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Would make sense that he would be afraid to prescribe a controlled substance…… surprised they cared about klonopin

Wonder if he couldn’t prescribe scheduled meds? Some might be on drug diversion ?

Gotta get a good internal med doc.. love my DO…… he knows where I get my glp’s lol…… down 195 lbs

TRT is easy to prescribe.. imho. . I’ve had more difficulty with glp’s and crazy rules and shortages

I have seen great benefits from TRT but also an equal amount of great harm. Unfortunately many providers check one total testosterone on a patient in the late afternoon and dx hypogonadism. Heck many providers don’t even warn patients about the sterility and other risk.

Any treatment plans should be based on physical assessment and bloodwork. There’s no one-size-fits-all if you have high estradiol. Surely don’t need any testosterone to raise it higher that be crazy.

Not sure didn’t see your bloodwork . I usually use endocrinologist guidelines, not family doctor or anything like that. most of times I can tell if you’re truly hypogonadal without any blood work too.

Don’t need AI I have prescribed testosterone almost 20 years and have seen the huge spikes in estradiol and many negative side effects . Many providers don’t know how to treat it properly. an aromatase inhibitor with or without testosterone can raise testosterone very well Total testosterone...

Obese folks will aromatize the testosterone into estrogen. Weight loss of course helps this. Total testosterone isn’t that helpful in diagnosing hypogonadism in the obese. Smarter for the obese to take a small dose of an aromatase inhibitor when weight normal taper off

Never tried but when I was in the Philippines last year many of the glutathione clinics bought it from South Korea.

Started april 16, 2024 at 352 lbs . Now 195 lbs. was on Tirz 13 mg and stopped for 5 weeks due to dizziness and increased calories from 1200 to 1800 a day. Restarted 3 weeks ago and reduced calories to 1200-1500 a day.

Tirz was on 13 mg . Stopped one month ago due to dizziness . Restarted it yesterday. 100 lbs first 5 1/2 months……152 lbs since I started April 2024 …. Around 43 percent……… scale keeps dancing between 200 and 205 ……..

Pounds of sugar……..

I hear ya first 5 1/2 months down 100 pounds 10 -11 months down 150 pounds.. it’s a miracle drug….. 202-203 now, 352 April last year….. my wife only weighs 120 pounds…… down 182 lbs in 2 years ….. just stopped it three weeks ago, seeing if mine food noise and hunger comes back

Good to have blood work. Yeah, orthostatic hypotension is when your blood pressure drops when you stand up usually heart rate goes up. Blood pressure could be good sitting ………They will check your blood pressure laying down, sitting up and then standing to diagnose it.

Yeah Dizziness is horrible. Have you had your orthostatic blood pressure checked? You don’t think you’re anemic do you? Could be from dehydration….

Yeah, I really pushed the electrolytes and hydration…. But it never got better most people do get used to the med…… i’ve also rotated the manufacturer on the med…thinking, maybe it was contamination.

At 3 weeks off tirz my instances of dizziness have improved ….. I thought it was orthostatic hypotension from standing but we checked it at the clinic I worked in and my blood pressure wasn’t dropping. I wore a watch and monitored heart rate … it wasn’t dropping…. Then I wore a glucose monitor...

Didn’t cut carbs … was on a 1200 calorie diet for 7-8 months… now 1800 calories ….. pushed the electrolytes and fluid ….. I thought maybe it was from the weight loss or tirz…….. dizziness is common but it usually goes away after a couple months. Mine started since the second month on it…….

I was having dizzy spells on it that is why I stopped .. has planned on being on it life long………. Reversed diabetes , sleep apnea, severe fatty liver is now very mild, etc. it has been a miracle drug

As a male ….pt 141 is amazing…… I was using 2 x’s a week at low dose 0.5 to 1 mg…… but unfortunately I kept getting new sunspots ….. and tanned well……

Stopped tirz 13 mg q week 3 weeks ago. Anyone notice food noise returning after stopping the med? I lost 100 lbs the first five and 1/2 months , now down 150 lbs since mid April 2024… total weight loss around 182 lbs the last 2 years…. goal is to be 195 lbs at 6’2 (8 more lbs) …. So far I...

Skinny guy with lots of extra skin here lol

Yeah, that’s called the quarter ffm rule….. so you did perfect….

Yeah, I was thinking about getting a DEXA scan to see how much fat I have…. I was gonna lift weights for six months then have it done

I lost 100 lbs in a little under 6 months and now down 142 lbs in 9 months … was 352 now 210….. lost muscle of course but don’t look like a crack head. Strength and muscle are normal for my weight … I am Not lifting as much weight either I had a size 52 waist ,now wear 34-36 “ …… buying...

