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10-07-2014, 12:02 AM #1Junior Member
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Blood test results back, looking for advice from the experts here. Please?
54 years old
6-4, 330 lbs
Gym rat my whole life but back serious for about 6 months now. When I say serious, I mean a new kind of serious at my age, lower weight higher intensity.
Heavy but basically healthy carrying muscle but obviously plenty of fat also.
The results I think you guys need will follow. I know that next time i need the assay for E2 but for this time:
Estradiol: 64 pg/mL Range (20-75)
Testosterone total: 751 ng/dL (250-1100)
Free testosterone: 163.0 pg/mL (35-155)
IGF1: 238 ng/mL (50-317)
z score??? 1.2 (-2--+2)
PSA 2.58 ng/mL (0-4.0)
TSH 2.79 uIU/mL (0.34-5.60)
I also have Metabolic panel, Lipids and CBC if those are needed. Ive been told that in addition to TSH i should have T3 and T4 checked and will do that next time. Anything I'm missing.
Currently taking prescribed 100 ml Test Cyp weekly however she allowed me to raise to 125 weekly starting today.
Ill be seeing a TRT nurse practicioner on Wednesday to discuss HCG and Anastrozole as I feel some E related issues and notice milky, swollen nipples.
I'm looking for all thoughts on my protocol including Clomid instead of HCG? My workouts had been kick ass until the last 2 weeks and I feel like I'm crashing with Estrogen now.
I appreciate in advance any advice from you guys. Told my Doc today that if she needed to learn anything from the experts, this was the place to go. Regards,
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10-07-2014, 01:35 AM #2
When was this test taken because your numbers look good.
It would also help to have FSH also
Your free test is pretty high. How much test are you taking a week?
I'm sure you are aware that your weight is pretty high and that can lead to E2 symptoms. You probably need to start using an AI like Adex. HCG can actually raise your E2 a little but it's still a must for TRT protocol.
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10-07-2014, 03:20 AM #3Junior Member
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AHA!! Thanks for responding lovbyts, you were one of the rockstars on here I was hoping to hear from. Tests were taken 9-25, very recent. I'm taking 100 ml test Cyp per week but Doc is allowing me to up to 125, should I with free that high? Have felt like shit the last couple weeks and from what I've read on this forum it sounds like E2 is the culprit.
If I could provide a little more background, when I joined in August, like a dumbass I had upped my dosage on my own, substantially. Times Roman ripped my ass and rightfully so. I went back to prescribed dosage and felt like an animal until 2 weeks ago.
I've fired my Endo but have a great GP who has recommended I go to a clinic where a nurse practicioner will prescribe HCG and I can probably get AI as well. They mentioned Anastrozole but I see you say Adex, I'll follow your advice.
I've read so much over 2 months on here that sometimes my head spins. I have read Dr. Crislers article but its a bit antiquated, wondering if anyone has any new dosage recommendations on HCG?
If you guys agree with my GP that its ok to up my Cyp from 100 to 125 then I will split and do twice a week injections so I know that changes HCG protocol. Trust me, if you all say no to upping, I'm not.
I very much appreciate and respect your knowledge and the committment you make to helping others to avoid mistakes. Times Roman had me cowering in the corner like a scared pup Thank you again. And yes, I am aware that my weight is high, much nicer than the way Roman put it At my best I was around 300 but packing much more muscle than now. 288 when I graduated high school in 78 so heavy for life.
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10-07-2014, 05:37 AM #4
Dropping back down to 100mg a week might lower your E2 enough to feel good again. You are pretty close and I'm afraid an AI might actually to to much of a drop but I'm not sure. I think it might be a good idea to try DIM (Di-Indole Methane) 400mg a day. You can get it from Amazon and other places in 100 up to 300mg per capsule. It works pretty good at helping regulate E2 in men on TRT as long as it's not to high.
No reason to up your dose, you are already running high and thats probably why you dont feel good. More is not better especially for the long run. I have had to talk a few people down I know personally and it took a good month before they really felt back to normal, feeling good again.
Well it sounds like your a big guy but it's never to late to get in the shape you want and it sounds like you are motivated you just need to feel a little better. One thing to remember, it's not a sprint, it's a marathon. Take it slow and steady. You will hit speed bumps and sometimes feel like you are not loosing any weight but sometimes it's because you are gaining muscle so the weight plateaus for a while. The scale is not always the best way to judge. Personally I think it's good to take a few pictures of yourself about every 2-3 weeks. Try to use the same camera, same room, same poses and you will be surprised in a couple months how much change you can see.
