Post Cycle Therapy (PCT)
by Anthony Roberts
Discussion of pharmaceutical agents below is presented for information only. Nothing here is meant to take the place of advice from a licensed health care practitioner. Consult a physician before taking any medication.
After a cycle, we have one goal: to hold onto the gains we made during the cycle. Unfortunately, this is easier said than done, because the levels of various hormones and other substances that were circulating around your body during the cycle (huge amounts of testosterone, insulin-like growth factor, growth hormone, and lower amounts of muscle-wasting glucocorticoids) are now changing. Sadly, they are making way for lower amounts of the hormones we want for building muscle, and higher amounts of the catabolic ones. What needs to be done, as quickly as possible, is to get your body to begin production of your own natural anabolic hormones, and produce less of the catabolic ones. Unfortunately, your body has other plans.
But then, so do I…
…and I’m very confident that this protocol will allow you to recover your own natural hormonal levels quickly and lose far less of the gains you worked so hard for on the cycle. This protocol, which is typically implemented after a cycle is called “Post Cycle Therapy” or “PCT” for short.
First, I’m going to tell you what anabolic hormones are typically low when a cycle ends, and which catabolic ones are high, then I’ll tell you what drugs can change that condition as fast as possible. Is all of this necessary? No, not at all. You can skip to the end of the article and look for a little chart I made - the extent of my computer skill - which has all of the dosage recommendations and compounds involved to properly recover from your cycle. I think, however, that you’ll see some very odd recommendations if you simply skip to the end, and will find yourself reading through the whole article to find out where they came from - or maybe you’ll just try to find out what’s gotten into me?
I’m not re-inventing the wheel here, and you may have seen a piece of this information elsewhere (possibly in something I’ve written, possibly somewhere else on the internet or in a magazine), but I’m sure of two things:
- You’ve never seen this PCT protocol anywhere
- This is the most effective PCT you’ll ever see
First, I’ll give you a brief explanation on the body and how it works, and why there’s a lag-time after the cessation of Anabolic Steroids before the body returns to normal. Remember, during this lag-time you lose gains, so we really need to make it as short as possible. First, we need to understand a bit of what is going on in your body, what causes it to happen naturally, and what hormones are performing what function. Don’t worry, I’ll try to make it painless.
At the age of puberty, Gonadatropin Releasing Hormone (GnRH) is increasingly released from the Hypothalamus, in turn causing the secretion of Follicle Stimulating Hormone (FSH) and Luetenizing Hormone (LH) from the pituitary, and finally the male gonads (testes) are then stimulated by those pituitary hormones (LH and FSH). (1). FSH, although generally thought to only have a role in production of sperm, actually aids the in regulation of Leydig Cell function (2), while LH directly causes the Leydig Cells in the testes to secrete androgenic hormones such as testosterone (which is causes a surge in other anabolic hormones: Insulin Like Growth Factor, Growth Hormone, etc…). Androgens do this by then targeting other tissues inside the body, either by attaching to the Androgen Receptors (AR), which are found primarily in the cytoplasm of specific cells, or by what’s known as non-receptor mediated effects. When an androgen (your own natural testosterone or an anabolic steroid you’ve injected or ingested) binds to a receptor inside the cell, it activates the transcription of specific genes. What does this mean? Don’t worry, it just means that the steroid molecule gives the cell a message to do something. In the case of testosterone, for example, one of the messages it sends to the cell is to increase nitrogen retention in your body, thus allowing you to use more of the protein you take in, and build more muscle. In the case of testosterone (or anabolic steroids in general), this transcription causes a lot of different anabolic effects to take place: an increase in IGF, a decrease in cortisol, an increase in Red Blood Cell count, and the increased protein synthesis I already told you about. This is not to say that AR binding is the only thing that causes anabolic or androgenic effects, however. Oxymetholone and Methandrostenolone (Anadrol and Dianabol) both bind very weakly to the AR yet are both highly anabolic and androgenic. The diagram below is an example of an androgen’s entry into a target cell, where it (in this case) stimulates protein synthesis, which is a major anabolic effect:
Under the control of this heightened state of androgens, you also go through androgenic development as well as anabolic development. This can be seen in puberty when males grow body hair experience voice changes, as experience genital development and growth.
