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Steroid nasal sprays are different to the anabolic steroids used by athletes and body builders to improve their performance. Thus, alcohol metabolism destroys the essential coenzyme required for T synthesis. As a result, the treating team chose to trial anabolic steroids as an adjunct to standard care.
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Some steroid abuses use pyramidding - starting with low doses and building up over days or weeks to a peak dose and then tailing off.
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