What needle length for IM TRT? Thinking of changing from subQ to IM to feel better

[Wolverine]

That's interesting. I don't want to change too many variables at once going from subQ to IM and also from daily to 2x/week, so I'm just going to switch from subQ to IM at first while staying on daily injections and see if that makes any difference.
[/QUOTE

With the caveat that we are all different: I was taking 45mg twice a week shallow IM (1/2 in needle). Total T levels were in the 700-800 range with free T a little over the top. Switched to Subq short insulin needle 30g three times a week (30 mg each time) and Total T went to 531 and free t at 12.7 (range 7.2 - 24). It did bring my H&H down which was the goal but not feeling as well with the lower levels and EQ and sex drive off. I'm going back to the 1/2 in needle shallow IM and twice a week. Trying to avoid giving blood as I have done in the past due to low ferritin result but may not be able to avoid it. Drinking lots of water.

 

[GeorgieBoy]

With the caveat that we are all different: I was taking 45mg twice a week shallow IM (1/2 in needle). Total T levels were in the 700-800 range with free T a little over the top. Switched to Subq short insulin needle 30g three times a week (30 mg each time) and Total T went to 531 and free t at 12.7 (range 7.2 - 24). It did bring my H&H down which was the goal but not feeling as well with the lower levels and EQ and sex drive off. I'm going back to the 1/2 in needle shallow IM and twice a week. Trying to avoid giving blood as I have done in the past due to low ferritin result but may not be able to avoid it. Drinking lots of water.

That's really interesting, I've read similar stuff about subQ from others, which is why I want to give shallow IM a shot. Do you know what your SHBG was before TRT?

Also do you think going from 2x/week to 3x/week could've been the difference and not subQ vs IM?

 

[madman]

I changed dosage about every 2 weeks. I could feel positive changes almost immediately after a few days (makes sense on daily injections) but then they would subside and I would go back to feeling terrible, so I just kept upping the dose from 100mg to 200mg/week, 25mg at a time. Finally I realized 125mg/week was where I felt the least terrible so I went back there and have been there for about 3 weeks now.

I'm getting labs done tomorrow to see what's going on. I ordered the 1/2'' insulin syringes to try IM and should get them hopefully tomorrow also.

Forget the switching from sub-q--->IM for now.

No wonder why you have no idea whether you are coming or going and if you keep at it like this the merry go round will keep on spinning.

As you can see increasing your dose every 2 weeks is going to result in disappointment.

You are not allowing your body enough time for blood levels to stabilize let alone adapt.

For trt the most commonly prescribed esters are T cypionate and enanthate.

Using such esters it will take 4-6 weeks on the said protocol (dose of T/injection frequency) to stabilize.

A lot is going on when you first start trt as not only are you injecting exogenous T which will eventually shut down your hpta (2-6 weeks depending on starting dose) but your serum levels are increasing and will be in FLUX in the weeks leading up until they stabilize and even then it will still take 2-3 months for the body to adapt to those new levels.

Depending on the individual and how they react to the said protocol it can be common to experience what we call the honeymoon phase where you almost feel euphoric due to a boost in dopamine and increasing T levels but it will be short-lived and temporary as the body will adjust and other individuals may have a rough ride experiencing ups/downs during this transition until blood levels stabilize (4-6 weeks).

Too many get caught and make the mistake of gauging how they feel during the first 6 weeks when unfortunately it can be misleading as serum levels will be in FLUX during the weeks leading up until they stabilize (4-6 weeks) let alone the hpta is getting shut down.

Once blood levels stabilize it can take 2-3 months for the body to adapt to those new levels and during this time is when one should gauge how they truly feel regarding relief/improvement of low-t symptoms and overall well-being.

When starting trt or tweaking a protocol (dose/injection frequency) blood work should be done at 6 weeks to see where said protocol has ones TT/FT/e2 among other blood markers and depending on where T levels sit a slight dose increase may be needed if levels are too low or in other cases a decrease may be needed.

The goal of trt is to replace physiological levels through the use of exogenous T which results in relief/improvement of low-t symptoms and increased overall well-being while at the same time avoiding/minimizing and potential side-effects and keeping blood markers healthy long-term.

Blood work is critical and although treating symptoms is what truly matters it is still important to pay attention to where said protocol (dose of T/injection frequency) has your TT/FT/e2 levels as there is such as thing as running too high T levels on trt let alone the impact such dose of T has on overall blood health markers.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.

