Site Reaction

[aaghabegian]

Hello everyone,
I’m honored to be on this site and thank you Mr. Vergel for all the education through your excellent books. I am a Physician Assistant practicing in CA and have been on TRT for about 11 years. My treatments began 11 years ago with a few IM injections that I could not tolerate due to painful injections site reactions and I switched over to compounded transdermal cream which worked well, but has been somewhat inconvenient. Several weeks ago I decided to switch to weekly subcutaneous injections in my abdomen. I’m using Testosterone Cypionated in cotton seed oil. Unfortunately I have been experiencing quite bad injection site reactions in which the site become very painful and tender to touch about 48 hours post injection, then becomes red and inflamed. The pain gets better about a week later, but the site remains endurated to the point where I wouldn’t be able to inject the same site even two weeks later. I would appreciate any helpful feedback that I can get as I would strongly prefer not to go back to transdermal cream.

 

[Systemlord]

There’s always the newer oral testosterone options, Jatenzo, Orlando and Kyzatrex. Cash pay is even affordable if insurance denies coverage.

 

[Cataceous]

Welcome to ExcelMale! Injection site reactions are a common problem, perhaps more so when first starting. There are various things you can try to mitigate the issue. Splitting the dose may be of marginal help, but changing esters and/or excipients will give the best odds for improvement. In particular there are anecdotal reports that switching from cypionate to enanthate can reduce such problems. I found it to work for me; reactions were reduced, but not completely eliminated. However, over the years the frequency of site reactions has diminished to the point of being virtually nonexistent. So there may be adaptation over time. There's speculation that getting away from benzyl benzoate may be helpful in some cases, and switching to enanthate usually accomplishes this as well, depending on the particular formulation.

I've also seen suggestions to try using an antihistamine for a period, but I haven't heard much about the efficacy of this.

 

[HSLD]

SubQ injections in the abdominal area often result in painful lumps. I’ve experienced this myself and read about it on the forums frequently.

I use the fat pad on my hip/ventrogluteal area. Also, you didn’t mention the volume of your injections, but IMHO there is a volume threshold for SubQ injections. Seems like anything over say .35 to .4 ml results in a lump for me.

 

[Vince]

Hello everyone,
I’m honored to be on this site and thank you Mr. Vergel for all the education through your excellent books. I am a Physician Assistant practicing in CA and have been on TRT for about 11 years. My treatments began 11 years ago with a few IM injections that I could not tolerate due to painful injections site reactions and I switched over to compounded transdermal cream which worked well, but has been somewhat inconvenient. Several weeks ago I decided to switch to weekly subcutaneous injections in my abdomen. I’m using Testosterone Cypionated in cotton seed oil. Unfortunately I have been experiencing quite bad injection site reactions in which the site become very painful and tender to touch about 48 hours post injection, then becomes red and inflamed. The pain gets better about a week later, but the site remains endurated to the point where I wouldn’t be able to inject the same site even two weeks later. I would appreciate any helpful feedback that I can get as I would strongly prefer not to go back to transdermal cream.

What kind of syringe are you using? Gauge length?

 

[Nelson Vergel]

Have you tried shallow IM at 90 degrees on delts using a 27 gauge 1/2 inch syringe?

Another option is to try testosterone in grapeseed oil.

Testosterone Oils: Cottonseed vs Sesame Seed Oils

enanthate or cypionate Since enanthate is made with sesame oil and cypionate is made with cottonseed oil, would it be best to use enanthate? Is the amount of cottonseed oil small enough to not have a negative effect on my body?

www.excelmale.com

When comparing testosterone cypionate blended with grapeseed oil, sesame oil, and cottonseed oil, several factors come into play, including viscosity, inflammatory response, and patient preference for injection type. Here is a detailed comparison based on the provided sources:

Grapeseed Oil​

• Viscosity and Injection Comfort: Grapeseed oil has a low viscosity, making it easier to inject, especially for subcutaneous injections. It is often preferred for this type of administration due to its ease of use and lower likelihood of causing irritation at the injection site[1][2][4][5].
• Inflammatory Response: Grapeseed oil is known for causing the least inflammatory response among the three oils. This can result in less water retention and fewer injection site reactions[1][17][18].
• Health Benefits: Grapeseed oil has additional health benefits, such as improved blood flow and reduced oxidative damage, which can be advantageous for overall health[17].

