Should You Be Injecting Testosterone Under the Skin?

[Dr. John Crisler]

Jasen, great questions about the different carrier oils and their respective viscosities as well as pH.

Firstly, pH isn't a factor in Oil based Injectables as pH is a measure of the amount of Hydrogen Ions is an AQUEOUS solution.

Now lets figure out which oil is best to use:
Flow Rate can be derived from Poiseuille's Law: Q = ∆p π R^4 / (8 η L)
where
Q is flow rate
∆p is the pressure differential on both sides
R is the radius of the needle
η is the viscosity of the fluid
L is the length of the needle

As you can see from the equation, pressure gradients when drawing are negligible due to the small cross sectional area of the needle acting as an effective choke. I ran an experiment with different gauge syringes and our Testosterone Cypionate in Sesame Oil.

Size of Needle 25G 27G 29G 31G Amount drawn in 1 minute 2mL 0.8mL 0.32mL 0.07mL

As the results show the amount drawn becomes exponentially smaller with a smaller gauge needle. This is due to the Radius^4 variable in our equation.

So what else does Poiseuille's law teach us? When you have a small radius changing the viscosity won't cause a huge difference in flow rates. It's the radius value that dominates the equation, not the viscosity, pressure differential or length. From this we can determine that the carrier oil wouldn't make a measurable difference in draw time.

Using the above data I recommend either a 27G or 29G needle to draw and inject Testsoterone Cypionate/Enanthate for a SQ injection. Preferably a 29G as it will only take 1-2 minutes out of a patient's week to draw their dose and 10-20 seconds to inject it.

Thank you, EP! That is very cool info. This dispels that Bro Science about warming the oil then, too.

I personally use a 1/2" 29ga insulin syringe. I inject into the gluteal region, just like the old IM shots, just with a shorter needle, so it goes into the fat. This particular needle works great for me.

 

[robs2nd75]

I have seen this, but only a couple times in many hundreds of patients.

A long time ago, I decided to never be surprised by anything I see in Interventional Endocrinology.

IF SHBG is high or high-normal, it can be an issue, because you then aren't getting the peak you need to get over the top; but that would be for subjective response, not lab values.

BTW, I don't see you commenting on how you feel, only what shape the ink is on a piece of paper.

BTW, a tip of the hat to the Endo for using SC injections!

I felt like absolute garbage. Labile mood, arthritic like pain (more than normal), decreased libido...the sides are almost instantaneous when I switch. Ty kindly for your wisdom it is greatly appreciated!!!

 

[Dr. John Crisler]

I felt like absolute garbage. Labile mood, arthritic like pain (more than normal), decreased libido...the sides are almost instantaneous when I switch. Ty kindly for your wisdom it is greatly appreciated!!!

I'm like a broken record that the goals of treatment are health and happiness, not numbers on a piece of paper. That is because everyone has their own best "sweet spots", and laboratory analysis of hormones can be tricky business.

So I always want a guy to start out by telling me how he feels, NOT what his numbers are.

 

[HarryCat]

Results have been reported for the Antares pharma QUICKSHOT™ mentioned earlier in this thread.

http://www.antarespharma.com/files/9413/9290/5678/Testosterone_release_final.pdf

 

[Nelson Vergel]

Thanks HarryCat

"Twenty nine adult males with hypogonadism (low testosterone) and testosterone blood levels less than 300 ng/dL were randomized into two groups. The first group received 50 mg testosterone enanthate administered subcutaneously with the QuickShot™ auto injector once weekly for six weeks and the second group received 100 mg of testosterone enanthate using the same device and time sequence. The clinical study followed patients for four weeks after the last dose.

The mean testosterone baseline for the 50 mg group was 214.6 ng/dL and 201.5 ng/dL in the 100 mg group. At week one, both doses produced normal mean total testosterone concentrations at 24 hours post-dose, 434 ng/dL in the 50 mg group and 572 ng/dL in the 100 mg group. During week six of the study when patients were already at steady state pharmacokinetic conditions, the 50 mg and 100 mg groups had average plasma testosterone values within the normal range at 422.4 ng/dL and 895.5 ng/dL, respectively. The study demonstrated rapid restoration, consistent maintenance of normal testosterone levels and dose proportionality of the 50 mg and 100 mg strengths. The once-weekly injection was generally well tolerated. No injection site pain was reported by 28 of 29 patients and seventeen patients reported mild to moderate adverse events which according to the investigators were unrelated to the drug or device. There were no deaths, serious adverse events or discontinuations due to adverse events in the study."

