[quote]KSman wrote:
Scally is bogus and because many refer to his PCT does not mean that it is correct, safe or effective. You have to watch out for bro-science. Scally is in that crowd.
Most important is understanding what you are trying to achieve and what the agents do.
High dose hCG was discredited years ago. High continued stimulation of the LH receptors by LH and/or hCG can desensitize the receptors. So when you are done, what good is your own LH when the receptors are tired of listening?
High LH and/or hCG can create very high intratesticular testosterone levels. That is turn drives high T–>E2 inside the testes. Anastrozole or any competitive AI drug cannot control that. So one can take relatively high anastrozole doses and still have high serum E2.
If you have high FSH/LH, you are primary and there is nothing to restart.
If hCG does not work, you are primary. Stop and do TRT.
If SERM does not create good LH/FSH levels, you are secondary, stop and do TRT.
You can do a restart [or PCT] with SERM or hCG then SERM. Never take multiple SERMs or SERM and hCG at the same time.
SERM’s increase E2 levels, aromatase inhibitors are needed if the SERM’s are effective.
1a) get testes physically recovered with 4-6 weeks of hCG or SERM [suggest nolvadex, not clomid]. You do not want high doses as you want the testes to be functioning on normal LH receptor stimulation. 250iu hCG SC EOD or 12.5 mg nolvadex ED.
1b)) If you start on hCG, time to switch to SERM [nolvadex]. Just stop hCG and start SERM. When using hCG, if the testes have been making decent amounts of T, then the top end of your HPTA has not been active. With the SERM, it will now be. Take SERM for two weeks, if you did 1a), you can skip this.
1c) Take 1.0 - 0.5 mg anastrozole per week in EOD divided doses. You will need a liquid product to get by-the-drop dose increments. Read about anastrozole over-responders, understand the signs and recourse.
2a) Slowly taper off of the SERM, do not stop suddenly or your HPTA may shutdown.
2b) You will want to be on 0.5 mg anastrozole and cruise on that for a few weeks, then taper.
Can you do PCT/restart without SERM? Yes, but may not be effective as the top end of your HPTA has not had a dress rehearsal. Can you do a SERM only PCT/restart? Yes. Note that some can obtain SERM’s but not hCG.
The duration’s and timing are all flexible. Nothing is carved in stone. Everyone’s responses and problems are unique. So seeking the perfect PCT/restart can be a bit misguided.
Labs [optional]: With SERM or hCG, your T and E2 levels should be uncreased [else do TRT]. If high normal, 1.0 mg anastrozole per week. If mid range, 0.5mg
If E2 is high, LH may be high, cut SERM by 50%, anastrozole can be ineffective
With SERM, your LH/FSH numbers should be good. Else do TRT.
If your T levels are good, no real point in checking for LH/FSH, as they will be good. However, if they are high, you will need to reduce SERM dose.
Your testes need DHEA to make T. Supplementing DHEA will help if your DHEA-S levels are low [deficient]; otherwise no advantage. High DHEA supplements can drive high E2 levels in some guys.
You can tell if T levels are good, so need for labs is not always needed to know T levels or that LH/FSH levels are up. But you can’t feel high LH.
During PCT if you start feeling better for a short while, that can be from elevated E2 levels. But when taking an AI, you can get same effect from E2 levels that are too low. So you can get lost. But if your thyroid is a mess, feeling good may not be achievable.
We know that hypothyroid states can lead to low LH and low T. So the prospects of a HPTA restart may be poor in such states. There is more to sexual functioning than your T levels. Do not have T tunnel vision. Note the other health issues and causes in the advice for new guys sticky. If there is a cause for low T, you need to identify and fix that.
Testicular response to hCG or LH is age dependent. HPTA restarts for old guys is silly. HPTA restarts can work very well for younger men if there are no other complication.
Some young guys have brittle HPTA’s that just fail. Sometimes this is spontaneous and idiopathic. However, adventures with 5-alpha reductase inhibitors [hair loss drugs], or stupid cycles can cause irreversible damage. A deca only cycle is a good way to get seriously messed up. So some of these HPTA failures can be caused by drugs/gear; but in some cases these events might just be bringing a future failure forward in time. I have to throw over-training, extreme low fat diets and starvation diets into the risk pool.
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Thn wht will you say about this study:
Another interesting study that showed that HCG use along with testosterone improves testicular function and testosterone despite increases in estradiol. They did not see regression of testicular size or functions after using a high dose of HCG for 5 months.
Human Chorionic Gonadotropin and Testicular Function: Stimulation of Testosterone, Testosterone Precursors, and Sperm Production Despite High Estradiol Levels
Matsumoto et al. The Journal of Clinical Endocrinology & Metabolism. Volume 56, Issue 4
Abstract
Excessive gonadotropin stimulation of the testis induced by the administration of high doses of hCG or LH markedly decreases testicular function in experimental animals. The adverse effects of supraphysiological gonadotropin stimulation are thought to be mediated, in part, by the very high levels of estradiol produced. We administered a supraphysiological dosage of hCG together with exogenous testosterone (T) to normal men for several months. The combination of these agents produced very high serum estradiol (E2) levels and (we assume) high intratesticular E2 levels. In this setting of supraphysiological gonadotropin stimulation and high E2 levels, we examined serum levels of T, the δ4 and δ5 steroid precursors of T, and sperm production. After a 3-month control period, five normal men received T enthanate (T; 200 mg, im, weekly) for 3â??5 months. Then, while T was continued in the same dosage, all subjects were given hCG (5000 IU, im, three times weekly) for an additional 4â??6 months. Serum E2 levels during hCG plus T treatment increased to a mean (±SEM) of 158 ± 16 pg/ml.
Despite the very high E2 levels generated by this prolonged administration of hCG and T, hCG stimulated a mean increase of 5.1 ng/ml in the total T level and 0.18 ng/ml in the free T level over those found during T administration alone. These increments in T levels approximate normal blood T levels in man. Significant changes in serum levels of δ4 steroid precursors of T biosynthesis occurred during the study. Serum progesterone and 17-hydroxyprogesterone levels fell significantly with gonadotropic suppression induced by T administration alone and then increased significantly with hCG stimulation. In contrast to the changes seen in serum levels of δ4 precursors, there were no significant changes in levels of δ5 steroid precursors of T biosynthesis. An increased ratio of 17-hydroxyprogesterone to T during hCG administration was the only suggestion of an E2-induced block in steroid synthesis. hCG also significantly stimulated sperm production, as assessed by sperm concentration, motilities, and morphologies, in spite of the very high serum E2 levels; the mean sperm concentration increased from 1.0 ± 1.0 million/cc during T administration alone to 46 ± 16 million/cc during hCG plus T treatment.
We conclude that chronic administration of supraphysiological dosages of hCG can stimulate testicular function in man, despite very high E2 levels, and that hCG in these dosages does not lead to severe testicular regression in man. Perhaps a higher dosage of hCG administered to men would replicate the severe testicular suppression reported in experimental animals. (J Clin Endocrinol Metab 56: 720, 1983)
Affiliations
Division of Endocrinology, Department of Medicine, University of Washington School of Medicine, Veterans Administration Medical Center (A.M.M., W.J.B.), Seattle, Washington 98108; Public Health Hospital (C.A.P.), Seattle, Washington 98105; and the Department of Reproductive Medicine, University of California at San Diego (B.R.H., R. W.R.), La Jolla, California 92093
