T Nation

Dosage/Frequency Advice, Switching to Twice per Week

Hey everyone, new to the page and hoping to get some help. Im 31 years old, have been on trt since September of 2020. This came about after asking my doctor to run some bloodwork due to feeling like crap and had also been dealing with many other health issues as well. Anyway my test level came back at 100ng/dl. I had already been seeing a urologist for bladder issues so my primary said the urologist could begin the trt protocol while I waited for my endocrinologist appointment which was a bit of a wait.

Urologist started me at 140mg cypionate every 14 days, one shot. Found my levels jumping to the 500’s and back to 100 after the 14 days. He then says let’s do 160mg every 10 days one shot. Bloodwork showed spike into the 1200’s and back to a 500 after 10 days. All the while I’m still feeling horrible. I ask about running tests for other parameters and am told nothing else needs to be looked at and im to stay at this dose/frequency.

Finally see the endocrinologist and he reviews my info and says what I’m currently doing looks great. Im like wait, so a jump to 1200 and a fall to 500 is great? I said there’s no stability. And what about checking other things besides test level? He said no other bloodwork is needed and none of it would matter anyway once testosterone id being injected. I said thats not at all what ive read and been told by other trt users. Of course he gets defensive and tells me what im reading is completely wrong.

Basically ive not had one day where ive felt any better since starting trt. Zero energy is an understatement. Constantly feel like a zombie. Cognitive abilities are crap. I forget things super easily, coordination problems. Sleep sucks. Very low sex drive. My stuff works fine I just don’t care to use it. And absolutely depressed. Ive been recommended to try 140mg weekly split into 2 shots, Monday morning and Thursday evening as this would provide more stable levels. Id like to try this out but I know my doctor wont agree because he seems to think everything is perfect.

I know ill need more bloodwork making this change and would have to find a way to do it on my own. For now the test cypionate is prescribed in 200mg/ml bottles and I use 160mg/0.8ml in one shot every 10 days. If 0.8ml is 160mg, is it as simple as 80mg being 0.4ml which would make 70mg 0.35ml? So id do 0.35ml twice weekly for 140mg total? The only positive ive seen since starting trt has been mainting some muscle but thats literally it. Im miserable to say the very least and need a change asap. Figured id make a post for some advice. The other hard part for me is that im currently unemployed and insurance covers my trt. Id love to pay out of pocket at a trt clinic where ive been told id get better care but can afford that unfortunatly. Thanks!

Both docs are morons and don’t deserve your money. Find a clinic that handles TRT

Edit: doing labs on your own with a discount website would run $100-200. A clinic will charge $99 per month with meds and labs included

Correct. At least the Dr is giving you the t.
Inject on your own schedule.

Well thats the issue, the endocrinologist is letting me do the shots and that’s only because he said they dont have anyone in their office to do the shots which is ridiculous. At least at the urologist they had a nurse who could do shots if needed. I dont mind doing them myself. But as of tomorrow ill start the above mentioned dose/frequency. I dont see how I could get any worse at this point with how bad I feel.

I couldn’t believe a blood specialist is so opposed to more blood work when it comes to hormones like this. He had that attitude of im right and everything you’ve read or been told is wrong. Im like okay buddy, he said come back in 8 months for a follow up. Of course when I eventually go back I may have to tell him ive altered things and idk of he can drop me as a patient. Either way I dont trust him. Id much rather a trt clinic but can’t afford it with being out of work. Im very lucky the test im getting is free. I get it in one month quantities which is 3 bottles at 200mg each. So even changing things up ill have 600mg for the month divided Into 140mg weekly brings me to 540mg monthly with a little to spare. I also have a ton of viles with 40mg left in each from all the previous shots. I may want a smaller syringe since im moving to 2 shots a week. Currently have 1.5" 21 gauge. Sometimes I dont feel it at all, other times get a bit of a sting. I primarily shoot into my right glute as its the easiest for me to get to. I have a hard time turning to the left and doing the left glute but ill have to alternate now as to not destroy the right side lol.

Sorry, but not surprised, you have had this experience. You’re on the right path, moving to more frequent dosing. You’ll likely be fine with 70mg q3.5d. As noted, you could use 27g, 0.5in needles with the lower volume. Good luck.

My body fat percentage is on the lower side but im not sure half inch would be quite long enough at least in my glutes. Im not wanting to pin anywhere else such as the shoulder or quad. But I know ill get tired of the 21 gauge quick doing twice per week. Ill see what the pharmacy has available when I pick up my prescription. And of course I called earlier to make sure its refilled and was told it expired and they had to send the info to my doctor for approval for an updated script. They told me to call the doctor to make sure they received it and hopefully expedite the process and im due for a shot tomorrow. Good thing I have extra bottles from previous shots so if for some reason they don’t rush the script I’ll be okay for tomorrow’s shot.

That’s fine, I can assure you they will work (I have the lab results that prove it) but nothing wrong using whatever you like. This is coming from someone who used 20g, 1.5in at one time.

Subcutaneous Injection of Testosterone Is an Effective and Preferred Alternative to Intramuscular Injection: Demonstration in Female-to-Male Transgender Patients - PubMed (nih.gov)

So it looks like getting my refill will be delayed. Not sure why noone informed me my prescription expired so now the day before my shot they tell me it need authorization and can take a few days. Good thing I have extra from previous shots. And I realized I wont be able to do a monday/Thursday routine as tomorrow would have been my next scheduled shot day so I can do Wednesday morning/Saturday evening which would be the same as Monday morning/Thursday evening. I just have to set reminders in my phone as I forget things so easily these days.

The infrequent protocols are an indication your doctors are clueless. Fire your doctors are seek out private care for your TRT.