Most men will do well having an FT in the 20-30 ng/dL range and some may run slightly higher levels.

When first starting TRT low and slow is key.

Trust me when I tell you that some of the beneficial effects of having testosterone levels may take longer and will improve over time.

Do not expect any miracles when first starting as patience is key.

If you are not willing to put in the time needed to truly reap the benefits of trt than you will be chasing your tail indefinitely!





Onset of effects of testosterone treatment and time span until maximum effects are achieved

Pre Trt panel

54 yr old starting Trt. After screening panel seen in pics below Doc put me on 200mg test cyp once weekly. I’ll be back for bloods again day before my 7th injection. Does this protocol look good for my initial panel

www.excelmale.com

 

[madman]

If you are dead set on injecting IM than pick a descent starting dose 100 mg/week and split into twice-weekly injections (50 mg every 3.5 days) unless you have low SHBG than injecting daily/EOD may be needed.

It is critical that you stay consistent with your protocol (dose of T/injection frequency) than have blood work done at 6 weeks.

Make sure to test at the true trough and try to make sure you get blood work done at the same lab using accurate assays (TT/FT/e2).

After 6 weeks you may very well need a slight dose increase or if your TT/FT levels are healthy on such protocol than give it 2-3 months to truly gauge how you feel overall regarding relief/improvement of low-t symptoms and overall well being.

After 2-3 months on such protocol, you can then decide if any further tweaking (dose of T/injection frequency) may be needed.

 

[GeorgieBoy]

If you are dead set on injecting IM than pick a descent starting dose 100 mg/week and split into twice-weekly injections (50 mg every 3.5 days) unless you have low SHBG than injecting daily/EOD may be needed.

It is critical that you stay consistent with your protocol (dose of T/injection frequency) than have blood work done at 6 weeks.

Make sure to test at the true trough and try to make sure you get blood work done at the same lab using accurate assays (TT/FT/e2).

After 6 weeks you may very well need a slight dose increase or if your TT/FT levels are healthy on such protocol than give it 2-3 months to truly gauge how you feel overall regarding relief/improvement of low-t symptoms and overall well being.

After 2-3 months on such protocol, you can then decide if any further tweaking (dose of T/injection frequency) may be needed.

Thanks for taking the time to type such detailed answers. Do you think there could be any downside to injecting IM daily even though my SHBG is very high (70)?

I've been doing subQ daily with insulin syringes because I wanted to minimize side effects (I didn't go into this completely without doing research), and I was thinking maybe it'd be smarter to only change one variable at first (subQ to IM but still daily injections) instead of changing both injection route and frequency and then if things get better having no idea which change is responsible for it.

 

[Wolverine]

That's really interesting, I've read similar stuff about subQ from others, which is why I want to give shallow IM a shot. Do you know what your SHBG was before TRT?

Also do you think going from 2x/week to 3x/week could've been the difference and not subQ vs IM?

Didn't measure SHBG this time but its usually in the 20 range. Could have been various factors. Shallow injection into fat resulting in less absorption, more frequent injections (although I kept the same dosage and usually more frequent injections at same dosage will increase T levels). As with many things with the human body, its a mystery. Only reason I switched was to lower H/H, which it did. Guess I could increase 3x a week subq dosage but I felt best on the twice a week shallow IM injections, but H/H was a problem. I think part of my H/H problem (if not the cause of it) is hemoconcentration (not enough fluids). My hematocrit is always more than three times (and some times a lot more) my hemoglobin.

 

[madman]

Thanks for taking the time to type such detailed answers. Do you think there could be any downside to injecting IM daily even though my SHBG is very high (70)?

I've been doing subQ daily with insulin syringes because I wanted to minimize side effects (I didn't go into this completely without doing research), and I was thinking maybe it'd be smarter to only change one variable at first (subQ to IM but still daily injections) instead of changing both injection route and frequency and then if things get better having no idea which change is responsible for it.

Higher doses of T 200+mg/week injected less frequently would have a bigger impact on lowering SHBG but even than c-17alpha alkylated oral will have the biggest impact on hammering down SHBG.

Depending on the dose of T/injection frequency some men may only notice a small drop in SHBG and others may see a more significant drop.

I inject 150mg/week (75mg every 3.5 days) pre-trt my SHBG was 34 nmol/L and as of now (3.5 yrs on trt) it has always hovered around 30-32 nmol/L.

