T Nation

Ideal? Restart Protocol

Does anyone know what an ideal restart protocol looks like?

I was put on HRT for low T due to low LH, but have since found out that I also had low ferritin, messed up Thyroid, low cortisol, messed up Aldosterone, low Vitamin D, low cholestorol, etc.

Since I have worked to correct those issues, I am wondering if I should try to reboot my system and see if my hypothalamis will start sending my pituitary the right signals and start sending out LH/FSH.

Id be interested to see what folks say about this as well…Ive been on HRT for less than a year and it makes me feel great…but I do wonder if I should try a restart at some point just for the hell of it, one more shot at seeing if my balls can get it going on their own…

Curious if doing a “regular” PCT like guys do after cycles (only from what I read on boards as I never did a AAS cycle), adding in HMG, after using HCG the entire time on HRT…

So maybe some sort of clomid/nolvadex PCT, and HMG for a few weeks?

Thoughts?

PC, much depends on age, how long on TRT and hCG use.

For giggles say I was on HRT for a year, with continuous HCG 3xweek 250iu. Would PCT/restart be crazy extended effort compared to guys doing 2-3 month cycles? Anyone on here do much experimentation with HMG in the mix?

For me, I’m 37 and have been on T+HCG+AI (all at various amounts) since Oct 09 - before that was a year+ of failed Androderm patches, T-creams, and T-lotions.

I thought I read that Clomid + AI was used to restart, but then I think I remember someone saying that there was something better than Clomid with less side effects.

I vaguely remember someone possibly recommending to stop the T-shots (I am on 30mg EOD) and HCG (I am on 150iu EOD) for 7 days. Keep the AI (.25mg EOD) then start the Clomid (no idea the dosage) for seven days. Keep using the AI after stopping Clomid to ensure that a possible E2 spike does not shut me back down, right? Not sure when to test blood - one immediately after to confirm LH/FSH response + one within 30 days?. The Clomid should start the Hypothalumus sending signals to the pituitary which (if able) would send LH/FSH signals to the testicles. I would continue with my HC, Vyvanse, Vitamin D, etc.

I am just trying to get some base information before I talk with my doc. I don’t even know if he will support this or not. If not, I probably won’t go down this road for now.

hCG is used to get the testes recovered, size and firmness, the transfer to SERM to provide LH/FSH to replace hCG. You do not want a gap between hCG and SERM. One could use a SERM alone without hCG, but I think that is is better to limits ones duration on SERMs. SERMs also ‘exercise’ the pituitary response to commands from the hypothalamus.

Note that high levels of hCG or LH can reduce LH receptor response. Open loop LH production from SERM use can cause problems, just like high dose hCG. This is another reason to limit SERM duration. It has been shown that lower doses of SERMs are just as effective, suggesting that standard SERM doses may be too high.

AI should be adjusted to FT/bio-T levels. This is guesswork without labs. If the testes are responding well to hCG or SERM, especially with young men, anastrozole 1mg/wk in EOD divided dosing would be appropriate and this should be reduced to 0.5mg/week as one tapers off of the SERM.

Never stop SERMs suddenly, SERMs increase E2 levels. Stopping suddenly exposes the HPTA to the elevated E2 levels and that is HPTA repressive.

When you are done, you will feel, or not feel success. You may not need labs to know if things are working.

thanks for the feedback.

just a couple of follow up questions:

Which SERM is best (info from the steriod pct sticky)?
Toremifene: 40mg/day
Nolvadex (Tamoxifen): 10mg/day
Clomid (Clomiphene): 25mg/day

Is it week 1 on full dose with .25mg AI EOD, week 2 on half dose with .125mg AI EOD, then off everything?

Or maybe (from steroid section)

  • Clomid at about 200mg first day, 150mg/d next few days, 100/mg/d for the next week, and 50mg/d for the last 2 weeks
  • Nolva at 80mg first day, 40mg/d for the first week after, and 20mg/d for the last few weeks.

Also are there any recommended supplements during the restart? I was thinking about taking 25mg lipid matrix Pregnenolone daily to help boost raw material supply.

I have written a lot about this and you are asking me to comment on things from the steroid BB.

Nolvadex for low sides and availability.

You need to cruise on 0.5mg anastrozole per week in OED doses per week post PCT to keep E2 levels that are HPTA friendly.


1- 250iu hCG EOD until testes have recovered size and firmness. If testes were small and do not recover size, abandon restart and live with TRT. Dose AI to match T levels, see my prior post. You can front load hCG with 500iu for the first 2 or 3 doses.

2- switch from hCG to SERM. No taper or delay. Time on could be two weeks. If you feel like things are getting worse, that may be an indication that you are not producing LH/FSH on SERM. One could do labs for that. If low LH/FSH, abandon restart and live with TRT.

3- Slowly taper off SERM and reduce anastrozole to 0.5mg per week in EOD doses.
4- PCT is now done, but stay on the reduced anastrozole for 4 weeks or longer.
5- Test TT, FT, LH, FSH. PCT may work, but not at the level you need.