how often to get blood work done on trt?

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    how often to get blood work done on trt?


    So just curious what a good practice is for regular bloodwork on when on trt. Every 3 months? Every 6? And what specifics to get and watch out for, RBC of course, anything else?

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    Once a year, once you find your proper HRT doses. Depending on how far off your hormones are; every 3 to 6 months while you are dialing in your treatment.
    A full set of labs is best and watch for changes in all of them. The usual suspects would be RBC, E2, SHBG, free and total T. All of the indicators are important and the more meds you take the more they can effect other areas.

    IMHA

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    once every 6 weeks then every 8 weeks then 12 weeks, then 6 months, or if you have symptoms check e2 or revisit thyroid, adrenals.
    •   
       

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    Quote Originally Posted by The Matrix View Post
    once every 6 weeks then every 8 weeks then 12 weeks, then 6 months, or if you have symptoms check e2 or revisit thyroid, adrenals.
    If money is no problem, this would be ideal.
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    I've been on TRT for over 5 years and I still do it twice a year.
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    Please elaborate on TRT and elevated RBC risk?
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    Quote Originally Posted by crazycrew View Post
    If money is no problem, this would be ideal.
    e2 and TT can be done cheap,
    Shbg tends to stay constant in majority of cases
    t-4, Ft3 and ft4 is all that is needed for thyroid when on meds

    for older guys I go after t and e2 stabilization then watch the thyroid function as HRT gets balanced because some time it may go down then return to normal over time. As long as symptoms are alleviate I suggest to ride it out, if symptoms come back after 4-5 months get e2 tested and ft3, ft4, t4 TT is pretty much constant.
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    Quote Originally Posted by Whacked View Post
    Please elaborate on TRT and elevated RBC risk?
    In some (like myself) using T can raise hemocrate levels and may require regular blood letting. I donate to Red Cross regularly and that is enough to keep my levels at an acceptable range.
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    Quote Originally Posted by The Matrix View Post
    e2 and TT can be done cheap,
    Shbg tends to stay constant in majority of cases
    t-4, Ft3 and ft4 is all that is needed for thyroid when on meds

    for older guys I go after t and e2 stabilization then watch the thyroid function as HRT gets balanced because some time it may go down then return to normal over time. As long as symptoms are alleviate I suggest to ride it out, if symptoms come back after 4-5 months get e2 tested and ft3, ft4, t4 TT is pretty much constant.
    I think I will be ordering the following test soon. SHBG is not included and mine was elevated on last 2 tests. However, considering my extreme stress level this past yr and especially now, I feel ok. Not good, but ok.

    Also from PriviteMD
    -------------------------
    Male Deluxe Anti-Aging Panel

    Description: The Male Deluxe Anti-Aging Panel contains the following tests:
    -Lipid Profile
    -Complete Blood Count w/ Differential
    -Estradiol, Sensitive
    -Insulin Growth Factor (IGF-1)
    -Comprehensive Metabolic Panel
    -Testosterone, Serum
    -Prostate-Specific Antigen (PSA)
    -Thyroid Profile

    Significant deviations from the normal range may require further evaluation by your physician.



    Includes: Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation); Hematocrit; hemoglobin; mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC); red cell distribution width (RDW); percentage and absolute differential counts; platelet count; red cell count; white blood cell count; Estradiol, Sensitive; IGF-1; A:G ratio; albumin, serum; alkaline phosphatase, serum; ALT (SGPT); AST (SGOT); bilirubin, total; BUN; BUN:creatinine ratio; calcium, serum; carbon dioxide, total; chloride, serum; creatinine, serum; globulin, total; glucose, serum; potassium, serum; protein, total, serum; sodium, serum; Testosterone, Serum; Prostate-Specific Antigen (PSA), Serum;Free Thyroxine Index (FTI);Thyroxine (T4); Thyroid Hormone Binding Ratio (T3 Uptake); Thyroid-Stimulating Hormone (TSH)

    Patient Instructions: Patient should fast for 12-14 hours before collection of the specimen. If using a testosterone cream please be sure you have not rubbed any into the antecubital area of your arm for the last 24 hours as it can give elevated results.