And the best part was when I started trt through my urologist office I was told that particular doctor was the testosterone guru and the man to see. Yet he barely did anything for me. And then the endocrinologist just went along with the urologist. I couldn’t believe it. But guess thats what happened when I have basic state insurance they do the bare minimum to make it look like they are giving me proper care. Today started the new setup so im hoping to see a difference. I will also make an appointment with my primary and try to get a referral to a different endocrinologist that isn’t opposed to doing more blood work like they all should be doing. And when I can afford it I’ll end up at a trt clinic.

Getting proper treatment for low-T is a worldwide problem, it’s a new field of medicine that isn’t taught in medical school. So another doctor is likely to be just as clueless.

Yes.

OP: I suggest, if your health plan allows, that you simply change docs until you find one that will work with you.

You might also start using the residual T in your partially used bottles and leave the new bottles unopened to build up a reserve. By always using the residual, over time you should amass a nice stockpile.

You might find three injections a week, with a much smaller needle, is something to test: you would inject the same total T a week, just spread out even more.

Blood tests, including to determine your SHBG, would be useful in many ways. If you get the tests, the fellows here should be able to advise you, particularly regarding what your SHBG levels might mean and what to do if high or low.

So as of today I’ve done two shots a week for the last 4 weeks at a dose of 140mg total, 70mg each shot. I will say it’s a pain to use the syringes I have. They are 21 gauge 1.5" long. I dont mind the needle itself but find that each shot a bit of testosterone gets trapped in the tip that isn’t able to be pushed in once the plunger hits its stop. Because of this ive been drawing 80mg figuring as much as 10mg is being trapped in the tip. Also drawing from the used vials I have is tough as well to get every last drop. But have been using the extras instead of the fresh bottles.

I still feel no better than I did before when my dose was 160mg every 10 days. I will say I noticed a tiny bit of an increased libido but most of the time its still not there. Still zero energy and otherwise just feel like complete crap day in and day out. As of now I can’t get a referral to a new doctor as ive already been sent to my urologist who started the trt and then the current endo who just agreed with the urologist and didn’t make any changes or want to do more bloodwork so im basically on my own. I just have to not let on that ive change my dose so the endo doesn’t decide to drop me or stop my prescription. As far as blood work goes when would the ideal times be to get bloodwork done now that im doing shots every 3.5 days? And what labs can I pay out of pocket that won’t cost an arm and a leg? Im definitly in a weird spot not being able to afford to just go to a trt clinic for proper care.

And as far as needle options go id like a syringe that doesn’t leave oil trapped every shot and have to try to guess at drawing in just a little more than needed to actually hit the 70mg. Pretty sure I may of been closer to 60mg this last shot due to not being able to get all the oil from the vials and the bit trapped in the syringe.

You’re already on a decent protocol, I wouldn’t expect a clinic to give you any better advice. I’d get labs now, just TT SHBG e2, prolactin, and just get a snapshot of where you’re at so you’ll know what levels you don’t feel good at. Based on those labs you can adjust things

Ive set this protocol up myself based on research and info from these forums. My endo had me on one160mg shot every 10 days so I changed it to 140mg weekly split into two doses. I just don’t understand why I feel nothing from this and in fact most of the time I feel worse than ever. But I know getting bloodwork is key. Its when to get the bloodwork im not sure of now that im injecting every 3.5 days. Ive read it can take multiple blood draws in a week to get all the right numbers. But of course that will get pricey and im not sure where to even go to get bloodwork done out of pocket. Which I really can’t afford anyway but have to figure it out since the doctor won’t do it.

I never felt good on injections when on 1-2x weekly at any level, the longer I was on it, the worse I felt. This experience wasn’t repeated on daily and EOD protocols, but do to having my levels very steady, it caused symptoms I couldn’t resolve.

So I went on oral TRT (Jatenzo) twice daily and found something that works.

Sick care doctors are NOT going to figure out the optimal protocol for you, after all this is managed healthcare where doctors are overworked and don’t have a lot of time for you.

Meh, I dunno about that, although I’ve thought of doing it before. I just get the lowest point checked now, so I know the rest of the time between shots I’m above that

Eskimo619,

Fwiw,

27g 1/2” needle works great in ventrogluteal injections. Just google ventrogluteal injections, if you’re not sure.

I was using 25g 5/8”, primarily ventrogluteal, for years. But when I needed new needles, I could only find the 27g 1/2”, and I’m glad I tried them.

And for not feeling better after 4weeks, when I change my protocol, it can take up to 10 weeks before I feel “optimal”, and libido is usually the last thing to level off.

Be patient. This is a lifelong process.

I do understand it takes time to see changes but ive now been on trt for one year almost to the day and not once felt better, only worse which I imagine is from the original protocols where I was started at one shot every 14 days then changed to one shot every 10 days. And then after tons of research and speaking with other trt users I was told to just do my own thing because the doctors are clueless. So even though I’m only a month into the 2x weekly shots I’d have expected something in the entire past year. The only thing I ever noticed was a very tiny increase in libido but generally its non existent. And im now keeping some muscle mass on which makes sense as well.

I do have many other health issues that have taken a huge toll on me so I wouldnt be surprised if my body just isn’t responding well because of the other issues. But I know it will be life long and not something I can stop now. A smaller needle would certainly make things better though lol. Some days I dont feel it at all while other times I get quite the sting. Its never an issue but could be easier. 21 gauge 1.5" needle is on the large side. Ill look into the ventrogluteal shot you mentioned. Did you ever have the issue of some oil being trapped in the tip basically impossible to inject the whole amount? Ive been recommended to use insulin syringes before but I don’t want to make things harder. Ill have to plan some bloodwork possibly for tomorrow later in the day if I can find a place locally. I have a shot Wednesday morning so Tuesday later in the day should have me on the decline to see where things are at.