Reddit AMA Podcast #2, Ask the Professionals

Our next Reddit AMA podcast video, multiple questions pulled from an AMA thread. Individual questions found on our channel's AMA playlist:

https://www.youtube.com/channel/UCiJwNOkWD0OUuTPT6Q5nSgg

Reddit AMA #2 Thread: https://www.reddit.com/r/trt/comments/10dxspj/ama_ask_professionals_alphamd_2/

This editable transcript was computer generated and might contain errors. People can also change the text after it was created.

Garrett Soames: We're gonna do some answers for the AMA which was posted on Reddit. So we're excited to kind of get to it and just you know, respond to people and hopefully you know help guide people as best we can from afar. So Brian. Yeah, if you want to go ahead and maybe just get started and and yeah,…

Brian Mckinley: Yeah. Yeah. So we got,…

Garrett Soames: read it off.

Brian Mckinley: I think we're gonna cover like three topics today. We're gonna talk a little bit about about TRT in the heart, we're gonna look at a gentleman who had kind of a lot of medical desires going on, talk a little bit about hCG and TRT for him and then they run to a wrap up a little bit of finasteride, prone, to baldness type of stuff. So yeah, the first dude that we got is gonna be talking about. I think it was something about his heart rate has been going up and ever since he started TRT for a couple of months, see if that's related. What do you think about essentially like a faster heart rate and starting TRT? Could those two things be related or you know, is resting heart rate, it says it's gone up. What do you think?

Garrett Soames: Sure. Yeah, so I guess No-toe 4083 specifically asked our extra systole something to be concerned about when having started TRT. He says, first, he goes off to say he's always had them. but now they're more common and noticeable, particularly when he lays down at night, So that last bit actually is a little bit of a clue as to medically speaking as to what might be causing these extra systallies for for the uninitiated. That's an extra heartbeat like b b b. So it's just a kind of a random extra beat out of there and they can become, you know, more or less frequent based on a lot of things. But to specifically answer, the question, is this related to the TRT? and I'm gonna,

Garrett Soames:  To make it short and sweet in all likelihood know. There's a very low likelihood that these extra beats are from TRT. And TRT itself, does not ever directly affect the heart rate at all. Testosterone does not cause any issues with electrolyte abnormalities potassium, you know, sodium calcium, you know, and in the case of, you know, palpitations magnesium sometimes can trigger that. But testosterone does not in any way, affect any electrolytes, so that being the most common cause, you know, For something like an extra systole or something concerning. I should say, I would say, no testosterone doesn't cause it. in your question, you mentioned specifically that

Garrett Soames:  when you lay down at night, they seem to be more prominent. Now, if if TRT is in any way, affecting your heart rate, it would have more to do with your blood. And your blood volume so TRT is known to. I mean, it's a widely known fact that increases, you know, bone marrow production. So you're gonna produce more blood, both red and white blood cells. So the volume of your blood becomes, you know, just a little more viscous, it's a little thicker, your your hemoglobin and hematocrit go up. This is a known side effect. To some men that actually need to get. Therapeutic phlebotomy, they need to, you know, donate blood. This is a known fact.

Garrett Soames:  Yeah, so I'm Donate on the regular about every eight weeks, you know, Brian's. And the reason we do that is, you know, again the Blood becomes thicker. So if you got this much volume of blood, and it's filled with basically plasma, which might as well be water, right? And then cell phone around, The the more cells you fill it up with it's like you know making it thicker more syrupy. now, you know, he trkey, that can make it go up, you know, not a significant amount but enough that it can cause, you know, bother some symptoms and some men So your heart is the pump of your blood. So yes, when you lay down, you're no longer fighting gravity up, you know, to get blood up into your head. You know, and out into your extremities when you lay down.

Garrett Soames: All that blood. Now, your heart is just pumping with gravity or I should say no longer against gravity. So The venous return, the blood coming back. To the heart is higher, so your heart, works more, your heart may be. Long story short, your heart made me pushing a thicker fluid. Oh, because you start TRT and,…

00:05:00

Brian Mckinley: Yeah.

Garrett Soames: you know, your heart's like any muscle, sometimes it, you know what, you know. So, if it's pushing against a little bit more viscous fluid because you're, you know, your hemoglobin levels gone up your credits gone up. when, you know,

Brian Mckinley: Yeah, do you think I really have been elevated for him though? Because he said, It's only been on it for for two months. I don't even think that would affected by…

Garrett Soames: It. It would be rare.