RS has Severe constipation due to weight loss and tirz. Tried everything but RS went back to miralax but to actually work have to take a double dose.

No they had to titrate it up

https://investor.lilly.com/news-releases/news-release-details/tirzepatide-reduced-sleep-apnea-severity-nearly-two-thirds Here it said 10 mg or 15 mg in trials

Once my RS was down 40 lbs sleep apnea completely resolved …. RS had it dx 15 years at a much lower weight. …….. felt like tongue size is about half of what is was…….RS went from 352 to 218 in 8 months ……. Fingers shrinked so much Ring now down 5 sizes , less than ring size at 185 lbs when in...

Would probably just be the standard 2.5 to 15 mg dosing titrated to patient response .

https://www.reuters.com/business/healthcare-pharmaceuticals/eli-lillys-obesity-drug-gets-medicare-coverage-sleep-apnea-cnbc-reports-2025-01-08/

I have heard similar from the middle men….. I really think it was to justify a higher price .…what would be the difference between the two? Maybe the lower grade failed purity testing or was a failed production run? Or maybe it is older…… I could never get a straight answer from the reseller.

I tried one company and they wanted a pharmacy only. Even as an NP…..

I am in middle Tennessee south of Nashville . We were lucky , house was on high land . Sold my house and left three months after Katrina , didn’t wanna raise a family in a disaster area.

It difficult. I love living near the water, the seafood and culture ……… but I have 6 kids in Tennessee with a better job market….

I moved to Tennessee after Katrina destroyed the Mississippi gulf coast. It was crazy just been moved back to hometown starting a family after military and college ……. It was horrible …… 26 miles of coastline most of it destroyed 1/2 mile - 1 mile inland…. Some places hit with a 28-32 foot...

I grew up on the Mississippi Gulf Coast I remember seeing them as well. Especially at the Barrier Islands… unfortunately Hurricane Katrina, the BP oil spill and freshwater from the Louisiana spillway killed much of our marine life close to shore ….

Nope I was wrong they have a synthetic test now FUJIFILM Wako PYROSTAR… still $ 300 a test

The synthetic test was just approved this year in July in the US. Will see if it ends the practice of blood letting the crabs…. I think it becomes a USP law until next year though.

Yeah for the endotoxin test. That is why they are so expensive….: crazy I know

Tell them to send off a throat culture next time … or tell them you are worried about the recent outbreaks of fusobacterium necrophorum…… Some folks go to tractor supply and use the penicillin G shots but those are for animal use only and easy to overdose on

Good advice above. I trend it monthly… I track every calorie on MyFitnessPal…. Started mid- April 2024 at 352 lbs with a 1200 calorie diet ….now I am 222 lbs. I would have 1-2 week periods with no weight loss….. mainly due to constipation. That has gotten better at lower body weights...

“Raw” peptides like tirzepatide are a near pure API and are Lyophilized Compounding pharmacies buy bulk raw API peptides from China. For example southend in Texas uses this company see COA pic from their website …FDA registered …. huge company, partly owned by a German company… The rep only...

True it proves the potency of the target peptide only ….. you will never know what impurities are in it……. Or endotoxin contaminants without much more expensive testing.

Yeah they are wrong. I have contacted manufacturers as well. Some fda approved too. The compounded pharmacies buy raw tirzepatide and semaglutide Interesting that my “raw tirz “ tested 99.8 percent potency ……

Disproven ? Nope. Some folks just don’t know the process and what actually occurs with lyophilization. Many think raw means the raw product to produce the peptides. It is a raw unsterile API….. How are compounded meds sold in a solution like tirzepatide made then? The vialed ones in cake...

No reason for all that . Compounded tirz that is sold in a solution is “raw tirz “ pure unsterile API mixed with a solution like b12 or bacteriostatic water/saline… filtered and tested for sterility, endotoxins , and potency …….

I have bought “raw” tirzepatide for an experiment . It tested 99.8 percent pure. I used a cheap scale and vialed it. I measured it with a cheap scale to 53 mg ….. so at the lab it weighed 55.78mg of powder, of which 51.64mg was Tirzepatide … so I was 2.78 mg off total weight ….. Resellers...

They aren’t hard to find. I buy mine from newstar via Alibaba for like $67 for a 100 filters… 37 dollar for the filters the rest shipping