Theoretical in-depth guide on how to SAFELY use r-hGH and aromatase inhibitor for pubertymaxxing

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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.



Contents:

Introduction to Human Growth Hormone and Aromatase Inhibitor:
  1. Human Growth Hormone (HGH)
  2. Aromatase Inhibitor (AI)

The impact of administering exogenous Human Growth Hormone (r-hGH) in healthy adolescents:
  1. Benefits and drawbacks

The impact of administering Aromatase Inhibitor (AI) in healthy adolescents:
  1. Comparison of anastrozole, letrozole and exemestane
  2. Benefits and drawbacks of exemestane

Sources I rely on:
  1. Sources

Precautions:
  1. Safety Measures
  2. Storage Guidelines
  3. Use of Assistive Devices
  4. Authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

Injecting r-hGH:
  1. Determining the appropriate r-hGH Dosage
  2. Administration Technique for r-hGH
  3. Timing of r-hGH Injections

Taking the correct dosage of Exemestane (Aromasin):
  1. Determining the appropriate exemestane Dosage
  2. Timing and method for exemestane administration

Estimated Costs and Cycle:
  1. List of Necessary Items with Pricing
  2. Cycle Outline and Weekly Schedule, Including Precautions
  3. Additional knowledge

Ending:
  1. 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.
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.

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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.
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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):

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(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)
For further understanding, the name of the generic active ingredient is written first while the name of the patented medication and developed pharmacy is written in brackets.

(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)

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.
External benefits (facially):
  • 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.​

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.
Internal benefits (effects on behavior):
  • 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.
And the best thing, it promotes height growth.


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.
Take special care if:
  • 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
Go to the doctor immediately and tell him what you are taking if you notice the following side effects:

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.
Very common side effects (may affect more than 1 in 10 people):
  • Decreased levels of the hormone thyroxine in blood tests (secondary hypothyroidism)
  • Pain and swelling at the injection site
Uncommon side effects (may affect up to 1 in 100 people):
  • 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
Frequency not known (cannot be estimated from available data):
  • 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.​

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(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)

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.

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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).

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Both non-steroidal and steroidal have advantages and disadvantages.

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.
Ultimately, all three Aromatase inhibitors are the same and FDA-approved with very few effect differences.

Generic nameAnastrozoleLetrozoleExemestane
Typenon-steroidalnon-steroidalsteroidal
LegalityPrescription-onlyPrescription-onlyPrescription-only
Dosage Form(s) AvailableOral tabletOral tabletOral tablet
Half-Life46 hours48 hours24 hours
First approval dateDecember 27, 1955November 25, 1996October 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 effectApplicable?, FrequencyApplicable?, Frequency
Hot flashesYes, 56%Yes, 55%
Joint painYes, 6%Yes, 7%
Muscle painYes, 16%Yes, 17%
Vaginal bleedingYes, 2%Yes, 1%
Abnormal liver enzyme levelsYes, 1%Yes, 1%
Abnormal bilirubin levelsYes, 1%Yes, 2%
OsteoporosisYes, 35%Yes, 31%
Atrial fibrillationYes, 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.
Benefits (also apply approximately to other Ais)
  • 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!!! :soy:", "YOU CAN'T GROW ABOVE YOUR GENETICS :feelswhy:", "HAVE FUN WITH YOUR HEART ATTACK AT 30!! :lul:"

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:

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
Radiograph:

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.

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The cost of an X-ray usually lies between 50-200$.
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.
Value explanation:
  • 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.
Values:

Liver function:

TestDescriptionCoverage in blood panelsEstimated price
ALT (Alanine Aminotransferase)An enzyme primarily found in the liver. High levels can indicate liver damage.Covered1-5 €
AST (Aspartate Aminotransferase)An enzyme found in various organs, especially the liver. Elevated levels can indicate liver disease.Covered1-5 €
ALP (Alkaline Phosphatase)An enzyme found in the liver, bile ducts, and bones. High levels can indicate liver or bile duct disease.Covered1-5 €
BilirubinA breakdown product of hemoglobin that the liver processes. Elevated levels can indicate liver or bile duct disorders.Covered1-5 €
GGT (Gamma-Glutamyltransferase):An enzyme found in the liver and bile ducts. High levels can indicate liver or bile duct disease.Not covered1-5 €
AlbuminA protein produced by the liver. Low levels can indicate liver disease.Not covered5-10 €

Lipid Profile / Cardiovascular Health (assess the risk of cardiovascular disease (CVD)):

TestDescriptionCoverage in blood panelsEstimated price
Total CholesterolThe overall amount of cholesterol in the blood. High levels can increase the risk of heart disease.Not covered1-5 €
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.Covered1-5 €
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.Covered1-5 €
TriglyceridesA 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 covered1-5 €
BNP (B-type natriureti Peptide)Measures a hormone produced by the heart in response to pressure changes, useful for diagnosing heart failure.Not covered20-40 €
TroponinMeasures proteins released when the heart muscle is damaged, used to diagnose heart attacks.Not covered20-40 €

Kidney Function:

TestDescriptionCoverage in blood panelsEstimated price
Serum Creatinine:A waste product from muscle metabolism that is excreted by the kidneys. Elevated levels can indicate impaired kidney function.Covered1-5 €
Blood Urea Nitrogen (BUN)A waste product from protein metabolism that is excreted by the kidneys. High levels can suggest reduced kidney function.Covered1-5 €
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:

TestDescriptionCoverage in blood panelsEstimated 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.
Covered10-20 €
Free T3 (Triiodothyronine)Measures the active form of T3 in the blood, which is crucial for metabolism regulation.Covered10-20 €
Free T4 (Thyroxine)Measures the active form of T4 in the blood, which is important for metabolic rate and growth.Covered10-20 €
Total T3Measures both the free and bound forms of T3 in the blood.Covered10-20 €
Total T4Measures both the free and bound forms of T4 in the blood.Covered10-20 €

Reproductive Hormones:

TestDescriptionCoverage in blood panelsEstimated price
TestosteroneMeasures the primary male sex hormone, which is important for developing and maintaining male characteristics.Covered20-30 €
EstradiolMeasures a form of estrogen, which is important for reproductive and sexual health.Covered20-30 €
EstroneMeasures another form of estrogen, which is important for reproductive health.Not covered20-30 €
EstriolMeasures the least abundant estrogen, significant during pregnancy.Not covered20-30 €
DHT (Dihydrotestosterone)Measures a potent androgen, derived from testosterone, which is important for male development.Covered20-30 €
IGF-1 (Insulin-Like Growth Factor 1)Measures a hormone that reflects the amount of growth hormone activity in the body.Covered10-30 €
HGH (Human Growth Hormone)Measures the amount of growth hormone.Covered10-30 €
SHBG (Sex Hormone Binding Globulin)Measures a protein that binds to sex hormones, influencing their bioavailability.Covered20-30 €
FSH (Follicle-Stimulating Hormone)Important for reproductive health and function.Covered10-20 €
LH (Luteinizing Hormone)Works with FSH to regulate reproductive processes.Not covered10-20 €
ProlactinMeasures a hormone that can influence reproductive health.Not covered10-20 €
IGFBP-3 (Insulin-Like Growth Factor Binding Protein 3)Measures the main carrier of IGF-1 in the blood, indicating GH activity.Not covered10-30 €
DHEADHEA 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.Covered20-30 €
DHEA-SDHEA-S levels in blood help diagnose adrenal and hormone-related disorders, offering insights into adrenal gland function and overall hormone balance.Covered20-30 €

General Health Markers:

TestDescriptionCoverage in blood panelsEstimated price
CBC (Complete Blood Count)Provides information about the cells in the blood, including red blood cells, white blood cells, and platelets.Covered5-10 €
CMP (Comprehensive Metabolic Panel)Includes tests for electrolytes, glucose, calcium, albumin, and more, providing a broad overview of metabolic health.Covered5-10 €
CRP (C-Reactive Protein)Measures a marker of inflammation in the body, which can indicate infection or chronic inflammatory conditions.Not covered5-15 €
ESR (Erythrocyte Sedimentation Rate)Another marker of inflammation, which can indicate chronic inflammatory conditions.Not covered5-15 €

Metabolic Function:

TestDescriptionCoverage in blood panelsEstimated price
Fasting GlucoseMeasures blood sugar levels after fasting, important for assessing glucose metabolism and risk of diabetes.Covered through blood sugar meter later discussed1-5 € (in lab)
HbA1c (Hemoglobin A1c)Measures average blood glucose levels over the past 2-3 months, used to diagnose and monitor diabetes.Not covered10-20 €
InsulinMeasures the level of insulin in the blood, important for understanding insulin sensitivity and pancreatic function.Not covered10-20 €

Immune Function:

TestDescriptionCoverage in blood panelsEstimated 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:

TestDescriptionCoverage in blood panelsEstimated price
PSA (Prostate-Specific Antigen)Measures a protein produced by the prostate gland. Elevated levels may indicate prostate cancer.Not covered10-20 €
CA-125Measures a protein often elevated in ovarian cancerNot covered10-20 €
CA 15-3Measures a protein elevated in breast cancer.Not covered20-30 €
AFP (Alpha-Fetoprotein)Elevated levels may indicate liver cancer or germ cell tumors.Not covered10-20 €
CEA (Carcinoembryonic Antigen)Elevated levels may indicate colorectal, lung, pancreatic, or breast cancer.Not covered10-20 €
CA 19-9Elevated levels may indicate pancreatic cancer.Not covered10-20 €

Bones markers:

TestDescriptionCoverage in blood panelsEstimated price
25-OH-vitamin DMeasures the level of vitamin D, which is crucial for bone health.Covered20-40 €
P1NPMeasures a marker of bone formation.Not covered30-40 €
OstasisMeasures a protein secreted by osteoblasts, important for bone formation.Not covered30-40 €
ß-CTX (Beta CrossLaps)Measures a marker of bone resorption.Not covered30-40 €
TRAP 5bMeasures an enzyme involved in bone resorption.Not covered1-5 €
OsteocalcinA protein secreted by osteoblasts, important for bone formation.Covered10-20 €
Alkaline PhosphataseAn enzyme important for bone and liver health.Covered1-5 €

Androgenic balding:

TestDescriptionCoverage in blood panelsEstimated price
DHEA-SMeasures a precursor hormone that can be converted into androgens and estrogens.Covered20-30 €
TestosteroneMeasures the primary male sex hormone, important for developing and maintaining male characteristics.Covered20-30 €
SHBGMeasures a protein that binds to sex hormones, including testosterone and estrogen.Covered20-30 €
AndrostenedioneMeasures a precursor to testosterone and estrogen, important for hormone balance.Not covered10-20 €

Electrolytes and Minerals:

TestDescriptionCoverage in blood panelsEstimated price
SodiumEssential for fluid balance and nerve function.Not covered1-5 €
PotassiumImportant for heart and muscle function.Not covered1-5 €
ChlorideHelps maintain fluid balance and pH levels.Not covered1-5 €
CalciumImportant for bone health, muscle function, and nerve signaling.Not covered1-5 €
MagnesiumInvolved in numerous biochemical reactions in the body.Not covered1-5 €
PhosphateImportant for bone health and energy production.Not covered1-5 €

Vitamins and Other Minerals:

TestDescriptionCoverage in blood panelsEstimated price
Vitamin B12Essential for nerve function and blood cell production.Not covered10-20 €
FolateImportant for DNA synthesis and cell division.Not covered10-20 €
ZincImportant for immune function, protein synthesis, and DNA synthesis.Not covered1-5 €
IronCrucial for oxygen transport in the blood.Not covered1-5 €

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.

TestPriceImportance
  • IGF-1
  • 10-30 €
  • important
  • Testosterone
  • 20-30 €
  • important
  • Estradiol
  • 20-30 €
  • important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • recommended
  • Total T3
  • 10-20 €
  • recommended
  • Total T4
  • 10-20 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHEA
  • 20-30 €
  • recommended
  • DHEA-S
  • 20-30 €
  • recommended
  • 25-OH-vitamin D
  • 20-40 €
  • optional
  • DHT
  • 20-30 €
  • optional
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
  • Comprehensive Metabolic Panel (CMP)
  • 5-10 €
  • optional
Total price: 180-330 €

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)
If you notice strong side effects like lasting tiredness throughout the day, strong and long headaches, Jaundice (yellowish discoloration of the skin and eyes), loss of appetite, nausea, chest pain, back pain etc. I advise you to add additional tests.

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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
Total price: 27-50 €

[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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • Complete Blood Count
  • 5-10 €
  • important
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • recommended
  • Bilirubin
  • 1-5 €
  • recommended
  • Blood Urea Nitrogen
  • 1-5 €
  • recommended
  • Creatinine
  • 1-5 €
  • recommended
  • HDL Cholesterol
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHT
  • 20-30 €
  • optional
  • Free T3
  • 10-20 €
  • optional
  • Free T4
  • 10-20 €
  • optional
  • Testosterone
  • 20-30 €
  • optional
Total price: 103-220 €

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]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • Complete Blood Count (CBC)
  • 5-10 €
  • Important
  • GGT (Gamma-Glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine Transaminase)
  • 1-5 €
  • Recommended
  • AST (Aspartate Transaminase)
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • Blood Urea Nitrogen (BUN)
  • 1-5 €
  • Recommended
  • Creatinine
  • 1-5 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • TSH
  • 10-20 €
  • Recommended
  • Free T3
  • 10-20 €
  • Optional
  • Free T4
  • 10-20 €
  • Optional
  • Testosterone
  • 20-30 €
  • Optional
  • DHT
  • 20-30 €
  • Optional
Total price: 113-200 €

[Test E]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • Blood creatine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Recommended
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
Total price: 153-320 €

[Test F]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Blood Creatinine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
  • Oestelcalcin
  • 10-20 €
  • Recommended
  • Alkaline phosphatase
  • 1-5 €
  • Recommended
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.
Glucose is the main source of energy for cells, and insulin is the hormone that ensures glucose gets from the blood into the cells. Without enough insulin or insulin resistance (as in type 2 diabetes), too much glucose remains in the blood, which can lead to high blood sugar levels and long-term health problems.

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.

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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.
Monitoring before and after meals (2 hours after the meal):
  • 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.
Monitoring before bedtime (less important):
  • 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).
Frequency of monitoring:

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 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).
Normal blood sugar levels:
  • 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).
Values that require intervention:
  • 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.).
The development of type 2 diabetes mellitus, the most common form of diabetes, can take years and is a gradual process.

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.
Symptoms of low blood sugar (hypoglycemia):

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.
Actions for High Values:

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.
Supplements:
  • 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.
Monitoring before bedtime (less important):

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.
Symptoms of Low Blood Pressure (Hypotension):
  • 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.
Supplements:
  • 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.

1717687916360

(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
If you have made yourself a better routine, be sure to post the routine in this post!

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.
If you notice any of those and the trigger is water retention at the heart, immediately stop the r-hGH administration and take further action.

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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Storage Guidelines

The storage of exemestane etc. is fairly easy, but storing r-hGH correctly is crucial to maintain its effectiveness and safety.

After the r-hGH has arrived, it’s unmixed r-hGH in lyophilized (freeze-dried) powder form. This form of r-hGH is relatively stable and can typically be used up to the expiration date printed on the packaging if stored in the refrigerator at temperatures between 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit - There could also be other storage information on the package, such as 2-4 degrees, etc.).

If there is no date, expect 3 - 18+ months or e-mail your provider directly.

The expiration date assumes that the product has been continuously stored under recommended conditions and can often extend several years into the future, depending on the manufacturing date.

While there are people who recommend only shipping r-hGH refrigerated in the winter or late autumn, this is not necessarily.

Nevertheless, you should insist on refrigerated express transport, especially in the warm season.

Avoiding r-hGH to extreme temperatures, especially heat and direct sunlight, is important as this could destroy the structure of the polypeptide hormone.

In Liquid Form (After Reconstitution): Once r-hGH has been converted into liquid form by mixing it with a solvent, its shelf life significantly shortens. The exact duration depends on the specific product and the manufacturer's instructions but typically ranges from 14 to 28 days when consistently stored in the refrigerator. Some products may have a shorter shelf life.

I recommend injecting the r-hGH right after reconstituting and only reconstituting the amount that you need for your immediate dose or the next two doses.

A high-quality refrigerator is incredibly important. Do not waste your time and money on refrigerators in a price range of 20-80€. This applies to most refrigerators smaller than 445 mm x 500 mm x 468 mm. They are simply not good at cooling most of the time.

Make sure that your refrigerator can cool at least 30 degrees below room temperature, especially if these temperatures can occur in your home in the summer.

Only store your r-hGH vials in the refrigerator and make sure that the refrigerator has no UV-Light function or make sure that it's turned off.

1718378985050


Medicine refrigerators are also a good option, they are much smaller and cool very precisely.

1718378997778


(This medicine refrigerator can easily carry up to 40 vials a 12IU for example)​
[/CENTER]

Ensure that the refrigerator is not connected to a cable that poses a risk of power failure.

When choosing a refrigerator, pay attention to its volume.

As said, for exemestane (Aromatase Inhibitor in general) everything is a bit easier, keep your exemestane at normal room temperature (not above 25 degrees), away from direct sunlight or wetness (Also low-humidity environment).



Use of Assistive Devices
Those are important devices for the use of r-HGH.
  • Bacteriostatic water: To reconstitute the freeze-dried r-hGH.
  • Alcohol wipes: For sterilizing the injection site and vial.
  • 3cc syringe: Used for drawing bacteriostatic water.
  • Insulin syringe: For precise r-hGH dosing and subcutaneous injections.
I'll go more in-depth about what to do with those things later.

Storage for them is similar to the storage of Aromatase inhibitors.



The authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

It's essential to make sure r-hGH and exemestane or Pfizer aromasin are effective.

This can be ensured in the first place by buying from sources that are accepted within the community.

For further ensure blood tests are required.

However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabeled as GH.

r-hGH Checklist:​

Test A:
  • Reconstitute the r-hGH.
  • Bring a pot of water to a boil.
  • Put the r-hGH vial into the boiling water for 2 minutes.
  • See if the solution turns milky/cloudy white.
  • If your r-hGH is real it will turn cloudy/milky white after this procedure.
  • Let the r-hGH vial stay at room temperature for one day.
  • If the solution becomes clear again and you don't see any milkiness then the r-hGH is fake.
Test B:
  • Buy a home pregnancy kit from a pharmacy.
  • Reconstitute the r-hGH and set it on the pregnancy kit.
  • If the result is positive, this indicates that the powder has tested positive for HCG, indicating that the r-hGH is counterfeit r-hGH.
  • Another way to perform the test is to urinate on it 2 days after ingesting the supposed r-hGH product. If the powder contains HCG, it will pass through the urine and the test should turn positive.
Test C:
Exemestane, Pfizer Aromasin Checklist:​

Exemestane from different pharmacies or UGLabs is hard to check for efficiency without trying it.

Known UGLabs usually have “verify” codes on the box and laborious analyses online on known Bodybuilding forums.

Aromasin is harder to check for authenticity
  • Inspect the pill, the pill should be:
  • Really small, roundish, white and with the number “7663” printed on the side
  • Inspect the package through comparison with photos on the internet



Injecting r-hGH:

Determining the appropriate r-HGH Dosage

The appropriate dose of r-hGH is the proper r-hGH dose for you.

While someone has to use a dose of 10IU r-hGH, you may only need a dose of 5IU r-hGH.

And the idea that the more IU of r-hGH you use means more effects is also wrong, this is because the liver simply stops producing more IGF-1 at some point, 30IU doesn't change that, you still reach the same peak as you may had with 5IU r-hGH.

This means that the only thing you achieve by injecting excessive amounts of r-hGH is burning money.

And by the way acromegalic, strong hormonal fluctuations and side effects.

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Since we are aiming for controlled growth, we should also keep our hormone levels within or not excessively above the reference ranges, this is enough to get our desired growth spurts.

Generally, this is the dose that gets used: 0,035 mg/kg per day (1mg r-hGH = 3IU r-hGH).

So for the most 5-8 IU r-hGH, regular blood tests of IGF-1 and HGH are crucial to adjust the doses (This is the dose that maxes out IGF-1).

I personally don't recommend going above 10IU r-hGH ed.

I personally don’t recommend going under 3IU r-hGH ed.

As I said, be careful not to increase your IGF-1 etc. levels too much over a too long time period.

Administration Technique for r-HGH

As said before, in order to inject r-hGH you first have to reconstitute it into a liquid form.

For the whole injection process following things are necessary:
  • Bacteriostatic water: To convert the r-hGH powder into liquid (about 1ml is needed for 6IU).
  • 3cc syringe: For getting the bacteriostatic water out of the vial.
  • Insulin syringe: For the injection.
  • Alcoholic wipes: To keep everything clean during the process.
(r-hGH in liquid form is up to 10 days usable)


For the reconstruction part, watch this video:


A good calculation help is this website:

For the injection part watch this video:



Injections into the thigh or upper arm are also possible.

When trying to inject the r-hGH, make sure that your syringe doesn’t contain any air, injection of air will cause discomfort.

Note: When initiating r-hGH treatment, it is common to start with a lower dose than the target dosage. This approach allows your body and you to gradually adapt to the changes, thereby minimizing potential side effects. By beginning with a smaller dose, you are likely to experience fewer adverse reactions (An example of this is included in the cycle plan).

Timing of r-hGH Injections

The full daily dose of r-hGH is administrated before bed.

Try to give it consistently within an hour timeframe, for example between 9 and 10 p.m. every night.

