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Hi all, I'm currently reviewing my options to beginning treatment for secondary hypogonadism privately in the UK, near London. My two front-runners are well known clinic Balance My Hormones, and the less prevalent Nebula Health. Some background on me: early 20's and classic symptoms of hypogonadism. My lifestyle is entirely conducive to a healthily functioning endocrine system (other than a stimulant medication used for ADHD since adolescence). I had a bout of mumps around 13 months ago. I want to avoid Testosterone Replacement as much as I can and focus on a therapy combining hCG and Clomid use to increase T and maintain/increase fertility. I am reassured by Balance My Hormones' testimonials and their large presence. However, I have been absolutely blown away by the service and expertise I've experienced with Nebula Health. I'm convinced these guys are on the cutting edge of these treatments and know an incredible amount, more than any youtube or internet guru I've come across in the last few years of passive research and the last two months of active research. I'm really interested in your guys' experience and recommendations and am happy to answer any questions you might have about my situation. Thanks in advance

Hi all, I'm currently reviewing my options to beginning treatment for secondary hypogonadism privately in the UK, near London. My two front-runners are well known clinic Balance My Hormones, and the less prevalent Nebula Health. Some background on me: early 20's and classic symptoms of hypogonadism. My lifestyle is entirely conducive to a healthily functioning endocrine system (other than a stimulant medication used for ADHD since adolescence). I had a bout of mumps around 13 months ago. I want to avoid Testosterone Replacement as much as I can and focus on a therapy combining hCG and Clomid use to increase T and maintain/increase fertility. I am reassured by Balance My Hormones' testimonials and their large presence. However, I have been absolutely blown away by the service and expertise I've experienced with Nebula Health. I'm convinced these guys are on the cutting edge of these treatments and know an incredible amount, more than any youtube or internet guru I've come across in the last few years of passive research and the last two months of active research. I'm really interested in your guys' experience and recommendations and am happy to answer any questions you might have about my situation. Thanks in advance

Link to the study: https://academic.oup.com/jcem/article/89/5/2498/2844817 This explains the gyno experienced by many on trenbolone. I do not get gyno from E2 no matter how high it gets, but low doses of Trenbolone/Nandrolone will do me in. Although the study doesn't show Nandrolone's binding capacity, Nandrolone is the parent hormone for many progestin's used in medicine, including those in hormonal birth control.

I got a great question from member @spardaa. Sharing the response as it may come in handy for many people here: Heart health: CT scans to get calcium score and check blood flow through all the chambers/etc and an EKG to check the rhythm will give you an idea of overall heart health. CBC : Check HGB and HCT. You want HCT between 40-50%. Too low can cause low energy and endurance due to anemia. Too high (polycythemia) will make the blood to thick and make your heart work much harder to pump blood, decreases blood flow and increases the risk of high blood pressure and increase coagulation (increased risk of stroke/heart attack) Kidneys: You want GFR over 60. If you take creatine or carry a lot of muscles, sometimes this number can be artificially low. Another cause of low GFR is poor thyroid function. GFR stands for glomerular filtration rate, basically, how quickly your kidneys are filtering your blood. Lipids: Cholesterol levels are overrated and the total count is not too important, but you want to have as high HDL as possible as it has a protective effect on arterial health. AAS will low HDL, especially tren and winstrol. This is not a problem as long as you don't do it year round for long periods of time. Liver: AST/ALT under 100 is fine, again, unless this is crazy elevated for long periods, it won't be a problem. TUDCA and NAC are very effective and increasing the livers natural defenses and preventing cholestasis. This is when the bile stops flowing properly through the liver and one of the main causes of oral AAS induced liver toxicity. IGF-1: It's a good idea to keep an eye on this as you age, generally, levels above 250 are good. GH increases igf-1 which is how it works for anti-aging, well-being and muscle growth. If your levels are low, bringing them up will help you age healthy (think Sylvester Stallone; who was actually caught with about $20,000 worth of HGH in Australia) Total T/Free T: Good to keep an eye on as you age or if you are cycling off to gauge natural testosterone recovery. Ideal levels for most people are 700-1,000 ng/dL for total testosterone, the average for a normal man is 500 ng/dL and can fluctuate due to genetics, lifestyle, and/or injury to the testes. You can google a calculator to convert the number to your metric system. The higher the test level, the harder it becomes to control things like E2 (estrogen), Hematocrit (blood thickness), drops in HDL (good cholesterol) and blood pressure (you never want this higher than 135/85 mmhg for longer periods of time, it damaged the heart, kidneys, eyes, etc). Always test early morning/fasted. (between 7-9 AM) E2: Ideal level for most people is 20-42 pg/ML, important for libido, bone health, mood/well-being, and heart health. HbA1c: aka glycated hemoglobin. This measures your average blood glucose of the last 3 months. Should be between 5-5.6%. Any higher is indicative of possible pre-diabetes. Thyroid panel: TSH/Free T4/Free T3. TSH: Any TSH level over 3 should be investigated for sublinical hypothyroidism if the patient has symptoms such as fatigue, cold intolerance, mood swings/depression, and constipation. TSH is not actually a thyroid hormone but a pituitary hormone that sends a signal from the brain to the thyroid to produce more hormone. The higher the level the poorer the thyroid function, but it's not always reliable because you can have perfect TSH and extremely bad thyroid function. TSH is the LH/FSH of the thyroid. Should be tested early morning fasted to get the best baseline level as it won't be accurate taken later in the day. (between 7-9 AM). FT4 & FT3: Free T4 and Free T3 are the active thyroid hormones. Contrary to popular belief, T4 is very important and is an active hormone on it's own with it's own functions. Certain tissues and cells are better at using T4 and others prefer T3. Sometimes T3 is poorly absorbed by certain tissues and needs T4 to convert the T3 it needs. Optimal levels of Free T4 should be around 1.4-1.8 ng/dL and Free T3 3.5-4.2 pg/mL. Cutting and long diets or overtraining can lower Free T3 levels naturally by decreasing the conversion of T4 to T3, this is the bodies way of trying to conserve energy, by down regulating the metabolism.

Hey guys. Back with another AMA. Have been away and busy lately. I'd like to introduce to you @ElChapo who will be part of AMA 3.0 El Chapo is a medical professional in the US that specialises as a endocrinology research nurse. He works alongside many various endocrine patients on a daily basis. We go back a long way and he is my ONLY go to individual when I need a second opinion on performance enhancing drugs. Fire away.