    Categories: Hormones and Metabolism, Male Specific Tests, Fitness, Nutrition and Anti-Aging

    Price: $169.49
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    One danazol best move I made!!
    50 mgs and gains in gym and libido are nots. Feel like I am back on roids again

    I use it for 6 months then stop it as o have uses to reset shbg levels for people that are high. 1 year post danazol levels are still 25

    Quote Originally Posted by crazycrew View Post
    I think I will be ordering the following test soon. SHBG is not included and mine was elevated on last 2 tests. However, considering my extreme stress level this past yr and especially now, I feel ok. Not good, but ok.

    Also from PriviteMD
    -------------------------
    Male Deluxe Anti-Aging Panel

    Description: The Male Deluxe Anti-Aging Panel contains the following tests:
    -Lipid Profile
    -Complete Blood Count w/ Differential
    -Estradiol, Sensitive
    -Insulin Growth Factor (IGF-1)
    -Comprehensive Metabolic Panel
    -Testosterone, Serum
    -Prostate-Specific Antigen (PSA)
    -Thyroid Profile

    Significant deviations from the normal range may require further evaluation by your physician.



    Includes: Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation); Hematocrit; hemoglobin; mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC); red cell distribution width (RDW); percentage and absolute differential counts; platelet count; red cell count; white blood cell count; Estradiol, Sensitive; IGF-1; A:G ratio; albumin, serum; alkaline phosphatase, serum; ALT (SGPT); AST (SGOT); bilirubin, total; BUN; BUN:creatinine ratio; calcium, serum; carbon dioxide, total; chloride, serum; creatinine, serum; globulin, total; glucose, serum; potassium, serum; protein, total, serum; sodium, serum; Testosterone, Serum; Prostate-Specific Antigen (PSA), Serum;Free Thyroxine Index (FTI);Thyroxine (T4); Thyroid Hormone Binding Ratio (T3 Uptake); Thyroid-Stimulating Hormone (TSH)

    Patient Instructions: Patient should fast for 12-14 hours before collection of the specimen. If using a testosterone cream please be sure you have not rubbed any into the antecubital area of your arm for the last 24 hours as it can give elevated results.

    Categories: Hormones and Metabolism, Male Specific Tests, Fitness, Nutrition and Anti-Aging

    Price: $169.49
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    Thanks!

    If your RBC's are elevated BUT your hematocrit is within normal range, is that ok?

    Quote Originally Posted by crazycrew View Post
    In some (like myself) using T can raise hemocrate levels and may require regular blood letting. I donate to Red Cross regularly and that is enough to keep my levels at an acceptable range.
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    I can't say. My experience was with the Hematocrit. Sorry.
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    Thanks!
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    Quote Originally Posted by Whacked View Post
    Please elaborate on TRT and elevated RBC risk?
    What effect does a high red blood cell count have on the body?
    In: Conditions and Diseases, Blood [Edit categories]



    Answer
    high red cells can increase the delivery of oxygen to your tissues, and can make you feel full of energy. However, past a point, the increased number of cells in your blood causes the blood to become thickened and kinda gluggy. This puts a HUGE strain on the heart, and can cause heart attacks and heart failure.

    Do not consider taking hormones such as EPO (erythropoietin) to increase your red cells- it is a dangerous practice and is illegal in sports and in the courts (it is a prescription medicine only).

    Altitude training provides enough stimulus for the body to increase blood cells to get the beneficial effects, but not enough to cause the adverse effects (provided it is done responsibly). Hope this helps!



