tempelcat4
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A complete guide for abusing r-hGH (Human Growth Hormone) and AI (Aromatase Inhibitor) to maximize your potential.
Wednesday, June 5, 2024
Disclaimer:
This guide is completely made out of enjoyment and published for informational purposes only.
I want to clarify that my intention in this guide is not to give Instructions on illegal (if the peptides are banned in your country) or dangerous actions.
Hormone therapy is done if a specialized doctor determines a deficiency only under professional medical supervision. Never disregard professional medical advice or delay seeking advice or treatment because of the information you read in this guide.
Acting on any information provided here is done solely at your own risk and responsibility.
The information provided in this guide may not be accurate - there could be incorrect or contradictory details.
Preface:
In this guide, my sole focus is on the core concept of drug usage, without delving into other crucial factors such as sleep, diet, or overall lifestyle.
This guide aims to replicate hormone therapy at the same level of expertise as professional endocrinologists.
During my time here on org, I've observed numerous users engaging in hormone therapy without fully understanding the substances they're injecting, the potential short-term and long-term side effects, or even the outcome of their injections.
This guide is completely made out of enjoyment and published for informational purposes only.
I want to clarify that my intention in this guide is not to give Instructions on illegal (if the peptides are banned in your country) or dangerous actions.
Hormone therapy is done if a specialized doctor determines a deficiency only under professional medical supervision. Never disregard professional medical advice or delay seeking advice or treatment because of the information you read in this guide.
Acting on any information provided here is done solely at your own risk and responsibility.
The information provided in this guide may not be accurate - there could be incorrect or contradictory details.
Preface:
In this guide, my sole focus is on the core concept of drug usage, without delving into other crucial factors such as sleep, diet, or overall lifestyle.
This guide aims to replicate hormone therapy at the same level of expertise as professional endocrinologists.
During my time here on org, I've observed numerous users engaging in hormone therapy without fully understanding the substances they're injecting, the potential short-term and long-term side effects, or even the outcome of their injections.
Contents:Introduction to Human Growth Hormone and Aromatase Inhibitor:
- Human Growth Hormone (HGH)
- Aromatase Inhibitor (AI)
The impact of administering exogenous Human Growth Hormone (r-hGH) in healthy adolescents:
- Benefits and drawbacks
The impact of administering Aromatase Inhibitor (AI) in healthy adolescents:
- Comparison of anastrozole, letrozole and exemestane
- Benefits and drawbacks of exemestane
Sources I rely on:
- Sources
Precautions:
- Safety Measures
- Storage Guidelines
- Use of Assistive Devices
- Authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify
Injecting r-hGH:
- Determining the appropriate r-hGH Dosage
- Administration Technique for r-hGH
- Timing of r-hGH Injections
Taking the correct dosage of Exemestane (Aromasin):
- Determining the appropriate exemestane Dosage
- Timing and method for exemestane administration
Estimated Costs and Cycle:
- List of Necessary Items with Pricing
- Cycle Outline and Weekly Schedule, Including Precautions
- Additional knowledge
Ending:
- Conclusion
Introduction to Human Growth Hormone and Aromatase Inhibitor:
Human Growth Hormone (HGH)
Human Growth Hormone or somatropin, GH, HGH, is a naturally occurring hormone within the human body produced by the pituitary gland in the brain.Human Growth Hormone (HGH)
Within the pituitary gland, HGH is not the only important hormone that gets produced, but rather only one of them, other hormones include TSH, ACTH, FSH, LH, MSH, etc.
Hormones are chemical messengers produced by glands in the endocrine system that regulate various bodily functions and processes.
The endocrine system is a network of glands that produce and release hormones to regulate numerous physiological processes within the body.
Physiological processes such as body growth and bone development, for instance, are among the functions regulated by the endocrine system.
The hormone HGH promotes growth, cellular replication, and regeneration in both humans and other animals, thereby playing a crucial role in human development.
Human Growth Hormone is the primary regulator of the growth process, and IGF-1 (Insulin-like Growth Factor 1) is a hormone that arises in response to the release of HGH and is also involved in growth.
Actually, the induction of growth is not directly attributed to growth hormone itself; rather, it is the metabolites of somatropin (HGH) that stimulate cell proliferation, hyperplasia (increase in the number of cells in a tissue or organ, leading to tissue growth), and hypertrophy (increase in the size of cells, leading to tissue growth). These metabolites belong to a class of growth factors known as IGFs (insulin-like growth factors), which share a molecular structure similar to insulin. Somatropin (HGH) is necessary for the synthesis of IGFs within the liver. Among these factors, IGF-2 primarily governs fetal development, while IGF-1 plays a pivotal role in promoting growth during adolescence.
For us, IGF-2 is irrelevant and will not be mentioned further, however IGF-1 will.
R-hGH requires a medical prescription in many countries, including the United States, Canada, and Europe. For countries in which r-hGH is legal, there are sources where acquiring r-hGH from private laboratories is possible.
r-hGH is usually contained in a powder form in a small vial and injected in a liquid form.
Aromatase Inhibitor (AI)
Aromatase Inhibitor (AI)
Aromatase inhibitors are medications that belong to an even broader class of drugs known as anti-estrogens.
Aromatase inhibitors work by suppressing the enzyme aromatase, consequently lowering estrogen levels. In adolescents, they are employed to manage conditions like precocious puberty or disorders characterized by excessive estrogen production.
Aromatase is an enzyme found in the human body that converts androgens (male hormones) into estrogens (female hormones):
(Estrogen refers to a group of hormones that include estradiol, estrone, and estriol, with estradiol being the most potent and prevalent form in premenopausal individuals)
(Estrogen refers to a group of hormones that include estradiol, estrone, and estriol, with estradiol being the most potent and prevalent form in premenopausal individuals)
Estrogen accelerates bone maturation by promoting the conversion of cartilage to bone, hastening the closure of growth plates, and limiting further bone growth in adolescents.
While estrogen is here often misunderstood as the only biomarker that influences epiphyseal closure (which is not the case), it’s indeed the one with the greatest impact on the process.
The most commonly used Aromatase Inhibitor are (numbered by frequency for adolescents):
- Anastrozole (Armidex, AstraZeneca)
- Letrozole (Femara, Novartis)
- Exemestane (Aromasin, Pfizer)
(The active ingredient exemestane was developed by Pharmacia & Upjohn. Pfizer later acquired Pharmacia & Upjohn. Exemestane was marketed under the brand name "Aromasin" by Pfizer.)
The active ingredient causes aromatase inhibition. Therefore, it’s not necessary to limit yourself to those three medications (If you can use them, but it's not severe to use another provider).
Original pharmaceutical medications are expensive and difficult to source, even from well-known sources within the bodybuilding community.
And they don't even promise a better effect, providers often do well-organized scams by faking every 10th pill in your package for example. This is not recognizable, even in a laboratory test usually only 1-2 tablets are tested. This means that the authenticity of your Aromatase Inhibitor can only be determined through blood tests.
All of the aromatase inhibitors will overshoot estrogen reduction if overdosed, or undershoot if underdosed. There is no reason to choose one over another because of what any may say about strength.
Anastrozole, letrozole, and Exemestane all are capable of working well and predictably for estrogen control. If already experienced with a given aromatase inhibitor, I recommend continuing with it, as personal dosing is already understood. If you have not yet tried any, then any of them can be effective. I hope the following explanation in this guide will assist you in your choice.
The impact of administering exogenous Human Growth Hormone (r-hGH) in healthy adolescents:
Benefits and drawbacks, for tanner stage 3-5 (open growth plates)
Benefits and drawbacks, for tanner stage 3-5 (open growth plates)
The impact of administered r-hGH is numerous and contingent upon the dosage of International Units (IU) administered and the period/cycle.
Benefits
External benefits (not ordered):
- Genitals: HGH promotes the growth of the penis.
- Hands and feet: HGH affects the growth of hands and feet, which can lead to an increase in the size of these extremities.
- Hair Growth: HGH promotes hair growth, both on the head and face. This includes an improvement in hair quality, which can lead to shinier and healthier-looking hair.
- Voice: HGH can also affect the growth of the larynx, which can lead to changes in voice pitch.
- Skin: Improved skin quality, including smoother and firmer skin.
- Physique and Muscle Definition: HGH increases muscle mass and improves muscle definition
- Body fat percentage: It can reduce body fat percentage and promote a slimmer body contour.
- Dimorphism: HGH can help accentuate and enhance gender characteristics, which can lead to a more attractive appearance.
- Dimorphism and Attractiveness: HGH causes pronounced sexual dimorphism, emphasizing masculine features such as the following.
