PCT Failed - Endocrinologist Seems Stumped - Please Help!

**razman** · 07-02-2018, 10:58 PM

I did two test E cycles (400mg/wk) for 12 weeks each. I like to think I did my cycles "right" in that I used an AI, hCG , and did regular blood work before, during and after my cycle. My PCT after each cycle consistented of Nolva + Clomid for 6 weeks. After my first cycle's PCT, my total test level came back up to about 600 ng/dL. Not quite back to 720 ng/dL, which is what it was before I started, but still I figured all went well.

My second cycle's PCT clearly did not go so well. I did the same Clomid + Nolva PCT as I did the first time but for whatever reason my test level never came back. For about 8 months it hovered at the 400 ng/dL mark, which is when I decided to see an endocrinologist. Doc got me on 50mg/day of clomid for 12 weeks, which at the end got my test level back up to 600 but only temporarily. Soon after stopping the Clomid my test level went back down to 350-400 and that is where it has stayed for the past 2 years. This has affected my labido, mood, and energy for too long now.

I went back to said Doc recently and the only thing he recommended is for me to get back on another 12 week 50mg/day Clomid therapy cycle.

I have little faith that the same 50 mg/day 12 week Clomid therapy will yield any different, long-lasting results this time around. Quite honestly my Doc, whose is an Ivy league top endocrinologist, seems like he's grasping at straws and doesn't seem to have a concrete plan either.

Does anyone have any recommendations as to what I can or should try at this point to get my body to recover? Any help would be much appreciated!

Thanks.

**alvinbwong** · 07-03-2018, 12:11 AM

in the same situation .......

**PeanutbutterDC** · 07-03-2018, 12:19 AM

Your doc knows about your test e cycles, right?
Are you a candidate for trt?

**almostgone** · 07-03-2018, 12:22 AM

Originally Posted by razman

I did two test E cycles (400mg/wk) for 12 weeks each. I like to think I did my cycles "right" in that I used an AI, hCG , and did regular blood work before, during and after my cycle. My PCT after each cycle consistented of Nolva + Clomid for 6 weeks. After my first cycle's PCT, my total test level came back up to about 600 ng/dL. Not quite back to 720 ng/dL, which is what it was before I started, but still I figured all went well.

My second cycle's PCT clearly did not go so well. I did the same Clomid + Nolva PCT as I did the first time but for whatever reason my test level never came back. For about 8 months it hovered at the 400 ng/dL mark, which is when I decided to see an endocrinologist. Doc got me on 50mg/day of clomid for 12 weeks, which at the end got my test level back up to 600 but only temporarily. Soon after stopping the Clomid my test level went back down to 350-400 and that is where it has stayed for the past 2 years. This has affected my labido, mood, and energy for too long now.

I went back to said Doc recently and the only thing he recommended is for me to get back on another 12 week 50mg/day Clomid therapy cycle.

I have little faith that the same 50 mg/day 12 week Clomid therapy will yield any different, long-lasting results this time around. Quite honestly my Doc, whose is an Ivy league top endocrinologist, seems like he's grasping at straws and doesn't seem to have a concrete plan either.

Does anyone have any recommendations as to what I can or should try at this point to get my body to recover? Any help would be much appreciated!

Thanks.

Do a little reading on the Scally Power PCT. It might benefit you. Also, post up a full copy of your labs and you may get more input.
Good luck!

**alvinbwong** · 07-03-2018, 12:33 AM

i can not find the scally power pct , could you please give a link for this
thanks a lot

**almostgone** · 07-03-2018, 12:37 AM

Originally Posted by alvinbwong

i can not find the scally power pct , could you please give a link for this
thanks a lot

Here's one:

https://forums.steroid.com/anabolic-...-question.html

Edit: You can type Scally Power PCT into any search engine and will get plenty of hits. Just do some reading. There are several versions of his Power PCT, I believe the link I posted is one of.the newer versions.
You may so want to visit excelmale dot com. I know it is posted on that site.

**Mr.BB** · 07-03-2018, 12:54 AM

Age?

**razman** · 07-03-2018, 01:26 AM

Originally Posted by PeanutbutterDC

Your doc knows about your test e cycles, right?
Are you a candidate for trt?

Yes, he knows. No I'm not a candidate for TRT since we're looking to keep me fertile. (Why? Not sure.

) Plus, a solution that means I won't be tied to a needle or medication for life would be nice.

**razman** · 07-03-2018, 01:32 AM

Originally Posted by Mr.BB

Age?

39 y/o.

**cousinmuscles** · 07-03-2018, 04:41 AM

You should find a doc who can investigate this further. Can be diet, stress, or the HPTA. HPTA has two parts that can fail, the hypothalamus-pituitary or testicular. This is why the Scally power PCT is good for assessing this.

