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Author Topic: subQ vs IM  (Read 18069 times)

Dallas

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subQ vs IM
« on: July 13, 2014, 03:07:26 am »
What are the differences in the two(besides injection spot) of these two styles?  Is one better than the other?

Kierkegaard

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Re: subQ vs IM
« Reply #1 on: July 13, 2014, 04:03:16 am »
Pretty much everyone I've talked with or heard about via Internet or real life has preferred subq over IM.  The only single person who didn't like it was because he compared his peaks IM vs. subq and found his total T a few hundred points lower with subq, which is erroneous reasoning for two points: subq has generally lower peaks and that's one of its big advantages -- it trims down the peaks and raises the troughs, making the pharmacokinetic profile much smoother, which means fewer symptoms (notably E2 and everything that goes with it); the other is that subq tends to metabolize considerably *slower* than IM, so comparing your expected peak days for subq using your peak for IM isn't fair at all: things will be slower to reach the trimmed down, flattened out peak for subq compared to IM, so this person should have waited another day or so. 

Subq is also ridiculously easier.  The big sell for me on this point is that I didn't have to aspirate.  I hated aspirating, and there was always a completely irrational man in my head when I aspirated that said I didn't do it right, that I'd inject into a vein, have a heart attack, etc.  Subq, for me, stings a bit more, for up to an hour or two afterwards when there's pressure to the injection site.  But you can get around this by finding a clever injection site that minimizes pressure. 

Not only this, but the big three of TRT prefer subq, and at least two of them use it on themselves: Crisler, Shippen, Marciano.  Shippen actually was nastily against IM injections in his book on testosterone from 16 years ago (great text otherwise), but has since changed his mind big time after trying subq on himself and his patients.  Crisler said a considerable number of his patients have gotten off an aromatase inhibitor entirely because their E2 levels lower out. 

How high your T level goes with subq depends on the person (and, obviously, pertinent variables, like SHBG).  Some people have to *reduce* their dose of T because it shoots up so much after a few weeks.  A good number keep it roughly the same.  Only a few I've read needed to up their dose, but they're probably committing the same "subq fallacy" mentioned above with the one person against subq. 
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

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Re: subQ vs IM
« Reply #1 on: July 13, 2014, 04:03:16 am »


PeakT

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Re: subQ vs IM
« Reply #2 on: July 13, 2014, 04:03:39 am »
What are the differences in the two(besides injection spot) of these two styles?  Is one better than the other?
Intramuscular has the advantage of being around forever and it has a long history.  The "problem" with intramuscular weekly cypionate is that you get a fairly high peak and fairly low trough.  So, for example, a typical trough would be about 650 with a peak of 1150 ng/dl at an HRT clinic.

SubQ is the new kid on the block, but it is now pretty tried and true and we have had quite a few guys on the board using it.  Typically, someone on subQ roughly takes their IM dosage, splits it and does it twice per week.  Actually, they will do every third day or so, but close enough. 

The advantages are many:  a) less of a peak, b) a higher trough and, because of a and b, less need for Arimidex and less estrogenic side effects.  Another advantage often cited is "less holes in muscles."

I think subQ will take over IM in 10-20 years and hope to talk my PCP into it sometime this year, but that brings up the biggest problem with it:  not many doctors know about it, so you have to do some explaining and hope they'll sympathize.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Kierkegaard

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Re: subQ vs IM
« Reply #3 on: July 13, 2014, 04:06:29 am »
What are the differences in the two(besides injection spot) of these two styles?  Is one better than the other?
Intramuscular has the advantage of being around forever and it has a long history.  The "problem" with intramuscular weekly cypionate is that you get a fairly high peak and fairly low trough.  So, for example, a typical trough would be about 650 with a peak of 1150 ng/dl at an HRT clinic.

SubQ is the new kid on the block, but it is now pretty tried and true and we have had quite a few guys on the board using it.  Typically, someone on subQ roughly takes their IM dosage, splits it and does it twice per week.  Actually, they will do every third day or so, but close enough. 

The advantages are many:  a) less of a peak, b) a higher trough and, because of a and b, less need for Arimidex and less estrogenic side effects.  Another advantage often cited is "less holes in muscles."

I think subQ will take over IM in 10-20 years and hope to talk my PCP into it sometime this year, but that brings up the biggest problem with it:  not many doctors know about it, so you have to do some explaining and hope they'll sympathize.

Should be interesting when the super long estered testosterone gets legal in the US (if it's not already), which when injected subq will completely replace the need for pellets, putting a few unethical docs in a nasty position with their patients. 
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

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Re: subQ vs IM
« Reply #3 on: July 13, 2014, 04:06:29 am »


Dallas

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Re: subQ vs IM
« Reply #4 on: July 13, 2014, 06:06:05 am »
OK I will be injecting subQ then, I see no reason not to.  I wonder what is yet to come for me.  This weekend I have had about an endless supply of energy.  My mind has cleared up, and while I cant say that I feel 'amazing' I do have more energy and less anxiety, so that is a huge start!

Any long term users have updates as to how I may feel in 4-6 weeks?