As far as anastrozole it's the same thing as Arimidex /liquidex by AR-R
HCG Once a Week Testosterone Injection Protocols
If a man injects Testosterone on a once a week basis the more common protocol is to use 250IU of hCG two days before and one day before their next testosterone injection. The theory here is that Testosterone serum levels are at near half life and the injection of hCG on these days increase natural production creating a bridge until the next testosterone injection.
Hopefully KelKel will still give his .02Last edited by lovbyts; 10-07-2014 at 05:52 AM.
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10-07-2014, 12:42 PM #5
I did that for a while. I didn't notice a marked positive effect from 100 mg to 125 mg a week. However my E2 was higher at that dose. You should always look for the smallest dose possible that will relieve your symptoms and feel optimal.
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10-07-2014, 02:01 PM #6Junior Member
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Ok, will stay with the 100 or maybe even drop to 75? What do you guys think. I'll be adding HCG so that would probably make up the 25 difference if I dropped T to 75 correct?
What about the AI. I'm pretty convinced and the Estradiol level shows I'm in the high normal. In my mind im crashing, extremely sore, swollen and milky looking nipples, dragging to and in the gym over last couple weeks.
As you saw above, total T is 751 (250-1100)
Free T is 163. (35-155).
My question I guess is does total T not matter that much since free is above top range? How do I bring that down into higher normal while raising total T into higher normal? Or do I need to? Thank you for joining in Beethoven, I'm really trying to do this correctly.
I have called my Doc and will have more blood drawn tomorrow to test FSH, E2, T3 and T4.
I'd love to get Kelkel's input too but don't have enough posts to pm him.
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10-07-2014, 07:26 PM #7
I would stay at 100mg Testosterone per week split every 3.5 days and when you get your hcg inject that subq 250ius every 3.5 days also (day before test). the hcg doesn't raise your T like cyp, but it will a bit. you dont need to worry about total T levels just the free T and your numbers look good imo.
if you want to get to the bottom of your e2 issue, check bloods yourself (google personal labs) and figure out where you really stand. then you can properly dose ai or try other less drastic ways to lower it.
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10-07-2014, 07:48 PM #8
Many good points by Lov above.
You didn't really answer LB's question. When was the BW pulled relative to your last injection?
Don't up your dose. Split it to 50mg's every 3-4 days and retest in a month. This will help with E2 conversion. Think less injected = less spike in E2. Explain that to your doc. Def get the Sensitive Assay. Standard Estradiol tends to read higher and is a factor in guys improperly dosing AI's.
Adding hcg will give T a boost and E slightly. Get your doc to prescribe this:
http://www.jurology.com/article/S002...867-7/abstract
Regarding dosing, twice weekly is fine if on the protocol I suggested above. You can even inject it in the same syringe as your test for simplicity purposes.
Your TT and FT numbers are great but need to know when injected and tested.
TSH is a bit high. A more modern range is .3 - 3.0. Next time test for FT3, FT4, RT3 and Antibodies as well.
FSH and LH will be bottomed out on TRT. No need to test them.
I'd guess E2's a bit high but it's really hard to tell without the proper test. I can provide Labcorp codes if needed. Get this done. Know that when you lower E2 your test will rise so be patient with all this. Dialing in is not always easy.
Keep an eye on your PSA. Be sure you always avoid orgasm for a couple days prior to BW as it will cause a temporary spike and skew your results.
Ultimately you may end up cutting your dose slightly once you dial in your E and add HCG. That, in essence is a great thing as less is more in this world.Last edited by kelkel; 10-07-2014 at 07:53 PM.
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10-07-2014, 08:01 PM #9
If it were me, I'd drop to 90mg or 80mg. One's reactions to dose changes are not linear, and small changes can have a big impact.
I believe hCG will add some to the Testosterone levels but the jury is out on exactly how much. Dr. Crisler considers it a "minute" amount. Either way, it's not the reason to add hCG to one's protocol, and blood work will tell you where you stand.
Don't be quick to jump on the AI bandwagon. Try to ride out the symptoms for the first couple months if you can. If you can't, my advice is to take Anastrozole on "as needed" basis only (don't even think about taking it on a regular basis), and remember that 0.25mg goes a long way.
