Shallow Testosterone IM versus SubQ Injections - Lab Results

[Simon7]

Several points regarding the original topic of this thread:

1. About a year ago I switched my Testosterone Enanthate injections from SubQ to shallow IM , using the same dosage and frequency (55mg e3.5d). I noticed after the switch to shallow IM (repeating the test twice three months apart) that my Total T levels went up as a result. I deduced that at least for me the absorption via shallow IM injections was better. I gradually dialed down my Testosterone dosage to achieve similar Total T levels as I had when on SubQ injections.

2. I don't test FT but rather calculate it using TruT website.

3. I ended up sticking with shallow IM - not because of the better absorption (as the dosage can be easily adjusted to meet my Testosterone level goal) but because I found the shallow IM injections to be more convenient than the SubQ - no annoying red lumps, less bleeding, less pain.

4. The late Dr. Crisler used to say that after a dosage/protocol change men often initially notice the direction that their testosterone levels are changing (increasing/decreasing), and it takes a while after the T levels have settled for men to notice how they actually feel on the new T level.

5. I feel just as good on IM as I did on SubQ.

 

[Simon7]

Several points re the recent thrash in this thread:

1. I find Excelmale a very helpful forum, with plenty of knowledgeable people who share information and experience that has helped me learn a lot.

2. I try to focus on what people are trying to add to the discussion (the what), and less on the how (their tone). No point in taking offense to anyone - most of the time no offense was meant, and even if it was it's best to simple ignore that aspect and focus on the what.

3. There is no use in trying to win an argument. Share your information and experience, address any misunderstandings, address others POV and comments and then move on. We are here to share and learn, and we can agree to disagree.

4. There is no point in attempting to change other participants behavior. They are who they are. The only thing we can change is how we engage and respond.

5. I would like to thank @MarkM for documenting and sharing your experience in detail and @madman for investing so much of your time to share with us so much important and pertinent information which I learn a lot from.

Peace be upon you.

 

[Warrior]

I've been a 15yr TRT vet, I am lucky to have no sides and have switched protocols based on this forum. Personally, not a fan of subQ due to lumps and pain. I do like shallow IM in delts and thighs. I only test 1x per year as my labs are the same.

 

[newuser]

I've been a 15yr TRT vet, I am lucky to have no sides and have switched protocols based on this forum. Personally, not a fan of subQ due to lumps and pain. I do like shallow IM in delts and thighs. I only test 1x per year as my labs are the same.

What your current protocol?

 

[Warrior]

What your current protocol?

30mg every 3 days of T, 250iu of HCG 2x per week.

 

[tareload]

Much appreciated on the clarification.

If I may further tap on your knowledge - is it at all possible to monitor E2 or FT levels if there are no laboratories in my country that performs the LC-MS (for E2) and Equilibrium Dialysis (for FT)?

For example, I've heard the ECLIA test for E2 confounds with C-reactive protein. Would it be feasible then, to take the ECLIA reading and deduct the CRP reading to get the true reading for E2?

My pleasure.

See this thread; unless you've got some high inflammatory markers you should get a decent indication with ECLIA reading.

Quest and Sensitive Estradiol Lab

Warning: Just had labs done at Quest. Doc specifically requested sensitive estradiol lab. I double checked what the technician was drawing (she was offended when I asked her to double check). She had the normal estradiol lab. When I pointed this out and that the doc had specifically ordered...

www.excelmale.com

Also, timely thread here on estimating fT and fE2:

A novel spreadsheet method for calculating the free testosterone, free DHT, and free estradiol.

Abstract In humans, testosterone (T), dihydrotestosterone (DHT), estradiol (E2), estrone (E1) and cortisol (C) bind to the serum proteins sex hormone-binding globulin (SHBG), albumin (Alb) and corticosteroid-binding globulin (CBG). Equilibrium dialysis is considered to be the "gold standard" for...

www.excelmale.com

You could compare fT estimate using cFTV above and Tru-T calculator:

Free & Bioavailable Testosterone calculator

TruT Free Testosterone Calculator by FPT

Free testosterone calculator by FPT. Improved accuracy of free T calculations.

tru-t.org

 

[DiegoG]

To all the newbies, men with their feet wet, OGzzz and yes I will include the BRUHs!


