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UPDATE [March 2006]

To newbies reading my post:

Just to summarize: I was first on Accutane in 2001. This course cleared up my acne & I loved my skin, but pimples began to return in 2005, so I asked for a second course. My dermatologist believes in 20-week courses, so thats what she prescribed both times.

FIRST COURSE(2001): 20 weeks [took full course]

* Suffered from moderate-severe acne

* Breakouts mostly in T zone (forehead, nose)

* Did not see signs of clearing up until very end of the 20 weeks (felt like forever)

SECOND COURSE(2005): 20 weeks prescribed [actual course was shorter]

* Return of acne, was mild-moderate

* Breakouts on cheeks (almost nothing in T zone this time)

* Cleared up very early - within first 4 weeks

SIDE EFFECTS

* Most serious/obvious: chapped lips, very dry skin, some peeling, dry scalp

* Moderate: occassional back aches & joint stiffness, often thirsty, sensitive to sun

* Mild: eczema on back of hands, some mood swings & insomnia (but unsure if Accutane-related)

WOULD I RECOMMEND FOR OTHERS?

* YES!!!

* This is the only drug that ever worked for me.

* I tried numerous OTC and prescription-strength topical treatments and antibiotics, and they all failed.

* Accutane is supposed to be a "last resort" treatment. Yes, the side effects may be uncomfortable, it's the ONLY thing that has ever worked to cure my acne and I highly recommend it. You must be willing to drink plenty of water, keep yourself in good condition physically & emotionally, and MOISTURIZE!!

My Personal Accutane Log starts here:

===========================================================

BACKGROUND Aug 29, 2005

===========

You can call me KittyK.

22 yr old female, 125lbs, moderate cystic acne

Just began my SECOND treatment of Accutane. My first course of treatment was over 4 years ago... right before I started college. No depression, no muscle problesm, no fatigue, no nose bleeds, no trouble with my contacts.. Just dry hair, lips and skin & a lot more breakouts. But the end result was beautiful -- clear skin!! If only it had lasted...

I started breaking out again somewhere about 1 year after my first treatment ended. However, it was relatively minor. I lived my life as I normally would, seeing a few pimples here and there... But recently, the large red cysts have returned to haunt me. Back to the dermatologist... antibiotics & benzoyl peroxide... didn't work (it never did, didn't expect it to this time). So here I am, back on Accutane over 4 years after my first treatment. Its the only thing thats ever worked for me, and I'm hoping it will work its magic on me once again.

This time around I'm on the generic version! (This didn't exist 4 years ago, but my insurance won't pay for the brand anymore) It's called Amnesteem, and I'm on 80mg/day (two 40mgs).

REGIMEN

========

- Two 40 mg pills of Amnesteem daily

- One or two 400 IU Vitamin E supplements daily

- Drinking AT LEAST 4 bottles (2 liters) of water a day

- Wash face 2x a day with Cetaphil face wash

- Moisturize as necessary with Cetaphil Moisturizing Lotion

- Aquaphor for the lips (a million times better than Chapstick)

And some extras:

- Complete Moisture Plus All-Purpose Contact Solution

- Blink Lubricant Eye Drops

- Neosporin + Pain Relief Creme

RESULTS TO DATE: DAY 10

====================

Not much flaking yet -- a tiny bit around the nose & lips, and a little spot in the middle of my forehead, but its all under control right now. I'm moisturizing religiously w/ Cetaphil Moisturizing Lotion but its leaving my T zone feeling a bit greasy at times. I thought I read that Cetaphil isn't greasy???? Gonna look for a better solution...

I am starting to remember how much I despised Accutane the first time around. I'm doing all that I can - using ONLY Cetaphil on my skin... keeping all the medicated stuff (benzoyl peroxide, salicylic acid) and harsh scrubs/masks away from my face... drinking TONS of water (averaging 3 liters, or 6 bottles, each day!! but not so much on weekends, i tend to forget)... taking Vitamin E... not wearing make-up... and trying soooo hard not to pick at my pimples.

