SERM "PCT" Alternatives

[JustPanicNoDisco]

I'm strongly considering getting off TRT after being on 1.5 years and worsening my health tremendously. Since I'm suffering from an abundance of low E2 symptoms which I would probably exacerbate majorly if I were to use SERMs. Are there any other good alternatives? Anything that antagonizes estrogen (even things like cialis) absolutely wreck me, hence my need for alternatives.

Current thoughts on potential tools for recovery:

- Triptorelin - some people have used this to recover HPTA function after failing to recover their HPTA with SERMs) by kickstarting GnRH production and all downstream hormones (LHRH -> LH -> T -> e2)
- Gonadorelin (another GnRH agonist, which sometimes is used for puberty, and I believe which @Cataceous uses for preserving some LH activity).

Any others to consider? Any input? Read story below for more info.

Back story:

I crashed my e2 for a prolonged period when I started TRT about 1.5 years ago, and it's been nothing but hell since (flat emotions, memory loss, brain fog, lack of sweating, loss of erection "fullness", loss of libido, anhedonia, apathy, anxiety, among many others).

When experimenting with exogenous estrogen, I did see some improvements in some symptoms; however, I was toying with too many variables. I may try a couple more regimens before throwing in the towel on TRT and trying to get my estrogen to work naturally (I wasn't technically hypogonadal prior to starting TRT, but I had lasting sexual side effects from SSRIs - a condition called PSSD, which is very similar to PFS with respect to symptoms).

 

[Dicky]

Do I understand correctly, you crashed your E2 sometime in the past. You have now stopped doing whatever you were doing that caused it to crash. But your levels have still not recovered? How long ago did you stop crashing it?

Or is it that your E2 was low the whole time you were on TRT?

Before you go through the hassle of trying to come off of TRT, you might want to post your labs and see if anyone can spot anything usual. You also should describe your protocol with dosages and timing.

 

[JustPanicNoDisco]

Do I understand correctly, you crashed your E2 sometime in the past. You have now stopped doing whatever you were doing that caused it to crash. But your levels have still not recovered? How long ago did you stop crashing it?

Or is it that your E2 was low the whole time you were on TRT?

Before you go through the hassle of trying to come off of TRT, you might want to post your labs and see if anyone can spot anything usual. You also should describe your protocol with dosages and timing.

Sorry if I wasn't clear in my post. I unknowingly crashed my E2 for prolonged periods (not with AIs, but with high-dose T and DHT derivatives, when I already had low e2), and ever since then, it seems I have been experiencing low e2 symptoms, in spite my e2 levels appearing normal on my labs.

I am getting blood work this week again to check where I am, this time including free test (dialysis) and DHT as well, given that it's an AI and antagonizes E2. In the past, total T and free T have typically been just over the reference range (trough, daily shots), while estro has been middle - top of the reference range.

The lowest my T:E2 ratio has been is about 30:1, while it usually hovers closer to 40:1. This could potentially result in some of the sides I'm seeing. However, when I did try using exogenous estrogen, I experienced worsened sexual function, rendering this option infeasible.

I was using daily shots for a while. I've tried every other day with long esters, daily shots with mixed esters, and now I'm back to EOD dosing (22 mg EOD).

Based on some of the threads where people crash their E2 and never see a recov ery in symptoms iin spite of e2 in bloods rebounding, I'm thinking I may need to restart my HPTA in order to fix the receptor issues -- or whatever else may be occurring and preventing my recovery. It's miserable down here.

 

[Checkdis]

Following.

I have tried everything and in the same boat since 2017, at this point all I have left to try is nolvadex and cold turkey; and possibly NAD therapy which is a guess.

If and when I do cold turkey i’m combining NAD therapy with it.

 

[JustPanicNoDisco]

Following.

I have tried everything and in the same boat since 2017, at this point all I have left to try is nolvadex and cold turkey; and possibly NAD therapy which is a guess.

