Post - PCT Blood Test Panel

[Nelson Vergel]

This 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) with hCG, clomiphene and/or tamoxifen. PCT is prescribed by some physicians for men who stop testosterone replacement therapy (TRT) or Anabolic-Androgenic Steroids (AAS).


Testosterone replacement therapy and anabolic steroids can lead to HPTA (Hypothalamic-Pituitary-Testicular Axis- shown in figure below) dysfunction. Supplemental testosterone can inhibit the release of the body's own 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 4 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)


BUY POST PCT PANEL

 

[Nelson Vergel]

Millions of men worldwide illicitly use anabolic-androgenic steroids (AAS) for muscle growth. However, AAS can cause death, cardiomyopathy, stroke, and psychosis. AAS use suppresses endogenous testosterone secretion for several months following cessation. Therefore, AAS cessation causes tiredness, low mood, insomnia, absent sexual function, and suicidality. There is currently no treatment recommended to reduce symptoms when men stop AAS. Some men empirically self-administer post-cycle therapy (PCT) drugs such as human chorionic gonadotrophin (hCG), selective oestrogen receptor modulators (SERM) and aromatase inhibitors (AI), aiming to restore endogenous testosterone. hCG directly stimulates endogenous testosterone production, while SERMs and AIs reduce the oestrogenic negative feedback on gonadotrophin secretion. Currently evidence is lacking to support the use of PCT in AAS-induced hypogonadism. Methods: Clinical audit from a single addiction service clinic, of 613 men stopping AAS in Scotland between 2015-2022. Men attended for a single, non-fasting, random blood test performed within 12 months of AAS cessation, with or without PCT use. Primary endpoint was the combination of reference range levels of serum LH, serum FSH and total testosterone, as a surrogate marker of biochemical recovery from hypogonadism. Results: PCT use was reported by 76% of men. Men using PCT had a significantly higher serum total testosterone following AAS cessation compared to men who did not (mean total testosterone nmol/L: 11.3 ± 6.7, no PCT; 12.8 ± 7.6, PCT; P=0.024). PCT use was associated with a higher probability (223/466, 48%, PCT; 56/147; 38%, no-PCT; P=0.04), and shorter time interval between stopping AAS and blood test of normalised reproductive hormones (13.3 ± 8.8 weeks, PCT;18.7 ± 12.0 weeks, no-PCT; P<0.01). The odds of biochemical normalisation during multivariable analysis were statistically significant when: (1) PCT was used (P=0.01); (2) fewer AAS were used (P=0.003); (3) shorter time of AAS use (P=0.02); (4) AAS used stopped for a longer time (P=0.03). Discussion: Our data provide primary evidence that self-administered PCT drugs may be associated with improved biochemical recovery from AAS-induced hypogonadism. These data require corroboration within an interventional study to determine causality. Nevertheless, these data may have important therapeutic implications for the future treatment of men who are motivated to stop AAS.



DOI:10.1210/jendso/bvad114.1702Corpus ID: 263702213

OR25-03 Self-administration Of Post-cycle Therapy Is Associated With Increased Probability Of Subsequent Normalisation Of Reproductive Hormones Following Anabolic-androgenic Steroid Cessation In Men

Bonnie Grant, John Campbell, +8 authors

 

[Nelson Vergel]

Fertility maintenance or restoration in men before, during, and after TRT or AAS

Fertility Preservation in Hypogonadal Men (2018) Robert J. Carrasquillo and Ranjith Ramasamy Introduction Testicular failure is defined as the impairment or loss of both the endocrine functions of the testis (production of testosterone, or T) and exocrine function (production of...

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