Brian Mckinley: then would

Garrett Soames: I personally though, I mean, I my blood count went up within about two to three months. So

Brian Mckinley:  Okay, okay.

Garrett Soames: And I, you know, I should make it clear. Most most people on TRT don't actually have this as a side effect. It is just like you.

Brian Mckinley:  Yeah, that's rare for us.

Garrett Soames: Yeah. So you know we mentioned at a fair amount but it's not. To be honest, I don't know that the percentage of people on it, they get now than have to, you know, do blood, you know, blood donations. But I would say it's probably about eight percent five percent. And so, first thing I would tell you no toe, 4083 is to Maybe. Yeah, get your CBC drawing again and see if you're mad, if it's going up. And then I'll mention the others thing that I thought about that might be the potential testosterone related. issue for why that these palpitations more, make or more frequently when you lay flat

Garrett Soames:  and this is less likely having just started it two months ago. But again, as you get bigger, you know, much more muscular you increase the weight on your chest, right? Or I should say the way to your muscle, it's thicker. And so, Push down. When you lay flat, you're now, when you breathe in and breathe out. You know, you're essentially, when you breathe in, you're pushing against a heavier weight, it's thicker chest, so, In two months time, that wouldn't be a big issue. But in, you know, if you put on a You know bigger bodybuilders with big huge chests. Actually can develop a Syndrome called pickwickian syndrome. Which literally means too heavy to breathe.

Brian Mckinley: Really, that's kind of crazy.

Garrett Soames: Not. Yeah. So, you know, those guys, I mean it's more often seen in women pretty, I mean, obese women, you know, with large, large breasts. Imagine, you know, if you were to lay down on your back and then I put 30 pounds on your chest. Yeah. This and…

Brian Mckinley: Yeah. Yeah, I'd be a lot.

Garrett Soames: so as you exhale especially when you sleep it that extra 30 pounds pushes down further and in a sense it's almost like giving you a little bit of a chest compression because of the extra weight as you exhale against and…

Brian Mckinley:  Yeah.

Garrett Soames: it kind of bounces and that can actually Again, it's a it's it's pickwickian. Syndrome, unfortunately is extremely common these days because of obesity So I would just say If you're already a big dude, no tow 40 83, you know, if you're maybe already away overweight or over obese. And in two months time, you know, you could have had maybe a little water retention and maybe you working out hard. You grew some

Garrett Soames:  you know, or at least you're retaining more water in your, in, your pecs, that could be a possibility to

Brian Mckinley: Yeah. So it doesn't sound like the TRT itself. Maybe it's just some of the side effects or, you know, just kind of what happened in with age there too, you know.

Garrett Soames: Yeah, yeah. And then, you know, I mean, you're 49, dude. No, no offense, but you're gonna have More frequent, you know, at the regular beats.

Brian Mckinley: Issues.

Garrett Soames: And that's, that's fine. That's normal. They can be distressing. I, you know, I get them every once in a while just like, Look, what is that? Oh, you know, you actually feel it sometimes and it's weird.

Brian Mckinley:  Yeah, I've got a couple of those that before and they always freak me out.

Garrett Soames: yeah, but it's nothing to worry about Yeah, so I'm gonna say no, you know, we're very unlikely.

Brian Mckinley:  Yeah.

Garrett Soames: yeah, especially two months in

Brian Mckinley:  Oh, we hope it feels better. And you know, let us, let us know. You're only two months in. You feel free to send us a message at some point. If, if something else is going on, or you just have another question related, we don't definitely don't mind

Brian Mckinley: Uh, yeah, we got a see. Our next guy is gonna be this denito, 5, 4 5, and so, there's a lot of text kind of from him. He has his own thread kind of going on. He's gotten hormone panels recently, So, I'm gonna do a little bit of a little bit of summarizing here. Essentially, he's looking at, I have some symptoms. Should I be on TRT? Some people are telling them. No. Some people are telling them. Yes, he's talking about potentially using hCG. Some people are telling him. No. And yes. And so his main symptoms when we ask them essentially like

00:10:00

Brian Mckinley:  You know, why are you looking at this? Why do you want to start this? Because he he's younger. I believe in his other thread. He mentions he's like, 21 or 24, or something like that. But his main things is that, he's always felt relatively behind behind his peers. I'm guessing and he says he's had like some gyno or man boobs, since he was in Grade 9 to 10. You know, he's done weight training, he's been eating better, but the kind of stayed and so, you know, we don't know for sure if that's real Gino, where it's like actual breast tissue growth, or if it's just, hey, you're overweight. You have a bigger chest, which is something I dealt with before. And so what he wants is to.

