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Article by Dr. White, Audio by Professor J.K.
The Best Testosterone Cypionate for Hypogonadism Treatment
Testosterone Cypionate is one of the many forms of Bio-Identical Testosterone Replacement Therapy available in the United States and it is considered one of the best. In particular, Testosterone Cypionate is a form of Injectable Testosterone Therapy.
As the majority of Testosterone Injections, Testosterone Cypionate is delivered intramuscularly (IM injections), where it is slowly absorbed by the human body. Can low Testosterone cause anxiety and depression? One of the most important clinical discoveries about low Testosterone replacement is that it can help fight depression and improve mood. Patients who have used this androgen drug have described it as one of the best for alleviating anxiety and depression in low T men.
Among Injectable Testosterone formulations, Testosterone Cypionate remains active for an extensive period of time, making it a popular choice for individuals interested in experiencing the benefits of Injectable Testosterone Treatment.
Other types of Testosterone include Enanthate and Propionate, these have a shorter half-life, which means they stay in the body for a shorter period of time.
Testosterone Cypionate is an Esterized Hormone Therapy, meaning that Bio-Identical Testosterone, which is identical to that made by the human body, is bound to an ester compound (this slows the release in the body).
As long as Testosterone is bound to an ester compound, it won't activate in the human body. The body slowly metabolizes the Testosterone Cypionate, freeing the Testosterone from the ester, where it then acts on Testosterone receptors throughout the body. It's brilliant the way it works.
How Long Does Testosterone Cypionate Work?
A Testosterone Cypionate injection takes around 1 week for the bulk of it to be fully absorbed by the human body. The body experiences maximum concentrations of Testosterone around 48 to 72 hours after the injection is delivered, and the level of active Testosterone slowly falls over the three week period.
Generally, an optimal Hormone Therapy Regimen with Testosterone Cypionate is injected around once per week, this way T levels are stabilized.
Testosterone Injections, including Testosterone Cypionate, are measured largely by their half-life.
It takes around four to twelve days for half of the Testosterone in a single injection to be metabolized. If you injected 300 milligrams of Testosterone Cypionate on day one, four to twelve days later, you would still have 150 milligrams of Testosterone still active in the bloodstream.
There are Testosterone Injections that take longer to be broken down, but Testosterone Cypionate is generally considered to be superior to these longer-acting forms of Testosterone Hormone Therapy.
Partial androgen deficiency (low t) has been shown to cause depression in men and of all the Testosterone therapies for treating low t symptoms available, Cypionate is the most popular and seems to offer the best results.
What Are the Benefits of Testosterone Cypionate?
For patients with Low-T Symptoms, Hypogonadism, and Andropause, Testosterone Cypionate provides a number of highly sought after benefits:
- Improved Bone Mineral Density
- Enhanced Strength
- Improved Body Composition
- Increased Metabolism and Fat Burning Power
- Reduced Fatigue
- Improved Cardiovascular Health
- Increased Sex Drive
- Improved Erectile Function
- Reduced Feelings of Depression
- Reduced Feelings of Anxiety
- Improved Immune Health
Testosterone is a necessary hormone for both men and women. It promotes normal sexual development in males and, along with Human Growth Hormone release, is responsible for male puberty. Throughout the lifespan, Testosterone acts as an important anabolism force, promoting physiological, psychological, and sexual health.
Its decline can cause anxiety, depression, and moodiness in men. Make an appointment with us, we can talk with you about your low T symptoms and discuss treatment options with Testosterone replacement therapy (TRT) for treating hypogonadism and andropause.
Low Testosterone has shown to cause insomnia in men, and a lack of sleep can lead to a whole slew of psychological disorders.
All forms of Testosterone, including Testosterone Cypionate, work via two mechanisms:
They promote the production of other related hormones, and they activate areas known as Androgen Receptors, which are responsible for many of the anabolic effects of the hormone. Many of these Androgen Receptors can be activated by a Testosterone relative known as Dihydrotestosterone or DHT.
How Does Testosterone Cypionate Increase Muscle Mass?
First, Testosterone Improves Muscle Tone, Size, and Strength through the combination of a few related anabolic mechanisms. For example, Testosterone improves the ability of muscle fibers to retain nitrogen, which naturally speeds up the rate at which muscle tissue is generated.
