T Nation

Testosterone Injection Dosage

I am 25 years old and was recently diagnosed with low T. My levels were around 200. My urologist put me on injections of 400mg every three weeks. Based on my research the standard looks to be two weeks. Should I try to get him to lower the dosage, but have more frequent injections? I’ve had other health complications that have made it hard to tell how my body is reacting to the injections. I have noticed a big change in libido though.

I spend a lot of time in the gym and want to be sure that I am keeping my T levels high enough.

Thanks for the help!

Read this:

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Every three weeks is an odd dosing schedule. This will give you all the information on the correct dosing schedule, so that you can avoid the troughs and peaks associated with dosing every three weeks.

Horrible!

Urologists piss me off. Collectively, they are absolute idiots and they have no right to claim your hormone health in their domain. Do women see urologists for bladder problems? Yes. Do women see urologists for their hormone problems? NO.

Also read the protocol for injections sticky.

Yes, you have found the right place to deal with your problem. We need info and lab data.

I’m new to this and don’t have any bloodwork numbers to share at this time. I just wanted to hear more about other people’s dosage and frequency of injections.

I inject test cyp twice a week. Many on here do the same. Some on here inject EOD (every other day). With the dosing schedule the standard is 100mg/week, so 50mg/2x a week. Thats .25ml if your vials are 200mg/ml. With doses this small, you can inject SC (subcutaneous) into the thigh.

If your doc has you on that protocol, I’m probably not too far off if I say he’s not very knowledgable on TRT. With that kind of schedule I assume you have to go to the office to get your shots? You will get serious peaks and troughs if you continue down that road. Your increase in libido will fade and you will feel worse than before you began.

You will want to get a copy of your labs and post them here to see if there isn’t an underlying problem. You’re 25 and it isn’t natural to already have low T. You may very well be treating the symptoms and not the problem. An issue many people see these days is doctors jumping on the TRT bandwagon thinking that’s the fix to whatever ails you. Could you have hypogonadism already? It’s possible, but it’s better to rule out other things before you jump to that.

You have to be proactive. You doctor probably isn’t as knowledgeable on this subject as you think he is or want him to be.

The cause of the low testosterone is testicular cancer. One testicle was removed, and the other one is damaged (atrophy). It still produces some T, but that is the cause of the low T.

Yes, I am going to the office to get the shots. Luckily his office is within walking distance of my office. He has been pretty open to my input (wanted to start with patches or cream instead of injections, but he let me choose), and is easy to work with. Great urologist if anyone in Nashville needs one.

I think part of the reason for the high dosage/less frequency is because I have been doing chemo. I’m finished with that now and am ready to change to a better dosing schedule.

I will work on getting those lab numbers for you guys. Thanks for the input.

That’s entirely possible. I don’t know the nuances of testosterone supplementation in conjunction with chemo-therapy. Sorry to hear about your cancer. Were they able to remove all of it?

It sounds like you may have a pretty good relationship with your doc. I would ask him to allow you to self inject using 29ga .5" insulin syringes. These are much less invasive than standard 1.5" IM injections. For me, the entire process is completely painless. Even if it’s just a walk, 2 office visits a week will get a little time consuming. With the 29ga syringes, you can pull the plunger, walk away and do whatever, and come back and pin.

I tried patches, androgel, pellets, and now injections. I have found the injections to be the most convenient, by far.

Good luck to you. Keep us informed.

Thanks, a lot. Yes, they were able to remove it all (I was only stage 1). There is a 99% chance that it will never be a problem again for the rest of my life. I am really lucky that my urologist was so aggressive with it. I was hesitant to do the surgery, but he was absolutely correct about it probably being cancer.

We do have a good relationship since we made it through the whole cancer thing together. Like I said he is has been very open to my input, and he even calls me a lot to see how I’m doing.

He wants me to do the pellets, but I’m just not sold on the idea. I really like the convenience and results of the injections so far.

Stick with the Injections, In my very limited research it seems like injections are the best option, pellets and patches being the worst.

That was my least favorite delivery method. I got a very painful hematoma about the size of a playing card for almost three weeks. It felt like a chunk of my muscle trying to “fall off” when I would run. Also, absorption rates vary. This many pellets might work for person A, but person B might not absorb as quickly, leaving him with sub-optimal T levels for 3-6 months. That’s another thing. I STILL can feel them despite them being implanted in the beginning of August.

Really knowing how many pellets YOU require would take the first trial and error implantation, and you’ll have to live with it right or wrong for the next few months. Too low and you’ll need to supplement with something else (androgel, injections, etc), OR you implant more?

On the positive side, once you do have the correct amount dialed in, you only have to deal with one office visits every four-ish months to maintain. Whatever works best for YOU.

With injections changing dosage is very simple. More simple than trying to do a half pump of gel. More simple than applying another patch. You get the point.

Long story short I think you’re on the right path and you won’t be disappointed.

Yeah, I will definitely stick with the injections. I just want to get them more frequently than every 3 weeks.

Saw this posted in another thread. First time I’ve read a post about a 400mg dose every 3 weeks:

“T cyp was designed to be dosed every three to four weeks at a large dose. Say 300 to 400mg at a time. You aren’t going to shoot 400mg SC. Now we know that small doses SC are fine. HCG, per the literature, is supposed to be shot IM also but of course no one does. The only difference I’ve had SC is a slower release of T. You won’t experience a spike and drop off.”

Maybe that’s what my doctor is basing it off of?

“T cyp was designed to be dosed every three to four weeks at a large dose” was the thinking from many years ago before single use syringes which meant office injections. The infrequent injections feature was the medical community trying to reduce the treatment burden on the patient.

When it is stated that such things keep a patient in normal range, it means that they do not fall below 300 or whatever the thinking was at the time.

Unfortunately the old literature cannot be changed as it is FDA approved. Changing the recommendations would be difficult and expensive. As this is a generic, as are all natural hormones, no company would do this without the leverage of a monopolistic advantage of a patent. So many doctors keep getting mislead and cannot think themselves beyond the literature.

Based on what I’m reading on this site it sounds like it would be a good idea for me to ask for anastrozole as well. Not worried about HCG since my sperm production is shot.

hCG may preserve pregnenolone and progesterone production, as well as physical image.

E2 management is mission critical for quality of life [QOL] and physical health.

I will talk to my doc about hcg and anastrazole and report back. Thanks ksman.

KSman,

He lost one testicle and the other one is damaged due to testicular cancer. In his situation, how are progesterone and pregnenolone produced? Would supplementation be needed? Is hCG still necessary?

Valid points. So the benefits may be nil or minor.

I have been doing the Testopel
pellets for two years. I really like them. I get new implants every 12-14 weeks. My level stays around 700-800. My estradiol is around 40 we are considering Armidex if my estradiol is that high when I have my blood work on the 26th. I am using six pellets and the insertion process is a little annoying. It leaves a bruise and is a little sore for a week.

They go in the same spot on my hip each time and you do build a little scar tissue and we may move to a different place next time. I would prefer to give HCG a try but cannot find a doc to do it in Nashville. I DO NOT like the testicular atrophy issue. Mine are now the size of a grape-NOT GOOD. But the benefits out weigh that problem.

Untreated I was at the 220 T level.

Any advice?

A little update:

I called my urologist today, and we are going to try 400mg every 2 weeks. We are going to closely monitor E2 levels, but he doesn’t think I will have a problem because I am not overweight. He was very agreeable and said that is willing to try whatever schedule I want. If my E2 is off I don’t see him having any issue with putting me on Arimidex.