The main benefit of injecting daily will be stable blood levels/minimizing peak--->trough.

Some do notice improvements in lowering of HCT and estradiol but it is not a given.

Seeing as you have already been injecting strictly sub-q daily than just switch to IM daily.

 

[GeorgieBoy]

Higher doses of T 200+mg/week injected less frequently would have a bigger impact on lowering SHBG but even than c-17alpha alkylated oral will have the biggest impact on hammering down SHBG.

Depending on the dose of T/injection frequency some men may only notice a small drop in SHBG and others may see a more significant drop.

I inject 150mg/week (75mg every 3.5 days) pre-trt my SHBG was 34 nmol/L and as of now (3.5 yrs on trt) it has always hovered around 30-32 nmol/L.

The main benefit of injecting daily will be stable blood levels/minimizing peak--->trough.

Some do notice improvements in lowering of HCT and estradiol but it is not a given.

Seeing as you have already been injecting strictly sub-q daily than just switch to IM daily.

Thanks, I just started my first daily injection shallow IM in delt and will stick with that for a while to see if it makes a significant difference with SubQ at the same injection frequency.

Do you notice a drop in mood/libido/energy at the end of 3.5 days before your next shot on 2x/week injections? Did you ever try daily injections?

 

[buckeye22]

I've been doing subcutaneous injections daily for a while but don't feel that good with them. I've tried all sorts of dosages from 100mg/week to 200mg/week and found I felt the least bad around 125mg/week, but nothing close to life changing. Still lots of brain fog, not much energy or motivation...

Some people claim they get higher levels on IM than subQ and more importantly that they feel a lot better with IM, so I've been thinking about trying something like twice/week IM instead of daily subQ. My shbg is pretty high so maybe I don't need to do daily subQ after all and I've never tried anything else.

For reference I'm very lean and in pretty good shape. Very clean diet + vit D/B and Magnesium supplements. Lab numbers are very good for lipids, cholesterol, blood pressure, etc...and I'm not on any (other) medication.

My question is what needle length do you guys use for IM? I've been using insulin syringes with 30G 5/16'' needles for subQ and my biggest concern with IM is scar tissue buildup over time, so I'd like to stick with 30G but obviously 5/16'' is going to be too short for IM.

I was thinking of trying 1/2'' needle length, is that too short?

Maybe you haven’t dialed in your correct dose for you as everyone is different in what works for them and how they feel. In addition, what else in your life have you looked? Maybe you have depression? Maybe you aren’t drinking enough clean water? This may sound funny but try drinking a gallon of clean water Daily starting early am stopping by 8 pm. Amazing effects on body.

anyways27g x 1”, anything smaller like 1/2” is not shallow IM like others believe unless you are an emaciated scrawny skeleton. It’s simply subq.
In addition you aren’t going to feel Any better at the same doses, that’s in your head. Test IM vs subq efficacy is the same. Route of administration is preference to user. Ssubq is just easier and less painful. Why don’t u just try 2 days wk subq. ie. M and F. Test peaks at 3-4 day mark. The daily microdosing schedule isn’t proven to be any better.

 

[tcmi]

If you’re really lean, there really isn’t any difference between subQ and “shallow” IM. I use 29g 5/16 directly into muscle (I have very little fat). I do daily mainly because my SHBG is very low.

 

[TucsonJJ]

I do 27ga 1/2" needle for shallow IM and it seems to work. I do Im 3 days and sub q 4 days. I notice no difference

Can I ask how much you are taking daily? I am wondering if daily injections are really necessary if my estradiol and hematocrit are fine... my dosage is very low, just 7 weeks into TRT... only 60mg/wk, I am doing 2 pins weekly...

 

[TucsonJJ]

There a little misplaced logic there. If you've dosed at 200mg and don't feel better at that higher level, it doesn't make sense to do IM to effectively get "higher levels". That said, maybe IM will suit you better.

I inject subQ and it has never been a problem in terms of blood levels, but YMMV. I would not try to use 30g for IM, rather 29 or 27 g depending on oil carrier. 27 will be quick.

What is the best oil carrier? I am switching from Pharmacy T (Portugal made) to a local compounder. Thx!

 

[TucsonJJ]

Read around this forum in depth and you will find that what I am saying is well supported.

And perhaps other members will chime in. particularly, @madman always has comments pertinent to this discussion.