Second, Testosterone promotes increased the ability of Red Blood Cells to transport oxygen through the body efficiently, which increases the energy available to the muscles, increasing capacity for anaerobic and cardiovascular activity while improving the gains associated with such activities.
Third, Testosterone enhances the production of Insulin-Like Growth Factor-1, a metabolite of Human Growth Hormone which improves cellular metabolism and muscle rehabilitation.
Fourth, Testosterone Cypionate increases Muscle Mass by suppressing the activity of catabolic hormones such as Cortisol which cause the body to build muscle less effectively when present at elevated levels.
What Are Issues Related to the Use of Testosterone Cypionate?
For patients with Testosterone Deficiency, Testosterone Cypionate injections have a very good safety profile, but there are some considerations that must be taken into account. For example, when Testosterone Levels increase in the body, a portion of that Testosterone is converted into other hormones, including DHT and Estrogen.
Estrogen is a hormone that is necessary for male health in small concentrations, but Testosterone Therapy can sometimes elevate these Estrogen Levels. Fortunately, there are treatments available, such as Estrogen Inhibitors like Arimidex (Anastrozole).
Elevated Estrogen Levels are most notable for contributing to Gynecomastia, a condition in which breast tissue grows as a result of increased Estrogen Concentrations. It can also lead to edema and bloating. Abnormally high Estrogen Levels also counteract the cardiovascular benefits of Testosterone Therapy.
DHT is responsible for some of the lesser symptoms of Testosterone Treatment, such as acne, oily skin, and male pattern baldness.
Testosterone Cypionate Reduces Fertility and Suppresses the Body's Own Testosterone Production
Like other forms of Bio-Identical Low-T Therapy, Testosterone Cypionate will suppress the normal production of Testosterone.
This is because introducing exogenous Testosterone of any kind will increase the levels of circulating Estrogen, which is the body's mechanism to tell the Hypothalamus to reduce signaling for Testosterone.
The reduced production of natural Testosterone associated with Low-T Therapy with Testosterone Cypionate and other forms of Testosterone does not lead to any significant issues which impact health, but it does impact reproductive function.
In addition to reducing the normal production of Testosterone, it also limits the production of a precursor hormone which stimulates healthy sperm production, known as Follicle Stimulating Hormone. This impacts the aesthetic appearance of the testes.
Sperm is stored in the testes, and if the body isn't producing sperm, then the testicles will shrink and draw up, in a state of dormancy.
Luckily, this is temporary, and the body will slowly recover if and when Testosterone Therapy is suspended.
Often, Testosterone is combined with Human Chorionic Gonadotropin (HCG) or Estrogen blockers, in order to sustain the normal health and function of the testes while providing all the benefits of Testosterone Therapy alone.
As was mentioned earlier, injectable Testosterone increases the size and density of Red Blood Cells in the bloodstream. This does provide benefits, but if RBC Counts get too high, this increases the risks associated with conditions related to hypertension, heart disease, stroke, and heart attack.
Luckily, a simple test can provide the patient with a clear picture of their RBC count. Also, this side-effect can be entirely mitigated by regularly donating blood.
Testosterone Cypionate with Arimadex (Anastrozole)
Because increased Estrogen Levels are a potential issue with injectable Testosterone Cypionate Therapy, it is highly beneficial to combine the treatment with Arimidex or other Estrogen Inhibitors.
Most Estrogen Inhibitors are taken orally and are available in generic form, which means that they are highly affordable, enhance the benefits of Testosterone Therapy, and are easy to take.
Among all forms of Injectable Testosterone, Testosterone Cypionate is by far the most popular form in the United States. This is because it is both an affordable form of Testosterone, and also because it is such a long-acting formation.
Although Testosterone Cypionate is the most prescribed Testosterone Injection Therapy in America, it is very rarely used in other parts of the world. Globally, Testosterone Enanthate, a similar Testosterone Ester compound, is most widely prescribed and used.
Clinical Testosterone Cypionate Data
Testosterone Cypionate shots are a very potent form of Hormone Replacement Therapy, and should only be used with a prescription from a licensed and board-certified medical specialist.
Clinical study shows that Testosterone Therapy is directly associated with both increases in muscle mass and strength as well as a reduction in body fat.
