Im gonna order more gel and up my gel dose and lower the oral E...
Its expensive though.... REALLY want IM injections or pellets
Based on the preponderance of evidence, smokers are likely to require higher doses of hormone replacement therapy (HRT) to achieve comparable clinical effect to that observed in nonsmokers. However, uptitrating the dose of HRT in smokers to achieve a desired systemic level or clinical response may simultaneously increase risk for adverse effects that are primarily driven by hepatic rather than systemic exposure.
http://www.ncbi.nlm.nih.gov/pubmed/14973414
Its expensive though.... REALLY want IM injections or pellets
Based on the preponderance of evidence, smokers are likely to require higher doses of hormone replacement therapy (HRT) to achieve comparable clinical effect to that observed in nonsmokers. However, uptitrating the dose of HRT in smokers to achieve a desired systemic level or clinical response may simultaneously increase risk for adverse effects that are primarily driven by hepatic rather than systemic exposure.
http://www.ncbi.nlm.nih.gov/pubmed/14973414