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Sometimes common sense may fall “out of the box”...

I have to say unfortunately it seems injectables may not be a a goodoption for you moving forward (hopefully I’m not being “captain obvious”)...and agree - no phenylephrine intravenous for this purpose!

Bingo with being curious about the rT3 seeing as his FT3 went down. Would have been REALLY interesting in that case to see a pre + post FT3.

You know I can’t argue with that one ;-)

Indeed, although as we see every day, a doctor need only to have his eyes and ears open to come to this conclusion without a study to prove it!

Not certain on potency with addition of theanine, thus I don’t prescribe the combo. We know hCG is very finicky.

This is correct, though I would say simply changing the vial size seems to be the safest path vs adding other components.

I can never, in good faith, encourage experimenting with any hormone treatment (even progesterone) without adequate and competent monitoring and adjusting from a healthcare professional. The challenge often is (as you’ve discovered) finding such a provider.

That’s actually a creative regimen that is sometimes used by knowledgeable providers to enhance DHT conversion, libido, erectile function, and various other androgenic features. Always works to raise DHT (can raise E2 as well) and commonly (but not always) helps libido, etc.

Dr Hertoghe would be an excellent option if geography and cost are not prohibitive.

I’ll look forward to it!

They wasted your/her time and, unfortunately, offered no insight whatsoever. Probably for the best as even IF they tested and discovered deficiencies it is highly unlikely they would (A) address the deficiencies and (B) address the deficiencies appropriately.

Perhaps a touch of anastrozole (0.125mg) twice per week as a trial. There are some, however, that are sensitive to the drug itself regardless of doses and E2 levels.

Another informative site a patient alerted me to just a few weeks ago and (WOW) the community has collectively supplied a goldmine of information and recommendations: http://Rt3-adrenals.org

In practice, and in males, I have not seen a clinically apparent impact on lipids as we are generally talking about very small doses. Now crashing estradiol levels would certainly be another story. Data that relates to female treatment is not pertinent as the dosage is typically 1 mg daily.

The fundraiser campaign is still ongoing for anyone seeking to pay gratitude.

Very welcome and welcome to the team.

Indeed and many would say “a marathon, not a sprint”.

As stated, injectable FSH would offer no additional benefit when endogenous FSH is already high (whether naturally or with Clomid). Lyophilized FSH can be used along with hCG, however, for a male on TRT to “replace” the lost LH/FSH (clomid is still an overall better fertility treatment...

Dozing at the wheel is scary...certainly fortunate that has resolved!

Copying from your other thread regarding anastrozole question: Holding the anastrozole until first follow-up would be reasonable, though Dr Calkins likely had some concern over your very low initial T and how you may aromatize with a significant increase in those levels (among other factors you...

Holding the anastrozole until first follow-up would be reasonable, though Dr Calkins likely had some concern over your very low initial T and how you may aromatize with a significant increase in those levels (among other factors you may have discussed during your consultation).

Yes some patients get more PIP (post-injection pain) with this technique, whereas some do just fine. Everyone is different and only way to know for sure is to try if that technique interests you. A word of caution is to NOT prefill and store multiple syringes in that manner...draw and inject...

Thank you for your kind words, T-dog, they are priceless to me and I never tire of hearing success stories from my patients!

Telemedicine is going to be an undeniably vital component of the future of healthcare. More efficiency and better access to care...that’s a win-win!

Gosh that’s scary, but unfortunately a story I hear on a weekly basis.

You should also check your prolactin with a repeat of your estradiol.

Yes...it can.

Indeed, just don’t do that directly into a vessel!

A lot of the online “guides” are very aggressive with the T3 titration. There is no reason to be too aggressive or impatient, as the risks of T3-induced hyperthyroidism are real. The best and most general answer is that you gradually titrate up on the T3 and periodically CHECK THE RT3 to track...

As systemlord stated the tiny air bubbles are of no significance. Now if you inject an entire syringe full of air directly into a vessel...well then it may be a different story. The DHEA/preg often improve sleep when taken in the evening, though some patients have the opposite reaction. Can try...