How to approach a pct!
Posted: Mon May 25, 2020 1:39 pm
The question is often asked among the anabolic steroid using community: Clomid or Nolvadex? Which one for PCT?
First of all, we will look at the two main SERMs people use for PCT -- Nolvadex & Clomid. Nolvadex on a mg for mg basis is far more effective than Clomid in stimulating endogenous Testosterone production, as well as being a more cost-effective choice than Clomid itself. Studies have demonstrated that 150mg of Clomid (Clomiphene Citrate) administered daily raised endogenous Testosterone levels of 10 healthy males by approximately 150%, while incidentally, 20 mg of Nolvadex (Tamoxifen Citrate) daily raised endogenous Testosterone levels by the same amount.\11]) It is very evident here that Clomid is very effective for this purpose, but Nolvadex seems to be a more cost-effective choice seeing as though it is more effective than Clomid when compared mg for mg. In the same study, they directly examined the effects of Nolva and Clomid on the pituitary. They infused the men with 100 mcg of GnRH and then measured LH output from the pituitary. The men taking nolvadex at 20 mg/day had a significantly increased LH response to GnRH. In contrast, the men taking clomid had reduced LH output, a decreased sensitivity to GnRH. The researchers stated that "a role of the intrinsic estrogenic activity of Clomid which is practically absent in Tamoxifen (Nolva) seems the most probable explanation."\11]) Likewise, Clomid actually has been studied to exhibit Estrogen agonist effects at the pituitary in vitro.\12]) What all this means is that Clomid potentially will work in varying degrees as an Estrogen at the pituitary gland, triggering the negative feedback loop and reducing the output of Testosterone stimulating gonadotropins (LH and FSH). This is a problem during post cycle therapy, which is a period in which individuals are trying to recover their HPTA function rather than halt it even further. Ideally, one would want a SERM that exhibits almost 100% Estrogen antagonistic effects on the pituitary gland.
In addition to all this, vision sides are common Clomid and could may cause irreversible changes.\18]) Nolvadex may potentially cause some vision sides as well,\19]) but they are known to be more prominent in Clomid than Nolvadex.\16]) More on Side Effects below.
Despite all of this, it should still be noted that the FDA actually recommends clomid for treatment of male hypogonadism and that high doses are unnecessary to bring hypogonadal men into range.\14][17])
Dosing
Nolvadex
In all studies involving Nolvadex, for doses used to stimulate endogenous Testosterone production, only 20–40 mg daily of Nolvadex was utilized, and it has in fact been shown that doubling the dose to 40 mg or higher will not produce any significant difference in endogenous Testosterone secretion.
The only reason why many elect to higher daily doses of Nolvadex for the first 1-2 weeks of a PCT is for the purpose of achieving optimal peak blood plasma levels more quickly, so as to ensure more rapid HPTA recovery.
This isn't necessary and just further increases your risk of potential sides.
Furthermore, the first week of PCT, there may be lingering suppressive AAS still in the bloodstream, simply leading to greater oxidative stress on the body by taking more compounds.
Recent studies have found that even lower doses than traditionally-prescribed are equally as effective.
A weekly low-dose tamoxifen vs raloxifene vs placebo in premenopausal women with estrogen receptor-positive breast cancer
Randomized dose trial of tamoxifen at low doses in hormone replacement therapy
Randomized trial of low-dose tamoxifen on breast cancer proliferation and estrogen biomarkers
PCT dosing with Nolvadex has been updated (2020) as follows:
6–8 Weeks at 10 mg ED. Doses can be taken as low as 5 mg/day if sides are a concern.
Clomid
According to the study previously mentioned,\14]) and thus recommended by the FDA, clomid for hypogonadism should be run at 25 mg EOD, 25 mg ED, or 50 mg EOD. Again, the side effects of clomid can be quite bothersome and bad. Why risk vision changes or loss running +50-150 mg ED when you could just do 25mg ED or 50mg EOD and get fantastic results? Dosing of a PCT including Nolvadex is as followed:
6-8 Weeks: 25mg ED or 50mg EOD
Torem
In the study above comparing Nolva, Torem, & Ralox, 60mg was the dosage used and found to be very sufficient for PCT purposes. 60mg ED is the FDA recommended dosage and they found no benefit upon doubling the dose in women with breast cancer. Again, doubling the dose for the purpose of achieving optimal peak blood plasma levels quicker isn't necessary and just further increases your risk of potential sides. Dosing of a PCT including Torem is as followed:
6-8 Weeks: 60mg ED
SERM Dosing Note
Note: As you've noticed above, /r/seroids recommends 6-8 weeks of SERMs. It is common for a lot of PCT options to only be 4 weeks. These protocols usually used double the dose for the first week or two. The only reason why many elect to utilize doubling the dose for the first 1-2 weeks of a PCT program is for the purpose of achieving optimal peak blood plasma levels quicker so as to ensure HPTA recovery quicker. This isn't necessary and just further increases your risk of potential sides. It has been studied that the longer you are on SERMs, the better your results of stimulating Testosterone.\15]) So to prevent unwanted sides as well as potentially achieve better results, we choose to suggest lower dosing over a longer period than 4 weeks.