Brian Mckinley:  Improve muscle synthesis, some strength and improve some nagging pains especially in in a non-joint areas a increase overall energy desire for effort and focus and said he might have ADHD. And so yeah we were asking like Why do you want to do hCG and those are his reasons, right? And so we're going to talk about like I look at that I'm like okay. So For everyone there. What is hCG do, right? So that's that's a human chorionic gonadotropin, right? And essentially, what that does is it treats infertility one, right? It treats hypogonadism which is you know, smaller testes. If that is a problem and it essentially promotes natural testosterone production by treating

Brian Mckinley:  your testes. And so the only one thing out of those two things or those three things, he's got the infertility, the testy size and the testosterone. Well, The only thing out of all those that would treat those symptoms would be the increased testosterone production, right? So, if you're looking to improve those symptoms and you're doing hCG, you're only doing hCG for the testosterone. It sounds like you might benefit from a more direct measure of. Hey, you're just taking it for the testosterone. Testosterone Treatment. So TRT sounds like it might be what you're looking for versus the hCG because unless you're trying to get someone pregnant and you're having issues.

Brian Mckinley:  It just kind of seems like you're adding an extra step at least that's my general. Take on hCG versus TRT like, you might as well go with a more controlled route be more direct like. Okay, I can math out exactly what I need. I can adjust my dose a little bit easier because, you know, TRT is very straightforward milligrams per week. Equals how much test you're going to get to a variable. So you know, the tour four to six times. They're very predictable. So he's young, he may not need these things. I know that when I was young I just have to keep trying different diets in different workouts, but he also might

Brian Mckinley:  So Garrett, if you maybe want to take a look at some of his, his hormone panel results, or maybe share your thoughts on it, because, you know, he seems very he wants something is my take like, he wants to do something about it, but maybe I don't know is trt for him based on the hormone panels that he posted in that other thread. Maybe, you know, is your opinion, the same as my opinion of like TRT or, you know, give me maybe give me some of your thoughts on the more science portion of it.

Garrett Soames: Sure. So yeah hCG again it's a LH or luteinizing hormone analog The word analog again, implies that attaches to the same receptors. but is not actually, you know, a mimic of LH, so There was some thought that, you know, hCG would actually, suppress natural, LH production, you know, surprisingly, it doesn't this hCG actually. His primarily been used as a medication for fertility treatment and women. So it's, it's always used 100% time off label in men. This year where but the tests and women have shown no LH suppression by using HCG.

Garrett Soames: So LH the hormone. And hCG. essentially again, the analog They attach specifically to lay dig cells in the testicles. So there's two main types of cells. There's a lady and saratolli cells lady cells, only function is testosterone production. And the sir totally sells only function is produced production of sperm. So, those are our two functions, right? So if if you have a failing test, testicle testicular production of testosterone, hCG will ramp that up. And you can use it long term. You can use it forever because it doesn't suppress anything else. There's nothing it's suppresses.

00:15:00

Garrett Soames:  Which is kind of cool. That's one of the few things out there that doesn't cause you know, a lot of feedback loops on on different endocrine glands, but ultimately the way it increases fertility. even though it doesn't affect the serotoli cells for sperm, It increases your natural production of testosterone from the testes themselves, so which means you're intra testicular testosterone level the testosterone within the testicles itself. goes up, which is essentially, like adding It's like An accelerator, you know, on, on the testicles to produce more sperm. So each, that's why we use hCG in men for fertility issues, is it really? It increases your intratisticular testosterone? And the most interesting thing about all of this to me, is again, if you do a testosterone injections,

Garrett Soames:  all that testosterone goes all throughout your body, but the only place, it doesn't can't penetrate. But we literally can't penetrate into the testicles. So you're intratisticular testosterone, which is needed for sperm production drops. When you use exondenous, testosterone, but, you can take hCG while on TRT to keep up that intro to secure testosterone and keep, you know, at least some sperm production going. but if your goal is to completely forgo testosterone, Then technically there's no harm in using hCG long term. And but the only people who would ever choose the more expensive option. Which is less effective than testosterone injections as far as increasing testosterone levels.