When getting blood work done let alone comparing labs it is critical that:


1. The protocol needs to be kept the same (ester/dose T/injection frequency)

2. 4-6 weeks for blood levels to stabilize (TC/TE) before getting blood work done (6 weeks)

3. Testing is done at the true trough

4. Using the same lab

5. Using the same assays (most accurate) TT/e2/DHT (LC-MS/MS) and FT (Equilibrium Dialysis or Ultrafiltration)

6. Each protocol needs to be given 12 weeks


The most accurate assays for TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Most accurate assays for TT/FT (Labcorp, Quest Diagnostics, ARUP)

1. 500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp

2. 070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

3. Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

4. 070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

5. Testosterone Free and Total by ED/LC-MS/MS (Free) and LC-MS/MS (Total), Adult Males | ARUP Laboratories Test Directory

Does Quest have a test that includes Testosterone total, free, estradiol and hematocrit with all the accurate assays listed here?

 

[Jerajera]

Does Quest have a test that includes Testosterone total, free, estradiol and hematocrit with all the accurate assays listed here?

Testosterone (Total + Free), Ultrasensitive Estradiol plus Hematocrit

This economical lab test panel includes the four tests more frequently ordered by men on TRT: Total Testosterone, Liquid Chromatography/ Mass Spectrometry (The most accurate testosterone test with no lower or upper limit).-Free Testosterone, Equilibrium D

www.discountedlabs.com

Discountedlabs works with Quest exclusively. I've used them for over 2 years since starting TRT, never had a problem. Now you get the lab requisition in your email within 5-10 minutes, can't beat that.

 

[Devcon]

Background: I have been on TRT for about 15 years. I've never really struggled with TRT but I was always tweaking my protocol like many do. The past several years I have been really dialed in well and have not messed with my protocol at all. That protocol has been injecting 24mg shallow IM ED with no HCG or AI. Prior to injecting ED I injected weekly, and E3.5D with various amounts of testosterone but could never get my HCT under control. That is what led me to try the ED protocol. So, all has been well under that protocol.

Me: 62 years old, 5'10", 190 lbs naked. Normally run about 10% body fat, sometimes as low as 8% but as high as 12%. I work out regularly but not obsessed with it. I am pretty solid and healthy looking for a 62 year old.

After reading numerous articles and opinions over the last year about the differences and variances in shallow IM verse SubQ it got me thinking maybe I should try the SubQ route. A study from UC showed increased testosterone, lower E2, and lower HCT injecting SubQ as compared to shallow IM. In the study there was no change in PSA.

I have attached a spreadsheet below comparing the lab results from June 7, 2021 on the shallow IM protocol and the lab results from October 20, 2021 using SubQ. I tested the same items in both labs to get a complete picture. You'll notice that my labs under the shallow IM were pretty good so one might ask why I would change if I was so dialed in........I guess curious to see if I could improve the numbers. I figured if the numbers did not impress me I would just go back to the shallow IM which I knew worked for me. A note on the testosterone testing. In June the labs did not use the LC/MS/MS for the Total Testosterone and did not use the Ultra Filtration on the Free T. Therefore, I did not use those assays on this round of testing so the testing would be apples to apples. I have numerous testosterone testing over the years use the most accurate assays but I wanted a good comparison. Plus, regardless of the number, it is about how I feel that is the most important and not a number.

I was on the SubQ protocol for 9 1/2 weeks to ensure there was no question about reaching a steady state. I did not change a thing about my protocol. I injected the same 24mg of testosterone ED and took all the same supplements I was taking previously.

You'll see below there was a nice decrease in HCT and Hb in the October testing on SubQ ......impressive. Total T and Free T dropped significantly on SubQ. Total T dropped 26.8% while Free T fell 47.2%. While the SubQ testosterone numbers are not terrible, they are much lower that the testosterone on shallow IM. There was not a big change on E2 with it going up slightly, 2.7%, on SubQ. Looking at all the other blood markers there wasn't much change at all. My DHT is high and over the range but it has always been that way and I'm not too concerned about it.

How do I feel? I feel pretty good but not as good as I felt on the shallow IM injections. I don't feel like I have quite the energy I had on shallow IM. I've never had an acne problem but I did notice some small acne on my chest and back that I did not have on the shallow IM. I didn't like that.