Another characteristic of androgens in the body is that they are subject to what’s known as a “negative feedback loop”. Lets review one of the first things I mentioned, ok? Your Hypothalamus secretes GnRH, thus making the pituitary secrete LH & FSH, finally in turn causing the testes to stimulate the Leydig cells to produce testosterone (by conversion of cholesterol), remember? Ok, now, once testosterone is created however, it has the ability to in turn to undergo various metabolic processes that will inhibit GnRH, which in turn inhibits the secretion of LH and FSH, and that brings a halt to natural testosterone production. Once testosterone has stopped being produced, it no longer sends this negative signal, and GnRH eventually begins to do its job again. In this way, your body prevents excess hormones from being secreted and thus maintaining homeostasis (the status quo… in this case a state where you are neither gaining nor losing muscle) (1). This negative feedback loop is partially why we use anabolic steroids…we want more testosterone for anabolic purposes (or more Anavar or whatever) than our body will let us produce (not that our bodies produce Anavar, but you get the idea). When we use that injectable testosterone, it sends the message to our body to begin the negative feedback loop and discontinue producing/secreting the hormones that cause our natural testosterone production. The chart below clearly shows this process, displaying both the negative and positive feedback system(s):
So what I’m saying is that anabolic steroids increase androgen levels in the blood, bringing a halt to GnRH, making the pituitary gland (eventually) responds by reducing the release of LH; this loss of LH has the effect of shutting down testosterone, of course, which you know is produced by the Leydig cells in the testes after they are stimulated by LH. Am I being repetitive? Yes. Do you need to understand all of this in order to understand the PCT protocol I’m about to outline? Yes. Remember, the negative feedback loop is, of course, no problem while we are on a cycle. Want more testosterone (or androgens) in your body? Fill up a few more syringes!
But all good things come to an end, and most of us choose to end our cycles at some point. At this point, while there is still some androgens floating around in us, our natural production won’t begin, and even once they are out, there may be some lag time before your body figures out that it needs to start producing its own androgens again. As I said before, this lag time is severely catabolic and it’s where you lose a lot of your gains. SO what we need to do is coax the body into quickly producing its own androgens.
One of the first drugs we’ll consider for this purpose is what is typically called a SERM. Nolvadex (Tamoxifen) is a SERM (Selective Estrogen Receptor Modulator, which means that it has the ability to act as an anti-estrogen with regard to certain genes, yet also acting as an estrogen with respect to others. That’s the “selective” part I guess. It does this by blocking gene transcription in some cases, and initiating gene transcription in others (3). Luckily for us, it has estrogenic effects on bones (meaning it increases their density), and blood lipids -meaning it lowers cholesterol-, (4)(5)as well as preventing gynocomastia by preventing estrogen gene transcription in breast tissue. However, it acts as an anti-estrogen in the pituitary, thus increasing LH and FSH, which results in an
increase in testosterone. 20mgs of Nolvadex will raise your
testosterone levels about 150% (6)...Nolvadex actually has quite a
few applications for the steroid using athlete. First and foremost,
it’s most common use is for the prevention of gynocomastia. Nolvadex
does this by actually competing for the receptor site in breast
tissue, and binding to it. Thus, we can safely say that the effect
of tamoxifen is through estrogen receptor blockade of breast tissue
Estrogen is also important for a properly functioning immune system,
and not only that, but your lipid profile (both HDL and LDL) should
also show marked improvement with administration of tamoxifen (34).
Nolvadex also has some important features for the steroid using
athlete. In hypogonadic and infertile men given nolvadex, increases
in the serum levels of LH, FSH, and most importantly, testosterone
were all observed (35)It can also block a bit of estrogen in the
pituitary, which is a great benefit when used with
HCG (more on that
later) (36)(37). The increase in testosterone Nolvadex can give
someone with a dysfunctional is basically that 20mgs of Nolvadex
will raise your testosterone levels about 150% (6)...Why don’t we
use Clomid, another SERM? Well, basically because it takes much more
to do the same thing. In comparison, it would require 150mgs of
Clomid to accomplish that type of elevation in testosterone, but
Nolvadex also has the added benefit of significantly increasing the
LH (Leutenizing Hormone) response to LHRH (LH-releasing hormone)
(6). This most likely indicates some kind of upregulation of the LH-receptors
due to the anti-estrogenic effect Nolvadex has at the pituitary.
Although both Nolvadex and Clomid are both SERMs, they are actually
quite different. As you already know, Nolvadex is highly
anti-estrogenic at the hypothalamus and pituitary, while Clomid
exhibits weak estrogenic activity at the pituitary (7), which as you
can guess, is less than ideal. It should be avoided for the PCT I’m
suggesting…and in fact, avoided in general…it’s simply not as good
Need I even add that the 150mgs of Clomid you need to get the
hormonal increase experienced with 20mgs of Nolvadex is much more
expensive? So lets dump the Clomid…and no, using it along with
Nolvadex will provide no “synergy” that I’ve ever seen in any
SO how much Nolvadex should you use during PCT? I favor using
20mgs.day, although to be totally honest, you can probably even get
away with far less than that. Doses as low as 5mgs/day have proven
to be as effective as 20mgs/day for certain areas of gonadal
stimulation. (8) 20mgs/day, however, is a dose that myself and
others have used with great success, and the research I’ve done in
this area typically uses this milligram amount. SO lets stick with
20mgs/day for now.