You may change the time occasionally, by a few hours earlier or later, but do not give before 5 p.m, except under unusual circumstances (such as leaving for a trip, a sleepover, etc.)



Taking the correct dosage of Exemestane (Aromasin):

Determining the appropriate exemestane Dosage
Determining the right dose of exemestane is fairly easy, but it’s a process that takes time.

After blood test A arrives and your E2 baseline lies between 20-40 pg/ml you can start a dose of 6,25mg ed (every day).

Anything below 20 pg/ml is rather unlikely, but as long as it stays there naturally exemestane is not really needed, through regular blood tests it’s easy to notice if the value rises above 20 pg/ml.

Otherwise, you can also try 3.15mg of exemestane ed (every day).

Anything above 40 pg/ml will most likely need a higher dose than 6,25 mg, although I personally still recommend starting with 6.25 mg to give your body, and especially yourself time to get used to the side effects and adapt.

The side effects of exemestane appear quickly and disappear quickly – in the first few days of using exemestane (no matter the dose), you’ll experience light headaches, Joint pain and stiffness, fatigue, and even slight dizziness, everything will feel a little strange.

But this goes away fast, usually about 5-7 days until you have no side effects at all, even when you increase the dose.

In the best-case scenario, if you are patient and don't mind the money you need, you can approach it like this:
  • Get blood Test A.
  • Start with 3,15 mg ed (usually not enough to lower E2 sufficiently, but good to get a first understanding of the drug).
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs, usually everything should be in the reference range).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Continue this until you are below the 20 pg/ml mark and understand your personal dosing.
For most, a daily dose of 12.5mg will be necessary to lower E2 levels enough.

For some, a daily dose of 12.5mg+ will be necessary to lower E2 levels enough.

Note that your exemestane, especially if it is not pharma Aromasin, may be underdosed, so you need higher doses even though your E2 levels are not that high.

Timing and method for exemestane administration
Exemestane shouldn’t be taken with the injection of r-hGH, a two-hour radius between those two drugs should be respected.

I recommend taking Exemestane around 12 o'clock to 14 o'clock, every day at the same time, preferably after eating a meal.

Studies and prescription instructions suggest better absorption by the body if Exemestane is consumed with or after a meal.

Alternatively, you can take Exemestane with a tablespoon of olive oil.

It’s also imperative to understand that AROMASIN requires a full 7 days to allow the body to achieve peak blood plasma levels of the compound.


Another method of administration is the sublingual administration. In short, the pill is placed under the tongue until it disappears, but this administration technique makes no real sense for exemestane, the idea is using the first-pass-effect to get the active ingredient directly into the bloodstream without it getting into the liver. But the enzyme CYP3A4 in the liver will metabolize exemestane either way.



Estimated Costs and Cycle:

List of Necessary Items with Pricing


Obviously, the listed prices are not precise and only fulfill the purpose of giving an idea moneywise.

I calculate with 60-day bulk in advance and 6IU r-hGH ed (every day).

Some things will last longer than the planned 60 days or are one-off expenses, that's why the start is the most expensive.


One-off expenses:
  • Refrigerator: 150€
  • Heart pressure monitor: 10-30€
  • Blood sugar meter: 10-30€
Recurring expenses:
  • Alcoholic Wipes (100 wipes): 10-15€
  • 3cc syringe: 10-30€
  • Insulin syringe: 10-30€
  • Blood sugar meter parts: 10-15€
  • Blood tests: 80-250
  • X-Ray: 70-150€
Recurring expenses:
  • 360IU r-hGH: 340-380€
  • 60ml (1ml ed) Bacteriostatic water: 50-70€ (If you want to save money just make your own bacteriostatic water it’s very easy actually)
  • 1x AROMASIN from Pfizer: 40-70€

Estimated total for the first 60 days:

About 750 - 950€

Estimated total price for the following 60 days:

About 650 – 800€ (mostly below this)​


Cycle Outline and Weekly Schedule, Including Precautions

This cycle outline is intended to provide a general visualization of the procedure. Variations from the plan in any aspect are entirely acceptable and should be tailored to your personal preferences.

It should be logical that you should not start the administration or do blood tests while you have any kind of illness, and start completely healthy (Of course, this also applies to your stress level).

[Stage 1] Preparation:
This should be done before doing anything.

PreparationImportance
Radiograph of the carpal bone or/and knee radiographImportant, except you experienced growth in the last 1-3 months
Blood Test AImportant
Measure, note, or photograph all important featuresImportant
All listed devices and drugsImportant, except you want to only do exemestane for now
A secure source of incomeImportant, mini job, etc.
Buffer budget (100-200€)Recommended

[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days.
After 7 days, Blood Test B - dose adjustImportant
Note side effects and thoughtsRecommended

[Stage 3] Start of r-hGH:
R-hGH should be started with a moderate dose, as in the example here, (it can also be started with the desired dose, e.g. 6IU, 7IU, 8IU, etc.) increase the dose, as long as no serious side effects occur, slowly with 0.5IU to 1IU weekly.
Blood Test CImportant, everything has to be in the reference range
Start of r-hGH with 2IU ed (every day)Important, an increase of 0,5IU to 1IU weekly until the desired dose is reached
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Important
Blood pressure monitoring (before and 2 hours after)Important
Before Bed:
Blood sugar monitoringImportant
Blood pressure monitoringImportant
Time irrelevant
Hair loss preventionRecommended

After 2-4 weeks Blood Test D, depending on your feeling.

[Stage 4] r-hGH and exemestane (after habituation phase):

Cycle Blood Test D, E, and F every monthImportant
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Recommended
Blood pressure monitoring (before and 2 hours after)Recommended
Before Bed:
Blood sugar monitoringOptional
Blood pressure monitoringOptional
Time irrelevant
Hair loss preventionRecommended

If you get things like facial water retention, also start using things like Gua Sha daily, or doing exercises etc.



Additional recommendations and knowledge

Information about r-HGH and Aromatase Inhibitors and the differences between pharma and UGLs

It is worth reiterating that r-hGH stands out as the priciest performance-enhancing product available.

Most counterfeit r-hGH kits are manufactured in China because the laws there are not very strict about making chemicals into products.

Therefore, the production of these r-hGH kits is not very strict either.

I’ve chatted with @lightskinbengali about this and the effects can be far-reaching.

From poor purity to mislabelled HCG powder* to dreamlike purity but with unknown contamination such as heavy metals, everything can be in your vial.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabelled as r-hGH.​
Using HCG and masquerading it as r-hGH proved both effective and profitable, as the freeze-dried HCG powder looks so similar to freeze-dried GH.​

Even with provided laboratory tests by Janoshik (The current market holder for laboratory analyses within the steroids market) it’s not sure what’s in the vial, especially because those analyses mostly don't even address possible contamination.

Ignoring that the technology behind bootleg r-hGH has become so advanced that many fake r-hGH kits contain unknown chemical additives that emulate the very same side effects that genuine r-hGH produces, there are also possible contaminations such as heavy metals in the r-HGH vial that arise during production.

Those looking to purchase premium r-hGH may want to consider Genotropin (made by Pharmacia), Norditropin (made by Novo Nodisk), Serostim (made by Serono), Humatrope (made by Eli Lilly), Omnitrope (made by Sandoz), and Saizen (made by Serono).

Human growth hormone (r-hGH) purity

Generally, the higher the peptide purity level, the more favorable the preparation; critically, for certain applications (such as in vitro studies or clinical trials), only exceedingly pure peptides will be appropriate (greater than 98% purity). However, for r-hGH is usually 95%.

The same applies more or less to Aromatase inhibitors such as exemestane, those who want to purchase premium exemestane may want to consider buying Aromasin (made by Pfizer).

Psychological stress

Uncertainty, constant fear of the family members finding anything, being alone, and not having anyone to talk to about this self-medication, not having anyone knowledgeable that the user could ask for advice, will cause stress and anxiety.

As I said previously using myself as an example, I would choose exemestane based on my self-knowledge to forget dosages, to just be an adolescent, going to a party and make mistakes forgetting about my responsibility.

And this is very similar to the entire topic, if you don't feel like it is something you can do, don’t even start. Suppose you are not able to approach the matter in a disciplined and orderly manner. In that case, I strongly advise against self-administration (which is what I generally do, I refer you to the disclaimer again).

I have written with people who told me about blood tests, that they couldn't do it because they didn't want to ask their parents.

That they couldn’t get a radiograph because their parents wouldn’t believe their made-up reason.

If you are unable to make an appointment with a laboratory or an orthopaedist yourself, if you don't trust yourself or don't even invest the time to understand what is possible, then you are not mature enough to go through with such self-medication and you will harm yourself.

Furthermore, I recommend that anyone who starts such self-medication anonymously contact a trustworthy endocrinologist. To establish contacts with other users (in this forum for example) and to involve parents or legal guardians in the project if possible.

The moral and ethical considerations surrounding the use of r-HGH and Aromatase Inhibitor for adolescents

I previously published a post similar to this one, and the first reply was “haram”, (Harām (حرام, harām) is an Arabic adjective that in Islam describes anything that is “forbidden, inviolable, sacred” according to Sharia law.), another interaction was someone who aggressively wanted to clarify to a user of steroids that he would never see how his body would have developed naturally, who he would have been without any aids.

In my opinion, a central point in this discussion is the question of fairness. Some people maintain their height and physical appearance without external intervention due to their genetic makeup, it's easy for them to play the moralizer. However, others consider using r-hGH and aromatase inhibitors to achieve similar results, to exploit their own personal potential fully.

If there is an opportunity to have a better life, why shouldn't you be allowed to take advantage of it?

If genetics are unfair, why shouldn’t we have the right to change their outcome?

This question is very profound but:

Every person has the right to make decisions about their own body, including the decision to undertake medical procedures to change external appearance.

Ultimately, ethical assessment depends heavily on individual values and social contexts in which these decisions are made.

A while ago I was lucky enough to chat with someone who decided against r-HGH a few years ago for similar reasons. He described it as one of his biggest mistakes, he tells me that he is unhappier today than ever before and wishes he had done it, took his chance, and changed his life forever.

Emergencies

It’s generally not possible to instantly die from r-hGH or aromatase inhibitors, no matter the dose.

If you notice strange feelings after your r-hGH injection and feel like it is something serious, stay calm. Call the emergency number, say what you are taking, how much, and how long, and have a vial of your r-hGH or pill of your Aromatase Inhibitor ready. If things get serious, use an EpiPen.

If you notice that you accidentally injected or took a too high dose of r-hGH your Aromatase Inhibitor assess the risks and maybe call the emergency number.

If you've swallowed the pill and it's been a short while, try throwing it up.

Drink water but don’t over-drink.

If you got eye contact with those drugs immediately flush your eye(s) with plenty of water. If irritation occurs or persists, get medical attention.

If the r-hGH has contact with your clothing or skin remove the clothing and wash the affected skin with soap and water. If irritation occurs or persists, get medical attention.

If you accidentally ingest the r-hGH get medical attention. Do not induce vomiting unless directed by medical personnel. Never give anything by mouth to an unconscious person.

If you inhale the r-hGH or your Aromatase Inhibitor remove to fresh air. If not breathing, give artificial respiration. Get medical attention.

Off-cycle
If you want to off-cycle r-hGH, gradually reduce the dose, similar to how you start, this helps the body adjust to the lower hormone levels.

Example: If you take 1 IU (International Unit) daily, reduce to 0.5 IU per day for one week, then to 0.25 IU per day for another week, and finally to 0.1 IU per day before you stop completely.

If you want to off-cycle exemestane, gradually reduce the dose, similar to how you start, this helps the body adjust to the hormone levels.

Example: If you take 25 mg daily, reduce the dose to 12.5 mg per day for one week, then to 12.5 mg every two days for another week, and finally to 6.25 mg per day for one week , before stopping completely.

Missing doses

Exemestane (Aromasin):

Missing a single dose of exemestane is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.

r-hGH doses:

Missing a single dose of r-hGH is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.


If you have plans for a party or an overnight stay and know you won't be able to inject at your regular time, you can inject a few hours earlier. It is generally safe to inject up to 4-6 hours earlier than usual, though injecting more than 6 hours earlier might not be ideal as it could affect the consistency of the treatment.
Alternatively, if feasible, you can inject later in the evening or night. If your usual injection time is before bedtime, you might delay the injection until you return home. Ensure that the injection is not delayed by more than a few hours to maintain consistent hormone levels. Missing a single dose occasionally is not likely to significantly impact your overall treatment, but this should not become a habit.

You should not miss doses more than once a month.

Supplements

[Optional] Use these supplements to ensure health:
  • Vitamin D and K2
  • Calcium
  • Magnesium
  • Ashwagandha
  • Zinc
Bitcoin and privacy

Acquiring Bitcoin is relatively easy. Many providers, such as BitPay or MoonPay, offer wallets without requiring extensive verification, and they allow payments via PayPal, Apple Pay, and other convenient methods. It is recommended to use the Tor Browser and a VPN when accessing illegal websites. Additionally, shipping to addresses other than your own is advisable. Using high-quality, new email accounts, such as ProtonMail, is also recommended for enhanced privacy.

Vacation

On vacation, do vacation.

Plan your vacation into your cycle and simply stop injecting r-hGH during that time.

It is possible to smuggle the r-hGH vials onto the plane, but it is strenuous and risky, as well as keeping it cool during the vacation and injecting it at the right time (hard if you party every day), storing the needles, etc. to take everything with you, this is all just stress.

On the other hand, it is quite easy to continue taking your exemestane pills.

If you really want to continue the administration, I recommend getting a Genotropin GoQuick pre-filled syringe and simply cooling it occasionally. Remove and replace the tag and smuggle it onto the plane.

Depression from drugs

Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible.

So, if you are already prone to depression or maybe even struggle with it, you should discard the idea of starting medication yourself. You are too mentally weak and will only harm yourself and go crazy afterward.

Not only because of the effects of Aromatase Inhibitors on the brain but also because you may not be able to accept the outcomes and start brainless increasing doses and harming yourself.

In the past, we could see similar phenomena from users here on org often.

Conversely, nothing will happen to your mood if you are mentally stable and mature enough.

Do not misjudge yourself, increase doses without full consideration, or trade hastily, and especially don't try to save money!

Side effects:

Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time.

Procrastination:

You are only one decision away from changing your life.

Don't waste your time letting this rot in the back of your head.

Days pass quickly and before you know it, another month has passed and then another. I know that for many people it is a big decision, but your time to do this is limited, so you have to decide. And then it's all or nothing.



Ending

Conclusion

Ultimately, other lifestyle changes are also necessary if someone really wants to fulfill his genetic potential and even go beyond it.

I would even say that if the lifestyle is not optimized, injections don't really help.

Perfecting sleep, diet, mindset, and overall lifestyle is a component of this topic that should not be ignored, for instance, if you sleep 4 hours a day, don't even bother thinking you’ll grow.

This guide could help you: click here


I refrain again to the disclaimer in the beginning.

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Storage Guidelines

The storage of exemestane etc. is fairly easy, but storing r-hGH correctly is crucial to maintain its effectiveness and safety.

After the r-hGH has arrived, it’s unmixed r-hGH in lyophilized (freeze-dried) powder form. This form of r-hGH is relatively stable and can typically be used up to the expiration date printed on the packaging if stored in the refrigerator at temperatures between 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit - There could also be other storage information on the package, such as 2-4 degrees, etc.).

If there is no date, expect 3 - 18+ months or e-mail your provider directly.

The expiration date assumes that the product has been continuously stored under recommended conditions and can often extend several years into the future, depending on the manufacturing date.

While there are people who recommend only shipping r-hGH refrigerated in the winter or late autumn, this is not necessarily.

Nevertheless, you should insist on refrigerated express transport, especially in the warm season.

Avoiding r-hGH to extreme temperatures, especially heat and direct sunlight, is important as this could destroy the structure of the polypeptide hormone.

In Liquid Form (After Reconstitution): Once r-hGH has been converted into liquid form by mixing it with a solvent, its shelf life significantly shortens. The exact duration depends on the specific product and the manufacturer's instructions but typically ranges from 14 to 28 days when consistently stored in the refrigerator. Some products may have a shorter shelf life.

I recommend injecting the r-hGH right after reconstituting and only reconstituting the amount that you need for your immediate dose or the next two doses.

A high-quality refrigerator is incredibly important. Do not waste your time and money on refrigerators in a price range of 20-80€. This applies to most refrigerators smaller than 445 mm x 500 mm x 468 mm. They are simply not good at cooling most of the time.

Make sure that your refrigerator can cool at least 30 degrees below room temperature, especially if these temperatures can occur in your home in the summer.

Only store your r-hGH vials in the refrigerator and make sure that the refrigerator has no UV-Light function or make sure that it's turned off.

View attachment 2980655

Medicine refrigerators are also a good option, they are much smaller and cool very precisely.

View attachment 2980656

(This medicine refrigerator can easily carry up to 40 vials a 12IU for example)​
[/CENTER]

Ensure that the refrigerator is not connected to a cable that poses a risk of power failure.

When choosing a refrigerator, pay attention to its volume.

As said, for exemestane (Aromatase Inhibitor in general) everything is a bit easier, keep your exemestane at normal room temperature (not above 25 degrees), away from direct sunlight or wetness (Also low-humidity environment).



Use of Assistive Devices
Those are important devices for the use of r-HGH.
  • Bacteriostatic water: To reconstitute the freeze-dried r-hGH.
  • Alcohol wipes: For sterilizing the injection site and vial.
  • 3cc syringe: Used for drawing bacteriostatic water.
  • Insulin syringe: For precise r-hGH dosing and subcutaneous injections.
I'll go more in-depth about what to do with those things later.

Storage for them is similar to the storage of Aromatase inhibitors.



The authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

It's essential to make sure r-hGH and exemestane or Pfizer aromasin are effective.

This can be ensured in the first place by buying from sources that are accepted within the community.

For further ensure blood tests are required.

However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabeled as GH.

r-hGH Checklist:​

Test A:
  • Reconstitute the r-hGH.
  • Bring a pot of water to a boil.
  • Put the r-hGH vial into the boiling water for 2 minutes.
  • See if the solution turns milky/cloudy white.
  • If your r-hGH is real it will turn cloudy/milky white after this procedure.
  • Let the r-hGH vial stay at room temperature for one day.
  • If the solution becomes clear again and you don't see any milkiness then the r-hGH is fake.
Test B:
  • Buy a home pregnancy kit from a pharmacy.
  • Reconstitute the r-hGH and set it on the pregnancy kit.
  • If the result is positive, this indicates that the powder has tested positive for HCG, indicating that the r-hGH is counterfeit r-hGH.
  • Another way to perform the test is to urinate on it 2 days after ingesting the supposed r-hGH product. If the powder contains HCG, it will pass through the urine and the test should turn positive.
Test C:
Exemestane, Pfizer Aromasin Checklist:​

Exemestane from different pharmacies or UGLabs is hard to check for efficiency without trying it.

Known UGLabs usually have “verify” codes on the box and laborious analyses online on known Bodybuilding forums.

Aromasin is harder to check for authenticity
  • Inspect the pill, the pill should be:
  • Really small, roundish, white and with the number “7663” printed on the side
  • Inspect the package through comparison with photos on the internet



Injecting r-hGH:

Determining the appropriate r-HGH Dosage

The appropriate dose of r-hGH is the proper r-hGH dose for you.

While someone has to use a dose of 10IU r-hGH, you may only need a dose of 5IU r-hGH.

And the idea that the more IU of r-hGH you use means more effects is also wrong, this is because the liver simply stops producing more IGF-1 at some point, 30IU doesn't change that, you still reach the same peak as you may had with 5IU r-hGH.

This means that the only thing you achieve by injecting excessive amounts of r-hGH is burning money.

And by the way acromegalic, strong hormonal fluctuations and side effects.


Since we are aiming for controlled growth, we should also keep our hormone levels within or not excessively above the reference ranges, this is enough to get our desired growth spurts.

Generally, this is the dose that gets used: 0,035 mg/kg per day (1mg r-hGH = 3IU r-hGH).

So for the most 5-8 IU r-hGH, regular blood tests of IGF-1 and HGH are crucial to adjust the doses (This is the dose that maxes out IGF-1).

I personally don't recommend going above 10IU r-hGH ed.

I personally don’t recommend going under 3IU r-hGH ed.

As I said, be careful not to increase your IGF-1 etc. levels too much over a too long time period.

Administration Technique for r-HGH

As said before, in order to inject r-hGH you first have to reconstitute it into a liquid form.

For the whole injection process following things are necessary:
  • Bacteriostatic water: To convert the r-hGH powder into liquid (about 1ml is needed for 6IU).
  • 3cc syringe: For getting the bacteriostatic water out of the vial.
  • Insulin syringe: For the injection.
  • Alcoholic wipes: To keep everything clean during the process.
(r-hGH in liquid form is up to 10 days usable)


For the reconstruction part, watch this video:


A good calculation help is this website:

For the injection part watch this video:



Injections into the thigh or upper arm are also possible.

When trying to inject the r-hGH, make sure that your syringe doesn’t contain any air, injection of air will cause discomfort.

Note: When initiating r-hGH treatment, it is common to start with a lower dose than the target dosage. This approach allows your body and you to gradually adapt to the changes, thereby minimizing potential side effects. By beginning with a smaller dose, you are likely to experience fewer adverse reactions (An example of this is included in the cycle plan).

Timing of r-hGH Injections

The full daily dose of r-hGH is administrated before bed.

Try to give it consistently within an hour timeframe, for example between 9 and 10 p.m. every night.

You may change the time occasionally, by a few hours earlier or later, but do not give before 5 p.m, except under unusual circumstances (such as leaving for a trip, a sleepover, etc.)