Don't worry about Total Testosterone . Free Testosterone is what's important.
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10-07-2014, 10:41 PM #10Junior Member
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Man, can't tell you how much I appreciate all you guys weighing in. Guess I misunderstood LB's question, the answer is that I had injected my 100mg 7 days prior to blood work.
I am definitely going to split dosage 50mg twice weekly and will add HCG with todays dose.
I called my GP today and will go in for further labs tomorrow. I requested FSH, T3 and T4 and the sensitive assay. Will take about a week for all results but I will post if I haven't worn you guys out. Looks like I may need to add a few more tests Kelkel? Ill see if she'll add the Ft3,4 and RT 3 and antibodies as well.
I will go with the 250 iu's with my Cyp intramuscularly twice weekly and avoid the AI until sensitive assay come back. Gotta find a way to deal with this lack of energy, back pain and nipple and breast flabbiness until then. See, has to be Estrogen, I'm whining like a bitch
As for avoiding orgasm prior to bloodwork, no problem there, been married for 36 years, NUFF SAID?
Thank you again you guys, I really soak up all this info. Hope I can keep you with me here and would like to be able to help someone else someday. Please shoot any further advice or info you may have. Regards,
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10-07-2014, 10:46 PM #11Junior Member
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Also, will 500iu be enough to make the fellas gain some size back?
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10-07-2014, 11:23 PM #12
No I just did not word it very well. Thats the great thing about kelkel, he is always very clear and precise. He's a hard act to follow.
The other nice thing about using less is you end up with a little extra at the end of each month and if you decide to do a blast sometime down the road you will already have what you need so no reason to look for UGL.
36 years, wow congratulations. Once your TRT is where it should be you might find a renewed interest. I would also have her get her hormone panel done because most women are out of whack and most dont know it. The Dim I mentioned is also very good for a lot of women and help regulate their estrogen also. Something to think about.
it should be, it is enough for most but if it doesnt it's easy enough to add a little more. Give it a few weeks at least though to see.Last edited by lovbyts; 10-07-2014 at 11:27 PM.
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10-07-2014, 11:32 PM #13Junior Member
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Thanks LB, funny you mentioned her BW. I scheduled her for yesterday and sent her in with a note. I had researched here on the women's forum and wrote down all the tests she needed. Hoping to post her results when they come back and get help with hers.
Thank you for the congrats, we have been very blessed. Looking at the DIM as we speak.
I've seen "Blast" mentioned numerous times throughout posts but curious as to what would be considered a blast for me? Always looking for SAFE improvement.
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10-08-2014, 01:13 AM #14
Only after your TRT is in place and stable for about 1yr and you have gotten more regular in the gym and body fat down, not necessarily 15% but closer then anywhere from 400-500mg a week for 12 weeks. You just follow the my 1st cycle sticky in the Q&A section except for the PCT. We dont need to do a PCT because natural test is not applicable. You just go back to your TRT protocol.
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10-08-2014, 08:59 AM #15
Remember, you really don't need FSH as it pretty much bottoms out on TRT. You can also skip T3 & T4.
Do you use Labcorp by chance?
250 IU's twice per week of HCG is fine to start out.
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10-08-2014, 12:10 PM #16Junior Member
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I can't say for sure on Labcorp. Drawn at Dr office and sent to hospital lab? Mpossibly? Ok, will scrub those 3 and see if they'll plug in the 4 you suggest KEL. Think I lknow what the FT's are but unsure on the Rt3?
I go to the nurse practicioner at 5:30 et. Will keep checking this up until appt. AI still playing games with my mind but gonna hold off till the Assay comes back and see what you guys suggest then.
I know this is another swing but they had told me to research Sermorelin also. Looks interesting from what I've read but again, I will do NOTHING without checking with you guys first. Thoughts? The fat loss aspect is very attractive but again...... I wanna be SAFE.
REGARDS FELLAS.
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10-08-2014, 02:00 PM #17Junior Member
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Ok, fresh back from todays BW. Testing for FT3, FT4 and RT3 as you suggested Kel. She was confused by the antibodies, as was I. Lab tech informed me that RT3 test included antibodies, does that sound correct.