But despite everything I'm doing, my skin hurts! I hate the PAINFUL cysts, the pus-filled pimples, the REDNESS, the chapped lips. Worst of all, my self-esteem is suffering. I just want to hide indoors until this treatment is over. I am too discouraged about the condition of my skin to meet new people, to speak up (dont want to attract too much attention), to go out drinking at night. I just started graduate school, so I really need to get out & meet people, get into study groups, etc. But to go from bad skin --> good skin --> bad skin is harsh. I wish I could fast forward the next 5 months. I think the current heat & humidity is aggravating my condition.

But at least I have my boyfriend -- he's unbelievably supportive. Turns out he was also on Accutane during his junior year of college. Part of me is embarassed to let him witness what I'm going through -- the cysts, the flaky skin, the oily patches. But its really reassuring to know that he loves me despite the mess on my facel AND that he knows what i'm going through cuz he has gone through it all too.

Anyway, right now, the thought of clear skin again is the only thing keeping me going... It WILL be all worth it when its over!

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Hey KittyK,

I know your pain about going to school and having to deal w/this treatment at the same time!!! I'm on day six as well, so we're around about the same stage in treatment. (I'm a 26 yr old female, 115 lbs 5'5" 40 mg/day of Claravis)

I'm not in graduate school, myself, but still a lowly undergrad! I was in the AF for about six years and then got out when my enlistment was up to stay home w/my son till he started preschool, which will be next Monday!! I've taken a few classes here and there, but am now going full time to finish up prerequisites to get into a Radiation Tech program. After I finish that, I want to get into the Radiation Therapy program and work w/cancer patients.

Anyway, to make my point finally! I know exactly how it feels to have had acne, then clear skin and then relapse into acne. I've never taken isotretinoin before, but when I was pregnant w/my son and for about a year after he was born my skin was perfect. Then, for some reason the acne slowly came creeping back. It was never severe in a clinical sense, but it is definitely moderate and I have some scarring from past experiences w/Retin-A.

Hope your journey is as successful, or more so, than the first time around! Looking forward to looking at your journal! eusa_dance.gif

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Hey Carys! I think we're already pretty damn lucky to have such a supportive boyfriend/husband, but its definitely nice being able to share experiences with others are going through the same exact thing!!

RESULTS TO DATE: DAY 11

====================

When I woke up this morning, I realized I was scratching my head. Gasp! ITCHY SCALP! What to do?? Man, Accutane really finds every way to be as much as a nuisance as possible, doesn't it?

I haven't changed my usual daily Pantene shampoo & conditiner routine (yet) cuz the last thing I want is to trade them in for some stinky tar shampoo, but hopefully the itchiness is a sign that I'm drying up. I'm actually looking forward to it (minus the itchy scalp), cuz it was wonderful being able to wash my hair every other day during the course of my first Accutane treatment. And my face could benefit from drying up --I'm not loving the slick, greasy look. I'm not sure if I'm imagining it, but I actually think my T-zone is shinier than it used to be! I'm tempted to use witch hazel to clean my face up a bit, but I'm not sure if this will be too drying, I don't want to irritate my skin.

I recently started using Neosporing + Pain Relief creme on some of the really red, painful infected spots. I don't know if this helps at all, but I guess it makes me feel like I'm DOING something rather than just sitting around waiting for Accutane/Amnesteem to kick in! After years of maximum strength topical acne treatments, it feels weird to switch to this gentle cleanser & moisturizer regimen.

SUMMARY

========

The Good

- No new pimples/cysts... old ones seem to be doing better

- No tightness of the skin yet. No dry flakes yet.

- No bloody nose yet and eyes seem to be tolerating the contacts fine.

- No muscle or joint aches.

The Bad

- Lips are dry, but manageable (thanks to Aquaphor

- Pimples are still red & still sore.

The Ugly

- New development: itchy scalp!

