IM Vs SubQ Testosterone Injections? Is SubQ Better? Doctor's Analysis

In this video on different testosterone administration techniques I look at whether SubQ (subcutaneous) Testosterone Injections are better than IM (intramuscular) Testosterone Injections. Does SubQ Testosterone result in higher testosterone levels? Lower E2 (Estradiol)? Less Acne? Lower DHT? Watch watch this video to find out.
Instagram: / nicholasdowney_md
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[@tuddarinn]

Awesome! Been wondering about this this week actually!

[@NicholasDowney]

Thank you!

[@danyg7251]

Great content doc! you always have something interesting to share

[@NicholasDowney]

Thank you Dany!

[@dlloydy5356]

Brilliant content as always. Particularly interested in the comments on how subQ in particular affects blood parameters such as hematocrit etc. I’ve not heard this referred to before. Thanks Dr Nick

[@NicholasDowney]

Thank you Lloyd! Hope this video helps a bit

[@dlloydy5356]

@@NicholasDowney it’s great info 👍

[@NicholasDowney]

@@dlloydy5356 thank you

[@user-mc5bz1bj7s]

Hate sub q, E2 levels through the roof for me, felt horrendous, bp raised, anxiety. Every day shallow IM changed everything, bloods great, feel awesome. Backload insulin pins 27g, 0.1 ml test e 250, 175/week. Switch from delta to quads, no issues, no pain. Game changer

[@Jdac333]

Mannnnn…. Sub Q made me anxious. Like crippling.

[@user-mc5bz1bj7s]

@@Jdac333 it’s horrendous pal, meant to go into the muscle for a reason

[@Jdac333]

@@user-mc5bz1bj7s​​⁠I agree. I am not anxious at all usually. It was daily panic attacks walking down the road for no reason (E2) and I have all the bloods to prove it. I’ve ran way higher test before(3x higher) with none of this. All issues started when I went SubQ

[@Jdac333]

@@user-mc5bz1bj7s did injecting into IM again relieve everything for you? I stopped completely. Even 40-60mg per week SubQ was hell for me.

[@Jdac333]

@@user-mc5bz1bj7s did switching back to IM relieve this for you?

[@fabianhernandez3667]

Great video doc

[@NicholasDowney]

Thank you, Fabian

[@forevermuscle3697]

very informative, thank you.

[@HeyJoeHaze]

Thank you for this video! This clears up a lot of questions that I had with IM vs Subq. I'm going back to SubQ injections.

[@betterplacetobe7896]

Good quality information as always Nick. Personally I inject ED all my compound even long ester, I use an insulin pin 1/2 long.

[@NicholasDowney]

Great approach!

[@natbornpuller]

What’s your hematocrit? Or whichever one measures blood thickness. Some people say to donate blood and some say do not.

[@betterplacetobe7896]

@@natbornpuller I’m even at the lowest

[@natbornpuller]

@@betterplacetobe7896 that’s good. 👍 maybe I just naturally have thicker blood than some people

[@thewarrior6916]

Great INFO doc, Thank you. about me : IM never work for me, it remains more than a month in the muscle like small balls in the muscle with a fever and inflammations , while Sub. Is more easier and less pain and no inflammations👍🏻

[@FS-wd3hu]

It could very easily be the oil

[@MarkKislich]

Heeheeheee this is perfect timing, I literally tested this out yesterday for the first time! 😁

[@NicholasDowney]

How is it going so far?

[@MarkKislich]

@@NicholasDowney so far some bruising and some pip but nothing major... 😁

[@NicholasDowney]

@@MarkKislich I find that certain brands cause worse PIP when going SubQ than others. Wonder what it is? Perhaps the amount of Benzyl Alcohol?

[@MarkKislich]

@@NicholasDowney I think so, yes. It was burning 🔥 first day when massaging. But.. Rather a little more alcohol than less, after all it helps keeping the solution sterile as well I guess? 😁

[@maxvantiggelen667]

@@NicholasDowney I actually experienced more pip with IM than SUBQ. This was not the case however with a different carrier oil

[@donaldwilson5693]

I currently use Nebido(testosterone undecanoate) IM 2ml/month. Lab tests show my T levels fairly normal. Do you think 1/4ml twice a week subcutaneously would be better? I would think it would provide a more stable T level(?)