So that effectively suggests Nolvadex can not be used at
Mega-doses to get a mega-increase in your natural hormones. We can’t
use huge doses of any Anti-Estrogen, actually, and expect huge
increases in our natural hormones, actually. Arimidex (an Aromatase
Inhibitor –which means it stops the conversion of testosterone into
estrogen-another drug used to fight breast cancer like Nolvadex)
exhibits basically the same effects when .5mgs or a full 1mg is used
(9) and I have even read studies where up to 10mgs/day of Arimidex
is studied with no clear benefit over 1mg/day. Letrozole (another
Aromatase Inhibitor) is capable of inhibiting Aromatase maximally at
a mere 100mcg/day (10.). So clearly we need to add in other
compounds to our PCT, because Mega-Doses of one compound will not I
think it’s absurdly funny to see people recommending upwards
40-80mgs/day of Nolvadex, or a full milligram (or two!) of Arimidex,
in their post-cycle or on-cycle suggestions. I’d steer very clear of
listening to anyone who makes those types of recommendations…
All of this tells me that you can’t simply use mega-doses of
Anti-Estrogens or SERMS to do anything more than reasonable doses.
It must be, therefore, that your body can only respond with so much
vigor to any one drug in those families. So lets add in another drug
or two, ok? This way we can use reasonable doses of a few drugs and
produce some synergy…hopefully decreasing our recovery time.
We’ll need something to go with Nolvadex, which acts in a
different manner, and
Human Chorionic Gonadatropin (HCG) is the
clear choice here. Here’s where things get a bit controversial (no,
really…I know you , because I’m pretty much the only person around
(currently) who recommends HCG for Post-Cycle Therapy. Although I’m
seen as Old School in this respect, really, this is a totally new
paradigm for HCG use, made possible only by the inclusion of the
other compounds I am introducing to you for PCT. HCG is the natural
choice, as it has been used successfully to cure AAS induced (11),
and this alone warrants its inclusion to our cycle.
HCG is a peptide hormone manufactured by the embryo in the early
stages of pregnancy and later by the placenta to help control a
pregnant woman’s hormones (can anything really be said to control a
pregnant woman’s hormones except ice-cream and chocolate?).
Obviously, as you can guess from the name, it is a substance that
stimulates the gonads (hence: gonadotropin). It does this by
initiating gene transcription that is identical to that of
Luetenizing Hormone, thereby causing the Leydig Cells to produce
testosterone. Sounds great right? We can stimulate LH and FSH
production with our Nolvadex, and then directly stimulate the Leydig
Cells as well, to produce tons of testosterone by different routes!
Well...it’s not all that simple.
Unfortunately, while HCG increases Testosterone, it increases
estrogen as well(12). As you probably know, estrogen acts directly
on the Leydig cells to effect changes in the activities of enzymes
important for testosterone synthesis (13) and may actually be
considered an important part of that negative feedback loop I
mentioned earlier. In addition, an increase in circulating levels of
LH have been shown to induce down-regulation of LH-receptors in both
rodent studies (14), as well as in human studies (15); since HCG
mimics LH, you can expect it to do the same. This LH downregulation
can cause an increase in steroidogenic cholesterol (the cholesterol
earmarked by your body for conversion into testosterone). (16).
Thus, after the initial HCG induced surge in testosterone is over,
if you have used enough to downregulate your LH-receptors and
increase estrogen too much, then more steroidogenic cholesterol is
available. This is telling me that less is being converted to
testosterone. In fact, rodent models suggest that if you take a dose
large enough to cause a sharp increase of plasma testosterone, you
will actually desensitize your Leydig cells to your next shot, and
will possibly not experience any rise in testosterone from the
second dose at all, or may only experience a very slight one at best
(17.). Since this is due to LH-Receptor downregulation, and that
occurs in human models too, it is pretty fair to assume that if your
first dose of HCG is too large, your second won’t be very effective.
Unfortunately, this lack of an increase in testosterone doesn’t
necessarily mean that the HCG may be unable to increase circulating
levels of Estrogen (18) And remember that increase in Estrogen will
(most likely) cause your body ultimately to produce less
testosterone. Low LH post-cycle is not the primary cause of slow
recovery, because LH generally rises to levels above baseline after
a cycle much sooner than testosterone production does. This is
probably because the pituitary is working very hard to get your
atrophied Leydig cells to start producing testosterone again. HCG
should also bring back testicular volume; I feel the need to mention
this because it’s important to me and I suspect most men as well. It
would also appear that HCG works very well when it’s used on men who
have low levels of LH to begin with (as you would be after a cycle),
as many studies on pre-pubertal boys and Hypogonadotropic
Hypogonadal men would suggest (19)
This suggests that a pre-exposure to normal LH levels or
gonadatropins in general is necessary for HCG-induced Leydig Cell
desensitization. This, of course is not a problem for us, as we’ll
be using it when LH/Gonadatropin levels are very low anyway …we just
need to stop using it before we regain normal function, or it will
work against us eventually. (19) (20). Luckily, the temporary
Anabolic steroid induced hypogonadism that is experienced after a
cycle basically allows us to respond to HCG like anyone with low LH
levels (21), and thus, as I told you, a lot of the possible
inhibitory effect of HCG is not going to be relevant because there
was no prior “priming” by circulating gonadotrophins. This is great
news for us, because we are going to be using HCG during PCT, when
we need to get back some HPTA function, and not when we have levels
of gonadatropins high enough to cause HCG-induced desensitization.
