Steroids Tren Cough "The exact reasons why is right here" ~Backed with clinical studies~ FYI - This can happen with any OIL

[Vision]

Tren Cough "The exact reasons why is right here"

It's actually called POME, "Pulmonary Oil Microbolism".. Also - Trenbolone increases the rise of prostaglandin production

Scroll down and read #1) at bottom, this explains Tren vs other oils

Tren Cough "The exact reasons why is right here"
Trenbolone or even any Injection cough can very well be explained ~Backed with clinical studies~

The 1st portion of this topic is my very own (Vision's) interpretation & detailed explanation on why some users may experience coughing upon injection of any oils.
Time and time again we see threads and topics containing questions & concerns about Tren cough or Post injection cough, but what exactly is it?
For some it seems to be a phenomenon in the world of PED use and some people could not come up with a definitive answer or reasonable explanation other than “You must have entered the blood stream with your oil“, or other times we see people posting ideas and theories all the while failing to provide any conclusive evidence.

Right here today we are going to review what exactly is taking place inside your body & respiratory system post injection.

Let's keep in mind that some people may very well be misinformed about this cough, at the same times others having a keen understanding of its mechanisms of action. So let's treat this as a refresher for all.
For myself I've experienced “coughing and struggling to breath” numerous times and not just from Trenbolone , furthermore I’ve experienced this with Testosterone with a IM "intramuscular Injections" injection..

Ok, now why does this take place and what is the causes and can this be avoided at all?
So, there’s a few variables that could be happening here in regards to the symptoms that someone may feel almost immediately post injection.. Some ranging from difficulties breathing, to mild or violent coughing fits, eyes watering, mild to extreme flush feeling and red of the face, feeling dizzy/faint, pressure in the chest, so on and so on.

Here's the scary part - this can actually last anywhere from 1-5 minutes and at times 5-10 mins in some cases.. In very rare instances there has been reports of it lasting up to 24-48 hrs with random coughing bouts.
I often hear people advocate that it’s the acetate ester only and others say it's mostly with potent trenbolone and that bunk trenbolone won't do this..

This is very far from the truth, however there's some traits here that bind this to such theories and understandably so.
However, this very well can happen with just about any compound regardless of the ester or parenting hormone..

What is the real initial cause of this?
Prior I stated that there’s many factors in which you could experience this. I’ll begin with the most common one and this is known as POME..

What's POME?
Pulmonary oil microembolism. It’s simply a case of acute respiratory distress/hypoxemia,
following the accidental intravenous injection of an oil steroid solution (Info about this is attached to one of the studies below in blue)..
The oily solution is carried through the blood stream tracking its way to the lungs in which the reaction of coughing is simply your bodies way of clearing it out.. This can be quite violent and very discomforting..
I had it happen with Test. It can happen with any injection.

With regards to "solution", Benzyl Benzoate/Benzyl alcohol is found present in MOST products especially UGL's

This is actually an other agent that is known for causing respiratory distress in many users..
This is a temporary acute onset of “Anaphylaxis” (Read study about this)..

Ok, can I avoid this at all?
Yes to a degree, however injection sites will vary with immune response, some areas have a heavy mapping system with veins and vessels....
Ranging from Pulmonary. pulmonary vessels are arteries that transport oxygen-poor blood from the heart’s right ventricle to the lungs. These Pulmonary veins will transport oxygen-rich blood back to the heart.

Systemic. The systemic vessels are arteries that carry oxygen-rich blood from the heart’s left ventricle to the tissues in all parts of the body. These then return oxygen-poor blood through the veins back to the heart.

#1)
Why does this seem to happen most with Trenbolone?
This is what everyone want's to know.. Hmmmm - Trenbolone increases the rise of prostaglandin production which can have great influence over bronchial constriction. Stay with me here..

What are prostaglandins?
There group of hormone like lipid compounds cells that are derived enzymatically from fatty acids that're precursors of Cyclooxygenase and Lipoxygenase.

