I’ve experimented with lowering my dosage on four separate occasions now: when I had my hysterectomy, when I started using DHT cream, and twice in response to out of range (high) free T levels in blood tests. I’d like to inject only the minimum amount of testosterone that I require to maintain virilization, healthy T levels and good general health and well being. Plus, the less I inject, the more money I can save.
In Canada, there’s only one company that I’m aware of that markets a 200mg/ml injectable testosterone: Theramed Corporation. This past summer, Theramed doubled the price of Delatestryl (Testosterone Enanthate). I’m now paying about $60 CAD for 5 ml instead of 10 ml. I can still opt for Depo-Testosterone (Testosterone Cypionate) instead—at roughly half the price of Delatestryl—but Pfizer only sells a 100mg/ml concentration. This means I could get T at half price if I’m willing to inject twice the volume or switch to a weekly injection. Neither of these are appealing to me though, so I opted for the pricier Delatestryl last time I stocked. I think my preferred pharmacy still has some Delatestryl available at the old price, and I’ll check soon.
Related: Testosterone Cypionate vs. Enanthate
I lowered my testosterone dose after my hysterectomy because I knew my hormones would be out of whack for a bit while my body adjusted to being post-hysto. Additionally, I started using topical DHT cream on April 29, 2009, about 6 weeks after the hysterectomy. There have been mixed results in DHT studies regarding how T levels are affected by supplemental DHT, and I wanted to err on the side of caution. My T levels dropped by almost half, but then remained steady and within normal male range. However, I wanted them in the higher end of the range, mostly because I’d only been on T for a year and had only had a few full shots of 200mg. I was still looking for significantly more virilization.
I lowered my T dose from 200mg to 180 mg from March 17, 2010 to April 28, 2010 because of the high T levels coming back in my blood work. But then I didn’t feel great: I was tired and more emotional than normal. I went back to 200mg 6 weeks later. I didn’t really give it very long. I stayed on 200mg until July 21 when I ran out of T with 160mg in the barrel. My lab reports were still showing high T, and I felt fine in the couple of weeks that followed, so when I did my next shot I drew up 180mg instead of going back up to 200. I’m going to try staying on this dose for a few months and re-evaluate. So far it feels fine, not like earlier this year.
I made this fancy chart that shows how my T levels and dosage have changed over 2 ½ years.
Gender Outlaw 
Heh. My doctor just upped mine from 100mgs a week to 125 a week, saying I can go as high as 150/week. My levels were in the lower male range, and have been for the entire 5 years I’ve been on T. I don’t expect to see any physical changes with the higher dose, I figure everything that can happen already has…but it will be good to see if the higher dose affects my moods.
If you have the time, let me know how the milk thistle goes. I’m a bit worried about my liver because of lengthy codeine use, and wouldn’t mind trying something out.
Thanks Linc, I hope that higher dosage proves beneficial for you. So far, my liver panels have always come back good in blood work. I’m being proactive with the liver support. I don’t know that I’ll notice anything from it, and I don’t have any new blood work scheduled to see if it affects those liver numbers. I wonder how I’m supposed to know if the milk thistle helps? I’ll ask the herbalist.
You do know that injected testosterone has little effect on the liver, right? Only oral steroids (17 alpha-alkylated steroids) cause liver problems because they have to be metabolized by the liver to produce blood levels of testosterone.
Also, I’m pretty sure that your free-testosterone levels are on the low side of the male range. Here are a pair of studies which examined the effects of anabolic steroids on male subjects. They provide basal levels of all hormones:
http://www.nejm.org/doi/full/10.1056/NEJM199607043350101#t=articleTop
http://ajpendo.physiology.org/content/281/6/E1172.full
If you need to convert from pmol/L to pg/mL, just multiply your values by 0.28842 (288.42 pg/pmol * 1 L/ 1000 mL). Your doctor probably won’t let you inject more, but you don’t have to reduce your dosage because you won’t suffer liver problems from injectable testosterone and your free testosterone levels are not too high.
Dan, while there have been studies that suggest only oral testosterone puts a load on the liver, there are virtually no studies of this nature that involve transgender men. For this reason, it’s still recommended for trans guys to have liver function checked periodically, and I think it’s only wise that I give consideration to this.
I haven’t had blood work in about 6 months but going on the target range of 23-82 pmol/L provided by my doctor, my levels had been high.
For what it’s worth, I increased by dose back to 200 mg a couple of week ago. I have free reign in choosing my dosage, though if my doctor suspected I was abusing the T, he’d surely step in. I agree that this alone is not likely to cause liver damage–I mean, I’m a much lower dose than what bodybuilders tend to use–but since I’m on this for life, I would like to take the minimum amount that I need for optimum health.