Good luck!

I am a newbie, only 7 weeks in... but have been changing my dose often and number of pins/wk... I have not felt the benefits of TRT... so I support what Blackhawk is saying. I am going to go with a consistent 60mg (low dose) for 6 weeks and then see what's what. I am doing low dose due to some anxiety... I will stick with 2X/wk pins.

 

[madman]

Maybe you haven’t dialed in your correct dose for you as everyone is different in what works for them and how they feel. In addition, what else in your life have you looked? Maybe you have depression? Maybe you aren’t drinking enough clean water? This may sound funny but try drinking a gallon of clean water Daily starting early am stopping by 8 pm. Amazing effects on body.

anyways27g x 1”, anything smaller like 1/2” is not shallow IM like others believe unless you are an emaciated scrawny skeleton. It’s simply subq.
In addition you aren’t going to feel Any better at the same doses, that’s in your head. Test IM vs subq efficacy is the same. Route of administration is preference to user. Ssubq is just easier and less painful. Why don’t u just try 2 days wk subq. ie. M and F. Test peaks at 3-4 day mark. The daily microdosing schedule isn’t proven to be any better.

Speak for yourself and one can easily hit shallow IM using 1/2" needle length depending on the area injected and how lean/muscular the individual.

Delts 1/2" needle length with ease!

T levels will peak 8-12 hrs post-injection!

 

[NoVa Biker]

GeorgieBoy

I think you may be expecting too much from TRT. It has some benefits, but it is not a miracle drug. It won't solve all problems. I doubt going from SQ to IM will make any difference. It didn't for me - the same either way.

 

[madman]

Thanks, I just started my first daily injection shallow IM in delt and will stick with that for a while to see if it makes a significant difference with SubQ at the same injection frequency.

Do you notice a drop in mood/libido/energy at the end of 3.5 days before your next shot on 2x/week injections? Did you ever try daily injections?

Tons of energy, mood is great, strong libido, and never had any issues with erections other than pre-trt when I had low-t (no libido, lack spontaneous/nocturnal erections).

I am on a T only protocol and have never used hCG/AI or a PDE-5 inhibitor.

Never felt the need to try daily as I feel great overall.

 

[GeorgieBoy]

GeorgieBoy

I think you may be expecting too much from TRT. It has some benefits, but it is not a miracle drug. It won't solve all problems. I doubt going from SQ to IM will make any difference. It didn't for me - the same either way.

I understand but right now I feel even worse than I did pre-TRT, and I keep reading about guys who say they feel better than they did when they were 20yo.

 

[GeorgieBoy]

Tons of energy, mood is great, strong libido, and never had any issues with erections other than pre-trt when I had low-t (no libido, lack spontaneous/nocturnal erections).

I am on a T only protocol and have never used hCG/AI or a PDE-5 inhibitor.

Never felt the need to try daily as I feel great overall.

Can I ask what your levels are? I just got my test results and I'm very high.

My TT is 1600 ng/dL (range: 250-1100), FT is 300 pg/mL (range: 35-155) and E2 is 40 (range: <29).

FT is twice the normal range, so maybe I'm too high? At the same time, shouldn't I feel better being really high? I have no apparent side effects. I can sleep fine (I sleep a lot actually...), no anxiety, just a lot of apathy and lack of drive/motivation.

 

[madman]

Can I ask what your levels are? I just got my test results and I'm very high.

My TT is 1600 ng/dL (range: 250-1100), FT is 300 pg/mL (range: 35-155) and E2 is 40 (range: <29).

FT is twice the normal range, so maybe I'm too high? At the same time, shouldn't I feel better being really high? I have no apparent side effects. I can sleep fine (I sleep a lot actually...), no anxiety, just a lot of apathy and lack of drive/motivation.

Why are you worrying about labs as of now?

Again as I stated previously you need to stick to the same protocol (dose of T/injection frequency) for 6 weeks until blood levels stabilize than have blood work done.

 

[madman]

I understand but right now I feel even worse than I did pre-TRT, and I keep reading about guys who say they feel better than they did when they were 20yo.

What were you expecting as you approached this in the wrong way right off the hop increasing your dose every 2 weeks let alone preventing any chance of letting blood levels stabilize which will take 4-6 weeks?

You need to stay consistent with your protocol (dose of T/injection frequency) otherwise you are wasting your time!