Garrett Soames:  The only people who would ever choose that are people who are like literally actively right now today trying to get their their female spouse pregnant. so,

Garrett Soames:  If your goal you can maintain fertility by doing bursts of hCG, you can take Clomid, you can take other things. Typically, you don't need those long-term, but if hCG were five bucks, I'd say, Yeah. Go for it. The HCG is not cheap. It just it isn't. It's not oh,

Brian Mckinley: Yeah, even from us, even from our compounding, pharmacies testosterone is significantly. Cheaper compared to HCG.

Garrett Soames:  Yeah, yeah. So you know, I would say to this guy Sure. Go that route if you want, but if your goal if, if you're you'll increase some testosterone, you may feel better if you have hypogonatal symptoms,

Garrett Soames:  But you definitely won't feel as good as you would. You know, at least physically speaking, you wouldn't get the same physique benefits or any of the other benefits of higher testosterone levels. um, as you would with testosterone and your levels wouldn't get nowhere, near what you can get, you know, because you're basically squeezing the testicles like work harder, And you know, so you may increase your production by 50%. But if you're already at 250 350 You know, it isn't really gonna change things.

Garrett Soames: So yeah, that's that's my that's on that,…

Brian Mckinley:  Yeah.

Garrett Soames: you know?

Brian Mckinley:  And that's, that's true too because, you know, Looking at his other thread where he had the hormones, he was at about 350 free testosterone.

Garrett Soames: Yeah, so if that was before hCG, you know, if you add 50% to that, you know, what is that? I'm not great at math. So I'd be like, 500, something 520, You…

Brian Mckinley:  Yeah.

Garrett Soames: not. Not bad, you know, but You do a cheap and…

Brian Mckinley:  But you can do it cheaper and better.

Garrett Soames: you we get you to 1,000, You…

Brian Mckinley:  You know.

Garrett Soames: your level could be a thousand and you'd have twice the physique benefits twice. Those, you know benefits, but again, you know that, that's what's so interesting about all this is, you know, a lot of these online clinics are just cookie cutters. It's like Here's your plan. We don't care here, Here's your dose whatever, but there's so much individual. You know. Variance with all of this, that we have to treat each person individually. So, if someone came to us and they were like, I just want to do hCG monotherapy and this is why and, you know, if it made sense sure but

Brian Mckinley: Yeah. Yeah.

Garrett Soames:  I haven't, I, I guess, I personally haven't met that patient yet, who, you know, who wants that, or where that makes sense for

Brian Mckinley: Yeah, so Danito, I got to tell you I was a bigger kid. I dealt with a lot of overweight issues, and Diet and exercise really helped me. I later in life, had testosterone very similar to you. Maybe even lower, I believe it was. But you know that 350 that is kind of on the lower end. And if these are some of your concerns and you have some weight to lose from it all, I've got to say is like that's what I did. It helped it put me back to where I was supposed to be it let me be the man that I wanted to be and felt like I deserve to be so you know. Try whatever. You're trying work with your doctors, but in terms of should you take HCG TRT? Would it help you? Yes, it would help you with the goals. Yes, it would help you because the testosterone you have

00:20:00

Brian Mckinley:  TRT is going to be better than hCG for you you know hope this video helps a little bit good luck, let us know and if you know you want to work with us. Cool too. If you want to work with the provider working with also, cool, just hope it works out and we're always happy to answer more questions in the future is, you know, stuff goes on.

Brian Mckinley: We're gonna go on to, I think our last topic for today, which is going to be talking a little bit about finasteride. Which is. so when someone who is prone to baldness, begins trt

Brian Mckinley:  We don't ever want to tell someone they shouldn't be on TRT, you know, I you know I have some hair thinning, but I'm also getting older.

Brian Mckinley:  And so for me TRT really hasn't affected that, but for some people, if it's in your family, if it's genetic, if you have a history of it, it is something you want to be concerned about on TRT. Well, finnestride is one of the ways to allow you to stay on a TRT regimen and to not have to worry as much about your hair loss. It's a substance that helps suppressed DHT. So that's di I hydrogen testosterone which is predominantly responsible for like essentially drying out the hair follicles and kind of call it causing it, die promoting hair loss. If you know you're prone to it. And finasteride essentially targets that and says, You know, please stop, please stop producing DHT and so the main reason we don't give it to everyone is because DHT is very strong 10 times stronger than regular testosterone, your body, produces it when it has testosterone. So when you add more testosterone today, adds more DHT as an effect but we like people to have that

Brian Mckinley:  because it's very beneficial if it doesn't hurt their hair and they're you know, from To baldness. And so this guy's asking essentially, Hey, I'm prone becoming bold finasteride, seems to work, good for that. From what I've read, you know. And what's your guys's opinion on taking it orally or using it topically? And then he also wanted another question of like, What's your opinion on subcutaneous and intramuscular injections of testosterone? Which Garrett has been experimenting with and we've been working with our patients on as well. So we'll touch on both of those. So yeah Garrett for finasteride. Oral versus topical. What's your take?

