PCT post Testosterone Therapy

    This is an example of just one protocol, since there really is no “one way” to do it. This has proven a very effective foundational protocol for Defy, but of course every patient is different and therefore treatments are individualized as needed.

    TRT: EndogenousRestoration protocol for Men Discontinuing TRT

    Male patients who have been taking any form of exogenous Testosterone long term, longer than 12 weeks, will have secondary hypogonadism induced by the negative feedback response to the exogenous T use. The purpose of this protocol is to stimulate the testes using HCG so that they are able to produce testosterone once again, while also preparing them to respond to endogenous LH/FSH(gonadotropins). Tamoxifen is taken beyond the HCG as it is shown, as a SERM, to stimulate the pituitaries release of LH/FSH whole suppressing the negative effects of excess estradiol. Estradiol can elevate in men who discontinueTRT so it is important to run the SERM for some time after discontinuingTRT to mitigate E2 rebound.
    Meds needed: HCG 11,000iu+mixing kit
    Clomiphene 50mg #30-#60 tablets
    Tamoxifen 20mg #30-#90 tablets
    Syringes and supplies for HCG

    Basic Protocol
    Begin protocol 5 days after the last T injection (Cyp/Enanth). If the patient is taking a T cream than begin the protocol one day following the last application of T cream.

    First 30 days: HCG 350iu daily sq
    Tamoxifen 20mg- 1 tablet POQD
    DHEA 50mg- 1 capsule QHS
    (Optional) Offer Sildenafil or Tadalafil for any ED. Many Pts experience ED during initial recovery.

    30 day F/U: Draw the following labs: Testosterone F&T; Sensitive Estradiol; CBC; CMP
    ** Physician can order additional labs at his/her discretion.

    After 30 days of HCG+Tamox
    After the initial 30 days of HCG+Tamox; If the total testosterone is elevated at f/u, then it can be assumed that pt is responding well to HCG. Discontinue HCG and titrate tamoxifen dosage to10mg after the last dose of HCG. Continue the Tamoxifen 10mg for 30 more days. Add Clomid 50mg QHS for 30 days. Set lab reminder for follow up labs 2 weeks after last dosage of Tamoxifen/Clomid. Levels should remain elevated from there. If not, at the physician’s discretion the above protocol can be repeated until labs reflect the desired response. Symptomology must also play a role in determining desired response.

    Labs Needed: Testosterone Free and Total; Sensitive Estradiol; LH; CBC; CMP-14; DHEA

    Patient Does not Respond after 30-90 days of HCG+Tamox
    If the patient does not respond to the HCG+Tamoxifen after90 days (3 cycles), then it can be assumed there is possible primary hypogonadism. This would not have been caused by the TRT, more than likely it has developed naturally with age or has been present for a long time. In this case itis best to suggest continuing TRT so that T levels remain optimal and the patient’s life quality and health also remain optimal. Educate the patient on the importance of maintaining good levels of T, even if that means being treated with TRT.

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    GettingAnswers

    If you are going to go back on TRT after the PCT, then why not just use some HCG and then keep it up as you use test? If you just want to restore your testes then HCG will do that and I imagine you could just do a slightly higher dose for a few weeks and then do a maintenance dose along with the TRT. Last time I tried to come off TRT I used HCG at 400iu 3x per week to jump start the testes and my TT was over 900. If your plan is to go back… Read more »

    Vettester Chris

    Jeff, good post, as I’ve seen this subject broached many times … Here’s the thing, you were probably put on TRT due to obviously not having the ability to produce endogenously. By what you have described with the testicular atrophy and personal experience with HCG, it’s probably a good assumption that your initial diagnosis was secondary hypogonadism (?). Not sure if your condition was derived from medications/AAS, or pathology, etc., but my point on this is that you have been on exogenous medication for 14 months. Even if your HPTA was perfectly healthy prior to starting Nebido, it would be… Read more »

    Nelson Vergel

    “Lastly, to address your concerns … What you are experiencing could be a litany of other variables. While testosterone (serum, free & bio) is a KEY component with our wellness program, it truly is only one component in a multitude of many that could be factoring in the symptoms you are experiencing. I.e., you could be dealing with a thyroid condition, E2 issues, iron or cortisol related, metabolic condition, etc … You mentioned “no AI” in your treatment, so that could be a deal breaker alone! If you can post labs that would be quite beneficial on our end to… Read more »

    mjm132

    Hi All – is this protocol the scientific consensus for restarting the HPTA(http://www.excelmale.com/content.php?56-How-to-Stop-Testosterone-Safely-and-Possibly-Reset-Your-Hormonal-Axis)?

    Whilst happy with the results of 12 months of Androderm, I would like to trial kickstarting my own endogenous supply before possibly accepting lifelong use.

    Thanks

    mjm132

    Jasen Bruce – thanks – apologies for the delayed response.

    GettingAnswers

    Jeff did you ever attempt the restart? Did it work? Any follow up?

    Vettester Chris

    Jeff has been MIA since 1/13/14. I wish more members would drop a line occasionally to let us know how things are working …

    mariops2

    I’m going to try this protocol since I’m already on my 3rd week of hcg using at 1250 iu EOD and introduce the clomid and nolva orals for a month..