It is hard for me to believe that once a week 50 mg and 100 mg doses can achieve those levels. Hey, may be subcutaneous injections get absorbed better! I would love to see the median and a distribution. I would also love to see data that compares TT levels with the amount of subcutaneous fat these guys had.

 

[Dr. John Crisler]

In this video the people from LowTestosterone.com teach us how to properly measure the dose for injecting testosterone under the skin. A must-watch for anyone considering this delivery method.

https://www.excelmale.com/?s=113-Subcutaneous-Testosterone-Injection-Tutorial-(Beneath-skin)

I really don't consider the technique injecting under the skin. My guys are putting it right into the fat. i like to inject into the fat pad right over the glutes, just like a regular IM injection, but with a shorter, smaller needle.

No bruising, no extrusion of the oil, very rarely even a drop of blood at the injection point. It works great.

 

[Dr. John Crisler]

Thanks HarryCat

"Twenty nine adult males with hypogonadism (low testosterone) and testosterone blood levels less than 300 ng/dL were randomized into two groups. The first group received 50 mg testosterone enanthate administered subcutaneously with the QuickShot™ auto injector once weekly for six weeks and the second group received 100 mg of testosterone enanthate using the same device and time sequence. The clinical study followed patients for four weeks after the last dose.

The mean testosterone baseline for the 50 mg group was 214.6 ng/dL and 201.5 ng/dL in the 100 mg group. At week one, both doses produced normal mean total testosterone concentrations at 24 hours post-dose, 434 ng/dL in the 50 mg group and 572 ng/dL in the 100 mg group. During week six of the study when patients were already at steady state pharmacokinetic conditions, the 50 mg and 100 mg groups had average plasma testosterone values within the normal range at 422.4 ng/dL and 895.5 ng/dL, respectively. The study demonstrated rapid restoration, consistent maintenance of normal testosterone levels and dose proportionality of the 50 mg and 100 mg strengths. The once-weekly injection was generally well tolerated. No injection site pain was reported by 28 of 29 patients and seventeen patients reported mild to moderate adverse events which according to the investigators were unrelated to the drug or device. There were no deaths, serious adverse events or discontinuations due to adverse events in the study."

It is hard for me to believe that once a week 50 mg and 100 mg doses can achieve those levels. Hey, may be subcutaneous injections get absorbed better! I would love to see the median and a distribution. I would also love to see data that compares TT levels with the amount of subcutaneous fat these guys had.

I have found that 40mg SC twice per week is about equal to 100mg IM in a single shot.

The idea is you are clipping off the peak, and the nadir, by doing it this way. This is especially useful for guys with lower SHBG.

 

[Nelson Vergel]

I use 1/2 - 27 gauge syringes now 90 degrees to my thighs or shoulders. I guess we should call it "Shallow IM"

 

[magnus]

I switched to SC injections, 50mg x 2/wk, in the fat pad of the butt, about 8 months ago. Within two weeks I noticed better libido and a subjective feeling of better well-being. The odd thing however, was that after six weeks of SC injections, my test levels dropped significantly. I continued on with SC injections and continue to feel fantastic and, I believe, better than I did during the 2 years of IM injections, although my numbers continue to be down significantly.


Part of me feels I should try IM again to see if it pops my numbers up, but I'm hesitant to mess with how well I'm feeling now.

 

[Nelson Vergel]

Margus

It is not the numbers that matter (unless your testosterone is under 300 ng/dL), it's how you feel. I am glad you are feeling great.

 

[Kelly]

I use 1/2 - 27 gauge syringes now 90 degrees to my thighs or shoulders. I guess we should call it "Shallow IM"

Exactly what I use pretty much anywhere I inject. I often wonder if you're very lean (even glutes) if it's IM, SQ or a combination of both! Never tried thighs, sorta scares me for some reason.

 

[biogeek46]

Clarification on EmpowerPharmacy post on different carrier oils

EmpowerPharmacy--

Thank you for the excellent post on different carrier oils.


I just wanted to make sure I'm getting the correct takeaways from this, because it goes counter to what I'd previously heard.


Previously, I'd been told that for SubQ injections of testosterone, I should use Grapeseed Oil, not Sesame Oil, because Sesame Oil would be too thick for the smaller gauge needle.


But it sounds like what you're saying is that it wouldn't really matter, and Sesame Oil would be fine, because at such a small radius, the viscosity of the oil won't make a major difference?


Thank you for your help!

Jasen, great questions about the different carrier oils and their respective viscosities as well as pH.

Firstly, pH isn't a factor in Oil based Injectables as pH is a measure of the amount of Hydrogen Ions is an AQUEOUS solution.

