PH/PS/DS/AAS and PCT

[dinoiii]

This is going to be open discussion for all things related to PH/PS/DS/AAS and PCT. Understand that Dana Houser, MD does NOT condone the use and/or sale of said controlled agents, but he does understand that it is, in fact, an active part of body composition alteration and athletic performance (with greater than 99% of athletes, in fact, using SOMETHING) with continued regulatory effects that will ONLY make the situation far worse (something government may never understand). In fact, it only continues many to turn to black market sourcing...

As such, while medical doctors treat your average heroin addict on a daily basis, turning your back on steroid users places a significant portion of the population at large at high risk as government has "your best interest in mind." Well, there is a large science involved with aesthetic-alteration and hormonal disarray that exists with continued use. We acknowledge that and accept what may come with its continued persuance.



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[David Dunn]

You didn't just put heroin (opiate) addiction and steroid abuse in the same category?

[dinoiii]

This reminds me of last year's ISSN Conference at the conclusion of my talk on post-cycle therapeutics, albeit with an opposing punch line.

A guy in the audience raised his hand and said, "So you're telling people how to use steroids?"

My response was very simple, "I am uncertain what talk you listened to over the course of the last 45 minutes, but you may be the only person in this room who took that message! When I treat a heroin user, I wouldn't turn him/her away in times of therapy, why is it you'd offer that I should do the same to someone using steroids?"

Of course, he had no reply.


In your situation, it sounds like I somehow struck a nerve. I can tell you that you're in luck because I treat both of the suggested patient subsets; not something many docs would tell you. At the same time, I can honestly say the following...

Anabolics are certainly "similar" to heroin in many instances outside of the receptor (androgen versus mu); but addiction rates and areas of highlight in the brain are very similar in cases of steroid abuse versus heroin abuse. In particular, the limbic system. This would not be new in that instance, however, as it is similar in addiction of food, sex, drugs (of any sort), etc...

BUT NO, I WAS NOT COMPARING THE TWO...please do not tell me you didn't see the forest through the trees like my "dear friend" from the FDA. I have been writing on the unfortunate demonization of steroids for almost two decades for Christ's sake.

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[David Dunn]

This reminds me of last year's ISSN Conference at the conclusion of my talk on post-cycle therapeutics, albeit with an opposing punch line.

A guy in the audience raised his hand and said, "So you're telling people how to use steroids?"

My response was very simple, "I am uncertain what talk you listened to over the course of the last 45 minutes, but you may be the only person in this room who took that message! When I treat a heroin user, I wouldn't turn him/her away in times of therapy, why is it you'd offer that I should do the same to someone using steroids?"

Of course, he had no reply.


In your situation, it sounds like I somehow struck a nerve. I can tell you that you're in luck because I treat both of the suggested patient subsets; not something many docs would tell you. At the same time, I can honestly say the following...

Anabolics are certainly "similar" to heroin in many instances outside of the receptor (androgen versus mu); but addiction rates and areas of highlight in the brain are very similar in cases of steroid abuse versus heroin abuse. In particular, the limbic system. This would not be new in that instance, however, as it is similar in addiction of food, sex, drugs (of any sort), etc...

BUT NO, I WAS NOT COMPARING THE TWO...please do not tell me you didn't see the forest through the trees like my "dear friend" from the FDA. I have been writing on the unfortunate demonization of steroids for almost two decades for Christ's sake.

D_

Who are you talking to?

To use the two in the same sentence is silly.

Physiological/physical addiction and psychological addiction are two different animals. In quitting, one risks physical death, the other will feel bad about himself and feel like dying.

I would caution those that "see the forest" in the story that you are telling to not miss the trees.

They'll listen to you. You're the doctor, right?

[dinoiii]

I am uncertain how to respond to your statement actually (a response like this sours me to posting at all).

I am afraid you missed the point with the comment and immediately fired out a response.

See - addiction aside, if you re-read my first post (and it's unfortunate on message boards that things somehow get lost in translation and you spend umpteen posts trying to get something back on track), you'd see that my statement was -

MAINSTREAM MEDICINE ("medical doctors") have no issue treating someone like a heroin addict.