[@ShooterMedic1818]

So, is this study you reference suggesting the dose be cut in half when going from IM to SC?

[@DystopianProphet]

Extremely helpful information. Based on this presentation, I would think injection frequency would be less relevant for subq than IM. I’m thinking of cases where 3+ small-dose injections are recommended per week to modulate peaks and valleys in T levels, low SHBG, and high Estradiol levels. Am I correct in thinking there’s less benefit of higher injection frequency in subq compared to IM?

[@DazePhase]

Also the risk of hitting a blood vessel while injecting subQ is lower. Can use smaller needles to not produce more scar tissue at the injection site. I started injecting 4 times/week subQ with 30G 13mm needles with insulin syringes and have no issues whatsoever. Testosterone levels are stable.

[@katlehomorobe5677]

Doesn’t drawing it take ages?

[@braedenbillon6207]

@@katlehomorobe5677you can backload the insulin syringe

[@anasdaouk7096]

You are using IM vials for Subq

[@DazePhase]

@@anasdaouk7096 It doesn't matter, it works both ways. SubQ is better be cause its easier to keep more stable levels when injecting 4 times a week without harming the muscles from that much pinning.

[@DazePhase]

@@katlehomorobe5677 With 30G yes. Around a minute and half for 0,25 ml.

[@Kw1h]

Started injections a week ago via low-dose QD SubQ with that very reasoning; to decrease fluctuations/peaks in an attempt to minimize AE and/or AI use. Obviously no noticeable effects yet, but will update at a later date (if I remember) with my thoughts.

[@NicholasDowney]

Curious to see how it goes!

[@tcgmonsterz2578]

How is it going? When did you start to notice any changes?

[@Kw1h]

@@tcgmonsterz2578 Appreciate the reminder. SubQ works wonderfully, highly recommended. Injections are quick/painless, levels are stable and roughly as expected based on dose. Primarily use stomach and flank. E2 did rise proportionally. I experienced mild water retention with subsequent HTN at week ~5-6, but minimal AI dosing eliminated that. Zero AE otherwise aside from some mild shedding. I did eventually switch to Q48H dosing, but for secondary reasons (bloodwork requirements), albeit it is slightly more convenient and allows site rotations to last a little longer. No noticeable change in effect vs QD.

[@gjguili]

Update please🙏🏻

[@Monke636]

@@gjguili He died

[@H-D1]

Great info

[@NicholasDowney]

Thank you!

[@janverschuren593]

Massive thanks for this information i am very greatfull. Love the bird too

[@NicholasDowney]

Hahaha thank you so much!!

[@ezetobebad]

Hi Dr D, may I just wanted to thank you for taking the time to share great information. Just a thought but would it be possible for you to post the links to any medical studies you quote from. Best regards

[@NicholasDowney]

Thank you for the kind words. I tend to only share screenshots of the titles and this is due to my own laziness but I will do in future. The reason for just posting the titles is that I use my works online library and it doesn’t give a link so I’d have to find it using the title on google. (Essentially I’m just saying I’m lazy 😂). But I will improve!

[@ezetobebad]

@@NicholasDowney Hi Doc, Thank you for replying, To be honest I am sure many of the studies are not exactly lay person friendly & sometimes I am aware that there may be a fee to review said study. Thanks again.

[@misterssippi601]

@@ezetobebad awesome avatar bro!

[@ezetobebad]

@@misterssippi601 thanks, it our old Malamute

[@maxvantiggelen667]

Great video as always! Huge fan of subq myself

[@NicholasDowney]

Thank you!

