For the novice, there is no specific drug as called a testosterone suspension. Testosterone is a large molecule and insoluble in water. To make formulation of the testosterone which can be injected, the steroid is often dissolved in a number of oils.
To the lipid solubility of the steroid, one can add a variety of compounds to the side of the molecule which alters it absorption and duration of action. Testosterone formulations come with a variety of side chains such as proportionate, acetate, decanoate, etc. When each of these is mixed in sesame seed oil it is called a suspension.
Esterification of testosterone is done in order to improve the solubility of testosterone in oil, which in turn slows the release of the testosterone from the site at which it enters the body.Suspensions of testosterone can not be taken in orally. There can only be injected intramuscularly. From the injected site the steroid is gradually absorbed slowly into the blood stream.
Some suspensions get absorbed faster than others. In all cases, suspensions of testosterone do not need to be injected on a daily basis. Most of them remain as a depot in the buttock muscles for a few days to a week.Testosterone or tesamone is simply an oily suspension of testosterone. It has the same activity as all testosterone products. It is both an anabolic and an androgenic agent. There are many types of testosterone suspension available in the USA. Of course one needs a physician’s prescription.
Testosterone suspensions are used to treat disorders where there is a deficiency of testosterone synthesis or problems with the release of the Gonadotropins. Testosterone is indicated to treat males with:
- delayed puberty
- women with advanced breast cancer
- promote growth in malnourished individuals
Testosterone is responsible for the normal growth and development of the male sex organs and for the maintenance of the secondary sexual characteristics. The drug can affect the growth of the prostate, testis, seminal vesicles, penis and scrotum and also is important for body growth. Even though testosterone is an androgenic hormone, it does posses anabolic properties. Its use has been shown to promote protein synthesis and a positive nitrogen balance in the presence of a rich calorie diet.
Testosterone also has the ability to cause a mild increase in the production of red blood cells by stimulating the synthesis of EPO from the kidney. This results in an increase in the red blood cells and hence an increase in the oxygen carrying capacity.
When testosterone is taken for prolonged periods, it inhibits the release of Gonadotropins from the pituitary gland through a negative feedback mechanism. At large doses, it can even inhibit spermatogenesis.
All testosterone suspensions are administered as an intramuscular injection and remain in the body for up to 48-72 hours. Testosterone can be detected in the urine for a lot longer period. The esterification of the testosterone increases the duration of action of the testosterone. There are many athletes who complain that injection of testosterone suspensions into the buttock area is painful. This pain may be due to injection of large amounts of the drug or the development of an abscess. It is best to use a low volume of the drug for injection and rotate to the site to prevent abscess formation.
The recommended dose of testosterone suspension for the novice body builder is about 25 mg once a week. There are others who start off at 50-100mg/week. And yet there are others who combine the various testosterone formulations in a cocktail. The duration of testosterone treatment should be limited to 4-6 weeks to allow for the hypothalamic – pituitary axis and testes to recover.
During the washout phase of the drug, many athletes take or Nolvadex (tamoxifen) to prevent the estrogenic side effects of the testosterone.
All vials should be inspected prior to the injection. During storage one may see some fine crystals which should disappear after shaking the vial. If the crystals remain, then the vial should not be used for injection.
Like all testosterone products, use of testosterone suspensions inhibits the synthesis of testosterone in the testes and affects the hypothalamic pituitary axis. For this reason, the testosterone should not be abruptly stopped but tapered off slowly.
The treatment of all individuals with testosterone suspensions depend on age, sex, diagnosis and the response to treatment – and the onset of adverse effects. Testosterone suspensions should always be injected in the buttock muscles and not simply underneath the skin. The injection site should be rotated to prevent abscess formation. Another option is to inject the drug on the outside of the thigh. The drug should never be administered intravenously.
The dose of testosterone suspensions should not exceed more than 200-1000 mg per month because of the onset of side effects. The drug should always be inspected before injection. It is usually a colorless-yellow suspension which is clear. Any particulate matter or clumping indicates that the product is expired or inactive. The duration of treatment varies from 1-2 months.
The drug should be stored at room temperature.