Taking the correct dosage of Exemestane (Aromasin):

Determining the appropriate exemestane Dosage
Determining the right dose of exemestane is fairly easy, but it’s a process that takes time.

After blood test A arrives and your E2 baseline lies between 20-40 pg/ml you can start a dose of 6,25mg ed (every day).

Anything below 20 pg/ml is rather unlikely, but as long as it stays there naturally exemestane is not really needed, through regular blood tests it’s easy to notice if the value rises above 20 pg/ml.

Otherwise, you can also try 3.15mg of exemestane ed (every day).

Anything above 40 pg/ml will most likely need a higher dose than 6,25 mg, although I personally still recommend starting with 6.25 mg to give your body, and especially yourself time to get used to the side effects and adapt.

The side effects of exemestane appear quickly and disappear quickly – in the first few days of using exemestane (no matter the dose), you’ll experience light headaches, Joint pain and stiffness, fatigue, and even slight dizziness, everything will feel a little strange.

But this goes away fast, usually about 5-7 days until you have no side effects at all, even when you increase the dose.

In the best-case scenario, if you are patient and don't mind the money you need, you can approach it like this:
  • Get blood Test A.
  • Start with 3,15 mg ed (usually not enough to lower E2 sufficiently, but good to get a first understanding of the drug).
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs, usually everything should be in the reference range).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Continue this until you are below the 20 pg/ml mark and understand your personal dosing.
For most, a daily dose of 12.5mg will be necessary to lower E2 levels enough.

For some, a daily dose of 12.5mg+ will be necessary to lower E2 levels enough.

Note that your exemestane, especially if it is not pharma Aromasin, may be underdosed, so you need higher doses even though your E2 levels are not that high.

Timing and method for exemestane administration
Exemestane shouldn’t be taken with the injection of r-hGH, a two-hour radius between those two drugs should be respected.

I recommend taking Exemestane around 12 o'clock to 14 o'clock, every day at the same time, preferably after eating a meal.

Studies and prescription instructions suggest better absorption by the body if Exemestane is consumed with or after a meal.

Alternatively, you can take Exemestane with a tablespoon of olive oil.

It’s also imperative to understand that AROMASIN requires a full 7 days to allow the body to achieve peak blood plasma levels of the compound.


Another method of administration is the sublingual administration. In short, the pill is placed under the tongue until it disappears, but this administration technique makes no real sense for exemestane, the idea is using the first-pass-effect to get the active ingredient directly into the bloodstream without it getting into the liver. But the enzyme CYP3A4 in the liver will metabolize exemestane either way.



Estimated Costs and Cycle:

List of Necessary Items with Pricing


Obviously, the listed prices are not precise and only fulfill the purpose of giving an idea moneywise.

I calculate with 60-day bulk in advance and 6IU r-hGH ed (every day).

Some things will last longer than the planned 60 days or are one-off expenses, that's why the start is the most expensive.


One-off expenses:
  • Refrigerator: 150€
  • Heart pressure monitor: 10-30€
  • Blood sugar meter: 10-30€
Recurring expenses:
  • Alcoholic Wipes (100 wipes): 10-15€
  • 3cc syringe: 10-30€
  • Insulin syringe: 10-30€
  • Blood sugar meter parts: 10-15€
  • Blood tests: 80-250
  • X-Ray: 70-150€
Recurring expenses:
  • 360IU r-hGH: 340-380€
  • 60ml (1ml ed) Bacteriostatic water: 50-70€ (If you want to save money just make your own bacteriostatic water it’s very easy actually)
  • 1x AROMASIN from Pfizer: 40-70€

Estimated total for the first 60 days:

About 750 - 950€

Estimated total price for the following 60 days:

About 650 – 800€ (mostly below this)​


Cycle Outline and Weekly Schedule, Including Precautions

This cycle outline is intended to provide a general visualization of the procedure. Variations from the plan in any aspect are entirely acceptable and should be tailored to your personal preferences.

It should be logical that you should not start the administration or do blood tests while you have any kind of illness, and start completely healthy (Of course, this also applies to your stress level).

[Stage 1] Preparation:
This should be done before doing anything.

PreparationImportance
Radiograph of the carpal bone or/and knee radiographImportant, except you experienced growth in the last 1-3 months
Blood Test AImportant
Measure, note, or photograph all important featuresImportant
All listed devices and drugsImportant, except you want to only do exemestane for now
A secure source of incomeImportant, mini job, etc.
Buffer budget (100-200€)Recommended

[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days.
After 7 days, Blood Test B - dose adjustImportant
Note side effects and thoughtsRecommended

[Stage 3] Start of r-hGH:
R-hGH should be started with a moderate dose, as in the example here, (it can also be started with the desired dose, e.g. 6IU, 7IU, 8IU, etc.) increase the dose, as long as no serious side effects occur, slowly with 0.5IU to 1IU weekly.
Blood Test CImportant, everything has to be in the reference range
Start of r-hGH with 2IU ed (every day)Important, an increase of 0,5IU to 1IU weekly until the desired dose is reached
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Important
Blood pressure monitoring (before and 2 hours after)Important
Before Bed:
Blood sugar monitoringImportant
Blood pressure monitoringImportant
Time irrelevant
Hair loss preventionRecommended

After 2-4 weeks Blood Test D, depending on your feeling.

[Stage 4] r-hGH and exemestane (after habituation phase):

Cycle Blood Test D, E, and F every monthImportant
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Recommended
Blood pressure monitoring (before and 2 hours after)Recommended
Before Bed:
Blood sugar monitoringOptional
Blood pressure monitoringOptional
Time irrelevant
Hair loss preventionRecommended

If you get things like facial water retention, also start using things like Gua Sha daily, or doing exercises etc.



Additional recommendations and knowledge

Information about r-HGH and Aromatase Inhibitors and the differences between pharma and UGLs

It is worth reiterating that r-hGH stands out as the priciest performance-enhancing product available.

Most counterfeit r-hGH kits are manufactured in China because the laws there are not very strict about making chemicals into products.

Therefore, the production of these r-hGH kits is not very strict either.

I’ve chatted with @lightskinbengali about this and the effects can be far-reaching.

From poor purity to mislabelled HCG powder* to dreamlike purity but with unknown contamination such as heavy metals, everything can be in your vial.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabelled as r-hGH.​
Using HCG and masquerading it as r-hGH proved both effective and profitable, as the freeze-dried HCG powder looks so similar to freeze-dried GH.​

Even with provided laboratory tests by Janoshik (The current market holder for laboratory analyses within the steroids market) it’s not sure what’s in the vial, especially because those analyses mostly don't even address possible contamination.

Ignoring that the technology behind bootleg r-hGH has become so advanced that many fake r-hGH kits contain unknown chemical additives that emulate the very same side effects that genuine r-hGH produces, there are also possible contaminations such as heavy metals in the r-HGH vial that arise during production.

Those looking to purchase premium r-hGH may want to consider Genotropin (made by Pharmacia), Norditropin (made by Novo Nodisk), Serostim (made by Serono), Humatrope (made by Eli Lilly), Omnitrope (made by Sandoz), and Saizen (made by Serono).

Human growth hormone (r-hGH) purity

Generally, the higher the peptide purity level, the more favorable the preparation; critically, for certain applications (such as in vitro studies or clinical trials), only exceedingly pure peptides will be appropriate (greater than 98% purity). However, for r-hGH is usually 95%.

The same applies more or less to Aromatase inhibitors such as exemestane, those who want to purchase premium exemestane may want to consider buying Aromasin (made by Pfizer).

Psychological stress

Uncertainty, constant fear of the family members finding anything, being alone, and not having anyone to talk to about this self-medication, not having anyone knowledgeable that the user could ask for advice, will cause stress and anxiety.

As I said previously using myself as an example, I would choose exemestane based on my self-knowledge to forget dosages, to just be an adolescent, going to a party and make mistakes forgetting about my responsibility.

And this is very similar to the entire topic, if you don't feel like it is something you can do, don’t even start. Suppose you are not able to approach the matter in a disciplined and orderly manner. In that case, I strongly advise against self-administration (which is what I generally do, I refer you to the disclaimer again).

I have written with people who told me about blood tests, that they couldn't do it because they didn't want to ask their parents.

That they couldn’t get a radiograph because their parents wouldn’t believe their made-up reason.

If you are unable to make an appointment with a laboratory or an orthopaedist yourself, if you don't trust yourself or don't even invest the time to understand what is possible, then you are not mature enough to go through with such self-medication and you will harm yourself.

Furthermore, I recommend that anyone who starts such self-medication anonymously contact a trustworthy endocrinologist. To establish contacts with other users (in this forum for example) and to involve parents or legal guardians in the project if possible.

The moral and ethical considerations surrounding the use of r-HGH and Aromatase Inhibitor for adolescents

I previously published a post similar to this one, and the first reply was “haram”, (Harām (حرام, harām) is an Arabic adjective that in Islam describes anything that is “forbidden, inviolable, sacred” according to Sharia law.), another interaction was someone who aggressively wanted to clarify to a user of steroids that he would never see how his body would have developed naturally, who he would have been without any aids.

In my opinion, a central point in this discussion is the question of fairness. Some people maintain their height and physical appearance without external intervention due to their genetic makeup, it's easy for them to play the moralizer. However, others consider using r-hGH and aromatase inhibitors to achieve similar results, to exploit their own personal potential fully.

If there is an opportunity to have a better life, why shouldn't you be allowed to take advantage of it?

If genetics are unfair, why shouldn’t we have the right to change their outcome?

This question is very profound but:

Every person has the right to make decisions about their own body, including the decision to undertake medical procedures to change external appearance.

Ultimately, ethical assessment depends heavily on individual values and social contexts in which these decisions are made.

A while ago I was lucky enough to chat with someone who decided against r-HGH a few years ago for similar reasons. He described it as one of his biggest mistakes, he tells me that he is unhappier today than ever before and wishes he had done it, took his chance, and changed his life forever.

Emergencies

It’s generally not possible to instantly die from r-hGH or aromatase inhibitors, no matter the dose.

If you notice strange feelings after your r-hGH injection and feel like it is something serious, stay calm. Call the emergency number, say what you are taking, how much, and how long, and have a vial of your r-hGH or pill of your Aromatase Inhibitor ready. If things get serious, use an EpiPen.

If you notice that you accidentally injected or took a too high dose of r-hGH your Aromatase Inhibitor assess the risks and maybe call the emergency number.

If you've swallowed the pill and it's been a short while, try throwing it up.

Drink water but don’t over-drink.

If you got eye contact with those drugs immediately flush your eye(s) with plenty of water. If irritation occurs or persists, get medical attention.

If the r-hGH has contact with your clothing or skin remove the clothing and wash the affected skin with soap and water. If irritation occurs or persists, get medical attention.

If you accidentally ingest the r-hGH get medical attention. Do not induce vomiting unless directed by medical personnel. Never give anything by mouth to an unconscious person.

If you inhale the r-hGH or your Aromatase Inhibitor remove to fresh air. If not breathing, give artificial respiration. Get medical attention.

Off-cycle
If you want to off-cycle r-hGH, gradually reduce the dose, similar to how you start, this helps the body adjust to the lower hormone levels.

Example: If you take 1 IU (International Unit) daily, reduce to 0.5 IU per day for one week, then to 0.25 IU per day for another week, and finally to 0.1 IU per day before you stop completely.

If you want to off-cycle exemestane, gradually reduce the dose, similar to how you start, this helps the body adjust to the hormone levels.

Example: If you take 25 mg daily, reduce the dose to 12.5 mg per day for one week, then to 12.5 mg every two days for another week, and finally to 6.25 mg per day for one week , before stopping completely.

Missing doses

Exemestane (Aromasin):

Missing a single dose of exemestane is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.

r-hGH doses:

Missing a single dose of r-hGH is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.


If you have plans for a party or an overnight stay and know you won't be able to inject at your regular time, you can inject a few hours earlier. It is generally safe to inject up to 4-6 hours earlier than usual, though injecting more than 6 hours earlier might not be ideal as it could affect the consistency of the treatment.
Alternatively, if feasible, you can inject later in the evening or night. If your usual injection time is before bedtime, you might delay the injection until you return home. Ensure that the injection is not delayed by more than a few hours to maintain consistent hormone levels. Missing a single dose occasionally is not likely to significantly impact your overall treatment, but this should not become a habit.

You should not miss doses more than once a month.

Supplements

[Optional] Use these supplements to ensure health:
  • Vitamin D and K2
  • Calcium
  • Magnesium
  • Ashwagandha
  • Zinc
Bitcoin and privacy

Acquiring Bitcoin is relatively easy. Many providers, such as BitPay or MoonPay, offer wallets without requiring extensive verification, and they allow payments via PayPal, Apple Pay, and other convenient methods. It is recommended to use the Tor Browser and a VPN when accessing illegal websites. Additionally, shipping to addresses other than your own is advisable. Using high-quality, new email accounts, such as ProtonMail, is also recommended for enhanced privacy.

Vacation

On vacation, do vacation.

Plan your vacation into your cycle and simply stop injecting r-hGH during that time.

It is possible to smuggle the r-hGH vials onto the plane, but it is strenuous and risky, as well as keeping it cool during the vacation and injecting it at the right time (hard if you party every day), storing the needles, etc. to take everything with you, this is all just stress.

On the other hand, it is quite easy to continue taking your exemestane pills.

If you really want to continue the administration, I recommend getting a Genotropin GoQuick pre-filled syringe and simply cooling it occasionally. Remove and replace the tag and smuggle it onto the plane.

Depression from drugs

Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible.

So, if you are already prone to depression or maybe even struggle with it, you should discard the idea of starting medication yourself. You are too mentally weak and will only harm yourself and go crazy afterward.

Not only because of the effects of Aromatase Inhibitors on the brain but also because you may not be able to accept the outcomes and start brainless increasing doses and harming yourself.

In the past, we could see similar phenomena from users here on org often.

Conversely, nothing will happen to your mood if you are mentally stable and mature enough.

Do not misjudge yourself, increase doses without full consideration, or trade hastily, and especially don't try to save money!

Side effects:

Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time.

Procrastination:

You are only one decision away from changing your life.

Don't waste your time letting this rot in the back of your head.

Days pass quickly and before you know it, another month has passed and then another. I know that for many people it is a big decision, but your time to do this is limited, so you have to decide. And then it's all or nothing.



Ending

Conclusion

Ultimately, other lifestyle changes are also necessary if someone really wants to fulfill his genetic potential and even go beyond it.

I would even say that if the lifestyle is not optimized, injections don't really help.

Perfecting sleep, diet, mindset, and overall lifestyle is a component of this topic that should not be ignored, for instance, if you sleep 4 hours a day, don't even bother thinking you’ll grow.

This guide could help you: click here


I refrain again to the disclaimer in the beginning.

View attachment 2980658



niggas reaaaally want that VIP huh
but bump good thread (BOTB for sure)
 
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  • JFL
Reactions: Deleted member 27550, Clavicular, not__cel and 4 others
holy we got ourselves a chatterbox over here
 
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Damn I'm mirin the effort. Lots of good steroid threads today. Will read in a little bit.
 
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just take the VIP bro
 
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over if templecat34 makes a thread
 
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DIDNT MOTHERFUCKING READ
 
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  • WTF
  • JFL
Reactions: Arabcored, Deleted member 91321, normie tiktoker and 2 others
Don't you think 6 iu is too high, I lowered my dose to 4,8 from 6
 
didnt read but i repped since you always put so much effort into your threads.

how do you do it though? i struggle to write a few paragraphs and you literally broke the character limit, are you a robot or something?

no but seriously can you give me some tips
 
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Don't you think 6 iu is too high, I lowered my dose to 4,8 from 6
No, but it differs from person to person, although it's true that a less dose would also be sufficient to promote growth, so if you get good results at 4,8IU just stick to it

didnt read but i repped since you always put so much effort into your threads.

how do you do it though? i struggle to write a few paragraphs and you literally broke the character limit, are you a robot or something?

no but seriously can you give me some tips
I usally start by creating the content table and simply do one subpoint by time.
Yes it get's boring but I just have mutliple word files in which I write about different things so it's ok. I'm not a nerd tho
 
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dnr
 
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@Master is going to have to read all this
 
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dnr yet, but will soon. :love:
 
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Every molecule, mirin the effort.
 
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good post.
 
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wait also @tempelcat4 where are you finding a place that will do a blood test for IGF1 and IGFBP3 for that cheap? can u pm me where u got that price form?
 
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wait also @tempelcat4 where are you finding a place that will do a blood test for IGF1 and IGFBP3 for that cheap? can u pm me where u got that price form?
Prices differ a lot, especially between different countries.
As said, the estimated prices are only there to give an idea of the roundabout price.
My lab does IGF-1 for 21,45€ and IGFBP3 for 32,18€.
 
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Reactions: Deleted member 27550 and LegitUser
Prices differ a lot, especially between different countries.
As said, the estimated prices are only there to give an idea of the roundabout price.
My lab does IGF-1 for 21,45€ and IGFBP3 for 32,18€.
which country? the cost for IGF1 and IGFBP3 in England combined is around £300 across a few different labs so not even joking its cheaper for me to come to europe jfl
 
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which country? the cost for IGF1 and IGFBP3 in England combined is around £300 across a few different labs so not even joking its cheaper for me to come to europe jfl
Germany
 
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Storage Guidelines

The storage of exemestane etc. is fairly easy, but storing r-hGH correctly is crucial to maintain its effectiveness and safety.

After the r-hGH has arrived, it’s unmixed r-hGH in lyophilized (freeze-dried) powder form. This form of r-hGH is relatively stable and can typically be used up to the expiration date printed on the packaging if stored in the refrigerator at temperatures between 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit - There could also be other storage information on the package, such as 2-4 degrees, etc.).

If there is no date, expect 3 - 18+ months or e-mail your provider directly.

The expiration date assumes that the product has been continuously stored under recommended conditions and can often extend several years into the future, depending on the manufacturing date.

While there are people who recommend only shipping r-hGH refrigerated in the winter or late autumn, this is not necessarily.

Nevertheless, you should insist on refrigerated express transport, especially in the warm season.

Avoiding r-hGH to extreme temperatures, especially heat and direct sunlight, is important as this could destroy the structure of the polypeptide hormone.

In Liquid Form (After Reconstitution): Once r-hGH has been converted into liquid form by mixing it with a solvent, its shelf life significantly shortens. The exact duration depends on the specific product and the manufacturer's instructions but typically ranges from 14 to 28 days when consistently stored in the refrigerator. Some products may have a shorter shelf life.

I recommend injecting the r-hGH right after reconstituting and only reconstituting the amount that you need for your immediate dose or the next two doses.

A high-quality refrigerator is incredibly important. Do not waste your time and money on refrigerators in a price range of 20-80€. This applies to most refrigerators smaller than 445 mm x 500 mm x 468 mm. They are simply not good at cooling most of the time.

Make sure that your refrigerator can cool at least 30 degrees below room temperature, especially if these temperatures can occur in your home in the summer.

Only store your r-hGH vials in the refrigerator and make sure that the refrigerator has no UV-Light function or make sure that it's turned off.

View attachment 2980655

Medicine refrigerators are also a good option, they are much smaller and cool very precisely.

View attachment 2980656

(This medicine refrigerator can easily carry up to 40 vials a 12IU for example)​
[/CENTER]

Ensure that the refrigerator is not connected to a cable that poses a risk of power failure.

When choosing a refrigerator, pay attention to its volume.

As said, for exemestane (Aromatase Inhibitor in general) everything is a bit easier, keep your exemestane at normal room temperature (not above 25 degrees), away from direct sunlight or wetness (Also low-humidity environment).



Use of Assistive Devices
Those are important devices for the use of r-HGH.
  • Bacteriostatic water: To reconstitute the freeze-dried r-hGH.
  • Alcohol wipes: For sterilizing the injection site and vial.
  • 3cc syringe: Used for drawing bacteriostatic water.
  • Insulin syringe: For precise r-hGH dosing and subcutaneous injections.
I'll go more in-depth about what to do with those things later.

Storage for them is similar to the storage of Aromatase inhibitors.



The authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

It's essential to make sure r-hGH and exemestane or Pfizer aromasin are effective.

This can be ensured in the first place by buying from sources that are accepted within the community.

For further ensure blood tests are required.

However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabeled as GH.

r-hGH Checklist:​

Test A:
  • Reconstitute the r-hGH.
  • Bring a pot of water to a boil.
  • Put the r-hGH vial into the boiling water for 2 minutes.
  • See if the solution turns milky/cloudy white.
  • If your r-hGH is real it will turn cloudy/milky white after this procedure.
  • Let the r-hGH vial stay at room temperature for one day.
  • If the solution becomes clear again and you don't see any milkiness then the r-hGH is fake.
Test B:
  • Buy a home pregnancy kit from a pharmacy.
  • Reconstitute the r-hGH and set it on the pregnancy kit.
  • If the result is positive, this indicates that the powder has tested positive for HCG, indicating that the r-hGH is counterfeit r-hGH.
  • Another way to perform the test is to urinate on it 2 days after ingesting the supposed r-hGH product. If the powder contains HCG, it will pass through the urine and the test should turn positive.
Test C:
Exemestane, Pfizer Aromasin Checklist:​

Exemestane from different pharmacies or UGLabs is hard to check for efficiency without trying it.

Known UGLabs usually have “verify” codes on the box and laborious analyses online on known Bodybuilding forums.