- Eyes: Some users report an improvement in eye contours and a brighter appearance to the eyes.
- Skin Elasticity: HGH improves skin elasticity and reduces the appearance of wrinkles and fine lines, which results in a more youthful appearance.
- Lower Jaw (Mandible): Growth of the lower jaw is stimulated by HGH, which results in an increase in jaw size and a more pronounced jawline.
- Upper jaw (maxilla): The maxilla, the upper part of the facial skull, is also affected by HGH, which leads to changes in the shape of the face. Normally in width.
- Cheekbones (Zygomaticus): The cheekbones are also affected in growth.
- Mandibular angle: The jaw angle, which forms the transition from the lower jaw to the jaw and contributes to the development of the jawline, can also be influenced by HGH.
- Frontal Bone (Brow Bridge): The frontal bone is the bone at the front of the skull, above the eyes. The growth of this bone can be affected by HGH, which can lead to changes in the shape of the forehead.
- Other bones that may be less good as they grow:
- Nasal Bone: The nasal bone, which forms the root of the nose, can also be affected by HGH, which leads to an increase in the size of the nose.
- Note that growth of these bones is minimal and for the nose water retention in the tissue can also cause the nose to temporarily appear larger. This can particularly occur in people who already have a slightly larger nose, as water retention can cause the nose to become additionally swollen and appear larger than usual. So do not stress if your nose gets notably larger after HGH injection, as it is not permanent.
Addition:
Currently, there is a user who claims significant facial changes after approximately 8 months of r-hGH administration.
Although he provides pictures (which are blurred, with different lighting and angles), there appear to be no major changes (in fact, almost none in my opinion; he merely looks more mature). It seems to be more of an imagined perception, possibly triggered by the recent breakup with his girlfriend (refer to my part on depression later). He also mentions that he hasn't grown during those 8 months, which cannot be confirmed but is rather unlikely if his growth plates are still open, even considering natural growth. Generally, facial changes are minimal and subtle, even after 12 months of therapy with 6 IU of HGH per day. There might be slight changes in facial proportions, but drastic changes are very uncommon.
Significant facial changes are only expected with an excess of HGH, which can lead to conditions like acromegaly. However, even in such cases, facial changes are not drastic over the short time period we are discussing.
In addition, because the application is done during puberty, it is impossible to say which changes were triggered by r-hGH administration, because the face already changes significantly naturally, especially over periods like 8 months.
That's why most people say that they suddenly look so much older and blame r-hGH as the trigger. But just go into your Snapchat memory and look at the snap from 12 months ago, you'll notice how different your face looks now.
Currently, there is a user who claims significant facial changes after approximately 8 months of r-hGH administration.
Although he provides pictures (which are blurred, with different lighting and angles), there appear to be no major changes (in fact, almost none in my opinion; he merely looks more mature). It seems to be more of an imagined perception, possibly triggered by the recent breakup with his girlfriend (refer to my part on depression later). He also mentions that he hasn't grown during those 8 months, which cannot be confirmed but is rather unlikely if his growth plates are still open, even considering natural growth. Generally, facial changes are minimal and subtle, even after 12 months of therapy with 6 IU of HGH per day. There might be slight changes in facial proportions, but drastic changes are very uncommon.
Significant facial changes are only expected with an excess of HGH, which can lead to conditions like acromegaly. However, even in such cases, facial changes are not drastic over the short time period we are discussing.
In addition, because the application is done during puberty, it is impossible to say which changes were triggered by r-hGH administration, because the face already changes significantly naturally, especially over periods like 8 months.
That's why most people say that they suddenly look so much older and blame r-hGH as the trigger. But just go into your Snapchat memory and look at the snap from 12 months ago, you'll notice how different your face looks now.
Internal benefits (endocrine system etc.):
- Sleep Quality: HGH will lead to improved sleep quality, and more sleep in the deep sleep phase (sws), which is crucial for good sleep. And by the way, you'll also fall faster into sleep.
- Healthy bone growth: HGH plays an important role in regulating bone metabolism and bone density.
- Boosting the immune system: HGH can support immune system function by promoting the production of immune cells and antibodies.
- Cholesterol Levels: HGH can help improve cholesterol profiles by increasing HDL (good) cholesterol levels and lowering LDL (bad) cholesterol levels.
- Cortisol levels: Although HGH does not directly affect cortisol production, it may indirectly help regulate cortisol levels by aiding in stress reduction and improving overall well-being.
- Confidence: By improving physical appearance and overall well-being, HGH can also increase self-confidence and self-esteem.
- Posture: HGH can improve posture and contribute to an upright and more confident appearance (Posture and well-being are closely linked).
- Radiance and energy: HGH can increase overall well-being, which can lead to a more positive charisma and increased energy.
- Neurotypicality and Social Interaction: Some users report an improvement in their ability to socially interact and communicate after administering HGH. This may be because they feel better overall and have more energy to actively participate in social activities.
- Sexual Drive: It is also reported that HGH can increase sexual desire and libido. Increased energy and confidence can make a person feel more sexually attractive and more interested in sexual activities.
- Competitiveness: Some individuals report an increased competitive drive and desire to compete with other men, particularly in terms of physical fitness and attractiveness. This may cause them to be more motivated to participate in sporting activities or work on their physical appearance to compete with others.
Drawbacks
The drawbacks of rhGH administration are generally avoidable and for the majority not dangerous or life-threatening. I separated the side effects, long-term effects, and short-term effects according to probability, without including the safety protocols that I will write about later in this guide. This means that the majority, if not even every drawback is avoidable through proper precaution.
As said before, they are contingent upon the dosage of International Units (IU) administered and the period/cycle.
I will start by clarifying when r-hGH injections are not suitable or more dangerous:
- If you have a tumor (cancer) that is growing. Tumor treatment must be completed and the tumors must be inactive before you start your treatment.
- If you have recently had open heart surgery, abdominal surgery, an accident with multiple injuries, or acute respiratory failure.
- If your doctor has told you that the parts of your bones that cause length growth (called growth plates or epiphyseal plates) have closed and stopped growing.
- Children with chronically impaired kidney function.
- In the event of a kidney transplant, the drug should be discontinued.
- If you are at risk of developing diabetes or have diabetes.
- If you are being treated with thyroid hormones, a dose adjustment of the thyroid hormone may be necessary.
- You have Prader-Willi syndrome
- If you were too small or too light at birth
If you experience increased intracranial pressure (with symptoms such as severe headaches, blurred vision, or vomiting), you must inform your doctor about this.
Common side effects (this will most likely affect you):
- Headache
- This is usually temporary and resolves after r-hGH is discontinued.
- Water retention and edema
- This is usually temporary and resolves after r-hGH is discontinued.
- Joint and muscle pain
- This is usually temporary and resolves after r-hGH is discontinued.
- Decreased levels of the hormone thyroxine in blood tests (secondary hypothyroidism)
- Pain and swelling at the injection site
- Sudden serious allergic reactions including angioedema (rapid swelling of the mucous membranes or skin that may occur in the face, mouth, tongue, stomach or arms and legs)
- Decrease in levels of the hormone cortisol in blood tests
- Joint stiffness (arthritis)
- Sideways curvature of the spine (scoliosis)
- Growing pains
- Breast enlargement in male patients
- Cancer
Risk of new primary cancers:
Available data in children do not indicate an increased risk of new primary cancers in GH recipients. The data for new cancer risk in adult GH recipients are reassuring. However, there are limitations to all these statements. A variety of information sources are available about cancer risk among GH-treated patients, including post-marketing surveillance (Phase 4) studies, a limited number of other cohort studies, and clinical series. While some of these data sources are large and include many patient years of observation with generally reassuring results, the number of subjects with long duration of follow-up is small and data are incomplete, precluding definitive long-term safety conclusions. Other weaknesses are insufficient to control for selection bias, inadequate sample sizes to assess cancers with low incidence, and lack of appropriate comparison populations.
Risk of recurrence of a previous primary cancer:
Available data in children do not indicate an increased risk of recurrence of primary cancer in GH recipients. The data in adult GH recipients are presently insufficient to address this situation, but available data on benign pituitary tumors do not indicate an increased risk of recurrence during long-term GH replacement
Use of GH therapy in patients with a background risk for cancer:
Definitive data are lacking regarding the safety of GH therapy in “high-risk” patients (in particular children), including those with syndromes, diseases, and mutations known to be associated with an inherently elevated risk for cancer and early mortality (e.g. Neurofibromatosis type 1, Fanconi anemia, or Down syndrome). Therefore, the decision to start GH therapy should be carefully considered and discussed with families.