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I've been reading other people's Accutane logs & saw many comment about outbreaks of blackheads on their noses. I haven't noticed anything like that yet, but am getting concerned. As if cysts aren't enough?! I dabbed some Clean & Clear Invisible Blemish Treatment (contains salicylic acid) on my nose just now, in an effort to keep my pores clear there. My nose is still a pretty oily spot, so I'm not too worried about sensitivity to the salicylic acid.

Are there any good facial masks I can use while I'm on Accutane? Something that can unplug blocked pores and maybe even hydrate my face?

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Well, chances are the blackhead infestation will happen. I had zero blackheads before this stuff. Didn't bother me much because you really have to look closely at someone to see blackheads, unlike whiteheads and cysts. They do clear by themselves, so I wouldn't worry about masks or using topicals for it. It's probably a good indicator of how your accutane treatment is coming along. Think of you nose as a measuring stick. biggrin.gif

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RESULTS TO DATE: DAY 12

====================

The itchy scalp WAS a sign! I woke up today and my hair was not greasy at all. I LOVE this part of Accutane! My face is also considerably less oily than last week, but not shine-free just yet.

Also new -- extremely tired today and noticed a bit of a back ache. Not sure if these are related to Accutane. Don't want to blame everything on the drug! I just started law school & have been studying a lot... Also I think its almost THAT time of the month, which usually makes me tired & my muscles a bit sore.

Overall, my cheeks are still covered with noticeably red pimples, but they are getting better, they look like they are retreating (a vast improvement over the swelling, ready-to-burst zits I had a few days ago).

SUMMARY

========

The Good

- Oily hair is gone!! biggrin.gif

- No new pimples/cysts. Overall, skin is improving.

- No problems with extremely dry skin, flakes, itchiness, bloody nose or dry eyes.

The Bad

- Lips are dry, but still very manageable (thanks to Aquaphor)

- Thirsty! But not a problem, I love water.

- Fatigue... might be due to late night studying??

- Back ache... mighe be due to late night studying??

The Ugly

- No real complaints today smile.gif

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Hi, KittyK -

Welcome to the party! There seem to be quite a number of people just starting. . . me included (Day 6 for me). This will be my first time on Accutane, but believe me, I have been battling mild/moderate acne for half my life (I'm 24 now). I just hope (like everyone else) that the Accutane will deal the final blow and my zits will be gone forever. . . the little pimples don't bother me as much, I would be okay with that, but I, too, have been getting a lot of the huge inflammed painful zits that return once I go off any sort of oral antibiotic. . . so here I am!

I noticed that you said Cetaphil lotion made you feel greasy. I have experienced the same thing, and I know others have as well. I tried the cream last night and this morning, and it seems quite a bit less greasy i.e. I'm not all shiny, just a little bit. Of course, this could be due to the Accutane finally starting to dry me out. . . . but if you are looking for another cetaphil product to try, this might be helpful!

Looking forward to hearing about your progress! I also have a journal, in case you were interested. . .

Good luck!

- C.

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C -

Thanks for the advice! I will pick up some Cetaphil cream this weekend...

RESULTS TO DATE: DAY 13

====================

No itchy scalp yesterday morning, but itchy scalp today! confused.gif

Also I was right! Fatigue & back ache were due to my period coming. Accutane can't be blamed for ALL my discomforts...

And once again... no new pimples this morning! And the bumps have decreased to the point where I think I could even wear makeup today and look decent... but I won't! Am doing my best to stay away from any makeup until I'm really in the clear.

SUMMARY

========

The Good

- No oily hair & less shine on my face.

- Still no new pimples/cysts! Woohoo

- No problems with extremely dry skin, flakes, bloody nose or dry eyes.

The Bad

- Lips are dry, but still very manageable (thanks to Aquaphor)

- Red spots still where acne is healing...

