Best Post Cycle Therapy (PCT): 100% T Recovery Within 45 Days

Dr George TouliatosDisclaimer: The following article is for educational purposes only and NOT to promote the use of illegal steroids. If you have any questions or concerns, Dr. Touliatos is currently available for consultations.


Post cycle therapy (PCT) is the phase when a bodybuilder utilizes medication(s) to restore endogenous (natural) testosterone production.

Anabolic steroids impair HPT (hypothalamic–pituitary–testicular) axis function, as the body detects excessively high serum testosterone levels.

Consequently, the body signals to cease testosterone production in a bid to keep a homeostasis, by inhibiting GnRH (Gonadotropin-releasing hormone).

This decreases the release of LH (luteinizing hormone) and FSH (follicle stimulating hormone) — two hormones crucial for testosterone synthesis.

Thus, when a bodybuilder comes off steroids and exogenous testosterone is removed, natural testosterone often becomes shut down.

This can result is various psychological and physiological side effects, such as:

  • Decreased well-being
  • Low libido
  • Erectile dysfunction
  • Catabolism (muscle loss)
  • Decreased sperm count
  • Testicular atrophy

The severity of the above effects depends on the anabolic steroids used, the dosages and length of cycle.

Low testosterone can persist for several weeks or months post-cycle, increasing the likelihood of addiction, due to strong withdrawal symptoms lingering.

The aim of a PCT is to dramatically shorten this process, thus accelerating the recovery of natural testosterone production. Bodybuilders typically utilize any or all of the following medications:

  • Clomid (clomiphene)
  • Nolvadex (tamoxifen)
  • HCG (human chorionic gonadotropin)

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Best PCT Protocol

Dr. Michael Scally is one of the leading medical experts in hormone therapy, having specialist knowledge in regards to ASIH (anabolic steroid induced hypogonadism).

After treating hundreds of patients, Dr. Scally developed a PCT protocol that was used in a clinical report to treat 19 healthy men. All of these men had extremely suppressed testosterone levels, as a result of using testosterone and deca durabolin for 12 weeks.

The following protocol successfully treated 100% of the male subjects, bringing their serum testosterone back to normal levels (within 45 days). This is quite a feat, considering it is common for bodybuilders to experience low testosterone for up to 4 months, following a steroid cycle.

  • hCG – 2000IU administered every other day for 20 days
  • Tamoxifen (nolvadex) – 2 x 20mg for 45 days
  • Clomiphene (clomid) – 2 x 50mg for 30 days

The above post cycle therapy plan should be viewed as aggressive. Thus, if potent AAS are used, it is necessary and very effective.

However, if milder steroids are used (such as anavar, primobolan or turinabol), testosterone levels may only be moderately suppressed (rather than completely shut down).

In this case, all three of these PCT medications taken simultaneously may not be necessary. Instead, one or two of these drugs can be used with great success.

The timing of a PCT is crucial in regards to its effectiveness. If began too early, it may be ineffective, due to exogenous testosterone still being present in the body. If started too late, the body will have already entered a catabolic state, with withdrawal symptoms occurring.

The timing of a PCT should be tailored to the half-life of the steroid(s) taken. If users are taking multiple AAS simultaneously, then a PCT should begin after the last compound clears out of the body i.e. the slowest.

Here is a guide so users know when to start their PCT:

pct guide

Clomid

Clomid is a SERM (selective estrogen receptor modulator), often prescribed to women as a fertility drug, acting as an ovulatory stimulant.

Clomid increases the secretion of gonadotropins (LH and FSH), via the inhibition of estrogen in various tissues, leading to an increase in endogenous testosterone.

Despite blocking estrogenic effects in many parts of the body, clomid increases estrogen activity in the liver, causing a positive shift in cholesterol levels. This is particularly useful in regulating blood lipids and easing cardiovascular strain following a cycle.

Clomid Side Effects

Visual changes sometimes occur on clomid, particularly in high doses or lengthy cycles.

This may include flashes or blurring, however these are often temporary and subside within a few days/weeks post-cycle.

It is unknown what causes such changes and in rare cases they may even be irreversible. If such visual side effects start to occur, users should discontinue clomid supplementation and visit an ophthalmologist for urgent examination.

