Injectable Testosterone. Soreness at site of injection or lack of results.
At Natural Bio Health, many men (and some women) on testosterone replacement therapy use 1/2 inch 27 gauge needles for their injections. *This produces minimal discomfort on injection and is satisfactory for most of our patients. This small needle is generally injected in the thigh area and sometimes in the Deltoids. Follow up lab tests prove that the smaller needle works for most men but not all. However, some men experience pain and/or swelling after some injections.
Pain or swelling at injection site. If pain at the injection site develops the day after injection that lasts for several days the medication may have been injected into subcutaneous tissue (fat) instead of into muscle. This can cause an inflammatory reaction in the leg resulting in discomfort and decreased testosterone effect. This is generally seen in men who have a layer of fat 1/2 inch or greater although it can happen in men with less fat in the area of injection. If this happens only occasionally, it is not a problem and cold compresses and ice will often solve the issue. Regardless, if the swelling is pronounced or uncomfortable or continues, we recommend you visit one of our physicians for treatment and to avoid future reactions.
*To make sure each patient gets the maximum benefits of the hormone and to avoid most of the inflammatory responses, a longer needle (1 inch) may be used. The injection is not more painful with the longer needle (and may even have less discomfort). The 1 inch needle may also promote higher testosterone levels in men who seem to not respond optimally to their therapy.
If you have a significant other person who can administer the injections, a gluteal (buttock) or deltoid (upper arm) injection site may be more comfortable. Our staff will show you how these alternative sites can be used. Please call for information.
Lack of results. *Most men can tell their testosterone is working after three to four weeks. *You should generally notice an increase in energy, increased muscle strength and declining fat mass (if you are eating health and exercising). *Men typically notice their “attitude” is better in that they feel more positive and ambitious. *The full benefits of testosterone are often not felt until six weeks or more.
However, if you have not noticed these benefits then your testosterone may not be working. There are two primary reasons why this may be happening. *First, you may not be injecting deep enough into the muscle. Changing to the one inch needle discussed above should solve this problem. *Second, you may be converting an excess amount of testosterone to estrogen. Blood tests will tell you and us whether
(1) your testosterone levels are not optimal and/or (2) whether your estradiol levels are too high when compared with your total and free testosterone and your sex hormone binding globulin.
The good news is that either is easy to fix as long as we know the problem exists.
NOTE: *Your benefits of receiving testosterone therapy are maximized when you have a healthy diet and you exercise regularly. *We have had men lose as much as 9% in body fat in two months through testosterone therapy, healthy eating and regular exercise (focusing on resistance training with some aerobics).
*Benefits of Testosterone. Sometimes we forget that in addition to an improvement in our quality of life, testosterone has many other health benefits including the following:
*Reduces the risk of heart disease in men and women.
*Reduces the risk of prostate cancer in men.
*Protects our brain (helps prevent build-up of amyloid plaque).
*Gives us the ability to increase lean muscle mass (No 1 predictor of longevity).
*Helps us to prevent/reverse type 2 diabetes.
David L. Weiler, MD
Medical Director, NBH Lifetime Health