    Definition
    By Mayo Clinic staff

    A high red blood cell count indicates an excess of red blood cells circulating in your bloodstream. Red blood cells (erythrocytes, or RBCs) are produced in your bone marrow and transport oxygen from your lungs to tissues throughout your body. A high red blood cell count is also called erythrocytosis (uh-rith-roh-sie-TOH-sis).

    The threshold for a high red blood cell count is somewhat different from one medical practice to another. A high red blood cell count is generally defined as more than 5.72 million red blood cells per microliter (mcL) of blood for men and 5.03 million per mcL for women. In children, the threshold for high red blood cell count varies with age and sex.


    Causes
    By Mayo Clinic staff

    A high red blood cell count may occur because:

    Red blood cell production increases to compensate for low oxygen levels due to poor heart or lung function The kidneys release too much of a protein (erythropoietin, or EPO) that enhances red blood cell production The bone marrow is producing too many red blood cells The oxygen-carrying capacity of red blood cells is impaired Red blood cell production increases to compensate for limited oxygen at higher altitudes The loss of blood plasma, the liquid component of blood, creates relatively high levels of red blood cells Specific causes of high red blood cell count may include:

    Anabolic steroids, which stimulate red blood cell production Congenital heart disease COPD Dehydration EPO doping (injections of erythropoietin (EPO) to enhance athletic performance) Heart failure Hemoglobinopathies (conditions present at birth that impair the oxygen-carrying capacity of red blood cells) Kidney cancer Kidney transplant Living at a high altitude, where there's less oxygen in the air Other types of heart disease Other types of lung disease Polycythemia vera Pulmonary fibrosis Smoking, which may result in low blood oxygen levels
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    Very Nice! Thanks buddy
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    That was a nice read man. Thanks
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    Quote Originally Posted by MakaveliThaDon View Post
    That was a nice read man. Thanks
    Dehydration is common with high RBC and hemocrit. I have dr's patients retest next blood work to rule it out drinking 16 oz water prior to blood test.
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    Quote Originally Posted by The Matrix View Post
    e2 and TT can be done cheap,
    Shbg tends to stay constant in majority of cases
    t-4, Ft3 and ft4 is all that is needed for thyroid when on meds

    for older guys I go after t and e2 stabilization then watch the thyroid function as HRT gets balanced because some time it may go down then return to normal over time. As long as symptoms are alleviate I suggest to ride it out, if symptoms come back after 4-5 months get e2 tested and ft3, ft4, t4 TT is pretty much constant.
    Ordered labs and had blood drawn yesterday

    -Lipid Cholesterol Profile
    -Complete Blood Count w/ Differential
    -Estradiol, Sensitive
    -Hemoglobin A1c
    -Cardiac C-Reactive Protein Test, High Sensitivity
    -Insulin Growth Factor (IGF-1)
    -Thyroxine-Stimulating Hormone (TSH)
    -Gamma Glutamyl Transpeptidase (GGT)
    -Insulin, Fasting
    -Comprehensive Metabolic Panel
    -Luteinizing Hormone(LH)
    -Testosterone Serum
    -Sex Hormone binding Globulin, Serum
    -Urinalysis, Routine
    -Follicle-Stimulating Hormone (FSH)
    -Magnesium, Serum
    -Thyroxine (T4) Free, Direct
    -Ferritin, Serum
    -Prostate-Specific Antigen (PSA)
    -Iron Serum w/TIBC
    -Dehydroepiandrosterone Sulfate (DHEA)
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    Quote Originally Posted by crazycrew View Post
    Ordered labs and had blood drawn yesterday

