Aquaviron is a testosterone suspension unesterified testosterone suspended in a water base and must be injected daily in order to maintain a steady concentration and elevated level of testosterone in the body. Aquaviron has the consistency of water and can be injected into the body via a small guage or gauge needle. Daily injection to testosterone would not only be uncomfortable but tedious to perform.
Therefore, esters are added to testosterone to prolong the half-life and slow the release of testosterone from the injection site allowing some injections to last up to 10 weeks.
There are a variety of testosterone esters and all have different half-lives. Examples of testosterone esters include testosterone enanthate, cypionate, acetate, propionate, phenylpropionate, isocaproate, caproate, decanoate, and undecanoate. Sustanan is blend of 4 testosterone esters. Sustanon is prescribed outside the United States and combines both fast acting and slow acting testosterone esters long and short half-lives.
Testosterone undecanoate will slowly release testosterone for up to 10 weeks. Testosterone Enanthate and Testosterone Cypionate are the most prescribed forms of testosterone in the United States today. Most patients will inject Testosterone Cypionate or Testosterone Enanthate once a week or every two weeks.
The more experienced patient may inject testosterone twice weekly to achieve more supra-physiologic level of testosterone. Whilst topical application of testosterone cream or gel remains a reasonable choice of delivery method, there are potential limitations to its efficacy due to inconsistent absorption with the skin barrier. There is considerable variation in the half-life of unbound testosterone, ranging from 10 to minutes.
Esters are attached to the testosterone molecule by a process called hydrolysis. Esters are essentially a class of organic compounds that react with water to produce alcohols and organic or inorganic acids. This equates to a chain of carbon atoms that makes the molecule less soluble.
The testosterone molecule can only become bioavailable when enzymes from the liver break down the carbon chains releasing the testosterone. The longer the carbon chain, the longer this process takes. Through clinical experience, I have become a huge proponent of daily subcutaneous Testosterone Cypionate injections, not only to achieve stable male androgen levels, but also to mimic natural physiology.
In some patients with high-normal Sex-Hormone Binding Globulin levels, it is possible to achieve stable levels with a less intensive injection frequency, however there is a reported qualitative difference in well-being with daily injections. There is natural diurnal variation in testosterone levels throughout the day, with levels being at their highest in the morning as anabolic processes predominate at night. Irrespective of how stable your levels are, by the very nature of injecting a hormone, there will be a slight peak and so daily injections makes perfect sense.
The similarity in ester length in both Testosterone Cypionate and Testosterone Enanthate, makes them essentially interchangeable. However, the increased fluidity of the olive oil solvent in Testosterone Cypionate, alongside its low concentration of Benzoyl Alcohol preservative, makes Cypionate a preferable choice for subcutaneous injections.
Testosterone Enanthate contains the carboxylic acid ester, enanthoic acid. It has a half-life of approximately days. According the British National Formulary, a single dose of mg Testosterone Enanthate should be injected every weeks 1.
According to the manufacturer, a single injection of mg leads to an increase in total plasma testosterone between It was also noted that testosterone levels returned to baseline typically after 2 weeks, so the suggested 3-week injection frequency would be ineffective in rising baseline figures 2. Steady-state mean serum levels of testosterone, bioavailable testosterone T , dihydrotestosterone DHT , and estradiol in thirty-three hypogonadal to year-old men given mg of intramuscular testosterone enanthate every 2 weeks.
Error bars indicate standard deviations. Dashed lines denote upper and lower limits of normal range. Adapted, with permission, from Dobs et al. The pharmacokinetic properties of Sustanon are not too dissimilar to that of Testosterone Enanthate. Levels then return to baseline after approximately 21 days, longer than Enanthate, presumably due to the longer half-life of the decanoate ester 4. Unfortunately, in practice, this is not the case.
Nebido contains the long undecanoic acid ester. Its half-life is approximately 90 days, with stability being achieved in approximately days. Due to the long-acting nature of this compound, a loading dose is recommended at six weeks. It is recognised that there is variance of the peak and trough levels between individuals 6 and so the data cannot apply to everybody.
The primary aim of TRT is to achieve stable hormone levels within the body so that homeostasis is maintained.
It must be noted that individuals with a peanut allergy should not consider Sustanon because it contains peanut oil. If you want to discuss the potential options for testosterone replacement therapy, get in contact with us today. We are not providing medical advice and are not a provider of medical care nor do we make any claims.
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We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us. If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal. You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help. You must be over 38, have had your ovaries removed or have suffered with premature menopause to warrant further hormone tests.
Please contact us to discuss your hormones, we need your total testosterone levels to validate your hormone deficiency. You can order a blood test here. You appear to have higher than normal testosterone levels, please contact us for further investigation.
You appear to have normal testosterone levels. Contact us if you have any concerns. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. If you often wake up drenched in your sweat at night, you may think you need to install a better fan or AC.
But if temperature is not the reason behind this sweating, you may have night sweats. Several internal factors can cause night sweats in men, and one of these factors is low testosterone. This article explains the connection between night sweats and testosterone levels. We have also talked about the best possible solution to reduce night sweats and […]. The male midlife crisis and how testosterone plays its part To help preserve skeletal muscle and avoid muscle wasting hormone replacement therapy HRT can be used to support an optimal hormone environment as we age.
Testosterone replacement therapy TRT specifically will ensure there is no catabolic effect of cortisol, which is antagonistic to androgens and testosterone in particular. After the age of 40 in men androgens typically decline and andropause commences. This is the reason men start to observe a […].
When you think about joint pain, your mind may automatically connect it to arthritis which is the swelling of joints. However, arthritis is not the only cause of joint pain.
Low testosterone can also contribute to joint pain. Therefore, your doctor will have to run different tests to determine whether this pain is due to arthritis, low testosterone, or some other condition.
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