Garrett Soames: um, actually this one actually, I think is a pretty clear Which is the winner. And it topical is always the winner. And here's why. So, Finasteride is a IT blocks the enzyme in your body. It blocks the enzyme that converts testosterone into DHD, so all DHT was once testosterone.

Garrett Soames:  And again, DHT has great benefits in that. It's actually, yeah, significantly stronger. As far as, you know, if you're looking for physique benefits, muscle growth weight loss, all that But it has downsides. It attaches to your your hair follicles and makes them atrophy over time and then yeah you're hair falls out so it can definitely cause Male pattern baldness baldness.

Garrett Soames:  If but here's the thing, if you can block, you can block the DHT conversion, right? Systemically or locally. So, think about it like this. You know, you've got DHT floating all through your body, right? But if if you take, if you apply it just directly to the scalp where you're trying to prevent the damaging effects of DHT, Then your body absorbs, some of that, you know, that topical stuff, you know, just like some creams and stuff, you could absorbs into the bloodstream, but it doesn't nearly get as as much. So, There was a A study done actually, just last year just a few months ago, 20 December 2022.

Garrett Soames: It was the Journal of European Academy of Dermatology and Venereal Disease. Basically, it was an interesting study that it basically proved that, The DHT concentrations in the blood. So the actual DHT levels. Were 100 times greater than 100 times.

00:25:00

Brian Mckinley: Here.

Garrett Soames: Look, lower In men who took the pill versus topical. So we know Oral finasteride lowers. The, you know, if I were to test your blood, it lowers it over a hundred times more than than the DH. The DHT blockage would, if you just applied, it but interestingly enough,

Garrett Soames: it works as effective at hair prevention, meaning You will lose less either way you won't lose. Oh, I should I should let me rephrase that if you take pills. Or if you do the topical, you're gonna protect the same amount of hair follicles. Oh, you get no.

Brian Mckinley: Okay.

Garrett Soames: You get zero benefit by adding pills. all you do is you add the side effects of finasteride, which Are in my opinion, not worth it and the main reason to me, honestly is the sexual dysfunction that can come with it.

Garrett Soames: You know it's it's a very known phenomenon. You can In fact there are many many support groups online about they call it Post Finasteride Syndrome. And really,…

Brian Mckinley: Oh damn.

Garrett Soames: yeah, so and there's some men that believe that it's permanent that the sexual dysfunction is permanent. I don't believe I believe you. You know, you can have performance and anxiety, performance, anxiety issues that associated with your lack to get an erection during your oral finasteride treatment. And then you get off of it. You're like this sucks. I'm getting off of it. But then you're stuck in your head about it and But again, it's it's a big. There are thousands of men who've reported. This is an issue. So, They're actually been lawsuits against doctors who failed to disclose this as a side effect. So

Garrett Soames:  long story short, if you if you want to take TRT and you want to protect your hair, You definitely should take finasteride, but you should only do the cream or shampoo.

Brian Mckinley: That's a surprising to me because, you know, a couple years ago, I might think something completely different.

Garrett Soames: Yeah. I mean if it logically you would think Okay? Well let's test what my DHT level is to see if it's actually working to protect my hair. Right. And so…

Brian Mckinley: Yeah.

Garrett Soames: if you draw your blood and you, you know, Hey is DHT levels, are are significant, they're they're lower but they're not as low as they could be just because he's using the shampoo. Well that doesn't matter because you're blocking the DHT right where it matters. This is this is the only part I want the DHD to block. Everywhere else,…

Brian Mckinley:  Yeah.

Garrett Soames: I want to actually want more of it. I want as much THC as I can get except for here. Right, so why not literally block it from? It's like putting on a, you know, a shower cap to keep your hair dry just in reverse. Mmm.

Brian Mckinley: Yeah, that's fine. Okay. Yeah, so definitely topical it sounds like and I don't think I'd really want to mess with with oral to be honest about the choice. and then yeah, the next part of this thing was, you know, sub Q injections versus intramuscular injections for testosterone and so, I'm someone who uses intramuscular injections for my TRT regiment which means you inject your your testosterone into your muscles.

