Sub Q injections quit working

[Cataceous]

...
This subq vs IM issue has nothing to do with areas under the curve. Its some other issue causing low levels over long periods of time.

Self-contradictory statements. Low levels over time would mean lower areas under the curve for SC injections, which is not the case when studied under controlled conditions. Random guys reporting one measurement in an entire injection cycle is saying very little about their overall absorption.

Thats not a study! Your paper is a joke.

....

The research directly contradicts the assertion that subcutaneous injections are not effective. SC was found to work, therefore it doesn't matter that there wasn't a comparison to placebo or IM. In fact if you bother read the study you'll find that many of the men had been on IM before this. Doses ranged from 25-100 mg TE per week. "The mean total testosterone prior to injection was 14.5 ± 3.14 nmol/L and 21.7 ± 7.32 nmol/L the day following the injection."

 

[Cataceous]

Nobody said that. Find me the proof someone here said that. Quote it.

What we did say is that benzyl alcohol affects absorbtion, and perhaps is responsible for the differences in subq vs IM levels. A hypothesis.

Do not twist words, perhaps your estrogen is at PMS levels and you need some AI?

It's completely implied in the statements you guys make. Benzyl alcohol is known to affect the rate of absorption, but not the total amount absorbed. The claim you guys have been making is that serum levels are lower with SC at the same doses. This implies lower overall absorption and is demonstrably false under controlled conditions. You have not been arguing that the absorption pattern is the issue, which is the only plausible difference.

I see the ad hominem attacks are coming out. Not uncommon when other arguments fail.

 

[bixt]

Again, you have lost the plot completely. The topic at hand: random guy has for example 1200ng/dl on IM, goes to subq and had levels of 600ng/dl after a few months. Everything else is claimed to be the same, and we have lots of such posts across the 10+ forums I searched.

You on the other hand, are totally satisfied that they have 600ng/dl. Because its "within range". Two totally different issues, and you keep masquerading around with your within range story.

 

[Cataceous]

... Everything else is claimed to be the same, and we have lots of such posts across the 10+ forums I searched.

And there's your problem. I see plenty of reports of guys getting higher levels with SC, which is expected for troughs due to the half-lives typically being longer.

 

[bixt]

We have 1000s of forum posts regarding tren cough, trensomnia, tren sweats. But no studies. Discounting the odd guy who has no tren side effects, we can now with certainty describe accurately tren side effects. With no study! This is the engineering method. Test. Observe. Record.

We now have plenty of evidence likewise for subq vs IM in certain individuals and its equally true.

I read with great interest your work on daily prop and cyp mixes. You didnt have a study to back up your "mixture", yet you did your experiment anyway and reported the results. Im not putting your work down, dont get me wrong. To say it was fantastic would be an understatement.

Im just saying, keep an open mind, accept the results and expermients for the outliers we are seeing without shooting them down as liers or not keeping all variables the same. Lets give them the benefit of the doubt if they claim everything is ceteris peribus. One day we will have the explanation of the WHY is it.

 

[Cataceous]

Anecdotal evidence has its uses, but there are circumstances in which relying on it leads to incorrect conclusions. In general the anecdotes should lead to hypotheses, which in turn are tested under controlled conditions.

...
We now have plenty of evidence likewise for subq vs IM in certain individuals and its equally true.
...

The nature of this evidence is weak. As I've said before, the problems include: single samples during an injection cycle, which do not reflect overall absorption; no controlling for changes in SHBG; no mention of inspections for site leakage; no independent verification that the same labs and testing methodologies were used.

...
I read with great interest your work on daily prop and cyp mixes. You didnt have a study to back up your "mixture", yet you did your experiment anyway and reported the results. Im not putting your work down, dont get me wrong. To say it was fantastic would be an understatement.
...

However, hypotheses in this situation are clearly labeled as such and none is blatantly contradicted by existing studies. On the contrary, the hypotheses are largely derived from existing research.