Lipoxygenase has some dictation through pathways which is expressed through branches of bronchi, in the entire respiratory system.. When the Cox-2 lipo levels increase it tends to have restriction or expulsion in the respiratory region..Thus, this is what dictates the Tren cough.
This tends to happen more with the Ace ester as it cause a faster metabolization and a faster rise with the prostaglandin levels!

Below are some studies that may help explain in better detail for those that wish to geek-out, enjoy

Vision (Team PSL)

 

[Vision]

Bonus material about other oils and solvents.

Studies below:

Pulmonary Oil Microembolism (POME) and Anaphylaxis in Controlled Clinical Studies
Medical Editor: John P. Cunha, DO, FACOEP

Adverse events attributable to pulmonary oil microembolism and anaphylaxiswere reported in a small number of patients in controlled clinical trials. In the 84-week clinical trial of Aveed, 1 patient experienced a mild coughing fit lasting 10 minutes after his third injection, which was retrospectively attributed to POME. In another clinical trial of intramuscular testosterone undecanoate (1000 mg), a hypogonadal male patient experienced the urge to cough and respiratory distress at 1 minute after his tenth injection, which was also retrospectively attributed to POME.
During a review that involved adjudication of all cases meeting specific criteria, 9 POME events in 8 patients and 2 events of anaphylaxis among 3,556 patients treated with intramuscular testosterone undecanoate in 18 clinical trials were judged to have occurred.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of Aveed. Because the reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Pulmonary Oil Microembolism (POME) and Anaphylaxis
Serious pulmonary oil microembolism (POME) reactions, involving cough, urge to cough, dyspnea, hyperhidrosis, throat tightening, chest pain, dizziness, andsyncope, have been reported to occur during or immediately after the injection of intramuscular testosterone undecanoate 1000 mg (4 mL) in post-approval use outside the United States. The majority of these events lasted a few minutes and resolved with supportive measures; however, some lasted up to several hours and some required emergency care and/or hospitalization.
In addition to serious POME reactions, episodes of anaphylaxis, including life-threatening reactions, have also been reported to occur following the injection of intramuscular testosterone undecanoate in post-approval use outside of the United States.

Both serious POME reactions and anaphylaxis have been reported to occur after any injection of testosterone undecanoate during the course of therapy, including after the first dose.

An other studyCase Reports in MedicineVolume 2012 (2012), Article ID 384054, 3 pages
http://dx.doi.org/10.1155/2012/384054
Anaphylaxis Triggered by Benzyl Benzoate

Abstract
We report the first case of an anaphylactic reaction to Reandron 1000 (depot testosterone undecanoate with a castor oil and benzyl benzoate vehicle). While considered to have a favourable safety profile,
serious complications such as oil embolism and anaphylaxis can occur. In our patient, skin testing identified benzyl benzoate to be the trigger, with no reaction to castor oil or testosterone undecanoate components.
As benzyl benzoate exists in multiple pharmaceuticals, foods, and cosmetics, individual components of pharmaceuticals should be tested when investigating drug allergies.
Doctors should be alert to the potential for serious reactions to any of the components of Reandron 1000.1.
Introduction
In men requiring testosterone therapy, depot testosterone undecanoate (TU) is a useful option.
Compared to conventional testosterone esters, depot TU maintains adequate testosterone levels with less frequent injections and has better pharmacokinetics.
Specifically, depot TU comparatively achieves higher trough serum testosterone concentrations without the wide variation between peak and trough levels between doses [1].
TU was initially developed in the 1970s as an oral testosterone replacement preparation, with a transdermal patch available in the 1990s [1]. In China, a depot TU preparation with a Chinese teaseed oil vehicle was manufactured for intramuscular use and found to have a long half-life of 21 days,
longer than conventionally used testosterone esters [2, 3]. Depot TU is currently marketed with a castor oil and benzyl benzoate vehicle [4], as the castor oil affords an even longer half-life (33.9 days) than the original Chinese depot preparation [2,5].The long-term overall safety profile of depot TU has been generally favourable [6, 7].
Anaphylaxis to depot TU has not been specifically reported although hypersensitivity is listed as an uncommon adverse effect in the manufacturer’s product information [4].
Hypersensitivity reactions have not been described in cohorts who have used this preparation from 4 to 8 years.Here, we report the first documented case of anaphylaxis to Reandron 1000, a depot preparation of TU.
This case is notable for the fact that the responsible agent was not the main active ingredient.2.

