Any thoughts on these PCT protocols:
First theory:
Dr G 5
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I hope everyone had a great weekend and is working hard in the gym. A question was posted this week about the whether it is better to essentially blast and cruise or to let your natural test production to return in between cycles. I think it is a very question that would benefit a large number of members here. It really all depends on what your goals are and that is because someone that aspires to be a bodybuilder on a very high level probably just doesn't ever come off. It is a true fact and i have many patients at that level and they just don't. It is what it is. Doesn't
make it right and i always warn them and discuss with them the risks they are taking but it is no different than riding a motorcycle without a helmet or smoking. Everybody knows the possible side effects, but i am not here to judge them. For the rest of the population i think coming off completely and lets your body come to homeostasis as long as you have the ability to produce natural test decent levels. Some of you guys just may not know and may be wise to come off during your next cycle and after a proper PCT check your natural test after 30 days. If your total test is over 500, preferably 600 then no reason to "cruise" and would benefit you to stay at that level, concentrate at working out, proper diet, and allow other labs such as liver enzymes, lipid profiles come back to where they should be normally. Now on the other hand, if your body's natural test level is under 500, then you basically quality for TRT anyways so when you come off your cycle you should go on a true TRT dose. And i see way too many people that are doing 250mg a week etc, and sorry to say but this is not a TRT dose and your test levels will be or should be way over 1100 with that dosage assuming you are using good and true test cypionate or enanthate. So if you are someone that either due to age or history of AAS usage that your natural test levels are so low anyways then i would advise transitioning to a TRT dosage of test to make sure that the crash is not severe and soft in nature.
I also like to address a proper PCT at least in my opinion. There are many different ways that a PCT is done and can be done but i think here is one best way. Recently i have been using Triptorelin for my patients along with toremifene and clomid. I don't use or recommend HCG when using triptorelin cause those two don't work so well together because the test spike from HCG by itself can further delay or halt the production of test that triptorelin is trying to achieve. If triptorelin was not being used then HCG definitely should come in to play at very low dosages as in 150-200iu three times a week. But assuming you have your triptorelin, tore and clomid in hand then this is how my PCT should be done:
1) SubQ injection of triptorelin 100mcg after most of the last and longest acting AAS is out of your system. For example, if you are only on tren A and test propionate then you can safely inject the triptorelin 4 days after the last dose. But if you are on tren, test enanthate and deca then you have to wait 3-4 weeks after your last dose to inject triptorelin. Injecting triptorelin too early when AAS levels are still high can make its use pretty ineffective. Once you have injected the triptorelin, i advise my patients for the first two weeks to take 100-120mg of toremifene split
twice a day along with 50mg of Clomid twice a day. For week three, reduce toremifene by half total daily dosage and still split twice a day and reduce clomid to 50mg once a day. For the fourth week, reduce the toremifene to 25-30mg daily once a day and clomid 50mg once a day to finish out the 4th week. This is the best chance to give your body to bring it to its natural test production levels. At this point, you need to wait 30 days before testing your total test levels. Testing right after you come off clomid or tore will give false results.
I hope the above helps everybody in their future planning and PCT protocol. Please continue to ask questions and like, bump or quote questions that you like to see answered. Thanks again.
Dr. G.
Second theory from another site and studies:
PCT Info
Post Cycle Therapy is an important part of an AAS cycle. The purpose is to assist the body to more quickly bring back production of FSH, LH and therefore Testosterone. PCT should be started after all compounds have cleared. For test enanthate, the typical recommendation is to wait two weeks. For cycles with equipoise (EQ) which is active for ~15 days, PCT shouldn't be started for 4-6 weeks after dropping the EQ (most continue to run test during this time).
PCT Protocols by Cycle Length
In general, the longer that you have been on cycle and not producing your own natural Test, the greater precaution you should take in your PCT.
When something is written as "X/X/Y/Y", think of it as Week 1 daily dose/Week 2 daily dose/Week 3 daily dose/Week 4 daily dose.
Short ( less than 13 weeks )
Pick one:
•Nolvadex 40/40/20/20
•Toremifine 90/60/60/30
For a simple and short cycle, a single compound PCT should suffice.
Medium ( 13 to 20 weeks )
Pick one:
•Nolvadex 40/40/20/20
•Toremifine 90/60/60/30
One may also consider running HCG for a cycle of this length, however it is not required. If the cycle in question used more than three or four compounds it may be worth running the nolvadex at 40mg/ED during the third week instead of lowering the dose to 20mg/ED. Adjust dosing based on results.
Long ( more than 20 weeks )
Pick one:
•Nolvadex 40/40/20/20/20/20 + Clomid 50/50/25/25 + HCG
•Toremifine 120/90/90/60/30/30 + HCG
The addition of clomid will help recovery from longer cycles. One should be cautious with clomid as it has been known to have certain undesirable side effects such as extreme mood swings, blurry vision, or loss of night vision. Anecdotal evidence claim that higher doses of toremifine is more than enough to match the nolvadex+clomid combination, however both nolvadex and clomid are much more commonly used. The inclusion of HCG is to assist recovery of the testes to natural size. Recovery from shut down is theorized to not only be based on how long you were shut down, but how much testicular atrophy has affected the testes. When atrophied, the testes must regrow the receptors needed for natural function. For more information, check out this thread:
Post Blast and Cruise Recovery
Power PCT by Michael Scally (former) M.D.