HCG
The majority of anabolic steroid users from the 1960s – mid 1980s did not even utilize any compounds for the purpose of hormonal recovery, and the term PCT did not even exist at that time. When the use of HCG became increasingly popular (circa 1980), it was the only compound utilized. Since then, the medical and scientific understanding of such things has increased exponentially and there should be no reason for any informed and properly educated individual to utilize HCG on its own for PCT. When utilized in conjunction with one of the other two categories of compounds (an AI and a SERM), the dynamics change considerably.
HCG mimics LH and therefore actually keeps the testicles producing testosterone even when anabolic steroids are present. However, it does not induce the production of actual LH. The use of HCG on cycle, this is primarily done so that post cycle recovery is easier. HCG is also used on cycle to prevent or at least minimize testicular atrophy that occurs due to the use of anabolic steroids. The testicular atrophy that occurs is not permanent but will reverse once steroid use is discontinued and natural testosterone production begins again.
It has been mentioned already that much of the difficulty in recovering the HPTA following an anabolic steroid cycle is the result of Leydig cell desensitization. HCG is essentially an analogue of LH, and the testes after a prolonged anabolic steroid cycle would be as equally desensitized to HCG as they are to LH. The human body, however, produces LH amounts on its own that are far too inefficient for proper and rapid Testosterone production. The body’s natural increase of LH and FSH following an anabolic steroid cycle is also not a rapid peak, but a very slow and steady incline, as evidenced by the study referenced earlier in which it was not until 3 weeks when LH levels only began to reach the normal physiological measurements following the cessation of exogenous Testosterone. Therefore, the body’s own natural LH production does not provide a high enough dose for stimulation, nor an immediate stimulation to the testes required for the initial increase in Testosterone needed during the post cycle therapy weeks. Now in our PCT will will be utilizing a SERM which will stimulate FSH/LH, but most will find recovery being a smother transition when HCG is utilized. Studies have in fact demonstrated the incredible effectiveness of HCG for this purpose, and it is even suggested clinically that HCG be utilized for the purpose of treating anabolic steroid induced hypogonadism.\4])
If you choose to include HCG in your PCT protocol, the best possible SERM for the PCT protocol is Nolvadex, as studies have demonstrated that HCG and Nolvadex utilized together have exhibited a remarkable synergistic effect in terms of stimulating endogenous Testosterone production, and that Nolvadex will actually work to block the desensitization effect on the Leydig cells of the testes caused by high doses of HCG.\10]) This is very important, because just as too little LH secretion for extended periods can cause desensitization to gonadotropins, too much gonadotropin stimulation (in the form of HCG or otherwise) may likewise cause a desensitization effect.
Dosing
HCG is ran a couple different ways:
Over The Entire Cycle
Weeks Leading Up To PCT
1-2 Weeks Before PCT
First 1-2 Weeks Of PCT
1. Over The Entire Cycle
This is the preferred option, as it keeps the Leydig cells active, reducing atrophy and the reactive oxygen species (ROS) free radical damage incurred by prolonged shutdown. HCG can be ran over the entire length of the cycle to make PCT easy and efficient, if desired:
Over Entire Length Of Cycle: 250 IU EOD
Stop HCG use before starting PCT (SERM)
Important Note: 250 IU 2x/week is used by some, but there have been studies on maintaining intratesticular testosterone in healthy men with gonadotropin suppression. This study found 125 iu EOD (437.5 iu/week) was 25% less than baseline. Alternatively, 250 iu EOD (875 iu/week) was found to only be 7% below baseline.\13]) For this reason, it is recommended to use at least 250 iu EOD. If desiring to be as close to baseline as possible, you would need more than 875 iu/week (7% less than baseline) and less than 1750 iu/week (26% above baseline). This is where the 500 iu 2x/week come in, but without a study comparing, we are only speculating and you could need more. Alternatively, if money is a factor, it is best to use some HCG rather than no HCGand you may do less than the recommended: 500-750 iu/week.