Case Presentation

A 16-year-old boy with primary hypogonadism due to bilaterally absent testes,
but otherwise without remarkable medical history, was converted from monthly intramuscular injections of testosterone esters (Sustanon, Schering-Plough) to depot testosterone undecanoate (Reandron 1000, Bayer) due to debilitating fluctuations in mood and energy levels.
There was significant improvement in symptoms on the depot preparation.Within four minutes after his third dose was administered, he developed sweatiness, facial swelling, itching, urticaria and
sensation of throat obstruction with chest tightness. He was normotensive without tachycardia.
He was treated with intravenous promethazine and hydrocortisone 250 mg and observed in an emergency department. Adrenaline (epinephrine) was not administered. The differential diagnosis of oil embolism was not pursued in view of the classical clinical features of anaphylaxis.
A skin prick test found definite reaction to Reandron 1000 with a 10 × 8 mm wheal, but no reaction to testosterone esters gel or saline solution control. Testing of the components of Reandron 1000 found that non-skin-irritating concentrations of benzyl benzoate resulted in a 10 × 10 mm wheal and smaller peripheral lesions.
Neither castor oil nor TU induced a response.
His father was tested as a control and did not react to any of the components.Since discontinuation of Reandron 1000, the patient has used topical testosterone ester gel and crystalline testosterone pellets were implanted subcutaneously.
There have been no further episodes of anaphylaxis.3.

Discussion
We report a case of anaphylaxis to a depot preparation of TU comprising three components.
Testing of each component identified benzyl benzoate as the likely trigger and demonstrates the importance of testing every component when investigating and managing medication-related anaphylaxis.
Neither Reandron 1000 nor benzyl benzoate has been previously reported as a trigger for anaphylaxis.Excipients are the components of pharmaceuticals apart from the active substance.
They fulfil a variety of different roles including colouring, flavouring, and alteration of the stability, solubility, durability, or permeability of the active ingredient.
These agents are capable of inducing severe adverse drug reactions, particularly in the paediatric population [8]. Immunologically mediated hypersensitivity reactions can manifest as immediate (within 1 hour) onset of urticaria, angioedema, or anaphylaxis. Alternatively, there can be a delayed (>1 hour) onset of mostly cutaneous symptoms which,
as in Stevens-Johnson syndrome, can still be severe [9]. In Reandron 1000, the excipient agents are benzyl benzoate and castor oil, while the active ingredient is TU.Benzyl benzoate (chemical formula C14H12O2) is a colourless oily liquid which is rapidly metabolised by the body to benzoic acid and benzyl alcohol [10].
The agent is widely used as an additive in many different pharmaceutical and nonpharmaceutical products for human consumption.
For instance, it is used as a preservative, a solvent in perfumes, a flavouring agent in foods and medications,
and in insecticides and insect repellents [10, 11]. In oil-based vehicles for depot steroids, it lowers viscosity to improve ease of administration [12] and prevents crystallisation of steroids during storage.