Here is a short write up on dr Scallys Power PCT:

Originally Posted by numbere

Welcome to the forum! I think before you do anything you should wait another 3-4 weeks and have a hormone panel assay. The PCT you ran might have reset your HPTA, but only time will tell.

If your blood work comes back and your hormone levels are poor then I think Scally's PCT program would be worth a try. You don't have many options other than TRT which is a lifelong commitment.

IMO the HCG aspect of Scally's PCT is only worth implementing if one is going to have blood work after the first 15 days, and would also like to test for functionality of the testicals. This first 15 day period is what Scally refers to as a "dynamic challenge." The hCG challenge aspect of his regimine is meant to test if one is suffering from primary hypogonadism.

Below is a synopsis of Scally's program.

Part I

The first half begins with administering an hCG challenge test consisting of 1,000-2,500 IU every other day for 15 days. At the of the 15 day period one should have a full hormone. A failed test for sufficient leydig cell functionality is when total test levels reside in the low 20% of the adult male reference range, which is about 400 ng/dl. If one is unable to attain normal levels through the hCG challenge then they are likely suffering from primary hypogonadism. This means that if SERM treatment in Part II is successful then natural test levels will likely be less than desirable.

Part II

The second half of the protocol uses nolva and clomid in order to stimulate the hypothalamus to produce gonadotropin releasing hormone (GnRH) and the pituitary to release luteinizing hormone (LH) and follicle stimulating hormone (FSH). LH will then signal the leydig cells to begin test production and FSH communicate with the sertoli cells to begin spermatogenesis.

SERM treatment should begin with clomid dosed at 50 mg twice a day for 30 days, and nolva dosed at 20 mg/day for 45 days. Then 6-8 weeks after succession of PCT, labs should be drawn which include a full hormone panel in order to assess the extent of HPTA restoration.

Notice that in this protocol you do a hormone panel test after using HCG for two weeks to see if your testicles are functional. And then again another hormone panel 6-8 weeks after finishing the PCT to see if your brain (hypothalamus-pituitary) function is restored. So the HCG is used to test if your testicles are still working.

What a doctor can do is check for varicoceles and who knows how many other things. Full hormone panel might reveal other issues.

Good luck and give us an update

**Octaneforce** · 07-03-2018, 04:54 AM

Sounds like you need trt. You may have developed low test even without the cycles. Theres pros and cons to everything. If you get trt you will feel better and can blast and cruise without pct cancer drugs. Hcg can possibly help maintain fertility. Or do a sperm bank

**Windex** · 07-03-2018, 05:24 AM

Originally Posted by razman

Yes, he knows. No I'm not a candidate for TRT since we're looking to keep me fertile. (Why? Not sure.

) Plus, a solution that means I won't be tied to a needle or medication for life would be nice.

You can still have children on TRT just as an FYI.

**Chrisp83TRT** · 07-03-2018, 06:38 AM

Originally Posted by razman

Yes, he knows. No I'm not a candidate for TRT since we're looking to keep me fertile. (Why? Not sure.

) Plus, a solution that means I won't be tied to a needle or medication for life would be nice.

You are 39... messing with cycles will put you in a position where you will need TRT. Most men hitting their 40’s should check regardless as we all at one point will need TRT.
You take vits ? Tech if you do you are “tied” down to a medication haha. Just be a man and take the pinning

**Quester** · 07-03-2018, 09:34 AM

Originally Posted by razman

39 y/o.

Your profile says your 30?

**mxgregg** · 07-03-2018, 09:52 AM

Some people just don't understand that taking steroids can have consequences and sometimes they affect you for the rest of your life. Seems like most young users really don't get this at all. Hope you can find some help.

**razman** · 07-03-2018, 10:26 AM

Originally Posted by cousinmuscles

Notice that in this protocol you do a hormone panel test after using HCG for two weeks to see if your testicles are functional. And then again another hormone panel 6-8 weeks after finishing the PCT to see if your brain (hypothalamus-pituitary) function is restored. So the HCG is used to test if your testicles are still working.

What a doctor can do is check for varicoceles and who knows how many other things. Full hormone panel might reveal other issues.

Good luck and give us an update

Thanks for the feedback cousinmuscles. My endo is ruling out primary hypogonadism since the last 12 week clomid (50mg/day) treatment he put me on brought back my test levels to 600 ng/dl. If it were a problem with the testes then I would assume we wouldn't see much response at all from clomid treatment and I'd be stuck at 350-400 during and after the clomid treatment. For this reason he strongly feels that it's secondary and I tend to agree. Thus, if we take the hCG out from Scally's PCT regimen you provided, then we're left with a stacked SERM protocol (clomid + nolva), which is what I did for my own self-administered PCT after my second cycle.