    -Lipid Cholesterol Profile
    -Complete Blood Count w/ Differential
    -Estradiol, Sensitive
    -Hemoglobin A1c
    -Cardiac C-Reactive Protein Test, High Sensitivity
    -Insulin Growth Factor (IGF-1)
    -Thyroxine-Stimulating Hormone (TSH)
    -Gamma Glutamyl Transpeptidase (GGT)
    -Insulin, Fasting
    -Comprehensive Metabolic Panel
    -Luteinizing Hormone(LH)
    -Testosterone Serum
    -Sex Hormone binding Globulin, Serum
    -Urinalysis, Routine
    -Follicle-Stimulating Hormone (FSH)
    -Magnesium, Serum
    -Thyroxine (T4) Free, Direct
    -Ferritin, Serum
    -Prostate-Specific Antigen (PSA)
    -Iron Serum w/TIBC
    -Dehydroepiandrosterone Sulfate (DHEA)
    LabCorp
    Salivary Cortisol, MS
    Test Number: 500179 CPT Code: 82533
    eight (8) serial samples
    Salivette tubes (item # 51.1532) and
    specialized patient collection kits
    (item # 38330G)
    255.3
    255.8
    255.4
    ============================== =====

    blood
    T3, Total
    T4, Total----------------------already included
    T3, Free
    T4,Free
    T3, Reverse
    Ultrasensitive TSH--------------already included
    Pregnenolone
    Progesterone

    ============================== =======

    Make sure that you have
    iodine (even excess is ok)
    Selenium


    ...

    where is your SHBG these days?

    How are you doing these days?
    have not seen posts about your health in a while.


    .
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    Quote Originally Posted by JanSz View Post
    LabCorp
    Salivary Cortisol, MS
    Test Number: 500179 CPT Code: 82533
    eight (8) serial samples
    Salivette tubes (item # 51.1532) and
    specialized patient collection kits
    (item # 38330G)
    255.3
    255.8
    255.4
    ============================== =====

    blood
    T3, Total
    T4, Total
    T3, Free
    T4,Free
    T3, Reverse
    Ultrasensitive TSH
    Pregnenolone
    Progesterone

    ============================== =======

    Make sure that you have
    iodine (even excess is ok)
    Selenium


    ...
    I wish I could afford more tests Janz but let me explain

    I know haven't posted for a few months and my excuse is I have been very busy.

    A year and a half ago my doctor told me to eliminate as many stressors as I could. Well some things can't be explained rationally.
    It could be Karma, but if I believed that I would have to of been a real SOB at some time in my past. So I'm going with the old antaige;"you'll never be given more than you can handle" and "when one door closes another opens".

    Its hard to lead a stress free life when. ( in order of occurrences)

    Wife has surgery to remove cancerous breast growth.
    Wife wreaks motorcycle (drifter) No comp ins.
    Wife wreaks motorcycle (Harley)
    Company truck wreaked when opposing traffic crosses lane and causes a near head on.
    Investigator filled out paperwork wrong so having to sue to get compensated. (no comp ins)
    Wife kills suicidal pedestrian in traffic accident, then suffers massive heart attack.
    Had to repair work truck w/o comp insurance.
    Wife started have seizures and is on massive doses of Dilantin for control.
    Step daughter wreaks motorcycle (Harley)
    Mother in law moves in and has Alzhiemers.
    After 40 yrs of service the Post Office contacted me a month ago and canceled my contract with 60 days notice.
    -------------------------------------------------------------------------------------------------------------------------
    As I was writing this the P.O. contacted me and modified my route with a new contract. Whew......
    Lets see what these tests show and maybe I will be able to get more in a couple of months.
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    Jansz I do not know how medicare or your insurance have not declined our tests because they are medical unnecessary according to standards of many insurances. It just going to be a matter of time. We are getting hammered with insurance companies rejecting claims even with the proper diagnosis codes with nedical neccessity.
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    Quote Originally Posted by windwords7 View Post
    I've been on TRT for over 5 years and I still do it twice a year.
    First couple years may be ok but after a while there is a good chance that
    pregnenolone and progesterone will tank.

    Pregnenolone is made from cholesterol.
    Cholesterol is carried by HDL and LDL LipoProteins, but only cholesterol that is in LDL is being converted.
    To convert cholesterol--->pregnenolone
    we need
    ACTH, LH & FSH

    Being on TRT, specially for prolonged time reduces LH and FSH to zero.

