Description:

Mixed testosterone is an injectable veterinary steroid formulation containing a mixture of three different testosterone esters. Each milliliter contains 12 mg of testosterone acetate, 12 mg of testosterone valerate, and 36 mg of undecanoate testosterone, totaling a steroid concentration of 60 mg/mL. This is the only commercially available steroid product containing testosterone valerate, a lower or medium-acting ester with approximately twice the half-life of propionate. Because it is a mixture of slow and fast-acting esters, mixed testosterone essentially serves as a low-dose alternative to testosterone, albeit with an imbalanced pharmacokinetic effect due to its use.

History:

Mixed testosterone was developed decades ago by Syntex Animal Health and has since been sold in the Mexican veterinary market. It is primarily used for treating impotence, weakness, fatigue, and reduced gonadal function in male breeding animals (cattle, pigs, dogs, sheep), as well as to reduce protein catabolic metabolism. Mixed testosterone is now sold under the Fort Dodge Animal Health label, which acquired the rights from Syntex Animal Health in the mid-1990s.

Specifications:

Mixed testosterone is available in the Mexican veterinary market. Each milliliter contains 12 mg of testosterone acetate, 12 mg of testosterone valerate, and 36 mg of testosterone undecanoate; packaged in 10 mL multi-dose vials. Each box contains twelve vials.

Structural Characteristics:

Mixed testosterone is a blend containing three testosterone compounds, each modified by the addition of a carboxylic acid ester (acetate, valerate, and undecanoate) to the 17-beta hydroxyl group. The esterified form of testosterone is less polar than free testosterone and is absorbed more slowly from the injection site. Once in the bloodstream, the ester is removed to yield free (active) testosterone. The esterified form of testosterone is designed to prolong the therapeutic window after administration, allowing for less frequent injection schedules compared to unesterified steroids.

Side Effects (Estrogenic):

Testosterone is easily aromatized in the body into estradiol (estrogen). The aromatase enzyme (estrogen synthetase) is responsible for this metabolism. Elevated estrogen levels can cause side effects such as increased water retention, increased body fat, and the development of gynecomastia. Testosterone is considered a moderately estrogenic steroid. Anti-estrogens such as clomiphene or tamoxifen are necessary to prevent estrogenic side effects. Aromatase inhibitors like anastrozole can be used to more effectively control estrogen by preventing its synthesis. However, compared to anti-estrogens, aromatase inhibitors can be quite expensive and may also negatively impact blood lipids.

Estrogenic side effects occur depending on the dose; higher doses (above therapeutic levels) of testosterone may require the simultaneous use of anti-estrogens or aromatase inhibitors. Due to water retention and muscle loss common with higher doses of testosterone, this drug is generally considered a poor choice for dieting or cutting phases. Its moderate estrogenicity makes it more suitable for bulking phases, where the stored water can provide raw strength and size and contribute to a more potent anabolic environment.

Side Effects (Androgenic):

Testosterone is the primary male androgen, responsible for maintaining male secondary sex characteristics. Elevated levels of testosterone can produce androgenic side effects, including oily skin, acne, and body/facial hair growth. Men with a genetic predisposition to hair loss (androgenic alopecia) may notice accelerated balding. Those concerned about hair loss might find a more comfortable option in nandrolone, a less androgenic steroid. Women are also warned of the virilizing potential of anabolic/androgenic steroids, especially potent androgens like testosterone. These side effects may include deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.

In androgen-responsive tissues like the skin, scalp, and prostate, testosterone's high relative androgenicity is because it is reduced to dihydrotestosterone (DHT). 5-alpha reductase is the primary enzyme responsible for this metabolism. Using 5-alpha reductase inhibitors such as finasteride or dutasteride can interfere with the site-specific action of testosterone, reducing the tendency for testosterone medications to produce androgenic side effects. It is important to remember that both anabolic and androgenic effects are mediated by the androgen receptor. It is impossible to completely dissociate testosterone's anabolic and androgenic actions, even with all 5-alpha reductase inhibited.

