PCT Failed - Endocrinologist Seems Stumped - Please Help!

[cousinmuscles]

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:

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

[razman]

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]

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.