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  1. I've taken brand-name Cortef for many, many...

    I've taken brand-name Cortef for many, many years. On a few occasions I have had generics substituted when the pharmacy didn't have enough Cortef in stock. I admit I did wonder if it was as...
  2. Very solid advice. Raising estradiol following...

    Very solid advice.

    Raising estradiol following a crash is accompanied by significant patient discomfort...tread carefully.
  3. That's a good point. I have learned to be aware...

    That's a good point. I have learned to be aware of subtle clues as to where things sit - even on daily injections. The peaks and valleys may be much, much smaller, but you can find them.
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    Here on the Forum, Dr. Saya has addressed that...

    Here on the Forum, Dr. Saya has addressed that issue. Nothing to be concerned about in the context you describe. My own doctor has told me she regularly reassures her patients that death isn't...
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    No. You're overthinking this.

    No. You're overthinking this.
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    Vince is correct. If you want to aspirate, a...

    Vince is correct. If you want to aspirate, a subtle pull should be enough, but it's not necessary. I believe Nelson has written that he doesn't aspirate and he's been playing this game for decades.
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    Where does your prolactin sit? Out of range...

    Where does your prolactin sit? Out of range prolactin levels can hammer libido. And your DHT?
  8. I know that we have at least one member who found...

    I know that we have at least one member who found he did better on a NON-daily protocol. After four years of daily injections, I couldn't be happier - which again points to how each of us is a unique...
  9. A little more information, as Madman suggested,...

    A little more information, as Madman suggested, will enhance the discussion.
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    Over the course of my years on TRT, and my...

    Over the course of my years on TRT, and my membership here at EM, I have never aspirated, nor heard from many members that do. We had a run of threads some years ago, they come and go, and that...
  11. Day after day men join EM with stories like...

    Day after day men join EM with stories like yours. They consult a doctor in good faith, drop a substantial amount of money, and get nowhere; it happened to me years ago. It's an expensive lesson too...
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    The body tries to recover, always and every time....

    The body tries to recover, always and every time. The younger one is and the better one's health is, the easier it will be. I would do nothing, I'd not add Clomid, until I knew where my levels stood...
  13. You are missing critical tests. SHBG DHT...

    You are missing critical tests.


    SHBG
    DHT
    DHEA
    Estradiol/Sensitive (LC, MS,MS)
    LH
    FSH
    Prolactin
  14. Your estradiol was measured with the incorrect...

    Your estradiol was measured with the incorrect lab test. Men should only have estradiol evaluated with the sensitive, LC, MS/MS lab test. Your test, one that is used for women, is unreliable and of...
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    Welcome to Excelmale. You're doing all of this on...

    Welcome to Excelmale. You're doing all of this on our own? No doctors involved? Have you determined if your testosterone has rebounded or are you basing this solely on feeling more agressive? Have...
  16. We can self-diagnose ourselves into a mental...

    We can self-diagnose ourselves into a mental breakdown.
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    We've heard from Dr. Saya and Dr. Rotman, the...

    We've heard from Dr. Saya and Dr. Rotman, the urologist, that almost all men on TRT experience a decreased ejaculate load. My urologist has said that some of his TRT patients (someone else manages my...
  18. It's certainly not the response you wanted....

    It's certainly not the response you wanted. You're receiving quality care, knowledgeable medical professionals, and it isn't unusual to find out that the starting protocol needs an adjustment.
    ...
  19. If SHBG wasn't tested it raises a number of...

    If SHBG wasn't tested it raises a number of questions. First of all, why wasn't it? How was it possible for a protocol to be designed if the odds of its success weren't held up to SHBG values? What...
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    You have every reason to believe that you'll find...

    You have every reason to believe that you'll find your footing. Really.
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    I'm sorry this is happening, but where did your...

    I'm sorry this is happening, but where did your DHEA sit before you initiated therapy?
  22. You said you're injecting 150mg of testosterone....

    You said you're injecting 150mg of testosterone. But how are you doing that? Twice weekly? EOD? Weekly? Your SHBG is certainly on the lower end.
  23. This isn't a sprint. Whether it's standard TRT,...

    This isn't a sprint. Whether it's standard TRT, HCG mono, or Clomid, the key to success is time...and patience. I understand that you feel badly, and it doesn't seem to be getting better, but it has...
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    Every doctor that I have dealt with/heard of who...

    Every doctor that I have dealt with/heard of who has happy and satisfied patients initiates therapy in a split-dosing protocol in which the total weekly dose does not exceed 150mg (unless there is an...
  25. I have great respect for Dr. McClain, he's a...

