Starting trt today and have some questions. Will be doing .30 ml 2 times a week subq. E2 was low so was not put on ai as of yet. Hcg 300 iu 2 times a week same days as subcutaneous test cyp. I have 27 and 26 gauge 1/2 inch needles but was reading preferred is 29. Is there really that big of a difference? What is the best 4 sites for subcutaneous? When people say they warm the test are they refrigerating it or is it room temp to begin with? What angle subcutaneous 45 or 90? When I do blood work in 3 months what day should I do it on in respect to a e3.5 day schedule?
A few questions come to mind when I read your post.
- Why are you doing subq injections of test and such a low dose?
- Are you doing this TRT at a clinic or doctor office or self treating? I assume at home since you mentioned keeping test in the refrigerator.
You can do subq test injections at the very low dosage , but why such a low dose of test and why subq?
With test injections the preferred and best method is intramuscular injections. This way the test will breakdown slowly, and be absorbed at a better rate than if subq.
With all test injections it is best to have it room temp or warm the vial up with warm water. This will ensure easier injecting and reduce PIP.
With subq injections you can inject at 45 or 90, it depends on where you inject and how much fat you have.Usual locations are thigh, stomach and shoulders. With abdominal subq injections you can use either angle. If you have more fat around your stomach 90 degree injection would be easy to pin.
I misspoke I’m doing 2 injections of .35 ml totaling .70 per week totaling 140 mg per week. I want to do sub q because I have read it limits the e2 conversion and honestly I’m not excited about going into the muscle or making holes in the muscle that many times. I’m only 35 and that a life long build up of muscle scar tissue IMO. I’m doing this at home under supervision of my primary care. It’s much cheaper that way and I figured I could use this forum and lab results to dial in a nice simple protocol.
I use a 28G 1/2" needle subq and can’t feel it. I’m sure 29G would be felt less, but longer to fill.
I am on TRT myself at 200mg a week with .5mg anastrozole 3 days a week. Test subq is not pleasant and can knot up.If you do IM injections and rotate through each injection site you will not damage your muscle tissue as you may think. I have been on TRT for 2 years now and have not had any issues at all with IM injections or the injection sites.
What are your total test, free Test , SHBG, estridol, and cortisol levels? 140mg is a low dose to start off with, but most TRT doses are low to start off with.
Since you are going to start off with a lower dose you may not need AI, but it is always good to take with testosterone. Regardless of where you inject the excess testosterone will convert to estrogen depending on how your body reacts. Some people can do up to 500mg a week and not have any issues with estrogen conversion while others can do 100mg and have to take an AI.
The HCG will be good to prevent luteinizing hormone shutdown. You can do 1.5 to 2 units 3x a week. It will help keep your test levels steady with such a low dose of test.
Where do you inject? do you have a link to any visual guide or video? How do you prevent the knots peanutkid talks about?
Free 9 pg 8.7-25 pg
E2 sensitive 14.9 pg 8-35pg reference
Shbg 35. 16-55
Did not have cortisol test run.
Your Total is low, but now too bad. Your SHGB will increase with the introduction of test resulting in lower free T. Your Free T is already low, but the HCG should help with that. You would be better off at a starting dose of test with 180MG/Week for 4 weeks then getting labs drawn to see what your SHB and free T is at.
Cortisol and SHBG usually follow each other. If SHBG is higher usually your cortisol levels will be high as well.
Adequate rest and trying to stay stress free will help lower cortisol.
Anywhere between my hip and belly button. 8 weeks and no issues.
SQ/SC is slower smoother release, less peaks and no decades of muscle damage. Easiest to visualize top of upper leg. Pinch up skin and inject into end of fold with needle parallel to muscles below.
So get lumps in belly fat and not in upper legs, some vice verse, so see what works best for you. Many do SC/SQ with no discomfort. I often feel nothing.
SHBG is increased with more E2 and decreased with higher T levels. SHBG does not typically become a problem with TRT if TRT is managed properly. TRT probably decreases SHBG. Some for reasons unknown simply have low SHGB. Diabetes can cause low SHBG. Starvation diets and liver conditions/disease can lead to high SHBG.
