Where Should I Stick the Needle?

Q: For prescribed testosterone replacement therapy (TRT), which is more beneficial, subcutaneous or intramuscular injection?

A: While going subcutaneous (sub-Q) is almost unheard of among old time testosterone injectors and steroid users in general, it's actually the way to go if you're using small, TRT-sized doses (200 mg. or less).

Rather than sticking a large needle in your behind, you stick a small (26 gauge, 3/8" needle) on either side of your abdomen. This method appears to have several advantages:

  1. Going under the skin saves you from jamming yourself in the glutes approximately 500 times every decade, thus saving you from a lot of scarring.
  2. It makes it more feasible to dose yourself twice each week, which allows for a more even and natural testosterone profile.
  3. Since you're injecting two times a week, the testosterone is more smoothly metabolized and might even bring estrogen levels down (and research seems to support this).
  4. The late Dr. Crisler, who helped popularize this method, believed that it gives you more bang for your testosterone buck. He said that 80 mg. of sub-Q testosterone has the effect of a 100 mg of testosterone administered intramuscularly. (Whether Crisler was right about the potency of sub-Q injections isn't known for sure, but it has the ring of truth and it's worth a try.)
  5. You can use the same needle to fill your syringe and administer the dose.
  6. Since there's no danger of puncturing a vein, there's no need to aspirate when you go sub-Q.

To do a sub-Q injection, just swab an area of skin on either side of your belly button. Swab in concentric circles, starting small and working your way out (it physically pushes away any bacteria that the alcohol failed to kill).

Then inject the needle at about a 45-degree angle – no need to pinch the skin. Fully depress the plunger, pull out the needle, and you're good to go. Here's Dr. Crisler with an injection demo: – TC Luoma

Hunger and the "Pound of Veggies" Misfire

Q: I'm trying to lose fat but my appetite is off the charts! Everyone says to just pack in the low-calorie veggies, like a pound per day. I'm doing it, but I'm still craving more food. Any advice?

A: First, you're not alone. Check out this recent survey from T Nation's Instagram:

Survey

Hunger is a complex issue; it's more like algebra than basic addition and subtraction. But let's get the math out the way first.

Eating under your maintenance level of calories – pretty much mandatory for fat loss – will make you somewhat hungry. You're also fighting off psychological habits and triggers as well, like snacking when watching TV. There's always going to be a certain amount of "suck it up and tough it out" required when dieting.

But let's make sure your caloric deficit isn't too deep. While studies show that athletes can eat about 25 percent under maintenance without losing muscle or tanking their hormone levels, that deficit will leave you pretty damn hungry.

A rough guide for estimating maintenance caloric intake is to multiply your bodyweight times 15. To achieve a more-doable 20 percent deficit, multiply that number by .8.

Example for a 200 pound man:

  • 200 x 15 = 3000 calories (rough maintenance intake)
  • 3000 x .8 = 2400 calories per day for fat loss

Now, that's 600 calories below maintenance. Still pretty strict. If the hunger is out of control, just shoot for 300 calories below maintenance. You'll still lose fat, a little more slowly, but a lot more comfortably.

The point is, no "hack" for suppressing appetite is going to work if you're eating an anorexic 900 calories a day. Shoot for a modest deficit and be patient.

About That Pound of Vegetables...

I understand where the diet gurus are coming from with their "gorge on low-calorie vegetables" recommendation. But it doesn't work very well for a lot of people. Why? Because hunger isn't as simple as having a full stomach vs. an empty stomach. Mechanical hunger is only part of the puzzle.

While eating a pound of green vegetables – or even two pounds as some recommend – every day will fill your stomach, it may not satisfy your appetite. Why? For one reason, not all veggies send your brain the "I'm full" signal.

Certain brain cells called tanycytes control appetite. These cells detect nutrients and inform your brain about the food you've eaten. And these cells respond to abundant amino acids, not lettuce.

The amino acids arginine and lysine react strongly with tanycytes, which in turn release info to the appetite-controlling portion of your brain in as little as 30 seconds. Foods with high concentrations of arginine and lysine include:

  • Sirloin steak
  • Chicken
  • Lentils
  • Almonds
  • Mackerel
  • Avocados

If you're worried about the calories that come with those foods, try supplementing with arginine and lysine when dieting. And yes, eat your veggies, just in non-stomach-distending amounts.

Other Ways to Control the Appetite

Sleep

Insufficient sleep – say 5 hours – causes the average person to consume around 385 more calories the following day (1).

