Injecting testosterone subcutaneously

[frankwhardy]

There are at least a couple of people on the forums who are apparently successfully doing their weekly testosterone (cypionate or enanthate) injections subcutaneously as opposed to the "recommended" intramuscular way. I'm wondering if there is a reason why subcutaneous injection might be suitable (apparently) for some people but not for others . . . is it a difference in physiology, vascularity, body fat levels, or what? Or is it really never a good idea to make a T injection subcutaneously? Is a subcutaneous injection more likely to cause an abnormally slow release of T, or an abnormally fast release? Is it more likely to cause tissue damage and/or pain? Why was it established that T injections should be made intramuscularly? Are there any studies proving one way is better than the other? Or is this just another case of well, it's always been done that way so that must be the way to do it? etc., etc. Thanks for any insight.
Frank

[cpeil2]

I think SWALE has said before that he has safety concerns about the SQ route, but he hasn't gone into it beyond that.

[LiquidGib]

I would like to know more about this too. I think the doctor I go to does T shots subq. I would really prefer to do it intramuscularly because that is the standard and I don't want to risk anything - I would rather do it the tried and tested way. Another reason I would like to do it this way is because I have alot of body fat and if I am correct, this could cause alot of aromatization into estrogen.

[cpeil2]

Originally Posted by LiquidGib

. . . this could cause alot of aromatization into estrogen.

I was wondering about that too.

[frankwhardy]

What I'm thinking, is that it is at least conceivable that the concept that T injections "have" to be given intramuscularly is something that was started and perpetuated by the developers (e.g., Upjohn) of the depot-type testosterones (i.e., the testosterone esters), because it may be that an IM injection does give a little better bioavailability and/or prolonged absorption profile over subQ and the drug company is wanting to squeeze every bit of extra duration of action out of each injection - simply because they were and are trying to market the T esters as being seemingly conveniently dosed once every 2 weeks or 3 weeks (or 4 weeks!), when in reality that is a bunch of bull for most men. So I'm very suspicious that subQ injections of T-cyp will work fine for most people, although perhaps a small dosage and frequency adjustment may need to be made.

I'm wondering about the possibility of greater aromatization with injections closer to the skin surface, too, but the question is whether that problem even comes into play with the ester derivatives of testosterone, which may not even fit into the aromatase receptor, i.e., the ester portion may need to be cleaved first and that may not happen until after the T ester has been absorbed into the blood stream well away from the skin surface.
Frank

[LiquidGib]

I actually was thinking about this the other day - small amounts of t injected subcutaneously more regularly. Maybe twice a week or even every day. Who knows maybe this will be the future of TRT?

[frankwhardy]

Found this interesting conversation on another website regarding subQ injection of Depo-T apparently being Dr. Shippen's favorite way to administer T - at least as of February 2004 . . . have any thoughts on this Dr. C?:

http://forum.avantlabs.com/index.php?showtopic=8130

[From the link above:]
[Initial posting:]
"I was corresponding with a patient of Dr. Eugene Shippen (THE TESTOSTERONE SYNDROME) about Dr. Shippen's protocol. Apparently his preferred method of testosterone replacement therapy in cases where he otherwise might have tried pellets, creams or gels is now SUBCUTANEOUS testosterone injection. According to this patient, unlike intramuscular injection, subcutaneous injection of a small amount three times per week results in ultra stable levels and low estrogen conversion. Apparently Shippen uses this method for his own testosterone replacement. Not only does it work better than even pellets apparently but it's dirt cheap compared to about any other method.

I was going to get pellets (hypopituitary) but now I wonder if I should try this. I have two questions though:

1) Are there any studies on this method? I couldn't find any.

2) I don't doubt Shippen; the lab work of who knows how many patients would not lie. But if it works so well, why the HELL wasn't this thought of and tested a long time ago?? It seems like there is a big "DUH" factor here."

[A second posting:]
"does he use free testosteorne? a suspension? does he used an oil based ester? specifics please

also, subQ injections are often more painful or lead to inflammation. if you ever have accidentally gotten a steroid injection into the subq instead of the muscle you would understand"

[A reply:]
"I heard back from the patient of Dr. Shippen. He injects depo-testosterone 200mg/ml, .35 ml every 3 days into abdominal fat. He splits the injections into two .18 ml injections which is .36 ml, and says this is because a tiny amount will leak out of the injection site.

According to this patient, this dosing schedule leaves him with a stable 900 ng/dl total testosterone level and none of the high estrogen conversion associated with large intramuscular injection.

Apparently Shippen is convinced enough that this is now his preferred method of TRT. I know he starts by trying to get levels into the high normal range by trying to get the body to make its own, but if TRT is called for apparently subcutaneous injection is the first thing he prescribes."
[This appears to be 70mg every 3 days for a total of 163mg/wk]

[mranak]

At this time, there isn't much data on the long term effects of injecting oil sub-q.

[frankwhardy]

I know that it's routine to inject laboratory animals with subQ oil preparations. I don't know how many of them get to hang around to see what effect repeated injections over the long term has, though. With repeated IM injections that aren't properly rotated amongst different sites, there's the possibility for muscle necrosis (and other types of damage), and I imagine the same is true for subQ - that you might have fat necrosis/damage if the injections are properly rotated. Question is, is it likely to be any worse or more dangerous? From a chemistry point of view, "like dissolves like," so injection of an oil (fat) into the subcutaneous area (fat) might have the potential to cause more (bio)chemical "disruption," but it would seem that an oil injection into muscle (protein) might have the potential to cause more physical "disruption."

All I know is that the drug companies' main deference is to their bottom line and not to the patients' benefit, and if an IM injection means that they're better able to tout (sell) their product as lasting for weeks, versus days, so that the patient is led to believe that he only need visit the doctor relatively infrequently to get his shot, then they're likely going to go that route.

[SWALE]

I'm just not ready to go there.