Now lets figure out which oil is best to use:
Flow Rate can be derived from Poiseuille's Law: Q = ∆p π R^4 / (8 η L)
where
Q is flow rate
∆p is the pressure differential on both sides
R is the radius of the needle
η is the viscosity of the fluid
L is the length of the needle

As you can see from the equation, pressure gradients when drawing are negligible due to the small cross sectional area of the needle acting as an effective choke. I ran an experiment with different gauge syringes and our Testosterone Cypionate in Sesame Oil.

Size of Needle 25G 27G 29G 31G Amount drawn in 1 minute 2mL 0.8mL 0.32mL 0.07mL

As the results show the amount drawn becomes exponentially smaller with a smaller gauge needle. This is due to the Radius^4 variable in our equation.

So what else does Poiseuille's law teach us? When you have a small radius changing the viscosity won't cause a huge difference in flow rates. It's the radius value that dominates the equation, not the viscosity, pressure differential or length. From this we can determine that the carrier oil wouldn't make a measurable difference in draw time.

Using the above data I recommend either a 27G or 29G needle to draw and inject Testsoterone Cypionate/Enanthate for a SQ injection. Preferably a 29G as it will only take 1-2 minutes out of a patient's week to draw their dose and 10-20 seconds to inject it.

 

[EmpowerPharmacy]

Hey Bio, you've got the right idea. Since the bore is so small the viscosity difference between sesame and grapeseed won't make a big difference in draw time.

 

[Nelson Vergel]

More discussion in this thread (click)

Subcutaneous Administration of Testosterone

 

[Brad Jhonsen]

I don,t think you should inject testosterone .If didn,t try natural ways ti increase testosterone then i would advice you to do so ..I think natural remedy is the best remedy than other process so try natural ways to increase testosterone .

 

[CoastWatcher]

I don,t think you should inject testosterone .If didn,t try natural ways ti increase testosterone then i would advice you to do so ..I think natural remedy is the best remedy than other process so try natural ways to increase testosterone .

As has been pointed out in response to another of your threads/posts, natural means of raising testosterone have been shown, time and time again, to only benefit a small number of men. In the case of a man dealing with primary hypogonadism, it's an impossibility. We wish you well as you work toward a natural resolution, you may well be one of those men who finds success, but for the vast majority, exogenous testosterone (injection or dermal application) is the only answer.

 

[Nelson Vergel]

Subcutaneous Testosterone Injections Are A Good Alternative to Intramuscular Ones

 

[ratbag]

Interesting as I haven't seen this thread before. A few comments. What Dr. Crisler is saying is really what evidenced based medicine is all about. And we don't update methods or protocols until we know it works so in reality learning what works no matter how we get there is all that matters and after 10 maybe 20 years the studies will be there.... what Dr. Crisler said.

I have never been able to to inject SC but I just realised why that may be. Being in Canada we can only get depot Testosterone that is 100mg/ml. Whereas Americans get 200mg/ml. This means I have to injects twice as much volume as an American does. And perhaps is the reason why I get painful lumps in my fat pad when I inject SC. I don't have any issues doing IM. Phil Gerogian once said I should do 2 SC injections and that may solve the problem but I'm not looking to increase the amount of shots I have to take. I'm looking for ways to reduce the number of shots I need.

 

[CoastWatcher]

Interesting as I haven't seen this thread before. A few comments. What Dr. Crisler is saying is really what evidenced based medicine is all about. And we don't update methods or protocols until we know it works so in reality learning what works no matter how we get there is all that matters and after 10 maybe 20 years the studies will be there.... what Dr. Crisler said.

I have never been able to to inject SC but I just realised why that may be. Being in Canada we can only get depot Testosterone that is 100mg/ml. Whereas Americans get 200mg/ml. This means I have to injects twice as much volume as an American does. And perhaps is the reason why I get painful lumps in my fat pad when I inject SC. I don't have any issues doing IM. Phil Gerogian once said I should do 2 SC injections and that may solve the problem but I'm not looking to increase the amount of shots I have to take. I'm looking for ways to reduce the number of shots I need.

It must be an issue in Quebec, the availability of testosterone dispensed at 200mg/ml. That's all I've ever purchased in Ontario (Delatestryl, Testosterone Enanthate, manufactured by Valeant, DIN 00029246).

 

[ratbag]

Thx Coast, why am I not surprised. I've asked my pharmacist for 200mg/ml for years and he always says he'll try but it never happens. Is there anyone from Quebec here that gets 200mg/ml? Because I`d sure like to find out whats up with that.