The hCG use can be during cycle, nearing the end of cycle, or at the conclusion of cycle. Confusing? The most important part is the timing for the hCG administration. For example, TC/TE 500 mg/week for 12 weeks will provide a serum testosterone
level upon the last injection somewhere around 7,000 ng/dL. The PCT must consider the TC/TE half-life. From 7,000 ng/dL, it will be about 4 weeks until the HPTA attempts to restart (ideally/theoretically). Thus, the SERMs
should not begin until this point, although I do include them earlier to decrease the negative feedback of the hCG and E2.
I prefer 500 IU SC Q3D throughout the AAS
administration. I do think that it aids it bringing the testes back online. However, this does not mean to stop hCG after stopping AAS
. One must have a sense of the testes response to hCG. Also, from the posts I have read, the HPTA is not in an environment for functioning after AAS
administration. The half-lives of the AAS
must be taken into consideration.
The first phase of the HPTA protocol examines the functionality of the testicles by the direct action of hCG. hCG raises sex hormone levels directly through the stimulation of testis and secondarily decreases the production and level of the gonadotropin LH. The increase in serum testosterone with the hCG stimulation is useful in determining whether any primary testicular dysfunction is present.
This initial value is a measure of the ability of the testicles to respond to stimulation from the hCG. Demonstration of HPTA functionality is by an adequate response of the testicles to raise the serum level of T well into the normal range. If this is observed the hCG is discontinued. The failure of the testes to respond to an hCG challenge is indicative of primary testicular failure.
In the simplest terms, the first half of the protocol is determine testicular production and reserve by direct stimulation with hCG. If one is unable to obtain adequate (normal) levels successfully to the first half there is little cause or reason to proceed to the second half.
The second phase of the HPTA protocol, clomiphene
, examines the ability of the hypothalamo-pituitary to respond to stimulation by producing LH levels within the normal reference range. Clomiphene
is a mixed agonist/antagonist. This is due o the fact that clomiphene is composed of two isomers: enclomiphene (trans-clomiphene) and zuclomiphene (cis-clomiphene). Enclomiphene is an estradiol receptor antagonist. Zuclomiphene is an estradiol receptor agonist. In all likelihood, the net antagonist effect might be due to the composition being 70% trans (enclomiphene) and 30% cis (zuclomiphene). Tamoxifen
is more of a strict antiestrogen, decreases the effect of estrogen in the body, and potentiates the action of clomiphene. This combination came about after 100s of clinical experience.
Tamoxifen and clomiphene citrate compete with estrogen for estrogen receptor binding sites, thus eliminating excess estrogen circulation at the level of the hypothalamus and pituitary allowing gonadotropin production to resume. Administration produces an elevation of LH and secondarily gonadal sex hormones. The administration leads to an appropriate rise in the levels of LH, suggesting that the negative feedback control on the hypothalamus is intact and that the storage and release of gonadotropins by the pituitary is normal. If there was a successful stimulation of testicular T levels by hCG but an inadequate or no response in LH production than the patient has hypogonadotropic, secondary, hypogonadism.
In the simplest terms, the second half of the protocol is to determine hypothalamo-pituitary production and reserve with clomiphene and tamoxifen. The physiological type of hypogonadism, hypogonadotropic or secondary, is characterized by abnormal low or low normal gonadotropin (LH) production in response to clomiphene citrate and tamoxifen. In the functional type of hypogonadism, the ability to stimulate is present.
Further, in my experience, an inadequate gonadotropin response is not reason for giving up on HPTA restoration. As I have said, discontinuing on a 12-18 month basis is still advocated. I have had success by this regimen. http://forum.mesomorphosis.com/675440-post39.html