•2500 IU HCG EOD
•Nolvadex 20/20/20/20/20/20
•Clomid 100/100/100/100
NOTE: Clomid and HCG dosings are extremely high, 50mg clomid should be the upper limit as you should never need more. Blasting high doses of HCG could lead to desensitization of receptors.
The above is a documented and approved PCT plan by former Dr. Scally. This can be found in Anabolics 10th Edition by William Llewellyn.
Triptorelin route
•Triptorelin 50-100mcg injected intra-muscularly ONCE
Pick one:
•Nolvadex 20/20/10/10
•Toremifine 30/30/15/15
The reason for the nolvadex or toremifine is to prevent the estrogen rebound that is common with triptorelin, one may also use an AI such as armidex or aromasin.
Doctor recommended PCT (TRT Clinic)
/u/DeludedOldMan's TRT doctor recommend this plan when coming off a 9-month cruise:
Weeks 1-2 (last 2 weeks of injecting test)
•Test C/E (normal TRT dose)
•400IU HCG E3D
•50mg Clomid EOD
Weeks 3-4
•400IU HCG E3D
•50mg Clomid EOD
Weeks 5 - 6
•50mg Clomid EOD
Week 7-8
•50mg Clomid E3D
NOTE: Switching to a short ester test base such as propionate would be better than using enanthate or cypionate in the first two weeks of the above plan. Also, HCG is not needed for four weeks straight, instead should be run for one week, either week 2 or 3 at 200IU/E3D.
PCT for Women
Michael Scally (former) M.D.'s thoughts:
In the case of pre-menopausal females, tapering the anabolic-androgenic steroids (AAS) would be the best treatment. Anabolic steroid administration, like males, causes the HPGA to shutdown. However, stopping the AAS will produce menopausal like symptoms, therefore tapering until menses returns is best. The labs follicle stimulating hormone (FSH), luteneizing hormone (LH), progesterone (P) and estradiol (E2) will be the best indicator. They will show if the HPGA is affected adversely. In marked contrast to a man, the period typically returns within 1-2 months and will occur while tapering.
I would NOT suggest “selective estrogen receptor modulators” (SERMs) or aromatase inhibitors (AIs) for a woman! NEVER! It is the equivalency of forcing them into menopausal symptoms. The HPGA/HPTA are very different. In fact, SERM/AI (such as Nolvadex and Arimidex) are used in Breast Cancer, which includes a significant number of adverse effects. Decreasing E2 in a man is far different from doing the same in a female. E2 and P are the main female hormones. Just imagine how a man feels that receives Androgen Deprivation Therapy (ADT) for Prostate Cancer.
FAQs
Mechanism by which Nolvadex works.
While the literature is scant in this field, a recent paper has shed some light on this mechanism.
jcem.endojournals.org/content/90/1/211.long
SERMs
The most common class of compounds used for PCT are called SERMS or Specific Estrogen Receptor Modulators. An example is Clomid (clomiphene), which interacts with the estrogen receptors in the hypothalamus in such a way as to reduce the inhibitory effect of estrogen on the hypothalamic output. This leads to increased LH secretion and therefore testosterone production. No two SERMs act exactly the same, there are pros and cons to each (clomid, nolvadex, toremifine, etc) For example, nolvadex has the ability to block estrogen receptors, preventing estrogen from binding.
•http://www.ergo-log.com/nolvabest.html
•http://brazjurol.com.br/july_august_2012/DaRos_512_518.htm
•http://jcem.endojournals.org/content/90/1/211.long
HCG (Human Chorionic Gonadotrophin) and HMG (Human Menopausal Gonadotropin)
HCG is a popular ancillary for both PCT and on-cycle support. HCG works by stimulating the testicles directly in a manner similar to how the luteinizing hormone does as HCG is a synthetic analog. A small amount of HCG will stimulate the Leydig cells to produce testosterone, but too much will desensitize the Leydig cells. Due to this, it is generally considered bad practice to "blast" high doses of HCG when coming off. HCG is also effective for increasing testosterone when off-cycle.
•http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360778/pdf/postmedj00085-0047.pdf
Using HCG or HMG
A reasonable dosing for both is 2000 IU/week, so something along the lines of 500 IU 4x/week would work. Another method is to dose 250 IU ED. There's little harm in going over the 2000 IU mark, however keep in mind one may experience diminishing returns after a certain point.
/u/DeludedOldMan has said his TRT doctor recommends dosing HCG as such (800IU/week):
Day 1 Test/AAS compounds Day 3 HCG 400IU Day 4 Test/AAS compounds Day 7 HCG 400IU
NOTE: 200-250IU is also an effective dose, 400IU is not necessary.