- Itchy scalp again

The Ugly

- Still no complaints smile.gif

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RESULTS TO DATE: DAY 14

====================

Not at my best. One cyst that I picked at last week (i know i shouldnt have) is looking a bit nasty. Some days its raw and red, other days its peeling and dry... somtimes its pus-filled.. sometimes its bleeding... and sometimes a combination of all of the above. I don't even know how to treat it. I simply can't leave it alone, its gross. SIGH. I hate acne.

The rest of the face is doing alright. But your eye goes straight to the nasty spot on my cheek.

SUMMARY

========

The Good

- No itchy scalp, no oily hair & less shine on my face.

- No problems with extremely dry skin, flakes, bloody nose or dry eyes.

The Bad

- Mildly dry lips

- Some peeling/flaking

The Ugly

- One particularly nasty spot on my cheek mad.gif

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RESULTS TO DATE: DAY 18

====================

Nasty spot is MUCH better today. Overall, face is looking better. Remaining spots seem to be healing. Nothing new to report. Not sure if I had the "initial breakout" yet, but if this is as bad as it gets, I'm quite the happy camper.

Even at 80mg (same dose as first time) I'm not very dry -- my hair and face are no longer oily and I still keep the Aquaphor in my purse, but I'm not obsessively applying it. It was SO MUCH WORSE during my first course of Accutane. And my skin isn't really flaking or uncomfortable. It stung a little while I was in the sun yesterday, but very minor... I've also become quite lazy with moisturizing - I don't seem to need it. Perhaps this will convince my derm to bump up the 80mg to 100mg?? Or perhaps I could alternate between the 80mg and 100mg for an avg of 90mg. I want to get rid of this acne FOREVER. On the other hand, if I'm tolerating this dose well, maybe I should stick to it.... Got some thinking to do.

SUMMARY

========

The Good

- No itchy scalp, no oily hair & less shine on my face.

- No problems with extremely dry skin, flakes, bloody nose or dry eyes.

- No hair loss/thinning.

The Bad

- Mildly dry lips

The Ugly

- Nothing! Hope this lasts eusa_pray.gif

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RESULTS TO DATE: DAY 21

====================

Saw my derm this morning. Since we agreed that (1) I'm tolerating 80mg/day very well, and (2) its possible that my absorption of the generic (Amnesteem) is less than with Accutane, I got bumped up to 100mg/dayl! eusa_clap.gif So once I finish my 80mg/day and fill my new prescription, I will be taking 40mg with breakfast, and 60mg (one 40mg + one 20mg) with dinner.

I also asked for the cortisone shots today. I know that some people advise against this, but some of the remaining spots are just stubborn (been around for like 3 weeks) and painful. The cortisone shots really do help calm my face a bit and prevent me from doing more damage by picking, sqeezing, etc.

Also, as you can tell by the reduced frequency of my postings, I am less obsessive about the condition of my face. No major developments. One little pimple on my chest (how weird, I neverbreak out there!)... and is that a spot on my left elbow!?? But otherwise, no real complaints here.

SUMMARY

========

The Good

- Hair and skin are less oily!

- Still no major side effects (no problems with itchy scalp, extremely dry skin, bloody nose, dry eyes, hair loss/thinning)

The Bad

- Mildly dry lips

- Minor flaking

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RESULTS TO DATE: DAY 21

====================

Saw my derm this morning.  Since we agreed that (1) I'm tolerating 80mg/day very well, and (2) its possible that my absorption of the generic (Amnesteem) is less than with Accutane, I got bumped up to 100mg/dayl!  eusa_clap.gif  So once I finish my 80mg/day and fill my new prescription, I will be taking 40mg with breakfast, and 60mg (one 40mg + one 20mg) with dinner. 

I also asked for the cortisone shots today.  I know that some people advise against this, but some of the remaining spots are just stubborn (been around for like 3 weeks) and painful.  The cortisone shots really do help calm my face a bit and prevent me from doing more damage by picking, sqeezing, etc.

