Testosterone Suspension
Testosterone suspension is often misunderstood by novices; it is fundamentally a form of testosterone that becomes injectable by dissolving the steroid in oils. Due to testosterone’s large molecule structure, water solubility is not achievable, necessitating the use of various oil carriers for injections.
To enhance absorption and prolong action, various compounds can be attached to the testosterone molecule, resulting in formulations like acetate, decanoate, and others. These combinations in a carrier oil, such as sesame oil, create what is termed a suspension.
Esterification improves testosterone’s oil solubility, allowing a slower release into the bloodstream post-injection. Testosterone suspensions must be injected intramuscularly and cannot be taken orally. The rate of absorption varies, with some suspensions releasing testosterone more quickly than others. Most formulations don’t require daily injections, as they can remain effective as a depot in muscle tissue for several days to a week.
Known as tesamone, this oily suspension delivers the same anabolic and androgenic activity as all testosterone products. A physician’s prescription is necessary for access to the various types of testosterone suspension in the USA.
Therapeutically, testosterone suspensions are indicated for conditions associated with testosterone deficiencies, including:
- Infertility
- Delayed puberty
- Advanced breast cancer in women
- Promoting growth in malnourished individuals
Pharmacology
Testosterone plays a vital role in the growth and maintenance of male reproductive organs and secondary sex characteristics. It affects the prostate, testicles, penis, scrotum, and overall body growth. Despite its androgenic profile, testosterone also possesses anabolic properties, which promote protein synthesis and a positive nitrogen balance, particularly with a high-calorie diet.
This hormone can stimulate red blood cell production via increased erythropoietin synthesis in the kidneys, thus enhancing oxygen delivery to muscles. Prolonged use of testosterone discourages the release of gonadotropins from the pituitary gland, risking inhibition of spermatogenesis at high doses.
Dosage
Testosterone suspensions are administered exclusively via intramuscular injections, remaining effective for 48-72 hours, while urine can detect the drug long after. Esterification increases duration of action. Many athletes report discomfort from injections into the buttocks, often due to volume or abscess formation; thus, lower volumes and site rotation are recommended to minimize complications.
Beginners typically start with about 25 mg weekly, while others may use 50-100 mg per week or even combine various formulations in cycles. Treatment duration should ideally be limited to 4-6 weeks for recovery of the hypothalamic-pituitary axis and testicular function.
Post-therapy, athletes may use Nolvadex (tamoxifen) to mitigate estrogenic side effects. Prior to injection, inspect vials for fine crystals, which should dissolve with shaking; if they persist, the vial should not be used.
As with all testosterone products, suspensions inhibit natural testosterone production and affect the hypothalamic-pituitary axis, necessitating a gradual tapering off rather than abrupt cessation.
Duration
How long testosterone suspensions are used depends on numerous factors, including age, sex, medical indications, response to treatment, and any adverse effects. Injections should be into the buttocks or outer thigh, never intravenously, and sites should rotate to avoid abscesses. Dosage must remain between 200-1000 mg per month to avert side effects. The treatment duration usually spans 1-2 months.
Storage should be at room temperature and vials checked for coloration and clarity before use, as cloudiness or particles can indicate degradation.
Bodybuilders
Many bodybuilders utilize testosterone suspensions during off-seasons, as their long-lasting effects are counterproductive during peak athletic performance. Though it promotes muscle growth and strength due to its anabolic and androgenic nature, effects may take 3-4 weeks to manifest. Bodybuilders often stack testosterone with other anabolic agents, like GH or thyroxin. However, increased estrogenic activity may lead to breast enlargement and fluid retention, often resolved with diuretics.
To counteract potential breast enlargement, bodybuilders cycle testosterone with agents like Arimidex or Tamoxifen. Typical dosages for muscle gain range from 250-1000 mg per week, with newcomers advised to start with lower doses to mitigate side effects.
The gradual increase in lean body mass occurs alongside heightened red blood cell production, enhancing endurance during strenuous workouts. Testosterone suspensions are favored among bodybuilders, although formulation availability may vary by source. Positive health effects, improved exercise performance, and nitrogen balance are often reported, alongside occasional dramatic water retention.
Side Effects
- Irregular menstrual cycles
- Virilizing effects
- Deepening voice
- Clitoral enlargement
- Gynecomastia
- Painful erections
- Hair loss, acne, oily skin
- Fluid retention
- Nausea, jaundice
- Liver cancer (rare)
- Mood changes: anger, depression
- Increased cholesterol
Most side effects are reversible, but breast enlargement and some virilization may persist. Concurrent estrogen use may not always alleviate virilizing effects.
Women
All testosterone analogues carry risk of virilization in women if used long-term, leading to deepening voice, hirsutism, disrupted cycles, mood changes, and clitoral enlargement. At the first sign of these effects, discontinuation of the drug is advised, as some symptoms may not revert.
Warnings
Those with the following conditions should use testosterone cautiously:
- Breast cancer/hypercalcemia
- Liver dysfunction
- Cardiovascular issues
Rare instances of dry cough and breathing difficulties have been reported post-injection, potentially linked to the carrier oil or contaminants. Regular monitoring of liver function and hematocrit levels is crucial for all users.
Overdose
While rare, overdose symptoms from tesamone can occur. Although they may not present immediate life threats, discomfort persists until the drug clears the system. In such cases, seeking emergency care is recommended.
Continuous users of anabolic steroids should maintain regular health follow-ups to monitor liver enzymes and hematocrit levels.
Legal
Under the Controlled Substances Act, testosterone is classified as a class 3 drug, requiring a doctor’s prescription for legality. Physicians remain cautious in prescribing performance-enhancing steroids.
Detection
Testosterone remains detectable in the body for an extended period. Current testing can reveal its presence or metabolites in urine 3-4 weeks post-discontinuation. Advanced methods can even identify traces in hair up to 2-4 months later. Notably, detection for testosterone suspensions is imperfect; roughly 50% of users may evade detection based on testosterone/epitestosterone ratios.
Cost
Obtaining legal testosterone suspensions poses challenges, pushing many bodybuilders to the black market. Generic formulations are commonly found in Europe and Mexico, with prices ranging from $10-$40 per vial (250 mg). Increased regulation by the DEA has led to a rise in counterfeit products, underscoring the importance of vigilance in purchasing.
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