[@perucho2194]

Well done. The SQ allows me to use smaller needle (vs IM) leading to less discomfort, good reason for me to use SQ, but might eventually do some glute hybrid IM/SQ. Keep up the good work 👍

[@NicholasDowney]

Thank you very much. That's a lot a massive reason people prefer SubQ

[@user-mh6kb6eu7s]

How so? I use a 29g 1inch. It's fairly cheap on Amazon too

[@PME16]

I am currently doing it like this, 250mg a week, i inject 0.28ml eod, once subq, once intramuscularly.

[@Rico_MC]

Very interesting

[@NicholasDowney]

Thank you!

[@jayson3843]

Disregarding the peeks (because you can inject intramuscular several times a week micro dosing) what is better, intramuscular or SubQ. Have you looked at the physiques of those who do IM and Subq abs compared?

[@brandonmeens]

I know this was a year ago, but as he said there aren’t many studies, there would have to be one that was looking for this exactly. The big names now don’t do subQ because they’re injecting such large amounts that it would leave large lumps at injection sites, it’s already a thing with TRT doses. I would like to see a study that does look at this though. Depending on injection frequency though, as the peaks would effect a lot of

[@gif24gt60]

Does heating the oil and/or the area to be injected help prevent scar tissue formation even from a subq injection? Or would apply a massage gun after injecting work?

[@lukaskidd4621]

Get more syringes and do less, but more frequently. The love handles are fine too.

[@timsawyer9231]

I've been getting subq shots on my butt cheeks for a couple months and I have acne all over near the injections sights. It's not that bad everywhere else, just my butt haha I was just given my own script so I can do it at home, but they didn't instruct me at all on how to do it (primary care doc, not a T clinic) so I'm left to figure it out on my own I guess. Since I think I'll have a lot of issues continuing to inject subq on my butt, I'm researching IM on my thighs.. Still haven't really settled on how to do this, or if I should split my dose or what... I really wish the doc would have given me some instructions here. Even though I'm saving a ton of money being able to do it myself, I think I might say to hell with the doc and just continue with the T clinic, they have been fantastic...

[@ChrisAbbott]

Love your bird.

[@pateko1523]

I m currently trying to inject nebido subcutaneous daily,i previously was doing nebido i m daily but i wanna see if my e2 goes down a Lili bit.how long should i wait before blood examination?

[@albertogino]

hi i use nebido too you can inject the whole 4 ml in to fat too there are studies just type testosterone undecanoate injection into subq

[@pateko1523]

It dis lower my e2 with same daily protocol but subcutaneous instead of intramuscular

[@livestrongforever]

great man

[@michaelphasey-sharp9457]

Hi Doc, quick question, I'm on 200mg trt was doing bi weekly & was feeling super wired up went to EOD this seems to be great, would you then recommend daily for even better hormone & blood stability? Will be trying subq

[@tonehernandez8598]

Has sub q helped ?

[@LL56721]

what brand can i use as SC inj? in my country, only available testo for IM only. can i use that as SC?

[@VirtualRonnie]

yes

[@nicoc7024]

Were these studies with subq on once per week injections?

[@dw4076]

Would testosterone suspension be absorbed subcutaneously

[@michaelphasey-sharp9457]

Hi all om a different note i am currently om 150mg split into 3 days MWF i am still feelimg tired would one thennrecomemd to go up a dose or lower the dose? Many thanks

[@WWETheDeadManDTF]

150mg a week is already a high dose for trt. Feeling tired and fatigue can have many causes. Do you sleep well? Do you eat healthy? Do you have high stress jobs or relationships? How long have you been on trt? Do you exercise frequent? Do you get enough sunlight?

[@tetekuka6982]

I get big bruises any reason why that would happen

[@billslusser2446]

Only one comment on the bird and no comments on your magic vanishing bird. Thanks for the info. I was doing IM in my thigh 100m per week m just switched to XYOSTED self injector. W copay card it’s $0 vs $10 a month to me. Self injector sure does make it easy to administer w less potential issues. I’m sure my insurance is not happy about it.

