Type-IIx
Well-known Member
Establishing a Base-Line Serum IGF-I Value
Author: Type-IIx
Intent: (1) To help users establish a base-line serum IGF-I value In order to form a meaningful basis for comparison of serum IGF-I changes to base-line. (2) To help prospective clients (i.e., Comprehensive Coaching [training + nutrition + PEDs + supplements], or Individualized Protocols [PEDs + supplements]) have this data ready even before intake, so that we can get straight to the work of determining their drug response and forego superfluous periods of management of wash-out from agents that affect IGF-I levels.
The user must request bloodwork for serum IGF-I under conditions of total washout from agents that affect IGF-I levels (time spent at either TRT if the user does not intend to restore physiologic testosterone secretion, or after recovery to normal endogenous testosterone levels). The following enumerated list (non-exhaustive) describes the procedures to ensure wash-out for bodybuilding agents in common use:
1. RhGH and/or GH secretagogues (i.e., Ghrelin mimetics, Growth hormone-releasing hormone agonists): After a minimum of 12 weeks after cessation (total abstinence) from rhGH and/or GH secretagogues, but ideally, if feasible, and time on > 12 weeks, then time off [washout period] = time on (e.g., if finishing up a 6 month or 24 week course of rhGH, request bloodwork for serum IGF-I after 24 weeks without any administration of rhGH; if this is impracticable, then, 12 weeks after cessation, or time off [washout period] = 12 weeks), and/or
2. Aromatizing androgen (e.g., testosterone, nandrolone [Deca durabolin, NPP], boldenone [Equipoise], methandienone [Dianabol], MENT [Trestolone], methyltestosterone) and stanozolol [Winstrol, Stromba]: After a minimum duration required for total aromatizing androgen (e.g., Test, Deca/NPP, EQ, Dbol, MENT, Methyltest) and/or Winstrol/Stromba washout. This time-course depends primarily on the ester side-chain length (i.e., duration of activity) of a parenteral (i.m.) oil-based preparation, e.g., undecanoate and undecylenate esters take months to reach washout after medium-term use (e.g., 10 – 26 week cycles), whereas enanthate and cypionate esters take weeks and 17AA oral drugs take days. Mathematical formulae and freely available graphing tools are available to plot the time-course of wash-out from specified preparations, doses, and administration schedule (e.g., SteroidPlotter).
4. Gonadotropins (hCG, hMG): HCG is a long-acting LH analogue with a duration of activity of 3 days. HMG, as bioidentical LH & FSH, is short-acting with a duration of activity of 1 – 2 days. After single doses of 1,500 IU & 6,000 IU hCG, blood estradiol levels had not returned to base-line after 6 days for the 6,000 IU dose; but did so for the lower doses of 1,500 IU, 375 IU, and 93.75 IU. The General Rule, then, applies to the use of hCG with or without combination with hMG – total wash-out (pharmacokinetics of duration of activity; here, 3 days) plus 1 additional week (i.e., time off [washout period] = 10 days) should be taken to tamp down pharmacodynamic effects on aromatase (testicular) before requesting bloodwork, and/or
5. Insulin (e.g., glargine), Sulfonylureas (e.g., glimepirid): While it is well-established that insulin per se potently increases serum IGF-I & bioavailability, and insulin glargine (e.g., Lantus) in particular potently activates IGF-IR directly, total washout from insulin preparations are particularly important to establish a valid base-line IGF-I measure. Since the bioactivity of various insulin preparations differ by formulation considerably with respect not only to pharmacokinetics but indeed mitogenic (growth) and metabolic effects, IGF-I receptor (IGF-IR) action, and pharmacodynamic effects on IGF-I secretion and bioavailability (i.e., by freeing up more bioactive IGF-I fractions vs. those in ternary complexes with the acid-labile subunit [ALS]), a Prudent Approach is strongly advised for washing out from exogenous insulin preparations:
Application:
If stopping all agents that affect IGF-I levels at the same time, then the agent that requires the longest washout period dictates the total duration of washout. That is, these agents affect IGF-I in parallel rather than in series, such that the user may wash out from all agents synchronously (at the same time) rather than one after another.
Author: Type-IIx
Intent: (1) To help users establish a base-line serum IGF-I value In order to form a meaningful basis for comparison of serum IGF-I changes to base-line. (2) To help prospective clients (i.e., Comprehensive Coaching [training + nutrition + PEDs + supplements], or Individualized Protocols [PEDs + supplements]) have this data ready even before intake, so that we can get straight to the work of determining their drug response and forego superfluous periods of management of wash-out from agents that affect IGF-I levels.
