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Old 02-19-2012, 09:18 AM   #1
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Question How long for Testosterone replacement injections to have an effect?

I've been prescribed Testosterone injections for a range of symptoms including lethargy, ADD-type cognitive symptoms, and belly fat centered obesity. I'm self-injecting 0.75ml of Testosterone Cypionate every two weeks.

I took the first one three days ago (how much fun is that, sticking a heavy gauge needle into your own quad for the first time! :-) ) We'll be checking my peak T levels in a couple of days, then in another 5 days we'll look at the trough and adjust dose if needed.

Question is, how long should it be before I see any effects. Obviously I'm not going to lose a ton of weight in a day, but how about cognitive effects?

By way of comparison:
  • Stimulant ADD meds, such as Adderall, typically take effect after only one dose and they do so within an hour.
  • Most antibiotics require multiple doses per day to be taken over several days before the effects are obvious
  • And SSRIs like Prozac require multiple doses, once per day, given over a week or more before the effects kick in.
  • And presumably there are meds that take effect over even longer periods.

So, where does Testosterone replacement fit in that range? Since the peak T levels are not expected until at least 4 days after the injection, it sounds like we're certainly not talking Adderall type timescales. But should I see results at that point, even though I've had only one dose? Or is this something that'll take a few doses and weeks/months to work?

thanks.

 
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Old 02-19-2012, 09:41 PM   #2
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Re: How long for Testosterone replacement injections to have an effect?

I found an answer to my own question. Various medical sites around the web seem to agree that typical duration until effects are felt is a few (3 or more) months, and possibly longer. That's despite the fact that T levels themselves can get up to their target range within a few weeks.

 
Old 02-27-2012, 09:32 AM   #3
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Re: How long for Testosterone replacement injections to have an effect?

Quote:
Originally Posted by chronological View Post
I've been prescribed Testosterone injections for a range of symptoms including lethargy, ADD-type cognitive symptoms, and belly fat centered obesity. I'm self-injecting 0.75ml of Testosterone Cypionate every two weeks.

I took the first one three days ago (how much fun is that, sticking a heavy gauge needle into your own quad for the first time! :-) ) We'll be checking my peak T levels in a couple of days, then in another 5 days we'll look at the trough and adjust dose if needed.

Question is, how long should it be before I see any effects. Obviously I'm not going to lose a ton of weight in a day, but how about cognitive effects?

By way of comparison:
  • Stimulant ADD meds, such as Adderall, typically take effect after only one dose and they do so within an hour.
  • Most antibiotics require multiple doses per day to be taken over several days before the effects are obvious
  • And SSRIs like Prozac require multiple doses, once per day, given over a week or more before the effects kick in.
  • And presumably there are meds that take effect over even longer periods.

So, where does Testosterone replacement fit in that range? Since the peak T levels are not expected until at least 4 days after the injection, it sounds like we're certainly not talking Adderall type timescales. But should I see results at that point, even though I've had only one dose? Or is this something that'll take a few doses and weeks/months to work?

thanks.
couple questions for you. What was your testosterone level pre-treatment? What does .75ml equate to in (mg)? From what I heard 1ml = 200mg, is that correct? Hears what you you will likely need to do. You begin to feel peaks and valleys, which is due to the testosterone wearing off because you are injecting at too long of an interval. You will likely need to inject weekly, starting at 100mg, and adjusting it up or down, based on how you feel, until you find your sweet spot. Also, since you are introducing exogenous testosterone into your body, your estrogen will naturally want to raise to get back to the testosterone:estrogen ratio from pre-treatment. Therefore, it is important to use blood work to observe this. If estrogen becomes too elevated it can counteract the benefits of the high testosterone, and therefore you will need to use an AI (aromatase inhibitor). Additionally, I don't know how old you are, but if you are still wanting to have children, you will likely want to use hcg, which will prevent testicular atrophy.

But Key Notes:
Get back to me with your testosterone pre-treatment.
Insist on injecting weekly
Ask about an AI, and if you're still planning on children, ask about hcg

 
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Old 03-03-2012, 11:12 AM   #4
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Re: How long for Testosterone replacement injections to have an effect?

Nate, excellent. Thanks for taking the time to give details.

Quote:
Originally Posted by natedeezy View Post
couple questions for you. What was your testosterone level pre-treatment?
Two readings, about a year apart, were (roughly) 380 and 450. I took the first to my Doc but he said it was fine and within normal levels (I'm 47, was 46 then). But more recently he's being doing research on "low normal" levels, and attending some talks by a local endocrinologist. It was in light of that that *he* suggested we re-test. Again, at first on seeing the 450 he said no need to replacement. But after further research on his part, we decided to give it a try.

Quote:
Originally Posted by natedeezy View Post
What does .75ml equate to in (mg)? From what I heard 1ml = 200mg, is that correct?
Correct. So my first 0.75ml dose was 150mg. My blood test after five days showed my T had peaked at about 800. I then took the next 150mg about ten days after the first. We're going to check the trough level about two weeks after that second dose.

He's already told me to now up the dose to 200mg every two weeks. He says his aim is to get that peak up to about 1200, so that the average over the whole two week period, dose to dose, is near 650. So that 800 peak obviously wasn't high enough.

Quote:
Originally Posted by natedeezy View Post
..You begin to feel peaks ...
Trouble is, so far I feel nothing at all. I'm now on day 7 after dose 2 (150mg), and if I should be feeling anything by now, I'm not. The only *possible* effect is that I have been deathly tired during the week. That said, I was traveling and at a conference, having moved two time zones, so maybe it was just that. There are certainly no positive changes in cognition/energy/alertness.

Quote:
Originally Posted by natedeezy View Post
...and valleys, which is due to the testosterone wearing off because you are injecting at too long of an interval. You will likely need to inject weekly, starting at 100mg, and adjusting it up or down, based on how you feel, until you find your sweet spot.
OK, I've seen that mentioned a lot. In fact, one site suggests that every three days is optimal. I'll mention to my Doc when we next talk.

That said, I assume the more frequent doses are lower, in which case the peaks are lower, in which case the peak *effects* are lower, yes? So if I'm feeling nothing right now with a big peak (800 and probably going to be higher), then a lower peak won't be an improvement.

Once we're done titrating me up to where I should be in absolute dose, maybe dose frequency is the next thing to work on. For now the question is, is low Testosterone even my problem at all, because so far replacing it is like eating Tic Tacs.

Quote:
Originally Posted by natedeezy View Post
...Therefore, it is important to use blood work ...
We're testing once every week or two right now, as we titrate.

Quote:
Originally Posted by natedeezy View Post
Additionally, I don't know how old you are, but if you are still wanting to have children, you will likely want to use hcg, which will prevent testicular atrophy.
47. My kids are grown up and we've no plans -- OM*G* we have no plans! :-) -- for any more. That said, I don't like the sound of atrophy. All of my junk is on the small side as it is, and I wouldn't like it to get any smaller! So I'll ask about the anti-small-balls stuff.

Question on Luteinizing hormone though. The nurse who told me about the first results -- the one with 800 -- said my LH was "a little bit below normal". I mentioned that to my doc and he said it was irrelevant and they shouldn't even have tested for it. He said words to the effect that it used to be important but now because of <something I didn't catch> it's not needed.

Any comments on that?

thanks again!

 
Old 03-03-2012, 05:33 PM   #5
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Re: How long for Testosterone replacement injections to have an effect?

First thing, don't get down, I know many people say it took them some 2 or 3 weeks to begin feeling noticeable changes; furthermore, some people experience increasing positive changes (each week gets even better than the last) for months after their initial changes, only then do the benefits cease seem to reach their maximum capacity and level off, leaving you living with the maximum results.

Of course this is all dependent on finding your ideal dosing schedule. Again, when you inject every 2 weeks with a moderately high level of testosterone like 200mg, you will likely experience the peaks and valleys, the initial spike in testosterone will cause estrogen to also spike, which can decrease the benefits you would feel from the testosterone. This is why it is good to also measure E2 levels to determine if E2 is increasing into an unwanted range; if it is, using an AI, will help counteract this. You mentioned injecting every 3 days, I've also heard of people having good results of this, and I believe the reason why is, you are injecting a lower dose, which limits the spike of estrogen. This wouldn't necessarily eliminate the Peak effects of testosterone as you mentioned, it would more so deliver more consistent benefits.

I noticed you mentioned in your initial post that you are experiencing ADD symptoms, would you please elaborate. I too suffer from the form of ADD called ADHD PI, which is basically ADD without hyperactivity. If you type into Google: 'ADD without hyperactivity' and click on the first link with the title 'ADD versus ADHD', the column on the left describing ADD without hyperactivity is pretty much me to a T. Check it out, I'd like to know if this describes you too or if your symptoms are different.

I just went and got my blood tested the other day, when the results come back, I will let you know what they are, as I fear I may too have low testosterone, that or hypothyroid. Please keep me updated on your situation and let me know if you change your dosing or if you begin to experience beneficial results. I am very interested to see if testosterone replacement will have any helpful effect on your ADD, as this is primarily why I would want to go on TRT.

All the best

Nate

 
Old 03-08-2012, 09:20 PM   #6
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Re: How long for Testosterone replacement injections to have an effect?

Nate,

Again, thanks. This is me in the middle of week four (i.e. 1.5 weeks after my second 150mg dose). I go for a trough blood test on Saturday, and take dose 3 -- this time it'll be 200mg. From everything I've read, it sounds like feeling no effects so far is pretty much the norm. And even moving into week 5 and beyond may still not see obvious effects, but I'll report back.

Quote:
Originally Posted by natedeezy View Post
I noticed you mentioned in your initial post that you are experiencing ADD symptoms, would you please elaborate. I too suffer from the form of ADD called ADHD PI, which is basically ADD without hyperactivity
Yep, that's my situation exactly. Story is this:

About two years ago, on a whim, I got my T level checked. My primary symptom was an inability to focus. I've always had a bit of that, but it just seemed to be getting worse. Also, I was often tired, and overweight. But my primary concern was the inattention. I took the T result (about 380 if I recall) to my doc, and asked him what he thought. He asked about sexual performance, which is fine, and he had a feel of my junk to make sure I didn't have an undescended ball, which I don't. So he dismissed the T thing, saying although it was low, it was still low-normal.

And then *he* mentioned ADD. He himself is a sufferer, and so I told him I was game to investigate. He referred me to a specialist psychologist. I met the psych, had about half an hour of interview, and then I did a test on a PC. Conclusion: diagnosis 75% chance of ADHD-PI. Suggested remedy, stimulant meds.

So, back to main doc with the result, and we got started. First I tried Adderall, titrating up to a medium/high dose. No effect. Then I moved to Concerta (extended release Ritalin). Some effect, so we stuck with that for a while. I am overweight, and so another possible benefit of the stimulants was appetite suppression. It did that a bit, but not enough to shift weight.

Eventually, about summer of last year, I began to wonder if I'd been simply experiencing a placebo effect because having had enough time to evaluate, I simply wasn't improving in my work performance, which I took as my key indicator. I suggested to my doc that maybe I should try to lose some weight, and then go back on the meds. Being overweight can reduce the effectiveness of the meds (basically because they can be partially lipophilic and get soaked up by the fat). I also have slightly elevated blood pressure (because of my weight), and the stimulants can add to that.

So, I took a 6 month vacation from the meds, but visited the doc about a month ago. Since my weight was still where it was, he suggested I try again, this time with Vyvnase. I did, and it was ... OK. But nothing worth writing home about.

At that point he asked, "Have we ever had your testosterone checked?", to which my answer was "Well, duh! That's what started this whole thing!" We retested, and after a little bit of hesitation, here we are.

So yes, relieving ADD (ADHD-PI) is exactly my main reason for being interested in TRT. Of course if it helps me shift weight, that'll be superb.

So far though, nothing happening on either front. But I'll keep you informed.

Last edited by chronological; 03-08-2012 at 09:26 PM.

 
Old 03-09-2012, 07:51 AM   #7
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Re: How long for Testosterone replacement injections to have an effect?

Yea, Keep me posted ! I can't wait to hear how things start going when you begin to feel the benefits. Hopefully it'll be soon !

I haven't gotten my blood work back yet, but when I do, I'll be sure to fill you in.

 
Old 04-16-2012, 02:49 PM   #8
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Re: How long for Testosterone replacement injections to have an effect?

Hey,

Sorry for the delay in response. I got my blood results back and am a bit frustrated as they came back pretty normal. My total testosterone was 665ng/dl and free testosterone was 117.6 pg/ml so I'm not real sure what to do next. Any new news your way? How's treatment goin, how are you feeling?

 
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