[@Casey-xv3gv]

Hi Dr. - I’m currently injecting 200mg of testosterone cypionate intramuscularly weekly. I think you said that dosage intramuscularly causes spikes followed by a marked drop in levels in the week following the injection, while a 100mg dosage kept levels stable and that the level in the second week was the same as the level of the 200mg intramuscular group. I understand it’s a limited study, but does this suggest someone can get by on half the 200mg dosage if they switch to intramuscular? I’m not a body builder, it’s just

[@atalasstefano62]

He said 100ml SubQ gave same levels as 200ml IM.

[@PME16]

​@@atalasstefano62 it was the second week, the first week 200mg im was more

[@GunsAndFishingU.S.A.]

I tried subq today in belly i used .08 ml cypionate very low but it burns afterwards why?

[@usasupra23]

What about SubQ locations being very itchy and swollen after 3 days of the shot and the oil lump staying for 6 weeks or longer? Move to IM instead or will that be worse???

[@chadbrobertson]

inject slower

[@WWETheDeadManDTF]

could also be a allergic reaction to the carrier oil. Or infection due to lack of hygiene.

[@usasupra23]

@@WWETheDeadManDTF thanks for thinking outside the box but I’m a nervous wreck around needles I’m overly careful about hygiene and changed from Cottonseed to Grapeseed carrier oil. Is there another I can try?

[@konz2891]

@@usasupra23 The nerves could be the problem, if your hand isn't steady while doing them you could be causing more damage than necessary. My first one was shaky and it took a few days for the injection site to calm down, since then I take a propranolol before hand and that issue went away.

[@WWETheDeadManDTF]

Maybe you need to change the kind of syringe you're using. Some plastics can get dissolved by the carrieroil and benzylalcohol. You might inject some dissolved plastic, wich you're body is reacting to. I had this one time with cheap 2ml syringes from braun. I changed to the 1ml tuberculin syringes with rubber piston and never had this problem since.

[@nikc1520]

I’m here for the bird❤ *Great info too 😄

[@GOLDEN-GRAMS]

Nick do you thing muscle gains would be better and faster from intramuscular injection instead of subq stomach injection?

[@torqueofthedevil8145]

Its about your Test levels nothing more, sleep, diet and how hard you train are bigger factors than between SQ and IM

[@Demiurge66]

The only difference is absorption rate when it comes down to it. SubQ is just days later vs IM just few days. It will absorb either way and effect you how it’s going to effect you regardless IM or SubQ

[@simplyhuman2213]

@@Demiurge66 SHBG would be different too if dosed daily though no?

[@MarkKislich]

Another thing: the complications around infection should be lesser. I've seen and treated glutes that were like a rock, like wood, like steel. It seems that when the area turns septic it literally damages/kills some muscle tissue? Some people have rather serious problems from this. If, on the other hand, an infection should occur in the skin, it'd probably be far less problematic? Ergo subcutaneous injections seem to make more sense on so many levels

[@NicholasDowney]

The research would also support this. Lipodystrophy would be the only issue with SubQ and if the person were overweight and injecting it in folds where bacteria collect. Otherwise, it seems safer from a self-administration aspect

[@MarkKislich]

@@NicholasDowney noice! 😁 I'm gonna give this a fair go, perhaps even switch over to subq for good now. Seems the intelligent course to take

[@NicholasDowney]

@@MarkKislich Let me know how it goes!

[@MarkKislich]

@@NicholasDowney absolutely

[@aot2002]

I couldn’t walk right for days on glute injections

[@jeffersonprice3800]

Intramuscular all the way. Ive done subQ once and got a massive bump that was sore and red. It says right on the packaging, for Intramuscular use only. This microdosing subcutaneously trend will fade away in a year just like microdosing psilocybin. Two IM injections a week is pretty straightforward of an enanthate, sustanon, or cypionate. Do we really have to make simple things complex?

[@jonaaranda4561]

I get those on my stomach but on quads and arms I am just fine no lumps no redness

[@HeyJoeHaze]

What needle gauge and length would be ideal for SubQ injections?