Aromasin is harder to check for authenticity
  • Inspect the pill, the pill should be:
  • Really small, roundish, white and with the number “7663” printed on the side
  • Inspect the package through comparison with photos on the internet



Injecting r-hGH:

Determining the appropriate r-HGH Dosage

The appropriate dose of r-hGH is the proper r-hGH dose for you.

While someone has to use a dose of 10IU r-hGH, you may only need a dose of 5IU r-hGH.

And the idea that the more IU of r-hGH you use means more effects is also wrong, this is because the liver simply stops producing more IGF-1 at some point, 30IU doesn't change that, you still reach the same peak as you may had with 5IU r-hGH.

This means that the only thing you achieve by injecting excessive amounts of r-hGH is burning money.

And by the way acromegalic, strong hormonal fluctuations and side effects.


Since we are aiming for controlled growth, we should also keep our hormone levels within or not excessively above the reference ranges, this is enough to get our desired growth spurts.

Generally, this is the dose that gets used: 0,035 mg/kg per day (1mg r-hGH = 3IU r-hGH).

So for the most 5-8 IU r-hGH, regular blood tests of IGF-1 and HGH are crucial to adjust the doses (This is the dose that maxes out IGF-1).

I personally don't recommend going above 10IU r-hGH ed.

I personally don’t recommend going under 3IU r-hGH ed.

As I said, be careful not to increase your IGF-1 etc. levels too much over a too long time period.

Administration Technique for r-HGH

As said before, in order to inject r-hGH you first have to reconstitute it into a liquid form.

For the whole injection process following things are necessary:
  • Bacteriostatic water: To convert the r-hGH powder into liquid (about 1ml is needed for 6IU).
  • 3cc syringe: For getting the bacteriostatic water out of the vial.
  • Insulin syringe: For the injection.
  • Alcoholic wipes: To keep everything clean during the process.
(r-hGH in liquid form is up to 10 days usable)


For the reconstruction part, watch this video:


A good calculation help is this website:

For the injection part watch this video:



Injections into the thigh or upper arm are also possible.

When trying to inject the r-hGH, make sure that your syringe doesn’t contain any air, injection of air will cause discomfort.

Note: When initiating r-hGH treatment, it is common to start with a lower dose than the target dosage. This approach allows your body and you to gradually adapt to the changes, thereby minimizing potential side effects. By beginning with a smaller dose, you are likely to experience fewer adverse reactions (An example of this is included in the cycle plan).

Timing of r-hGH Injections

The full daily dose of r-hGH is administrated before bed.

Try to give it consistently within an hour timeframe, for example between 9 and 10 p.m. every night.

You may change the time occasionally, by a few hours earlier or later, but do not give before 5 p.m, except under unusual circumstances (such as leaving for a trip, a sleepover, etc.)



Taking the correct dosage of Exemestane (Aromasin):

Determining the appropriate exemestane Dosage
Determining the right dose of exemestane is fairly easy, but it’s a process that takes time.

After blood test A arrives and your E2 baseline lies between 20-40 pg/ml you can start a dose of 6,25mg ed (every day).

Anything below 20 pg/ml is rather unlikely, but as long as it stays there naturally exemestane is not really needed, through regular blood tests it’s easy to notice if the value rises above 20 pg/ml.

Otherwise, you can also try 3.15mg of exemestane ed (every day).

Anything above 40 pg/ml will most likely need a higher dose than 6,25 mg, although I personally still recommend starting with 6.25 mg to give your body, and especially yourself time to get used to the side effects and adapt.

The side effects of exemestane appear quickly and disappear quickly – in the first few days of using exemestane (no matter the dose), you’ll experience light headaches, Joint pain and stiffness, fatigue, and even slight dizziness, everything will feel a little strange.

But this goes away fast, usually about 5-7 days until you have no side effects at all, even when you increase the dose.

In the best-case scenario, if you are patient and don't mind the money you need, you can approach it like this:
  • Get blood Test A.
  • Start with 3,15 mg ed (usually not enough to lower E2 sufficiently, but good to get a first understanding of the drug).
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs, usually everything should be in the reference range).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Continue this until you are below the 20 pg/ml mark and understand your personal dosing.
For most, a daily dose of 12.5mg will be necessary to lower E2 levels enough.

For some, a daily dose of 12.5mg+ will be necessary to lower E2 levels enough.

Note that your exemestane, especially if it is not pharma Aromasin, may be underdosed, so you need higher doses even though your E2 levels are not that high.

Timing and method for exemestane administration
Exemestane shouldn’t be taken with the injection of r-hGH, a two-hour radius between those two drugs should be respected.

I recommend taking Exemestane around 12 o'clock to 14 o'clock, every day at the same time, preferably after eating a meal.

Studies and prescription instructions suggest better absorption by the body if Exemestane is consumed with or after a meal.

Alternatively, you can take Exemestane with a tablespoon of olive oil.

It’s also imperative to understand that AROMASIN requires a full 7 days to allow the body to achieve peak blood plasma levels of the compound.


Another method of administration is the sublingual administration. In short, the pill is placed under the tongue until it disappears, but this administration technique makes no real sense for exemestane, the idea is using the first-pass-effect to get the active ingredient directly into the bloodstream without it getting into the liver. But the enzyme CYP3A4 in the liver will metabolize exemestane either way.



Estimated Costs and Cycle:

List of Necessary Items with Pricing


Obviously, the listed prices are not precise and only fulfill the purpose of giving an idea moneywise.

I calculate with 60-day bulk in advance and 6IU r-hGH ed (every day).

Some things will last longer than the planned 60 days or are one-off expenses, that's why the start is the most expensive.


One-off expenses:
  • Refrigerator: 150€
  • Heart pressure monitor: 10-30€
  • Blood sugar meter: 10-30€
Recurring expenses:
  • Alcoholic Wipes (100 wipes): 10-15€
  • 3cc syringe: 10-30€
  • Insulin syringe: 10-30€
  • Blood sugar meter parts: 10-15€
  • Blood tests: 80-250
  • X-Ray: 70-150€
Recurring expenses:
  • 360IU r-hGH: 340-380€
  • 60ml (1ml ed) Bacteriostatic water: 50-70€ (If you want to save money just make your own bacteriostatic water it’s very easy actually)
  • 1x AROMASIN from Pfizer: 40-70€

Estimated total for the first 60 days:

About 750 - 950€

Estimated total price for the following 60 days:

About 650 – 800€ (mostly below this)​


Cycle Outline and Weekly Schedule, Including Precautions

This cycle outline is intended to provide a general visualization of the procedure. Variations from the plan in any aspect are entirely acceptable and should be tailored to your personal preferences.

It should be logical that you should not start the administration or do blood tests while you have any kind of illness, and start completely healthy (Of course, this also applies to your stress level).

[Stage 1] Preparation:
This should be done before doing anything.

PreparationImportance
Radiograph of the carpal bone or/and knee radiographImportant, except you experienced growth in the last 1-3 months
Blood Test AImportant
Measure, note, or photograph all important featuresImportant
All listed devices and drugsImportant, except you want to only do exemestane for now
A secure source of incomeImportant, mini job, etc.
Buffer budget (100-200€)Recommended

[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days.
After 7 days, Blood Test B - dose adjustImportant
Note side effects and thoughtsRecommended

[Stage 3] Start of r-hGH:
R-hGH should be started with a moderate dose, as in the example here, (it can also be started with the desired dose, e.g. 6IU, 7IU, 8IU, etc.) increase the dose, as long as no serious side effects occur, slowly with 0.5IU to 1IU weekly.
Blood Test CImportant, everything has to be in the reference range
Start of r-hGH with 2IU ed (every day)Important, an increase of 0,5IU to 1IU weekly until the desired dose is reached
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Important
Blood pressure monitoring (before and 2 hours after)Important
Before Bed:
Blood sugar monitoringImportant
Blood pressure monitoringImportant
Time irrelevant
Hair loss preventionRecommended

After 2-4 weeks Blood Test D, depending on your feeling.

[Stage 4] r-hGH and exemestane (after habituation phase):

Cycle Blood Test D, E, and F every monthImportant
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Recommended
Blood pressure monitoring (before and 2 hours after)Recommended
Before Bed:
Blood sugar monitoringOptional
Blood pressure monitoringOptional
Time irrelevant
Hair loss preventionRecommended

If you get things like facial water retention, also start using things like Gua Sha daily, or doing exercises etc.



Additional recommendations and knowledge

Information about r-HGH and Aromatase Inhibitors and the differences between pharma and UGLs

It is worth reiterating that r-hGH stands out as the priciest performance-enhancing product available.

Most counterfeit r-hGH kits are manufactured in China because the laws there are not very strict about making chemicals into products.

Therefore, the production of these r-hGH kits is not very strict either.

I’ve chatted with @lightskinbengali about this and the effects can be far-reaching.

From poor purity to mislabelled HCG powder* to dreamlike purity but with unknown contamination such as heavy metals, everything can be in your vial.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabelled as r-hGH.​
Using HCG and masquerading it as r-hGH proved both effective and profitable, as the freeze-dried HCG powder looks so similar to freeze-dried GH.​

Even with provided laboratory tests by Janoshik (The current market holder for laboratory analyses within the steroids market) it’s not sure what’s in the vial, especially because those analyses mostly don't even address possible contamination.

Ignoring that the technology behind bootleg r-hGH has become so advanced that many fake r-hGH kits contain unknown chemical additives that emulate the very same side effects that genuine r-hGH produces, there are also possible contaminations such as heavy metals in the r-HGH vial that arise during production.

Those looking to purchase premium r-hGH may want to consider Genotropin (made by Pharmacia), Norditropin (made by Novo Nodisk), Serostim (made by Serono), Humatrope (made by Eli Lilly), Omnitrope (made by Sandoz), and Saizen (made by Serono).

Human growth hormone (r-hGH) purity

Generally, the higher the peptide purity level, the more favorable the preparation; critically, for certain applications (such as in vitro studies or clinical trials), only exceedingly pure peptides will be appropriate (greater than 98% purity). However, for r-hGH is usually 95%.

The same applies more or less to Aromatase inhibitors such as exemestane, those who want to purchase premium exemestane may want to consider buying Aromasin (made by Pfizer).

Psychological stress

Uncertainty, constant fear of the family members finding anything, being alone, and not having anyone to talk to about this self-medication, not having anyone knowledgeable that the user could ask for advice, will cause stress and anxiety.

As I said previously using myself as an example, I would choose exemestane based on my self-knowledge to forget dosages, to just be an adolescent, going to a party and make mistakes forgetting about my responsibility.

And this is very similar to the entire topic, if you don't feel like it is something you can do, don’t even start. Suppose you are not able to approach the matter in a disciplined and orderly manner. In that case, I strongly advise against self-administration (which is what I generally do, I refer you to the disclaimer again).

I have written with people who told me about blood tests, that they couldn't do it because they didn't want to ask their parents.

That they couldn’t get a radiograph because their parents wouldn’t believe their made-up reason.

If you are unable to make an appointment with a laboratory or an orthopaedist yourself, if you don't trust yourself or don't even invest the time to understand what is possible, then you are not mature enough to go through with such self-medication and you will harm yourself.

Furthermore, I recommend that anyone who starts such self-medication anonymously contact a trustworthy endocrinologist. To establish contacts with other users (in this forum for example) and to involve parents or legal guardians in the project if possible.

The moral and ethical considerations surrounding the use of r-HGH and Aromatase Inhibitor for adolescents

I previously published a post similar to this one, and the first reply was “haram”, (Harām (حرام, harām) is an Arabic adjective that in Islam describes anything that is “forbidden, inviolable, sacred” according to Sharia law.), another interaction was someone who aggressively wanted to clarify to a user of steroids that he would never see how his body would have developed naturally, who he would have been without any aids.

In my opinion, a central point in this discussion is the question of fairness. Some people maintain their height and physical appearance without external intervention due to their genetic makeup, it's easy for them to play the moralizer. However, others consider using r-hGH and aromatase inhibitors to achieve similar results, to exploit their own personal potential fully.

If there is an opportunity to have a better life, why shouldn't you be allowed to take advantage of it?

If genetics are unfair, why shouldn’t we have the right to change their outcome?

This question is very profound but:

Every person has the right to make decisions about their own body, including the decision to undertake medical procedures to change external appearance.

Ultimately, ethical assessment depends heavily on individual values and social contexts in which these decisions are made.

A while ago I was lucky enough to chat with someone who decided against r-HGH a few years ago for similar reasons. He described it as one of his biggest mistakes, he tells me that he is unhappier today than ever before and wishes he had done it, took his chance, and changed his life forever.

Emergencies

It’s generally not possible to instantly die from r-hGH or aromatase inhibitors, no matter the dose.

If you notice strange feelings after your r-hGH injection and feel like it is something serious, stay calm. Call the emergency number, say what you are taking, how much, and how long, and have a vial of your r-hGH or pill of your Aromatase Inhibitor ready. If things get serious, use an EpiPen.

If you notice that you accidentally injected or took a too high dose of r-hGH your Aromatase Inhibitor assess the risks and maybe call the emergency number.

If you've swallowed the pill and it's been a short while, try throwing it up.

Drink water but don’t over-drink.

If you got eye contact with those drugs immediately flush your eye(s) with plenty of water. If irritation occurs or persists, get medical attention.

If the r-hGH has contact with your clothing or skin remove the clothing and wash the affected skin with soap and water. If irritation occurs or persists, get medical attention.

If you accidentally ingest the r-hGH get medical attention. Do not induce vomiting unless directed by medical personnel. Never give anything by mouth to an unconscious person.

If you inhale the r-hGH or your Aromatase Inhibitor remove to fresh air. If not breathing, give artificial respiration. Get medical attention.

Off-cycle
If you want to off-cycle r-hGH, gradually reduce the dose, similar to how you start, this helps the body adjust to the lower hormone levels.

Example: If you take 1 IU (International Unit) daily, reduce to 0.5 IU per day for one week, then to 0.25 IU per day for another week, and finally to 0.1 IU per day before you stop completely.

If you want to off-cycle exemestane, gradually reduce the dose, similar to how you start, this helps the body adjust to the hormone levels.

Example: If you take 25 mg daily, reduce the dose to 12.5 mg per day for one week, then to 12.5 mg every two days for another week, and finally to 6.25 mg per day for one week , before stopping completely.

Missing doses

Exemestane (Aromasin):

Missing a single dose of exemestane is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.

r-hGH doses:

Missing a single dose of r-hGH is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.


If you have plans for a party or an overnight stay and know you won't be able to inject at your regular time, you can inject a few hours earlier. It is generally safe to inject up to 4-6 hours earlier than usual, though injecting more than 6 hours earlier might not be ideal as it could affect the consistency of the treatment.
Alternatively, if feasible, you can inject later in the evening or night. If your usual injection time is before bedtime, you might delay the injection until you return home. Ensure that the injection is not delayed by more than a few hours to maintain consistent hormone levels. Missing a single dose occasionally is not likely to significantly impact your overall treatment, but this should not become a habit.

You should not miss doses more than once a month.

Supplements

[Optional] Use these supplements to ensure health:
  • Vitamin D and K2
  • Calcium
  • Magnesium
  • Ashwagandha
  • Zinc
Bitcoin and privacy

Acquiring Bitcoin is relatively easy. Many providers, such as BitPay or MoonPay, offer wallets without requiring extensive verification, and they allow payments via PayPal, Apple Pay, and other convenient methods. It is recommended to use the Tor Browser and a VPN when accessing illegal websites. Additionally, shipping to addresses other than your own is advisable. Using high-quality, new email accounts, such as ProtonMail, is also recommended for enhanced privacy.

Vacation

On vacation, do vacation.

Plan your vacation into your cycle and simply stop injecting r-hGH during that time.

It is possible to smuggle the r-hGH vials onto the plane, but it is strenuous and risky, as well as keeping it cool during the vacation and injecting it at the right time (hard if you party every day), storing the needles, etc. to take everything with you, this is all just stress.

On the other hand, it is quite easy to continue taking your exemestane pills.

If you really want to continue the administration, I recommend getting a Genotropin GoQuick pre-filled syringe and simply cooling it occasionally. Remove and replace the tag and smuggle it onto the plane.

Depression from drugs

Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible.

So, if you are already prone to depression or maybe even struggle with it, you should discard the idea of starting medication yourself. You are too mentally weak and will only harm yourself and go crazy afterward.

Not only because of the effects of Aromatase Inhibitors on the brain but also because you may not be able to accept the outcomes and start brainless increasing doses and harming yourself.

In the past, we could see similar phenomena from users here on org often.

Conversely, nothing will happen to your mood if you are mentally stable and mature enough.

Do not misjudge yourself, increase doses without full consideration, or trade hastily, and especially don't try to save money!

Side effects:

Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time.

Procrastination:

You are only one decision away from changing your life.

Don't waste your time letting this rot in the back of your head.

Days pass quickly and before you know it, another month has passed and then another. I know that for many people it is a big decision, but your time to do this is limited, so you have to decide. And then it's all or nothing.



Ending

Conclusion

Ultimately, other lifestyle changes are also necessary if someone really wants to fulfill his genetic potential and even go beyond it.

I would even say that if the lifestyle is not optimized, injections don't really help.

Perfecting sleep, diet, mindset, and overall lifestyle is a component of this topic that should not be ignored, for instance, if you sleep 4 hours a day, don't even bother thinking you’ll grow.

This guide could help you: click here


I refrain again to the disclaimer in the beginning.

View attachment 2980658



good thread
 
  • +1
Reactions: Pandora and tempelcat4
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.



Contents:

Introduction to Human Growth Hormone and Aromatase Inhibitor:
  1. Human Growth Hormone (HGH)
  2. Aromatase Inhibitor (AI)

The impact of administering exogenous Human Growth Hormone (r-hGH) in healthy adolescents:
  1. Benefits and drawbacks

The impact of administering Aromatase Inhibitor (AI) in healthy adolescents:
  1. Comparison of anastrozole, letrozole and exemestane
  2. Benefits and drawbacks of exemestane

Sources I rely on:
  1. Sources

Precautions:
  1. Safety Measures
  2. Storage Guidelines
  3. Use of Assistive Devices
  4. Authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

Injecting r-hGH:
  1. Determining the appropriate r-hGH Dosage
  2. Administration Technique for r-hGH
  3. Timing of r-hGH Injections

Taking the correct dosage of Exemestane (Aromasin):
  1. Determining the appropriate exemestane Dosage
  2. Timing and method for exemestane administration

Estimated Costs and Cycle:
  1. List of Necessary Items with Pricing
  2. Cycle Outline and Weekly Schedule, Including Precautions
  3. Additional knowledge

Ending:
  1. 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.
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.

View attachment 2964921

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.
View attachment 2964915


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):

View attachment 2964902

(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)
For further understanding, the name of the generic active ingredient is written first while the name of the patented medication and developed pharmacy is written in brackets.

(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)

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.
External benefits (facially):
  • 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.​

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.
Internal benefits (effects on behavior):
  • 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.
And the best thing, it promotes height growth.


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.
Take special care if:
  • 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
Go to the doctor immediately and tell him what you are taking if you notice the following side effects:

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.
Very common side effects (may affect more than 1 in 10 people):
  • Decreased levels of the hormone thyroxine in blood tests (secondary hypothyroidism)
  • Pain and swelling at the injection site
Uncommon side effects (may affect up to 1 in 100 people):
  • 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
Frequency not known (cannot be estimated from available data):
  • Cancer

  • Stroke

  • CVD and Metabolic Risk

  • Type 2 diabetes mellitus
  • Scoliosis

  • 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)

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.

View attachment 2966168

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).

Both non-steroidal and steroidal have advantages and disadvantages.

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.
Ultimately, all three Aromatase inhibitors are the same and FDA-approved with very few effect differences.