Requested the simple assay for Estrogen and she spent about half an hour researching the internet with me before finding that she thought she had already performed that. Turns out the following result wasn't given to me initially:
Estrogens total; 210.7 Range (40-115) and again:
Estradiol; 64 Range (20-75 pg/mL)
Tech explained this was E1 and E2 and that E3 was not necessary for males??
My uneducated assumption is as I expected, E is way too high.
Don't know what the chance is of a quick response from you guys but I go to the nurse Prac in 1 hour for HCG . Still don't think a small dosage of AI is necessary?
Further guidance?
Kind regards in advance.
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10-08-2014, 02:13 PM #18
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10-08-2014, 02:28 PM #19Junior Member
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I know this makes me look like a dumbass and the last thing I wanna do is run you guys off but am confused by above. I did have blood taken today for the work you mention above Kel. The Labcorp link threw me. Have I still not gotten it correct after my last post above? E1 and E2 are not the correct tests? I'm trying to get there.
Lovbyts, I ordered the DIM on Amazon last night. Thank you.
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10-08-2014, 05:05 PM #20
don't worry brotha you're just asking questions and nobody minds being helpful in this community.
it needs to be an E2 sensitive essay specifically. it will say it on the test results and look like this: Estradiol, Sensitive 30 pg/ml
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10-08-2014, 07:09 PM #21
MBOS,
The most important things have already been mentioned but I'd like to add a few things. As has been said, abundant body fat makes for more E2 conversion so it's best to do everything you can to keep this conversion down. Of course, diet and exercise is the top of the list and, as others have suggested, keep you T at the lowest dose to be symptom free. I would also suggest that you consider more frequent dosing AND doing it SQ, to keep serum T spikes and consequently, E2 spikes, to the lowest levels possible. The lessons I learned here had me design my protocol for this very purpose. Other here follow a similar dosing schedule but mine is simple and straightforward: 16mg/day of T cyp along with 125iu hCG /day in the same syringe. Of course, everyone is different and what works for me won't necessarily work for you BUT in theory this is a very sound approach.
From what I'm hearing, and what you've presented so far, you will need and AI sooner or later. I would suggest that you look into Aromasin /Exemestane as an AI, once you settle into your protocol and determine your need to keep your E2 under control. I've said this often but it bears repeating: Adex is VERY strong and a tough medication to get along with - as many will attest to. And it has a well known rebound effect which is extremely uncomfortable and difficult to deal with. This has been my experience. Anyway, I take 12.5mg Aromasin every 5.5-6 days and I don't even know I'm on an AI. I highly recommend it.
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10-08-2014, 07:39 PM #22
No, it does not. You had no reason to have this type of knowledge previously. You do now though. That said, stick around, keep reading and learning and asking questions. Self education is key here. Hopefully you got the correct test. It's why I gave you the link. It's amazing how medical professionals (some) aren't up on the proper test. These codes are what you need:
Test Number: 140244 CPT Code: 82670
Keep a folder with all your BW in it. You paid for it so you're entitled to copies. Keep these codes and take them with you every time you go to the lab. I still do.
Here's a very good read on AI's. 2Sox you'll like this as well if you haven't seen it already. I posted it once before.
An overview of the pharmacology and pharmacokinetics of the newer generation aromatase inhibitors anastrozole, letrozole, and exemestane - Buzdar - 2002 - Cancer - Wiley Online Library
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10-08-2014, 08:08 PM #23
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10-08-2014, 08:09 PM #24
OP good questions by the way. You want learn if you dont ask. That what I do.
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10-09-2014, 12:15 AM #25Junior Member
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Have I said thank you yet? I'll keep saying it, you guys have made me feel welcomed and that means alot.I appreciate ALL of you. Kel, my Dr uses Quest labs along with our local hospital lab. I went to the nurse Prac today and she prescribed 125iu per day of HCG but will follow the protocol most of you guys have given, 250iu twice weekly along with my Cyp which I'll split with it, 50mg twice a week. Lovbyts, I started DIM today, had ordered off Amazon last night but bought from the pharmacy today as well. Pharmacist recommends 100mg twice daily. I know you said 400mg a day so I'm torn.
I still have Labs from yesterday which I'll post when they come in and I'm told I will be sent to Labcorp in 1 month for next round of BW. Now I need to prepare a COMPLETE list of labs I want drawn, can I find a total list somewhere that's already prepared? I had to go back 3 times to get close to right this time, can't wait to see the bill. Trying to wrap my head around this very complex system we call the body. Again, many thanks to all you guys for help and kind words.