A lot of bodybuilders use testosterone suspensions during the off season. The drug stays in the body for a long time and it is advisable not to use it during the active sports season. The testosterone definitely has anabolic and androgenic properties. However, the effects of the drug are not immediate and may take at least 3-4 weeks to become evident. Many bodybuilders also use other anabolic hormones like GH/thyroxin in combination. Because testosterone is also converted to estrogen in the fatty tissues, many bodybuilders develop breast enlargement and retain water. The dose used to increase muscle mass and strength is about 250- 1000 mg/week. However, at the higher doses the drug has potent side effects and it is highly recommended that all beginners start off with the low dose.
The increase in protein mass is gradual but does occur. Because the steroid also stimulates red blood cell production, many bodybuilders also notice that they have an increased capacity to perform under intense exercise conditions.
Testosterone suspensions are preferred by most bodybuilders but the type of formulation available depends on where and from whom it is bought. The drug has been claimed to promote good health, increase exercise performance and leads to a positive nitrogen balance. There are reports that it also selectively decreases fat and increases muscle mass. Sometimes the water retention can be quite dramatic and some individuals do take a diuretic pill to remove it.
To prevent the breast enlargement, testosterone is cycled with drugs like Arimidex or Tamoxifen. Most individuals take the testosterone for 4-6 weeks and then stop for a few weeks. During this wash out phase, one may use Arimidex.
- irregular menstrual cycles
- virilizing effects
- deepening voice
- clitoral enlargement
- painful penile erections
- hair loss, acne, oily skin
- retention of body water
- nausea, vomiting, jaundice
- liver cancer (rare)
- mental changes – anger, depression, headaches, anxiety,
- increased serum cholesterol
While most of these side effects are reversible, the breast enlargement and some virilizing effects are not. The concomitant use of estrogens to diminish the side effects of virilization is not always helpful.
All testosterone analogues have the potential to cause virilizing effects when the duration of use is prolonged. In females, these virilizing signs may be deepening of voice, excessive hair growth, irregular menstrual cycles, mood alterations and clitoral enlargement. It is recommended that at the first sign of virilizing symptoms the drug should be stopped. The reason for this is that some of the virilizing signs may not be reversible even after discontinuation of the steroid.
The drug should be used very cautiously in individuals with:
- breast cancer and hypercalcemia
- liver dysfunction
- heart problems
There have been isolated reports of individuals developing a dry cough, breathing difficulties after injection with testosterone suspension. This has been linked to the oil based preparation or a contaminant in the formulation.
All individuals who use testosterone should have their liver enzymes and blood hematocrit regularly checked to ensure that they are within normal limits.
It is very rare for anyone to overdose form tesamone. While a large dose can be injected, the drug does not have any acute effects which are life threatening. Of course, one will feel like crap for the next few weeks until the drug disappears from the body. Nevertheless, a visit to the ER is high recommended.
All individuals who do use any type of anabolic steroid should follow up with a health care worker. The liver enzymes and the hematocrit must be followed to ensure that everything is within normal limits.
Testosterone is classified as a class 3 drug under the controlled substance act. The drug is only available with a physician’s prescription. However, most physicians are hesitant in writing scripts for any steroids.
Testosterone suspensions do remain in the body for some time. Current techniques of testing can identify testosterone or its metabolites in the urine at least 3-4 weeks after the drug has been stopped. Infact, the screening has even gone beyond urine testing. If excessive use of the testosterone is suspected, one can even detect traces of the testosterone in the hair 2-4 months after the drug has been stopped.
However, one should know that the testing today for testosterone suspensions is not perfect. About 50% of individuals who take this steroid are missed based on the testosterone/epitestosterone ratios.
The legal testosterone suspensions are quite difficult to get hold off. The majority of bodybuilders get their testosterone from the black market. Generic testosterone formulations made in Europe and Mexico are widely available. The drug is not cheap and a vial of 250 mg can cost anywhere from $10-$40. In the last 2 decades, the increasing control of these drugs by the DEA has led to unscrupulous dealers selling fake or counterfeit products. So in the end, it is always buyer beware.