(The term ‘robust” is used when multiple independent published sources support the statement (References listed in the Supplemental list). The term ‘suggestive’ is used when there are <3 sources supporting the statement. The term ‘insufficient’ is used when available publications provide inadequate evidence to support the statement.)
- Stroke
There was agreement that data were inadequate to determine whether GH therapy in childhood increases the risk of stroke in young adults. The rationale for reaching this conclusion was that in the one published study reporting an association (10), the number of subjects was small and the risk of developing this complication in a comparable population was unknown. This single study reported 11 validated cases of stroke, including subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke at a mean age of 24 ± 7 years, out of a population of 6874 patients with either isolated idiopathic GH deficiency, or short stature in those born small for gestational age (SGA) or idiopathic short stature (ISS), who started treatment with rhGH between 1985 and 1996. The absolute risk of stroke was still small in this population (1.6 per 1000 persons) and there may have been potential confounding factors; data were lacking on family history, concomitant medications, smoking, or hypertension. Stroke is a potentially serious complication that warrants further scrutiny, but at present the evidence is insufficient to raise stroke as a concern with families before starting GH treatment in children.
- CVD and Metabolic Risk
Multiple studies have analyzed the effects of GH therapy on risk factors for cardiovascular and metabolic disease. Administration of GH modulates insulin sensitivity in a complex manner influenced by numerous factors such as age, body composition, and duration of therapy. The incidence of developing glucose intolerance or overt type 2 diabetes mellitus (T2D) during GH treatment in pediatric patients with GH deficiency or ISS is very low. Although the lifetime risk of glucose intolerance and T2D in several conditions treated with GH, including Turner syndrome (TS) and in short children born SGA, is higher than in the background population, GH treatment does not increase the incidence of T2D in these conditions in the short-term. In a subset of adult GHD patients with a propensity towards the development of T2D, such as obesity and/or a family history of T2D, GH therapy can be associated with the development of glucose intolerance or T2D in the first year of therapy, so monitoring with hemoglobin A1c (HbA1c) is important. GH reduces visceral fat and leads to an increase in lean body mass. Cardiovascular risk markers are increased in children and adults with GHD; these can improve with the administration of GH. GH has also been shown to reduce LDL cholesterol, and there is a suggestion that GH can increase HDL cholesterol and reduce carotid intimal thickness; however, it has not been demonstrated that GH replacement decreases the rate of cardiovascular events. There is no increase in blood pressure (BP) in children or adults on GH therapy. There is a modest reduction in diastolic BP with GH administration in short-SGA children and adults with GHD.
- Type 2 diabetes mellitus
- Scoliosis
Scoliosis is more prevalent in patients with TS or Prader Willi Syndrome (PWS) even 278 in the absence of GH treatment. Progression of scoliosis can be accelerated by rapid 279 growth, such as the pubertal growth spurt, and is not associated with GH treatment 280 per se. Clinical examination of the spine should be occur before start of therapy and 281 at follow-up of pediatric patients receiving GH therapy. Even in the presence of 282 scoliosis, GH therapy can be initiated or continued, though radiographic studies 283 should be obtained to monitor for any change.
- rash
- itch
- hives
- swelling of the face
- Swelling of the lower legs and feet and/or arms and hands
- Muscle aches
- Numb feeling/tingling
- Increased pressure of the fluid surrounding the brain (with symptoms such as severe headaches, blurred vision and vomiting)
The impact of administering Aromatase Inhibitor (AI) in healthy adolescents:
Benefits and drawbacks, for tanner stage 3-5 (open growth plates)
Benefits and drawbacks, for tanner stage 3-5 (open growth plates)
As mentioned for the r-hGH administration, the effects of Aromatase Inhibitor on you depend particularly on your dose.
Or rather, on the estrogen levels you'll be at:
Normal levels of Estrogen (Estridol, E2) in teens in late puberty range from 15-40 pg/ml.
Estrogen above 20 pg/ml will fuse your growth plates.
Estrogen levels of 8-10 pg/ml crash your estrogen, meaning serious side effects.
We want estrogen levels between the 11-19 pg/ml range.
(Note that those levels are not unnaturally low, in fact, they are normal in some adolescents)
Comparison of anastrozole, letrozole and exemestane
Anastrozole, letrozole, and exemestane all work by suppressing the enzyme aromatase, thereby lowering the estrogen levels in the body.
Anastrozole, letrozole, and exemestane all work by suppressing the enzyme aromatase, thereby lowering the estrogen levels in the body.
The main difference is that anastrozole and letrozole are non-steroidal aromatase inhibitors, while exemestane is a steroidal aromatase inhibitor.
Simply put, this means that anastrozole and letrozole anesthetize the aromatase enzyme while exemestane kills the aromatase enzyme (The enzyme is reproduced by the body).
It’s hard for me to recommend which aromatase inhibitor is the best.
Personally, my choice would be exemestane. This is why I will focus on the Aromatase Inhibitor exemestane in this guide.
I’ve seen multiple people having various problems with anastrozole or letrozole, ranging from estrogen rebound to strong side effects (also gyno after discounting the AI) and even no effect.
Estrogen rebound is one of the biggest disadvantages of letrozole or anastrozole.
Estrogen rebound is a phenomenon that occurs when the body experiences an increase in estrogen levels after discontinuing or reducing the dosage of aromatase inhibitors like Anastrozole or Letrozole. This rebound effect happens because these AIs suppress the production of estrogen, but once the AI is stopped, estrogen levels rise temporarily as the body's natural production resumes.
This abrupt rise in the body’s natural production of estrogen could lead to premature closure of growth plates, potentially impacting final height.
Missing a dose of non-steroidal Aromatase Inhibitors could cause that.
If you choose another Aromatase Inhibitor over exemestane, please note that this guide does not cover sufficient information on the use of those.
I must point out that Aromatase inhibitors used for children with Idiopathic and short Stature are actually commonly anastrozole or letrozole and not exemestane.
This is mainly due to these reasons:
- Anastrozole and letrozole are more available or have specific approvals for the treatment of stunting in adolescents compared to exemestane.
- Some studies used aromasin (exemestane) during the treatment of stunting in adolescents.
- There is more clinical experience and research on anastrozole and letrozole in relation to the treatment of stunting in adolescents, which gives doctors more confidence in these medications.
- This means that anastrozole and letrozole are used more frequently in adolescents, simply because those AIs were always used and doctors are experienced with their side effects, short-term effects, and long-term effects.
- This is mainly because these substances were discovered earlier, as you can see in the table below.
Generic name | Anastrozole | Letrozole | Exemestane |
Type | non-steroidal | non-steroidal | steroidal |
Legality | Prescription-only | Prescription-only | Prescription-only |
Dosage Form(s) Available | Oral tablet | Oral tablet | Oral tablet |
Half-Life | 46 hours | 48 hours | 24 hours |
First approval date | December 27, 1955 | November 25, 1996 | October 21, 1999 |
To this date, no data suggest that there are any major differences in clinical efficacy between the newer generation AIs anastrozole, letrozole, and exemestane. However, there are differences between the three agents in terms of pharmacokinetics and their effects on plasma lipids, bone, and adrenosteroidogenesis.
Anastrozole (Armidex) | Exemestane (Aromasin) | |
Side effect | Applicable?, Frequency | Applicable?, Frequency |
Hot flashes | Yes, 56% | Yes, 55% |
Joint pain | Yes, 6% | Yes, 7% |
Muscle pain | Yes, 16% | Yes, 17% |
Vaginal bleeding | Yes, 2% | Yes, 1% |
Abnormal liver enzyme levels | Yes, 1% | Yes, 1% |
Abnormal bilirubin levels | Yes, 1% | Yes, 2% |
Osteoporosis | Yes, 35% | Yes, 31% |
Atrial fibrillation | Yes, 2% | Yes, 1% |
Benefits and drawbacks of exemestane
Exemestane (Aromasin) is available as a 25 mg tablet taken once daily. For our purposes, a dose of 25mg is generally too high, this is why the pill is usually cut.
Benefits (only seen in exemestane)
- Exemestane does not have a negative feedback loop, which means if you forget to take your pills, it is not severe, while on other AIs like Anastrozole and Letrozole, this could lead to premature fusion of the growth plates.
- For this reason, it is also far easier to off-cycle of exemestane.
- Exemestane is gentler on your blood lipid profile compared to non-steroidal aromatase inhibitors.