...
Im just saying, keep an open mind, accept the results and expermients for the outliers we are seeing without shooting them down as liers or not keeping all variables the same. Lets give them the benefit of the doubt if they claim everything is ceteris peribus. One day we will have the explanation of the WHY is it.

To be clear, here's what's being shot down:

•The claim that less total testosterone is absorbed via SC delivery compared to IM
•The claim that most men will fare worse with SC than with IM injections
•The claim that most men need more than 100 mg per week of testosterone cypionate/enanthate in TRT

And here's what's not:

•The claim that different subjective results may be observed between IM and SC
•The claim that different absorption patterns may be observed between IM and SC
•The claim that more injection site leakage is possible with SC compared to IM

 

[madman]

Its pointless trying to talk sense to these guys @madman and @Cataceous

If they get a study that says the sky is red, its red. Doesnt matter what everyones eyes are seeing.

Here we go again with that everyone bullshit!

post #9

Daily Intramuscular injections.

Hey guys I'm currently on m-w-f injections. Ive actually started to feel way better on shot days on Im vs sub q. However through years of testing my t levels drop off quite a bit 24 hrs post injection. I respond very well to lower doses. 90mg a week has my ft slightly over range. And TT around...

www.excelmale.com

52 weeks.....BRUH!

F**k the.....It was the autoinjector study. There is no BA, no BB, and no other preservatives in that sterile injector.

Going to make a shitlick a difference when it comes to claiming that injecting strictly sub-q is not effective let alone absorbed and to make matters worse will result in T levels taking a nose-dive months later!

Again as you seem to be slow in the head.

As I have stated numerous times on the forum.....yes some men may not do well when injecting sub-q.

It is far from common that one would not be able to achieve a healthy let alone high-end T level on such.

Again there should be no difference in the absorption/effectiveness of T when injecting strictly sub-q.

Are there outliers that may not achieve good numbers.....sure but again far from F**KING COMMON!

The men that lurk/live on the forums represent a small slice of men on trt/hrt!

You claim that sub-q is inferior to IM let alone make it sound as if everyone and their brother is having a bad experience on such and to make matters worse claim that the absorption/effectiveness is subpar compared to IM injections.

The mean TT Ctrough @6, 12, 18, 26, 38....52 weeks in!

Who the F**K knew..... Mean TT Ctrough was 487.2 ± 153.33 ng/dL at week 52.

I could have just ended this in one shot when I stated.....The men that lurk/live on the forums represent a small slice of men on trt/hrt!

IM versus Sub-q T Injections: Effect on TT, hematocrit, E2, and PSA

Comparison of Outcomes for Hypogonadal Men Treated with Intramuscular Testosterone Cypionate Versus Subcutaneous Testosterone Enanthate (2020) Introduction Intramuscular testosterone cypionate (IM-TC) is the conventional treatment option for hypogonadal men with baseline serum total...

www.excelmale.com

2 points that need to be stressed:

*IM-TC and SCTE-AI both provide significant increases in total testosterone when treating hypogonadal men.

*SCTE-AI is an effective testosterone delivery system with a preferable safety profile over IM-TC.

Sub-q Testosterone Autoinjector is a safe and effective alternative method for TRT

Introduction: Xyosted® is a subcutaneous testosterone enanthate-autoinjector (SCTE-AI) which was approved by the Food and Drug Administration in 2018 for patient-administered weekly testosterone replacement therapy (TRT). Objective: This is the largest non-industry sponsored post-market study...

www.excelmale.com

So let me get this right.....after 6 weeks (steady-state) of achieving healthy numbers all of a sudden it becomes common that T levels take a nose-dive ending up much lower months let alone 2 years later when injecting strictly sub-q?

Could it happen in some.....sure but again it is far from common as you claim!

Soon enough you will be claiming that many men on Subcutaneous Testosterone Pellets have the same issue.....LMFAO!

Make yourself a sticky note.....The men that lurk/live on the forums represent a small slice of men on trt/hrt!

 

[Neil]

I've been doing Sub Q for over 5 years now (Easy Touch 30ga, 1/2" buried deep in belly fat). I found the previous IM shots painful, barbaric, and sometimes I was limping around for a day or two after a deep IM shot. They f'ing hurt. The Sub Q method was a blessing for sure. My levels are exactly the same either way, every time, but no way in Hello am I going back to IM. I Sub Q inject 25 units (E-100, 200mg/ml) on M-W-F. The last test, three days after a shot, was total T 923, Free T 192.8, and E2 34. My buddy also does Sub Q and so does my wife (small dose). All is good here.

 

[madman]

Its pointless trying to talk sense to these guys @madman and @Cataceous

If they get a study that says the sky is red, its red. Doesnt matter what everyones eyes are seeing.

You and ivkonst2017 by any chance related to this idiot merry it's all about balance Gary?

The Lil guy running around with a trough TT1600-1800/FT through the roof on EOD injections that threw in some ND let alone OXO, and to make matters worse drove his highish SHBG down to 11 nmol/L.

Same manchild that never tested his FT using an accurate assay (ED/UF) let alone making the absurd claim.....It's not advised to do subQ with enanthate. Only cypionate.

Downright embarrassing!

That's what happens when you spend all your time lurking on those bro-forums you know the ones filled with those blast/cruisers and all that he said she said bullshit.

Not to mention some of those gootube videos spewing misinformation.

My reply:

eyeheartnys reply:

 

[madman]

Article

Over 10-15 years ago there were several progressive doctors in the cash HRT/TRT (hormone replacement therapy/testosterone replacement therapy) space who at some point realized subcutaneous administration of testosterone cypionate or enanthate not only absorbed as effectively as IM (intramuscular injections). They also found that more frequent subcutaneous (SC) injections yielded more stable levels than once per week IM injection. Some of these doctors started writing about it including TRT expert Dr. Eugene Shippen who wrote the book “The Testosterone Syndrome.” These doctors may have also found old studies (or did small observational studies themselves) showing that oil-based hormone injections can be administered SC with efficacy.

Over the years as TRT became more prevalent, experts and physicians have attempted to develop novel ways to administer testosterone. This lead to more formal studies being done on the effects of subcutaneous testosterone injections.

In addition to formal studies, many progressive doctors also experimented and observed that SC delivery is equal if not superior (in pharmacokinetics) over single larger dosed IM injections.

Subcutaneous testosterone injections may also present lower Cmax levels of testosterone (peaks), which could translate into fewer problems with increased blood viscosity, blood pressure, and cardiovascular risks related to increased red blood cell volume (hematocrit).

Subcutaneous testosterone injections have been found effective by the FDA. They approved Xyosted for that purpose.

Its pointless trying to talk sense to these guys @madman and @Cataceous

If they get a study that says the sky is red, its red. Doesnt matter what everyones eyes are seeing.

You this same idiot.

Your very first post (DEC 8/2019) on Excel!

You were hurt from the get-go.....LMFAO!

When does estrogen become a concern?

There is a fair bit of speculation that this is the case. Moreover, with scrotal cream DHT can get very high, which also counteracts estradiol, both in creation and in receptor binding. Interesting. In theory I see how it should counteract the creation. However, my labs just came back on the...

www.excelmale.com

your post #36
I am self medicating "TRT". I simply started at 80mg as kept increasing every 6 weeks by 20mgor so until I reached 200-250mg which is where I feel well. I have also experimented similarly with subq (a waste of time for me) and shallow IM (excellent, man up and do it). Also with dosing E2d, e3.5d and weekly.

Im using pharma Cyp procured through a friendly pharmacy. Have never tested T, FT or E2, but I feel fantastic. Did put on water weight in the beginning even with the small dose, but that went away.

Not using an AI, and feel like a million bucks. HCG made no difference either way really so I dropped it.

Age 31, and my main motivation for continuing is the supreme confidence gained as well as the "aggression" which is really useful when negotiating in the business world. People simply dont mess with me anymore! Im pretty sure high E2 is a factor here. Ever tried to win a fight with a chick who has PMS? Well, with high E2 no one will mess with you either. Im dead serious here.

To all those not "dialed" in after so many years of posting, call it a "mild cycle" if you insist, but you have to trial 200 or 250mg\week IM EOD for just a month and revert back. You may just be amazed!

And yes, I jumped over 200mg after reading all the hype created by a certain you know who.

------------------------------------------------------------------------------------------------------



You stated.....I simply started at 80mg as kept increasing every 6 weeks by 20mgor so until I reached 200-250mg which is where I feel well.

My reply:
80 mg.....6 weeks later 120 mg.....6 weeks later 140 mg.....6 weeks later 160 mg.....6 weeks later 180 mg.....6 weeks later 200 mg.....6 weeks later 220 mg.....6 weeks later 240 mg.

40 weeks later.....really? Yes, we can shorten this some as you did state....."I simply started at 80mg as kept increasing every 6 weeks by 20mgor so until I reached 200-250mg which is where I feel well"

How can you even state....."200-250mg which is where I feel well".....as you never gave your body a fighting chance to see how you truly feel on the said protocol (T dose/injection frequency)..... you changed your dose every 6 weeks which is nowhere near enough time to truly gauge such.

As not only did you not have blood work done to see where your TT/FT and e2 levels sit but you kept upping your dose every 6 weeks and as you should know whenever one starts trt or is tweaking dose (increasing/decreasing) blood levels will be in FLUX during the following weeks leading up until when they have stabilized at 5-6 weeks and even then once levels have stabilized one would need to give it 2-3 months at new said T levels to not only allow the body to adjust to those new levels.....but to truly gauge how one feels overall regarding mood/energy/libido/erectile function/body composition/recovery.

6 weeks on the said protocol (T dose/injection frequency) would in no way be enough time to state whether the TT/FT /e2 levels achieved truly result in the overall improvement in low-t symptoms.....let alone overall well-being.




You stated.....Have never tested T, FT or E2, but I feel fantastic.

My reply:
That sounds like a sensible approach! No one could truly gauge a protocol (T dose/injection frequency).....let alone state they feel best at such T dose.....changing T dose every 6 weeks.....top it off with the fact that you have never tested your TT/FT/e2.....let alone the effects such levels have on your blood markers.

Just to be clear.....yes some men may very well need 200 mg/week or slightly higher to achieve a healthy FT level but needing such a dose is not common for many men on trt.

Although symptom relief is what truly matters lab work is critical as not only do we want to know how said protocol (T dose/injection frequency) affects ones TT/FT levels but also to keep an eye on the impact it has on overall blood markers as we are not only trying to relieve/improve symptoms of low-t but to minimize/avoid any potential negative effects on overall health especially long-term.

Regarding reference ranges, they are not set in stone and should be used as a guideline to give us an idea of where hormones/blood markers sit as levels could very well be too high or low resulting in negative effects.

*There is nothing wrong with one running TT/FT level above range as long as blood markers are healthy and you feel well overall.

No one is saying you have to keep your levels in a set range as the goal is to achieve the beneficial effects of having healthy FT levels while making sure overall health is maintained long term.

If you feel great on such a dose then stick to your protocol but you should not be self-treating yourself blindly by avoiding blood work.

It is naive for you to go on claiming you feel great at such dose when you never gave your body a FIGHTING CHANCE because you were changing your dose every 6 weeks.....it is misleading.

This has been stated numerous times on the forum.....many are struggling because they are changing protocols (T dose/injection frequency) way too soon.....let alone in many cases changing too many things at once (use of an aromatase inhibitor/hCG).



Your post #61
I really dont have years to do such testing and wait 2-3 months between changes and spin my wheels like most others seem to do. I needed solutions NOW, and a solution I have found!

As you said many others are struggling by changing doses too often. Why mention that? I am having the time of my life!


My reply post #63

You clearly missed the point on this one!

Your levels were in FLUX the majority of the time.....you have no clue how you would feel on a lower dose.....every 6 weeks you upped your dose..... then go on and state you feel great at such dose.....seriously.

Would in no way take years if you had any sense in your head.







This is coming from a guy who upped his dose every 6 weeks.....spent months on end in FLUX only to go on and state that once he reached such dose he feels great.

Then he one-ups the complete s**t show by stating....." To all those not "dialed" in after so many years of posting, call it a "mild cycle" if you insist, but you have to trial 200 or 250mg\week IM EOD for just a month and revert back. You may just be amazed!

4 weeks..........you f***ing amateur!

Nothing but a stink coming out your piehole!

Stick to those bro forums.....BRUH!

 

[ivkonst2017]

@Cataceous , @bixt so yes, my idea is that if the study for which we relay that sub q is reliable is done with testosterone with no BA this puts that study out of reality. In practice me and many other guys have reported inferior results on TRT.

My hypothesis without having study to back it up: maybe the BA alcohol creates the nodules under the skin of some people(not all) and this somehow affects the serum levels after that. Obviously that doesnt happen in IM. Also another thing - the sub q nodules are reported in most cases with sustanon when sub q was was tried. What we know for sustanon for sure - higher percentage of BA.

And like @bixt lets stop looking for studies for everything, we dont have good studies for the nuance debates in HRT(we see what major flaws this one has)! When we dont have the studies then we have to use logic upon what we know and trial and error!

Also luck of evidence in the medicine should not be considered as evidence for the opposite. One very local and famos guy in the TRT community who is doing more harm than good claims that since we dont have evidence that the high levels of estrogen are harmful, they are ok and should be just ignored! As much as I am against any use of AI and controlling estrogen, the simple medical logic points to me that high levels of estrogen(I mean really high, not just outside the range) are a SYMPTOM of an underlying health condition that should be addressed.

 

[Fortunate]

100% correct. It was the autoinjector study. There is no BA, no BB and no other preservatives in that sterile injector.

The SAME guys also correctly point out how these excipients affect values in other threads.

Therefore this autoinjector study cannot be used. Also check the scatterbox in that study, theres plenty of outliers all over the chart.

This subq vs IM issue has nothing to do with areas under the curve. Its some other issue causing low levels over long periods of time.

I have used enanthate in both an autoinjector without alcohol or preservatives as well as standard version in vial with alcohol and preservatives. Both subcutaneous. Subjectively, I believe I felt the same, regardless of the preparation. In fairness, I did not run this experiment very thoroughly and I did not use them close together in time, so memory could be a bit faulty.

If anyone else wants to try this experiment, I came up with a novel way. If you have Xyosted, it is very easy to inject it into a sterile vial. You can then use your syringe to draw up the amount that you want for each injection. The reason I did this is that Xyosted only comes in specific strengths. 100 mg is too much for me at one time. 50 mg is too little for me over the course of a week, I think. Therefore, I use the 100 mg pens that I already had, injected them into a vial and drew up the amount I wanted to inject. Disclaimer: if you are drawing multiple times through the same vial, you could theoretically contaminate it, as it does not have preservatives.

 

[Cataceous]

...
My hypothesis without having study to back it up: maybe the BA alcohol creates the nodules under the skin of some people(not all) and this somehow affects the serum levels after that. Obviously that doesnt happen in IM. Also another thing - the sub q nodules are reported in most cases with sustanon when sub q was was tried. What we know for sustanon for sure - higher percentage of BA.
...

You'll find a load of anecdotal data contradicting this idea. I never get nodules from drugs in bacteriostatic water, such as hCG and peptides. The nodules, when they occur, are following injections of testosterone esters in oil. When I inject progesterone in oil with 20% benzyl alcohol there is less of an inflammatory response than with the testosterone. I've found that palmitoylethanolamide can reduce or eliminate these reactions by "downregulating hyperactive mast cells".

 

[ivkonst2017]

You'll find a load of anecdotal data contradicting this idea. I never get nodules from drugs in bacteriostatic water, such as hCG and peptides. The nodules, when they occur, are following injections of testosterone esters in oil. When I inject progesterone in oil with 20% benzyl alcohol there is less of an inflammatory response than with the testosterone. I've found that palmitoylethanolamide can reduce or eliminate these reactions by "downregulating hyperactive mast cells".

But here we come to different people reacting different. Yes it is just a theory the BA causes this, but I know I get the biggest nodules from Sustanon. On enanthe I also was getting nodules, in both cases test levels were much lower than I would get on IM administration with this product on this dosages.

Whether there is a connection between BA, nodules and lower serum levels - I dont know, just a theory

 

[bixt]

You'll find a load of anecdotal data contradicting this idea

Wow. Talk about double standards.

 

[Fortunate]

Wow. Talk about double standards.

Not true. The best available information should guide decision making. If there is data derived from a well designed study (I have an old post on levels of scientific rigor), then logic demands us to pay attention to that data. Although I could be wrong, I am going to go out on a limb and say that I doubt anyone has conducted a double blinded, randomized study to evaluate what preparations are more likely to cause said skin nodules and irritation. If you believe in using the best available information, then there are plenty of circumstances in which the only information is anecdotal.

I am pretty sure @Cataceous even said there is a role for using anecdotal information above. He isn’t above discounting it. Yet, some think it is appropriate to discount information derived in a controlled, disciplined way just because the personal experience of some people doesn’t match what the science says.

Calling this a double standard feels like we are now arguing for the sake of winning - not for trying to understand each other’s views.

 

[Cataceous]

Wow. Talk about double standards.

Hardly. To add to @Fortunate's eloquent statement, anecdotal evidence can certainly be used to weaken a suggested hypothesis when the hypothesis appears to be pure speculation. I'll grant that with time you may be able to find someone who has reactions to both oil- and water-based injections containing benzyl alcohol. The point is that reported reactions to the injections of testosterone esters are common, which is not the case with hCG injections, even though they also contain benzyl alcohol.

 

[ivkonst2017]

And here we come again to the main point of the discussion: There is enough data that for many people sub q is not as effective as IM in achieving the expected serum concentrations. Which means that for this men sub q will not achieve optimal results.
At the opposite site is the advantage of sub q over IM - easier to inject, less pain and scar tissue.

So I think the advantages and disatvantages of both methods should be stated so the new users will make an informed decision - sub q easier to inject and less painful, but there is a chance it will not work well for you(we dont know what is the chance - 5 percent or 50). IM - you will 99 percent not have issues with serum concetrations according to the dose, but it is more painful, you need to rotate muscles and almost impossible to inject daily.

If you are needlefobic and injection pain is a big issue for a guy new to TRT best is to start sub q. But in my perspective I would never do that knowing what would be the result. For me this is taking a chance of sacrificing the outcome for inferior benefits. For me and many other guys I know feeling best and getting the most out of therapy is the most important. I know guys who would inject few times a day IM every day if this would give them enough benefits over their current protocol.

So no matter what we choose there are benefits and downsides, the question is what matters most for you.

 

[Cataceous]

And here we come again to the main point of the discussion: There is enough data that for many people sub q is not as effective as IM in achieving the expected serum concentrations. Which means that for this men sub q will not achieve optimal results.
...

Your idea of "enough data" is a few haphazard measurements. You couldn't be bothered to investigate the situation properly. Instead you just claim that testosterone is mysteriously disappearing and we're supposed to take this seriously because a few other guys have measurements they didn't expect. In reality you can't even give an approximate frequency of this purported phenomenon, let alone provide a plausible explanation, let alone explain why clinical trials don't show it. If you have "enough data" then the scattered reports of pain from IM injections would be enough data to recommend against that method.

 

[ivkonst2017]

We dont know why, but yes the data is more than enough according to your own words for anecdotal data itself. I dont know why, I gave some theories but really dont know why for sure. The studies have a lot of flaws as discussed.

So at the end you suggest risking the treatment being innefective because of a possible pain? At least the person should be warned about his options and the possible downsides of both.

For me compromising treatment for the sake of causing a bit of a pain is pussying out, for other guy can be a deal he is willing to accept. In any case that should be clearly stated even though we dont have the proper studies to support it.