    I have great respect for Dr. McClain, he's a member here and answers questions regularly on the Forum. I respectfully disagree with him based on my own clinical experience.

    I do wish you well.
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    I think this crosses the mind of many guys when...

    I think this crosses the mind of many guys when they start injecting.
  27. Good luck with that.

    Good luck with that.
  28. Going "up" in your protocol, if by that you mean...

    Going "up" in your protocol, if by that you mean adding more testosterone per injection, may not deliver the results you hope for. Increasing the frequency of your injections, with a subtle...
  29. Dr. Khera, the author of this material, is a good...

    Dr. Khera, the author of this material, is a good friend of Nelson's. They have lectured together on a number of occasions.
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    What was the elevated estradiol threshold that...

    What was the elevated estradiol threshold that triggered the problem? Dramatically high, in respect to you, or a moderate increase?
  31. Are you seeking private care, or through the NHS?

    Are you seeking private care, or through the NHS?
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    Has it been pointed out that your likely...

    Has it been pointed out that your likely measuring estradiol with the wrong lab test? The reference range is a dead giveaway. Men ALWAYS want to test e2 via the sensitive (LC, MS/MS) lab. You and...
  33. You must have your sleep evaluated. There is an...

    You must have your sleep evaluated. There is an "undiagnosed epidemic " of sleep apnea in men (Dr. Justin Saya's words). Lack of solid, continuous sleep can - and almost always does - hammer your...
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    Elevated LH suggests primary hypogonadism, a...

    Elevated LH suggests primary hypogonadism, a testicular problem. If that is the case, if you confirm those elevated values, all the Clomid in the world is a waste of time and money.
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    Lowering estradiol is simple (to the extent any...

    Lowering estradiol is simple (to the extent any aspect of the TRT game can be called simple). Raising it requires time, patience, and - all too often - suffering.
  36. Sticky: Comprehensive/Adjunctive Hormone Monitoring...

    Comprehensive/Adjunctive Hormone Monitoring (Thyroid, Adrenal)
  37. Sticky: Second time this year I have read of/heard from...

    Second time this year I have read of/heard from someone with Xarelto issues.
  38. Welcome to Excelmale. May I ask how old you are?...

    Welcome to Excelmale. May I ask how old you are? What are your sleeping patterns like? Medications you're taking (prescribed, over the counter, and supplements)? History of steroid or prolonged...
  39. Yep...we are our own, best advocates.

    Yep...we are our own, best advocates.
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    If such a thing as an estradiol sweet-spot...

    If such a thing as an estradiol sweet-spot actually existed the entire dialing-in process would be a breeze. It's a dance between the objective, the lab results, and the subjective, how the patient...
  41. I feel confident you're not injecting 500mg of...

    I feel confident you're not injecting 500mg of testosterone weekly.
  42. Welcome to Excelmale. As we ask so often...where...

    Welcome to Excelmale. As we ask so often...where does your SHBG sit? SHBG values are like arrows pointing patient and doctor toward the correct injection protocol. Members here at Excelmale inject...
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    Consider contacting Dr. Robert Stevens. He's a...

    Consider contacting Dr. Robert Stevens. He's a member of the Forum here at Excelmale and is doing good work with men dealing with hypogonadism. http://themenshealthclinic.co.uk
  44. Wrong estradiol test - men should measure e2...

    Wrong estradiol test - men should measure e2 levels with the sensitive (LC, MS/MS) lab test. Your values can't be relied upon. There's no reason to test LH and FSH once TRT is initiated. Exogenous...
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    Welcome to Excelmale. We hope you'll be an active...

    Welcome to Excelmale. We hope you'll be an active member.
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    There are doctors practicing privately in the UK...

    There are doctors practicing privately in the UK who know how to manage androgen therapy. Where do you live?
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    It's your choice, obviously, but there are many...

    It's your choice, obviously, but there are many who receive a diagnosis that may require a lifetime of medication and monitoring. In my case, I'm glad that a regimen is available that permits me to...
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    What, at root, is causing you to feel uncertain?

    What, at root, is causing you to feel uncertain?
  49. Improve Sperm Quality By Eating Nuts?

    Men who ate about two handfuls of mixed almonds, hazelnuts and walnuts daily for 14 weeks improved their sperm count and had more viable "swimmers", scientists found.

    The study comes amid a...
  50. Nitrate-Cured Meats and Mania: An Association

    Diets high in nitrates were associated with higher risk for experiencing a manic episode, a recent study has shown. Among those with a history of psychiatric disorders, people who reported eating a...
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