Regards,
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10-09-2014, 02:52 AM #26Associate Member
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10-09-2014, 09:57 AM #27
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10-09-2014, 09:00 PM #28Junior Member
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Thank you Chaueffer for that info, will look for the sticky. Kelkel, I will not be able to have the sensitive assay work until next month so I'm stuck with what I have as far as the two results listed. All I can do at this point is split my 100mg dose in two, which is the plan, or drop my dosage until my next BW. You recommended splitting in an earlier post and I have started with DIM and Iron anyway as I apparently have no other choice for now. I have also obtained my HCG and am excited by that.
I have a long way to go and a ton of knowledge to obtain but I'm willing. Even though the 2 results I listed for Estrogen results are obviously not the correct tests, I can definitely tell my E2 is high and its kickin my ASS royally but will have to deal with it. Hopefully the DIM and split doses will stem the tide until I can get my next BW.
KIND REGARDS,
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10-09-2014, 09:09 PM #29
MBOS are you aware you can obtain Liquidex from the site sponsor, ar-r ? Just click the link at the top right of the forum.
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10-09-2014, 11:18 PM #30Junior Member
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I was not aware, take it you'd recommend? Ideas on dosage? Really feel like I should be paying you for office visits?
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10-10-2014, 08:04 AM #31
You described E2 as "kickin" your ass. Think of this feeling every time the Adex wears off and you need another dose. It's like you "crash" and it's not a good feeling. Your feet feel like lead, your thinking gets foggy and your eyes don't seem to follow your brain's orders. You do NOT have this feeling on Aromasin - ever. If you know how to dose Adex before this feeling hits you, you are very lucky. But most of the time catching this is very tricky and very often in trying to do so, you knock E2 very low. This has been my experience and from what I understand, the experience of others. Adex is a tough medication to get right. Since there is a much gentler AI available - Aromasin - IMO, it's just not worth it.
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10-10-2014, 10:03 AM #32
It's used by a ton of guys here. Effective and efficient. As with any medicine, the minimum effective dose should be used. Your doctor should be assisting you here.
Why Estrogen Balance is Critical to Aging Men – Life Extension
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10-10-2014, 11:02 PM #33Junior Member
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I got ya both 2Sox and Kelkel. Will see how this plays out with splitting my dosage. May eventually have to rehire my endo?? Sermorelin was also brought up in one of my appointments but I'm scared to think too much past getting this issue lined out first. Any of you guys have thoughts on this relative to the BW I have listed? I'm working out as hard as I have in my life intensity wise but the thought of something that fights body fat at the same time is interesting. I've read numerous articles but again, overload?
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10-11-2014, 06:06 AM #34
I wouldn't be reluctant to look into Sermorelin while you are educating yourself on TRT and how to get you protocol right. Our brains were meant to multitask. Anyway, from my knowledge Sermorelin is a substance that helps with GH release and IMO, that can only be good - especially if you are nearing or in the "senior" category, as we both are. There's an excellent site you might want to look into which gives a great deal of detailed information on GH releasing peptides - DatBtrue. Extremely educational. I've been studying it for some weeks and I'm seriously considering dosing both Sermorelin and Ipamorelin simultaneously.
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10-11-2014, 10:06 AM #35
Sermorelin: A better approach to management of adult-onset growth hormone insufficiency?
Also, read anything from Dr. Richard Walker. Pretty much "the authority" on Sermorelin:
Interview with Dr. Richard Walker about sermorelin
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10-11-2014, 10:56 AM #36
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10-11-2014, 05:50 PM #37Junior Member
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I'll be reading up this weekend, thanks my friends.
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10-11-2014, 06:03 PM #38Junior Member
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DatBtrue making me wait up to 24 hours to receive email for entry to site. Will check it out along with Dr. Walkers info.
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10-12-2014, 10:17 AM #39
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10-12-2014, 11:59 AM #40
great info in those links kel!
it sounds like a very interesting addition to trt therapy, but the dosing range Dr. Walker gave seems to be huge from .2mg~2mg daily. Although it varies person to person, has anyone done testing/research to gain a general idea of what is an effective daily dose to produce beneficial results?
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