Book - PCT/AIH

[Michael Scally MD]

I have finally begun the drafting of a book on PCT/AIH. Following is a draft of TOC areas. I anticipate a January 2013 completion. Suggestions welcomed.

HISTORIES - CASE STUDIES
AAS /SARM/PED
HYPOTHALAMIC PITUITARY TESTES AXIS (REGULATION)
AIH [BALLS & BRAINS = PSYCHOLOGY & INFERTILITY ...]
AAS ADDICTION [NOT]
RECOGNITION/DIAGNOSIS
CASE STUDIES - TREATMENT


For example (easy case), in 2003, there was a reported case study of a male patient with azoospermia receiving prescription androgens; testosterone enanthate and oxandrolone, undergoing assisted reproduction.

Initial treatment was discontinuation of testosterone enanthate but not oxandrolone. Three months after discontinuation of testosterone enanthate the serum T level was 30-ng/dL (270-1100-ng/dL), continued azoospermia, suffered from notable depression and irritability, and was placed on an antidepressant.

In the hope of inducing spermatogenesis, both prescription AAS, testosterone enanthate and oxandrolone, were discontinued. Three additional months after the discontinuation of androgens, six months total, the serum T level rose to 134-ng/dL with adequate spermatogenesis for harvesting.

What are the steps in treatment - successful HPTA restoration?

 

[Sworder]

After discontinued testosterone and oxandrolone I am assuming the patients muscle mass has atrophied a lot. Consequently, a cycle of 500mg Test E and 600mg Trenbolone Enanthate for 8-10 weeks should be in order to rebuild some mass.

At the end of the cycle blast hCG for 2 weeks up until PCT nolva + clomid. Most important is the restoration of the muscle via Trenbolone. I believe trenbolone's mixed PrR activity helps with restoration of the HPTA. This is just a theory.. Just like God works in mysterious ways so does Tren..

 

[Millard]

Make sure the info is accessible to as many people as possible in the bodybuilding community with practical use information. Hopefully, they can take to their own personal doctors for medical supervision. The book can provide rational for PCT and educate both patients and doctors alike.

 

[Sworder]

Scally would help a lot of people on this forum too and could be a wealth of information if he would make himself available to help and share. All posts are available to every single person on the internet and Google snaps up on keywords so the the question is rather:
Would Scally be more of a contribution to the community by actively participating in discussions on here so that his responses would be available to the whole internet rather than the select people who has his book?
Personally I would ask him for a copy as I have done with the ASIH book.


Note the personal frustration as I have inquired about some AR related matters which have gone under the radar Scally please

 

[Pericles]

Make sure the info is accessible to as many people as possible in the bodybuilding community with practical use information. Hopefully, they can take to their own personal doctors for medical supervision. The book can provide rational for PCT and educate both patients and doctors alike.

I do think that this book would be very valuable.

Dr. Scally's use of HCG leading into full pct is almost identical to the one I use and advocate.

Having said that, most of the vets on this forum use small amounts of HCG throughout their cycle, and go right into Clomid and Nolva for pct w/ out the use of large amounts of HCG.

The reasons I use/advocate something along the lines of Dr S's protocol is that doing very small amounts of HCG means that one will end up wasting a lot of HCG, which is an expensive drug to begin with. Plus, it is a hassle to prep and shoot sub 500IU amounts of HCG.

I can barely convince the guys I work with to spend the money needed for effective HPTA restoration to begin with (they are skeptical of the fact that HCG/PCT cost as much as the steroids themselves). I try and steer them towards Cem Meso products, which would save a lot of money, but they more often than not will not use them.

Thus I advocate blasting 2kIU of HCG eod, 5 shots total at the 2/3rds point in the cycle, and then again at the end, transitioning to Clomid and Nolva (although usually they are already on nolva).

Correct me if I am wrong, but I remember reading that Dr S's end use of HCG is similar to mine. For a practicing MD, it is probably much more likely that a needle adverse patient to follow Dr S's/my ( I have been doing this for over 20 years...learned it from Dan Duchaine) end game blast approach.

 

[foreveryoung]

books are so 20th century

 

[Dr JIM]

I suspect it will be worth it's weight in gold DOC! Who is the target audience (BB, recreational AAS users, docs, phd's, etc)? What educational level will be necessary to understand it's contents? To what extent will references be used to support the chapters? Will algorithms be used and readily accessible for certain topics (like treatment options) if applicable?

 

[Michael Scally MD]

Thanks for the input. The plan is for two versions. The first is directed to the general audience for the purpose of increasing awareness of AIH. Currently, almost all (if not all) physicians do not take an approach towards HPTA restoration. In the later version, the drugs posted will be addressed in detail.

 

[Dr JIM]

Great, I'd like three copies of the latter and one of the former once available.

 

[Michael Scally MD]

Please keep any suggestions, needs, etc. coming. While the initial book is for the general audience, its main purpose is to raise awareness for AIH treatments. The "professional" edition will include treatment details. If you want something included, let me know.