Side Effects (Hepatotoxicity):

Testosterone does not exhibit hepatotoxic effects; thus, the occurrence of liver toxicity is unlikely. A study examined the potential for liver toxicity from high doses of testosterone by administering 400 mg of hormone per day (2,800 mg per week) to a group of male subjects. Oral steroids, compared to intramuscular injections, can reach higher peak concentrations in liver tissue. The hormone was administered daily for 20 days, with no significant changes in liver enzyme values, including serum albumin, bilirubin, alanine amino transferase, and alkaline phosphatase.

Side Effects (Cardiovascular):

Anabolic/androgenic steroids can adversely affect serum cholesterol. This includes a tendency to lower HDL (good) cholesterol values and increase LDL (bad) cholesterol values, potentially leading to a greater risk of arteriosclerosis. The relative impact of anabolic/androgenic steroids on serum lipids depends on the dose, the route of administration (oral vs. injectable), the type of steroid (aromatizable or non-aromatizable), and the level of resistance to hepatic metabolism. Anabolic/androgenic steroids can also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and cause left ventricular hypertrophy, potentially increasing the risk of cardiovascular disease and myocardial infarction.

Compared to synthetic steroids, testosterone has a much smaller impact on cardiovascular risk factors, partly due to its openness to liver metabolism, which lessens its impact on liver cholesterol management. The aromatization of testosterone to estradiol also helps to mitigate the negative impact of androgens on serum lipids. In one study, 280 mg of testosterone ester (enanthate) per week had a negligible and statistically insignificant effect on HDL cholesterol after 12 weeks, but a significant (25%) reduction was observed when an aromatase inhibitor was used. Using 300 mg of testosterone ester (enanthate) per week for 20 weeks without an aromatase inhibitor only showed a 13% reduction in HDL cholesterol, while 600 mg reduced it by 21%. The negative effects of aromatase inhibition should be considered before testosterone therapy.

Due to the positive effects of estrogens on serum lipids and because they exhibit partial estrogenic activity in the liver, tamoxifen citrate or clomiphene citrate is preferable to aromatase inhibitors. They can potentially improve lipid profiles and offset some of the negative effects of androgens. Doses of 600 mg per week or less tend to have a noticeable but not dramatic effect on the lipid spectrum, making anti-estrogens (for cardiac protection purposes) perhaps unnecessary. Doses of 600 mg per week or less also failed to significantly alter LDL/VLDL cholesterol, triglycerides, apolipoprotein B/C-III, C-reactive protein, and insulin sensitivity, indicating their relatively weak impact on cardiovascular risk factors. When used at moderate doses, injectable testosterone is generally considered the safest of all anabolic/androgenic steroids.

To help reduce cardiovascular strain, it is recommended to maintain an active cardiovascular exercise program and always minimize the intake of saturated fats, cholesterol, and simple carbohydrates during AAS use. It is also advisable to supplement with fish oil (4 grams per day) and natural cholesterol/antioxidant formulations such as Lipid Stabil or products with similar ingredients.

Side Effects (Testosterone Suppression):

When taken in doses sufficient to promote muscle gain, all anabolic/androgenic steroids are expected to suppress endogenous testosterone production. Testosterone is the primary male androgen, exerting strong negative feedback on endogenous testosterone production. Likewise, testosterone-based drugs have a strong effect on hypothalamic regulation of natural steroid hormones. Without interventions involving testosterone-stimulating substances, testosterone levels are expected to return to normal within 1-4 months after drug discontinuation. Note that hypogonadism may be secondary to steroid abuse and require medical intervention.

In addition to the above side effects, other potential side effects are discussed in more detail in the steroid side effects section of this book.

Treatment Guidelines (Men):

For bodybuilding purposes, it is generally recommended to inject 120-360 mg (2-6 mL) per week. Dividing the weekly dose into two or more injections can reduce the volume of each injection. Cycles usually last between 6 to 12 weeks. This level is sufficient to provide significant gains in muscle size and strength. Testosterone drugs are very versatile and can be combined with many other anabolic/androgenic steroids to achieve the desired effects based on individual goals.

Treatment Guidelines (Women):

Due to its strong androgenicity, tendency to produce toxic side effects, and slow-acting characteristics (making blood levels difficult to control), it is not recommended for women for performance enhancement purposes.

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