HMG vs HCG
HMG is very similar to HCG, the key difference being that HCG acts as a synthetic LH (luteinizing hormone). hMG contains the real hormones the body produces, because of this it can stimulate the testes without risk of desensitizing the testes to LH. For this reason, if using hMG or HCG long term, hMG would be the safer option.
How to use HCG in conjunction with PCT:
Starting from the last three weeks of your cycle for short esters, 2 weeks for long esters:
Weeks 1-4: 500iu E3D or twice a week Weeks 5-xx: Start PCT, discontiune HCG use
Triptorelin/GnRH
A newer approach receiving recent attention is Triptorelin, the GnRH agonist. This is used in a continuous manner to chemically castrate a man, but in a one off dose, has been reported to kick start the PTA in a hypogonadic BB. Triptorelin is a synthetic analogue of GnRH. It causes constant stimulation of the pituitary gland and by acting as such, it stimulates the pituitary gland to pump out LH and FSH. The dose needed to cause chemical castration is much greater than the dose one would use to restart HPTA. The way triptorelin hinders gonadotropin release is similar to how HCG wil hinder test production in the testes. A small amount of HCG will stimulate the Leydig cells to produce testosterone, but too much will desensitize the Leydig cells. This is what GnRH does, but with the pituitary gland. Triptorelin has been studied to restore full HPTA function in a steroid user who cycled for 13 years. Due to it's nature it is advised that triptorelin only be used if coming off long-term blasting and cruising or if one plans to cease AAS forever.
Anecdotal evidence claims that triptorelin is capable of restoring HPTA function to those diagnosed with hypogonadism.
•http://www.sciencedirect.com/science/article/pii/S0015028210005030
•http://www.ncbi.nlm.nih.gov/pmc/articles/PMC370609/
•http://www.ncbi.nlm.nih.gov/pubmed/1691703
•http://www.ncbi.nlm.nih.gov/pubmed/20416868
What's the point of using two different SERMs during PCT?
There are 2 major components involved in recovery. Testosterone production and Spermatogenesis.
LH and FSH are both required for the equation. LH is produced by the pituitary and stimulates the Leydig cells to produce testosterone. Once testosterone is in production it works alongside FSH and stimulates sertoli cells to produce sperm. Sperm production is hindered if either of these are unhealthy. They both work in synergy. You need BOTH to be at healthy levels. Nolvadex is dominant in LH promotion and Clomid is dominant in promoting FSH.
clomid has multiple effects. It's an anti-estrogen, so it obviously decreases the estrogenic effects in your body by stimulating the Hypothalamus back to life and sending gonadotropin releasing hormone (GnRH) to your pituitary, so that LH/FSH can be secreted.
Nolva boosts the effects of clomid because it put clomid into "competition" mode where they both fight for a receptors to bind to. This competitiveness will only occur with the presence of BOTH nolva/clomid, and will inevitably resolve the issue of excess estrogen in the Hypothalamus. This will trigger both LH and FSH to crank UP, as the high estrogen in this cluster is suppressive. This entire scenario is not as effective with only one drug.
Furthermore varying the compounds; Since we know both stimulate LH, what most don't know is that the act is different. clomid boosts the amplitude of LH serum, but has no effect on the frequency. Nolvadex is the complete opposite in that area, where it boosts the actual frequency of LH and has no effect on its amplitude.
You're probably assuming they're identical and overpowering... clomid is a mixed agonist/antagonist for the estradiol receptor. Nolva is also mixed, however.... it is a pure antagonist in the E receptor in breast tissue. There is a reason that clomid is not recommended for gynecomastia reversal, but Nolva is.
Can you recover with just Nolvadex, or just clomid? Well, anything is possible. But why would you take that risk if the combination gives you a much better chance? To save a few bucks and risk your health? clomid when coupled with Nolvadex is clearly the safer choice over using either compound individually.
*You can substitute clomid with toremifine as well.
Why is nolvadex prefered over clomid in most cases?
The reasons for leaving clomid out of shorter cycles is because of the sides. There's no need to risk exposing yourself to those harsher sides (vision/ crazymood swings) when nolvadex alone or toremifine work just as well.
Prolonged visual disturbances that can last many years are a common side for clomid
www.ncbi.nlm.nih.gov/pubmed/7710399
How clomid affects the eyes:
onlinelibrary.wiley.com/doi/10.1002/ddr.20253/abstract
Nolva can trigger some vision sides, but it's much more common for those on clomid to experience long lasting sides involving vision, even after cessation of use.
Here's some research comparing the two (should be the two bottom right paragraphs)
books.google.com/books?id=Pmcy24y2HyMC&p...ate%20ocular&f=false
Also, it seems that much of nolvadex's vision issues are resolved when one discontinue's use.
archive.bcaction.org/index.php?page=newsletter-25g
Explains the possible cause behind vision effects:
www.ncbi.nlm.nih.gov/pubmed/15229354
If caught early enough, vision sides from nolvadex are (mostly) reversible:
onlinelibrary.wiley.com/doi/10.1002/1097...E3.0.CO;2-I/abstract
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