T Nation

Protocol for HPTA Restart? (Monotherapy)


Hey guys, I’m currently experiencing symptoms of low testosterone and have been since 2013. I have never done any kind of anabolics so my system has never been ‘shut down’ so I don’t need hcg as far as I’m aware.

I cleaned up my lifestyle quite heavily (8 hours of sleep consistently, compound lifting 3 times a week if I can handle it, paleo diet, quit smoking/drinking, take Vitamin D, zinc etc). Still feel like shit. I’m also prone to getting depression/anxiety since 2013 so that affects my levels as well I’m sure (never had mood disorder previously).

Total Test 7.2nmol/L (8.3-30.2)
SHBG 23nmol/L (13-71)
Free test 167pmol/L (225-725)
LH 5 (1-10)
Fsh 3 (1-10)

Now I’ve been getting a lot of conflicting informing about whether I’m secondary or primary hypogonadism. 3 specialists have checked my little ones and say they look perfectly fine. My LH levels are in the mid-range so this complicates things further. I would like to attempt a 4-6 week protocol to see if I can boot things up naturally.

Most websites suggest clomid over nolvadex as nolvadex seems to put stress on the liver and blunts IGF-1. However these come from men who are doing PCT, not those seeking first-line alleviation from hypogonadism through SERM monotherapy. My other fear is that any benefits of increased testosterone will be blunted by increase in SHBG and E2, which seems to be a common trend in forums, men take SERM, get better levels but no actual libidio/energy/mood benefits. In fact, google “Nolvadex libido” for a good amount of horror stories about sex-drive annihilation.

Anyway, no shame in giving this a shot for a few weeks before committing to lifelong pinning. I’m thinking, 20mg of nolvadex EOD for 6 weeks, then taper to 10mg for 2 weeks and 5mg for 2 weeks. This would avoid the need of Arimidex and any mood rollercoasters associated with these drugs. Would this be a feasible protocol?


Well if you decide to start Nolva we will be doing it at the exact same time. I’m just finishing up my hCG portion of the restart. Not good to hear that Nolvadex kills libido. But if E2 goes up, you’re supposed to take an AI right?


Have you read the HPTA restart topic?

Links in 2nd post of 1st forum topic.

You have some primary hypogonadism. You are expecting that more LH will solve the problem.

Docs have determined that you testes do not have cancer or vascular abnormalities. That still leaves room for problems.

fasting cholesterol?


I’m just assuming secondary because that’s what you said in my 2013 post. I couldn’t find the HPTA restart in the topic but I found a lengthy post you made about it and seems hcg is the gold standard. I would like to avoid this as the only way I can obtain hcg is by… Alternative means. Not very safe/reliable.

FSH is low, 2-3, LH not too bad at 4-5. Never had testicle trauma, maybe heat from a laptop? I have however taken a lot of serious trauma to the head from boxing, a gang attack, slip/fall accident involving head hitting curb, some synthetic marijuana useage (bad for HPTA).


KSman I found the results:

DHEA-S 14.2umol/L (3.0-10.5)
Total cholesterol 4.4mmol/L (<4)
Chol/HDL ratio 3.1

In regards to thyroid, I find it interesting my fT3 is always on the top range 5.7 (3.2-6.4)

Any idea what’s going on here? Would nolvadex monotherapy not work for this scenario?


What’s your situation? Are you doing PCT? Well yes it seems about 0.25mg arimidex EOD is the standard recommendation to keep E2 in check. Personally I’m going to take a tiny amount of nolvadex to avoid this issue, maybe 10mg a day


Please see the links in the 2nd post of the first forum topic. That is how to access what used to be the forum stickies.


KSman I just read it a few times over. I get the general protocol, hcg + arimidex for 6 weeks for testes and nolvadex for 6 weeks to get the top end working. I can’t get hcg however, would there be any risk if I skip that part and do the SERM treatment alone? Based on my DHEA-S results maybe it’s possible my testes are fully functional but the pituitary is damaged or something.

This seems like quite a complicated rabbit hole to enter, especially without a doctor or full time support. Maybe I’m better off just riding things out with low testosterone levels.


The problem with the rabbit hole is that the doctors fade away and all that is left is the smile.

You need to know what you are doing and the confidence will help you.

Yes, you can do this without hCG.


That’s comforting to hear. Unfortunately it’s so difficult to find quality information that isn’t associates with steroid users. Like I have yet to find any explanation for how FSH levels can be low but LH at a reasonable middle.

I’ll put the pressure on my doc to prescribe me some nolvadex and arimidex in just about an hour. I was planning to freeze some swimmers before making the jump but if anything there’s a good chance I’m already low count in that area.

If nolvadex doesn’t shoot up my testosterone, then I’ll know with certainty that it’s a testicular issue. In which case just jump to TRT or try to give hcg a chance?


I froze my swimmers. They will analyze your sample before billing you. No point in freezing something that isn’t sufficient. However, I was low T and just before starting Androgel. Surprisingly my volume was sky high (not liquid volume but sperm count and motility). They actually were shocked by how high it was. Weird considering I’ve suffered with zero libido for 12+ years.

You could always do some clomid for a week or so prior to freezing the swimmers, as this will boost them significantly. My swimmer freezer doctor (erroneously or not, I dont know) hypothesized that since my LH was fine, therefore so were my swimmers, despite my T levels.


Your LH is fine. Boys seem to be working. Hmm, I wonder what could be causing your low T, perhaps too high or low SHBG?

Why do you suggest clomid over nolvadex? Clomid seems to have estrogenic effects. Also, I heard gels seem to have higher estrogen turnover, any issues with it?


Doctor nearly shit himself when I tried to get cleared for ksmans hpta restart. Looks like I might have to take things in to my own hands