Restarts: Only for Past TRT/Steroid Users?

AJ

New Member
In essence a "restart" is an attempt to restart the HPTA (hypothalamic-pituitary-testicular axis) for a patient who's axis is suppressed or shutdown due to being on TRT or AAS.

It is similar to a "stimulation" type regimen (as opposed to frank TRT), except for the starting point for a restart is typically a FULLY suppressed HPTA due to TRT/AAS, whereas the starting point for a general stimulation regimen is simply a sub-optimal or partially suppressed HPTA for various other factors (not current TRT/AAS use). Semantics really, the first paragraph gives the jist.

Hello Dr. Saya
Is the restart protocol only for a patient who is suppressed/shutdown due to TRT/AAS? I currently have low T(330) and have been prescribed TRT(T + HCG). A lot of people told me to look into the HPTA restart protocol. Is that something recommended for a person who has never been on any AAS/TRT. Thank you for sharing your valuable inputs.
 
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Bump.
If anybody has any idea if the HPTA restarts are only for Past TRT/AAS users?
I suffer from low T and currently been prescribed with TRT protocol. So i was wondering if doing an HPTA restart would be the correct way to go as I am only 33.
 
If on TRT (and HPTA suppressed) - then yes can do a restart just as with AAS. If not on TRT/AAS, then can basically go with a Clomid stimulation (leave out the 2 weeks of HCG).
 
Hello Dr. Saya
Is the restart protocol only for a patient who is suppressed/shutdown due to TRT/AAS? I currently have low T(330) and have been prescribed TRT(T + HCG). A lot of people told me to look into the HPTA restart protocol. Is that something recommended for a person who has never been on any AAS/TRT. Thank you for sharing your valuable inputs.

Awesome Dr. Saya. I am so happy you replied.
So Clomid ED 25 mg for 4 weeks leaving out the HCG ? (I do have HCG on hand as my doc gave me 1500 iu per week dosage + Test E 160 mg per week)
I have attached my results.
Age: 33 years, 165 lb, 14-16% bf
Symptoms: ED(may be due to low E2 or T), Depression.

I am going to be in Tampa in June. I hope i can get in office appointment. Thanks for your amazing contribution.
 

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Awesome Dr. Saya. I am so happy you replied.
So Clomid ED 25 mg for 4 weeks leaving out the HCG ? (I do have HCG on hand as my doc gave me 1500 iu per week dosage + Test E 160 mg per week)
I have attached my results.
Age: 33 years, 165 lb, 14-16% bf
Symptoms: ED(may be due to low E2 or T), Depression.

I am going to be in Tampa in June. I hope i can get in office appointment. Thanks for your amazing contribution.

If you are currently on TRT, then do the 2 weeks of HCG (immediately following your last shot of T enanthate).

Very good if you make it in to office or otherwise find a knowledgeable doc to guide you as Clomid therapy and restarts are complex.
 
If you are currently on TRT, then do the 2 weeks of HCG (immediately following your last shot of T enanthate).

Very good if you make it in to office or otherwise find a knowledgeable doc to guide you as Clomid therapy and restarts are complex.

No Sir. I am not on TRT and never used AAS. I think i suffer from secondary hypogonadism with my normal LH & FSH and low T and E2. Sorry for the confusion but I have my TRT medicines on hand but still not used them.

I will start with clomid 25mg ED for 4 weeks and report back with my progress.
Any dosage recommendations ?

Theory Question for us noobs who might read this thread in future for knowledge:

  • Why would HCG not be part of the restart protocol for non TRT/AAS users ?
  • If say after 4 weeks my blood work is not as expected, instead of going on TRT. Would it warrant another SERM cycle at a different dosage or perhaps put HCG to fire up my minions ?

Thank you for your response and knowledge sharing. I really appreciate all your help.
 
[*]Why would HCG not be part of the restart protocol for non TRT/AAS users ?
[*]If say after 4 weeks my blood work is not as expected, instead of going on TRT. Would it warrant another SERM cycle at a different dosage or perhaps put HCG to fire up my minions ?
[/LIST]

Thank you for your response and knowledge sharing. I really appreciate all your help.

HCG (as an analog of LH) will suppress endogenous LH production when given to a non-HPTA suppressed patient. It is used for a TRT patient during the 2 week washout period after last T injection while waiting for the exogenous T to leave the system.

The second question is one to discuss with your treating doctor as they can evaluate your entire case (including follow-up labs) and determine the next best step.
 
HCG (as an analog of LH) will suppress endogenous LH production when given to a non-HPTA suppressed patient. It is used for a TRT patient during the 2 week washout period after last T injection while waiting for the exogenous T to leave the system.

The second question is one to discuss with your treating doctor as they can evaluate your entire case (including follow-up labs) and determine the next best step.

Thank you Dr. Saya. Appreciate you taking time to explain it. I will try with Clomid for 4 weeks before pinning myself with TRT.
 
AJ

Any results from your experience that you would like to update me on? In a similar situation where I do not know if I should start TRT, or go with a restart protocol. Mine is AAS induced, but nonetheless, I think your situation might be able to shed some light on which route I am to go.

Thanks!
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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