MAINSTREAM MEDICINE does - for the most part - have an issue with people using anabolics.

I don't know that I was comparing the two per se. What I said threafter was...inherent in ALL addiction is that similar areas of the limbic system light up in brain studies of ANY addictive substance (save the physiological vs. psychologic argument as it is something created to rationalize a difference that doesn't exist). This is a neuroendocrine offering and the dopaminergic interplay (neurons) of said system and endocrine feedback is VERY MUCH SO RELATED. Suggest it as you will and we can agree to disagree but the distaste in your last statement was enough to really dishearten me to this.


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[David Dunn]

I am uncertain how to respond to your statement actually (a response like this sours me to posting at all).

Really? Your convictions and beliefs are so easily swayed. You're skin that thin? Toughen up big guy. There's a cold cruel world out there. Not everyone is going to agree with you.

I am afraid you missed the point with the comment and immediately fired out a response.

I did miss your point but did not immediately fire a response.

See - addiction aside, if you re-read my first post (and it's unfortunate on message boards that things somehow get lost in translation and you spend umpteen posts trying to get something back on track), you'd see that my statement was -

MAINSTREAM MEDICINE ("medical doctors") have no issue treating someone like a heroin addict.

MAINSTREAM MEDICINE does - for the most part - have an issue with people using anabolics.

I understand better your point.

I don't know that I was comparing the two per se. What I said threafter was...inherent in ALL addiction is that similar areas of the limbic system light up in brain studies of ANY addictive substance (save the physiological vs. psychologic argument as it is something created to rationalize a difference that doesn't exist). This is a neuroendocrine offering and the dopaminergic interplay (neurons) of said system and endocrine feedback is VERY MUCH SO RELATED.

I agree with the fact that the administration of the respective substances has similarities in the sense that you present it. But that is where it ends IMHO.

Medically supervising or treating a heroin addict to recover from his addiction (whether physical or psychological) has a means to an end. It is to get and remain heroin (illegal substance) free for a lifetime.

Medically supervising or treating a steroid user (or addict, whether physical or psychological) to properly perform a PCT for an illegal substance is an other animal entirely. One is potentially a lifesaving treatment for an addiction to an illegal substance. The other is enabling the safer and continued use of an illegal substance. If not, then please explain to me how they are not different or the same?

Suggest it as you will and we can agree to disagree but the distaste in your last statement was enough to really dishearten me to this.


D_

Again with the whining "I'll stop posting."

Did you suppose you would just post away here and not have differing opinions and views that you would need to entertain in intelligent discussion without assuming one has ill will?

You are a doctor, right? A real one? You are a grown man, right? Then please don't be so easily dissuaded by a challenge.

It was and is not in any way inflammatory. It was simply a challenge to your reasoning.

I apologize for the forest and the trees comment. You were the one that got all metaphoric on us.

Seriously. Sorry.

[chocolatemilk]

Questions...

1.) Does using hCG during the cycle to keep testicles functioning actually help once you reach PCT since the testes are semi-functional?

2.) Can low doses of hCG be administered in PCT without LH suppression?

[mattrag]

Great topic!!Thx Im subbed!

[TheDarkHalf]

subbed!

[RickRock13]

In for the great discussion..

[MAxximal]

In.......

[kevinhy]

Also in.

[chocolatemilk]

One more question here...

I've read that there is more of the aromatase enzyme in the chest area for males and females... does this mean if I am injecting testosterone suspension into the chest, it will convert to estrogen at a higher rate than if I was injecting into the quads? I'm thinking it would since the testosterone is fully active with no ester and exposed to higher amounts of aromatase.

Is there truth to this and is this of any concern where you would advise not to inject testosterone suspension into the chest?

[kevinhy]

One more question here...

I've read that there is more of the aromatase enzyme in the chest area for males and females... does this mean if I am injecting testosterone suspension into the chest, it will convert to estrogen at a higher rate than if I was injecting into the quads? I'm thinking it would since the testosterone is fully active with no ester and exposed to higher amounts of aromatase.

Is there truth to this and is this of any concern where you would advise not to inject testosterone suspension into the chest?

