There was recently a post on our
forum/ email discussion group, OzGuys, where
a member was refused assistance with their
regular Sustanon
injection. The doctor refused to assist him,
and made some statements about Sustanon being
synthetic and therefore harmful.
The same doctor also said testosterone gel
was made from all natural products and therefore
better.
I want to clear up a few points about how the
shots that most of us are on actually work. I am
not a medic, but I am a research chemist.
The following explanation is my best effort
at explaining to someone who hasn’t studied
any science.
The gel contains free testosterone
(“Free” testosterone is simply
testosterone that isn’t bound to anything.
Most of the testosterone in our bodies is bound
to a protein called Sex Hormone Binding
Globulin or SHBG if you see it on your
bloodwork).
The injections contain testosterone esters,
which are a simple derivative of testosterone,
explained below. Sustanon250 contains 30 mg
testosterone propionate, 60 mg
testosterone isocaproate, 60 mg
testosterone phenylpropionate and 100 mg
testosterone decanoate. There is a total
of 176 mg free testosterone in each ml (the
other 74 mg are the ‘ester bits’).
As testosterone is not easily soluble in oil,
they make an ester of it by tacking on (to the
OH bit at the top of the picture above) some
carbon chains (propionate = tiny, isocaproate =
small, phenylpropionate = medium, decanoate =
large – you can look up the structures of
these on the patient information sheet that
comes in the box, all that’s important
though is the size) that increase the oil
solubility of testosterone.
This works because oils are basically long
carbon chains and “like dissolves
like”. The esters aren’t all that
stable and once injected, they hydrolyse (the
tacked on bit falls off), once this happens the
free testosterone is no longer soluble in oil
(but is soluble in water) and thus migrates to
where water is - which happens to be your
bloodstream - this is a good thing. The smaller
the tacked on bit is, the faster it hydrolyses
(breaks down in water).
Propionate takes around 3-4 days to do this,
isocaproate takes about 6 days, phenylpropionate
takes 9-10 days and decanoate takes around
fourteen days. The longer the time, the more
spread out the peak from that particular ester
is.
Overall, what happens looks roughly like the
following graph:
So at four days after an injection, your
total testosterone (T) level is made up of
mainly T-propionate, but a little bit of
T-isocaproate. At seven days, the T-propionate
has pretty much gone, your T level is made up of
mostly T-isocaproate but a fair bit of
T-phenylpropionate and a tiny bit of
T-decanoate. At twelve days nearly all the
T-isocaproate has hydrolysed and your T level is
mainly made up of T-phenylpropionate and
T-decanoate. After about two weeks, T-decanoate
is all that is left.
The ester bits and the oil are simply
disposed of by your body.
Testosterone in the injections is modified
(i.e., the modification is undone in your body),
whereas the gel contains free testosterone,
could be taken to mean that the gel is
“more natural” but then the absorption
enhancers in the gel certainly aren’t
natural. Remember testosterone is poorly soluble
in fat/oil? The absorption enhancers present in
gel work by creating channels between fat cells
for the testosterone to “burrow
through” - not a very efficient process,
which is why a 5mg patch actually contains 10x
that. The absorption enhancers (the simplest one
is ethanol – which is the alcohol in
drinks) are also the main culprits in skin
irritation.
The idea of taking one thing (in this case
testosterone ester) into the body, when the
actual drug is something else (in this case
testosterone) is not new. Many drugs are
converted to their active form once in they are
put into the body. The stuff you take is called
a pro-drug. Once the pro-drug is converted to
its active form, it is a drug. For example, the
well known cancer treatment cisplatin is a
pro-drug.
The “more natural” mentality is
pseudoscience, whether it is applied to
pharmaceuticals or food. There are many forms of
testosterone in your body. So ask yourself, is
the protein bound hormone less natural than the
free form? (both are naturally present).
All that matters for your body, is that
adequate androgenisation (masculinising) is
occurring, and that all other parameters
(cholesterol etc) are in order. Of course,
regardless of where you are in transition,
it’s a good idea to get your GP to check
your cholesterol every six months or so.
Another point the guy on the email discussion
group was told by the medic was because Sustanon
is synthetic, it destroys the natural
testosterone that the body produces. This is
mixing correct and incorrect science together
(pseudoscience).
Firstly a chemical (be it a food additive or
a drug or something else) is the same chemical,
regardless of whether it was isolated from a
natural source (a plant or an animal) or whether
it was manufactured by chemists. Both the
testosterone in the gel and the testosterone in
the injections are manufactured the same way.
The T in the injections has one extra step
(taking on the ester bits) which is undone in
your body.
It is true, that taking large amounts of
exogenous (from outside the body) hormones will
decrease natural hormone production, but not
because they are synthetic.
When testosterone abusers (for example,
bodybuilders who often take in excess of
1000mg/week!) they have problems (with
ejaculation etc) because their natural
testosterone production has decreased. In the
same way, a few months worth of T shots provides
feedback to your brain and gonads (ovaries)
telling them to stop female hormone
production.
Any natural male hormone production is also
altered. Remember that you are overriding your
body’s natural homeostasis (the body
regulates itself such that everything is is
equilibrium). After a shot, the body has stacks
of T – so it doesn’t need to make any
more. Remember though, you don’t have much
natural T production to start with!
A bodybuilder who is abusing testosterone,
will lose much of their ability to produce
testosterone, simply because they are feeding
their body so much of the stuff that their body
says, “Oh hey! I’ve got loads and
loads of testosterone, I’d better not make
any more” and once they stop taking
testosterone their body takes some time to
realise it doesn’t have huge amounts of T
floating around and that it needs to wake up the
machinery that normally makes T, sometimes
permanent damage is done.
In our case, like that of an androgen
deficient natal-male, we are simply making up
for a lack of natural testosterone. True, the
small amounts of T that we did produce prior to
seeking treatment are probably not being
produced any more, but the injections more than
make up for that.
If you have other questions about
testosterone, please send them in and I’ll
do my best to find answers for you and publish
them in this newsletter and on the website. Your
GP should also be able to find answers for
you.
Your GP is an invaluable guide through this
process and another source of information. A
guide on what to look for in a GP is at our
website <http://www.ftmaustralia.org/library/06/drmann.html>