In testosterone preparations, it is also found in testosterone cypionate (Depo-Testosterone,
Pharmacia) but not testosterone esters (Sustanon) or testosterone gel.In its role as a topical insecticide for scabies, benzyl benzoate is applied in a diluted solution with a concentration between 10% and 25%.
It is known to cause skin irritation and contact dermatitis in this context,
but hypersensitivity reactions have not been recorded in existing studies.
No information is available as to whether or not benzyl benzoate possesses the intrinsic ability to induce mast cell degranulation.
Databases for adverse reactions have also identified convulsions occurring with ingested benzyl benzoate [10, 14].Although not previously reported,
hypersensitivity reactions to benzyl benzoate are unlikely to be isolated to our patient.
Its presence in numerous consumer products raises the possibility of underreporting due to lack of awareness and failure to identify it as the trigger.
Existing guidelines by the British Society for Allergy and Clinical Immunology [15] recommend skin prick testing if a compatible history of IgE-mediated drug hypersensitivity exists.
In our patient, signs and symptoms of anaphylaxis to testosterone therapy and the clinical need for ongoing testosterone therapy warranted such investigation.
Although intuitive and in common practice, there are no specific recommendations regarding testing of individual components of pharmaceutical preparations in either British or Australian [16] guidelines.
In our patient, discovery of a reaction to a single component of the depot vehicle will better guide selection of testosterone replacement therapies.

It will also allow him to remain vigilant to benzyl-benzoate-containing products.
Castor oil has been used as a vehicle for steroid hormones for decades, prolonging their effect compared to equivalent aqueous suspensions by increasing storage in fatty depots in the body [12].
While there have been no reports of anaphylaxis to castor oil, sudden onset of respiratory symptoms can signify oil-related pulmonary microembolism after entry via the lymphatic or venous system. This complication is rare [17].
In this case, our patient received supportive care for anaphylaxis with antihistamines and glucocorticoids. The immediate management of anaphylaxis is not guided by randomised placebo-controlled trials which are unethical due to the potential for rapid progression to fatality arising from delay of treatment. The use of adrenaline (epinephrine) is widespread and recommended in multiple guidelines as first-line therapy based upon results of uncontrolled studies [18].
However, recommendations for use of adjunctive agents such as antihistamines and glucocorticoids are more heterogeneous. The use of H1-antagonists as a first-line agent is not recommended, as they are of slow onset, fail to relieve bronchospasm or gastrointestinal symptoms, and have anticholinergic effects which can induce drowsiness and confuse the clinical picture in a critically ill patient [19].
Similarly, glucocorticoids do not acutely relieve symptoms but prevent prolonged or biphasic symptoms of anaphylaxis [18]. These agents are best used in conjunction with, rather than in place of adrenaline.4.

Conclusion
Anaphylactic reactions can occur to the benzyl benzoate component of depot preparations of testosterone undecanoate.
It is potentially unrecognised or can be misdiagnosed as oil embolism and underreported.
Testing for reactions to the individual components of pharmaceutical agents may prevent inappropriate exclusion of all available preparations of a particular agent if it is the vehicle rather than the active ingredient that is causative.
Similarly, it will alert the patient to risk of hypersensitivity to unrelated products which may utilise the same agent. Doctors should remain aware of the potential for serious reactions to testosterone replacement therapies and should consider appropriate further investigation.Conflict of Interests
There is no conflict of interests that could be perceived as prejudicing the impartiality of the research reported.
This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit
sector.

 

[GHgut4life]

Tren cough is easy to fix with cardarine gw501516

 

[CEO]

bros tren cough easy to combat with cardarine

 

[ROIDDERS]

tren cough nothing with cardarine

 

[QuadSweep]

run cardarine gw no tren cough

 

[Ulter]

gw+tren = no cough

 

[e2]

trenbolone cough is legit i did albuterol for it

 

[2Thick]

albuterol? why? just use cardarine

 

[MONSTRO]

trenbolone cough aka tren cough needs both albuterol and cardarine for mitigation

 

[StevenDarwinMD]

APPROVED ARTICLE

APPROVED SOURCE - PLS (PuritySourceLabs)

 

[Mobster]

The guys have you covered.

 

[Vadim Fedorov]

important write up, recommend

 

[Tiger Salman Khan]

Good info shared........

 

[Tazz]

Interesting info