Epidsode 11 Notes

Where have I been – staying busy in the summer, new dog

Today I want to talk about PCT.  A lot of supplement companies offer products for PCT…these are fine for the most part, not great.  Consider ingredients.  DAA and Tonkat Ali  but overal very little scientific evidence.

Univeristy of tennesee and Baylor College Urology department.

Who Uses Steroids

Anabolic steroid-induced hypogonadism: diagnosis and treatment

The lifetime prevalence of AAS use for men is estimated to be from 3.0% to 4.2% (12) and is increasing (29).

Use among male gym attendees is estimated to be as high as 15%–30%

n reality, at least four out of five AAS users are not competitive athletes but rather men who desire what they perceive to be an ‘‘enhanced’’ appearance

Consistent with these data, Cohen et al. (17) found that 94% of the 1,955 adult AAS users began after the age of 18 years with an overwhelming number being whites in their late 20s–30s with a slightly above-average socioeconomic status. These men were self-reported perfectionists and highly goal-oriented.

Sources of Info

Now the most easily accessible source for information regarding the details of illicit AAS use is the Internet (9, 17, 44). Numerous blogs and forums exist (e.g., www.roidstore1.com) where AAS users around the world can anonymously offer or request advice, share drug sources, chronicle results, and collaborate on dosing schedules.

It is also apparent that some users achieve popular authority within the Internet bodybuilding community and are often consulted for medical advice via forums.

Indeed, it is the general consensus within the AAS community that experienced AAS users are more educated than their physicians on AAS use, a sentiment that may contribute to the AAS user’s hesitancy to approach his physician for advice when adverse symptoms occur

Why use steroids?

Lean body mass, fat loss, and many other reasons are why most people start taking an anabolic steroid.

These users also reported feeling compelled to continue their regimens for a fear of the withdrawal that would result in excessive hypogonadal symptoms and the loss of muscle mass.

In stark contrast to the classic drug abusers, most AAS users show considerable forethought in their illicit substance use (47).

Central to this is the need for physicians to become more educated about the psychology and pathophysiology underlying AAS use.

What happens when you use steroids or prohormone?

Use of AAS results in hypogonado- tropic hypogonadism by feedback suppression of the hypothalamic-pituitary-gonadal (HPG) axis via inhibition of pulsatile GnRH release and a subsequent decrease in LH and FSH (Fig. 1).

Our experience and that of other investigators suggests that younger men may have a more ‘‘elastic axis’’ capable of recovering GnRH pulsation and gonadotropin secretion faster and more completely than older AAS users (50). It is possible that shorter durations, lower doses, younger ages, and higher T levels at baseline are associated with a quicker recovery of HPG axis function after AAS use.

Here’s the latest on prohormones.

Table 1 – Side effects and Treatment

a 4-week tapered course of transdermal or injectable TRT may provide immediate symp- tom improvement. Simultaneous administration of a SERM (such as clomiphene citrate, 25 mg every other day) will interact at the hypothalamus causing stimulation of LH and ultimately increase intratesticular T (Fig. 1). For patients with ASIH-induced gynecomastia, 20 mg tamoxifen daily will block the breast estrogen receptors and stimulate HPG axis recovery (60–65).

After 4 weeks of treatment with TRT and/or a SERM, repeated hormone panels should be obtained. If the patient has had either a poor gonadotropin response or a poor T response, the authors commence a 4-week course of hCG (1,000–3,000 IU, 3 times per week) while continuing daily treatment with a SERM at the initial starting dose (66–69). If a patient develops gynecomastia while on hCG, tamoxifen (10 mg b.i.d.) or anastrazole may be commenced. After 8 weeks of hCG and adjunctive treatment, hormone levels should once again be assessed. At this point, if the total serum T remains low and the patient continues to be symptomatic, primary testicular failure is likely (46). These patients will require a longer duration of TRT to avoid permanent ASIH. If appropriately increased serum T and gonadotropin levels are observed, the SERM may be reduced to 50% of its starting dose at 10 weeks of treatment and continued through weeks 12–16 or until target serum T level is achieved (70) (Fig. 2). Recovery of hormonal function may be limited in men with testicular failure, and close monitoring is recommended.