HPTA Restart Protocol

[Bjorg89]

Found this HPTA Restart Protocol from 2013 posted in another forum(the guy who wrote it is inactive).

Any thoughts, if this might actually work?

Scally is bogus and because many refer to his PCT does not mean that it is correct, safe or effective. You have to watch out for bro-science. Scally is in that crowd.

Most important is understanding what you are trying to achieve and what the agents do.

High dose hCG was discredited years ago. High continued stimulation of the LH receptors by LH and/or hCG can desensitize the receptors. So when you are done, what good is your own LH when the receptors are tired of listening?

High LH and/or hCG can create very high intratesticular testosterone levels . That is turn drives high T–>E2 inside the testes. Anastrozole or any competitive AI drug cannot control that. So one can take relatively high anastrozole doses and still have high serum E2.

If you have high FSH/LH, you are primary and there is nothing to restart.

If hCG does not work, you are primary. Stop and do TRT.

If SERM does not create good LH/FSH levels, you are secondary, stop and do TRT.

You can do a restart [or PCT] with SERM or hCG then SERM. Never take multiple SERMs or SERM and hCG at the same time.

SERM’s increase E2 levels, aromatase inhibitors are needed if the SERM’s are effective.

1a) get testes physically recovered with 4-6 weeks of hCG or SERM [suggest nolvadex , not clomid]. You do not want high doses as you want the testes to be functioning on normal LH receptor stimulation. 250iu hCG SC EOD or 12.5 mg nolvadex ED.

1b)) If you start on hCG, time to switch to SERM [nolvadex]. Just stop hCG and start SERM. When using hCG, if the testes have been making decent amounts of T, then the top end of your HPTA has not been active. With the SERM, it will now be. Take SERM for two weeks, if you did 1a), you can skip this.

1c) Take 1.0 - 0.5 mg anastrozole per week in EOD divided doses. You will need a liquid product to get by-the-drop dose increments. Read about anastrozole over-responders, understand the signs and recourse.

2a) Slowly taper off of the SERM, do not stop suddenly or your HPTA may shutdown.

2b) You will want to be on 0.5 mg anastrozole and cruise on that for a few weeks, then taper.

Can you do PCT/restart without SERM? Yes, but may not be effective as the top end of your HPTA has not had a dress rehearsal. Can you do a SERM only PCT/restart? Yes. Note that some can obtain SERM’s but not hCG.

The duration’s and timing are all flexible. Nothing is carved in stone. Everyone’s responses and problems are unique. So seeking the perfect PCT/restart can be a bit misguided.

Labs [optional]: With SERM or hCG, your T and E2 levels should be uncreased [else do TRT]. If high normal, 1.0 mg anastrozole per week. If mid range, 0.5mg

If E2 is high, LH may be high, cut SERM by 50%, anastrozole can be ineffective

With SERM, your LH/FSH numbers should be good. Else do TRT.

If your T levels are good, no real point in checking for LH/FSH, as they will be good. However, if they are high, you will need to reduce SERM dose.

Your testes need DHEA to make T. Supplementing DHEA will help if your DHEA-S levels are low [deficient]; otherwise no advantage. High DHEA supplements can drive high E2 levels in some guys.

You can tell if T levels are good, so need for labs is not always needed to know T levels or that LH/FSH levels are up. But you can’t feel high LH.

During PCT if you start feeling better for a short while, that can be from elevated E2 levels. But when taking an AI, you can get same effect from E2 levels that are too low. So you can get lost. But if your thyroid is a mess, feeling good may not be achievable.

We know that hypothyroid states can lead to low LH and low T. So the prospects of a HPTA restart may be poor in such states. There is more to sexual functioning than your T levels. Do not have T tunnel vision. Note the other health issues and causes in the advice for new guys sticky. If there is a cause for low T, you need to identify and fix that.

Testicular response to hCG or LH is age dependent. HPTA restarts for old guys is silly. HPTA restarts can work very well for younger men if there are no other complication.

Some young guys have brittle HPTA’s that just fail. Sometimes this is spontaneous and idiopathic. However, adventures with 5-alpha reductase inhibitors [hair loss drugs], or stupid cycles can cause irreversible damage. A deca only cycle is a good way to get seriously messed up. So some of these HPTA failures can be caused by drugs/gear; but in some cases these events might just be bringing a future failure forward in time. I have to throw over-training, extreme low fat diets and starvation diets into the risk pool.[/COLOR]

[Windex]

No exaggeration : I would do chemotherapy before ever using an AI again.

[Bjorg89]

How do you guys find this aproach for treating Anabolic steroid –induced hypogonadism?

For AAS users seeking treatment and assistance in permanently discontinuing AAS, certain steps should be taken. Following establishment of a nonjudgmental, healthy, and trusting physician-patient relationship, the patient should be counseled to discontinue all AAS as well as any self-administered ancillary drugs and supplements. For the severely symptomatic patients, a 4-week tapered course of transdermal or injectable TRT may provide immediate symptom improvement. Simultaneous administration of a SERM (such as clomiphene citrate, 25 mg every other day) will interact at the hypothalamus causing stimulation of LH and ultimately increase intratesticular T (Fig. 1). For patients with ASIH-induced gynecomastia , 20 mg tamoxifen daily will block the breast estrogen receptors and stimulate HPG axis recovery (60, 61, 62, 63, 64, 65).

After 4 weeks of treatment with TRT and/or a SERM, repeated hormone panels should be obtained. If the patient has had either a poor gonadotropin response or a poor T response, the authors commence a 4-week course of hCG (1,000–3,000 IU, 3 times per week) while continuing daily treatment with a SERM at the initial starting dose (66, 67, 68, 69). If a patient develops gynecomastia while on hCG, tamoxifen (10 mg b.i.d.) or anastrazole may be commenced. After 8 weeks of hCG and adjunctive treatment, hormone levels should once again be assessed. At this point, if the total serum T remains low and the patient continues to be symptomatic, primary testicular failure is likely (46). These patients will require a longer duration of TRT to avoid permanent ASIH. If appropriately increased serum T and gonadotropin levels are observed, the SERM may be reduced to 50% of its starting dose at 10 weeks of treatment and continued through weeks 12–16 or until target serum T level is achieved (70) (Fig. 2). Recovery of hormonal function may be limited in men with testicular failure, and close monitoring is recommended.

The whole Article: https://www.fertstert.org/article/S0...ulltext#sec2.6

[Bjorg89]

Nothin'?