[@torqueofthedevil8145]

29 Gauge and half inch

[@Demiurge66]

I use 31 gauge slin needle, it works like a charm. I actually look forward to injection days with subQ

[@ShooterMedic1818]

25g

[@michaeldemarco899]

I have done both. Def easier subq but I do get irritation and a lump almost every time that lasts for 4-5 days. Sometimes it’s painful. Spoke to my dr he says it’s normal.

[@HHalloweenCandy]

Subq is better for average TRT protocol. A combination of intramuscular and subq if you're dosing of testosteone is high. .5mL split between two subq spots twice a week and you'll be good. Also only subq cypionate as enathate usually causes inflamation.

[@zacharystuart7162]

Dude your awesome!! I have been looking for this advice all morning. Could you tell me if my dose is 500mg per week. What would my daily dose be and how do I do it. Testosterone Cypionate.

[@PME16]

​@zacharystuart7162 if your test is 250mg/ml, you can do a hybrid approach,once subq,once shallow IM, at 0.28 ml everyday.Use a 29G 1/2 inch.

[@Tjan-qr5sn]

that bird is so sweet😅❤

[@NicholasDowney]

Hahaha thanks

[@gregyance9901]

I get little bumps injecting SQ in the belly fat, I use a 27G needle, should I change for a 29G?

[@WWETheDeadManDTF]

It wont make a difference. Maybe you should split injections. I never inject more than 0,5ml subQ at a time.

[@atalasstefano62]

Never inject more then 0.3ml a time for SubQ. eather do it more often then larger dosages. Ive done SubQ for like 3 years and not even a lump yet. Remember to always clean injection spot with alchohol swabs.

[@WWETheDeadManDTF]

0.5ml i never has problems. You just have to inject slowly. I use 25g needes only.

[@WWETheDeadManDTF]

*had

[@dlindo8892]

Where in the body is the best place to do a subcutaneous testosterone injection?

[@NicholasDowney]

Love handle fat

[@dlindo8892]

@@NicholasDowney Should I wait longer before getting blood work if I switch over to subq injections? I ask because I’ve tried it in the past and got blood work after five weeks of being on subq and my total testosterone dropped 350 points. I had been on trt for about 12 years already.

[@gjguili]

I would also like to know the answer to this

[@atalasstefano62]

Can it be done in the buttox aswell? Same spot as you do IM. i use 1 week for belly fat, then next week buttox@@NicholasDowney

[@equima]

Verdict is also - Sustanon 250 is the best one on the market as far as rbc counts 😉

[@MarkKislich]

Howdy Sir Big Paul over on Anabolic Bodybuilding says he has you on the list for an interview 😎💪🏻💪🏻✋🏻

[@NicholasDowney]

Awesome, I look forward to that!

[@MarkKislich]

@@NicholasDowney and me! 😁

[@solo-nx5ml]

Is Sub Q way will help for fat burning in that injection spot ?

[@atalasstefano62]

no.

[@toadamine]

I'm using 8mm long insulin syringes, am I doing sub cutaneous or IM, if I poke it straight into my thigh?

[@NicholasDowney]

If it is in the thigh there is usually minimal fat so it is likely IM

[@toadamine]

I was doing sub q, but it's annoying so I started doing IM the other day and it's definitely easier and you don't get the bump... but I want nice even levels... that's why I do it daily instead of twice a week like they told me to... (I split the doses into smaller doses but the same amount total per week/month) made a huge difference with the acne... acne was bad till I started doing smaller daily doses...

[@atalasstefano62]

i think SubQ is alot easier.@@toadamine

[@toadamine]

@@atalasstefano62 I switched from thigh to outer buttocks, and injecting every other day, now straight in, is still sub Q... not IM... and less soreness after and during than the thigh.

[@atalasstefano62]

Ive been doing subQ in belly fat, then IM in buttox for rotation. Just did SubQ first time in outer buttox today, hoping it will work =)@@toadamine

[@iamthefiremanjj]

Testosterone always makes me feel sick nausea , flu like symptoms etc just feel like shit

[@atalasstefano62]

then try to subq injection.