If and when I do cold turkey i’m combining NAD therapy with it.

What is the purpose of "NAD therapy"? I have not heard of this.

 

[JustPanicNoDisco]

@Dicky

And for anyone else curious, I have been running 22 mg EOD for several months and feel like shit. These are my blood results I recently received from Quest:

DHT: 72 [12-65] -H
E2, sensitive: 32 [ < 29 ]
TT: 856 [250-1100 ng/dL] (lol did they finally raise the range)
FT: 135 [35-155 pg/mL)
Prolactin: 7.9 [ 2- 18]
TSH: 1.07 [0.4 - 4.5] - *nearly perfect*
Free T3: 3.6 [ 2.3 - 4.2 ]

I've measured preg, prog, DHEA-S, etc. in the past on similar regimens, and they've always been very normal (normal - high) -- the same as before starting TRT.

No other issues besides cholesterol rising a bit.

Erectile function and libido are quite poor. They fluctuate sometimes, but I would never qualify them as good.

Running T higher helps erectile function at the expense of making me feel like complete shit (worsens joint pain/cracking, insane anxiety, disrupts sleep, etc.). It didn't have this effect before I crashed my estrogen.

 

[BigTex]

I'm strongly considering getting off TRT after being on 1.5 years and worsening my health tremendously. Since I'm suffering from an abundance of low E2 symptoms which I would probably exacerbate majorly if I were to use SERMs. Are there any other good alternatives? Anything that antagonizes estrogen (even things like cialis) absolutely wreck me, hence my need for alternatives.

Current thoughts on potential tools for recovery:

- Triptorelin - some people have used this to recover HPTA function after failing to recover their HPTA with SERMs) by kickstarting GnRH production and all downstream hormones (LHRH -> LH -> T -> e2)
- Gonadorelin (another GnRH agonist, which sometimes is used for puberty, and I believe which @Cataceous uses for preserving some LH activity).

Any others to consider? Any input? Read story below for more info.

Back story:

I crashed my e2 for a prolonged period when I started TRT about 1.5 years ago, and it's been nothing but hell since (flat emotions, memory loss, brain fog, lack of sweating, loss of erection "fullness", loss of libido, anhedonia, apathy, anxiety, among many others).

When experimenting with exogenous estrogen, I did see some improvements in some symptoms; however, I was toying with too many variables. I may try a couple more regimens before throwing in the towel on TRT and trying to get my estrogen to work naturally (I wasn't technically hypogonadal prior to starting TRT, but I had lasting sexual side effects from SSRIs - a condition called PSSD, which is very similar to PFS with respect to symptoms).

I personally like triptorelin and think it has been shown to work well at small doses (100iu). I have known a few who have used it between cycles to get everyting working again, especially in those who have been on for a while.

Attached is a published observational study.

 

[JustPanicNoDisco]

I personally like triptorelin and think it has been shown to work well at small doses (100iu). I have known a few who have used it between cycles to get everyting working again, especially in those who have been on for a while.

Attached is a published observational study.

I'm going to read more literature before attempting it, and hopefully even get a script from the doc under whom I have been using TRT. Thanks for the link.

 

[JustPanicNoDisco]

@BigTex The publication you sent me showed that a single dose 100 ug dose of trip caused a HUGE rise in LH, peaking at about 40 mIU/mL within 30 minutes, and then slowly falling back down. I've heard people mention the risk of irreversibly damaging the HPTA with tript, and giving the dosing (especially when buying potentially incorrectly dosed products online), it makes sense.

Were you thinking of just using one single dose of 100 ug, as was done in that study?

I think I would prefer using several smaller doses. If LH production is proportional to dose, then taking about 1/5th of that would put you at the top of the normal range for LH (~ 8 mIU/mL). This might be less risky with respect to HPTA damage.