The problem here is that after the SERM is taken away the test levels go right back to low levels. I'm wondering if anyone has ever seen someone get out of this hole without resorting to TRT. Wondering what my chances are...

**Quester** · 07-03-2018, 10:32 AM

Originally Posted by razman

Thanks for the feedback cousinmuscles. My endo is ruling out primary hypogonadism since the last 12 week clomid (50mg/day) treatment he put me on brought back my test levels to 600 ng/dl. If it were a problem with the testes then I would assume we wouldn't see much response at all from clomid treatment and I'd be stuck at 350-400 during and after the clomid treatment. For this reason he strongly feels that it's secondary and I tend to agree. Thus, if we take the hCG out from Scally's PCT regimen you provided, then we're left with a stacked SERM protocol (clomid + nolva), which is what I did for my own self-administered PCT after my second cycle.

The problem here is that after the SERM is taken away the test levels go right back to low levels. I'm wondering if anyone has ever seen someone get out of this hole without resorting to TRT. Wondering what my chances are...

Sounds like you already know the answers, except your age.

**razman** · 07-03-2018, 10:32 AM

Originally Posted by Windex

You can still have children on TRT just as an FYI.

Thanks Windex. I've read that too. Specifically, taking hCG while on TRT helps with fertility. However, the impression I'm getting is that conceiving while on TRT/hCG is the exception and not the rule, and is significantly more difficult than relying on a long term therapy that involves low dose SERMs (e.g., clomid 12 - 25 mg/EOD) to keep test levels reasonable (e.g., 600 ng/dL).

**razman** · 07-03-2018, 10:39 AM

Originally Posted by Chrisp83TRT

You are 39... messing with cycles will put you in a position where you will need TRT. Most men hitting their 40’s should check regardless as we all at one point will need TRT.
You take vits ? Tech if you do you are “tied” down to a medication haha.

Very true. haha.

Originally Posted by Chrisp83TRT

Just be a man and take the pinning

Honestly before I went to the doc this time I was quite certain there was no alternative but to do TRT. So I was a little surprised when he suggested we try clomid again. I mean if there is some chance it or some other PCT regimen can work I'm all for it.

**razman** · 07-03-2018, 10:53 AM

Originally Posted by mxgregg

Some people just don't understand that taking steroids can have consequences and sometimes they affect you for the rest of your life. Seems like most young users really don't get this at all. Hope you can find some help.

This is so true. I thought to myself that I wouldn't be a statistic because I'd done my homework and educated myself on the importance of taking an AI and hCG during my relatively tame test only cycles. Clearly I was wrong... If anything I hope this thread gives people who are considering starting their first cycle some pause.

**Windex** · 07-03-2018, 11:14 AM

Originally Posted by razman

Thanks Windex. I've read that too. Specifically, taking hCG while on TRT helps with fertility. However, the impression I'm getting is that conceiving while on TRT/hCG is the exception and not the rule, and is significantly more difficult than relying on a long term therapy that involves low dose SERMs (e.g., clomid 12 - 25 mg/EOD) to keep test levels reasonable (e.g., 600 ng/dL).

I wouldn't stress about what you read too much. Keep in mind it takes 2 to conceive so the other half is just as important.

**Mr.BB** · 07-03-2018, 11:51 AM

Originally Posted by razman

39 y/o.

39 with natty 720ng/dl?

Well, I guess the cycle put you back to normal. If you want the 720, although it's not necessary for a normal life, you will have to be pinning oil for the rest of your life.

350-400 is not hypogonadism, and in a country where there isn't TRT clinics it would be very difficult for you to be prescribed.

**mxgregg** · 07-03-2018, 11:57 AM

My normal level is 422 and I am just fine in most respects. lol

Originally Posted by Mr.BB

39 with natty 720ng/dl?

Well, I guess the cycle put you back to normal. If you want the 720, although it's not necessary for a normal life, you will have to be pinning oil for the rest of your life.

350-400 is not hypogonadism, and in a country where there isn't TRT clinics it would be very difficult for you to be prescribed.

**razman** · 07-03-2018, 01:06 PM

Originally Posted by Mr.BB

39 with natty 720ng/dl?

Well, I guess the cycle put you back to normal. If you want the 720, although it's not necessary for a normal life, you will have to be pinning oil for the rest of your life.

350-400 is not hypogonadism, and in a country where there isn't TRT clinics it would be very difficult for you to be prescribed.

I was 35 at the time I tested at 720 natural. I guess at a 1% natural decline per year (which is supposedly the norm) my baseline would have likely still been in the high 600s. At 350 my wife has been going through a lot of batteries.