The level of ambient anabolic growth is directly associated with the dosage of Testosterone Cypionate administered. The more Testosterone is taken, the bigger the anabolic effects.
Of course, there are limits to the responsible use of Testosterone. The more Testosterone that a patient takes, the more likely that he will experience Testosterone Side-Effects and symptoms of abuse.
For Testosterone Therapy, a dose of Testosterone Cypionate is prescribed with the end goal of bringing Free Testosterone Levels in the bloodstream back to a concentration considered normal for a healthy man in his early to mid-20s.
For women, Testosterone Cypionate is prescribed in much lower concentrations, because women have a significantly lower need for Testosterone. For women, Testosterone Cypionate is generally prescribed either as a treatment to alleviate menopause, or as a treatment to restore sexual function and libido.
Testosterone Cypionate vs. Testosterone Enanthate
Most research indicates that there is very little difference between Injectable Testosterone Cypionate and its close relative Testosterone Enanthate.
Among bodybuilding enthusiasts, there have been rumors that Testosterone Enanthate provides a more immediate burst of benefits, but most controlled research indicates that this is likely the result of a placebo effect.
Testosterone Cypionate stays in the system for 24 days, and Testosterone Enanthate stays in the system for 22 days. That means that the difference in half-life between the two is a single day. Preference is based primarily upon availability.
Advantages of Testosterone Cypionate vs. Other Testosterone Injections
Injectable Testosterone Cypionate is widely popular in the United States among Hormone Specialists and users because it only requires a weekly injection and provides reliable benefits for patients suffering from Testosterone Deficiency (and men looking for a way to increase their muscle mass under the table).
What to Expect on Testosterone Cypionate
It's important to understand that Testosterone Cypionate does not lead to immediate changes. The changes are cumulative. In order to experience the full benefits of Testosterone, you'll have to stay on the therapy for a number of months.
The type of results that you get from your treatment will also depend upon how you adjust your lifestyle while using the therapy. For example, if you are interested in restoring and increasing muscle mass, you should combine the Testosterone Cypionate Therapy with weight training.
On the other hand, if you are interested in just increasing tone and improving body composition, it would be in your best interest to adopt a healthy diet and engage in an exercise routine based primarily on cardiovascular activity.
If you are overweight, the diet and exercise regimen, combined with the natural anabolic effects of Testosterone Cypionate Therapy will lead directly to significant weight loss.
Testosterone Cypionate Dosage
Clinical research has shown that the most potent anabolic benefits of Testosterone Cypionate Therapy are achieved at a dose of around 400 milligrams per week (broken up into two or more shots). Though this dosage is very high and should never be conducted without physician supervision.
Men that take this level of Testosterone Cypionate display a number of significant benefits including increased muscle strength and tone, as well as reduced fat and improved cholesterol balance. A five-month regimen of Bio-Identical Treatment at this concentration improves muscle mass by around fifteen percent on average.
The key to ensuring correct Testosterone treatment protocol is blood testing to make sure one's hormone levels are balanced and not too high. Regular blood testing to check Testosterone levels is crucial.
Because of Testosterone's use as a performance-enhancing drug, there is a lot of evidence out there regarding the effects and potential benefits of Testosterone at various doses.
The general consensus is that a dose of 750-1000 milligrams per week is the maximum dose to provide solid benefits with the highest medically acceptable risk of side-effects, though most doctors only prescribe 200mg per week.
High doses of testosterone can lead to a number of side effects, risks, and dangers, which is why normal optimal doses of 1cc of 200mg testosterone are generally injected once per week, with estrogen blockers (aromatase inhibitors like Arimidex) and HCG injections protect against testicular atrophy.
Athletes and Bodybuilders have a history of using Testosterone as a steroid, using some 2,000 milligrams per week or more (very dangerous high dose, 10x too high), but this greatly increases the risk of side-effects associated with the treatment. Doses of 500mg or more are generally only used by individuals for bodybuilding or athletic training.
Our clinic does not prescribe testosterone for bodybuilders, Olympic athletes or professional sportsmen. For purposes of Testosterone Replacement Therapy, the general Testosterone Cypionate dosage is a bit lower, around 200 milligrams of the treatment every week to ten days.