With TRT, if E2 is well managed, near 22pg/ml - 80 pmol/L for most, and FT is good, there is no compelling reason to test SHBG. If TT high and FT disappointing, SHBG suspected elevated. If FT is oddly high, low SHBG is suspected. There is nothing that can be done to directly change SHBG, so other best practices are all that can be done. AST/ALT should be part of labs to see if liver is OK. T does not cause liver problems, some think that is possible, but that is from body builders using high doses of other anabolic substances, orals are the major problem.
Pea Nut Kid is sowing bad information and dumb dosing ideas. Then I need to write this to undo damage.
Please read the stickies found here: About the T Replacement Category
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
I guess I’m still having problems visualing where to inject subq in the thigh. I had my liver checked and it was good and my tsh was 1.7. I’ve never thought to check my tempuratures because I am always hot. I look outside and I sweat. For follow up labs when should I get them done? I’m going to try to inject on wed night and Sunday morning so what day would I get the labs. And can I get by with just tt ft and e2 sensitive and hemocrit?
Try to always do labs halfway between injections to avoid lab timing artifacts in lab results.
yes. tt ft and e2 sensitive and hematocrit will do.
Do not see your age here. If >40, probably should have a baseline PSA and DRE.
I’m 35 and my psa was very low 1 month ago. What are lab timing artifacts? How many weeks after beginning trt should you have labs run in the absence of an ai? Should that warrant sooner than 12 weeks or only if I notice nipple sensitivity?
When you start TRT without an AI and if E2 increasing: You can feel like TRT is really working then at 6~12 weeks it starts slipping away. That is in part a delay as the -ve effects involve changes in the brain from E2 induced changes in gene expression and subsequent effects on brain patterns. Yes, nipples may create issues sooner.
Your TT, FT and E2 levels are changing between injections. Lab timing changes produce different results - artifacts. If you do not change lab timing, then any changes represent something real that can be used to drive AI dosing changes etc. When guys get T injections every two weeks, their levels have huge swings and then the results are mostly determined by lab timing.
I inject 0.4 ml every 4 days (equivalent to 140 mg/week). I use a 29 gauge 1/2 inch needle in the lower thigh toward the outside. I don’t have much fat so it is probably shallow IM. I have a needle phobia and could never imagine doing a deep IM with a huge needle.
It works beautifully. I avoid the huge needle. The 29 gauge is slow to fill, but that is OK with me. Injections are usually almost painless, although I occasionally hit a sensitive spot and it hurts.
For me the results are fabulous. I feel great and am having no adverse symptoms. That dose keeps my test levels quite high (above 1100-1200) just before an injection.
Hey I really appreciate all the info your giving me Ksman. So if e2 climbs too high and you feel it start slipping away bringing it back in range with an ai will bring back the week 3-6 feeling? Besides your quads where else do you pin?
How does test in quad compare to hcg in the abs. I tried a restart which utilized hcg and i could pin everyday if it was like that. Kinda what led me to looking into subq only to find that it looks to be superior for long term trt. Does it matter that one injection goes shallow IM and the next completely subq. Will the diffferent absorption rates have your levels up and down? Or have an effect on ai dosages? Is there need for complete consistency in that regard?
KSman, My information is from the years I have been on TRT, and from the endocrinologists that have worked with me on getting my levels where they need to be. Im not an expert by any means, but I have been through so many different protocols that I know what works for me. Each person is different and will react differently though based on type of test and dosing. If my information is not correct then I will have to tell my endo and various other specialists I have seen to get their facts together.
Best of luck with the TRT trt0021. It all boils down to trying different things and checking your labs to see what works best for you. There is no absolute set in stone way to do something. There are just opinions and those that have went through the same thing you are going through, and found the correct dosing and method through trial and error.
I have the vantage of working with hundreds of guys, over 10 years. I see the relationships and complicating/confounding factors quite clearly. The biggest problems we see here are the doctors and the endocrinologists seem to be the biggest idiots when they should be the best. We only see guys coming here because they are starting off and want to understand things or they are fed up with their doctors. Guys who find a doc that does everything right really have no driving motivation to get here. The quality of this forum really creates a search engine preferred site.
Your TRT has been good so far?
Was this truly necessary? “found the correct dosing and method through trial and error” - maybe not
Stay strong, your fitness pix look great!
I have never tried hcg. I tried injecting test in abs with a 1/4 inch
insulin syringe but did not like it. Lumps sometimes.
I doubt it makes much difference whether you inject SQ or IM. Both should
work. With my 4-day SQ injections I do not get any ups or downs. Just relax
and don’t worry.