Brian Mckinley: I like doing it because I don't have to do it as frequently in my mind and I'm just comfortable with it and I'm used to it. Sub-q, essentially means you're subcutaneous. You're trying to inject your testosterone in to the fat that sits kind of above your muscles, or above your organs, that kind of stuff like your surface fat right below the skin. They do both work. I'm just not very versed in that. I think it both of them are pretty successful. Garrett is actually someone who has experience with subcutaneous. Or testosterone.

Garrett Soames: You sure?

Brian Mckinley: Do you want to break down? Like a quick little overview. One comparing the other from your kind of experience because you've done both,

Garrett Soames: Yeah. Um, I personally prefer. Subcutaneous injections. Despite the hassle of needing to do a daily injection. I feel like, you know, I I am someone who can notice, you know, the peaks in the valleys. Right. And so I like my peaks and valleys to not be as high or as low. I like to be you know, in the middle. So that's the benefit, it makes sense, right? A smaller amount but every single day as opposed to a much larger amount though, only twice a week, You know, or there are some people out there who do it once a week.

00:30:00

Garrett Soames:  And honestly if you look at the textbooks that it still tells you to do one shot every two weeks, which is idiotic but yes a you know it you can think about it. If you did it every two weeks you're, you know, you've got a huge wave right up high and then down, if you do it every one week, it's a, you know, a smaller wave. If you do it twice a week, you know, it's multiple small waves and if you do it every day, it's just like that. So, That's the easiest way to think about it is, you know? You know, are you someone who sensitive to the highs and the lows or not?

Garrett Soames:  I also am a fan of using the smaller needles, you know, those some of those big 25 gauge needles, can be really painful and cause scar tissue and maybe I'm a wimp. So I like the little insulin needles, you know? So I don't feel them like literally can't feel them so, whereas I, you know, I can feel the, the larger needles we sometimes use for the For the intramuscular injections. But if you look at the studies again, they're pretty seems to be that the left the ultimate levels tend to be pretty comparable. There are some studies that suggest it, that it creates more depoting, which actually is depoting is, again, like a depot where Something for later, right? So it, they believe that the it might because there's a little less blood flow to the skin.

Garrett Soames: Um, that the testosterone may be more slowly released into the bloodstream, you know, over time. Um, and…

Brian Mckinley: Yeah. Yeah.

Garrett Soames: you get almost like it's almost like little pellets of testosterone sitting in your skin that are sitting there and waiting to go. So, there are some that say that you can get a higher level. Over time with sub Q injections. But I don't know…

Brian Mckinley: Yeah. You know,…

Garrett Soames: if I believe that or not, but

Brian Mckinley: one question. Why why daily though, why does it have to be more frequently? I know it needs to be. But is it just because the volume or what?

Garrett Soames: Well, yeah, that's a good. That's a great question. So you should never do a large volume into the skin itself. It just it doesn't tolerate, you know, big, you know, bubbles of oil. It remember that the skin is our first line of defense for infection.

Brian Mckinley:  Yeah.

Garrett Soames: So there are some times bacteria that can work their way you know into You know, small small, you know, bits of our skin, but our immune system takes care of it. But now imagine you get some bacteria in there. You get, you've got an abscess pretty quick. So the risk that's the main reason why We don't we you, if you're gonna do some Q, You have to do it daily because the volume you use is much, much smaller. Yeah, so you can inject,…

Brian Mckinley:  Okay.

Garrett Soames: you know, in in a muscle. I mean, Brian, You know, this like what was the rule one, one CC per in the shoulders but to one in the top two in the thigh and like what

Garrett Soames:  Two to four. And yeah, in the But

Garrett Soames: Yeah. yeah, so if you know but subcutaneous it's, you know, you you'd be, I would never give more than half a cc subcutaneously of anything, you know,…

Brian Mckinley: Yeah.

Garrett Soames: so just because the risk of damage and so yeah, you know, a lot of guys if you're taking you know, You know, over 150 milligrams in a week. You can't do that twice a week based on volume. Typically. Yeah.

Brian Mckinley:  Right. okay, so at the end of the day, Sq versus intramuscular kind of preference. Both work as well and depends on if you have the time. To do either one or what you kind of want out of it.

Brian Mckinley: Doable wrap up at some point but yeah yeah thanks for popping on today and checking out our reddit posts our replies and stuff and you know feel free to keep asking us questions.

Garrett Soames: All right. Thanks guys. Take care.