Testosterone Cypionate Cycling
Testosterone Cypionate, as with other forms of Testosterone Therapy, is delivered via a pattern known as cycling. This means that patients take the treatment for a specific period of time, takes a short break, and comes back to therapy.
After suspending therapy, the patient is often provided with a treatment like Clomiphene Citrate or HCG to stimulate the natural production of Testosterone, helping the body recover from the consecutive weeks and months of active Low-T Treatment, and extending the length of time needed until therapy resumes.
A single cycle of Testosterone Therapy for Andropause lasts between four and six months. Shorter than four months, and the benefits have not had the opportunity to sufficiently accumulate, especially if it is the patient's first time using Testosterone.
Because Testosterone Cypionate stays in one's system for around three weeks, post-cycle Therapy is generally prescribed 21 days after the Testosterone Treatment is suspended.
Testosterone Cypionate Precautions
Some individuals may be allergic to certain formulations of Testosterone. This can either be the result of the concentration of Testosterone administered at once, or because of sensitivities to other ingredients, such as the cottonseed oil or sesame oil suspension used to deliver the medication.
Men that have Reproductive Cancers including Prostate and Testicular Cancer should not use Testosterone Cypionate, because Testosterone Hormone Therapy can exacerbate cancer.
Patients with the following issues should use caution with Testosterone Cypionate or other forms of Testosterone Therapy:
- Diabetes
- Sleep Apnea
- Enlarged Prostate
- Hypertension
- Poor Cholesterol Levels
- Renal/Liver Issues
- Cardiovascular Disease
Patients with Diabetes can take Testosterone, but Testosterone does interact with Insulin/Glucose Levels.
It is imperative that patients with Diabetes keep close track of their Glucose Levels while they take Testosterone. Symptoms such as sweating, nausea, and hunger are signs that the therapy is interacting with treatment.
Testosterone should never be used by women that are pregnant or may become pregnant. In order to reduce the risk of pregnancy, multiple birth control methods should be used for the duration of treatment.
Testosterone should not be used during breastfeeding, because it is unclear how Testosterone interacts with breast milk.
How to Administer a Testosterone Cypionate Injection
Testosterone Cypionate, because of the large dose administered at once, is delivered intramuscularly to one of the larger muscles of the body, most commonly into the gluteal muscle.
Although the medication is generally administered once every week to ten days for Testosterone Hormone Therapy, your physician may choose to prescribe an injection once per week to once per month depending upon your needs.
Testosterone Cypionate can be administered by a physician, but many patients choose to self-administer the medication or train a loved one to do so.
If you choose to do so, follow all instructions from your physician regarding proper administration and storage procedures. Testosterone Therapy must be kept under refrigeration and used before the treatment goes out of date.
Never quit using Testosterone cold turkey. If you stop taking Testosterone Cypionate without going through Post-Cycle Therapy as prescribed by your physician, you will often experience side-effects resulting from the rapid change in Testosterone Levels, including depression, weakness, and exhaustion. Your physician may also choose to let you off of Testosterone slowly by adjusting your dose downward over the course of a month or more.
Testosterone Cypionate Interactions
As with any medication, Testosterone Cypionate can alter the effects of other medications, and your physician should be aware of any medications that you are taking when you initiate therapy.
For example, the increase in Red Blood Cells associated with Testosterone Cypionate can counteract the benefits of blood-thinning medications.
Also, combining Testosterone Cypionate with Corticosteroids can lead to issues with fluid retention and congestive heart failure. You may also need to adjust your dosage of diabetes medication while taking Testosterone, because of how Testosterone alters metabolism.
Are you experiencing Low T Symptoms, make an appointment with us so we can discuss treatment options.
Your's in Hormonal health
Dr. White
Testosterone References:
- Anatomia, Histologia, Embryologia. 2003 Apr; Volume 32 Issue 2:70-79
- Journal of Clinical Endocrinology and Metabolism. 1997 Feb; Volume 82 Issue 2: 407-413
- Heart. 2004 Aug; Volume 90 Issue 8: 871-876
- Testosterone Cypionate Intramuscular: http://www.webmd.com/drugs/2/drug-5185/testosterone-cypionate-im/details
Depression Resources:
Depression Health Center at WebMD
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