    That is one reason why production of pregnenolone tanks.

    Lack of pregnenolone have a dire consequences.
    Most often we talk about Adrenal Fatigue, which is not Fatigue at all.
    But it results in Low FreeCortisol.
    That is a cortisol which can be measured by saliva testing.

    There is many people on Adrenal Fatigue for their own reasons, but we are creating it to ourselves by using Testosterone.

    When we need testosterone we do not have much choice,
    but
    we have to know what we are doing by taking testosterone
    and
    take preventive measures.

    If low, Pregnenolone can be supplemented.

    Some people are already doing it.
    99% that supplementation is worthless.
    Pregnenolone must be supplemented
    very frequently
    using only excellent product

    The only pregnenolone that works is very high density in Lipoderm base.

    Many compounding pharmacies can do what we need.
    I have found best deal (below).
    If someone finds better deal, please let me know, I am always short of $$.

    Important note, it must be loaded into Topi-Click.
    That is a tool to dispense accurate dose and to spread it on skin without loosing any even smallest amount of cream.
    ============================== ==
    I spread pregnenolone on my neck, progesterone on my thigh.
    Always same location, no need for additional washing other than usual.
    Keep skin clean, Lipoderm transports any junk better than DMSO does.

    Guys working in dust, welders, (painters?), chemical lab technicians,
    probably should not use this.
    ============================== ==
    Last dose, bedtime, is better when instead of pregnenolone
    progesterone is used, unless you newer had any prostate issue.
    Divide any thyroid hormones into equal portions per each preg dose,


    0100
    0200
    0300
    0400
    0500
    0600
    0700 wakeup--1click-pregnenolone + thyroid hormone
    0800
    0900
    1000 ---------1click-pregnenolone + thyroid hormone
    1100
    1200
    1300 ---------1click-pregnenolone + thyroid hormone
    1400
    1500
    1600 ---------1click-pregnenolone + thyroid hormone
    1700
    1800
    1900 ---------1click-pregnenolone + thyroid hormone
    2000
    2100
    2200 bedtime--1click-progesterone + thyroid hormone
    2300
    2400




    ============================== ==
    University Compounding Pharmacy
    1875 3rd Ave, San Diego, CA 92101, USA
    Toll Free: 1-800-985-8065
    Local: 1-619-683-2005
    Fax: 1-619-683-2008
    Email*info@ucprx.com
    ============================== ===

    Script
    300grams pregnenolone cream
    200mg/gram in Lipoderm base
    in 30mL Topi-Clic
    total 10 Topi-Clicks
    use 3mL/day=600mg/day
    6 refils
    Total cost $199.95 including $15 2nd day Fed-Ex

    ============================== ====

    Script
    150mL progesterone cream
    100mg/gram in Lipoderm base
    in 30mL Topi-Clic
    total 5 Topi-Clicks
    6 refils
    Total cost $119.95 plus $15 for 2nd day Fed-Ex

    ============================== ====
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    Quote Originally Posted by JanSz View Post
    First couple years may be ok but after a while there is a good chance that
    pregnenolone and progesterone will tank.

    Pregnenolone is made from cholesterol.
    Cholesterol is carried by HDL and LDL LipoProteins, but only cholesterol that is in LDL is being converted.
    To convert cholesterol--->pregnenolone
    we need
    ACTH, LH & FSH

    Being on TRT, specially for prolonged time reduces LH and FSH to zero.

    That is one reason why production of pregnenolone tanks.

    Lack of pregnenolone have a dire consequences.
    Most often we talk about Adrenal Fatigue, which is not Fatigue at all.
    But it results in Low FreeCortisol.
    That is a cortisol which can be measured by saliva testing.

    There is many people on Adrenal Fatigue for their own reasons, but we are creating it to ourselves by using Testosterone.