- Exemestane tends to have positive effects on triglycerides, LDL (low-density lipoproteins), and HDL (high-density lipoproteins)
- Exemestane contains 17-hydro exemestane, a metabolite that acts as a potent androgen. Exemestane has been shown in studies to strengthen bone tissue (to a point), while AIs like Anastrozole and Letrozole have shown severe reductions in the same.
- Exemestane stimulates increases in IGF-1 (Insulin-Like Growth Factor 1).
- Exemestane displays little incompatibility with other compounds.
- Exemestane offers less of a negative impact on cholesterol values.
- Exemestane has been demonstrated to increase levels of endogenous Testosterone production in men by 30-60%, which is considerably significant, especially after only 10 days.
- Exemestane can reduce Estrogen levels by 85% at a dose of 25mg.
Drawbacks (only seen in exemestane)
The only drawback of exemestane compared to anastrozole and letrozole is the possibility of androgenic side effects. Those include increased oily skin (and acne), increased facial and body hair, and the trigger of MPB (Male Pattern Baldness) provided the genetics are there for it. Other side effects include a noticeable boost in aggression and drive. These side effects are uncommon, rare, and less pronounced.
Drawbacks (also apply approximately to other Ais)
The following Side effects
- Altered bone density: Long-term, low estrogen levels can lead to decreased bone density.
- Joint pain and stiffness: Frequently reported using aromatase inhibitors.
- Fatigue: A common side effect of hormonal changes.
- Mood swings and depression: Hormonal fluctuations can affect mental health.
- Changes in blood fat levels: Can increase the risk of cardiovascular diseases.
- Hair loss: Hormonal changes can cause an imbalance promoting hair loss.
- Impairment of fertility: Low estrogen levels can affect sperm production and quality.
- Hot flashes: A typical symptom of low estrogen levels, also possible in men.
- Delayed wound healing: Estrogen plays a role in regeneration and healing.
- Potential impairment of cardiovascular health: Long-term, low estrogen levels can increase the risk of cardiovascular diseases, although this is less direct and therefore less likely.
Sources I rely on:
INB4 "HGH IS COPE IF YOU'RE NOT IN DEFICIT!!! ", "YOU CAN'T GROW ABOVE YOUR GENETICS ", "HAVE FUN WITH YOUR HEART ATTACK AT 30!! "
INB4 "HGH IS COPE IF YOU'RE NOT IN DEFICIT!!! ", "YOU CAN'T GROW ABOVE YOUR GENETICS ", "HAVE FUN WITH YOUR HEART ATTACK AT 30!! "
There are indeed studies that suggest that r-hGH injection without r-hGH deficiency has no effects on the final height of adolescents, but there are also studies that suggest that r-hGH injection has effects on the final height of adolescents:
1) Study 1: "Final Height of Children with Idiopathic Short Stature: GH Therapy's Effectiveness during Peri-puberty – A Multicenter Study"
This study investigates the effectiveness of growth hormone (GH) therapies in children with idiopathic short stature (ISS) without GH deficiency. It demonstrates that longer durations of GH treatment significantly increase final adult height. Particularly, the study suggests that girls tend to approach target height more closely than boys. The average treatment duration for the group treated for over two years was approximately 2.92 years, with this group showing the greatest improvement in final height compared to baseline. Emphasizing the need for individually tailored treatment under medical supervision, the study highlights the potential to maximize growth in ISS patients.
2) Study 2: BMC Pediatrics "Therapeutic Effects on Final Adult Height in Males with Idiopathic Short Stature and Advanced Bone Age"
This study evaluates different therapy regimens aimed at increasing final adult height in male adolescents with idiopathic short stature and advanced bone age. Combining GH with GnRHa (a hormone delaying puberty) or an aromatase inhibitor (AI, a medication blocking the conversion of androgens to estrogens) showed a significant improvement in final adult height compared to GH treatment alone. Particularly, the combination of GH and AI led to a surprising surpassing of the predicted adult height by an average of 11.67 cm. These findings underscore the potential of these combination therapies to maximize final height in ISS adolescents but require careful monitoring for potential side effects.
3) Study 3: BMJ: "Impact of Growth Hormone Therapy on Adult Height of Children with Idiopathic Short Stature: A Systematic Review"
This systematic review aimed to determine the influence of growth hormone therapy on adult height in children with idiopathic short stature. Children were included if they exhibited initial short stature, defined as height more than 2 standard deviations below the mean, and had no history of growth hormone therapy or comorbid conditions affecting growth. The primary efficacy measure was the difference in adult height between treated and untreated children. The analysis revealed that growth hormone treatments can lead to a significant increase in adult height, with a mean difference of over 0.9 standard deviation points (approximately 6 cm) considered a satisfactory response to therapy.
4) Study 4: International Journal of Pediatric Endocrinology: "A Randomized Pilot Trial of Growth Hormone with Anastrozole versus Growth Hormone Alone, Starting at the Very End of Puberty in Adolescents with Idiopathic Short Stature"
In this pilot study, the effects of combining growth hormone with anastrozole (an aromatase inhibitor) versus growth hormone alone were investigated in adolescents with idiopathic short stature who were at the very end of puberty. The study questioned the assumption that it might be too late to use growth hormones to achieve a significant increase in height in adolescents nearing the end of their growth period. The results indicated that the combination treatment could be effective in increasing final height, particularly when administered toward the end of the growth process. This study provides valuable insights into potential treatment approaches for adolescents with ISS who are nearing the end of their growth phase.
5) Study 5: “Randomized Trial of Aromatase Inhibitors, Growth Hormone, or Combination in Pubertal Boys with Idiopathic, Short Stature”
Children were given AI alone, GH alone, and AI + GH among their respective groups and were treated at age 14 for periods of 12- 36 months. When using AI alone they gained height at a rate of 7cm per year, GH alone 8.5cm per year, and AI + GH was 9.45cm per year. It would help if you also considered your current bone age, the older it is the less likely you are to come close to these gains. But if your bone age is 16-17, you could squeeze a few extra cm out before adulthood.
6) Study 6: “Growth hormone significantly increases the adult height of children with idiopathic short stature: comparison of subgroups and benefit”
Eighty eight of our children (68 males and 20 females) attained an adult height or near adult height of -0.71 SDS (0.74 SD) (95% CI, -0.87 to -0.55) with a benefit over untreated controls of 9.5 cm (7.4 to 11.6 cm) for males and 8.6 cm (6.7 to 10.5 cm) for females.
In the analysis of the subgroups, the adult height and adult height gain of children with non-familial short stature were significantly higher than of familial short stature. No difference was found in the cohorts with normal or delayed puberty in any of the subgroups, except between the non-familial short stature and familial short stature puberty cohorts. This has implications for the interpretation of the benefit of treatment in studies where the number of children with familial short stature in the controls or treated subjects is not known.
The treatment was safe. There were no significant adverse events. The IGF-1 values were essentially within the levels expected for the stages of puberty.
R-hGH administration will make you grow more dedicated, due to the higher levels of IGF-1, you'll reach your final height faster, if you are above the height, you would have grown without injection is not secure, but most likely.
You are considered to have ISS (Idiopathic Short Stature) if you are significantly shorter than your peers despite normal growth hormone levels and other tests being normal, ISS might be diagnosed. In my opinion, you have a mild form of ISS if your not taller or at the same height as your father with 16 years old.
Especially if your growth was stunted for some time, due to excessive training (gym stunts growth/muscle stunt growth), poor diet, or sleep problems, r-hGH injection could make up for this and make you taller than you would have been naturally.
Precautions:
Safety Measures
In the following, all recommended safety measures will be listed. Without a recommendation on the frequency, this will be done later in this guide.
This protocol aims at counteracting the named side effects from r-hGH and Exemestane administration.
Documentation:Safety Measures
In the following, all recommended safety measures will be listed. Without a recommendation on the frequency, this will be done later in this guide.
This protocol aims at counteracting the named side effects from r-hGH and Exemestane administration.
It is important to not underestimate this and make it quality.
Note every measurement (blood pressure, blood sugar, etc.) taken in a notebook or similar, orderly and tidy.
Those measurements include:
- Height measurements: Correct size measurements can only be made using a stadiometer.
- Take measurements of your height and optionally the length of your arms and legs, hands and feet, torso and neck, etc.
- Pictures:
- Take regular photos of your face from different angles, ideally under similar lighting conditions and environments.
- Take photos in different poses and with different facial expressions to capture different aspects of your face. These include straight shots, side shots, smiling shots, etc.
- Also take pictures of your naked body.