Generic nameAnastrozoleLetrozoleExemestane
Typenon-steroidalnon-steroidalsteroidal
LegalityPrescription-onlyPrescription-onlyPrescription-only
Dosage Form(s) AvailableOral tabletOral tabletOral tablet
Half-Life46 hours48 hours24 hours
First approval dateDecember 27, 1955November 25, 1996October 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 effectApplicable?, FrequencyApplicable?, Frequency
Hot flashesYes, 56%Yes, 55%
Joint painYes, 6%Yes, 7%
Muscle painYes, 16%Yes, 17%
Vaginal bleedingYes, 2%Yes, 1%
Abnormal liver enzyme levelsYes, 1%Yes, 1%
Abnormal bilirubin levelsYes, 1%Yes, 2%
OsteoporosisYes, 35%Yes, 31%
Atrial fibrillationYes, 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.
Benefits (also apply approximately to other Ais)
  • 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!!! :soy:", "YOU CAN'T GROW ABOVE YOUR GENETICS :feelswhy:", "HAVE FUN WITH YOUR HEART ATTACK AT 30!! :lul:"

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:

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
Radiograph:

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.
The cost of an X-ray usually lies between 50-200$.
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.
Value explanation:
  • 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.
Values:

Liver function:

TestDescriptionCoverage in blood panelsEstimated price
ALT (Alanine Aminotransferase)An enzyme primarily found in the liver. High levels can indicate liver damage.Covered1-5 €
AST (Aspartate Aminotransferase)An enzyme found in various organs, especially the liver. Elevated levels can indicate liver disease.Covered1-5 €
ALP (Alkaline Phosphatase)An enzyme found in the liver, bile ducts, and bones. High levels can indicate liver or bile duct disease.Covered1-5 €
BilirubinA breakdown product of hemoglobin that the liver processes. Elevated levels can indicate liver or bile duct disorders.Covered1-5 €
GGT (Gamma-Glutamyltransferase):An enzyme found in the liver and bile ducts. High levels can indicate liver or bile duct disease.Not covered1-5 €
AlbuminA protein produced by the liver. Low levels can indicate liver disease.Not covered5-10 €

Lipid Profile / Cardiovascular Health (assess the risk of cardiovascular disease (CVD)):

TestDescriptionCoverage in blood panelsEstimated price
Total CholesterolThe overall amount of cholesterol in the blood. High levels can increase the risk of heart disease.Not covered1-5 €
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.Covered1-5 €
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.Covered1-5 €
TriglyceridesA 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 covered1-5 €
BNP (B-type natriureti Peptide)Measures a hormone produced by the heart in response to pressure changes, useful for diagnosing heart failure.Not covered20-40 €
TroponinMeasures proteins released when the heart muscle is damaged, used to diagnose heart attacks.Not covered20-40 €

Kidney Function:

TestDescriptionCoverage in blood panelsEstimated price
Serum Creatinine:A waste product from muscle metabolism that is excreted by the kidneys. Elevated levels can indicate impaired kidney function.Covered1-5 €
Blood Urea Nitrogen (BUN)A waste product from protein metabolism that is excreted by the kidneys. High levels can suggest reduced kidney function.Covered1-5 €
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:

TestDescriptionCoverage in blood panelsEstimated 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.
Covered10-20 €
Free T3 (Triiodothyronine)Measures the active form of T3 in the blood, which is crucial for metabolism regulation.Covered10-20 €
Free T4 (Thyroxine)Measures the active form of T4 in the blood, which is important for metabolic rate and growth.Covered10-20 €
Total T3Measures both the free and bound forms of T3 in the blood.Covered10-20 €
Total T4Measures both the free and bound forms of T4 in the blood.Covered10-20 €

Reproductive Hormones:

TestDescriptionCoverage in blood panelsEstimated price
TestosteroneMeasures the primary male sex hormone, which is important for developing and maintaining male characteristics.Covered20-30 €
EstradiolMeasures a form of estrogen, which is important for reproductive and sexual health.Covered20-30 €
EstroneMeasures another form of estrogen, which is important for reproductive health.Not covered20-30 €
EstriolMeasures the least abundant estrogen, significant during pregnancy.Not covered20-30 €
DHT (Dihydrotestosterone)Measures a potent androgen, derived from testosterone, which is important for male development.Covered20-30 €
IGF-1 (Insulin-Like Growth Factor 1)Measures a hormone that reflects the amount of growth hormone activity in the body.Covered10-30 €
HGH (Human Growth Hormone)Measures the amount of growth hormone.Covered10-30 €
SHBG (Sex Hormone Binding Globulin)Measures a protein that binds to sex hormones, influencing their bioavailability.Covered20-30 €
FSH (Follicle-Stimulating Hormone)Important for reproductive health and function.Covered10-20 €
LH (Luteinizing Hormone)Works with FSH to regulate reproductive processes.Not covered10-20 €
ProlactinMeasures a hormone that can influence reproductive health.Not covered10-20 €
IGFBP-3 (Insulin-Like Growth Factor Binding Protein 3)Measures the main carrier of IGF-1 in the blood, indicating GH activity.Not covered10-30 €
DHEADHEA 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.Covered20-30 €
DHEA-SDHEA-S levels in blood help diagnose adrenal and hormone-related disorders, offering insights into adrenal gland function and overall hormone balance.Covered20-30 €

General Health Markers:

TestDescriptionCoverage in blood panelsEstimated price
CBC (Complete Blood Count)Provides information about the cells in the blood, including red blood cells, white blood cells, and platelets.Covered5-10 €
CMP (Comprehensive Metabolic Panel)Includes tests for electrolytes, glucose, calcium, albumin, and more, providing a broad overview of metabolic health.Covered5-10 €
CRP (C-Reactive Protein)Measures a marker of inflammation in the body, which can indicate infection or chronic inflammatory conditions.Not covered5-15 €
ESR (Erythrocyte Sedimentation Rate)Another marker of inflammation, which can indicate chronic inflammatory conditions.Not covered5-15 €

Metabolic Function:

TestDescriptionCoverage in blood panelsEstimated price
Fasting GlucoseMeasures blood sugar levels after fasting, important for assessing glucose metabolism and risk of diabetes.Covered through blood sugar meter later discussed1-5 € (in lab)
HbA1c (Hemoglobin A1c)Measures average blood glucose levels over the past 2-3 months, used to diagnose and monitor diabetes.Not covered10-20 €
InsulinMeasures the level of insulin in the blood, important for understanding insulin sensitivity and pancreatic function.Not covered10-20 €

Immune Function:

TestDescriptionCoverage in blood panelsEstimated 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:

TestDescriptionCoverage in blood panelsEstimated price
PSA (Prostate-Specific Antigen)Measures a protein produced by the prostate gland. Elevated levels may indicate prostate cancer.Not covered10-20 €
CA-125Measures a protein often elevated in ovarian cancerNot covered10-20 €
CA 15-3Measures a protein elevated in breast cancer.Not covered20-30 €
AFP (Alpha-Fetoprotein)Elevated levels may indicate liver cancer or germ cell tumors.Not covered10-20 €
CEA (Carcinoembryonic Antigen)Elevated levels may indicate colorectal, lung, pancreatic, or breast cancer.Not covered10-20 €
CA 19-9Elevated levels may indicate pancreatic cancer.Not covered10-20 €

Bones markers:

TestDescriptionCoverage in blood panelsEstimated price
25-OH-vitamin DMeasures the level of vitamin D, which is crucial for bone health.Covered20-40 €
P1NPMeasures a marker of bone formation.Not covered30-40 €
OstasisMeasures a protein secreted by osteoblasts, important for bone formation.Not covered30-40 €
ß-CTX (Beta CrossLaps)Measures a marker of bone resorption.Not covered30-40 €
TRAP 5bMeasures an enzyme involved in bone resorption.Not covered1-5 €
OsteocalcinA protein secreted by osteoblasts, important for bone formation.Covered10-20 €
Alkaline PhosphataseAn enzyme important for bone and liver health.Covered1-5 €

Androgenic balding:

TestDescriptionCoverage in blood panelsEstimated price
DHEA-SMeasures a precursor hormone that can be converted into androgens and estrogens.Covered20-30 €
TestosteroneMeasures the primary male sex hormone, important for developing and maintaining male characteristics.Covered20-30 €
SHBGMeasures a protein that binds to sex hormones, including testosterone and estrogen.Covered20-30 €
AndrostenedioneMeasures a precursor to testosterone and estrogen, important for hormone balance.Not covered10-20 €

Electrolytes and Minerals:

TestDescriptionCoverage in blood panelsEstimated price
SodiumEssential for fluid balance and nerve function.Not covered1-5 €
PotassiumImportant for heart and muscle function.Not covered1-5 €
ChlorideHelps maintain fluid balance and pH levels.Not covered1-5 €
CalciumImportant for bone health, muscle function, and nerve signaling.Not covered1-5 €
MagnesiumInvolved in numerous biochemical reactions in the body.Not covered1-5 €
PhosphateImportant for bone health and energy production.Not covered1-5 €

Vitamins and Other Minerals:

TestDescriptionCoverage in blood panelsEstimated price
Vitamin B12Essential for nerve function and blood cell production.Not covered10-20 €
FolateImportant for DNA synthesis and cell division.Not covered10-20 €
ZincImportant for immune function, protein synthesis, and DNA synthesis.Not covered1-5 €
IronCrucial for oxygen transport in the blood.Not covered1-5 €

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.

TestPriceImportance
  • IGF-1
  • 10-30 €
  • important
  • Testosterone
  • 20-30 €
  • important
  • Estradiol
  • 20-30 €
  • important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • recommended
  • Total T3
  • 10-20 €
  • recommended
  • Total T4
  • 10-20 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHEA
  • 20-30 €
  • recommended
  • DHEA-S
  • 20-30 €
  • recommended
  • 25-OH-vitamin D
  • 20-40 €
  • optional
  • DHT
  • 20-30 €
  • optional
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
  • Comprehensive Metabolic Panel (CMP)
  • 5-10 €
  • optional
Total price: 180-330 €

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)
If you notice strong side effects like lasting tiredness throughout the day, strong and long headaches, Jaundice (yellowish discoloration of the skin and eyes), loss of appetite, nausea, chest pain, back pain etc. I advise you to add additional tests.

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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
Total price: 27-50 €

[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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • Complete Blood Count
  • 5-10 €
  • important
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • recommended
  • Bilirubin
  • 1-5 €
  • recommended
  • Blood Urea Nitrogen
  • 1-5 €
  • recommended
  • Creatinine
  • 1-5 €
  • recommended
  • HDL Cholesterol
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHT
  • 20-30 €
  • optional
  • Free T3
  • 10-20 €
  • optional
  • Free T4
  • 10-20 €
  • optional
  • Testosterone
  • 20-30 €
  • optional
Total price: 103-220 €

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]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • Complete Blood Count (CBC)
  • 5-10 €
  • Important
  • GGT (Gamma-Glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine Transaminase)
  • 1-5 €
  • Recommended
  • AST (Aspartate Transaminase)
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • Blood Urea Nitrogen (BUN)
  • 1-5 €
  • Recommended
  • Creatinine
  • 1-5 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • TSH
  • 10-20 €
  • Recommended
  • Free T3
  • 10-20 €
  • Optional
  • Free T4
  • 10-20 €
  • Optional
  • Testosterone
  • 20-30 €
  • Optional
  • DHT
  • 20-30 €
  • Optional
Total price: 113-200 €

[Test E]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • Blood creatine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Recommended
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
Total price: 153-320 €

[Test F]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Blood Creatinine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
  • Oestelcalcin
  • 10-20 €
  • Recommended
  • Alkaline phosphatase
  • 1-5 €
  • Recommended
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.
Glucose is the main source of energy for cells, and insulin is the hormone that ensures glucose gets from the blood into the cells. Without enough insulin or insulin resistance (as in type 2 diabetes), too much glucose remains in the blood, which can lead to high blood sugar levels and long-term health problems.

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.

View attachment 2966296

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.
Monitoring before and after meals (2 hours after the meal):
  • 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.
Monitoring before bedtime (less important):
  • 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).
Frequency of monitoring:

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 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).
Normal blood sugar levels:
  • 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).
Values that require intervention:
  • 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.).
The development of type 2 diabetes mellitus, the most common form of diabetes, can take years and is a gradual process.

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.
Symptoms of low blood sugar (hypoglycemia):

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.
Actions for High Values:

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.
Supplements:
  • 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.
Monitoring before bedtime (less important):

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.
Symptoms of Low Blood Pressure (Hypotension):
  • 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.
Supplements:
  • 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.

View attachment 2966298
(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
If you have made yourself a better routine, be sure to post the routine in this post!

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.
If you notice any of those and the trigger is water retention at the heart, immediately stop the r-hGH administration and take further action.

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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Storage Guidelines

The storage of exemestane etc. is fairly easy, but storing r-hGH correctly is crucial to maintain its effectiveness and safety.

After the r-hGH has arrived, it’s unmixed r-hGH in lyophilized (freeze-dried) powder form. This form of r-hGH is relatively stable and can typically be used up to the expiration date printed on the packaging if stored in the refrigerator at temperatures between 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit - There could also be other storage information on the package, such as 2-4 degrees, etc.).

If there is no date, expect 3 - 18+ months or e-mail your provider directly.

The expiration date assumes that the product has been continuously stored under recommended conditions and can often extend several years into the future, depending on the manufacturing date.

While there are people who recommend only shipping r-hGH refrigerated in the winter or late autumn, this is not necessarily.

Nevertheless, you should insist on refrigerated express transport, especially in the warm season.

Avoiding r-hGH to extreme temperatures, especially heat and direct sunlight, is important as this could destroy the structure of the polypeptide hormone.

In Liquid Form (After Reconstitution): Once r-hGH has been converted into liquid form by mixing it with a solvent, its shelf life significantly shortens. The exact duration depends on the specific product and the manufacturer's instructions but typically ranges from 14 to 28 days when consistently stored in the refrigerator. Some products may have a shorter shelf life.

I recommend injecting the r-hGH right after reconstituting and only reconstituting the amount that you need for your immediate dose or the next two doses.

A high-quality refrigerator is incredibly important. Do not waste your time and money on refrigerators in a price range of 20-80€. This applies to most refrigerators smaller than 445 mm x 500 mm x 468 mm. They are simply not good at cooling most of the time.

Make sure that your refrigerator can cool at least 30 degrees below room temperature, especially if these temperatures can occur in your home in the summer.

Only store your r-hGH vials in the refrigerator and make sure that the refrigerator has no UV-Light function or make sure that it's turned off.

View attachment 2980655

Medicine refrigerators are also a good option, they are much smaller and cool very precisely.

View attachment 2980656

(This medicine refrigerator can easily carry up to 40 vials a 12IU for example)​
[/CENTER]

Ensure that the refrigerator is not connected to a cable that poses a risk of power failure.

When choosing a refrigerator, pay attention to its volume.

As said, for exemestane (Aromatase Inhibitor in general) everything is a bit easier, keep your exemestane at normal room temperature (not above 25 degrees), away from direct sunlight or wetness (Also low-humidity environment).



Use of Assistive Devices
Those are important devices for the use of r-HGH.
  • Bacteriostatic water: To reconstitute the freeze-dried r-hGH.
  • Alcohol wipes: For sterilizing the injection site and vial.
  • 3cc syringe: Used for drawing bacteriostatic water.
  • Insulin syringe: For precise r-hGH dosing and subcutaneous injections.
I'll go more in-depth about what to do with those things later.

Storage for them is similar to the storage of Aromatase inhibitors.



The authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

It's essential to make sure r-hGH and exemestane or Pfizer aromasin are effective.

This can be ensured in the first place by buying from sources that are accepted within the community.

For further ensure blood tests are required.

However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabeled as GH.

r-hGH Checklist:​

Test A:
  • Reconstitute the r-hGH.
  • Bring a pot of water to a boil.
  • Put the r-hGH vial into the boiling water for 2 minutes.
  • See if the solution turns milky/cloudy white.
  • If your r-hGH is real it will turn cloudy/milky white after this procedure.
  • Let the r-hGH vial stay at room temperature for one day.
  • If the solution becomes clear again and you don't see any milkiness then the r-hGH is fake.
Test B:
  • Buy a home pregnancy kit from a pharmacy.
  • Reconstitute the r-hGH and set it on the pregnancy kit.
  • If the result is positive, this indicates that the powder has tested positive for HCG, indicating that the r-hGH is counterfeit r-hGH.
  • Another way to perform the test is to urinate on it 2 days after ingesting the supposed r-hGH product. If the powder contains HCG, it will pass through the urine and the test should turn positive.
Test C:
Exemestane, Pfizer Aromasin Checklist:​

Exemestane from different pharmacies or UGLabs is hard to check for efficiency without trying it.

Known UGLabs usually have “verify” codes on the box and laborious analyses online on known Bodybuilding forums.

Aromasin is harder to check for authenticity
  • Inspect the pill, the pill should be:
  • Really small, roundish, white and with the number “7663” printed on the side
  • Inspect the package through comparison with photos on the internet



Injecting r-hGH:

Determining the appropriate r-HGH Dosage

The appropriate dose of r-hGH is the proper r-hGH dose for you.

While someone has to use a dose of 10IU r-hGH, you may only need a dose of 5IU r-hGH.

And the idea that the more IU of r-hGH you use means more effects is also wrong, this is because the liver simply stops producing more IGF-1 at some point, 30IU doesn't change that, you still reach the same peak as you may had with 5IU r-hGH.

This means that the only thing you achieve by injecting excessive amounts of r-hGH is burning money.

And by the way acromegalic, strong hormonal fluctuations and side effects.


Since we are aiming for controlled growth, we should also keep our hormone levels within or not excessively above the reference ranges, this is enough to get our desired growth spurts.

Generally, this is the dose that gets used: 0,035 mg/kg per day (1mg r-hGH = 3IU r-hGH).

So for the most 5-8 IU r-hGH, regular blood tests of IGF-1 and HGH are crucial to adjust the doses (This is the dose that maxes out IGF-1).

I personally don't recommend going above 10IU r-hGH ed.

I personally don’t recommend going under 3IU r-hGH ed.

As I said, be careful not to increase your IGF-1 etc. levels too much over a too long time period.

Administration Technique for r-HGH

As said before, in order to inject r-hGH you first have to reconstitute it into a liquid form.

For the whole injection process following things are necessary:
  • Bacteriostatic water: To convert the r-hGH powder into liquid (about 1ml is needed for 6IU).
  • 3cc syringe: For getting the bacteriostatic water out of the vial.
  • Insulin syringe: For the injection.
  • Alcoholic wipes: To keep everything clean during the process.
(r-hGH in liquid form is up to 10 days usable)


For the reconstruction part, watch this video:


A good calculation help is this website:

For the injection part watch this video:



Injections into the thigh or upper arm are also possible.

When trying to inject the r-hGH, make sure that your syringe doesn’t contain any air, injection of air will cause discomfort.

Note: When initiating r-hGH treatment, it is common to start with a lower dose than the target dosage. This approach allows your body and you to gradually adapt to the changes, thereby minimizing potential side effects. By beginning with a smaller dose, you are likely to experience fewer adverse reactions (An example of this is included in the cycle plan).

Timing of r-hGH Injections

The full daily dose of r-hGH is administrated before bed.

Try to give it consistently within an hour timeframe, for example between 9 and 10 p.m. every night.

You may change the time occasionally, by a few hours earlier or later, but do not give before 5 p.m, except under unusual circumstances (such as leaving for a trip, a sleepover, etc.)



Taking the correct dosage of Exemestane (Aromasin):

Determining the appropriate exemestane Dosage
Determining the right dose of exemestane is fairly easy, but it’s a process that takes time.

After blood test A arrives and your E2 baseline lies between 20-40 pg/ml you can start a dose of 6,25mg ed (every day).

Anything below 20 pg/ml is rather unlikely, but as long as it stays there naturally exemestane is not really needed, through regular blood tests it’s easy to notice if the value rises above 20 pg/ml.

Otherwise, you can also try 3.15mg of exemestane ed (every day).

Anything above 40 pg/ml will most likely need a higher dose than 6,25 mg, although I personally still recommend starting with 6.25 mg to give your body, and especially yourself time to get used to the side effects and adapt.

The side effects of exemestane appear quickly and disappear quickly – in the first few days of using exemestane (no matter the dose), you’ll experience light headaches, Joint pain and stiffness, fatigue, and even slight dizziness, everything will feel a little strange.

But this goes away fast, usually about 5-7 days until you have no side effects at all, even when you increase the dose.

In the best-case scenario, if you are patient and don't mind the money you need, you can approach it like this:
  • Get blood Test A.
  • Start with 3,15 mg ed (usually not enough to lower E2 sufficiently, but good to get a first understanding of the drug).
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs, usually everything should be in the reference range).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Double the dose if you're not under the 20 pg/ml mark.
  • After 7 days do blood Test B (to see changes in your E2 levels and effects on fundamental organs).
  • Continue this until you are below the 20 pg/ml mark and understand your personal dosing.
For most, a daily dose of 12.5mg will be necessary to lower E2 levels enough.

For some, a daily dose of 12.5mg+ will be necessary to lower E2 levels enough.

Note that your exemestane, especially if it is not pharma Aromasin, may be underdosed, so you need higher doses even though your E2 levels are not that high.

Timing and method for exemestane administration
Exemestane shouldn’t be taken with the injection of r-hGH, a two-hour radius between those two drugs should be respected.

I recommend taking Exemestane around 12 o'clock to 14 o'clock, every day at the same time, preferably after eating a meal.

Studies and prescription instructions suggest better absorption by the body if Exemestane is consumed with or after a meal.

Alternatively, you can take Exemestane with a tablespoon of olive oil.

It’s also imperative to understand that AROMASIN requires a full 7 days to allow the body to achieve peak blood plasma levels of the compound.


Another method of administration is the sublingual administration. In short, the pill is placed under the tongue until it disappears, but this administration technique makes no real sense for exemestane, the idea is using the first-pass-effect to get the active ingredient directly into the bloodstream without it getting into the liver. But the enzyme CYP3A4 in the liver will metabolize exemestane either way.



Estimated Costs and Cycle:

List of Necessary Items with Pricing


Obviously, the listed prices are not precise and only fulfill the purpose of giving an idea moneywise.

I calculate with 60-day bulk in advance and 6IU r-hGH ed (every day).

Some things will last longer than the planned 60 days or are one-off expenses, that's why the start is the most expensive.


One-off expenses:
  • Refrigerator: 150€
  • Heart pressure monitor: 10-30€
  • Blood sugar meter: 10-30€
Recurring expenses:
  • Alcoholic Wipes (100 wipes): 10-15€
  • 3cc syringe: 10-30€
  • Insulin syringe: 10-30€
  • Blood sugar meter parts: 10-15€
  • Blood tests: 80-250
  • X-Ray: 70-150€
Recurring expenses:
  • 360IU r-hGH: 340-380€
  • 60ml (1ml ed) Bacteriostatic water: 50-70€ (If you want to save money just make your own bacteriostatic water it’s very easy actually)
  • 1x AROMASIN from Pfizer: 40-70€

Estimated total for the first 60 days:

About 750 - 950€

Estimated total price for the following 60 days:

About 650 – 800€ (mostly below this)​


Cycle Outline and Weekly Schedule, Including Precautions

This cycle outline is intended to provide a general visualization of the procedure. Variations from the plan in any aspect are entirely acceptable and should be tailored to your personal preferences.

