PCT, what does it mean?
Post Cycle Therapy.
What does it do?
It returns your Hypothalamus, Pituitary, Testicular, Axis (HPTA) back to producing its own endogenous testosterone production.
How long does it last?
Good question but in my opinion the normal 21 to 30 days protocol is too short unless suppression of the HPTA is minor.
Ok, you produce about 7 mg of testosterone a day or around 49 mg a week on average, some more, some less (usually older guys).
So, you go on a cycle of lets say 500mg of testosterone a week or about 10 times your natural production. The body sees this as too much testosterone and will lower production of testosterone to try to maintain homeostasis (balance). The body loves homeostasis.
Testosterone in a man gets converted into two other hormones; one of those hormones is DHT (dihydrotestosterone) this is done by an enzyme called 5-alpha-reductace. DHT is actually about 3-5 times more androgenic than testosterone.
The other hormone it gets converted to is estradiol (E2), this is a strong estrogen but from now on we will just refer to it as estrogen, even though there are 3 different kinds of estrogen. Testosterone gets converted into estrogen by another enzyme called aromatase. The conversion is called aromatization.
Ok, the body will convert more testosterone into estrogen probably to try and maintain homeostasis, so the more test, the more estrogen. For most this estrogen is not a problem. But for some it will be a problem and this extra estrogen can give side effects like gynecomastia (gyno) or water retention, but one big problem is estrogens suppressive effects on Luteinizing Hormone or (LH) LH is what the pituitary gland sends as a chemical hormone to the Leydig cells in the testicles where the testicles will product testosterone. Estrogen is probably 100-200 times as suppressive as testosterone.
So when LH production stops (exogenous testosterone will do this too) the testicles will stop producing and like anything not being used will atrophy.
What does this mean?
You will get some small balls, no kidding mine have been the size of almonds without the shell.
OK, so you come off a cycle, the exogenous testosterone is tapering down and after about a couple of weeks (this is the clearance time for testosterone cypionate and enanthate) you end up with low levels of testosterone as your endogenous production has long been stopped. Now here where the problem starts. You potentially have the testosterone of a woman, and high estrogen from all that aromatization.
This can be a recipe for disaster, why? Because men need test to feel normal and not only that hard earned muscle will be eaten up by being in a catabolic environment, not to mention there is still going to be some suppression because of elevated estrogen.
I have seen big strong men carry on like crying women in this state; it is very bad, sex drive is zero, no energy, emotional, insecure, the list is long.
So, what can you do?
First of all in my opinion bringing the nuts back online is very important, the most important. This is done with the use of Human Chorionic Gonadotropin (HCG)
It basically is pregnant woman’s urine. HCG mimics LH and as we learned above that LH is the chemical hormone that stimulates the Leydig cells to produce testosterone. HCG is very strong and many times stronger than the amount of LH that the pituitary puts out.
The typical dose is anywhere around 350iu to as much as 2500iu and even in some cases more but I don’t recommend this. Best advice is to use as little as possible to achieve success at bringing the nuts back to life from their nice little vacation.
The half life of HCG is around 3 days or so, so Subcutaneous (Sub-Q) shots or Intramuscular Shots (IM) are done about Every Other Day (EOD or Every 3 Days (E3D).
If you use too much for too long desentization of the Leydig cells can happen and this is not good.
One other thing is HCG aromatizes pretty heavily. So an anti estrogen is always recommended if you shoot more than 500iu and even that if you are gyno prone would be a good idea to add an anti E.
HCG comes in tow bottles or vials and one is powder and the other is a solvent or bacteriostatic water, the water gets added to the powder and this is called reconstitution. Once HCG is mixed it must be refrigerated. In bacteriostatic water it will last around a month.
Now next we want to block the hypothalamus and pituitary gland from that excess estrogen as that in itself is suppressive.
How is this done? With a drug called Clomiphene citrate (clomid). This is really a drug to help women ovulate but it acts as a Selective Estrogen Receptor Modulator (SERM).
It occupy’s the estrogen receptors in the hypothalamus and pituitary and blocks estrogens exertion on those glands. It’s like putting a key in a lock but not turning the key. It is just occupying that space without really doing anything.
Clomid in my opinion works better than another SERM that many people use called Nolvadex. Both pretty much do the same thing but together I have found to be far superior than using any of them by themselves.
Clomid is used to test the pituitary for secondary hypogonadism, clomid @ 100mg a day after 5 to 7 days will double LH responce and increase FSH by 20% to 50%, that is huge.
Both clomid and nolva are in pill form as well as liquid form.