Thank for the links! I always like checking out studies of this nature, even if they don’t directly address my experience.
I’ve been on T for about three months and all the changes have been great and fast actually which was really awesome but everytime i go to inject it myself i get really bad anxiety. It makes me feel like i wont be able to do it myself but i would to. I was just wondering if you experienced this too and if you had any advice. Thanks
I always have an intense moment when the needle is poised above my flesh, right before I plunge it in. Every time. Some times it’s worse than others, but it’s always better for me than the alternative, which is a doc’s appt every 2 weeks. That’s what I did for much of my first year on T and the lack of control really bothered me (occasionally appt canceled or moved, etc.)
I think it’s perfectly normal to have apprehension about sticking one’s self with sharp objects! If you think that you’re closer to a needle phobia though, you could have someone else do your injection for you, or may find that anxiety eases with sub-cutaneous injection rather than intra-muscular. If it stays bad, then you could also look into T gel or sub-cutaneous pellets. Both are more expensive options, but no needles. Hope this helps!
You should choose a dose and stick with it for at least 3 preferably 6 months. If you are going to use the cream choose a premeasured amount and do not deviate. Testosterone is created in other places in the body and small amounts are held in certain cells. Your blood chart shows your numbers all over the place. Give your body some time to adjust. Maintain a constant weight +/- a few per month to. Your cells and organs will level out and should show more steady readings. You have put your body through tremendous changes over the last few years. Injectable Testosterone is not going to make you ‘feel’ any particular way unless it drops very low. Virilization is permanent, is genetic and also takes time. Even a bio male takes years from puberty to adulthood (25ish) Slow down, bouncing around is not healthy. Injectable testosterone does not destroy your liver unless you over use. 24yr. vet of use.
Yes, my docs recommend 3 months for a dose to settle in. I have never used T gel or cream, but I have used DHT cream. You probably didn’t see that post… I used 20mg 3x daily. I adjusted my T dose during DHT use based on discussion with my doctor. We both thought it was prudent since there’s little information available about exogenous DHT and FTM transsexuals.
My numbers jumped around largely due to slow dose titration (endo’s plan), hysterectomy and DHT cream–all to be expected. I’m not sure what you mean by “slow down.” I started on a low dose and slowly increased it over 12 months until I got to 200mg, also according to my endo’s plan. (The slow titration was pretty frustrating.) I’ve done things quite methodically and with medical supervision. Unfortunately, I don’t have control over everything: there’s currently a testosterone shortage in Canada and I can’t get my prescription filled, so I will be without for a while and my levels may bounce around again.
I disagree that T is “not going to make you ‘feel’ any particular way unless it drops very low.” Maybe that’s the case for you, but it isn’t for me (and I know lots of guys who feel pretty crappy the day before their shot.) Additionally, my doctor told me that a blood test is only a “snapshot in time” and that how I’m feeling is a better indication of the appropriateness of my dose. I’m all too aware that transition takes time. Some traits of virilization are not permanent. I never said injectable T “destroys” your liver; I said it can affect liver health, which is why liver screening is recommended for guys on T. I respect your experience though there’s not much of a template for this, hormones affect everyone a little differently.
I just had to switch from enanthate (Delatestryl) to depo (cypionate) because of the shortage here in Quebec. I got a new prescription from my endo. Isn’t that possible in B.C.? Hope you get your next dose soon. Good luck!
Funny timing, Damien, I just wrote about this… there’s been a Depo shortage as well.
You are wrong about testosterone and liver damage. Testosterone is a bio-identical hormone, meaning the body is fully aware about its use, it is not foreign and is not liver toxic. This line from the page you linked to: . “Specifically, the use of orally-administered C-17 alpha alkylated testosterone has been associated with such complications, in addition to being associated with hepatocellular carcinoma and hepatic adenomas.”
Explains that the 17alkyl steroids, with the alkyl group attached so they can make the first pass through the liver are what makes them toxic, but also makes them able to be taken orally. We inject, it’s different.
Gah, you are correct of course, Joey. Thanks for the heads up! By 2010, I’d heard the myth about T and liver toxicity enough times to believe it. (I’ve deleted the incorrect text.) That said, a theoretical hazard still exists. It’s minimal, but has not been studied enough in trans male populations to totally disregard. (It’s the reason why liver panels are included in routine blood work for trans men.) And it’s an extra concern for trans men with preexisting liver conditions (though not necessarily a contraindication.) Also worth noting is that in addition to IM testosterone, newer oral formulations, like Andriol, are also fine in terms of liver toxicity.