T Nation

New to TRT, Question about Dosing and Type of Shot

I have not been myself for a probably a couple years, never seemed to recover from lifting, and have had no energy, so finally decided to get a doctor. Diagnosed with depression and asked how I wanted to medicate it. I had done research and didn’t want anti-depressants and read about low-T. I practically had to beg for a T test, but it came back at 226. For a 32 year old who lifts heavy every week, that was low. Got a referral and urologist prescribed 200mg test cyp, every 2 weeks intramuscular.

I have read over and over that biweekly causes peaks and troughs. I have also read about subcutaneous being more efficient and not scarring muscle. When I asked the dr about subq, he dismissed it saying that it had to be done intramuscularly.

Any advice on how to ask the doctor in a different way? Taking the same dose over two shots in the same time period is still following the prescription…
Anyone have issues like this and not follow the dr’s protocol to a T? (pun intended)

Do you go into the office and get the shot, or do it yourself at home? If you do it yourself, I fail to see why he needs to know how you administer it. Many guys have reported that they prefer IM to sub-Q. I do shallow IM myself, I found no magic in sub-Q. Every two weeks usually sucks. Every week is good. For some guys more frequent is better, for some it is not. Muscle scarring is not going to be an issue unless you have some weird disorder that facilitates that.

He said that once they show me how to do the first one at the office, I can do them at home.

What size needle do you use? 1.5 in seems like overkill. If I’m going into my thigh, there is not much fat there… Also, the whole idea of hitting a vein scares me, lol.

SubQ is inferior IMO to IM for quality of life purposes. Not infrequently in my experience, subq will welt up or leak upon injection. I pin with 29G 1/2” in my medial delts twice weekly. Aside from a sensation that is about 10% as bad as a pinch on the very outside edge of the skin, I feel nothing at all. Maybe 1 in 10 times I’ll get close to a nerve and can sense the pressure - not exactly comfortable. Not a big deal.

You’re not going to hit a vein, and even if you do it will leak a little blood and that’s it. Unless you pin quads and then you may get some squirters.

Ventrogluteal is also a fantastic spot. I feel it there even less than my delts even though I use a 27G 1.5” in that location.

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I am using 30ga 1/2" syringes atm. I usually use 27ga or 28ga, just depends on what I find when I restock.

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Given 200mg bimonthly, I’d go with 100mg weekly, 27g 1/2in into the glute.

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If you’re married, get your wife to pin you. Makes life SO MUCH EASIER! Mine was nervous at first and even when she hurt me, I never said a word and her confidence increased quickly. Also, (assuming your wife will help) consider using 1/2" 27 gauge in your delts and alternate with each shot. As far as frequency, pinning twice a week is a long proven method to prevent peaks and valleys.

Edit: Your Dr doesn’t need to know everything. You’re ultimately responsible for your treatment and health. Do what makes you feel best. Drs rarely consider how you actually feel, they tend to dwell on lab tests.

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Totally concur. Old school deep IM is the most fail safe and secure way to start. Once optimized a guy can experiment with sub q and find the difference which he will prefer

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The simplest way to start - 2 times a week IM 50-70mg.

Wow, 1.5” for your vg injections? I have been using .5 27g in both delts and vg… I am pretty lean and both seem to be working equally as well. I would be afraid of 1.5”, but I suppose all the pain receptors are on your outer dermis?

I don’t insert them all 1.5” deep. Why would it hurt more just because it’s longer anyway?

Maybe, I really don’t know… It took me months to get used to giving myself shots without a few seconds hesitation with the short ones so the long ones would intimidate me for sure… I bet my needle phobia would re-surface using a 1.5" needle… But as I also mentioned, I understand pain receptors are at the skins surface so it should not be much different???

It doesn’t feel any different whatsoever. Whichever gauge/length I use I insert the needle slowly and depress the plunger very slowly. I just never feel anything at all, and never have PIP, which is all about technique IMO.

This seems like what I will do. And I have a doctor friend, as well as a nurse friend, so they can help with getting over needles and all that fun stuff…

Yea, I’m looking for someone, but very single right now. I got peeps who might be willing to help though. Some might even enjoy getting to stab me.

This protocol is absolutely one of the worst protocols out there as the study below shows and works for a very small percentage of men, the endocrine society has the most updated guidelines 75-100mg weekly which still is in need of improvement because some individuals have problems 4-5 days after their injection because the difference between peak and trough is significant and some guys are sensitive to hormonal fluctuations.

Hormone profiles after intramuscular injection of testosterone enanthate in patients with hypogonadism

Graph B

Your doc is just reading the label on the vial that states it must be injected IM only, but every now and then a doc experiments and redefines what can be done and it’s going to take awhile for everyone to catch up.

There is a company with patents on auto SQ injectors in 50mg, 75mg and 100mg strengths. It’s a safe bet your doc doesn’t specialize in TRT, that much is certain. You doc is only good for the script for test, optimizing your protocol is all on you.

I use a 29 gauge Easy Touch 1/2" insulin syringe.

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Finally got the script but there were no needles or syringes. I ordered some online, 18g to draw and 27g to inject.
So, the vials that I got are all single use, 1ml vials. Apparently they dont give you 10mL anymore. I’m gonna do the full thing the the first time. Any advice? It seems like I wouldnt be able to get all of it out of the vial…

Is it a vial or an ampule? Sometime single use stuff comes in an ampule.

With an 18g, you’d be surprised. Those things are like a garden hose. If you think you’re not getting it all then pull the cap off and back fill your syringe.

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Will this take multiple stabs? Or is it truly single use?

image

Dr only gave me 6 of these.

Thank you. You can really get almost everything with an 18g but like I said, you can clip the metal cap and pull the rubber stopper and pour the rest into the back of the syringe.

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