Injectable Testosterone

Long-acting injectable testosterone is suspended in oil and injected into muscle, where the ester releases gradually into circulation over the days that follow. Because it enters through the bloodstream rather than the gut, it bypasses first-pass liver metabolism — and the slow release smooths out the peak-and-trough swings you’d get from shorter-acting protocols.

One to two intramuscular injections per week, on the same day(s) each week, into the gluteal muscle — rotating between sides so a single site doesn’t get repeatedly stressed. Most men self-administer at home after a single training session with our health team. Dr. Salim’s protocol sets your exact dose, frequency, and rotation pattern based on your bloodwork.

Levels rise within the first day or two after an injection and stabilize across the first few weeks. Most men notice subtle shifts in energy, mood, and libido early on, while the fuller effect on body composition, recovery, and bone density builds gradually as your levels settle into range — typically over two to three months of consistent dosing.

The most common are mild soreness or bruising at the injection site, acne or oily skin, fluid retention, and shifts in libido or mood. Injectable testosterone can also raise hematocrit and hemoglobin (the red-blood-cell measures) and can move PSA — which is why ongoing bloodwork is part of the protocol, not an afterthought. The one most men ask about is hair loss: testosterone converts to DHT, and in men with a male-pattern predisposition, more DHT can accelerate thinning. It doesn’t cause hair loss in men who weren’t already going to lose hair, but it can speed up what was already on the cards. If thinning is a concern, our specialist can pair your protocol with hair-loss medication — oral or topical — that targets DHT directly.

The needles used for intramuscular gluteal injection are small, and most men describe the sensation as a brief pinch followed by mild pressure — not the sharp pain people picture. Our health team walks you through your first injection step by step: drawing the dose, sterilizing the site, the angle, the rotation pattern, and what to do if you hit a tender spot. After one session, almost everyone is comfortable doing it themselves at home.

Yes. Because injectable testosterone enters the bloodstream directly through the muscle, it bypasses first-pass liver metabolism — the same reason it’s dosed as an injection rather than a pill. The hepatotoxicity risk associated with some older oral testosterone formulations isn’t seen with intramuscular delivery. Liver enzymes are still tracked as part of routine bloodwork.

Yes. Like any form of TRT, injectable testosterone signals your body to slow its own testosterone production, which can reduce sperm output and other fertility markers over time. If preserving fertility matters to you now or later, tell our health team during your assessment — there are fertility-sparing alternatives, and adjuncts that can be paired with TRT, that support your body’s own production instead of fully replacing it.

Yes. Bloodwork confirms eligibility, sets your starting dose, and lets our specialist monitor your markers over time. You can run the panel at any local lab — LifeLabs, APL, Dynacare, or your hospital lab all work. The markers that matter for injectable testosterone are Total Testosterone, SHBG (or Free Testosterone), LH, PSA, and Hematocrit. If you’ve had recent bloodwork, share it during your assessment as context — but our panel includes proprietary markers Dr. Salim needs before prescribing, so you’ll still complete the Gambit bloodwork.