Kierkegaard

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Re: subQ vs IM
« Reply #5 on: July 13, 2014, 05:15:47 pm »
OK I will be injecting subQ then, I see no reason not to.  I wonder what is yet to come for me.  This weekend I have had about an endless supply of energy.  My mind has cleared up, and while I cant say that I feel 'amazing' I do have more energy and less anxiety, so that is a huge start!

Any long term users have updates as to how I may feel in 4-6 weeks?

Sounds like you should be feeling like a new man in 4-6 weeks.  I know for me, my progress was seriously dampened because I had otherwise idiots docs who knew nothing about aromatization, so I had significantly high E2 levels alongside rising T levels, which reduced my T-to-E2 ratio, and was generally bad because my absolute E2 number was well above the 30 pg/ml cutoff recommended by the research.

I'd just keep an eye on the E2 and get things tested (if you can) every few weeks with this, total T, and free T.  Are you using an AI?  You might want to reduce dosage if you are at least a little bit, given subq's tendency to lower E2. 
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

wholbrook

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Re: subQ vs IM
« Reply #6 on: July 13, 2014, 05:41:04 pm »
Is there a site that can teach you how to do this and the freq?

Kierkegaard

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Re: subQ vs IM
« Reply #7 on: July 13, 2014, 05:47:16 pm »
Frequency is really a function of SHBG, whether you're a hyperexcreter, and just personal preference.  I have high SHBG, so E3D injections should be enough, but I might dabble with EOD given my high conversion to E2.  This video is awesome on how to:http://www.lowtestosterone.com/injection-videos.php
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

wholbrook

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Re: subQ vs IM
« Reply #8 on: July 13, 2014, 05:53:16 pm »
Great video. I am thinking of doing subq and breaking up my once a week injection to 3 times a week. I am hoping by doing subq I can lower my spike of E. Maybe I won't have to take an AI after all.

PeakT

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Re: subQ vs IM
« Reply #9 on: July 13, 2014, 05:55:37 pm »
Is there a site that can teach you how to do this and the freq?

Great video by Dr. Crisler here, who is one of the pioneers of subQ:

https://www.peaktestosterone.com/forum/index.php?topic=841.0
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

PeakT

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Re: subQ vs IM
« Reply #10 on: July 13, 2014, 06:04:33 pm »
K and Wholbrook:  I sticked this How to Do Injections thread per Kierkegaard's suggestion:

https://www.peaktestosterone.com/forum/index.php?topic=4587.0

Look at the top of the board...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

wholbrook

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Re: subQ vs IM
« Reply #11 on: July 14, 2014, 03:47:11 pm »
Well I just started my T again after a lay off of 6 weeks. This time I started for the first time using the subq method and using a insulin needle. My protocol is .5 of cypinate once a week so what I did was break that amount up and doing .1.7 on Monday, .1.6 on Wed and .1.7 on Friday. I did it the same way Dr. Chrisler recommended in the abdomen. No pain whatsoever with a insulin needle. I hear people complain that you have a hard time drawing the oil with a insulin needle but it was fairly easy and painless whic makes it easier to stick with this protocol.

I'm trying it this way in the hopes of avoiding taking an AI. I keep hearing that your E does not go up as much by taking subq vs IM.

Let me know if anyone else has had success with this method. Or if my protucal makes sense.

Thanks,

Wayne

PeakT

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Re: subQ vs IM
« Reply #12 on: July 14, 2014, 04:04:00 pm »
Well I just started my T again after a lay off of 6 weeks. This time I started for the first time using the subq method and using a insulin needle. My protocol is .5 of cypinate once a week so what I did was break that amount up and doing .1.7 on Monday, .1.6 on Wed and .1.7 on Friday. I did it the same way Dr. Chrisler recommended in the abdomen. No pain whatsoever with a insulin needle. I hear people complain that you have a hard time drawing the oil with a insulin needle but it was fairly easy and painless whic makes it easier to stick with this protocol.

I'm trying it this way in the hopes of avoiding taking an AI. I keep hearing that your E does not go up as much by taking subq vs IM.

Let me know if anyone else has had success with this method. Or if my protucal makes sense.

Thanks,

Wayne

What size needle did you use?
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

wholbrook

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Re: subQ vs IM
« Reply #13 on: July 14, 2014, 04:46:37 pm »
3o gauge 5/16 (8mm) length. I press deep

Kierkegaard

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Re: subQ vs IM
« Reply #14 on: July 14, 2014, 07:55:06 pm »
Random note: I've found that injecting against Crisler's advice by going 45 degrees rather than 90 is the way to go.  It allows me to get deep into the fat, which you can't do as well drilling it perpendicularly to your skin or else you'll hit muscle.  It helps with much less leakage.  Just to be safe I always plug up the hole immediately after removing the needle and swirl it around for half a minute. 
"The same thing that makes you live can kill you in the end." -- Neil Young

March 2014: Dx low T (158ng/dl)
September 2015: Dx hypothyroidism, other adrenal hypofunction
2016: chronic fatigue, unspecified

Depression and anxiety guide: http://www.peaktestosterone.com/Help_Anxiety_Depression

Peak Testosterone Forum

Re: subQ vs IM
« Reply #14 on: July 14, 2014, 07:55:06 pm »