@Cataceous do you use gonadorelin over other GnRH agonists for any specific reason? While triptorelin seems indicated for purposeful HPTA suppression, it seems Gonadorelin is marketed for the opposite purpose -- inducing puberty. They're both GnRH agonists, so I imagine they can serve either purpose, depending on the dose in which they are administered.

 

[BigTex]

@BigTex The publication you sent me showed that a single dose 100 ug dose of trip caused a HUGE rise in LH, peaking at about 40 mIU/mL within 30 minutes, and then slowly falling back down. I've heard people mention the risk of irreversibly damaging the HPTA with tript, and giving the dosing (especially when buying potentially incorrectly dosed products online), it makes sense.

Were you thinking of just using one single dose of 100 ug, as was done in that study?

I think I would prefer using several smaller doses. If LH production is proportional to dose, then taking about 1/5th of that would put you at the top of the normal range for LH (~ 8 mIU/mL). This might be less risky with respect to HPTA damage.

@Cataceous do you use gonadorelin over other GnRH agonists for any specific reason? While triptorelin seems indicated for purposeful HPTA suppression, it seems Gonadorelin is marketed for the opposite purpose -- inducing puberty. They're both GnRH agonists, so I imagine they can serve either purpose, depending on the dose in which they are administered.

That is the exact doe guys I have known wh have been on for year and wanted to come off steroids used. As you note from the abstract: Result(s): Within 1 month, the patient’s serum testosterone was in the normal range, and he reported a return to normal energy and libido

The doctors saw the bodybuilder 10 days later. His energy had returned and the testosterone concentration in his blood had risen to 7 ng/ml. Another three weeks later, his testosterone level was still normal, and his libido had returned too. Keep in mind this is a single case study. But I do knwo a few in the same boatr that have used it successfully.

By the way, youu don't really need a prescription:

Triptorelin (GnRH) 2mg

Triptorelin (GnRH) 2mg for Sale | Find the Best Triptorelin (GnRH) 2mg [year] | Shop Online Here From USA | FREE Shipping | Triptorelin for Sale

researchpeptides.net

 

[Cataceous]

@Cataceous do you use gonadorelin over other GnRH agonists for any specific reason? While triptorelin seems indicated for purposeful HPTA suppression, it seems Gonadorelin is marketed for the opposite purpose -- inducing puberty. They're both GnRH agonists, so I imagine they can serve either purpose, depending on the dose in which they are administered.

Gonadorelin is of course bioidentical GnRH, and compared to readily available analogs is the only drug that's practical for frequent dosing—if you want stimulation rather than suppression. For example, the half-life of triptorelin is around an order of magnitude longer. The anecdotes suggest that an isolated, small dose is stimulatory. But try to use triptorelin for long-term pituitary stimulation and it would result in suppression. Gonadorelin is fairly impractical as a suppressing agent. It would be most effective for this when administered as a constant infusion.

 

[JustPanicNoDisco]

Gonadorelin is of course bioidentical GnRH, and compared to readily available analogs is the only drug that's practical for frequent dosing—if you want stimulation rather than suppression. For example, the half-life of triptorelin is around an order of magnitude longer. The anecdotes suggest that an isolated, small dose is stimulatory. But try to use triptorelin for long-term pituitary stimulation and it would result in suppression. Gonadorelin is fairly impractical as a suppressing agent. It would be most effective for this when administered as a constant infusion.

Fair points. I read through your TRT protocol and the theory behind it. It was definitely interesting. If I recall correctly, you mentioned synthetic GnRH potentially being used as a PCT tool after long-term TRT.

Do you see gonadorelin as being a viable PCT alternative in isolation?

It is my understanding that tript, at the doses typically used for PCT, causes massive LH spikes (in the paper, it brought blood levels up to ~ 40 mIU/mL). Gonadorelin would seem a much more gentle approach, and would also work from the top down (hypothalamus -> pituitary -> leydig cells), operating similarly to SERMs with respect to end goal, if through a different MOA. I'm just wondering if the GnRH stimulation, at reasonable doses, would be enough to successfully restart the HPTA after a long period of suppression (have been on TRT for about 1.5 years now). It's my understanding that leydig cells become desensitized to LH both in the presence of low LH and high LH (hCG, for instance).