Sesame Oil​

• Viscosity and Injection Comfort: Sesame oil is more viscous than grapeseed oil but less so than cottonseed oil. It is commonly used for intramuscular injections, where the resultant level of tenderness is perceived as more manageable[1][2][5][8].
• Inflammatory Response: Sesame oil has a moderate inflammatory response, making it a middle-ground option between grapeseed and cottonseed oils[17][18].
• Usage: It is the most commonly used oil by compounding pharmacies due to its balance of cost and production efficiency[17].

Cottonseed Oil​

• Viscosity and Injection Comfort: Cottonseed oil is the most viscous of the three, which can make injections more difficult and potentially more painful. It is typically used for intramuscular injections[3][6][9].
• Inflammatory Response: Cottonseed oil is known to cause the highest inflammatory response, which can lead to more significant water retention and injection site reactions[17][18].
• Health Concerns: Long-term use of cottonseed oil has been associated with negative health effects, including decreased testosterone levels, infertility, and other health issues[3][6][17].

Summary​

• Grapeseed Oil: Preferred for subcutaneous injections due to low viscosity and minimal inflammatory response. It is less likely to cause irritation and has additional health benefits.
• Sesame Oil: Commonly used for intramuscular injections, offering a balance between viscosity and inflammatory response. It is widely used by compounding pharmacies.
• Cottonseed Oil: Typically used for intramuscular injections but has the highest viscosity and inflammatory response, making it less desirable for many patients.

In conclusion, the choice of carrier oil for testosterone cypionate largely depends on the type of injection (subcutaneous vs. intramuscular), patient comfort, and potential inflammatory responses. Grapeseed oil is generally preferred for its ease of injection and lower irritation, while sesame oil is a common choice for intramuscular injections. Cottonseed oil, despite being widely used, is less favored due to its higher viscosity and inflammatory response[1][2][3][4][5][6][17][18].

Citations:[1] Testosterone Cypionate 200mg/mL, 15mL (Compounded)
[2] https://www.defymedicalstore.com/1272-hal
[3] TESTOSTERONE CYPIONATE INJECTION USP FOR INTRAMUSCULAR USE ONLY C-III Rx only
[4] Testosterone Cypionate / Testosterone Propionate Injection
[5] Testosterone Cypionate/Propionate Blend (160/40mg/mL), 10mL
[6] Testosterone Cypionate Injection, USP CIII
[7] Testosterone Cypionate Anastrozole Grapeseed Oil Compound - Belmar Pharma Solutions
[8] Testosterone Cypionate in the UK - The Men’s Health Clinic
[9] https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/216318s000lbl.pdf
[10] https://www.carieboyd.com/hormone-injections/testosterone-cypionate-200mg-propionate-10mg/
[11]

https://www.reddit.com/r/FTMMen/comments/tkmbwg/differences_between_different_types_of_t_carrier

[12] The Complete Guide to TRT for Men
[13] https://dailymed.nlm.nih.gov/dailym...ec5e-8910-3b3f-e053-2a95a90a8334&type=display
[14] Testosterone Cypionate Intramuscular: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD
[15] https://www.carieboyd.com/news/the-return-of-testosterone-cypoinate/
[16] TESTOSTERONE CYP INJ IN SESAME OIL 200mg/mL - 5 mL vial (HC)
[17] Best Oils To Use When Injecting Testosterone Therapy - medicalhealthinstitute.com
[18] Which type of oil should you be injecting testosterone therapy with? Find out what is the best option to use