ASK DR. TESTOSTERONE | POST-CYCLE THERAPY (PCT)
Dr. Testosterone
By George Touliatos, MD
Post-Cycle Therapy (PCT)
After the end of an anabolic-androgenic steroid (AAS) cycle, the steroid user should estimate the half-life of the particular esters he used.
This will define the correct timing of drug clearance in the system.
Depending on the slow or fast esters, approximately one or two weeks are required in order to eliminate the substance from the body.
The idea of the gradual reduction of injectable testosterone does not provide any benefit to the hormonal system.
It only reinforces the belief that the user is still on a cycle.
Either one reduces the dose gradually or abruptly cold turkey, the hypothalamic pituitary testicular axis (HPTA) is shut off from day one (when testosterone is used).
The first phase of PCT involves the administration of beta-human chorionic gonadotropin (beta-HCG) peptide that will ensure stimulation of HPTA.
HCG is produced from the placenta after implantation, during the early stages of pregnancy.
Actually, the prediction test for pregnancy works by measuring serum, or urine levels of HCG.
It is a mimicker-analogue of luteinizing hormone (LH) that stimulates endogenous testosterone production in the Leydig cells of the testicles.
It is obvious that HCG, as a gonadotropin, will inhibit GnRH in the hypothalamus.
All AAS suppress the HPTA, therefore, the endogenous testosterone production is reduced significantly (homeostatic mechanism).
The use of HCG permits testicles and scrotum to keep their volume and triggers endogenous testosterone production.
The usual protocol provides the intramuscular or subcutaneous injections of 1000/1500 IU every third day (72 hours) for two or three weeks.
Usually the dosage of 5000 IU is used for cases of cryptorchidism in boys who have not yet entered puberty and in IVF procedures.
Initially all AAS users suffer from primary hypogonadism, which gradually turns into secondary (late onset).
Abuse of beta hCG (> 5000 IU) and its extensive use (over four weeks) will cause testicle whipping and saturation of LH receptors.
The resulting rise in natural testosterone will inhibit its own production on the hypothalamus and pituitary gland and eventually will have a negative impact. The prolonged HCG abuse may lead to high levels of estradiol with peripheral edema and gynecomastia.
However, we should be concerned that a peptide, from a chemical point of view, does not aromatize.
However, as LH will increase endogenous testosterone production, this testosterone will eventually get aromatized.
The second phase of PCT involves clomiphene citrate, a medication belonging to the class of selective estrogen receptor modulators (SERMs), along with tamoxifen citate.
This compound acts as half estrogenic and the half as anti-estrogenic.
Clomiphene’s actual action is to trick the hypothalamus by giving the sensation of decreased estrogens.
The drop in estrogens would signal for GnRH release from the hypothalamus, thus stimulating LH and FSH production from hypophysis.
Therefore, we realize that this mechanism is opposite of how beta-HCG works.
Along with clomiphene citrate, another SERM (tamoxifen citrate/nolvadex) can also be used simultaneously.
It lowers beta estradiol (E2) in the blood and this is a positive signal to trigger GnRH and LH, FSH production.
SERMs are also used for two to three weeks, with considerably low doses (25/10mg).
The fact that clomiphene acts estrogenically to other tissues (brain) explains the fact that the medication may cause moodiness.
In the liver, aromatization by SERMs improves atheromatic profile and elevates LDL in partiucular.
Occasionally, after the discontinuation of SERMs, estrogens might rise; this is why some men are using AIs afterward.
However, too low estrogens may impact libido negatively.
George Touliatos, MD is an author, lecturer, champion competitive bodybuilder and expert in medical prevention regarding PED use in sports. Dr. Touliatos specializes in medical biopathology and is the medical associate of Orthobiotiki.gr and Medihall.gr, Age Management and Preventive Clinics in Athens, Greece. Heis the author of four Greek books on bodybuilding, has extensively developed articles for www.anabolic.org and is the medical associate for the book Anabolics, 11th Edition (2017). Dr. Touliatos has been a columnist for the Greek editions of MuscleMag and Muscular Development magazines, and has participated in several seminars across Greece and Cyprus, making numerous TV and radio appearances, doing interviews in print and online. His personal website is https://gtoul.com/
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