- Body weight
- Blood sugar
- Blood pressure
- Blood tests
- Bone density measurements
- Additionally:
- Penis measurements
- Voice depth measurements
A radiograph is crucial for the safety of pubertymaxxing, if the outcome is closed growth plates or a too-old bone age – you can’t pubertymaxx.
Usually, a radiograph of the carpal bone is done for this, because the carpal bones tend to close first. Moreover, I suggest including a knee radiograph to evaluate the potential for leg growth. Generally, radiographs of other bones are unnecessary if the carpal bone results are favorable.
This cost could be avoided if a “sudden” feeling of pain in the knee or hand is felt and an x-ray is desired to be sure it’s not serious (If insurance pays for it).
Blood tests:
A blood test is the most usual, important for safety alone and to find the right dose for exemestane.
I want to clarify, that a laboratory where you can make blood tests of various values is very important. There’s no way around it.
A blood test involves a short blood sample, in advance you specify which values you would like to have tested, after a few days you will receive your values by email, telephone, etc. Payment is usually made via bank transfer, after the arrival of the values with a 30-day deadline.
The cost of a blood test is calculated per value that is to be tested later in the laboratory. The prices of the values that can be tested vary greatly, reaching from 2 to 35€ (the majority).
Now I will prescribe and explain a blood test protocol which I will refer to later.
Note:
- Logically, abnormal values are direct indicators that something is going wrong, which is why each value itself is important
- This blood test protocol assumes that you are a healthy, athletic young person with no previous illnesses. Otherwise, additional tests are necessary.
- These values may have different names in your native language.
- If your laboratory does not offer certain tests, ask personally whether there is a way to get these tests still; laboratories often work together or have contacts to do additional tests.
- The lies-out test panels should all be done sober in the morning.
- The following test sets are personal pre-builds. Adjustments to the tested values may be necessary to identify the cause of side effects. For example, if one experiences twitches after starting AIs, he might want to include an electrolyte check that covers chloride, potassium, magnesium, sodium, etc.
- I included an estimated price of each value itself and the full blood work, those prices are estimated and may differ based on your laboratory.
Liver function:
Test | Description | Coverage in blood panels | Estimated price |
ALT (Alanine Aminotransferase) | An enzyme primarily found in the liver. High levels can indicate liver damage. | Covered | 1-5 € |
AST (Aspartate Aminotransferase) | An enzyme found in various organs, especially the liver. Elevated levels can indicate liver disease. | Covered | 1-5 € |
ALP (Alkaline Phosphatase) | An enzyme found in the liver, bile ducts, and bones. High levels can indicate liver or bile duct disease. | Covered | 1-5 € |
Bilirubin | A breakdown product of hemoglobin that the liver processes. Elevated levels can indicate liver or bile duct disorders. | Covered | 1-5 € |
GGT (Gamma-Glutamyltransferase): | An enzyme found in the liver and bile ducts. High levels can indicate liver or bile duct disease. | Not covered | 1-5 € |
Albumin | A protein produced by the liver. Low levels can indicate liver disease. | Not covered | 5-10 € |
Lipid Profile / Cardiovascular Health (assess the risk of cardiovascular disease (CVD)):
Test | Description | Coverage in blood panels | Estimated price |
Total Cholesterol | The overall amount of cholesterol in the blood. High levels can increase the risk of heart disease. | Not covered | 1-5 € |
LDL Cholesterol (Low-Density Lipoprotein) | Often referred to as "bad" cholesterol. High levels of LDL cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart disease and stroke. | Covered | 1-5 € |
HDL Cholesterol (High-Density Lipoprotein): | Known as "good" cholesterol. HDL helps remove cholesterol from the bloodstream, transporting it to the liver for excretion. Higher levels of HDL cholesterol are generally protective against heart disease. | Covered | 1-5 € |
Triglycerides | A type of fat found in the blood. High levels of triglycerides can increase the risk of heart disease, especially when accompanied by high levels of LDL cholesterol or low levels of HDL cholesterol. | Not covered | 1-5 € |
BNP (B-type natriureti Peptide) | Measures a hormone produced by the heart in response to pressure changes, useful for diagnosing heart failure. | Not covered | 20-40 € |
Troponin | Measures proteins released when the heart muscle is damaged, used to diagnose heart attacks. | Not covered | 20-40 € |
Kidney Function:
Test | Description | Coverage in blood panels | Estimated price |
Serum Creatinine: | A waste product from muscle metabolism that is excreted by the kidneys. Elevated levels can indicate impaired kidney function. | Covered | 1-5 € |
Blood Urea Nitrogen (BUN) | A waste product from protein metabolism that is excreted by the kidneys. High levels can suggest reduced kidney function. | Covered | 1-5 € |
eGFR (Estimated Glomerular Filtration Rate) | A calculated value based on serum creatinine, age, sex, and race that estimates the filtering capacity of the kidneys. Low values indicate impaired kidney function. | Not covered | - |
Thyroid function:
Test | Description | Coverage in blood panels | Estimated price |
TSH (Thyroid-Stimulating Hormone) | The pituitary gland produces TSH and stimulates the thyroid gland to produce thyroid hormones T3 and T4. Elevated TSH levels indicate hypothyroidism, while low levels suggest hyperthyroidism. | Covered | 10-20 € |
Free T3 (Triiodothyronine) | Measures the active form of T3 in the blood, which is crucial for metabolism regulation. | Covered | 10-20 € |
Free T4 (Thyroxine) | Measures the active form of T4 in the blood, which is important for metabolic rate and growth. | Covered | 10-20 € |
Total T3 | Measures both the free and bound forms of T3 in the blood. | Covered | 10-20 € |
Total T4 | Measures both the free and bound forms of T4 in the blood. | Covered | 10-20 € |
Reproductive Hormones:
Test | Description | Coverage in blood panels | Estimated price |
Testosterone | Measures the primary male sex hormone, which is important for developing and maintaining male characteristics. | Covered | 20-30 € |
Estradiol | Measures a form of estrogen, which is important for reproductive and sexual health. | Covered | 20-30 € |
Estrone | Measures another form of estrogen, which is important for reproductive health. | Not covered | 20-30 € |
Estriol | Measures the least abundant estrogen, significant during pregnancy. | Not covered | 20-30 € |
DHT (Dihydrotestosterone) | Measures a potent androgen, derived from testosterone, which is important for male development. | Covered | 20-30 € |
IGF-1 (Insulin-Like Growth Factor 1) | Measures a hormone that reflects the amount of growth hormone activity in the body. | Covered | 10-30 € |
HGH (Human Growth Hormone) | Measures the amount of growth hormone. | Covered | 10-30 € |
SHBG (Sex Hormone Binding Globulin) | Measures a protein that binds to sex hormones, influencing their bioavailability. | Covered | 20-30 € |
FSH (Follicle-Stimulating Hormone) | Important for reproductive health and function. | Covered | 10-20 € |
LH (Luteinizing Hormone) | Works with FSH to regulate reproductive processes. | Not covered | 10-20 € |
Prolactin | Measures a hormone that can influence reproductive health. | Not covered | 10-20 € |
IGFBP-3 (Insulin-Like Growth Factor Binding Protein 3) | Measures the main carrier of IGF-1 in the blood, indicating GH activity. | Not covered | 10-30 € |
DHEA | DHEA levels in blood are measured to assess adrenal gland function and hormone production, particularly androgens, and to evaluate the risk of conditions like adrenal insufficiency. | Covered | 20-30 € |
DHEA-S | DHEA-S levels in blood help diagnose adrenal and hormone-related disorders, offering insights into adrenal gland function and overall hormone balance. | Covered | 20-30 € |
General Health Markers:
Test | Description | Coverage in blood panels | Estimated price |
CBC (Complete Blood Count) | Provides information about the cells in the blood, including red blood cells, white blood cells, and platelets. | Covered | 5-10 € |
CMP (Comprehensive Metabolic Panel) | Includes tests for electrolytes, glucose, calcium, albumin, and more, providing a broad overview of metabolic health. | Covered | 5-10 € |
CRP (C-Reactive Protein) | Measures a marker of inflammation in the body, which can indicate infection or chronic inflammatory conditions. | Not covered | 5-15 € |
ESR (Erythrocyte Sedimentation Rate) | Another marker of inflammation, which can indicate chronic inflammatory conditions. | Not covered | 5-15 € |
Metabolic Function:
Test | Description | Coverage in blood panels | Estimated price |
Fasting Glucose | Measures blood sugar levels after fasting, important for assessing glucose metabolism and risk of diabetes. | Covered through blood sugar meter later discussed | 1-5 € (in lab) |
HbA1c (Hemoglobin A1c) | Measures average blood glucose levels over the past 2-3 months, used to diagnose and monitor diabetes. | Not covered | 10-20 € |
Insulin | Measures the level of insulin in the blood, important for understanding insulin sensitivity and pancreatic function. | Not covered | 10-20 € |
