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Normal serum total T levels were attained in all patients in all BMI categories ( Fig. 3 ). The median dose of SC T required to attain serum T levels within the normal range (75/80 mg) did not differ among patients with BMI in the normal, overweight, or obese WHO BMI categories ( P = 0.69 by Kruskal-Wallis). Similarly, there was no relationship between BMI and T dose among patients at the dose giving normal male serum T levels ( ρ = 0.20; P = 0.11; n = 63). Serum free T concentrations did not differ significantly between WHO BMI categories ( P = 0.92 by ANOVA). Serum total T, however, differed across normal [754 (217) ng/dL, n = 26], overweight [765 (220) ng/dL, n = 14], and obese [606 (169) ng/dL, n = 23] BMI categories ( P = 0.021 by ANOVA). In post hoc analysis, the difference in total serum T between normal and obese groups was statistically but not clinically significant ( P = 0.04).

Figure 3.
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Optimized doses of SC T in patients according to BMI. SC T injections were effective across the broad range of BMI values encountered in our patients. No effect of BMI on dosing requirements was observed. The bars indicate mean values. Note that patients administered a dose of 75 mg were combined with patients administered a dose of 80 mg for this graph.

Figure 3.
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Optimized doses of SC T in patients according to BMI. SC T injections were effective across the broad range of BMI values encountered in our patients. No effect of BMI on dosing requirements was observed. The bars indicate mean values. Note that patients administered a dose of 75 mg were combined with patients administered a dose of 80 mg for this graph.

Surveys administered to patients who had previously received IM T prior to SC demonstrated that after initiating SC therapy, all 22 preferred SC injections; two had a mild preference and 20 a marked preference for SC injections. No patients were neutral or expressed a preference for IM injections.

There were 10 site reactions reported by 9 patients. Four patients reported a small nodule at the site of injection that occurred intermittently or consistently, resolved in 1 to 2 days, and was not bothersome. Two patients reported that a small area of urticaria appeared at the injection site several hours after each injection and persisted for 2 to 3 days. Two patients reported some transient inflammation at the injection site, one of whom later experienced a single episode of cellulitis that resolved without therapy. There were no other local or systemic adverse effects.

Acne emerged in 37 of our 63 patients and was usually mild. In only two patients was the degree of acne sufficient to prompt referral to a dermatologist. No patients opted to decrease their T dose on the basis of the acne. None of our patients, including those who had undergone ovariectomy, experienced vasomotor symptoms while receiving T therapy.

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Brenda says

Ugh I wish you would do more research and rewrite this article. Up to 60% of people have a methylation issue and can not process the synthetic cyanocobalamin that food is fortified with. It actually causes more problems. Also advise to people to get a blood test results in a false negative with this part of the population. I test that I have too much which perplexes the doctors as I’m vegan. My first test was prior to me eating vegan. My mother eats meat and lots of eggs and her test results are the same too. This is because this fake vitamin cyanocobalamin is floating around unused in our blood stream. There is study I guess you missed that supplementation with nutritional yeast corrected the b12 deficiency in a group of raw foodest. There is more updated news in these comments than in your article. This is a horrible and eventually fatal imo so people need the truth.

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alia says

So i was diagnosed with a b12 deficiency of 90, i had tingling, numbness in my leg hand, heart palpitattions. I have had 5 i injections yet in 2 weeks. I dont think I am getting better. How much time does it take? Also, since i have been taking my mecobalamine shots my heart palpitations have increased and i cant sleep properly. Please tell if it will get better!

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B12 uses up minerals, perhaps potassium, magnesium, and possibly calcium are needed? I take 2,000mg potassium daily in 4 doses and all heart issues stopped. Occasionally I need more. If you choose to try minerals, start low like with 300mg in the morning and evening. See if it helps.

Magnesium may also help, I take it as well. Start with a low dose like 100-200mg in morning and evening and see if it helps. You can take more as needed. I do not take calcium because I eat a lot of raw cheese which has a lot of bioavailable calcium in it. Best Wishes.

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Em says

Molly, I am sincerely worried for your health. (I don’t know where you have been receiving your information.) 1. Unlike sodium, magnesium is a scientifically PROVEN cause of hypertension, and a very, very, very minuscule number of people in the world would need to take magnesium supplements. Most (if not all) of these people would need to NOT use the supplements for an extended amount of time. … The popular belief that salt causes hypertension is based on a correlation, NOT a causation. 2. The 2,000 milligrams of potassium is an enormous amount to be taking daily. 3. From the numerous medical journals I have read, (unless a person has an EXTREMELY rare contrition or are severely anorexic/bulimic), the only supplements that can be taken daily without severe side effects are B- vitamins (and B-12 can safely be taken in extremely high doses). Also (from what I have read so far), the only mineral supplement that people may need to take OCCASIONALLY is zinc. (THE ALL CAPS IS FOR EMPHASIS, I AM NOT YELLING AT YOU.)

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