That seems very plausible, id like to here an opinion on this as well. I definitely have no plan on pec injections though, haha

[AtomicFox]

Subbed too

[dinoiii]

Really? Your convictions and beliefs are so easily swayed. You're skin that thin? Toughen up big guy. There's a cold cruel world out there. Not everyone is going to agree with you.

I did miss your point but did not immediately fire a response.

I understand better your point.

I agree with the fact that the administration of the respective substances has similarities in the sense that you present it. But that is where it ends IMHO.

Medically supervising or treating a heroin addict to recover from his addiction (whether physical or psychological) has a means to an end. It is to get and remain heroin (illegal substance) free for a lifetime.

Medically supervising or treating a steroid user (or addict, whether physical or psychological) to properly perform a PCT for an illegal substance is an other animal entirely. One is potentially a lifesaving treatment for an addiction to an illegal substance. The other is enabling the safer and continued use of an illegal substance. If not, then please explain to me how they are not different or the same?Again with the whining "I'll stop posting."

Did you suppose you would just post away here and not have differing opinions and views that you would need to entertain in intelligent discussion without assuming one has ill will?

You are a doctor, right? A real one? You are a grown man, right? Then please don't be so easily dissuaded by a challenge.

It was and is not in any way inflammatory. It was simply a challenge to your reasoning.

I apologize for the forest and the trees comment. You were the one that got all metaphoric on us.

Seriously. Sorry.

There are not many, if any, physicians who would take the time out to partake in such a thing as posting on message boards. Be that all as it may with the "whining" - my point remains clear...I take the time out, NOT because I feel everyone will listen to me cause I am the doctor; but perhaps offer some insight with a career rooted in bodybuilding FIRST and medicine SECOND. The passion for medicine actually arrived out of the passion for bodybuilding and this is no chicken and egg argument. It is challenging to come on and take time out for any unimpactful discussion; I just don't have the time - hence my comment and nothing more.

My associative offering of heroin was not necessarily one of comparison, but one to illustrate that something seen AS "BAD" AS heroin (if you want to harbor a paternalistic view; although I try not to in either case) to the layperson AND modern medicine as a whole - no one questions the implementation of therapies designed toward the worse of two evils (but again, that is a judgement I am not positioned to place). I try and remain as objective as is feasibly possible and nothing more.

Hopefully that position is more clear; but if not - perhaps we could entertain further discussion in PM as this would be a thread I would ultimately look at as bicker and become disinterested if I were the reader and that was NOT the point.


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[dinoiii]

I am happy to see that hCG was one of the first discussion points. Oftentimes the quintessential concern is centered on peripheral side effects (i.e. - gyno, hair loss, lipids, blood pressure, et al...) at the expense of the most serious central side effect, hypothalamic-pituitary-dysfunction. hCG does play quintessential role here as the most tried and true (not the only). To answer your questions...

1.) Does using hCG during the cycle to keep testicles functioning actually help once you reach PCT since the testes are semi-functional?

The two prototypical regimens I might employ therapeutically are one with low dose (as little as 300-500 IU daily) used throughout the cycle and/or higher dose (1000-as much as 5000 IU three times per week) if simply initiated in PCT. I would continue hCG in the case of the low-dose peri-cycle protcol; especially for the guy who still wants children. Even with on-cycle use; we have noted an average decline in sperm count that approaches literature values still at 22 months in some people (the subfertile state thought to be direct result in attenuation of testosterone). Still, there are dose- and time-dependency factors that will come into play here as well.

Again, some may not like my sperm count offering as they may certainly not care about fertility status, but it is a reflective number to approximate how long the HPGA may remain compromised, and given the dearth of research alloted in this subject area, it is the way we can translate that which has, in fact, been looked at.

2.) Can low doses of hCG be administered in PCT without LH suppression?

Yes; dependent upon duration of the cycle and relative HPGA dysfunction (as alluded to above). There is negative feedback at the level of the hypothalamus to shut down GnRH and subsequently LH (and FSH), which will be inherently dependent upon the degree of shutdown. If you look at doses and ways used (daily versus three times per week); this focuses on how to best bring back the HPGA in my experience over the last few years with select patients and likely reflects the doses able to best keep negative feedback at bay.