More common side effects of clomid, include:

  • Flushes
  • Abdominal discomfort
  • Nausea
  • Headaches
  • Liver stress
  • Impaired eyesight

Nolvadex

Nolvadex (tamoxifen citrate) is a SERM, commonly prescribed to women with breast cancer, and is regarded as one of the main reasons why mortality rate for breast-cancer sufferers has significantly dropped in the last decade.

Nolvadex was first synthesized in 1962 and initially prescribed to treat female infertility.

However, it was later observed to have anti-mitogenic effects, reducing the stimulation of breast tissue — beneficial for slowing the growth of breast cancer.

Nolvadex also exhibited cancer-killing properties, due to the blocking of protein kinase C (PKC) via oxidative stress mechanisms (1).

Today, bodybuilders commonly use nolvadex to prevent the onset of gynecomastia (accumulation of breast tissue).

As a PCT, nolvadex works in the same way as clomid, stimulating LH and FSH production, via the inhibition of estrogen’s negative effects in the hypothalamus (and thus restoring the HPTA axis).

Nolvadex Side Effects

  • Skin rash
  • Hot flashes
  • Decreased white blood cell count
  • Visual disturbances
  • Blood clots (deep vein thrombosis)
  • Liver stress

Uterine sarcoma and endometrial cancer have also been linked with nolvadex-use, however the risk is very low, being approximately 1 in 500 cases (2). Such side effects are also correlated with long term use (more than 2 years).

HCG

HCG (human chorionic gonadotropin) is a hormone produced by women in high quantities in the early stages of pregnancy, facilitating an increase in progesterone, helping to nurture the developing fetus and its surrounding environment (preventing miscarriage).

Bodybuilders take hCG post-cycle due to its ability to elevate luteinizing hormone (LH) levels, thus stimulating the Leydig cells to produce more endogenous testosterone.

HCG has not only been used in the treatment of male hypogonadism, but also obesity. It was previously believed that hCG may have a stimulating effect on T3 levels, however this is not known. Instead, hCG has an appetitive suppressant effect, meaning people could eat very low calorie diets, without feeling excessive hunger.

In 1957, hCG became the most prescribed medication for weight loss, due to this powerful (yet indirect) effect on satiety.

Thus, hCG may be particularly beneficial after a cutting cycle to minimize any potential weight gain following steroids.

HCG is regarded as the most effective post cycle therapy medications for treating testicular atrophy (shrinkage), due to its spermatogenesis-inducing effects.

PCT for Women

Post cycle therapy is often deemed as unnecessary for women, which may stem from them having smaller quantities of endogenous testosterone.

As with men, women’s endogenous testosterone production will also shut down, due to the body detecting an excess of this male hormone.

Testosterone remains a crucial hormone in females; greatly affecting their libido, well-being, energy and muscle mass.

With testosterone declining, estrogen will also drop significantly, due to to less aromatization (conversion of testosterone into estrogen).

Dave Crossland has anecdotal evidence of female steroid-users experiencing: very low estrogen levels, low mood, diminished libido and depression post-cycle (3).

Nolvadex has been used as a PCT among women, in a dose range of 5-15mg for up to 4 weeks. Many women are reporting this to have a positive effect on their mood and accelerating regulation in hormone levels.

However, some of these women are still experiencing 3-6 month delays before menstrual cycles return.

HCG is not an optimal PCT medication for women, with it potentially causing virilization and enlargement of the ovaries.

Clomid may also not be optimal due to ovarian hypersensitivity.

The medical treatment for women deficient in androgens is DHEA (dehydroepiandrosterone), which is one of the most critical hormones in females, being a key precursor of androgen and estrogen synthesis (4).

One study found that 50mg/day of DHEA ‘significantly increased’ libido in women over 70 years old, when taken for 1 year (5).

Another study found that a 6 week cycle of DHEA improved sexual function in women, including: arousal, orgasm quality and libido (6). They also found that depression symptoms decreased by 50%, significantly improving mood.

These women took 90mg/day of DHEA for the first 3 weeks, followed by 450mg/day of DHEA for the remaining 3 weeks.

Other research (Morales et al. 1994) has shown that 50mg/day of DHEA, when administered for 3 months, improves well-being in women by 82% (7). They also reported: greater relaxation, improved sleep, less stress and higher energy levels.

Thus, an effective post cycle therapy for women is:

  • 50mg/day of DHEA for 12 weeks.

FAQs

Is a PCT essential?

A post cycle therapy is not essential, as natural testosterone levels will eventually recover.