Lack of sleep messes with the reward centers of your brain and disrupts your internal body clock. This affects the regulation of leptin (the satiety hormone) and ghrelin (the hunger hormone). In short, bad sleep gives you cravings, usually for calorically dense foods.

If sleep is an issue for you, try 3 capsules of Z-12™ before bed.

Eat more protein

As T Nation contributor Dr. Jade Teta has noted, "Protein is the king of reducing hunger. If you want to reduce your hunger, then amplify protein intake above all else."

The old rule of eating about a gram of protein per pound of bodyweight works for most moderately chubby people. A little over 1 gram per pound is fine too since it's very difficult for your body to store excess protein compared to carbs and fats.

Protein powders with a good amount of thick micellar casein really stick to your ribs. Metabolic Drive® Protein is a top choice. If you're having a late-night craving, a thick 21-gram protein shake (one scoop of Metabolic Drive®) will get you through the craving.

Eat the RIGHT kinds of fiber

This is what the "eat two pounds of veggies" people are trying to accomplish. But soluble, gel-like fibers have the most powerful hunger-suppressing response – and in fact may be the only appetite-killing types of fibers (2).

Dr. Teta notes: "These types of fiber coat the digestive lining, interacting with L and K cells which then signal, through hormones like GLP and GIP, to turn down hunger."

Viscous fibers include:

  • B-glucan (oats)
  • Psyllium (Metamucil)
  • Glucomannan (root of the konjac plant)
  • Guar gum (a seed fiber)
  • Pectins (like the fiber in apples)

You can find all these in powdered supplement form. Mix a couple of them up with water and consume between meals or 30 minutes before a meal to blunt appetite.

Get your micronutrients

You know how pregnant women get weird cravings? One theory is that they're lacking in a certain vitamin or mineral.

Cravings during your fat-loss diet are somewhat related. Some diets have you really limit food variety, which may lead to a deficiency in certain vitamins or minerals. Your body is "asking" for what it needs, and your taste buds make suggestions... usually bad suggestions because those little bastards are very self-serving and not that smart.

Bill Lagakos, PhD, introduced me to the term, "micronutrient deficiency-induced leptin resistance." That theory could explain why it's so easy for the average North American to overeat – all that processed food is full of calories but lacking in vitamins and minerals, so their bodies keep asking for more food, searching for those missing micros.

A dieter with limited food variety could suffer the same problem. To cover your micronutrient bases, use Biotest Superfood, a blend of 18 berries, fruits, and vegetables.

For more info and tips, read Dr. Teta's Hunger: The Definitive Guide. – Chris Shugart

Pull-Up

Only Three Exercises

Q: You can only do three exercises – one bodyweight exercise, one kettlebell exercise, and one dumbbell exercise. What are they? Go.

A: "Go?" What is this, a game show? Okay Steve Harvey, I'll bite.

For the bodyweight exercise, I'd choose pull-ups as they're aptly nicknamed "the upper body squat." You could probably develop a pretty good torso and arms by doing nothing but pull-ups.

For the kettlebell exercise, I'd go with swings, mostly because of a research study I wrote about in The Absolute Best Way to Burn Calories. It showed kettlebell swings, done in a particular manner, burn roughly 20 calories per minute, which is astronomical when compared to most other calorie-burning exercises.

KB Swing

As far as the specific protocol, researchers from the University of Wisconsin had a group of men and women do alternating one-arm KB swings for 20 minutes. The number of swings they did per set was based on how many kettlebell snatches each subject could do in one minute and dividing the number by 4, ostensibly coming up with a number like 4, 5, 6, or 7.

So they swung a kettlebell that weighed either 12, 16, or 20 kilograms, say, 6 times, and then rest 15 seconds. Then they'd do 6 swings with the other arm and rest 15 seconds. They'd go back and forth like this for 20 minutes.

The only other activity I could find that burns a roughly equivalent amount of calories is cross country skiing done uphill at a really fast pace. And even if you're not interested in losing weight, the kettlebell swing works as a pretty nice conditioning exercise, too.

For my one dumbbell movement, I choose goblet squats. To do these, you hold a dumbbell against your chest, vertically, grabbing on with both hands just underneath the innermost plate (like you're in King Arthur's court and you're holding a fat goblet against your chest). Then you just squat down until your elbows slide past the inside of the knees.

Here's Dr. Bret Contreras with a breakdown:

The beauty is that they're almost impossible to do with bad form. To paraphrase Dan John, the squat, when done properly, is probably the most effective exercise there is. Done incorrectly, it can cause more damage than any other exercise. Doing it goblet squat-style ensures you do it right.