Immune Function:
Test | Description | Coverage in blood panels | Estimated price |
WBC (White Blood Cell Count) | Measures the number of white blood cells, important for detecting infections and immune function. | Not covered | - |
Immunoglobulins (IgA, IgG, IgM) | Measures antibodies to assess immune function. | Not covered | - |
ANA (Antinuclear Antibody) | Screens for autoimmune disorders that could be affected by hormonal treatments. | Not covered | - |
Cancer Markers:
Test | Description | Coverage in blood panels | Estimated price |
PSA (Prostate-Specific Antigen) | Measures a protein produced by the prostate gland. Elevated levels may indicate prostate cancer. | Not covered | 10-20 € |
CA-125 | Measures a protein often elevated in ovarian cancer | Not covered | 10-20 € |
CA 15-3 | Measures a protein elevated in breast cancer. | Not covered | 20-30 € |
AFP (Alpha-Fetoprotein) | Elevated levels may indicate liver cancer or germ cell tumors. | Not covered | 10-20 € |
CEA (Carcinoembryonic Antigen) | Elevated levels may indicate colorectal, lung, pancreatic, or breast cancer. | Not covered | 10-20 € |
CA 19-9 | Elevated levels may indicate pancreatic cancer. | Not covered | 10-20 € |
Bones markers:
Test | Description | Coverage in blood panels | Estimated price |
25-OH-vitamin D | Measures the level of vitamin D, which is crucial for bone health. | Covered | 20-40 € |
P1NP | Measures a marker of bone formation. | Not covered | 30-40 € |
Ostasis | Measures a protein secreted by osteoblasts, important for bone formation. | Not covered | 30-40 € |
ß-CTX (Beta CrossLaps) | Measures a marker of bone resorption. | Not covered | 30-40 € |
TRAP 5b | Measures an enzyme involved in bone resorption. | Not covered | 1-5 € |
Osteocalcin | A protein secreted by osteoblasts, important for bone formation. | Covered | 10-20 € |
Alkaline Phosphatase | An enzyme important for bone and liver health. | Covered | 1-5 € |
Androgenic balding:
Test | Description | Coverage in blood panels | Estimated price |
DHEA-S | Measures a precursor hormone that can be converted into androgens and estrogens. | Covered | 20-30 € |
Testosterone | Measures the primary male sex hormone, important for developing and maintaining male characteristics. | Covered | 20-30 € |
SHBG | Measures a protein that binds to sex hormones, including testosterone and estrogen. | Covered | 20-30 € |
Androstenedione | Measures a precursor to testosterone and estrogen, important for hormone balance. | Not covered | 10-20 € |
Electrolytes and Minerals:
Test | Description | Coverage in blood panels | Estimated price |
Sodium | Essential for fluid balance and nerve function. | Not covered | 1-5 € |
Potassium | Important for heart and muscle function. | Not covered | 1-5 € |
Chloride | Helps maintain fluid balance and pH levels. | Not covered | 1-5 € |
Calcium | Important for bone health, muscle function, and nerve signaling. | Not covered | 1-5 € |
Magnesium | Involved in numerous biochemical reactions in the body. | Not covered | 1-5 € |
Phosphate | Important for bone health and energy production. | Not covered | 1-5 € |
Vitamins and Other Minerals:
Test | Description | Coverage in blood panels | Estimated price |
Vitamin B12 | Essential for nerve function and blood cell production. | Not covered | 10-20 € |
Folate | Important for DNA synthesis and cell division. | Not covered | 10-20 € |
Zinc | Important for immune function, protein synthesis, and DNA synthesis. | Not covered | 1-5 € |
Iron | Crucial for oxygen transport in the blood. | Not covered | 1-5 € |
Blood panels:
[Test A] First blood test, understanding your natural values:
This blood panel aims at determining your natural hormone status to better understand changes after starting hormone therapy.
Since this Blood panel is written for healthy adolescents no additional tests are necessary as they are in a normal range anyway – but feel free to add tests you acknowledge as important.
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Note: The following test panels are aligned with the cycle plan which will be addressed later.
[Test B] Short Estradiol check test – 1 week after starting exemestane
This blood panel is used for:
- Dosage adjustments
- Effectiveness of exemestane (Authenticity of the aromatase inhibitor)
I recommend using ChatGPT to assess the possible reason for the side effects and blood tests that could help understand the cause of the side effect and their seriousness.
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[Test C] Check Test – 2-4 weeks after starting exemestane (done after side effects fade away)
This blood panel aims at determining the effects of exemestane on the body.
If all results are within the reference range, r-hGH is started.
As said, additional tests may be necessary if you have uncommon side effects.
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Note: The following blood panels are for r-hGH and exemestane administration.
This protocol ensures that you get a broad overview of your health status each month, with specific tests focusing on different aspects of your health in a cost-effective manner. By rotating Test D, E, and F, you cover all essential areas while minimizing redundancy and managing costs effectively.
This rotation ensures that critical health markers are regularly monitored while spreading the cost over three months/three blood tests.
[Test D]
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[Test E]
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[Test F]
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Total price: 164-365 € |
Blood sugar meter:
A blood sugar meter is important for decreasing the risk of diabetes type 2, which can occur due to the increased blood sugar levels while being on r-HGH and exemestane.
A blood glucose meter typically resembles a handheld device with a screen and a lancet to draw a small drop of blood, which is then placed on a test strip inserted into the meter, providing a digital reading of the blood glucose level. The test strips have to be repurchased.
Monitoring blood sugar levels is particularly important in the first few weeks of treatment. After the adaptation phase, the monitoring can become less.
The most significant concern with r-HGH is the increased likelihood of developing type 2 diabetes, so following this protocol is crucial.
To optimally protect from diabetes, I will first explain how it occurs and what it is.
Type 2 diabetes is a chronic condition where the body either resists the effects of insulin, a hormone that regulates sugar (glucose) in your cells, or doesn’t produce enough insulin to maintain normal glucose levels. This leads to high blood sugar levels, which can cause various health problems over time, including heart disease, nerve damage, and vision problems.
Insulin is a hormone produced by the beta cells in the islet cells of the pancreas. It plays a crucial role in metabolism and the regulation of blood sugar levels.
Glucose is a simple sugar and an important energy source for the body. It is a carbohydrate that comes from food and circulates in the blood to provide energy to cells.
- After eating, carbohydrates are broken down into glucose in the digestive tract. This glucose then enters the bloodstream, causing blood sugar levels to rise.
- When blood sugar levels rise, the pancreas responds by releasing insulin. Insulin is a hormone that ensures that glucose from the blood is absorbed into the cells.
- Insulin binds to receptors on the cell surface and allows glucose to enter the cells. Once in the cells, the glucose is either used immediately for energy or stored as glycogen in the liver and muscles.
- By absorbing glucose into cells and storing it, insulin helps lower blood sugar levels and maintain them at normal levels.
HGH can reduce insulin sensitivity, meaning cells are less responsive to insulin. This results in more insulin being needed to transport glucose from the blood into the cells. When the body cannot produce enough insulin to compensate for the reduced sensitivity, blood sugar levels rise, which can lead to insulin resistance and ultimately type 2 diabetes.
A distinction is made between hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Hyperglycemia is the more common reaction when taking HGH, especially with long-term or high-dose use.
Times for monitoring Blood sugar levels, frequency and symptoms
Different times for measuring blood sugar:
Monitoring in the morning on an empty stomach (after waking up):
- This measurement provides a baseline value for blood sugar before influences from food intake or other factors occur.
- It helps to determine the so-called fasting blood sugar level, which provides important information about the body's metabolic state.
- These measurements allow assessment of how food intake affects blood sugar levels.
- It helps to understand how the body reacts to certain foods and whether there are significant fluctuations in blood sugar.
- This allows blood sugar levels to be monitored during sleep, when the body is not consuming food and metabolism is at rest.
- It can help detect the risk of nocturnal hypoglycemia episodes (which are not common on r-HGH), especially in people who are prone to low blood sugar levels (which is not common on r-HGH).
Adaptation phase (first 2-3 weeks):
- Daily: During the first few weeks of r-hGH therapy, blood sugar should be monitored daily.
- Monitoring in the morning on an empty stomach (most important).
- Monitoring before and after meals.
- Monitoring before bedtime (least important, optional).
