Low Testosterone After Anabolic Steroids: A Review of Online Site PCT Protocols

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Nelson Vergel

Founder, ExcelMale.com
Male central hypogonadism secondary to exogenous androgens:a review of the drugs and protocols highlighted by the onlinecommunity of users for prevention and/or mitigation of adverseeffects:

Androgen- or anabolic steroid-induced hypogonadism (ASIH) is no longer confined to professional athletes; its prevalence amongst young men and teenagers using androgens and/or anabolic steroids (AASs) is rising fast, and those affected can experience significant symptoms. Clinicians are increasingly encountering demanding, well-informed men affected by ASIH, yet lacking authoritative information on the subject may struggle to project a credible message. In this article, we overview the methods and drugs that men use in an attempt to counteract ASIH (with a view to either preventing its onset, or reversing it once it has developed) and summarize the scientific evidence underpinning these. The main channel for obtaining these drugs is the Internet, where they can be readily sourced without a valid prescription. An Internet search using relevant terms revealed a huge number of websites providing advice on how to buy and use products to counteract ASIH. Drugs arising repeatedly in our search included human chorionic gonadotrophin (hCG), selective oestrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). The quality and accuracy of the online information was variable, but review of medical literature also highlighted a lack of scientific data to guide clinical practice. It is important for clinicians to be aware of the AAS user's self-treatment strategies with regard to ASIH side-effect mitigation. By ensuring that they are well-informed, clinicians are more likely to retain the credibility and trust of AAS users, who will in turn likely be more open to engage with appropriate management.

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This post PCT panel is designed to measure the health and recovery of the Hypothalamic-Pituitary-Testicular Axis (HPTA) after attempting to normalize it spontaneously or with the use of Post-Cycle Therapy (PCT)

Testosterone replacement therapy and anabolic steroids can lead to HPTA (Hypothalamic-Pituitary-Testicular Axis- shown in the figure below) dysfunction. Supplemental testosterone can inhibit the release of the body's testosterone production through negative feedback inhibition on LH levels. This feedback inhibition also results in suppression of FSH levels, leading to suppression of sperm production (spermatogenesis).

It is suggested that this panel be done no sooner than four weeks after PCT cessation and in a fasting state (morning time)

Tests included:
- Sensitive Estradiol (E2) by Liquid Chromatography/Mass Spectrometry (LC/MS assay used to more accurately measure estradiol in men)
- Total and Free Testosterone [ Free T: direct analog/radioimmunoassay (RIA); Total T: electrochemiluminescence immunoassay (ECLIA) ]
- Luteinizing Hormone (LH) (Responsible for activating Leydig testicular cells to produce your own testosterone). This hormone is shut down by testosterone replacement or AAS.
- Follicle Stimulating Hormone (FSH) (Responsible for activating Sertoli testicular cells to produce sperm). This hormone is shut down by testosterone replacement or AAS.


- CBC - Complete Blood Count (Includes hematocrit)
- CMP - Comprehensive Metabolic Panel (Includes liver and kidney function, glucose and electrolytes)
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