Article: PCT post Testosterone Therapy

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PCT post TRT....

My first post on excel male...yippeee...I finished a 14 month episode of TRT two months past and would like advice on a good PCT. My experience on TRT began with nebido which did not resolve any of my health issues lacking libido,ED,fatigue,no gains at gym , lack of muscle tone.
it was felt that switching to gels would resolve things and despite using stronger strength 10% creams I did not experience relief from my symptoms. I am fit, I am healthy ,I often fight with the blues but I keep going. I try to keep a good hormonal balance using dhea and pregnenolone and good quality vitamins and minerals.
I did not supplement my TRT with HCG or an aromatiase inhibitor during administration as this is not the practice in the UK at any clinic!!!
i experienced testicular atrophy and tightness which was for me awful during TRT but occasional administration of HCG administered by myself brought sweet relief.
i really wish to begin a PCT which will firstly give me back my testicular size and their ability to start working on their own again. I am believing that HCG in combo with clomid and tamoxifen will kick start things again.
at back of my mind I am thinking I should begin TRT again after PCT but this time with simultaneous administration of HCG and say arimidex and maybe I might experience a better journey.
Jeff
 
Defy Medical TRT clinic doctor
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 on, then I would not use Clomid or Nolva. They restart pituitary function of LH and FSH but that will be shut down as soon as you start TRT again. HCG is all that is needed for the testes.
 

Vettester Chris

Super Moderator
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 quite the task to get your HPTA in a functional mode to sustain a normal production of GnRH->LH/FSH thereafter a PCT protocol. Of course anything is possible, but I have not seen or heard of too many success stories from others in similar situations.


Jeff, this isn't necessarily directed at you, as it is for EVERYONE looking at HRT ... Once you start, it's a lifetime commitment and should be viewed as such. The novelty of it fades in the distance pretty quick when you start seeing it's just another year of having to stay on top of the medications, labs, and other variables thereof. My personal take is, if the pituitary and testicles 'can' work in alliance to produce a healthy amount of testosterone today, then HRT is not needed tomorrow. In essence, there's no going back ...


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 see the bigger picture. If you're unsure of what labs to get, let us know.
 

Nelson Vergel

Founder, ExcelMale.com
"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 see the bigger picture. If you're unsure of what labs to get, let us know."


This quote is probably the best I have seen! So many guys think their quality of life and erections only depend on two variables: Testosterone and estradiol. I wish it was that simple!! Thanks Chris
 
First and foremost, imo 14 months is too short of a time to assess the benefits of TRT especially with Nebido since its so long acting. It may take that much time for your doctor to get you completely balanced. In addition to not receiving a "complete" treatment you may have thrown in the towel too fast, but the good news is you can restart at anytime. If you are serious about PCT, or HPTA restoration, than you need to commit to it 100%. Its not something you do and then just go back on TRT, that would be a waste. I will post a protocol which can be used to restore T levels after being on TRT. If you need a good source for clomid and fertility peptides check out www.IVFmeds.com which I believe is located in the UK, unfortunately I did not see HCG on their list but try calling them as they may know where to locate it by prescription.
 
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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 beentaking any form of exogenous Testosterone long term, longer than 12 weeks,will have secondary hypogonadism induced by the negative feedback response tothe exogenous T use. The purpose of this protocol is to stimulate thetestes 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 aSERM, to stimulate the pituitaries release of LH/FSH whole suppressing the negativeeffects 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 followingthe 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 totalTestosterone is elevated at f/u, then it can be assumed that pt isresponding well to HCG. Discontinue HCG and titrate tamoxifen dosage to10mg after last dose of HCG. Continue the Tamoxifen 10mg for 30 more days. Add Clomid 50mg QHS for 30 days. Set lab reminder for follow uplabs 2 weeks after last dosage of Tamoxifen/Clomid. Levels should remainelevated from there. If not, at the physicians discretion the aboveprotocol can be repeated until labs reflect a 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; PSA


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 primaryhypogonadism. This would not have been caused by the TRT, more thanlikely 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 thepatient’s life quality and health also remain optimal. Educate thepatient on the importance of maintaining good levels of T, even if that meansbeing treated with TRT.
 

mariops2

New Member
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..
 
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