- After the first few weeks, the frequency of blood glucose measurements can be reduced as the body adapts to the r-hGH. This could be reduced to 2-3 times per week depending on how stable the levels are.
- If symptoms: Additional measurements should be taken if symptoms of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) occur.
- Monitoring in the morning on an empty stomach (most important - recommended).
- Monitoring before and after meals. (optional)
- Monitoring before bedtime (least important, optional).
- In the morning, before eating or drinking anything (fasting), normal blood glucose levels for adolescents during r-hGH therapy typically range between 70-100 mg/dL (3.9-5.6 mmol/L).
- Normal results for blood glucose levels during r-hGH therapy in adolescents may vary but generally fall within the range of 70-130 mg/dL (3.9-7.2 mmol/L) before meals and below 180 mg/dL (10 mmol/L) two hours after meals.
- Before bedtime, blood glucose levels should ideally be within a similar range, typically between 70-130 mg/dL (3.9-7.2 mmol/L).
- High blood sugar (hyperglycemia): A value above 180 mg/dL (10 mmol/L) after meals may indicate hyperglycemia and may require treatment adjustments or lifestyle changes. A value above 130 mg/dL (7.2 mmol/L) in the morning on an empty stomach can also be cause for concern and require medical evaluation, especially if repeated.
- Low blood sugar (hypoglycemia): A level below 70 mg/dL (3.9 mmol/L) is considered low and usually requires intervention, especially if symptoms such as shaking, sweating, confusion, or fainting occur (not common, except rather high blood sugar.).
One-time elevated blood sugar levels can be an indication of a temporary disorder or an acute situation and do not necessarily mean that diabetes is present immediately.
Levels that may require immediate medical attention depend on various factors, including individual health, disease progression and possible symptoms. In general, individuals with severely elevated blood sugar levels (e.g., over 400 mg/dL or 22 mmol/L), particularly if accompanied by symptoms such as intense thirst, increased urination, fatigue, confusion, or loss of consciousness, should seek immediate medical attention. These symptoms could indicate a serious metabolic disorder such as diabetic ketoacidosis, which can be life-threatening and requires immediate medical attention.
Symptoms of high blood sugar (hyperglycemia):
- Intense thirst (polydipsia): The desire to drink a lot of fluids.
- Frequent urination (polyuria): The urge to urinate more often than usual.
- Fatigue and weakness: A feeling of exhaustion and weakness that lasts longer.
- Food cravings: Especially sweet or carbohydrate-rich foods.
- Blurred vision: A temporary worsening of vision.
- Dry mouth and skin: The increased loss of fluids can cause the mouth to become dry and the skin to appear dry and irritated.
- Nausea and vomiting: Nausea and vomiting may occur, particularly in severe hyperglycemia.
- Slow healing of wounds: Hyperglycemia can slow down the body's healing processes.
Again, this is not common on r-HGH.
- Trembling or shaking: Especially in the hands or legs.
- Sweating: A sudden increase in sweat production, especially on the forehead.
- Heart palpitations or racing heart: A fast or irregular heartbeat.
- Nervousness or anxiety: A feeling of restlessness or fear.
- Hunger: A sudden craving for food.
- Concentration problems: Difficulty concentrating or thinking clearly.
- Fatigue: A sudden feeling of exhaustion or weakness.
- Confusion or disorientation: Difficulty orienting yourself or carrying out normal tasks.
If you consistently find high blood sugar values, it's important to lower those levels.
- Reduce Carbohydrate Intake: Limiting foods high in refined carbohydrates like sugary snacks, white bread, and sugary drinks can help control blood sugar levels.
- Increase Fiber Intake: Consuming fiber-rich foods such as fruits, vegetables, legumes, and whole grains can slow down the absorption of sugar and help stabilize blood sugar levels.
- Choose Low-Glycemic Index (GI) Foods: Opt for foods with a low glycemic index, which are less likely to cause spikes in blood sugar levels. Examples include non-starchy vegetables, whole grains, and legumes.
- Healthy Fats: Incorporate sources of healthy fats such as avocados, nuts, seeds, and olive oil into your diet, as they can help improve insulin sensitivity.
- Regular Exercise: Engage in regular physical activity, such as brisk walking, jogging, cycling, or swimming, for at least 30 minutes most days of the week. Exercise helps your body use insulin more effectively and can lower blood sugar levels.
- Maintain a Healthy Weight: Losing excess weight, if overweight or obese, can significantly improve insulin sensitivity and blood sugar control.
- Stay Hydrated: Drink plenty of water throughout the day to stay hydrated, as dehydration can affect blood sugar levels.
- Manage Stress: Practice stress-reducing techniques such as deep breathing, meditation, yoga, or mindfulness to help lower stress hormones that can raise blood sugar levels.
- Adequate Sleep: Aim for 7-9 hours of quality sleep per night, as insufficient sleep can impair insulin sensitivity and lead to higher blood sugar levels.
- Chromium: Some studies suggest that chromium supplementation may help improve insulin sensitivity and lower blood sugar levels, although more research is needed.
- Alpha-Lipoic Acid: Alpha-lipoic acid, an antioxidant, has been shown to have beneficial effects on blood sugar control in some studies.
- Cinnamon: Cinnamon supplements or adding cinnamon to foods may help lower fasting blood sugar levels, but results are mixed and more research is needed.
Blood pressure monitor:
Monitor heart rate and blood pressure consistently to minimize the risk of hypertension (high blood pressure) and ensure cardiovascular health, it even makes fun somehow and is easy!
Obtain a reliable blood pressure monitor. Automatic digital monitors are commonly used for at-home measurements. A cuff is placed on the bare upper arm, approximately at heart level.
Monitoring blood sugar levels is particularly important in the first few weeks of treatment. After the adaptation phase, the monitoring can become less.
Preparation:
- Sit quietly and comfortably in a chair with your back supported and feet flat on the floor.
- Rest for 5-10 minutes before taking the measurement.
- Avoid caffeine, tobacco, and exercise for at least 30 minutes prior to measurement, as they can affect blood pressure readings.
- Start the monitor and wait till the measurement is complete.
- Don‘t cross your legs while doing the measurement - sit on a chair with a straight back and relax your arm on a tabletop so that your upper arm is at heart level.
Times for monitoring Blood pressure, frequency, and symptoms
Different times for measuring blood pressure:
Monitoring in the morning on an empty stomach (after waking up):
This measurement provides a baseline value for blood pressure before influences from food intake or other factors occur.
Monitoring before and after meals (2 hours after the meal):
- These measurements allow assessment of how food intake affects blood pressure.
- It helps to understand how the body reacts to certain foods and whether there are significant fluctuations in blood pressure.
While less important than morning measurements, taking blood pressure readings before bedtime can still provide valuable data, especially if there are concerns about nocturnal blood pressure changes.
Adaptation phase (first 2-3 weeks):
- Daily: During the first few weeks of r-hGH therapy, blood sugar should be monitored daily.
- Monitoring in the morning on an empty stomach (most important).
- Monitoring before and after meals.
- Monitoring before bedtime (least important, optional).
After the adaption phase:
- After the first few weeks, the frequency of blood pressure measurements can be reduced as the body adapts to the r-hGH. This could be reduced to 2-3 times per week depending on how stable the levels are.
- If symptoms: Additional measurements should be taken if symptoms occur.
- Monitoring in the morning on an empty stomach (most important).
- Monitoring before and after meals.
- Monitoring before bedtime (least important, optional).
Understand results:
- The blood pressure monitor measures blood pressure (systolic and diastolic) and heart rate (pulse).
- Heart Rate (Pulse): Heart rate, also known as pulse, is the number of times the heart beats per minute (bpm). It indicates the rate at which the heart is pumping blood throughout the body.
- Systolic Pressure: The higher number represents the pressure in the arteries when the heart contracts (beats) and pumps blood out into the body.
- Diastolic Pressure: The lower number represents the pressure in the arteries when the heart relaxes between beats and refills with blood.
Interpretation of Results (ask ChatGPT to get a personal assessment of the values):
- Normal blood pressure: Systolic less than 120 mmHg and diastolic less than 80 mmHg.
- Elevated blood pressure: Systolic 120-129 mmHg and diastolic less than 80 mmHg.
- Hypertension stage 1: Systolic 130-139 mmHg or diastolic 80-89 mmHg.
- Hypertension stage 2: Systolic 140 mmHg or higher or diastolic 90 mmHg or higher.
Symptoms:
Symptoms of High Blood Pressure (Hypertension):
- Headaches: Persistent or severe headaches, especially at the back of the head, can be a symptom of high blood pressure.