Element	Range	Measure	6/7/21	10/20/21
WBC	3.4 - 10.8	x10E3/ul	6.0	4.9
RBC	4.14 - 5.80	X10E6/ul	5.42	5.66
Hemoglobin	13.0 - 17.7	g/dl	15.9	14.8
Hematocrit	37.5 - 51.0	%	48.5	46.1
Ttl Cholesterol	100- 199	mg/dl	141	148
LDL	0 - 99	mg/dl	89	92
HDL	> 39	mg/dl	36	37
Triglycerides	< 150	mg/dl	82	92
VLDL Cholesterol	5 - 40	mg/dl	20	21
Ferritin	30 - 400	ng/ml	148	121
Iron	38 - 169	ug/dl	92	57
Iron Saturation	15 - 55	%	31	28
TIBC	250 - 450	ug/dl	280	261
UIBC	111 - 343	ug/dl	202	175
Glucose	65 - 99	mg/dl	96.0	97.0
Hemo A1C	4.8 - 5.6	%	5.2	5.3
TSH	0.45 - 4.50	uiu/ml	0.390	0.371
T3	.79 - 1.49	ng/dl	1.1	1.0
Free T3	2.0 - 4.4	pg/ml	3.7	3.5
T4	4.5 - 12.0	ug/dl	6.8	6.9
Free T4	0.82 - 1.77	ng/dl	1.29	1.22
Reverse T3	9.2 - 24.1	ng/dl	12.2	9.3
TgAB Antibody	0.0 - 0.9	iu/ml	<1.0	<1.0
TPOab Antibody	0 - 34	iu/ml	10	10
Vitamin D	30 - 100	ng/ml	69.0	57.7
Vitamin B12	> 231	pg/ml	962	846
Testosterone	264 - 916	ng/dl	1055	778
Free Test	7.2 - 24.0	pg/ml	31.6	16.7
% Free to Total	2.0 - 3.0	%	2.87%	2.15%
Bioavailable T	250 - 600	ng/dl	613	423
% Bio of Total	30 - 60	%	58.1%	54.4%
PSA	0.0 - 4.0	ng/ml	0.7	0.9
DHT	30 - 85	ng/dl	92	96
DHT % of Test	3.5 - 8.5	%	8.7%	12.4%
Prolactin	4.0 - 15.2	ng/ml	9.6	8.9
Estradiol, Sens	8.0 - 35.0	pg/ml	30.1	30.9
Free Estradiol E2	0.2 - 1.5	pg/ml	1.2	1.3
% Free E2 to Total	1.7 - 5.4	%	3.98%	4.21%
Estradiol (E2) % T	1.0 - 5.0	%	2.85%	3.97%
T:E Ratio	20 - 50	Ratio	35.0	25.2
SHBG	19.3 - 76.4	nmol/l	32.7	31.0
DHEA-S	49 - 344	ug/dl	331.8	287.2
Pregnenolone	< 180	ng/dl	81	70
Progesterone	0.0 - 0.5	ng/ml	0.3	0.3
T Cyp Per Week	150 - 200	mg/ml	168 mg	168 mg
Protocol		Daily	24 mg Daily	24 mg Daily
Peak/Trough		Peak/Trough	Trough	Trough
Method		IM/SubQ	Shallow IM	SubQ

I was surprised to be honest with you. I wanted the SubQ to come out on top. It did when it comes to HCT and Hb. That's a big deal, but my HCT and Hb on the shallow IM were fine, just not as good as the SubQ. I thought the E2 might decrease like in the study but that didn't happen. It actually went up as a percent of my testosterone. I did not expect the testosterone to drop like it did. I thought it might go up like in the study. Total T drop did not bother me as the Free T drop did.




So considering how I feel with less energy and some acne (minor) I will probably go back to the shallow IM. I probably don't need the 1064 Total Testosterone and Free T of 31.6 that I consistently get with the shallow IM injections of 24 mg a day. I could probably drop that a tad and have great results.

These were my results and yours may vary. I paid careful attention to keep everything exactly the same during the 9 1/2 weeks to eliminate any variable other than the injection type.

Just one more example that proves subq is inferior to intramuscular injections.

 

[Devcon]

Well, it was not my intent to run my study for 2 years, nor for three of four months. It was for 9 to 10 weeks and that is what I did. If you wish to run studies that you partake for 3 to 4 months or 2 years, go for it.

But, guess what? I ran this study for me, not you. I did it my way and whether you like it or not, I feel just fine about the steps I took to remove variables. As long as I am happy knowing what all the facts are then I'm good with that. I really don't care if you agree or not.

For the record, in the future, I will no longer share information with this forum. instead of it being a sharing situation I feel like I have to defend myself which is

I've never read once that one should use 12 weeks when changing a protocol, but I haven't read every post on this site. You don't come across as harsh, you come across like an ass. Sorry if that comes across as harsh.

You took a well meaning post and turned it into a piss poor pissing contest. Thank you.

That’s how he operators. He thinks he’s the God of trt or something. Give me a break. How he became a super moderator is beyond me. . You did a great job. Subq does not work for everyone. PERIOD!

 

[madman]

That’s how he operators. He thinks he’s the God of trt or something. Give me a break. How he became a super moderator is beyond me. . You did a great job. Subq does not work for everyone. PERIOD!