It should be logical that you should not start the administration or do blood tests while you have any kind of illness, and start completely healthy (Of course, this also applies to your stress level).

[Stage 1] Preparation:
This should be done before doing anything.

PreparationImportance
Radiograph of the carpal bone or/and knee radiographImportant, except you experienced growth in the last 1-3 months
Blood Test AImportant
Measure, note, or photograph all important featuresImportant
All listed devices and drugsImportant, except you want to only do exemestane for now
A secure source of incomeImportant, mini job, etc.
Buffer budget (100-200€)Recommended

[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days.
After 7 days, Blood Test B - dose adjustImportant
Note side effects and thoughtsRecommended

[Stage 3] Start of r-hGH:
R-hGH should be started with a moderate dose, as in the example here, (it can also be started with the desired dose, e.g. 6IU, 7IU, 8IU, etc.) increase the dose, as long as no serious side effects occur, slowly with 0.5IU to 1IU weekly.
Blood Test CImportant, everything has to be in the reference range
Start of r-hGH with 2IU ed (every day)Important, an increase of 0,5IU to 1IU weekly until the desired dose is reached
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Important
Blood pressure monitoring (before and 2 hours after)Important
Before Bed:
Blood sugar monitoringImportant
Blood pressure monitoringImportant
Time irrelevant
Hair loss preventionRecommended

After 2-4 weeks Blood Test D, depending on your feeling.

[Stage 4] r-hGH and exemestane (after habituation phase):

Cycle Blood Test D, E, and F every monthImportant
Measure, note, or photograph all important features (every month)Recommended

Daily safety plan from here on:

DailyImportance
Morning (after waking up):
Blood sugar monitoring (empty stomach)Important
Blood pressure monitoring (empty stomach)Important
Midday (after a meal):
Blood sugar monitoring (before and 2 hours after)Recommended
Blood pressure monitoring (before and 2 hours after)Recommended
Before Bed:
Blood sugar monitoringOptional
Blood pressure monitoringOptional
Time irrelevant
Hair loss preventionRecommended

If you get things like facial water retention, also start using things like Gua Sha daily, or doing exercises etc.



Additional recommendations and knowledge

Information about r-HGH and Aromatase Inhibitors and the differences between pharma and UGLs

It is worth reiterating that r-hGH stands out as the priciest performance-enhancing product available.

Most counterfeit r-hGH kits are manufactured in China because the laws there are not very strict about making chemicals into products.

Therefore, the production of these r-hGH kits is not very strict either.

I’ve chatted with @lightskinbengali about this and the effects can be far-reaching.

From poor purity to mislabelled HCG powder* to dreamlike purity but with unknown contamination such as heavy metals, everything can be in your vial.

Many counterfeit operations in China are infamous for bottling Human Chorionic Gonadotropin (HCG) powder into vials that are mislabelled as r-hGH.​
Using HCG and masquerading it as r-hGH proved both effective and profitable, as the freeze-dried HCG powder looks so similar to freeze-dried GH.​

Even with provided laboratory tests by Janoshik (The current market holder for laboratory analyses within the steroids market) it’s not sure what’s in the vial, especially because those analyses mostly don't even address possible contamination.

Ignoring that the technology behind bootleg r-hGH has become so advanced that many fake r-hGH kits contain unknown chemical additives that emulate the very same side effects that genuine r-hGH produces, there are also possible contaminations such as heavy metals in the r-HGH vial that arise during production.

Those looking to purchase premium r-hGH may want to consider Genotropin (made by Pharmacia), Norditropin (made by Novo Nodisk), Serostim (made by Serono), Humatrope (made by Eli Lilly), Omnitrope (made by Sandoz), and Saizen (made by Serono).

Human growth hormone (r-hGH) purity

Generally, the higher the peptide purity level, the more favorable the preparation; critically, for certain applications (such as in vitro studies or clinical trials), only exceedingly pure peptides will be appropriate (greater than 98% purity). However, for r-hGH is usually 95%.

The same applies more or less to Aromatase inhibitors such as exemestane, those who want to purchase premium exemestane may want to consider buying Aromasin (made by Pfizer).

Psychological stress

Uncertainty, constant fear of the family members finding anything, being alone, and not having anyone to talk to about this self-medication, not having anyone knowledgeable that the user could ask for advice, will cause stress and anxiety.

As I said previously using myself as an example, I would choose exemestane based on my self-knowledge to forget dosages, to just be an adolescent, going to a party and make mistakes forgetting about my responsibility.

And this is very similar to the entire topic, if you don't feel like it is something you can do, don’t even start. Suppose you are not able to approach the matter in a disciplined and orderly manner. In that case, I strongly advise against self-administration (which is what I generally do, I refer you to the disclaimer again).

I have written with people who told me about blood tests, that they couldn't do it because they didn't want to ask their parents.

That they couldn’t get a radiograph because their parents wouldn’t believe their made-up reason.

If you are unable to make an appointment with a laboratory or an orthopaedist yourself, if you don't trust yourself or don't even invest the time to understand what is possible, then you are not mature enough to go through with such self-medication and you will harm yourself.

Furthermore, I recommend that anyone who starts such self-medication anonymously contact a trustworthy endocrinologist. To establish contacts with other users (in this forum for example) and to involve parents or legal guardians in the project if possible.

The moral and ethical considerations surrounding the use of r-HGH and Aromatase Inhibitor for adolescents

I previously published a post similar to this one, and the first reply was “haram”, (Harām (حرام, harām) is an Arabic adjective that in Islam describes anything that is “forbidden, inviolable, sacred” according to Sharia law.), another interaction was someone who aggressively wanted to clarify to a user of steroids that he would never see how his body would have developed naturally, who he would have been without any aids.

In my opinion, a central point in this discussion is the question of fairness. Some people maintain their height and physical appearance without external intervention due to their genetic makeup, it's easy for them to play the moralizer. However, others consider using r-hGH and aromatase inhibitors to achieve similar results, to exploit their own personal potential fully.

If there is an opportunity to have a better life, why shouldn't you be allowed to take advantage of it?

If genetics are unfair, why shouldn’t we have the right to change their outcome?

This question is very profound but:

Every person has the right to make decisions about their own body, including the decision to undertake medical procedures to change external appearance.

Ultimately, ethical assessment depends heavily on individual values and social contexts in which these decisions are made.

A while ago I was lucky enough to chat with someone who decided against r-HGH a few years ago for similar reasons. He described it as one of his biggest mistakes, he tells me that he is unhappier today than ever before and wishes he had done it, took his chance, and changed his life forever.

Emergencies

It’s generally not possible to instantly die from r-hGH or aromatase inhibitors, no matter the dose.

If you notice strange feelings after your r-hGH injection and feel like it is something serious, stay calm. Call the emergency number, say what you are taking, how much, and how long, and have a vial of your r-hGH or pill of your Aromatase Inhibitor ready. If things get serious, use an EpiPen.

If you notice that you accidentally injected or took a too high dose of r-hGH your Aromatase Inhibitor assess the risks and maybe call the emergency number.

If you've swallowed the pill and it's been a short while, try throwing it up.

Drink water but don’t over-drink.

If you got eye contact with those drugs immediately flush your eye(s) with plenty of water. If irritation occurs or persists, get medical attention.

If the r-hGH has contact with your clothing or skin remove the clothing and wash the affected skin with soap and water. If irritation occurs or persists, get medical attention.

If you accidentally ingest the r-hGH get medical attention. Do not induce vomiting unless directed by medical personnel. Never give anything by mouth to an unconscious person.

If you inhale the r-hGH or your Aromatase Inhibitor remove to fresh air. If not breathing, give artificial respiration. Get medical attention.

Off-cycle
If you want to off-cycle r-hGH, gradually reduce the dose, similar to how you start, this helps the body adjust to the lower hormone levels.

Example: If you take 1 IU (International Unit) daily, reduce to 0.5 IU per day for one week, then to 0.25 IU per day for another week, and finally to 0.1 IU per day before you stop completely.

If you want to off-cycle exemestane, gradually reduce the dose, similar to how you start, this helps the body adjust to the hormone levels.

Example: If you take 25 mg daily, reduce the dose to 12.5 mg per day for one week, then to 12.5 mg every two days for another week, and finally to 6.25 mg per day for one week , before stopping completely.

Missing doses

Exemestane (Aromasin):

Missing a single dose of exemestane is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.

r-hGH doses:

Missing a single dose of r-hGH is not serious and will usually not have any negative effects.

If you miss a dose within a few hours of the usual time, take the missed dose as soon as possible.

If the next dose is due soon (e.g. within 12 hours), skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed dose.

Continue your normal dosing schedule as usual.


If you have plans for a party or an overnight stay and know you won't be able to inject at your regular time, you can inject a few hours earlier. It is generally safe to inject up to 4-6 hours earlier than usual, though injecting more than 6 hours earlier might not be ideal as it could affect the consistency of the treatment.
Alternatively, if feasible, you can inject later in the evening or night. If your usual injection time is before bedtime, you might delay the injection until you return home. Ensure that the injection is not delayed by more than a few hours to maintain consistent hormone levels. Missing a single dose occasionally is not likely to significantly impact your overall treatment, but this should not become a habit.

You should not miss doses more than once a month.

Supplements

[Optional] Use these supplements to ensure health:
  • Vitamin D and K2
  • Calcium
  • Magnesium
  • Ashwagandha
  • Zinc
Bitcoin and privacy

Acquiring Bitcoin is relatively easy. Many providers, such as BitPay or MoonPay, offer wallets without requiring extensive verification, and they allow payments via PayPal, Apple Pay, and other convenient methods. It is recommended to use the Tor Browser and a VPN when accessing illegal websites. Additionally, shipping to addresses other than your own is advisable. Using high-quality, new email accounts, such as ProtonMail, is also recommended for enhanced privacy.

Vacation

On vacation, do vacation.

Plan your vacation into your cycle and simply stop injecting r-hGH during that time.

It is possible to smuggle the r-hGH vials onto the plane, but it is strenuous and risky, as well as keeping it cool during the vacation and injecting it at the right time (hard if you party every day), storing the needles, etc. to take everything with you, this is all just stress.

On the other hand, it is quite easy to continue taking your exemestane pills.

If you really want to continue the administration, I recommend getting a Genotropin GoQuick pre-filled syringe and simply cooling it occasionally. Remove and replace the tag and smuggle it onto the plane.

Depression from drugs

Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible.

So, if you are already prone to depression or maybe even struggle with it, you should discard the idea of starting medication yourself. You are too mentally weak and will only harm yourself and go crazy afterward.

Not only because of the effects of Aromatase Inhibitors on the brain but also because you may not be able to accept the outcomes and start brainless increasing doses and harming yourself.

In the past, we could see similar phenomena from users here on org often.

Conversely, nothing will happen to your mood if you are mentally stable and mature enough.

Do not misjudge yourself, increase doses without full consideration, or trade hastily, and especially don't try to save money!

Side effects:

Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time.

Procrastination:

You are only one decision away from changing your life.

Don't waste your time letting this rot in the back of your head.

Days pass quickly and before you know it, another month has passed and then another. I know that for many people it is a big decision, but your time to do this is limited, so you have to decide. And then it's all or nothing.



Ending

Conclusion

Ultimately, other lifestyle changes are also necessary if someone really wants to fulfill his genetic potential and even go beyond it.

I would even say that if the lifestyle is not optimized, injections don't really help.

Perfecting sleep, diet, mindset, and overall lifestyle is a component of this topic that should not be ignored, for instance, if you sleep 4 hours a day, don't even bother thinking you’ll grow.

This guide could help you: click here


I refrain again to the disclaimer in the beginning.

View attachment 2980658


 

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@mathis
"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."

Do you really think an AI would write like that? AI Checkers find AI-created text in every text.

But yeah some parts are rephrased or formatted with AI and few are even created with the help of AI, I don't deny that. I don't think this is bad, who cares, the info is right either way (Everything is checked so the there are no incorrect statements as far as I know).

If this deeply bothers someone because they still live in the 19th century, they should close the tab asap
 
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@mathis
"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."

Do you really think an AI would write like that? AI Checkers find AI-created text in every text.

But yeah some parts are rephrased or formatted with AI and few are even created with the help of AI, I don't deny that. I don't think this is bad, who cares, the info is right either way (Everything is checked so the there are no incorrect statements as far as I know).

If this deeply bothers someone because they still live in the 19th century, they should close the tab asap
The fact that you use an AI isnt the problem. I do too. But you used it too much and didnt reformated ( not well at least ) it.
I copy pasted way more than just that btw. And its easy to see where you used it or not im talking with chat gpt at least 2h a day i know exatly how it talk
The thread is overall good i read it. Just take this as an advice not trying to insult you if anything
 
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Why not 25 mg Ed aromasin? We want maximize our growth!!!!!
 
Keep the vip contest forever holy fuark
 
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niggas not even tryna hide it anymore jfl
 
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80% LLM+
 
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80% on an LLM paid checker jfl
So much inaccurate info js for price and necessity dump just like ur other thread that got botb hate how admins give botb over just long text if master lets this win vip comp im pressed
 
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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.



Contents:

Introduction to Human Growth Hormone and Aromatase Inhibitor:
  1. Human Growth Hormone (HGH)
  2. Aromatase Inhibitor (AI)

The impact of administering exogenous Human Growth Hormone (r-hGH) in healthy adolescents:
  1. Benefits and drawbacks

The impact of administering Aromatase Inhibitor (AI) in healthy adolescents:
  1. Comparison of anastrozole, letrozole and exemestane
  2. Benefits and drawbacks of exemestane

Sources I rely on:
  1. Sources

Precautions:
  1. Safety Measures
  2. Storage Guidelines
  3. Use of Assistive Devices
  4. Authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

Injecting r-hGH:
  1. Determining the appropriate r-hGH Dosage
  2. Administration Technique for r-hGH
  3. Timing of r-hGH Injections

Taking the correct dosage of Exemestane (Aromasin):
  1. Determining the appropriate exemestane Dosage
  2. Timing and method for exemestane administration

Estimated Costs and Cycle:
  1. List of Necessary Items with Pricing
  2. Cycle Outline and Weekly Schedule, Including Precautions
  3. Additional knowledge

Ending:
  1. 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.
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.

View attachment 2964921

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.
View attachment 2964915


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):

View attachment 2964902

(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)
For further understanding, the name of the generic active ingredient is written first while the name of the patented medication and developed pharmacy is written in brackets.

(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)

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.
External benefits (facially):
  • 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.​

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.
Internal benefits (effects on behavior):
  • 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.
And the best thing, it promotes height growth.


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.
Take special care if:
  • 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
Go to the doctor immediately and tell him what you are taking if you notice the following side effects:

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.
Very common side effects (may affect more than 1 in 10 people):
  • Decreased levels of the hormone thyroxine in blood tests (secondary hypothyroidism)
  • Pain and swelling at the injection site
Uncommon side effects (may affect up to 1 in 100 people):
  • 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
Frequency not known (cannot be estimated from available data):
  • Cancer

  • Stroke

  • CVD and Metabolic Risk

  • Type 2 diabetes mellitus
  • Scoliosis

  • 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)

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.

View attachment 2966168

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).

Both non-steroidal and steroidal have advantages and disadvantages.

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.
Ultimately, all three Aromatase inhibitors are the same and FDA-approved with very few effect differences.

Generic nameAnastrozoleLetrozoleExemestane
Typenon-steroidalnon-steroidalsteroidal
LegalityPrescription-onlyPrescription-onlyPrescription-only
Dosage Form(s) AvailableOral tabletOral tabletOral tablet
Half-Life46 hours48 hours24 hours
First approval dateDecember 27, 1955November 25, 1996October 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 effectApplicable?, FrequencyApplicable?, Frequency
Hot flashesYes, 56%Yes, 55%
Joint painYes, 6%Yes, 7%
Muscle painYes, 16%Yes, 17%
Vaginal bleedingYes, 2%Yes, 1%
Abnormal liver enzyme levelsYes, 1%Yes, 1%
Abnormal bilirubin levelsYes, 1%Yes, 2%
OsteoporosisYes, 35%Yes, 31%
Atrial fibrillationYes, 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.
Benefits (also apply approximately to other Ais)
  • 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!!! :soy:", "YOU CAN'T GROW ABOVE YOUR GENETICS :feelswhy:", "HAVE FUN WITH YOUR HEART ATTACK AT 30!! :lul:"

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:

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
Radiograph:

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.
The cost of an X-ray usually lies between 50-200$.
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.
Value explanation:
  • 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.
Values:

Liver function:

TestDescriptionCoverage in blood panelsEstimated price
ALT (Alanine Aminotransferase)An enzyme primarily found in the liver. High levels can indicate liver damage.Covered1-5 €
AST (Aspartate Aminotransferase)An enzyme found in various organs, especially the liver. Elevated levels can indicate liver disease.Covered1-5 €
ALP (Alkaline Phosphatase)An enzyme found in the liver, bile ducts, and bones. High levels can indicate liver or bile duct disease.Covered1-5 €
BilirubinA breakdown product of hemoglobin that the liver processes. Elevated levels can indicate liver or bile duct disorders.Covered1-5 €
GGT (Gamma-Glutamyltransferase):An enzyme found in the liver and bile ducts. High levels can indicate liver or bile duct disease.Not covered1-5 €
AlbuminA protein produced by the liver. Low levels can indicate liver disease.Not covered5-10 €

Lipid Profile / Cardiovascular Health (assess the risk of cardiovascular disease (CVD)):

TestDescriptionCoverage in blood panelsEstimated price
Total CholesterolThe overall amount of cholesterol in the blood. High levels can increase the risk of heart disease.Not covered1-5 €
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.Covered1-5 €
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.Covered1-5 €
TriglyceridesA 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 covered1-5 €
BNP (B-type natriureti Peptide)Measures a hormone produced by the heart in response to pressure changes, useful for diagnosing heart failure.Not covered20-40 €
TroponinMeasures proteins released when the heart muscle is damaged, used to diagnose heart attacks.Not covered20-40 €

Kidney Function:

TestDescriptionCoverage in blood panelsEstimated price
Serum Creatinine:A waste product from muscle metabolism that is excreted by the kidneys. Elevated levels can indicate impaired kidney function.Covered1-5 €
Blood Urea Nitrogen (BUN)A waste product from protein metabolism that is excreted by the kidneys. High levels can suggest reduced kidney function.Covered1-5 €
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:

TestDescriptionCoverage in blood panelsEstimated 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.
Covered10-20 €
Free T3 (Triiodothyronine)Measures the active form of T3 in the blood, which is crucial for metabolism regulation.Covered10-20 €
Free T4 (Thyroxine)Measures the active form of T4 in the blood, which is important for metabolic rate and growth.Covered10-20 €
Total T3Measures both the free and bound forms of T3 in the blood.Covered10-20 €
Total T4Measures both the free and bound forms of T4 in the blood.Covered10-20 €

Reproductive Hormones:

TestDescriptionCoverage in blood panelsEstimated price
TestosteroneMeasures the primary male sex hormone, which is important for developing and maintaining male characteristics.Covered20-30 €
EstradiolMeasures a form of estrogen, which is important for reproductive and sexual health.Covered20-30 €
EstroneMeasures another form of estrogen, which is important for reproductive health.Not covered20-30 €
EstriolMeasures the least abundant estrogen, significant during pregnancy.Not covered20-30 €
DHT (Dihydrotestosterone)Measures a potent androgen, derived from testosterone, which is important for male development.Covered20-30 €
IGF-1 (Insulin-Like Growth Factor 1)Measures a hormone that reflects the amount of growth hormone activity in the body.Covered10-30 €
HGH (Human Growth Hormone)Measures the amount of growth hormone.Covered10-30 €
SHBG (Sex Hormone Binding Globulin)Measures a protein that binds to sex hormones, influencing their bioavailability.Covered20-30 €
FSH (Follicle-Stimulating Hormone)Important for reproductive health and function.Covered10-20 €
LH (Luteinizing Hormone)Works with FSH to regulate reproductive processes.Not covered10-20 €
ProlactinMeasures a hormone that can influence reproductive health.Not covered10-20 €
IGFBP-3 (Insulin-Like Growth Factor Binding Protein 3)Measures the main carrier of IGF-1 in the blood, indicating GH activity.Not covered10-30 €
DHEADHEA 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.Covered20-30 €
DHEA-SDHEA-S levels in blood help diagnose adrenal and hormone-related disorders, offering insights into adrenal gland function and overall hormone balance.Covered20-30 €

General Health Markers:

TestDescriptionCoverage in blood panelsEstimated price
CBC (Complete Blood Count)Provides information about the cells in the blood, including red blood cells, white blood cells, and platelets.Covered5-10 €
CMP (Comprehensive Metabolic Panel)Includes tests for electrolytes, glucose, calcium, albumin, and more, providing a broad overview of metabolic health.Covered5-10 €
CRP (C-Reactive Protein)Measures a marker of inflammation in the body, which can indicate infection or chronic inflammatory conditions.Not covered5-15 €
ESR (Erythrocyte Sedimentation Rate)Another marker of inflammation, which can indicate chronic inflammatory conditions.Not covered5-15 €

Metabolic Function:

TestDescriptionCoverage in blood panelsEstimated price
Fasting GlucoseMeasures blood sugar levels after fasting, important for assessing glucose metabolism and risk of diabetes.Covered through blood sugar meter later discussed1-5 € (in lab)
HbA1c (Hemoglobin A1c)Measures average blood glucose levels over the past 2-3 months, used to diagnose and monitor diabetes.Not covered10-20 €
InsulinMeasures the level of insulin in the blood, important for understanding insulin sensitivity and pancreatic function.Not covered10-20 €

Immune Function:

TestDescriptionCoverage in blood panelsEstimated 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:

TestDescriptionCoverage in blood panelsEstimated price
PSA (Prostate-Specific Antigen)Measures a protein produced by the prostate gland. Elevated levels may indicate prostate cancer.Not covered10-20 €
CA-125Measures a protein often elevated in ovarian cancerNot covered10-20 €
CA 15-3Measures a protein elevated in breast cancer.Not covered20-30 €
AFP (Alpha-Fetoprotein)Elevated levels may indicate liver cancer or germ cell tumors.Not covered10-20 €
CEA (Carcinoembryonic Antigen)Elevated levels may indicate colorectal, lung, pancreatic, or breast cancer.Not covered10-20 €
CA 19-9Elevated levels may indicate pancreatic cancer.Not covered10-20 €

Bones markers:

TestDescriptionCoverage in blood panelsEstimated price
25-OH-vitamin DMeasures the level of vitamin D, which is crucial for bone health.Covered20-40 €
P1NPMeasures a marker of bone formation.Not covered30-40 €
OstasisMeasures a protein secreted by osteoblasts, important for bone formation.Not covered30-40 €
ß-CTX (Beta CrossLaps)Measures a marker of bone resorption.Not covered30-40 €
TRAP 5bMeasures an enzyme involved in bone resorption.Not covered1-5 €
OsteocalcinA protein secreted by osteoblasts, important for bone formation.Covered10-20 €
Alkaline PhosphataseAn enzyme important for bone and liver health.Covered1-5 €

Androgenic balding:

TestDescriptionCoverage in blood panelsEstimated price
DHEA-SMeasures a precursor hormone that can be converted into androgens and estrogens.Covered20-30 €
TestosteroneMeasures the primary male sex hormone, important for developing and maintaining male characteristics.Covered20-30 €
SHBGMeasures a protein that binds to sex hormones, including testosterone and estrogen.Covered20-30 €
AndrostenedioneMeasures a precursor to testosterone and estrogen, important for hormone balance.Not covered10-20 €

Electrolytes and Minerals:

TestDescriptionCoverage in blood panelsEstimated price
SodiumEssential for fluid balance and nerve function.Not covered1-5 €
PotassiumImportant for heart and muscle function.Not covered1-5 €
ChlorideHelps maintain fluid balance and pH levels.Not covered1-5 €
CalciumImportant for bone health, muscle function, and nerve signaling.Not covered1-5 €
MagnesiumInvolved in numerous biochemical reactions in the body.Not covered1-5 €
PhosphateImportant for bone health and energy production.Not covered1-5 €

Vitamins and Other Minerals:

TestDescriptionCoverage in blood panelsEstimated price
Vitamin B12Essential for nerve function and blood cell production.Not covered10-20 €
FolateImportant for DNA synthesis and cell division.Not covered10-20 €
ZincImportant for immune function, protein synthesis, and DNA synthesis.Not covered1-5 €
IronCrucial for oxygen transport in the blood.Not covered1-5 €

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.