Also, as you can tell by the reduced frequency of my postings, I am less obsessive about the condition of my face.  No major developments.  One little pimple on my chest (how weird, I neverbreak out there!)... and is that a spot on my left elbow!??  But otherwise, no real complaints here. 

SUMMARY

========

The Good

- Hair and skin are less oily!

- Still no major side effects (no problems with itchy scalp, extremely dry skin, bloody nose, dry eyes, hair loss/thinning)

The Bad

- Mildly dry lips

- Minor flaking

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RESULTS TO DATE: DAY 24

====================

Most of my face calmed down after the cortisone shots, but I am left with two cysts on my forehead... I don't know if they weren't injected, or if they showed up after the injections, or got worse after the injections, but it sucks anyway... oh yea, and suddenly BLACKHEADS all over my nose! cry.gif

I also think I've been noticing joint stiffness lately. I don't recall having this the first time I was on Accutane, but it may be that I'm more aware of the possible side effects this time around... Its not bothering me much, but I am noticing it in the mornings.

Moisturizers. I had been getting pretty lazy about moisturizing because (1) Cetaphil Moisturizing Lotion made my face feel greasy and (2) I wasn't getting very dry and didn't really need to moisturize yet. But my skin is starting to show signs of dryness, so I tried the Cetaphil again and it is absorbing well and not feeling greasy anymore.

More supplements -- I have added fish oil and vitamin C to my regimen! I just bought Salmon Oil (the directions say to take two 1000mg softgels after breakfast and two softgels after dinner) and I replaced my Vitamin E supplements with a "Vitamin C & E" (1 softgel daily).

REGIMEN

========

- 100 mg of Amnesteem daily (40mg in the morning, 60mg at night)

- 1 Vitamin C & E softgel daily (C 500 mg + Rose Hips, E 400 IU Natural)

- 4,000mg Salmon Oil daily

- Drinking AT LEAST 4 bottles (2 liters) of water a day

- Cetaphil face wash twice a day

- Cetaphil Moisturizing Lotion

- Aquaphor for the lips

- Neosporin + Pain Relief Creme

SUMMARY

========

The Good

- I don't wake up with oily hair & skin.

- Still no major side effects (no problems with itchy scalp, extremely dry skin, bloody nose, dry eyes, hair loss/thinning)

The Bad

- Mildly dry lips

- Very minor flaking, hardly noticeable

- Joints somewhat stiff?

- Loads of blackheads on my nose

The Ugly

- Two cysts on my forehead

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Blackheads means it's working. They clear on their own, so I wouldn't worry about extracting them. It's probably best not to. My nose is almost blackhead free and smooth without even exfoliating. I've noticed that cysts don't always respond to the shots and they have to be injected more than once. But then you really risk depressions forming. A cyst for a few weeks is better than a permanent depression though.

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So do you have to pay extra for the cortisone shots or is it covered w/your insurance? I'm seeing a GP, so no cool shots for me!

I'm getting the blackheads, too. They suck, but fortunately you can't see them when I'm wearing makeup!!!

I'm loving the non-oilyness as well and am finding Cetaphil to be completely non-greasy at the moment. About a minute after putting it on, it's completely absorbed into my skin! LOVE IT!

Sounds like you're tolerating your dosage well. I'm due to go back for my 1 month appt on the 19th and I hope my doc will up my dosage to at least 80 mg/day (I'm on 40 right now).

Keep us posted! smile.gif

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So do you have to pay extra for the cortisone shots or is it covered w/your insurance?  I'm seeing a GP, so no cool shots for me! 

I'm getting the blackheads, too.  They suck, but fortunately you can't see them when I'm wearing makeup!!! 

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RESULTS TO DATE: DAY 27

====================

I'm almost afraid to say it but... no new zits! eusa_dance.gif

Still some blackheads and some red marks, but everything seems to be on its way out. The cysts on my forehead last week are gone, just a slightly pink mark remaining. Hooray! No complaints about side effects, other than some stiffness in the joints and soreness in my back. I can live with that biggrin.gif

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Hello!

I'm on day 21 (3 weeks done - hooray!), and I've got a massive army of blackheads. . . From your experience, when do they go away? I'm trying to be patient. . .

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Don't hold me to this, but I think the blackheads leave on their own around the second month.

That's what I'm hoping anyway! eusa_pray.gif

Recently, out of nowhere, my boyfriend commented that my skin is looking much better already (and no, i didn't ask him or mention anything related to my skin or Accutane). I thought so myself, but its nice to hear it from someone else sometimes.

My only concern now is that I'm STILL not really drying up... Could it be the difference between Amnessteem vs. Accutane? I'm on 100mg of Amnesteem right now; I was only on 80mg of Accutane the entire time. Same weight. I was so dry all the time and flaking everywhere last time I was on Accutane. Well anyway, I'm seeing results much faster this time. I don't think I had any improvements until the very end (around the fourth month) during my first course of Accutane.

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GUILT

I have to admit that I've been popping some pimples up till now. I just can't handle going out with pus-filled bumps all over my face. I know, I know, its bad. eusa_wall.gif

After a shower, I use a warm washcloth and use very gentle pressure to coax the pus out of the pimple. I don't squeeze, it usually doesn't take much pressure, if nothing comes out I leave it alone. Otherwise, the zit is drained, I dab on some Neosporin, and this allows me to go about and face the world.

So far, no scars.

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RESULTS TO DATE: DAY 28

====================

I looked in the mirror very carefully... NO ZITS!! eusa_dance.gifeusa_dance.gifeusa_dance.gif

My face is far from being totally clear yet, there are red marks that are still healing and such, but its free of bumps and a vast improvement from a month ago. Don't worry, I realize that Accutane course is a rollercoaster ride, so I'm prepared to see some more ups & downs, but I am glad that I decided to do this once again. Whatever stage you're at, don't get discouraged, this is definitely worth it.

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GUILT

I have to admit that I've been popping some pimples up till now.  I just can't handle going out with pus-filled bumps all over my face.  I know, I know, its bad.  eusa_wall.gif

After a shower, I use a warm washcloth and use very gentle pressure to coax the pus out of the pimple.  I don't squeeze, it usually doesn't take much pressure, if nothing comes out I leave it alone.  Otherwise, the zit is drained, I dab on some Neosporin, and this allows me to go about and face the world. 

So far, no scars.

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Hello, fellow poppers!

I'm guilty, so very guilty, of the same offense. . . just poped one today, as a matter of fact!

But I follow the same gentle technique, and I know when to stop. . . I'd just rather have a big red mark than a sac of pus on my face. . . I've had no scarring yet, either. . . I think we're okay, right?!

But congratulations on being clear! I also have no active zits on my face, just the remains of a few that I've popped in the last couple days - this will probably change, though - I can see a few trouble spots that might be brewing something nasty. . .

And the blackheads - they are going away too (maybe because I extracted them?).

Hope things are still going well!

- C.

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RESULTS TO DATE: DAY 30

====================

I still find it so hard to believe that the Amnesteem has gotten my acne under control in only ~30 days, but its true! No active pimples, just red marks healing... blackheads seem to be getting better on their own, but to speed things up, I've been dabbing on a little Clean & Clear Maximum Strength Invisible Blemish Treatment (2.0% Salicylic Acid) onto my nose after I shower. My nose doesn't feel quite so sandpaper-ish as last week.

I've been feeling so good about myself I even put on some makeup & went out to the bars on Friday , danced a bit and had a few drinks with my friends. eusa_dance.gifeusa_dance.gifeusa_dance.gif Last night, I went out for steak and then we met up with friends at a lounge/pool hall and had a great time. Woohooo, my desire to have a social life is returning!

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RESULTS TO DATE: DAY 32 (Week #5)

====================

Things are good. Side effects are minimal.

I wonder if its possible to go over 100mg/day??!

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