2. Weeks Leading Up To PCT
This is the preferred method after Option 1, especially for those that are coming off a long cycle or blast and cruise.
Starting 6 weeks before PCT:
Weeks 6-4: 500-1000 iu 3x/week
Weeks 3-1: 500-1000 iu 2x/week
Week 0: Start PCT (SERM)
3. 1-2 Weeks Before PCT
Typically this will be run in the ~2 weeks leading up to PCT after your last injection, while you are waiting for your AAS esters to clear (assuming long esters -- Ex: Test E or C). If using short esters (Prop and/or Ace), nothing changes. You just start the HCG while on cycle (1-2 weeks before PCT).
If you chose to utilize HCG in this fashion (unless using short esters (Prop and/or Ace), there is one remaining issues to be addressed:
The fact that HCG causes increased production of aromatase, leading to increased Estrogen levels. See Below
This is where the AI is to be utilized as a supportive compound for HCG use in this 1–2 week period, and after HCG is discontinued early on in PCT, only the SERM to be used in order to carry along the hormonal recovery process. HCG utilized in this fashion will be ran:
1-2 Weeks Before PCT: 1000-1500 iu EOD
1-2 Weeks Before PCT: AI will be used only as long as HCG
4. First 1-2 Weeks Of PCT
Some will say HCG shouldn't be ran into PCT as it's suppressive, but as noted above in the study with Nolvadex, it has shown to be effective and fine when ran simultaneously with Nolvadex.\10])
If you chose to utilize HCG in this fashion, there is one remaining issues to be addressed:
The fact that HCG causes increased production of aromatase, leading to increased Estrogen levels. See Below
This is where the AI is to be utilized as a supportive compound for HCG use in this 1–2 week period, and after HCG is discontinued early on in PCT, only the SERM to be used in order to carry along the hormonal recovery process. HCG utilized in this fashion will be ran:
First 1-2 Weeks Of PCT: 1000-1500 iu EOD
First 1-2 Weeks Of PCT: AI will be used only as long as HCG
First of all, we will look at the two main SERMs people use for PCT -- Nolvadex & Clomid. Nolvadex on a mg for mg basis is far more effective than Clomid in stimulating endogenous Testosterone production, as well as being a more cost-effective choice than Clomid itself. Studies have demonstrated that 150mg of Clomid (Clomiphene Citrate) administered daily raised endogenous Testosterone levels of 10 healthy males by approximately 150%, while incidentally, 20 mg of Nolvadex (Tamoxifen Citrate) daily raised endogenous Testosterone levels by the same amount.\11]) It is very evident here that Clomid is very effective for this purpose, but Nolvadex seems to be a more cost-effective choice seeing as though it is more effective than Clomid when compared mg for mg. In the same study, they directly examined the effects of Nolva and Clomid on the pituitary. They infused the men with 100 mcg of GnRH and then measured LH output from the pituitary. The men taking nolvadex at 20 mg/day had a significantly increased LH response to GnRH. In contrast, the men taking clomid had reduced LH output, a decreased sensitivity to GnRH. The researchers stated that "a role of the intrinsic estrogenic activity of Clomid which is practically absent in Tamoxifen (Nolva) seems the most probable explanation."\11]) Likewise, Clomid actually has been studied to exhibit Estrogen agonist effects at the pituitary in vitro.\12]) What all this means is that Clomid potentially will work in varying degrees as an Estrogen at the pituitary gland, triggering the negative feedback loop and reducing the output of Testosterone stimulating gonadotropins (LH and FSH). This is a problem during post cycle therapy, which is a period in which individuals are trying to recover their HPTA function rather than halt it even further. Ideally, one would want a SERM that exhibits almost 100% Estrogen antagonistic effects on the pituitary gland.
In addition to all this, vision sides are common Clomid and could may cause irreversible changes.\18]) Nolvadex may potentially cause some vision sides as well,\19]) but they are known to be more prominent in Clomid than Nolvadex.\16]) More on Side Effects below.