But are we still risking some inhibition and possibly delaying
our recovery by using HCG? Probably not…you see, some studies in
humans have shown that HCG does not actually have a direct effect on
inhibiting LH release in men (22)(23), but rather (probably) works
to inhibit LH secretion indirectly, simply by stimulating the
production of testosterone (thus activating the negative feedback
loop). Another factor involved is the induction of testicular
aromatase, which raises estrogen levels, again causing inhibition.
Unfortunately, yet another process, the downregulation of the Leydig
Cell LH receptor itself, seems to also play a role in high dose HCG
testicular desensitization. This is also done by HCG actually
blocking the conversion of 17 alpha-hydroxyprogesterone (17 OHP) to
testosterone (24). Nolvadex actually stops this blocking-action of
HCG from taking place (25). Most likely, because of Nolvadex’s
direct antiestrogenic effect and LH-upregulating effect on the
Pituitary, suppression of gonadotropins via HCG is (25) almost
totally stopped with concurrent administration of Nolvadex! So if we
Use Nolvadex and we are only using HCG when we are low in
gonadatropins, we won’t be inhibited by it at all! Right?
Well…maybe…but there’s still the issue of estrogen caused by that
HCG-stimulated surge in testosterone. Well…we can use low doses
(300iu or so) to avoid some of that major spike in estrogen, and
thus cause far less inhibition from the HCG (26). Of course, I’d
want to use a bit more HCG per injection (500iu), if I could, to get
my body functioning fully more quickly, and lose less of my gains.
Maybe we can get away with taking some Vitamin E with our HCG, since
it increases the responsiveness of plasma testosterone levels to HCG,
making them significantly higher during vitamin E administration
than without it (27). So we can get a better response with our HCG
by taking Vitamin E (I recommend 1,000iu/day), but that doesn’t get
rid of the problem that we have, which is the estrogen increase the
HCG will cause.
Lets solve that pesky estrogen problem now….
Lets add in an Aromatase Inhibitor! Which one, though? Well,
since we are already using Nolvadex, we can’t use Letrozole or
Arimidex, as the Nolvadex will actually greatly decrease the blood
plasma levels of them (28)!
So we have to use Aromasin (exemestane) as our AI, because it’s
an aromatase inactivator, meaning it makes estrogen receptors
useless, and instead of just inhibiting production (as an anti-aromatase
would do) it cuts off production totally. Aromasin can also cause
androgenic sides (29)(30)(31), which may help to elevate your mood
while you are on PCT. This final drug in my recommended PCT can
effectively remove up to about 85%+ of estrogen from your body (32).
Most importantly, using Aromasin together with Nolvadex doesn’t
reduce exemestane’s effectiveness (33). So now, I think the problem
of ANY inhibition possible with HCG is solved, and we can use that
500iu/day dose that I wanted to use previously.
With this PCT, there will be a rapid increase in LH, FSH, and
testosterone, as well as almost a complete block on all the factors
that could be causing your natural hormones to be delayed in
returning to baseline. For this reason, I feel that the second your
cycle is over is when you should start this PCT (a week after your
last shot, or the day after your last pill is fine). Remember,
waiting for some of the extra androgens you’ve been taking to leave
your body is nonsensical, as we want to start recovery as soon as
possible to retain maximum gains. There is no evidence to suggest
waiting any length of time after your cycle is over will increase
PCT effectiveness…it simply prolongs the time you aren’t doing
anything positive to regain your natural hormones. And how long do
we run this for? Well…we need to stop the HCG relatively soon for
reasons discussed earlier. But the Nolvadex, and Aromasin can be
used for awhile longer. Ideally, we’d be getting weekly blood work,
but we could also get it done monthly, and just running this PCT
until we see our natural hormones restored…but weekly bloodwork
isn’t really an option for most of us. Failing the option of
monitoring recovery with blood-work, I’m going to give you my best
thoughts on the time you should be running your PCT. It’s important
to note I haven’t discussed nutrition or other compounds that may be
beneficial…this is because in this article, I am primarily concerned
with the restoration of hormonal function, nothing else. And with no
further delays, here are my recommendations for PCT: