This post was recently referred to in a current post.
Needle size: Large needles can core the rubber and you do not want rubber in your muscles. A shorter needle will have less flow resistance than a longer one. So a 1" #25 syringe might flow as well as a 1.5" 23?22 gauge. One can inject test cyp in small amounts with #29 .5" insulin syringes; the small pistons of a .5 ml syringe develops high forces that make injection times reasonable. Time to fill the syringe is extended.
Injection force: If you are having to push hard to get flow, it should not matter and should not create discomfort at all. You hand should absorb all of the forces involved. Do not push on the needle plunger with your injection site providing the opposing force. The plunger force required also depends on the diameter of the piston. Smaller pistons create larger pressures. So use a smaller capacity syringe if you can. For the glut’s when self injecting with one hand, a 3ml syringe, while way larger than one needs for TRT doses, may be easier to handle… mostly from the point if view of one handed aspiration.
Injection site: All of the injected dose gets absorbed and it does not matter if glut’s or vastus lateralis. Yes the glut’s are more difficult for some and more time consuming. Injecting in the vastus lateralis is simply easier and you can visualize and avoid veins as well. When you read that someone started injecting in the glut’s for a few weeks and then switched to the vastus lateralis and then really got a strong T effect, that is the delayed effect of starting TRT and would have occurred if injections had continued in the glut’s. Note that the injection site in the glut’s is very important to avoid major nerves and blood vessels. You need know how to landmark things properly.
Soreness: If the muscle injected is tight or tense, the result will not be good. For the glut’s, massage and feel for any tight muscles (quite common). If you feel such, then the results can be unpleasant. The resulting pain can last for days and refer down the leg etc. If you massage the tight muscles and get them supple, then the injections can be painless. The upper leg can be quite insensitive to the needle penetrating the skin. Veins can hurt when punctured.
Bleeding and bruising: With the legs and lower fat, you can see the larger veins and the smaller surface veins. You can’t see much of anything on your glut’s. When you get used to injecting, you will notice that when you bleed and bruise, that this is also distinctly painful. That pain also is spread out and does not seem to refer to the point of injection like the skin prick does. When you go through a larger vein, two punctures, there can be a lot of blood. Apply firm pressure to stop bleeding for a while. A good injection can be totally blood free, at least with smaller needles (larger gauge numbers).
Injection site preparation: Other than the proper swabbing; one needs to carefully choose the site. In the glut’s, to land mark you have to touch the area so it must be swabbed after that and then you can’t see the location and need to start over… but you can’t touch the swabbed area. Find a piece of larger plastic tube, 3/8" would be ideal, or a plastic pen top. Select the location and press on the skin to mark it. Then swab that location, and the target is clearly in view when you inject. This is particularly useful if for glut’s you are standing and using a mirror to landmark, then lay down to inject.
Injection depth/needle length: For divided doses, the injected amounts can be quite tiny. For such small amounts, the depth into the muscle need not be very deep. For glut’s, 1.5" is needed to get through the fat. For vastus lateralis; the skin and fat can be quite thin and 1" will be fine for larger doses and .5" will be fine for smaller doses.
Injection rate: This is mostly a concern for the larger doses. For smaller vastus lateralis doses, if a small (larger gauge number) is used, the flow rates will be automatically be slower from the gauge restriction and then there is no issue.
Massage: For larger doses, this may cause more damage as the pocket of fluid is forced around causing more tissue separation.
Heating the testosterone: Warm oil will flow better than cold. The temperature should not be an issue from a muscle trauma point of view. I can’t see that this makes any difference other than the force required on the plunger and time to inject. Room temperature oil might be better to limit the flow rate for larger doses where fast rates can be painful. Test cyp is cotton seed oil based and test eth is sesame oil. I cannot recall which has the greater flow resistance. If you are happier warming the injection, no problem. Just don’t assume that this is needed.
Injection frequency: When test cyp and such drugs were first approved, the product use guidelines were then approved and cannot be easily changed from a regulatory point of view. So these are carved in stone and do not reflect current best practices. So injecting every two or three weeks is totally insane. The T levels after the injection will cause higher levels of E and SHBG. The dropping T levels are unnatural and will leave you feeling crappy. Even injecting once a week is not good enough. If you have been doing so and feel drained and worse for a few days… you know. Inject more often… what works best for you is best. Blood work and your doc are not authoritative on how you feel.
Blood work: Blood work should be done 1/2 way through your injection cycle. If on a 3 week cycle, no meaningful results can be had at all.
Half-life of test: This is around 8 days for the larger doses that were used in the original studies; which were high to go with 2 or 3 week injections at the doctor’s office. For 100mg weekly doses, the half-life will be shorter… and you will feel the drop off. When you see a reference to something like 14 days; that is not the half-life, but the time when the T levels drop back to baseline and the increase in T is no longer detectable. In continued dosing, as a dose wears off with weekly or longer injections; the levels can drop to levels that are lower than when you started TRT as the HPTA has shut down. So you can feel lower and worse off then when you started TRT… waiting for your next injection. And as the high T levels from these larger doses for longer injection cycles can trigger greater amounts of aromatization of T–>E, the E starts to interfere with T receptors which makes test less effective and reduces libido after a while.
Transient effects: The first few injections might not seem to do too much. Then there comes a few weeks of hyper sexuality as the body starts to respond to the higher levels of free testosterone. Then the body also ramps up SHBG which reduces the free T and T–E atomization increases. The resulting E competes with T at the T receptors which interferes with the action of the T. Libido then goes down and for some, libido and ED issues are worse than when they started TRT. This short term increase in sexually that then goes away is a very cruel event. You see what you can have then it gets taken away.
HCG & Sore and shrinking testicles: An effective TRT dose will shut down LH production and the testes will stop doing what they are designed to do. They will shrink and this causes soreness/pain for some. For young guys who need TRT, this also threatens fertility; but should not be depended on as a form of birth control. HCG, a female hormone of pregnancy, is almost the same as LH and has the same effects when men take it. It will keep the testes working. It is a protein structure, otherwise referred to as a peptide hormone. As such, it is in water and must be kept refrigerated when reconstituted. You would need the multidose vials, typically 10,000 IU. Do not get glass ampules! Inject with an insulin syringe into belly fat. IM injection is not needed, so spare the muscles from unneeded scarring. Research published in early 2005, which most docs are not aware of, showed that 250iu EOD of HCG injected SQ, not IM, maintained baseline testicular function in ‘normal men’ who has LH suppressed with T injections. Older men, 70’s and older, may not be responding to their own LH and will not respond to HCG either. When you take HCG, any T that the testes produces will be added to the amounts injected. Docs have not had research based rational for dosing before, and practice has been to inject once or twice a week on the days before the injection. Do not use high doses of HCG, as this will cause the testes to down regulate the LH receptors. When you read about high doses, these are simply wrong or otherwise not applicable to continued use in TRT. When you mix HCG power with water, inject the water into the vial slowly down the side of the vial and swirl gently to mix - never shake. Load and inject slowly. These are the cautions for HGH which is also a peptide hormone. As water flows so well, it take care to keep flow rates slow through the needles.
Scrotum: Also see above section. When TRT shuts down LH production and the testes shut down; the scrotum also reacts and pulls up tight to the body in a manner similar to a prepubescent boy’s. When HCG is administered, the scrotum will hang down the way that it should. This action of the scrotum pulling up to the body is a very obvious indicator that there is little or no LH.
Anti-E: Anti estrogens reduce the amounts of T that are automatized to E, which lowers E levels. Increased E will reduce the effects of T, kill libido and can cause breast tissue growth AKA gyno. The most well known anti-E is perhaps arimidex AKA adex or dex. The generic name is anastrozole. As a drug in tablet form, it is very expensive, costing $8-$10 per 1mg tablet. There are other products. You do not want to reduce E to extremes as that will also kill libido. High levels of T from large dose injections for longer cycles will cause higher amounts of T–>E conversion. Transdermals are also known to have higher conversion rates. If you are on TRT for a while and getting into high range on blood tests, you should be getting lots of nocturnal erections or wood. If you do not get morning wood, the problem can be levels of E that are too high for you. Blood work readings do not tell you much. Then if you take arimidex, perhaps the typical 1mg/week in 1/2 tablet divided doses, morning wood should happen. Along with that, libido should increase and ED problems reduced if your blood vessels are healthy. So let your morning wood be your guide to determine if T:E ratios are ok. You will have had morning wood during the early parts of your TRT when you also had the hypersexuallity. The morning wood goes away over time. Some docs/clinics will start anti-E at the start of TRT.
HCG+T: If you are injecting both and the HCG is EOD, then you can also inject your T on the same day. So for 100mg/wk of test T, you can inject 28mg of test EOD (which would be 0.14ml for a 200mg/ml compound). 0.5" #29 .5ml insulin syringes can be used for both. When drawing up test cyp/eth into these syringes, the preservative alcohol will boil or ‘flash’ as it hits the vacuum in the syringe. This boiling stops as the vapor pressure of the alcohol balanced in the syringe and the vapor will reincorporate with the fluid. That does take time. Injecting takes about 10-14 seconds for 0.14ml. The small piston of the 0.5ml syringe creates very high pressures.
Building muscle mass and loosing fat: This should be easy with a high normal range of total T. I will not get into wieght training etc. Just note that you need protein to build muscle. If you start to work out and start to gain some muscle, and start to feel persistant hunger between your normal meal patterns; this is your muscles talking to you. Don’t eat carbs to curb that hunger, you probably have enough carbs in your diet. Get a whey protein power ‘shake mix’. These are inexpensive in large formats at Sam’s Club and Costco. Otherwise can be found in some pharmacies, GNC and WalMart. Do not use a meal replacement product such as slim-fast. Look for around 22-23 grams of protien per serving which is usually a 60ml scoop. You might want to use two scoops per serving. As you gain muscle, that muscle mass uses carbs 24x7. So gained muscle helps you loose fat.
Cholesterol: Often an effective TRT dose will also lower low density cholesterol while keeping high density cholesterol the same or slightly increasing it. Triglicerides can also be lowered. Some progressive docs will use TRT as an cholesterol lowering therapy. One can avoid statin drugs in some cases.
Costs: Insurance may cover injectables or refuse to pay for any injectables. Test cyp and eth are very cheap compared to transdermals. Some insurance will pay for the expensive transdermals and refuse to pay for the less costly injectables. 10ml of test cyp (20omg/ml) at Walgreen’s seems to be going for $99 for a generic. The same generic can be had for $42 at Sam’s Club with a business membership. So for some without insurance, injectables can be cheap… it is the doctor consults and blood work that makes TRT costly. Buy syringes in boxes of 100. At Sam’s 1.5" #23 3ml syringes are $18/100. Walgreen’s will ten in a bag for you and charge more than $1.00 each.
How do you feel?: Mood should increase with TRT and many also report improvements when HCG is used after been on TRT. Same with anti-E. But if HCG and/or anti-E starts when TRT is started, one would not notice independent effects. It one has been low on T for a long time, there long term effects will have created changes in brain function that will take longer to resolve, part of that been habit of thought process etc. Many men with low T are also depressed and that an other life circumstances may also contribute. Vitamin T can do wonders. With its boost, get motivated to improve your diet, build some muscle mass and try to take some actions to improve external factors that affect how you feel about life. You may find that as you start to feel better on T, that the negative effects of alcohol are more noticeable. Listen to your body. Alcohol is also thought to increase aromatization as well. T should allow you to be better able to judge what your body wants and dislikes. And if you smoke… stop.