I know SERMs are really the gold standard for PCT, but since I a, still dealing with many... "low e2"... issues, I'm trying to think through some potential alternatives, aside from just attempting a fully natural restart, which would be slow and painful, if it recovered levels at all.

I haven't really found any data -- even anecdotal -- on such.

 

[BigTex]

Gonadorelin is easy to obtain as well

Gonadorelin 10mg

Gonadorelin is a gonadotropin releasing hormone agonist that has shown benefit in the treatment of infertility and hypogonadism. Recent research suggests that gonadorelin may be useful in slowing th...

www.peptidesciences.com

 

[RAS]

Following as I am in the same boat, and have been for years. I have seen 2 endocrinologists and they have been absolutely no help They even said that what I am feeling is not connected to HRT. The only thing that has helped is I stopped using testosterone. I felt better for a while and then was hit with the problems of low T. So I started using test again, but then the low e2 symptoms came back up. So I am out of ideas.

 

[FunkOdyssey]

The only thing that has helped is I stopped using testosterone. I felt better for a while and then was hit with the problems of low T. So I started using test again, but then the low e2 symptoms came back up. So I am out of ideas.

hCG monotherapy?

 

[MDavidW76]

Has anyone combined these, hcg, gonadarelin, triptorelin etc… seems like someone would whip something up following the “Sustanon” model… short medium long lives, idk

 

[RAS]

hCG monotherapy?

From my understanding HCG is no longer available. Or at least that is what my provider stated. They replaced HCG with Gonadarelin. From what I have read it seems that gonadarelin lowers E2 levels. This may sound weird but anything that can lower E2 levels impacts me, I can't even have caffeine, I have cut out anything that can or may lower E2 levels. When I 1st crashed my E2 I couldn't figure out why the symptoms always got worse, so I looked into everything I was taking vitamin wise and removed everything that impacts E2 levels, then the killer anxiety went away after about a week, but the other symptoms stayed. So I removed any food or drink that could lower E2 and then my symptoms lessoned a little but never went away. I have tried everything from micro dosing test, to a large shot once a week, to every 3 days, EOD, lowering doses until I was at like 50mg per week, nothing helped. What is really weird is that I usually felt fine with my E2 levels around 11 on the sensitive test, but after the crash its been like a total nightmare at 11. I don't know what to do, my BP is super high even the BP meds aren't working to bring it down, from the constant dehydration my stomach is all fucked up, and I seem to be caring water weight which I never have done, the only thing that made an impact is when I stopped taking test, then I started to really feel better, but then with Test levels at 38, the low t symptoms took over, which was not ideal in any way shape or form, so I restarted with the test at like 10mg EOD and then the low e2 symptoms came back.....

 

[bixt]

Use clomid as the serm of choice for this case. Never heard of low E2 symptoms using it. If anything, it gives "high E2" symptoms.

 

[sammmy]

PCT is only for bodybuilders that don't want to "lose the gains" until they start the next cycle of unhealthy high testosterone and anabols. The goal of PCT is not to restore normal functioning but bridging to the next cycle.

For people trying to restore their function, PCT has no useful function whatsoever. Let your body systems compute and restore without any more messing around with them. If they restore, fine. If not, no PCT will help you restore them, and you are doomed to eternal TRT.

 

[bixt]

PCT is only for bodybuilders that don't want to "lose the gains" until they start the next cycle of unhealthy high testosterone and anabols. The goal of PCT is not to restore normal functioning but bridging to the next cycle.

For people trying to restore their function, PCT has no useful function whatsoever. Let your body systems compute and restore without any more messing around with them. If they restore, fine. If not, no PCT will help you restore them, and you are doomed to eternal TRT.

Wrong, wrong and wrong