[@jensronnest1072]

Can you do 500 milligram sub q?

[@Rico_MC]

3:40

[@solo94gt]

Can I inject in belly?

[@aot2002]

Yes if using subq

[@chattop]

Great video. While I was in US, I used Testosterone Cypionate subcutaniously for last few years and felt good, stable level. However in India cypionate is not available, doctoe prescribes Sustanon 250 mg which is I guess heavier and mixed of 4 different esters. I am wondering if I can continue with subq injections with Sustanon. Any thoughts would be appreciated.

[@ianbrown5955]

I don't like the idea of stable levels of Testosterone. It is more natural to have daily swings. But I also prefer doing sub-q, so I use propionate (a fast ester) and I give my daily injection in 3 different areas of fat around my mid-section. This allows for the natural daily swing that I think is important. It makes sense that smaller injections in more areas would allow for a quicker absorption.

[@dw4076]

What do you think of sub q testosterone suspension

[@ianbrown5955]

@@dw4076 Have you done "suspension" sub-q? To tell you the truth, I didn't know much about it. I'm interested. It's called a "mass producer". It's actually the best for every day use, but painful if done intramuscular. But sub-q should work. What do you know about it? Experience?

[@natbornpuller]

What’s your hemoglobin? And do you donate to lower it?

[@ianbrown5955]

@@natbornpuller That was the old medical fear. The thickness of blood (hemoglobin) that testosterone gives you is now identified as the same as you would get if you lived at higher elevations. It is not the same thickening that causes blood clots. The new information is that you don't need to donate blood. More is being learned all the time. I am actually prone to blood clotting in my legs, yet I've been on testosterone therapy for 3 years without a clot. My hemoglobin is elevated, but as said, it doesn't cause clotting.

[@natbornpuller]

@@ianbrown5955 I see. Okay, thanks for the insight.

[@danatomalty396]

Good info but not sure about the bird……😮

[@NicholasDowney]

Sorry the bird is needy😂

[@jorgeanderson9032]

Looking juicy in that thumbnail doc! Why dont you make a more personal video talking about your experience with working out and steroids

[@NicholasDowney]

Haha I don’t think anyone would be interested. I am also worried that people take what I’ve done in the past as advice as my approaches are quite unconventional. Currently not looking my best, haven’t trained in over 6 months.

[@R3idMyLips]

I have a very important question for myself and other transgender males or nonbinary folks that may want more masculine changes! Please don’t be intimidated by the long comment lol. You had mentioned DHT for a moment and said you would get back to it, but I do not believe it was returned to? It is my understanding that DHT has a major affect on bottom growth… Can you confirm if that is correct for me? I would like to have the best results for bottom growth possible. I am considering switching from IM injections to SubQ that way I can, hopefully, do them myself at home (or have my wife do them) instead of travelling to the clinic every week. It would save me a lot of money and time, especially in the winter here in Canada!! The main motivation to go to the clinic in the snow is how much I care about my levels and changes, but it would be nice to not have to force myself to go out into the cold and travel on public transit. My lower region is my biggest dysphoria… I’d like to maximize my growth, especially during the first few years. I’m also unsure of if this is true but my anxiety makes me feel like if I don’t maximize my potential growth right now, I’ll forever miss out on what I could have. Do you believe there would be an impact on bottom growth when switching to SubQ from IM?

[@R3idMyLips]

@@ShiManIonEvnKno it seems more fitting that you apply this to yourself. Therapy could be beneficial to you in order to learn how to be inclusive and supportive instead of judgemental and hateful… Sorry you miss out on so many amazing people because you view the world through such a negative lens. I hope one day you learn to respect the many different ways people can live their life and be happy.

[@hansroth6749]

Mg my friend

[@jeremybly]

Did you say "from 12 to 80%? Lmao, that a wide range 😂

[@NicholasDowney]

I did, that’s the problem with small sample sizes 😭

[@aqualane1]

This all sounds like good news to me! Hate IM

[@genebuchanan7130]

birb

[@koopher]

🦜