Despite all of this, it should still be noted that the FDA actually recommends clomid for treatment of male hypogonadism and that high doses are unnecessary to bring hypogonadal men into range.\14][17])
Dosing
Nolvadex
In all studies involving Nolvadex, for doses used to stimulate endogenous Testosterone production, only 20–40 mg daily of Nolvadex was utilized, and it has in fact been shown that doubling the dose to 40 mg or higher will not produce any significant difference in endogenous Testosterone secretion.
The only reason why many elect to higher daily doses of Nolvadex for the first 1-2 weeks of a PCT is for the purpose of achieving optimal peak blood plasma levels more quickly, so as to ensure more rapid HPTA recovery.
This isn't necessary and just further increases your risk of potential sides.
Furthermore, the first week of PCT, there may be lingering suppressive AAS still in the bloodstream, simply leading to greater oxidative stress on the body by taking more compounds.
Recent studies have found that even lower doses than traditionally-prescribed are equally as effective.
A weekly low-dose tamoxifen vs raloxifene vs placebo in premenopausal women with estrogen receptor-positive breast cancer
Randomized dose trial of tamoxifen at low doses in hormone replacement therapy
Randomized trial of low-dose tamoxifen on breast cancer proliferation and estrogen biomarkers
PCT dosing with Nolvadex has been updated (2020) as follows:
6–8 Weeks at 10 mg ED. Doses can be taken as low as 5 mg/day if sides are a concern.
Clomid
According to the study previously mentioned,\14]) and thus recommended by the FDA, clomid for hypogonadism should be run at 25 mg EOD, 25 mg ED, or 50 mg EOD. Again, the side effects of clomid can be quite bothersome and bad. Why risk vision changes or loss running +50-150 mg ED when you could just do 25mg ED or 50mg EOD and get fantastic results? Dosing of a PCT including Nolvadex is as followed:
6-8 Weeks: 25mg ED or 50mg EOD
Torem
In the study above comparing Nolva, Torem, & Ralox, 60mg was the dosage used and found to be very sufficient for PCT purposes. 60mg ED is the FDA recommended dosage and they found no benefit upon doubling the dose in women with breast cancer. Again, doubling the dose for the purpose of achieving optimal peak blood plasma levels quicker isn't necessary and just further increases your risk of potential sides. Dosing of a PCT including Torem is as followed:
6-8 Weeks: 60mg ED
SERM Dosing Note
Note: As you've noticed above, /r/seroids recommends 6-8 weeks of SERMs. It is common for a lot of PCT options to only be 4 weeks. These protocols usually used double the dose for the first week or two. The only reason why many elect to utilize doubling the dose for the first 1-2 weeks of a PCT program is for the purpose of achieving optimal peak blood plasma levels quicker so as to ensure HPTA recovery quicker. This isn't necessary and just further increases your risk of potential sides. It has been studied that the longer you are on SERMs, the better your results of stimulating Testosterone.\15]) So to prevent unwanted sides as well as potentially achieve better results, we choose to suggest lower dosing over a longer period than 4 weeks.
HCG
The majority of anabolic steroid users from the 1960s – mid 1980s did not even utilize any compounds for the purpose of hormonal recovery, and the term PCT did not even exist at that time. When the use of HCG became increasingly popular (circa 1980), it was the only compound utilized. Since then, the medical and scientific understanding of such things has increased exponentially and there should be no reason for any informed and properly educated individual to utilize HCG on its own for PCT. When utilized in conjunction with one of the other two categories of compounds (an AI and a SERM), the dynamics change considerably.
HCG mimics LH and therefore actually keeps the testicles producing testosterone even when anabolic steroids are present. However, it does not induce the production of actual LH. The use of HCG on cycle, this is primarily done so that post cycle recovery is easier. HCG is also used on cycle to prevent or at least minimize testicular atrophy that occurs due to the use of anabolic steroids. The testicular atrophy that occurs is not permanent but will reverse once steroid use is discontinued and natural testosterone production begins again.
