Dr Justin Saya MD
Moderator
Make sure the vial of trimix is mixed up VERY WELL prior to every injection. As the name suggests, Trimix includes 3 active ingredients, and as the vial sits in the refrigerator awaiting your next use gravity is constantly at work pulling those ingredients towards the bottom of the vial. In this scenario, if not mixed very thoroughly, a draw from the top end of the vial will produce a diluted product (and consequently poor response), whereas a draw from the bottom portion of the vial will produce a highly concentrated solution (and robust response). The key here is that the response can be unpredictable, erratic, and risky if the vial is not THOROUGHLY mixed prior to EVERY use to ensure uniformity of solution. This effect is magnified for hyper-responders.