Must have gone over your head!

Coming from the same guy running his mouth first post in spewing that bulls**t.

*Subq doesn’t work. It’s a piss poor delivery method for injecting an oil based testosterone


This is downright embarrassing.

Do your homework next time or better yet skate!

subcutaneous injection into stomach

Is 80mg injected into my belly every 4th day to much? Meaning is 80mg to much to inject at one time into belly?

www.excelmale.com

 

[Devcon]

Must have gone over your head!

Coming from the same guy running his mouth first post in spewing that bulls**t.

*Subq doesn’t work. It’s a piss poor delivery method for injecting an oil based testosterone


This is downright embarrassing.

Do your homework next time or better yet skate!

subcutaneous injection into stomach

Is 80mg injected into my belly every 4th day to much? Meaning is 80mg to much to inject at one time into belly?

www.excelmale.com

View attachment 27382

Then explain to me why the majority of men on these forums and at my local gyms that have tried subq all went back to intramuscular injections. And don’t give me that crap about not using the most accurate blood testing methods. It’s inferior. Period!

 

[Devcon]

Then explain to me why the majority of men on these forums and at my local gyms that have tried subq all went back to intramuscular injections. And don’t give me that crap about not using the most accurate blood testing methods. It’s inferior. Period!

And by the way I’ve been at this for about 15 years so I think I know a thing or two about testosterone and it’s derivatives.

 

[madman]

Then explain to me why the majority of men on these forums and at my local gyms that have tried subq all went back to intramuscular injections. And don’t give me that crap about not using the most accurate blood testing methods. It’s inferior. Period!

Broscience at its best!

What that very small slice of the pie that represents all men on trt!

LMFAO.

 

[Devcon]

Broscience at its best!

What that very small slice of the pie that represents all men on trt!

LMFAO.

You’re a clown. One of those guys that runs his mouth too much in a bar and gets smacked! And go ahead and ban me. I don't give two shits!

 

[madman]

You’re a clown. One of those guys that runs his mouth too much in a bar and gets smacked! And go ahead and ban me. I don't give two shits!

Go back to the herd!

Homey don't play that S**T BRUH!

 

[tareload]

 

[Estiffler13]

Background: I have been on TRT for about 15 years. I've never really struggled with TRT but I was always tweaking my protocol like many do. The past several years I have been really dialed in well and have not messed with my protocol at all. That protocol has been injecting 24mg shallow IM ED with no HCG or AI. Prior to injecting ED I injected weekly, and E3.5D with various amounts of testosterone but could never get my HCT under control. That is what led me to try the ED protocol. So, all has been well under that protocol.

Me: 62 years old, 5'10", 190 lbs naked. Normally run about 10% body fat, sometimes as low as 8% but as high as 12%. I work out regularly but not obsessed with it. I am pretty solid and healthy looking for a 62 year old.

After reading numerous articles and opinions over the last year about the differences and variances in shallow IM verse SubQ it got me thinking maybe I should try the SubQ route. A study from UC showed increased testosterone, lower E2, and lower HCT injecting SubQ as compared to shallow IM. In the study there was no change in PSA.

I have attached a spreadsheet below comparing the lab results from June 7, 2021 on the shallow IM protocol and the lab results from October 20, 2021 using SubQ. I tested the same items in both labs to get a complete picture. You'll notice that my labs under the shallow IM were pretty good so one might ask why I would change if I was so dialed in........I guess curious to see if I could improve the numbers. I figured if the numbers did not impress me I would just go back to the shallow IM which I knew worked for me. A note on the testosterone testing. In June the labs did not use the LC/MS/MS for the Total Testosterone and did not use the Ultra Filtration on the Free T. Therefore, I did not use those assays on this round of testing so the testing would be apples to apples. I have numerous testosterone testing over the years use the most accurate assays but I wanted a good comparison. Plus, regardless of the number, it is about how I feel that is the most important and not a number.

I was on the SubQ protocol for 9 1/2 weeks to ensure there was no question about reaching a steady state. I did not change a thing about my protocol. I injected the same 24mg of testosterone ED and took all the same supplements I was taking previously.

You'll see below there was a nice decrease in HCT and Hb in the October testing on SubQ ......impressive. Total T and Free T dropped significantly on SubQ. Total T dropped 26.8% while Free T fell 47.2%. While the SubQ testosterone numbers are not terrible, they are much lower that the testosterone on shallow IM. There was not a big change on E2 with it going up slightly, 2.7%, on SubQ. Looking at all the other blood markers there wasn't much change at all. My DHT is high and over the range but it has always been that way and I'm not too concerned about it.