TestPriceImportance
  • IGF-1
  • 10-30 €
  • important
  • Testosterone
  • 20-30 €
  • important
  • Estradiol
  • 20-30 €
  • important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • recommended
  • Total T3
  • 10-20 €
  • recommended
  • Total T4
  • 10-20 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHEA
  • 20-30 €
  • recommended
  • DHEA-S
  • 20-30 €
  • recommended
  • 25-OH-vitamin D
  • 20-40 €
  • optional
  • DHT
  • 20-30 €
  • optional
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
  • Comprehensive Metabolic Panel (CMP)
  • 5-10 €
  • optional
Total price: 180-330 €

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)
If you notice strong side effects like lasting tiredness throughout the day, strong and long headaches, Jaundice (yellowish discoloration of the skin and eyes), loss of appetite, nausea, chest pain, back pain etc. I advise you to add additional tests.

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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
Total price: 27-50 €

[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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • Complete Blood Count
  • 5-10 €
  • important
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • recommended
  • Bilirubin
  • 1-5 €
  • recommended
  • Blood Urea Nitrogen
  • 1-5 €
  • recommended
  • Creatinine
  • 1-5 €
  • recommended
  • HDL Cholesterol
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHT
  • 20-30 €
  • optional
  • Free T3
  • 10-20 €
  • optional
  • Free T4
  • 10-20 €
  • optional
  • Testosterone
  • 20-30 €
  • optional
Total price: 103-220 €

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]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • Complete Blood Count (CBC)
  • 5-10 €
  • Important
  • GGT (Gamma-Glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine Transaminase)
  • 1-5 €
  • Recommended
  • AST (Aspartate Transaminase)
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • Blood Urea Nitrogen (BUN)
  • 1-5 €
  • Recommended
  • Creatinine
  • 1-5 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • TSH
  • 10-20 €
  • Recommended
  • Free T3
  • 10-20 €
  • Optional
  • Free T4
  • 10-20 €
  • Optional
  • Testosterone
  • 20-30 €
  • Optional
  • DHT
  • 20-30 €
  • Optional
Total price: 113-200 €

[Test E]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • Blood creatine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Recommended
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
Total price: 153-320 €

[Test F]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Blood Creatinine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
  • Oestelcalcin
  • 10-20 €
  • Recommended
  • Alkaline phosphatase
  • 1-5 €
  • Recommended
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.
Glucose is the main source of energy for cells, and insulin is the hormone that ensures glucose gets from the blood into the cells. Without enough insulin or insulin resistance (as in type 2 diabetes), too much glucose remains in the blood, which can lead to high blood sugar levels and long-term health problems.

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.

View attachment 2966296

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.
Monitoring before and after meals (2 hours after the meal):
  • 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.
Monitoring before bedtime (less important):
  • 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).
Frequency of monitoring:

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 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).
Normal blood sugar levels:
  • 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).
Values that require intervention:
  • 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.).
The development of type 2 diabetes mellitus, the most common form of diabetes, can take years and is a gradual process.

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.
Symptoms of low blood sugar (hypoglycemia):

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.
Actions for High Values:

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.
Supplements:
  • 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.
Monitoring before bedtime (less important):

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.
Symptoms of Low Blood Pressure (Hypotension):
  • 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.
Supplements:
  • 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.

View attachment 2966298
(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
If you have made yourself a better routine, be sure to post the routine in this post!

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.
If you notice any of those and the trigger is water retention at the heart, immediately stop the r-hGH administration and take further action.

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.


Continues in replies
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bookmarked and repped
 
  • +1
Reactions: tempelcat4
It turns out that even with prolonged use of hgh, my face will not become a horse? I read the thread of a guy who claimed that after using hgh, his midface became longer. Btw, a very good thread
 
Guys this thread is AI generated and feels so hard to read. It's also impractical


You put contest in wacko order, first you talk about blood sugar meter, then about insulin, and about blood sugar meter AGAIN, then about glucose, then about monitoring sugar levels AGAIN... Like wtf bruh 💀 maby get to the point?

We're gonna become decaying corpses until you get to the point and say that insulin raises blood sugar!!!

Seth Meyers Time GIF by Late Night with Seth Meyers
Aging Matt Damon GIF


Also, who really needs to supplements CoQ10 supplements to lower blood pressure? That's bs... is this thread targeted to 90 year olds ??? And why would you possibly take cinnamon to lower fasting blood sugar levels (JFL) :lul: You don't understand biochemistry and pharmacology

Steve Harvey Reaction GIF
Text What GIF by Clarity Experiences


i feel like this thread is targeted to vegan, hippie, karen feelgood community, instead of teencels on here. Bunch of nonsense

it's unoriginal too


Del


I'm not saying this to hate on u or anything, it's that i've actually read the entire thread, and for someone who passionately research biochemistry, pharmacology, and how body works - This guide is purely impractical, and you wasted my time. You owe me my time back pal...
 
  • +1
Reactions: tempelcat4

So I'm giving a answer on this. I don't want to discuss further about this, because it has nothing to do with the sole purpose of this post - to help adolescents that start r-hGH and any Aromatase Inhabitor and give them an in-depth overview what will happen to them.

I did not wrote this guide to get a chance of VIP, actually I started writing on this 3 month ago, where Master had not announced anything related, so it was pure coincidence that I logically used and submitted this post in Masters thread.

In the following, I wont give proof, but I have the chats, word details everything on my PC at home (currently in vacation).

Guys this thread is AI generated and feels so hard to read.

This thread is not AI generated, even with the newest version of ChatGPT or any other AI a guide of this length and about this topic wouldn’t be made.

It's also impractical

I can't really get how you come to say something like that. It is actually very practical and even gives examples for routines.

I myself use it, because it written by me, someone who does all this himself.

I would even say that you only need this guide, there is nothing else that you need to know then the info written here, although I not recommending only reading this guide.

You put contest in wacko order, first you talk about blood sugar meter, then about insulin, and about blood sugar meter AGAIN, then about glucose, then about monitoring sugar levels AGAIN... Like wtf bruh 💀 maby get to the point?

No reason to hurry. This post was never meant to give fast answers, it's ok if there is addional info, maybe not necessary needed. If you don't want to read just skip.

I don't think the order is bad. The title says blood sugar monitor - I start by declaring what a blood sugar monitor is and how it's used, continue with explaining the need of it, through shortly explaining what Diabetes type 2 is. And then go more in-depth about the use.

Yeah could be ordered better, by starting with Diabetes but nothing to yap about.

Also, who really needs to supplements CoQ10 supplements to lower blood pressure? That's bs... is this thread targeted to 90 year olds ??? And why would you possibly take cinnamon to lower fasting blood sugar levels (JFL) :lul: You don't understand biochemistry and pharmacology

Those are supplements that lower blood pressure, no matter age.

I don't doubt that you may have better knowledge about biochemistry and pharmacology than me, but if so you indeed know that cinnamon does lower fasting blood sugar.

I could have mentioned stronger blood pressure medications like ACE inhibitors or Tadalafil, but I think people needing those should do their own research. It's rare for adolescents to need such strong medications, so it's not worth discussing here. Plus, I want to keep the guide safe and concise, and talking about the risks would make it too long.


Yeah no, as already mentioned at the beginning. the guide is not 100% AI generated. As english is not my first language, I rephrased several things before putting in here. I do have the old chats of rephrasing, I think it's doesn't matter at all, but if you really want I'll send it to you later.

Although I'm not denying that some is made 100% AI generated, especially the Blood sugar meter and Blood pressure part. But how cares??!!!! The info is right either way, I read everything and corrected if necessary, everything is true written. And things like Diabetes type 2 explanation are made through readings from my private laboratory. Also the blood panels are made 100% by me in combination with a REAL endocrinologist and one doctor at my private lab.

I'm not saying this to hate on u or anything, it's that i've actually read the entire thread, and for someone who passionately research biochemistry, pharmacology, and how body works - This guide is purely impractical, and you wasted my time. You owe me my time back pal...

Yeah it's ok. No bad blood.
I'm also looking to better my knowledge in biochemesty and currently reading fat ass book about the topic, about your time, I paid you back through the answer.

Please don't try discussing about the AI thing further, it just is irrelevant.
If you want to discuss about statements do it because it could be that here is false Info, I'm looking to remake a full heightmaxxing post when I really have good results and more knowledge, in line 6-10 months maybe and combine everything I know so it only helps me finding errors.
 
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poor little nigger nobody read his thread
 
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didnt read but i repped since you always put so much effort into your threads.

how do you do it though? i struggle to write a few paragraphs and you literally broke the character limit, are you a robot or something?

no but seriously can you give me some tips
If you want to read these longer threads, you could just put it into an AI and ask for a summary. I have an unbelievably large amount of time so I can read through whole threads, but I recommend just using an AI to summarize the key ideas into smaller paragraphs or bullet points.
 
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We want estrogen levels between the 11-19 pg/ml range. - tempelcat4


This is a bit too high, around 16pg/ml would be the highest I’d want to go! You’d typically want your e2 levels reminiscent of a child during the late stages of prepubescence. If any higher, you can still risk more bone age progression than preferred from the data I’ve seen, so I’d prefer to be on the safer side!


Exemestane stimulates increases in IGF-1 (Insulin-Like Growth Factor 1). - tempelcat4
I believe this isn't true for men, but only for postmenopausal women. AI effects men and women in different ways. This leads to conflicting results when tested on the two gender populations. As in women, when their estrogen levels decrease, their IGF-1 increases, so that's why in studies using AI's in female breast cancer patients, it will says that the AI used elicited an increase in IGF-1!
LODKDND

When 25mg of Aromasin was given to young adult males, their plasma IGF-1 decreased significantly as a matter of a fact, but typically, Aromasin and most other AI's in young males will lead to either no effect on IGF-1 concentrations or a suppression!

LOWKEBM


However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them. - tempelcat4

I’d say that the best way is just to only buy from websites that have sent their product to purity testing labs and have posted their results on their website or have had customers post their product’s results!

[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days. - tempelcat4

Realistically, most people won’t be able to get a blood test that often. I recommend people start with 12.5mg of Aromasin ED if they can’t afford multiple blood tests. Get one blood test after a month so that the e2 lowering effects can take place, and if their e2 levels still aren’t in the desired range, take 25mg of Aromasin ED. Aromasin doesn’t do the greatest job at lowering E2 at it’s lower doses.

Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time. - tempelcat4

In terms of breaks, I’d say you shouldn’t take a day in the week off or reduce your dosage during a particular day of the week since that will make your hormones fluctuate. I used to once believe this as well, to “give your body a break,” during the week, but in reality, it will only make side effects worse. I’d say something better to do is to take a break every 2-3 months potentially! And when you take a break, it doesn’t mean you completely stop everything and go cold turkey, but only remove some of the accessory compounds. reduce or stop HGH dosing and only use AI! I’d say take a 2-3 week break, and allow all of the side effects of your stack to dissipate and wear off!

Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible. - tempelcat4

A large part of AI users, especially younger ones who are more prone to changes in mood due to already fluctuating hormones will experience some sort of negative mental effect from taking an AI! It is pretty unavoidable for many young teens who decide to take these compounds. This is a large cause behind the reason why many people will quit taking AI!
 
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We want estrogen levels between the 11-19 pg/ml range. - tempelcat4


This is a bit too high, around 16pg/ml would be the highest I’d want to go! You’d typically want your e2 levels reminiscent of a child during the late stages of prepubescence. If any higher, you can still risk more bone age progression than preferred from the data I’ve seen, so I’d prefer to be on the safer side!


Exemestane stimulates increases in IGF-1 (Insulin-Like Growth Factor 1). - tempelcat4
I believe this isn't true for men, but only for postmenopausal women. AI effects men and women in different ways. This leads to conflicting results when tested on the two gender populations. As in women, when their estrogen levels decrease, their IGF-1 increases, so that's why in studies using AI's in female breast cancer patients, it will says that the AI used elicited an increase in IGF-1!
View attachment 3000425
When 25mg of Aromasin was given to young adult males, their plasma IGF-1 decreased significantly as a matter of a fact, but typically, Aromasin and most other AI's in young males will lead to either no effect on IGF-1 concentrations or a suppression!

View attachment 3000433

However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them. - tempelcat4

I’d say that the best way is just to only buy from websites that have sent their product to purity testing labs and have posted their results on their website or have had customers post their product’s results!

[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days. - tempelcat4

Realistically, most people won’t be able to get a blood test that often. I recommend people start with 12.5mg of Aromasin ED if they can’t afford multiple blood tests. Get one blood test after a month so that the e2 lowering effects can take place, and if their e2 levels still aren’t in the desired range, take 25mg of Aromasin ED. Aromasin doesn’t do the greatest job at lowering E2 at it’s lower doses.

Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time. - tempelcat4

In terms of breaks, I’d say you shouldn’t take a day in the week off or reduce your dosage during a particular day of the week since that will make your hormones fluctuate. I used to once believe this as well, to “give your body a break,” during the week, but in reality, it will only make side effects worse. I’d say something better to do is to take a break every 2-3 months potentially! And when you take a break, it doesn’t mean you completely stop everything and go cold turkey, but only remove some of the accessory compounds. reduce or stop HGH dosing and only use AI! I’d say take a 2-3 week break, and allow all of the side effects of your stack to dissipate and wear off!

Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible. - tempelcat4

A large part of AI users, especially younger ones who are more prone to changes in mood due to already fluctuating hormones will experience some sort of negative mental effect from taking an AI! It is pretty unavoidable for many young teens who decide to take these compounds. This is a large cause behind the reason why many people will quit taking AI!
U wrote alot damn
 
Last edited:
We want estrogen levels between the 11-19 pg/ml range. - tempelcat4


This is a bit too high, around 16pg/ml would be the highest I’d want to go! You’d typically want your e2 levels reminiscent of a child during the late stages of prepubescence. If any higher, you can still risk more bone age progression than preferred from the data I’ve seen, so I’d prefer to be on the safer side!


Exemestane stimulates increases in IGF-1 (Insulin-Like Growth Factor 1). - tempelcat4
I believe this isn't true for men, but only for postmenopausal women. AI effects men and women in different ways. This leads to conflicting results when tested on the two gender populations. As in women, when their estrogen levels decrease, their IGF-1 increases, so that's why in studies using AI's in female breast cancer patients, it will says that the AI used elicited an increase in IGF-1!
View attachment 3000425
When 25mg of Aromasin was given to young adult males, their plasma IGF-1 decreased significantly as a matter of a fact, but typically, Aromasin and most other AI's in young males will lead to either no effect on IGF-1 concentrations or a suppression!

View attachment 3000433

However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them. - tempelcat4

I’d say that the best way is just to only buy from websites that have sent their product to purity testing labs and have posted their results on their website or have had customers post their product’s results!

[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days. - tempelcat4

Realistically, most people won’t be able to get a blood test that often. I recommend people start with 12.5mg of Aromasin ED if they can’t afford multiple blood tests. Get one blood test after a month so that the e2 lowering effects can take place, and if their e2 levels still aren’t in the desired range, take 25mg of Aromasin ED. Aromasin doesn’t do the greatest job at lowering E2 at it’s lower doses.

Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time. - tempelcat4

In terms of breaks, I’d say you shouldn’t take a day in the week off or reduce your dosage during a particular day of the week since that will make your hormones fluctuate. I used to once believe this as well, to “give your body a break,” during the week, but in reality, it will only make side effects worse. I’d say something better to do is to take a break every 2-3 months potentially! And when you take a break, it doesn’t mean you completely stop everything and go cold turkey, but only remove some of the accessory compounds. reduce or stop HGH dosing and only use AI! I’d say take a 2-3 week break, and allow all of the side effects of your stack to dissipate and wear off!

Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible. - tempelcat4

A large part of AI users, especially younger ones who are more prone to changes in mood due to already fluctuating hormones will experience some sort of negative mental effect from taking an AI! It is pretty unavoidable for many young teens who decide to take these compounds. This is a large cause behind the reason why many people will quit taking AI!
Any advice on what to do if u crash ur e on this stuff? What’s the best way to recover from a crash on both arimidex and Aromasin? i just crashed on Arimidex recently and found enclo to be helpful on recovery
 
U wrote alot damn
I am practicing writing threads again. I need to get used to writing long-form content once again 😭
 
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Any advice on what to do if u crash ur e on this stuff? What’s the best way to recover from a crash on both arimidex and Aromasin? i just crashed on Arimidex recently and found enclo to be helpful on recovery
I'd say wait it out if you are doing it for heightmaxxing. If you take any estrogen-increasing compound like Enclo to recover, then you are risking the chance of closing your growth plates for no reason as that rise of E2 can be too high and if it's maintained for a long period, can cause early closure of growth plates.
 
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I'd say wait it out if you are doing it for heightmaxxing. If you take any estrogen-increasing compound like Enclo to recover, then you are risking the chance of closing your growth plates for no reason as that rise of E2 can be too high and if it's maintained for a long period, can cause early closure of growth plates.
Will my estrogen eventually rebound since it was crashed on arimidex and not Aromasin?
 
ヽ(✿゚▽゚)ノ
Thank you for the great response, I really appreciate it!



We want estrogen levels between the 11-19 pg/ml range. - tempelcat4


This is a bit too high, around 16pg/ml would be the highest I’d want to go! You’d typically want your e2 levels reminiscent of a child during the late stages of prepubescence. If any higher, you can still risk more bone age progression than preferred from the data I’ve seen, so I’d prefer to be on the safer side!

Yeah, you're right the lower the better for the growth plates.
But even below 25 pg/ml is enough to prevent premature growth plate closure, but yeah, we don't want them to close any further tho.

I haven't personally experienced having my E2 (estradiol) levels below 18 pg/ml, as determined by blood tests, since my exemestane is severely underdosed. However, I plan to address this issue soon by using pharmaceutical aromasin from Turkey. Consequently, I don't know if I would experience side effects from even lower E2 levels. That said, I couldn't participate in handball (which was a sports topic in school at the time) due to extreme pain in my upper from throwing arms that made it impossible to throw properly.

I definitely think you should take your time working down instead of trying to lower your E2 levels too quickly. What do you think? Also, what would you say is the lowest safe E2 level to aim for or the best, and what has been your lowest E2 or your current level so far?


Exemestane stimulates increases in IGF-1 (Insulin-Like Growth Factor 1). - tempelcat4
I believe this isn't true for men, but only for postmenopausal women. AI effects men and women in different ways. This leads to conflicting results when tested on the two gender populations. As in women, when their estrogen levels decrease, their IGF-1 increases, so that's why in studies using AI's in female breast cancer patients, it will says that the AI used elicited an increase in IGF-1!
View attachment 3000425
When 25mg of Aromasin was given to young adult males, their plasma IGF-1 decreased significantly as a matter of a fact, but typically, Aromasin and most other AI's in young males will lead to either no effect on IGF-1 concentrations or a suppression!