So there. Pull-ups, kettlebell swings, and goblet squats. What do I win? – TC Luoma

Steroids

Does T Nation Promote Steroids?

Q: Why does it seem to some extent you endorse steroids? Maybe I'm reading something wrong here, but it seems you guys actually promote them sometimes.

A: I've personally written most of those "steroid promoting" articles, but rather than write an essay, I'll just give you my reasons for being interested in them in list form:

  • They're fascinating.
  • They're a big part of the lifting culture and if people are going to use them (and they are), they might as well use them in a safe way.
  • The formal name of this website is Testosterone Nation, and all anabolic steroids are essentially synthetic versions of testosterone.
  • They can be used to increase health and longevity.
  • They can be used in certain medical conditions to ameliorate or even cure diseases.
  • They could be used by the military to increase the strength and endurance of combat soldiers. (See Soldiers Should Juice Up.)
  • Testosterone is inextricably associated with masculinity, which is something I've written about extensively.
  • There's a negative stigma about them that, while largely earned by decades of abuse, needs to go away so we can look at them without bias.

But am I (are we) endorsing their use? I don't think so. I can honestly say that if someone asked me if they should use steroids, my response would be to just give them the facts without attempting to influence them in any way.

And if you don't believe that, consider the economic reason we'd avoid "promoting" steroids: With the exception of protein powder, guys who use steroids generally don't buy as many supplements as "clean" lifters, and of course we want people to buy Biotest supplements. – TC Luoma

Calves

Calf Training For Non-Mutants

Q: I train my calves 3-4 times per week and they're still small. Any advice?

A: Pants. The answer is pants.

Just kidding. Okay, there are some genetic factors involved: muscle fiber makeup, insertion points, etc. Some mutants never train their calves and have monster calves anyway. And some folks have to train the hell out of their calves just to make them average.

But most every T Nation coach agrees you don't have to walk around with VERY tiny calves. To paraphrase Dr. Chad Waterbury, calves that look like an apple on a Popsicle stick are better than calves that look like a grape on a Popsicle stick.

So, here's a quick roundup of what we know about effective calf training:

Train them often

Frequency rules, with most coaches recommending a minimum of 3 days a week of calf training, usually more. Sounds like you have that covered.

Do a lot of work

That means volume: lots of sets, lots of reps, and a few different exercises.

One study of runners showed that athletes who ran 59 miles a week had 20 percent larger calves than those athletes running "only" 15 miles a week.

No, you don't have to start running 59 miles a week, but this does show that the calves need a lot of volume to grow. Three sets of 10 at the end of leg day just isn't enough for non-genetic mutants.

Hit both major calf muscles

That would be the gastrocnemius and the soleus. The problem here is that most people just choose one calf exercise, typically the standing or seated calf raise. But you need both.

Your soleus is worked mainly when your knees are bent (seated calf raise) and your gastrocs are worked mostly when your knees are straight (standing calf raise or leg press machine calf raise.)

Go slow and uses pauses

This is where most people go wrong. Try this:

  1. Take a few seconds to lift the weight.
  2. Pause and contract at the top for a few seconds.
  3. Take a few seconds to lower the weight.
  4. Pause and hold the stretch at the bottom for a few seconds.

That means every rep would take about 12 seconds, and a set of 10 reps would take about 2 minutes to complete. Now, how many people do you see in your gym doing that?

If you're already doing all of that, try something crazy. I picked this superset idea up from Charles Poliquin:

  • A1. Do the standing or seated calf raise for 8-10 reps using the tempo described above.
  • 1B. Without rest, hop out of the machine and do 30 reps of continuous bodyweight bounding. Just jump up and down with your knees locked. Your calves should be doing most of the work. Try to jump high and get a rhythm going. Play some House of Pain like it's 1992.

Repeat 2-3 more times and have fun getting out of bed the next morning. – Chris Shugart

Related:  Ask Us Anything 2

Related:  Honest Advice About Steroids

References

  1. H K Al Khatib, S V Harding, J Darzi, G K Pot. The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. European Journal of Clinical Nutrition, 2016
  2. Clark, Michelle J., and Joanne L. Slavin. "The Effect of Fiber on Satiety and Food Intake: A Systematic Review." Journal of the American College of Nutrition, vol. 32, no. 3, 2013, pp. 200-211., doi:10.1080/07315724.2013.791194.