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By isolating the trans-isomer, pharmaceutical developers produced a compound with a cleaner pharmacokinetic profile: enclomiphene is absorbed quickly, reaches peak plasma concentrations within two hours, and is cleared within about 24 hours, allowing for predictable daily dosing [1]

This is one of the reasons its so important to test your estrogen metabolism before starting estrogen hormone therapy

GPs cannot rely on symptoms or macrocytosis to determine which patient needs testing for B12 deficiency, nor can these clinical parameters be used for follow-up when results are low or borderline

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