However, a better question may be: ‘Is a PCT optimal?‘. The answer to this is yes, as not only will users retain more of their gains from a cycle, but they will also improve their mental and sexual health.

A PCT may be deemed less essential when taking mild AAS, such as anavar, with studies showing a moderate reduction of just 45% when taking 20-40mg/day for 12 weeks (8).

How Do I Know If I Need a PCT?

The most accurate way to know if you need a PCT is to get your testosterone levels checked.

However, if you have reasons for not wanting to see a doctor, you can often tell from the following signs:

  • Depression
  • Low libido
  • Testicular atrophy (shrinkage)

Where Do Bodybuilders Buy PCT medications?

Bodybuilders will either make an appointment with a doctor and hope they will be prescribed necessary PCT medications, or they will purchase them on the black market (in the same way they buy anabolic steroids).

The second method involves asking around and finding a source where you can pay with cash, or by making a payment online (which is more risky if entering your card details).

How Much Do PCT Medications Cost?

A reliable supplier of anabolic steroids has provided us with the UK market price for PCT drugs. We have done a rough conversion into dollars for our American readers. 

  • Clomid 50 (50mg) tablets – £35 / $49
  • Tamoxifen (Nolvadex) 50 (20mg) tablets – £35 / $49
  • HCG 11,000iu –  £54 / $75

Do SARMS Require a PCT?

Selective androgen receptor modulators (SARMs) are suppressive, thus a PCT is necessary. However, the severity of decline in testosterone will determine the PCT protocol and how aggressive it should be.

As with steroids, some SARMs cause greater declines in endogenous testosterone than others.

However, as general rule if users take one SARM, stick to a low to moderate dosage and cycle it for 8 weeks or less — only a moderate decline in testosterone is likely to occur.

In this case, 3 weeks of nolvadex will be suffice in bringing endogenous testosterone levels back to normal, with 30mg/day taken for week 1, 20mg/day for week 2 and 10mg/day for week 3.

If slightly higher dosages are taken or/and lengthier cycles are utilized, nolvadex can be taken for 4 weeks, starting on 40mg for week 1, then decreasing the dosage by 10mg each week for the remaining 3 weeks.

For a high-dosed SARM cycle, a 4 week nolvadex PCT may be necessary, being: 40mg/day during week 1 and 2, then 20mg/day during week 3 and 4.

Some individuals take more risks with SARMs i.e. stacking multiple compounds together, such as combining Ostarine, RAD-40 and LG simultaneously and utilizing excessive cycles, lasting 12-16 weeks. In this case a more drastic PCT protocol is needed, being Dr. Michael Scally’s combination of:

  • hCG – 2000IU administered every other day for 20 days
  • Tamoxifen (nolvadex) – 2 x 20mg for 45 days
  • Clomiphene (clomid) – 2 x 50mg for 30 days

Note: Some people mistake certain compounds as SARMs, such as: cardarine and MK-677. These are not SARMs, and thus do not require a PCT, with cardarine being a fat burner and MK-677 a growth gormone secretagogue. Both of these products are not suppressive.

How Much Muscle Will a PCT Help Keep?

As a general rule, a PCT can help to retain anywhere from 50-75% of lean muscle gains from a cycle.

Mild compounds, such as anavar or primobolan, may enable users to retain high amounts of muscle tissue, due to less dramatic peaks in exogenous testosterone levels on-cycle (and thus less endogenous shut down).

Note: It is normal to lose some weight when coming off steroids, particularly when utilizing wet, bulking compounds; with users losing some intracellular and extracellular fluid (that previously accumulated due to high estrogen levels). This should not be confused with losing muscle weight.

PCT Diet & Supplementation

A person’s diet can also help to increase testosterone and anabolism post-cycle.

Dr. George Touliatos recommends eating a diet rich in meat and egg yolks, with cholesterol being a steroid hormone that synthesizes testosterone. Research has also found a link between higher HDL levels and high testosterone males (9).

Dr. Touliatos also states that ZMA, D-aspartic acid, tribulus terrestris, maca and vitamin D3 supplements can help to maximize natural testosterone production.

PCT Pros and Cons

Pros:

  • Increases testosterone production
  • Improves well-being
  • Enhances energy
  • Helps to retain lean muscle
  • Increases testicular size
  • Increases libido and erection quality
  • Improves fertility
  • Affordable

Cons:

  • More expense (on top of steroids)
  • Some medications come with side effects (in sensitive users)