The user must request bloodwork for serum IGF-I under conditions of total washout from agents that affect IGF-I levels (time spent at either TRT if the user does not intend to restore physiologic testosterone secretion, or after recovery to normal endogenous testosterone levels). The following enumerated list (non-exhaustive) describes the procedures to ensure wash-out for bodybuilding agents in common use:
1. RhGH and/or GH secretagogues (i.e., Ghrelin mimetics, Growth hormone-releasing hormone agonists): After a minimum of 12 weeks after cessation (total abstinence) from rhGH and/or GH secretagogues, but ideally, if feasible, and time on > 12 weeks, then time off [washout period] = time on (e.g., if finishing up a 6 month or 24 week course of rhGH, request bloodwork for serum IGF-I after 24 weeks without any administration of rhGH; if this is impracticable, then, 12 weeks after cessation, or time off [washout period] = 12 weeks), and/or
2. Aromatizing androgen (e.g., testosterone, nandrolone [Deca durabolin, NPP], boldenone [Equipoise], methandienone [Dianabol], MENT [Trestolone], methyltestosterone) and stanozolol [Winstrol, Stromba]: After a minimum duration required for total aromatizing androgen (e.g., Test, Deca/NPP, EQ, Dbol, MENT, Methyltest) and/or Winstrol/Stromba washout. This time-course depends primarily on the ester side-chain length (i.e., duration of activity) of a parenteral (i.m.) oil-based preparation, e.g., undecanoate and undecylenate esters take months to reach washout after medium-term use (e.g., 10 – 26 week cycles), whereas enanthate and cypionate esters take weeks and 17AA oral drugs take days. Mathematical formulae and freely available graphing tools are available to plot the time-course of wash-out from specified preparations, doses, and administration schedule (e.g., SteroidPlotter).
- Durations of Activity (parenteral; i.m. preparations):
- propionate: 2 days
- phenylpropionate: 10 days
- enanthate, cypionate, cyclohexane carboxylate: 15 days (2 weeks)
- hexahydrobenzylcarbonate: 20 days (3 weeks)
- decanoate: 28 days (4 weeks)
- undecylenate: 56 days (8 weeks)
- undecanoate: 84 days (12 weeks)
- Durations of Activity (oral, 17α-alkylated (“17AA”); p.o. preparations):
- stanozolol: 4 days
- everything else: 1 – 2 days
- General Rule: After drug clearance (time off = duration of activity ≈ 4 * t1/2), a period of about 1 additional week should be taken to tamp down pharmacodynamic effects on aromatase before requesting bloodwork (time off [washout period] = duration of activity + 1 week), and/or
4. Gonadotropins (hCG, hMG): HCG is a long-acting LH analogue with a duration of activity of 3 days. HMG, as bioidentical LH & FSH, is short-acting with a duration of activity of 1 – 2 days. After single doses of 1,500 IU & 6,000 IU hCG, blood estradiol levels had not returned to base-line after 6 days for the 6,000 IU dose; but did so for the lower doses of 1,500 IU, 375 IU, and 93.75 IU. The General Rule, then, applies to the use of hCG with or without combination with hMG – total wash-out (pharmacokinetics of duration of activity; here, 3 days) plus 1 additional week (i.e., time off [washout period] = 10 days) should be taken to tamp down pharmacodynamic effects on aromatase (testicular) before requesting bloodwork, and/or
5. Insulin (e.g., glargine), Sulfonylureas (e.g., glimepirid): While it is well-established that insulin per se potently increases serum IGF-I & bioavailability, and insulin glargine (e.g., Lantus) in particular potently activates IGF-IR directly, total washout from insulin preparations are particularly important to establish a valid base-line IGF-I measure. Since the bioactivity of various insulin preparations differ by formulation considerably with respect not only to pharmacokinetics but indeed mitogenic (growth) and metabolic effects, IGF-I receptor (IGF-IR) action, and pharmacodynamic effects on IGF-I secretion and bioavailability (i.e., by freeing up more bioactive IGF-I fractions vs. those in ternary complexes with the acid-labile subunit [ALS]), a Prudent Approach is strongly advised for washing out from exogenous insulin preparations:
- Prudent Approach: After drug clearance (time off = duration of activity ≈ 4 * t1/2) from the longest-duration insulin preparation or sulfonylurea in use, a minimum of an additional 12 weeks after drug clearance (total abstinence) from the insulin preparation or sulfonylurea in use, but ideally, if feasible and if time on > 12 weeks, washout = drug clearance + time on (e.g., if finishing up a 6 month or 24 week course of glimepirid (duration of activity = 6 days), request bloodwork for serum IGF-I after 25 weeks without any administration of glimepirid; if this is impracticable, then, after 13 weeks without any administration of glimepirid.
Application:
If stopping all agents that affect IGF-I levels at the same time, then the agent that requires the longest washout period dictates the total duration of washout. That is, these agents affect IGF-I in parallel rather than in series, such that the user may wash out from all agents synchronously (at the same time) rather than one after another.
