Why is the leg superior to the abdominal area again ?

Just my experience but SQ may have lowered my numbers so I went back to IM. Could have been any number of other reasons why my TT and FT went down when doing SQ. I guess I could just inject a larger dose SQ. That would be easier. Of coarse I’m still trying to figure out if a 5/8 inch needle is giving me a IM injection. It feels much different than the little SQ needels. I think I might have a problem with the 1.5 inch needel for a true IM but I guess you get used to anything. (Hum, maybe that is not such a good thing)

Regarding the Low T commercials. That is an interesting point about the generics and cost. They really are just pushing “Androgel” Woo Hoo get testosterone with out injections, just rub it on. Not a mention in the information about E2 or testicular atrophy. At $450 a month you can afford to advertise. So what makes the stuff so expensive. Will we see it come down in price eventually. So far the cheapest I’ve found test cyp is $55/2000mg. That is a lot less than 450/month.

[quote]GeoBob wrote:
Just my experience but SQ may have lowered my numbers so I went back to IM. Could have been any number of other reasons why my TT and FT went down when doing SQ. I guess I could just inject a larger dose SQ. That would be easier. Of coarse I’m still trying to figure out if a 5/8 inch needle is giving me a IM injection. It feels much different than the little SQ needels. I think I might have a problem with the 1.5 inch needel for a true IM but I guess you get used to anything. (Hum, maybe that is not such a good thing)

Regarding the Low T commercials. That is an interesting point about the generics and cost. They really are just pushing “Androgel” Woo Hoo get testosterone with out injections, just rub it on. Not a mention in the information about E2 or testicular atrophy. At $450 a month you can afford to advertise. So what makes the stuff so expensive. Will we see it come down in price eventually. So far the cheapest I’ve found test cyp is $55/2000mg. That is a lot less than 450/month.[/quote]

I did not like the 1.5 inch needles, so I ordered 1 inch needles, I assume 1.5 is for people who need to go thru a bit of body fat first and I have none.

I was reading Chrislers piece again and he is a huge fan of gels.

Chrisler says:

"The constant variability of serum androgens provided by T gels mimic the hormones of a young man; the stable daily level provided by T injections mimic the hormones of an old man; those of implantable pellets mimic the hormones of no one. Entropic hormone levels are part and parcel of the process of youth. "

You need to try injecting SC on your belly and legs and see what works best. I get knots and lumps in belly fat, not much problem over quads. Some report that there are areas over their quads where the skin is almost numb, so more comfortable.

Do not inject around belly below the level of the umbilicus as there are some larger blood vessels there in the fat, which can hurt and bleed/bruise.

I get very good lab levels with IM or SC. There may be some that are exceptions to this and that is something that each will have to understand and deal with on their own. We are all different and stats and norms are only useful to a point, after that we all have to become experts about our own bodies.

OK, I tried sub-q and it burned and appeared to not go in so I doubled the pressure and it slowly went in. The area then immediately turned red.

First is all of this normal ?

My other question relates to backfilling the insulin syringes like BBB described. I pulled out the plunger and squirted it in there. Then I realized I needed to invert it with the plunger at the max draw position, then right it and squirt the air out so that only the oil is at the needle end. I could stop short and on the day of sub-q injection squeeze the last bit of air out and a bit of oil to be sure. But being an novice I squirted all air and a little oil out only to notice when replacing the caps it is all oily now and does not seem very sterile, seems microbes could grow on this stuff in the next couple days. Am I completely missing the point here ?

Thanks

HiredGun, 5/8 inch 25 gauge needels work well for me. They fill just find and I can probably manage a SQ or IM depending on where I inject. Have you tried this size. I also inject EOD with out problems.

I find that if I put the T oil in my pocket for a awhile or just hold it in my hand until it warms to near body temp, that the 29g .5cc syringes fill just fine and I don’t have to mess with back-filling. It takes maybe a minute to fill .17ml this way. Make sure you swab the elastomer stopper really well after being in your pocket though, not the most sterile environment :slight_smile:

To support what KSman said earlier about shooting above the navel, I find that there are spots on me about 2" above the navel and 3-4" away laterally that are virtually pain free. It’s hard for me to find a comfortable place below the navel. My most comfortable injection location is easily the quad. (for me 1.5" lateral from the femur and 1"-2" proximal from the midpoint of the femur) Also, if I feel sensation the instant the needle starts to pierce the skin I just move it away from that spot about a cm in any direction and try again. I always find a numb spot this way. You have been doing this for awhile so I am sure you know to let the alcohol evaporate on your skin bofore injecting to avoid that burn.

Forgive me if I am regurgitating stuff you already know. I’m definitely not a know it all, just putting empirical information about what works for me out there in case it may help somebody.

I was not even using alcohol on my abs, everything is so small compared to the quad injections I was not worried about it. I guess I should get with the program and swab the insulin needle locations just like the quad deep injection locations.

The needles do not bother me, it was the injection of the oil that burned and burned - it kept burning after I was done injecting and then faded. The red color faded too.

Is that normal ?

When I first started SC all of my injection sites turned red and felt hard underneath, but they never burned while injecting. I switched brands of cypionate and now I don’t have any reactions whatsoever.

I’ve been injected T SC for three years with no issues. Labs are not significantly different from IM. The only difference is how it feels. I don’t feel a T spike and then drop off. It just feels consistent.

I found the best area to inject is off the upper side of either hip. The T goes in without leaking a drop and for some reason the skin in the area does not get irritated. No bumps or injection sight reaction of any kind.

For injection I use a 1/2" 29 gauge slin pin and it’s easy to load the syringe. I pull the plunger back until it sticks open and set the vial upside down between two glasses until the syringe fills. Takes about 3 minutes.

Personally I feel T cyp was injected IM in the past because it was designed for once a month injection and then down to two weeks (When they discovered once a month wasn’t going to work!). You aren’t going to shoot 400mg of T SC. I inject 80mg a time SC and do fine.

Overall people get carried away with this treatment. Done properly I think it’s a wise and healthy choice. It does make international travel a little nerve racking but I’ve never been questioned in any country clearing security with my meds and needles. I put everything in an insulin pouch and pass it through the x-ray on it’s own. I routinely get on airplanes with my meds and needles in my carry on. I’m actually shocked that it’s never been an issue but I guess with the amount of people with diabetes today they probably see similar supplies all day.