Along those lines, I have begun to revise and update the website - ASIH HOME - there is a link to the free download of "Anabolic Steroids - A Question of Muscle: Human Subject Abuses in Anabolic Steroid Research." [ame="http://www.amazon.com/Anabolic-Steroids-Question-Subject-Research/dp/096622311X"]Anabolic Steroids - A Question of Muscle: Human Subject Abuses in Anabolic Steroid Research: Michael Scally M.D.: 9780966223118: Amazon.com: Books@@AMEPARAM@@http://ecx.images-amazon.com/images/I/51PVsdrB2WL.@@AMEPARAM@@51PVsdrB2WL[/ame]

More in the works ...

Thanks for your input and help.

 

[Sworder]

It would probably be good to include why HPTA restoration is preferable to supplying exogenous testosterone. I believe the latter option is one preferred by physicians and it would be needed to an informative kick in the right direction to what treatment option is preferable in different cases.

A patient telling a doctor what treatment option is viable may be rejected as the "I am the doctor I know best" syndrome comes out.

 

[Michael Scally MD]

I have begun the updating, revising, etc. of my website on AIH - ASIH HOME1 . I need your input to make this a go to source for AIH/PCT. Just so you know, I will be including actual case studies once I have the main parts of the site complete. Additionally, the site will be continually updated to reflect advances (Kisspeptin, etc.) in the field and new case studies. I am on a January 2013 goal. Thanks for your help.

 

[Michael Scally MD]

Link: http://www.asih.net/ASIH – Towards a unified hypothesis of anabolic steroid action.pdf

Tan RS, Scally MC. Anabolic steroid-induced hypogonadism--towards a unified hypothesis of anabolic steroid action. Med Hypotheses 2009;72(6):723-8.

Anabolic steroid-induced hypogonadism (ASIH) is the functional incompetence of the testes with subnormal or impaired production of testosterone and/or spermatozoa due to administration of androgens or anabolic steroids. Anabolic-androgenic steroid (AAS), both prescription and nonprescription, use is a cause of ASIH. Current AAS use includes prescribing for wasting associated conditions. Nonprescription AAS use is also believed to lead to AAS dependency or addiction. Together these two uses account for more than four million males taking AAS in one form or another for a limited duration. While both of these uses deal with the effects of AAS administration they do not account for the period after AAS cessation. The signs and symptoms of ASIH directly impact the observation of an increase in muscle mass and muscle strength from AAS administration and also reflect what is believed to demonstrate AAS dependency. More significantly, AAS prescribing after cessation adds the comorbid condition of hypogonadism to their already existing chronic illness. ASIH is critical towards any future planned use of AAS or similar compound to effect positive changes in muscle mass and muscle strength as well as an understanding for what has been termed anabolic steroid dependency. The further understanding and treatments that mitigate or prevent ASIH could contribute to androgen therapies for wasting associated diseases and stopping nonprescription AAS use. This paper proposes a unified hypothesis that the net effects for anabolic steroid administration must necessarily include the period after their cessation or ASIH.

 

[Sworder]

Will there be any discussion on triptorelin?

 

[Michael Scally MD]

Will there be any discussion on triptorelin?

Yes.

I have been asked to add a chapter on Fertility. Any suggestions/comments?

On schedule for mid-January 2013.

 

[Michael Scally MD]

I have been running behind on the book publication for a variety of reasons. But, getting closer!!! BTW: I am going through the Meso posts for a Q&A chapter on PCT/AIH. IMO, this will be the best chapter. I created a FB group today.

Post Cycle Therapy (PCT)/ Androgen Induced Hypogonadism (AIH) is a group focused on Hypothalamic Pituitary Testicular Axis Function & Restoration. https://www.facebook.com/groups/609337655745437/

At this time, the group is “Secret.” That will probably change, but I wish to get member input first. I expect a slow start, but that should quickly accelerate with added members and questions. Any and all comments and suggestions are welcomed. Please spread the word.

 

[MR10X]

If you need any info on prostrate issues and cancer i would be happy to give you any first hand information on my experience and sucessful treatment for it. The doctor i went to has treated patients in their 40s and its something every man should be concerened about when the get older.

 

[skofan]

if you're taking suggestions, a paragraph at the end of each chapter breaking down the results and implications of the studies provided, to ordinary english. for those who sometimes have a hard time understanding the medical terms used due to english not being their first language, or have a hard time understanding them for other reasons.

 

[Michael Scally MD]

Historical Beliefs Held by the Athletic and the Academic Communities On Androgens

Historically, the difference in the beliefs held by the athletic and the medical communities on AAS are contradictory and irreconcilable. The bases of the athletes' opinions are on direct observational material. In contrast, the medical communities' bases for their opinions are political in nature, self-serving, and absent support from the scientific literature. It is no surprise, than, that peer-reviewed literature proves the athletic community has been correct on issues concerning AAS, while the medical community was wrong.

 

[attic]

that chart is amazing! im a novice user and the things that the academics believe are preposterous, even with my limited knowledge!