- Vision Problems: Blurred or impaired vision may occur as a result of high blood pressure affecting the blood vessels in the eyes.
- Chest Pain: Chest pain, tightness, or discomfort may occur due to reduced blood flow to the heart muscles.
- Shortness of Breath: Difficulty breathing or shortness of breath, particularly during physical activity or exertion, can be a sign of high blood pressure affecting the heart and lungs.
- Dizziness or Lightheadedness: Feeling dizzy, lightheaded, or fainting may occur due to reduced blood flow to the brain.
- Nosebleeds: Frequent or severe nosebleeds may sometimes be associated with high blood pressure.
- Irregular Heartbeat: Palpitations or irregular heart rhythms may occur as a result of high blood pressure affecting heart function.
- Dizziness or Lightheadedness: Feeling dizzy, faint, or lightheaded, especially upon standing up from a sitting or lying position, is a common symptom of low blood pressure.
- Fatigue: Persistent fatigue, weakness, or feelings of tiredness may occur with low blood pressure.
- Blurry Vision: Blurred or tunnel vision, especially when standing up quickly, may indicate low blood pressure.
- Nausea or Vomiting: Feeling nauseous or experiencing vomiting may occur, particularly when blood pressure drops suddenly.
- Clammy Skin: Skin that feels cool, clammy, or excessively sweaty may be a sign of low blood pressure.
- Weakness or Fainting: Generalized weakness or fainting episodes, especially in response to sudden changes in posture, may occur with low blood pressure.
- Difficulty Concentrating: Difficulty concentrating, confusion, or feeling "foggy" may be experienced with low blood pressure, particularly if it affects blood flow to the brain.
Actions for High Values:
If you consistently find high blood pressure values, it's important to lower those levels.
If the first reading seems unusually high or low, wait a few minutes and then measure again to check for accuracy.
- DASH Diet: Follow a Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while reducing sodium, saturated fats, and cholesterol.
- Reduce Sodium Intake: Limit sodium consumption to less than 2,300 milligrams per day (or even lower, to 1,500 milligrams) by avoiding processed foods, canned soups, and salty snacks.
- Increase Potassium-Rich Foods: Consume potassium-rich foods such as bananas, oranges, spinach, sweet potatoes, and avocados, as potassium helps counteract the effects of sodium on blood pressure.
- Moderate Alcohol Intake: Limit alcohol consumption to moderate levels (up to one drink per day for women and up to two drinks per day for men), as excessive alcohol can raise blood pressure.
- Get Adequate Sleep: Aim for 7-9 hours of quality sleep per night, as insufficient sleep can contribute to high blood pressure.
- Regular Exercise: Engage in aerobic exercises such as brisk walking, jogging, cycling, or swimming for at least 150 minutes per week, or aim for 30 minutes most days of the week.
- Manage Stress: Practice stress-reduction techniques such as deep breathing, meditation, yoga, or mindfulness to lower stress hormones and promote relaxation.
- Quit Smoking: If you smoke, quit smoking as it can raise blood pressure and increase the risk of heart disease.
- Limit Alcohol and Caffeine: Reduce alcohol intake and limit caffeine consumption, as both can raise blood pressure.
- Omega-3 Fatty Acids: Consider incorporating omega-3 fatty acids from sources such as fatty fish (salmon, mackerel, sardines) or fish oil supplements, which may help lower blood pressure.
- Magnesium: Magnesium supplements or magnesium-rich foods like nuts, seeds, and leafy greens may have a modest lowering effect on blood pressure.
- Coenzyme Q10 (CoQ10): CoQ10 supplements may help lower blood pressure, particularly in individuals with hypertension.
- Garlic: Garlic supplements or fresh garlic in the diet may have a modest effect on reducing blood pressure
Bone density measurements:
Bone density measurements are not as necessary as the other safety precautions, but are still recommended if possible.
Blood tests alone cannot diagnose osteoporosis, but they can help assess the risk of osteoporosis and monitor bone metabolism.
HGH stimulates bone growth and Aromatase Inhibitor reduces estrogen levels, this is why bone density measurements are important to evaluate the risk of osteoporosis or other bone diseases.
Bone density measurements, also known as DXA scans (Dual-Energy X-ray Absorptiometry), are imaging procedures for measuring bone density. These measurements help assess the risk of osteoporosis and bone fractures.
(JFL if you think a healthy adolescent gets any form of osteoporosis due to a bit lower estrogen level, this won't happen anyway)
Hair Loss:
Androgenic hair loss, also known as androgenetic alopecia, may be increased when taking aromatase inhibitors such as exemestane. This is because the reduction of estrogen increases relative androgen levels in the body, which can promote hair loss.
This is the routine I recommend to prevent hair loss:
- Supplement zinc, iron, biotin, and vitamin D.
- Avoid heat styling and hair styling products, except hair oils.
- Avoid shampoos or at least use mild, sulfate-free shampoos and conditioners to protect the hair.
- Microneedling for blood circulation:
- Use a microneedling stamp or preferably pen once a week (1.5mm to 2.0mm) in combination with rosemary oil or Minoxidil (if you think rosemary oil is not effective enough).
- On the other days only use rosemary or Minoxidil.
- Daily head massagess
Bloat:
Water retention or a puffy face may occur because r-hGH can increase fluid retention in the body. This can cause temporary weight gain and a bloated appearance. This often happens because HGH can stimulate the kidneys to excrete less water. Water retention usually decreases from alone after 2-8 weeks.
While these effects are generally reversible once the treatment is stopped or the adaption phase, there is a possibility that prolonged swelling could lead to tissue changes. Specifically, chronic water retention might stretch the skin and tissues, potentially making them appear larger even after the swelling subsides (nose for example).
A gradual increase in the r-hGH dose is important to give the body enough time to adjust hormonally.
A balanced diet with an appropriate ratio of carbohydrates, proteins and healthy fats can help control water retention. Limit your consumption of salty foods and season your food with herbs and spices instead.
Drinking enough water can paradoxically help reduce water retention because it helps the body flush out excess sodium.
If water retention occurs a cardio routine helps improve blood circulation, stimulate lymphatic flow, and remove excess fluid from the body. I recommend cardio activities like skipping rope, jumping on the trampoline, or sprinting/jogging.
Additionally supplementing with potassium, magnesium or other electrolyte supplements helps balance electrolyte balance.
If you suffer from strong water retention, adjust your r-hGH dose or supplement with Glauber's salt (natural) or Thiazide diuretics.
If you start getting water retention in your legs or another area, immediately wear compression clothing in the affected areas. This will increase pressure on tissues and reduce fluid accumulation.
Symptoms of water retention at the heart
- Shortness of breath: Especially during physical exertion or while lying down.
- Swelling: In the legs, ankles or feet, also known as peripheral edema.
- Weight gain: Sudden weight gain due to fluid retention.
- Increased fatigue: General weakness and exhaustion.
- Coughing or wheezing: Especially when lying down or at night.
- Racing heartbeat or irregular heartbeat: palpitations or arrhythmias.
For reducing water retention in your face:
- Gua Sha is a traditional Chinese medicine technique that involves scraping the skin with a tool to improve circulation and reduce swelling. Regularly massaging the face, especially around the nose area, might help reduce water retention by promoting lymphatic drainage.
- After nasal surgeries, taping is often used to reduce swelling and support the nasal structure. Similar techniques can be applied to manage water retention. Using medical-grade tape, gently tape the nose at night to provide light compression. This might help minimize swelling and prevent the nose from stretching due to water retention.
- Applying cold compresses to the nose can help reduce swelling and water retention. Use a cold pack or wrap ice in a cloth and apply it to the nose for 10-15 minutes at a time. This can help constrict blood vessels and reduce fluid accumulation.
- This might even reduce possible growth of the nose, applying cold compresses may help limit tissue expansion by constricting blood vessels.
- Sleeping with your head elevated can prevent fluid from accumulating in your face and nose overnight.
Cardiologist:
This is something that many may choose to overlook. However, if you occasionally experience discomfort in your left breast or detect irregularities in your heartbeat or an unusually strong pulse, it would be beneficial to schedule a routine appointment with a cardiologist to evaluate whether there could be any potential risks. Keep in mind: once your heart is compromised, the consequences can be severe, so it's wise to err on the side of caution, even though heart issues in adolescents are uncommon.
Cancer:
If there is a significant cancer history in your family, especially if one type of cancer is prevalent, taking preventive measures could be advantageous. These measures might include routinely conducting cancer marker blood tests, as mentioned earlier, or regularly taking aspirin supplements, self-examinations, or preferably scheduling appointments with your doctor.
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