What these do is block estrogen. The body sees this as it is low in testosterone and estrogens suppressive effects are not there as the receptors are blocked. So it see’s this as low testosterone and low estrogen so the body turns on the hypothalamus to produce Gonadotropin Releasing Hormone (GnRH) which in turn tells the pituitary gland to produce LH and FSH (follicle stimulating hormone). FSH is another hormone that stimulates the Sertoli cells in the testicles to produce sperm.
Ok, so lets put this all together.
There are a couple of ways you can do this.
First you can take HCG in small amounts during the cycle to maintain testicular function or you can take it after the cycle is finished to start your PCT.
Either way is fine but if the cycle is very long then long use of HCG can be a problem due to the possibility of desentization of the Leydig cells.
That’s pretty much the last thing you want to do as you want your own LH production to keep the testicles producing test.
So, what you can do is wait about 2 weeks for the testosterone to clear your system or be around base levels of normal producing test and start your HCG, clomid and nolvadex all at the same time.
You don’t have to worry about the aromatization issue because both clomid and nolvadex are anti-estrogens or act as anti-estrogens in the body.
By the way nolvadex is used in estrogen sensitive cancer tissues like in treating breast cancer.
take clomid at 50mg twice a day (12hrs apart) for 30 days.
take nolvadex at 20 mg a day for 45 days.
take anywhere from 1000iu EOD to 2500 EOD for 8 shots (16 days).
So the HCG is taking care of the nuts and taking them off vacation and putting them back to work and the nolvadex and clomid will help the hypothalamus produce GnRH which will tell the pituitary to produce LH and FSH.
Once the testicles are producing test on their own you stop the administration of HCG and let the body take over, kind of like handing a baton when doing a relay race.
Depending on the type of gear, length of time on, amount of gear, all play in this factor of recovery, not to mention the genetic factors involved in shutdown.
I shutdown very hard and I notice atrophy in as little as 3 weeks.
This is what the doc wrote for the reason why clomid and nolvadex are to be taken together:
Almost everything you hear or read will be anecdotal and therefore subject to no verification. Experiences with hCG while on TRT are posted. The use of hCG for PCT is only partly related to its use on TRT.
hCG while on TRT is used for 2 reasons. One reason is cosmetic. While on TRT it is not unusual and more often expected to have testicular atrophy. This is variable from individual to individual. The other reason is to act as a stimulus so the testicles do not shut down and therefore will be easier to initiate independent function after AAS cessation.
Desensitization is a potential problem with hCG. I do not think you will experience it with doses of 500IU or less 3X/week. Studies have used this dose for considerably long periods. In my patients when hCG was used while on AAS the dose was 1000IU every 3 days with one month on hCG followed by one month off hCG.
hCG for PCT involves additional concepts. This is the timing of hCG in relation to other medications for return of HPTA functionality. Under normal conditions the HPTA is a tightly coupled dynamic feedback loop. It is this coupling that has to be achieved after AAS cessation to return to normal. The analogy I use is the starting of a car by pushing it from behind. Alone the care will not start but with pushing the clutch can be popped and the car started.
After AAS cessation the secretion of LH is nil. It will not be able to initiate T production until a certain stimulus LH level is reached. Studies have shown that the time for this to occur can be lengthy. Thus the idea is to ‘push’ the testicles with hCG and get them started. Once T production is initiated the dependent variable is LH. If the hCG is withdrawn without adequate LH to couple with the testicles return of HPTA functionality will fail.
The increased production of LH is achieved by a dual action of clomiphene citrate and tamoxifen. Clomiphene is a mixed agonist/antagonist (SERM) at the estradiol receptor. Clomiphene will increase the secretion of LH by action at the hypothalamo-pituitary area. Clomiphene will cause an increase in LH and secondarily increases in T and estradiol. Estradiol has a negative feedback influence on the HPTA. Estradiol is 200X the inhibitory effect of T per molar basis. Normal serum levels are the following:
Testosterone: 3-10 ng/ml (10-35 nM/L)
Estradiol: 15-65 pg/ml (55-240 pmol/L)
Tamoxifen will counteract the effect of the estradiol. Once the hCG is withdrawn the LH, initiated by clomiphene and tamoxifen, will couple with the testicles and take over production of T by the testicles. The levels of LH to maintain and couple with the testicles are maintained by clomiphene and tamoxifen. Clomiphene is continued for 15 days while Tamoxifen is continued for 30 days.
In healthy adult men, circulating levels of testosterone have a distinct pattern, with increasing levels during sleep toward a maximum around the time of awakening and a decrease during the day. In PCT hCG is administered every other day. I suggest the same time each injection in an attempt to simulate this rhythm. This is purely empirical but I recommend hCG at bedtime (2200). Clomiphene is taken in divided doses of 50mg 2X/day.
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