It has been mentioned already that much of the difficulty in recovering the HPTA following an anabolic steroid cycle is the result of Leydig cell desensitization. HCG is essentially an analogue of LH, and the testes after a prolonged anabolic steroid cycle would be as equally desensitized to HCG as they are to LH. The human body, however, produces LH amounts on its own that are far too inefficient for proper and rapid Testosterone production. The body’s natural increase of LH and FSH following an anabolic steroid cycle is also not a rapid peak, but a very slow and steady incline, as evidenced by the study referenced earlier in which it was not until 3 weeks when LH levels only began to reach the normal physiological measurements following the cessation of exogenous Testosterone. Therefore, the body’s own natural LH production does not provide a high enough dose for stimulation, nor an immediate stimulation to the testes required for the initial increase in Testosterone needed during the post cycle therapy weeks. Now in our PCT will will be utilizing a SERM which will stimulate FSH/LH, but most will find recovery being a smother transition when HCG is utilized. Studies have in fact demonstrated the incredible effectiveness of HCG for this purpose, and it is even suggested clinically that HCG be utilized for the purpose of treating anabolic steroid induced hypogonadism.\4])
If you choose to include HCG in your PCT protocol, the best possible SERM for the PCT protocol is Nolvadex, as studies have demonstrated that HCG and Nolvadex utilized together have exhibited a remarkable synergistic effect in terms of stimulating endogenous Testosterone production, and that Nolvadex will actually work to block the desensitization effect on the Leydig cells of the testes caused by high doses of HCG.\10]) This is very important, because just as too little LH secretion for extended periods can cause desensitization to gonadotropins, too much gonadotropin stimulation (in the form of HCG or otherwise) may likewise cause a desensitization effect.
Dosing
HCG is ran a couple different ways:
Over The Entire Cycle
Weeks Leading Up To PCT
1-2 Weeks Before PCT
First 1-2 Weeks Of PCT
1. Over The Entire Cycle
This is the preferred option, as it keeps the Leydig cells active, reducing atrophy and the reactive oxygen species (ROS) free radical damage incurred by prolonged shutdown. HCG can be ran over the entire length of the cycle to make PCT easy and efficient, if desired:
Over Entire Length Of Cycle: 250 IU EOD
Stop HCG use before starting PCT (SERM)
Important Note: 250 IU 2x/week is used by some, but there have been studies on maintaining intratesticular testosterone in healthy men with gonadotropin suppression. This study found 125 iu EOD (437.5 iu/week) was 25% less than baseline. Alternatively, 250 iu EOD (875 iu/week) was found to only be 7% below baseline.\13]) For this reason, it is recommended to use at least 250 iu EOD. If desiring to be as close to baseline as possible, you would need more than 875 iu/week (7% less than baseline) and less than 1750 iu/week (26% above baseline). This is where the 500 iu 2x/week come in, but without a study comparing, we are only speculating and you could need more. Alternatively, if money is a factor, it is best to use some HCG rather than no HCGand you may do less than the recommended: 500-750 iu/week.
2. Weeks Leading Up To PCT
This is the preferred method after Option 1, especially for those that are coming off a long cycle or blast and cruise.
Starting 6 weeks before PCT:
Weeks 6-4: 500-1000 iu 3x/week
Weeks 3-1: 500-1000 iu 2x/week
Week 0: Start PCT (SERM)
3. 1-2 Weeks Before PCT
Typically this will be run in the ~2 weeks leading up to PCT after your last injection, while you are waiting for your AAS esters to clear (assuming long esters -- Ex: Test E or C). If using short esters (Prop and/or Ace), nothing changes. You just start the HCG while on cycle (1-2 weeks before PCT).
If you chose to utilize HCG in this fashion (unless using short esters (Prop and/or Ace), there is one remaining issues to be addressed:
The fact that HCG causes increased production of aromatase, leading to increased Estrogen levels. See Below
This is where the AI is to be utilized as a supportive compound for HCG use in this 1–2 week period, and after HCG is discontinued early on in PCT, only the SERM to be used in order to carry along the hormonal recovery process. HCG utilized in this fashion will be ran:
1-2 Weeks Before PCT: 1000-1500 iu EOD
1-2 Weeks Before PCT: AI will be used only as long as HCG
4. First 1-2 Weeks Of PCT
Some will say HCG shouldn't be ran into PCT as it's suppressive, but as noted above in the study with Nolvadex, it has shown to be effective and fine when ran simultaneously with Nolvadex.\10])
If you chose to utilize HCG in this fashion, there is one remaining issues to be addressed:
The fact that HCG causes increased production of aromatase, leading to increased Estrogen levels. See Below
This is where the AI is to be utilized as a supportive compound for HCG use in this 1–2 week period, and after HCG is discontinued early on in PCT, only the SERM to be used in order to carry along the hormonal recovery process. HCG utilized in this fashion will be ran:
First 1-2 Weeks Of PCT: 1000-1500 iu EOD
First 1-2 Weeks Of PCT: AI will be used only as long as HCG