How do I feel? I feel pretty good but not as good as I felt on the shallow IM injections. I don't feel like I have quite the energy I had on shallow IM. I've never had an acne problem but I did notice some small acne on my chest and back that I did not have on the shallow IM. I didn't like that.

Element	Range	Measure	6/7/21	10/20/21
WBC	3.4 - 10.8	x10E3/ul	6.0	4.9
RBC	4.14 - 5.80	X10E6/ul	5.42	5.66
Hemoglobin	13.0 - 17.7	g/dl	15.9	14.8
Hematocrit	37.5 - 51.0	%	48.5	46.1
Ttl Cholesterol	100- 199	mg/dl	141	148
LDL	0 - 99	mg/dl	89	92
HDL	> 39	mg/dl	36	37
Triglycerides	< 150	mg/dl	82	92
VLDL Cholesterol	5 - 40	mg/dl	20	21
Ferritin	30 - 400	ng/ml	148	121
Iron	38 - 169	ug/dl	92	57
Iron Saturation	15 - 55	%	31	28
TIBC	250 - 450	ug/dl	280	261
UIBC	111 - 343	ug/dl	202	175
Glucose	65 - 99	mg/dl	96.0	97.0
Hemo A1C	4.8 - 5.6	%	5.2	5.3
TSH	0.45 - 4.50	uiu/ml	0.390	0.371
T3	.79 - 1.49	ng/dl	1.1	1.0
Free T3	2.0 - 4.4	pg/ml	3.7	3.5
T4	4.5 - 12.0	ug/dl	6.8	6.9
Free T4	0.82 - 1.77	ng/dl	1.29	1.22
Reverse T3	9.2 - 24.1	ng/dl	12.2	9.3
TgAB Antibody	0.0 - 0.9	iu/ml	<1.0	<1.0
TPOab Antibody	0 - 34	iu/ml	10	10
Vitamin D	30 - 100	ng/ml	69.0	57.7
Vitamin B12	> 231	pg/ml	962	846
Testosterone	264 - 916	ng/dl	1055	778
Free Test	7.2 - 24.0	pg/ml	31.6	16.7
% Free to Total	2.0 - 3.0	%	2.87%	2.15%
Bioavailable T	250 - 600	ng/dl	613	423
% Bio of Total	30 - 60	%	58.1%	54.4%
PSA	0.0 - 4.0	ng/ml	0.7	0.9
DHT	30 - 85	ng/dl	92	96
DHT % of Test	3.5 - 8.5	%	8.7%	12.4%
Prolactin	4.0 - 15.2	ng/ml	9.6	8.9
Estradiol, Sens	8.0 - 35.0	pg/ml	30.1	30.9
Free Estradiol E2	0.2 - 1.5	pg/ml	1.2	1.3
% Free E2 to Total	1.7 - 5.4	%	3.98%	4.21%
Estradiol (E2) % T	1.0 - 5.0	%	2.85%	3.97%
T:E Ratio	20 - 50	Ratio	35.0	25.2
SHBG	19.3 - 76.4	nmol/l	32.7	31.0
DHEA-S	49 - 344	ug/dl	331.8	287.2
Pregnenolone	< 180	ng/dl	81	70
Progesterone	0.0 - 0.5	ng/ml	0.3	0.3
T Cyp Per Week	150 - 200	mg/ml	168 mg	168 mg
Protocol		Daily	24 mg Daily	24 mg Daily
Peak/Trough		Peak/Trough	Trough	Trough
Method		IM/SubQ	Shallow IM	SubQ

I was surprised to be honest with you. I wanted the SubQ to come out on top. It did when it comes to HCT and Hb. That's a big deal, but my HCT and Hb on the shallow IM were fine, just not as good as the SubQ. I thought the E2 might decrease like in the study but that didn't happen. It actually went up as a percent of my testosterone. I did not expect the testosterone to drop like it did. I thought it might go up like in the study. Total T drop did not bother me as the Free T drop did.




So considering how I feel with less energy and some acne (minor) I will probably go back to the shallow IM. I probably don't need the 1064 Total Testosterone and Free T of 31.6 that I consistently get with the shallow IM injections of 24 mg a day. I could probably drop that a tad and have great results.

These were my results and yours may vary. I paid careful attention to keep everything exactly the same during the 9 1/2 weeks to eliminate any variable other than the injection type.

What size syringe do you use shallow IM? .5 inch 27 gauge in delts? That’s what I use and I was told since I’m “muscular” that would be shallow IM? Thanks! Blood work looks great!