View attachment 3000433

I found this info for the first time under a product description of exemestane here:
Some of these advantages that are not seen in any other aromatase inhibitors include: suicide inhibition, stimulating increases in IGF-1 (Insulin Like Growth Factor 1), displays little incompatibility with other compounds (something not seen with other aromatase inhibitors), as well as offering less of a negative impact on cholesterol values (again, something unseen with other aromatase inhibitors).

So now I did a little deep dive into it and:

Yeah, as it looks there is no increase. IGF-1 should remain unaffected by estradiol suppression. I would agree on that, althrough it does not really matter fortunately.
  1. professionalmuscle
  2. elitefitness
  3. t-nation

But many talk about that tho:
  1. steroidal.com
Some of these advantages that are not seen in any other aromatase inhibitors include: suicide inhibition, stimulating increases in IGF-1 (Insulin Like Growth Factor 1), displays little incompatibility with other compounds (something not seen with other aromatase inhibitors), as well as offering less of a negative impact on cholesterol values (again, something unseen with other aromatase inhibitors).
  1. elitefitness.com
The PK properties of the 25-mg dose showed the highest exemestane concentrations 1 h after administration, indicating rapid absorption. The terminal half-life was 8.9 h. Maximal estradiol suppression of 62 ± 14% was observed at 12 h. The drug was well tolerated. In conclusion, exemestane is a potent aromatase inhibitor in men and an alternative to the choice of available inhibitors. Long-term efficacy and safety will need further study.

I could list more, but those are no studies and I think it could just be a misunderstanding related to the difference between women and men, as you said, as this is never addressed.



However, there are additional methods available to verify the authenticity of your r-hGH and exemestane or Pfizer Aromasin before using them. - tempelcat4

I’d say that the best way is just to only buy from websites that have sent their product to purity testing labs and have posted their results on their website or have had customers post their product’s results!

Yeah



[Stage 2] Start of exemestane:
This is a 7-day plan. Only proceed to the next stage if your E2 levels are below 20 pg/ml and you no longer experience side effects from exemestane. Repeat this stage until your E2 levels are below 20 pg/ml and your body has fully adjusted to the hormonal changes, which typically takes about 7-14 days. - tempelcat4

Realistically, most people won’t be able to get a blood test that often. I recommend people start with 12.5mg of Aromasin ED if they can’t afford multiple blood tests. Get one blood test after a month so that the e2 lowering effects can take place, and if their e2 levels still aren’t in the desired range, take 25mg of Aromasin ED. Aromasin doesn’t do the greatest job at lowering E2 at it’s lower doses.

Yes, when I wrote that, I took it more seriously. I think you've also become a bit too jaded now. I wouldn't recommend starting with 12.5mg; 6.25mg is safer and easier, with fewer pronounced side effects.

Younger readers, aged 14, 15, or 16, may lack knowledge about substances and could unintentionally harm themselves. That's why I prefer to offer straightforward, cautious advice. Those who are well-informed can make their own decisions.

Some might become fearful of side effects and stop taking it abruptly. I recently spoke with someone in that situation who took aromasin without understanding it, then stopped and asked me for basic information. It's a bit laughable. They just rush it.

However, starting with 12.5mg is an option; while side effects may be more pronounced initially, they tend to diminish over time.



Take breaks, maybe take every Saturday off, or decrease your dose until your body adapts, it will give it time. - tempelcat4

In terms of breaks, I’d say you shouldn’t take a day in the week off or reduce your dosage during a particular day of the week since that will make your hormones fluctuate. I used to once believe this as well, to “give your body a break,” during the week, but in reality, it will only make side effects worse. I’d say something better to do is to take a break every 2-3 months potentially! And when you take a break, it doesn’t mean you completely stop everything and go cold turkey, but only remove some of the accessory compounds. reduce or stop HGH dosing and only use AI! I’d say take a 2-3 week break, and allow all of the side effects of your stack to dissipate and wear off!

Ok, I understand this, do you take breaks?
I am thinking of doing this too.



Estrogen plays a role in regulating neurotransmitters such as serotonin and dopamine, which are linked to mood. A deficiency can therefore promote depressive symptoms. Aromatase Inhibitors are not the reason for depression but rather make it more susceptible. - tempelcat4

A large part of AI users, especially younger ones who are more prone to changes in mood due to already fluctuating hormones will experience some sort of negative mental effect from taking an AI! It is pretty unavoidable for many young teens who decide to take these compounds. This is a large cause behind the reason why many people will quit taking AI!

Personally, I did not had any kind of negative mental effect from AI.
In fact, I documented in my notes that during the first week of taking exemestane, I noticed a significant increase in hunger and sex drive, along with heightened stiffness in my penis. However, these effects subsided over time. I attribute this to exemestane use, though it was most likely due to related hormone fluctuations.
 
is it possible to experience downgrowth, especially of the maxilla?
 
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.



Contents:

Introduction to Human Growth Hormone and Aromatase Inhibitor:
  1. Human Growth Hormone (HGH)
  2. Aromatase Inhibitor (AI)

The impact of administering exogenous Human Growth Hormone (r-hGH) in healthy adolescents:
  1. Benefits and drawbacks

The impact of administering Aromatase Inhibitor (AI) in healthy adolescents:
  1. Comparison of anastrozole, letrozole and exemestane
  2. Benefits and drawbacks of exemestane

Sources I rely on:
  1. Sources

Precautions:
  1. Safety Measures
  2. Storage Guidelines
  3. Use of Assistive Devices
  4. Authenticity of r-hGH and Exemestane (Aromasin) and Ways to Verify

Injecting r-hGH:
  1. Determining the appropriate r-hGH Dosage
  2. Administration Technique for r-hGH
  3. Timing of r-hGH Injections

Taking the correct dosage of Exemestane (Aromasin):
  1. Determining the appropriate exemestane Dosage
  2. Timing and method for exemestane administration

Estimated Costs and Cycle:
  1. List of Necessary Items with Pricing
  2. Cycle Outline and Weekly Schedule, Including Precautions
  3. Additional knowledge

Ending:
  1. 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.
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.

View attachment 2964921

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.
View attachment 2964915


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):

View attachment 2964902

(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)
For further understanding, the name of the generic active ingredient is written first while the name of the patented medication and developed pharmacy is written in brackets.

(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)

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.
External benefits (facially):
  • 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.​

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.
Internal benefits (effects on behavior):
  • 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.
And the best thing, it promotes height growth.


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.
Take special care if:
  • 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
Go to the doctor immediately and tell him what you are taking if you notice the following side effects:

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.
Very common side effects (may affect more than 1 in 10 people):
  • Decreased levels of the hormone thyroxine in blood tests (secondary hypothyroidism)
  • Pain and swelling at the injection site
Uncommon side effects (may affect up to 1 in 100 people):
  • 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
Frequency not known (cannot be estimated from available data):
  • Cancer

  • Stroke

  • CVD and Metabolic Risk

  • Type 2 diabetes mellitus
  • Scoliosis

  • 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)

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.

View attachment 2966168

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).

Both non-steroidal and steroidal have advantages and disadvantages.

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.
Ultimately, all three Aromatase inhibitors are the same and FDA-approved with very few effect differences.

Generic nameAnastrozoleLetrozoleExemestane
Typenon-steroidalnon-steroidalsteroidal
LegalityPrescription-onlyPrescription-onlyPrescription-only
Dosage Form(s) AvailableOral tabletOral tabletOral tablet
Half-Life46 hours48 hours24 hours
First approval dateDecember 27, 1955November 25, 1996October 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 effectApplicable?, FrequencyApplicable?, Frequency
Hot flashesYes, 56%Yes, 55%
Joint painYes, 6%Yes, 7%
Muscle painYes, 16%Yes, 17%
Vaginal bleedingYes, 2%Yes, 1%
Abnormal liver enzyme levelsYes, 1%Yes, 1%
Abnormal bilirubin levelsYes, 1%Yes, 2%
OsteoporosisYes, 35%Yes, 31%
Atrial fibrillationYes, 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.
Benefits (also apply approximately to other Ais)
  • 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!!! :soy:", "YOU CAN'T GROW ABOVE YOUR GENETICS :feelswhy:", "HAVE FUN WITH YOUR HEART ATTACK AT 30!! :lul:"

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:

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
Radiograph:

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.
The cost of an X-ray usually lies between 50-200$.
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.
Value explanation:
  • 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.
Values:

Liver function:

TestDescriptionCoverage in blood panelsEstimated price
ALT (Alanine Aminotransferase)An enzyme primarily found in the liver. High levels can indicate liver damage.Covered1-5 €
AST (Aspartate Aminotransferase)An enzyme found in various organs, especially the liver. Elevated levels can indicate liver disease.Covered1-5 €
ALP (Alkaline Phosphatase)An enzyme found in the liver, bile ducts, and bones. High levels can indicate liver or bile duct disease.Covered1-5 €
BilirubinA breakdown product of hemoglobin that the liver processes. Elevated levels can indicate liver or bile duct disorders.Covered1-5 €
GGT (Gamma-Glutamyltransferase):An enzyme found in the liver and bile ducts. High levels can indicate liver or bile duct disease.Not covered1-5 €
AlbuminA protein produced by the liver. Low levels can indicate liver disease.Not covered5-10 €

Lipid Profile / Cardiovascular Health (assess the risk of cardiovascular disease (CVD)):

TestDescriptionCoverage in blood panelsEstimated price
Total CholesterolThe overall amount of cholesterol in the blood. High levels can increase the risk of heart disease.Not covered1-5 €
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.Covered1-5 €
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.Covered1-5 €
TriglyceridesA 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 covered1-5 €
BNP (B-type natriureti Peptide)Measures a hormone produced by the heart in response to pressure changes, useful for diagnosing heart failure.Not covered20-40 €
TroponinMeasures proteins released when the heart muscle is damaged, used to diagnose heart attacks.Not covered20-40 €

Kidney Function:

TestDescriptionCoverage in blood panelsEstimated price
Serum Creatinine:A waste product from muscle metabolism that is excreted by the kidneys. Elevated levels can indicate impaired kidney function.Covered1-5 €
Blood Urea Nitrogen (BUN)A waste product from protein metabolism that is excreted by the kidneys. High levels can suggest reduced kidney function.Covered1-5 €
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:

TestDescriptionCoverage in blood panelsEstimated 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.
Covered10-20 €
Free T3 (Triiodothyronine)Measures the active form of T3 in the blood, which is crucial for metabolism regulation.Covered10-20 €
Free T4 (Thyroxine)Measures the active form of T4 in the blood, which is important for metabolic rate and growth.Covered10-20 €
Total T3Measures both the free and bound forms of T3 in the blood.Covered10-20 €
Total T4Measures both the free and bound forms of T4 in the blood.Covered10-20 €

Reproductive Hormones:

TestDescriptionCoverage in blood panelsEstimated price
TestosteroneMeasures the primary male sex hormone, which is important for developing and maintaining male characteristics.Covered20-30 €
EstradiolMeasures a form of estrogen, which is important for reproductive and sexual health.Covered20-30 €
EstroneMeasures another form of estrogen, which is important for reproductive health.Not covered20-30 €
EstriolMeasures the least abundant estrogen, significant during pregnancy.Not covered20-30 €
DHT (Dihydrotestosterone)Measures a potent androgen, derived from testosterone, which is important for male development.Covered20-30 €
IGF-1 (Insulin-Like Growth Factor 1)Measures a hormone that reflects the amount of growth hormone activity in the body.Covered10-30 €
HGH (Human Growth Hormone)Measures the amount of growth hormone.Covered10-30 €
SHBG (Sex Hormone Binding Globulin)Measures a protein that binds to sex hormones, influencing their bioavailability.Covered20-30 €
FSH (Follicle-Stimulating Hormone)Important for reproductive health and function.Covered10-20 €
LH (Luteinizing Hormone)Works with FSH to regulate reproductive processes.Not covered10-20 €
ProlactinMeasures a hormone that can influence reproductive health.Not covered10-20 €
IGFBP-3 (Insulin-Like Growth Factor Binding Protein 3)Measures the main carrier of IGF-1 in the blood, indicating GH activity.Not covered10-30 €
DHEADHEA 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.Covered20-30 €
DHEA-SDHEA-S levels in blood help diagnose adrenal and hormone-related disorders, offering insights into adrenal gland function and overall hormone balance.Covered20-30 €

General Health Markers:

TestDescriptionCoverage in blood panelsEstimated price
CBC (Complete Blood Count)Provides information about the cells in the blood, including red blood cells, white blood cells, and platelets.Covered5-10 €
CMP (Comprehensive Metabolic Panel)Includes tests for electrolytes, glucose, calcium, albumin, and more, providing a broad overview of metabolic health.Covered5-10 €
CRP (C-Reactive Protein)Measures a marker of inflammation in the body, which can indicate infection or chronic inflammatory conditions.Not covered5-15 €
ESR (Erythrocyte Sedimentation Rate)Another marker of inflammation, which can indicate chronic inflammatory conditions.Not covered5-15 €

Metabolic Function:

TestDescriptionCoverage in blood panelsEstimated price
Fasting GlucoseMeasures blood sugar levels after fasting, important for assessing glucose metabolism and risk of diabetes.Covered through blood sugar meter later discussed1-5 € (in lab)
HbA1c (Hemoglobin A1c)Measures average blood glucose levels over the past 2-3 months, used to diagnose and monitor diabetes.Not covered10-20 €
InsulinMeasures the level of insulin in the blood, important for understanding insulin sensitivity and pancreatic function.Not covered10-20 €

Immune Function:

TestDescriptionCoverage in blood panelsEstimated 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:

TestDescriptionCoverage in blood panelsEstimated price
PSA (Prostate-Specific Antigen)Measures a protein produced by the prostate gland. Elevated levels may indicate prostate cancer.Not covered10-20 €
CA-125Measures a protein often elevated in ovarian cancerNot covered10-20 €
CA 15-3Measures a protein elevated in breast cancer.Not covered20-30 €
AFP (Alpha-Fetoprotein)Elevated levels may indicate liver cancer or germ cell tumors.Not covered10-20 €
CEA (Carcinoembryonic Antigen)Elevated levels may indicate colorectal, lung, pancreatic, or breast cancer.Not covered10-20 €
CA 19-9Elevated levels may indicate pancreatic cancer.Not covered10-20 €

Bones markers:

TestDescriptionCoverage in blood panelsEstimated price
25-OH-vitamin DMeasures the level of vitamin D, which is crucial for bone health.Covered20-40 €
P1NPMeasures a marker of bone formation.Not covered30-40 €
OstasisMeasures a protein secreted by osteoblasts, important for bone formation.Not covered30-40 €
ß-CTX (Beta CrossLaps)Measures a marker of bone resorption.Not covered30-40 €
TRAP 5bMeasures an enzyme involved in bone resorption.Not covered1-5 €
OsteocalcinA protein secreted by osteoblasts, important for bone formation.Covered10-20 €
Alkaline PhosphataseAn enzyme important for bone and liver health.Covered1-5 €

Androgenic balding:

TestDescriptionCoverage in blood panelsEstimated price
DHEA-SMeasures a precursor hormone that can be converted into androgens and estrogens.Covered20-30 €
TestosteroneMeasures the primary male sex hormone, important for developing and maintaining male characteristics.Covered20-30 €
SHBGMeasures a protein that binds to sex hormones, including testosterone and estrogen.Covered20-30 €
AndrostenedioneMeasures a precursor to testosterone and estrogen, important for hormone balance.Not covered10-20 €

Electrolytes and Minerals:

TestDescriptionCoverage in blood panelsEstimated price
SodiumEssential for fluid balance and nerve function.Not covered1-5 €
PotassiumImportant for heart and muscle function.Not covered1-5 €
ChlorideHelps maintain fluid balance and pH levels.Not covered1-5 €
CalciumImportant for bone health, muscle function, and nerve signaling.Not covered1-5 €
MagnesiumInvolved in numerous biochemical reactions in the body.Not covered1-5 €
PhosphateImportant for bone health and energy production.Not covered1-5 €

Vitamins and Other Minerals:

TestDescriptionCoverage in blood panelsEstimated price
Vitamin B12Essential for nerve function and blood cell production.Not covered10-20 €
FolateImportant for DNA synthesis and cell division.Not covered10-20 €
ZincImportant for immune function, protein synthesis, and DNA synthesis.Not covered1-5 €
IronCrucial for oxygen transport in the blood.Not covered1-5 €

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.

TestPriceImportance
  • IGF-1
  • 10-30 €
  • important
  • Testosterone
  • 20-30 €
  • important
  • Estradiol
  • 20-30 €
  • important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • recommended
  • Total T3
  • 10-20 €
  • recommended
  • Total T4
  • 10-20 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHEA
  • 20-30 €
  • recommended
  • DHEA-S
  • 20-30 €
  • recommended
  • 25-OH-vitamin D
  • 20-40 €
  • optional
  • DHT
  • 20-30 €
  • optional
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
  • Comprehensive Metabolic Panel (CMP)
  • 5-10 €
  • optional
Total price: 180-330 €

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)
If you notice strong side effects like lasting tiredness throughout the day, strong and long headaches, Jaundice (yellowish discoloration of the skin and eyes), loss of appetite, nausea, chest pain, back pain etc. I advise you to add additional tests.

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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • Complete Blood Count (CBC)
  • 5-10 €
  • optional
Total price: 27-50 €

[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.

TestPriceImportance
  • Estradiol
  • 20-30 €
  • important
  • Complete Blood Count
  • 5-10 €
  • important
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • recommended
  • Bilirubin
  • 1-5 €
  • recommended
  • Blood Urea Nitrogen
  • 1-5 €
  • recommended
  • Creatinine
  • 1-5 €
  • recommended
  • HDL Cholesterol
  • 1-5 €
  • recommended
  • LDL Cholesterol
  • 1-5 €
  • recommended
  • TSH
  • 10-20 €
  • recommended
  • DHT
  • 20-30 €
  • optional
  • Free T3
  • 10-20 €
  • optional
  • Free T4
  • 10-20 €
  • optional
  • Testosterone
  • 20-30 €
  • optional
Total price: 103-220 €

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]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • Complete Blood Count (CBC)
  • 5-10 €
  • Important
  • GGT (Gamma-Glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine Transaminase)
  • 1-5 €
  • Recommended
  • AST (Aspartate Transaminase)
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • Blood Urea Nitrogen (BUN)
  • 1-5 €
  • Recommended
  • Creatinine
  • 1-5 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • TSH
  • 10-20 €
  • Recommended
  • Free T3
  • 10-20 €
  • Optional
  • Free T4
  • 10-20 €
  • Optional
  • Testosterone
  • 20-30 €
  • Optional
  • DHT
  • 20-30 €
  • Optional
Total price: 113-200 €

[Test E]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • Blood creatine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Recommended
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
Total price: 153-320 €

[Test F]

TestPriceImportance
  • Estradiol
  • 20-30 €
  • Important
  • DHEA
  • 20-30 €
  • Important
  • DHEA-S
  • 20-30 €
  • Important
  • SHBG (Sex Hormone Binding Globulin)
  • 20-30 €
  • Important
  • HGH (Human Growth Hormone)
  • 10-30 €
  • Important
  • IGF-1
  • 10-30 €
  • Important
  • Blood Creatinine
  • 1-5 €
  • Important
  • Testosterone
  • 20-30 €
  • Important
  • Hematocrit
  • 1-5 €
  • Important
  • CBC (Complete Blood Count)
  • 5-10 €
  • Important
  • DHT
  • 20-30 €
  • Recommended
  • HDL Cholesterol
  • 1-5 €
  • Recommended
  • LDL Cholesterol
  • 1-5 €
  • Recommended
  • Bilirubin
  • 1-5 €
  • Recommended
  • AST (Aspartate transaminase)
  • 1-5 €
  • Recommended
  • GGT (Gamma-glutamyltransferase)
  • 1-5 €
  • Recommended
  • ALT (Alanine transaminase)
  • 1-5 €
  • Recommended
  • Oestelcalcin
  • 10-20 €
  • Recommended
  • Alkaline phosphatase
  • 1-5 €
  • Recommended
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.
Glucose is the main source of energy for cells, and insulin is the hormone that ensures glucose gets from the blood into the cells. Without enough insulin or insulin resistance (as in type 2 diabetes), too much glucose remains in the blood, which can lead to high blood sugar levels and long-term health problems.

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.

View attachment 2966296

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.
Monitoring before and after meals (2 hours after the meal):
  • 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.
Monitoring before bedtime (less important):
  • 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).
Frequency of monitoring:

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 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).
Normal blood sugar levels:
  • 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).
Values that require intervention:
  • 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.).
The development of type 2 diabetes mellitus, the most common form of diabetes, can take years and is a gradual process.

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.
Symptoms of low blood sugar (hypoglycemia):

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.
Actions for High Values:

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.
Supplements:
  • 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.
Monitoring before bedtime (less important):

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.
Symptoms of Low Blood Pressure (Hypotension):
  • 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.
Supplements:
  • 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.

View attachment 2966298
(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
If you have made yourself a better routine, be sure to post the routine in this post!

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.
If you notice any of those and the trigger is water retention at the heart, immediately stop the r-hGH administration and take further action.

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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This is not a safe guide apart from for those deficient like messi.. At best u will end up an ugly lanklet fk with mesed p prportions aand a shit face, u wont be proptioned and athletic like aa lebron
 

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