D_

[dinoiii]

One more question here...

I've read that there is more of the aromatase enzyme in the chest area for males and females... does this mean if I am injecting testosterone suspension into the chest, it will convert to estrogen at a higher rate than if I was injecting into the quads? I'm thinking it would since the testosterone is fully active with no ester and exposed to higher amounts of aromatase.

Is there truth to this and is this of any concern where you would advise not to inject testosterone suspension into the chest?

That seems very plausible, id like to here an opinion on this as well. I definitely have no plan on pec injections though, haha

Kevinhy, I think I was thinking the same thing as I was reading that...why on Earth would one subject themselves to pec injections (unless perhaps the experienced user who has accumulated a boat-load of scarring and/or the elite-level competitor), but alas I digress...

To give only an educated guesstimate on the question at hand though (as I admittedly have no familiarity with this practice); the functioning level of aromatase is directly correlational to the amount of adipose tissue which does tend to run prevelant in the area of the breast by default. This could be compounded in the aged male and/or the person with gyno and mammary-stromal changes; where the sheer number of adipose cells is on the upswing.

So, while a pec injection may certainly offer more area for rotation; it may be irresponsible to offer it as even an option for some people (as above). Looking at your avatar and provided that this is representative of you; I don't think adipose would be your concern though.


D_

[chocolatemilk]

Thanks for the detailed responses.

I run multiple short esters at a time and sometimes no ester compounds so I run out of injection sites very fast. That's why I resorted to chest but I will be very careful not to pin in fatty areas using testosterone suspension from now on.

Some other questions I have are:

1.) What doses of hCG in PCT would be best to keep LH suppression at bay from the hCG itself? (I don’t think you mentioned what dose for PCT).

2.) I’m noticing scar tissue in my delts very recently. The area lumps with oil post injections and the area is a lot harder to push the needle into (smooth as butter before) and also harder to inject the oil into. If I lay off injections to the delts for a while will the area return back to normal since this happened very recently or is it once these “symptoms” show up it is already true scar tissue for life?

3.) Are the benefits of Deca-Durabolin or Nandrolone Phenyl Propionate (NPP) on the joints temporary only during use of the compound or do they have the ability to permanently help/heal the joints even after coming off the compound? My shoulder has felt amazing since starting Deca and I'm hoping this will last after I stop the Deca...

[dinoiii]

1.) What doses of hCG in PCT would be best to keep LH suppression at bay from the hCG itself? (I don’t think you mentioned what dose for PCT).

Well, this is a qualified "it depends." If using low-dose throughout the cycle; similar low-dosing protocol is still usually ample (possibly a little higher); but if you have foregone use of hCG through the cycle, then we're probably talking a minimum of 1,500 IU to make certain you are still getting LH-mimetic effects from the hCG itself. Possibly needless to say, however, I cannot give "recommendations" on this matter that would be any more specific than that.

2.) I’m noticing scar tissue in my delts very recently. The area lumps with oil post injections and the area is a lot harder to push the needle into (smooth as butter before) and also harder to inject the oil into. If I lay off injections to the delts for a while will the area return back to normal since this happened very recently or is it once these “symptoms” show up it is already true scar tissue for life?

Unfortunately as I am unable to examine the area myself, I am at a loss for what is actually happening to said area. If it is, in fact, true SCAR tissue....you will have it for life; scar tissue is fibrotic change, but I am suspicious given the apparent abruptness of your site concerns.

3.) Are the benefits of Deca-Durabolin or Nandrolone Phenyl Propionate (NPP) on the joints temporary only during use of the compound or do they have the ability to permanently help/heal the joints even after coming off the compound? My shoulder has felt amazing since starting Deca and I'm hoping this will last after I stop the Deca...

Unfortunately, I am unsure one can predict with certainty whether or not anabolic effects felt at the level of the joint would be promoted long-term. There is a lot more data on the effects on the tendon as opposed to the overt joint (articular cartilage) itself. I would presume without too much compromise to the hypothalamic axis (see hCG discussion); you are probably going to see some improvement continue after, although there may be some regression...but I think its anyone's guess.


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