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It was shown that stimulation of PKC led to enhanced StAR expression and progesterone secretion in Leydig and granulosa cells (Figure 2) (121, 122)

If you have dosed consistently through a fair trial window and genuinely see nothing, that is a reason to talk to your provider, not a reason to quietly increase the dose

You can tilt the vial gently if needed, but shaking is not recommended

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The 2025 systematic review noted that despite increasing clinical use, this level of evidence does not yet exist