    When we need testosterone we do not have much choice,
    but
    we have to know what we are doing by taking testosterone
    and
    take preventive measures.

    If low, Pregnenolone can be supplemented.

    Some people are already doing it.
    99% that supplementation is worthless.
    Pregnenolone must be supplemented
    very frequently
    using only excellent product

    The only pregnenolone that works is very high density in Lipoderm base.

    Many compounding pharmacies can do what we need.
    I have found best deal (below).
    If someone finds better deal, please let me know, I am always short of $$.

    Important note, it must be loaded into Topi-Click.
    That is a tool to dispense accurate dose and to spread it on skin without loosing any even smallest amount of cream.
    ============================== ==
    I spread pregnenolone on my neck, progesterone on my thigh.
    Always same location, no need for additional washing other than usual.
    Keep skin clean, Lipoderm transports any junk better than DMSO does.

    Guys working in dust, welders, (painters?), chemical lab technicians,
    probably should not use this.
    ============================== ==
    Last dose, bedtime, is better when instead of pregnenolone
    progesterone is used, unless you newer had any prostate issue.
    Divide any thyroid hormones into equal portions per each preg dose,


    0100
    0200
    0300
    0400
    0500
    0600
    0700 wakeup--1click-pregnenolone + thyroid hormone
    0800
    0900
    1000 ---------1click-pregnenolone + thyroid hormone
    1100
    1200
    1300 ---------1click-pregnenolone + thyroid hormone
    1400
    1500
    1600 ---------1click-pregnenolone + thyroid hormone
    1700
    1800
    1900 ---------1click-pregnenolone + thyroid hormone
    2000
    2100
    2200 bedtime--1click-progesterone + thyroid hormone
    2300
    2400




    ============================== ==
    University Compounding Pharmacy
    1875 3rd Ave, San Diego, CA 92101, USA
    Toll Free: 1-800-985-8065
    Local: 1-619-683-2005
    Fax: 1-619-683-2008
    Email*info@ucprx.com
    ============================== ===

    Script
    300grams pregnenolone cream
    200mg/gram in Lipoderm base
    in 30mL Topi-Clic
    total 10 Topi-Clicks
    use 3mL/day=600mg/day
    6 refils
    Total cost $199.95 including $15 2nd day Fed-Ex

    ============================== ====

    Script
    150mL progesterone cream
    100mg/gram in Lipoderm base
    in 30mL Topi-Clic
    total 5 Topi-Clicks
    6 refils
    Total cost $119.95 plus $15 for 2nd day Fed-Ex

    ============================== ====
    This is not feasible or realisitic for the normal person who has a 9-5 job.
    For christ sakes, I have better things to do then to set my alarm clock to take meds, people at work think you are fkn nuts !!

    I be stressed out trying to fit this on top of seeing, training, phone consults,working out myself, returning emails, time on forum.

    I have a hard enough time taken my thyroid meds 2 times a day LOL
  24. Registered User
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    Quote Originally Posted by The Matrix View Post
    This is not feasible or realisitic for the normal person who has a 9-5 job.
    For christ sakes, I have better things to do then to set my alarm clock to take meds, people at work think you are fkn nuts !!

    I be stressed out trying to fit this on top of seeing, training, phone consults,working out myself, returning emails, time on forum.

    I have a hard enough time taken my thyroid meds 2 times a day LOL
    Why do not you take thyroid hormones and testosterone once a month.
    It would be much less intrusive.


    ..
  25. Registered User
    The Matrix's Avatar
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    Quote Originally Posted by JanSz View Post
    Why do not you take thyroid hormones and testosterone once a month.
    It would be much less intrusive.


    ..
    I am in the process of working on taking none of it to tell you the truth...
    I am already off hcg and adex, cortef,
    waiting for nutraeval results then I will recalibrate from there.

    Already pulled several people off HRT and are doing fine..

    Being a human sponge and pin cushion is not my idea of fun

    i am sure the vast majority will agree ...
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