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January 28, 2019 by Joseph Fermin 0 Comments

The importance of Testosterone Post Cycle Therapy? 0 (0)

Why Is Testosterone
Post Cycle Therapy Is Need It?

Why is Post Cycle Therapy (PCT) is perhaps the most critical aspect of testosterone use? The concept of the post cycle therapy (PCT), did not exist before the late 1980s, and 1990s and the mechanisms by which testosterone affected, the body were not wholly understood during the 1950s, 1960s, and 1970s.

This period were doctors, scientists, and testosterone injections users were only beginning to learn about the dynamics of testosterone and how they affect the endocrine system. We believed and understood since the beginning of testosterone injections use, the administration of testosterone resulted in triggering the body’s negative loop of the (HPTA) Hypothalamic Pituitary Testicular Axis. That endogenous Testosterone production would result become suppressed and shut down. The, unfortunately, is during the early periods of testosterone use between the 1950s and 1990, there was limited access to the compounds or knowledge or effectively.

Today it is a very different story. Now scientific and medical understanding of bio-identical testosterone use has soared exponentially since the old ‘golden era’ days of looking young and testosterone therapy use in athletics. Countless developments of beneficial compounds for hormonal recovery after testosterone therapy use, alongside the increased scientific and medical knowledge, has enabled testosterone use and its associated endocrine disruptions. The proper knowledge on how to recover the body’s from Hypothalamic Pituitary Testicular Axis (HPTA). Through post cycle therapy (PCT), we can not only emerge from their testosterone therapy while holding on to almost all of their benefits, but they can also increase the chances upwards to 90 percent or higher range of emerging with a fully healthy (HPTA).

Following the use of exogenous testosterone injections, the majority of users will experience what has been a hormonal crash or post cycle therapy crash, which is a physical environment in which key hormones essential is has been suppressed or shut down. The critical hormones in question are Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), and subsequently (and are most importantly), for our natural testosterone. The Luteinizing Hormone (LH), and the Follicle Stimulating Hormone (FSH), known as phototropism. These hormones increase Testosterone secretion. Also alongside low levels of these hormones, to balance the essential hormones that have been thrown off balance, whereby Testosterone levels will be small, and most of the time, depending on the factors, estrogen levels will be higher than usual, and levels of Cortisol a steroid hormone that destroys muscle tissue. With the testosterone levels low and Cortisol levels in the average or high, Cortisol now can become a threat to the new muscle during the new testosterone therapy (“Testosterone correctly suppresses and counteracts Cortisol’s catabolic effects on muscle tissue”). The SHBG (Sex Hormone Binding Globulin) is also a concern here as well, which is a protein that binds to sex hormones Testosterone renders them inactive, essentially ‘handcuffing’ them and preventing them from exerting their effects. SHBG will also usually elevated during the post cycle therapy weeks as a result of the supraphysiological levels of androgens from the new testosterone therapy.

The human body will generally and restore this imbalance of hormones and recover from testosterone levels on its own, over time with no outside assistance or post cycle therapy (PCT), but the studies have demonstrated and shown us that without the intervention of testosterone stimulating agents, this will occur throughout one to four months. Therefore, all testosterone therapy should be concerned with the fastest possible hormonal recovery, assisted and boosted with the use of Testosterone stimulating compounds correctly, also the attempt to allow the body to recover on its own, from a very high probability of long-term endocrine damage to the Hypothalamic Pituitary Testicular Axis (HPTA), whereby the individual will develop-induced hypogonadism to inability the production of proper levels of Testosterone to rest. So therefore paramount that an appropriate post cycle therapy that includes multiple recovery compounds to be utilized to not only restore the (HPTA) function but also to normalize the levels as quickly as possible. To avoid any possible permanent damage, which can take priority over the concern of maintain to the recently gained muscle mass and any other benefits from it.

What Post Cycle Therapy Protocol?

There are many different types of post cycle therapy (PCT) protocols that have overdeveloped over the years; any individual will become extremely confused about how many different opinions exist among the testosterone community, This article will present the best possible and most efficient post cycle therapy protocol valid scientific data, also myths in regards to post cycle therapy (PCT), and outline which post cycle therapy (PCT) protocols should not follow due to recent more advanced developments, as well as contemporary better scientific and medical understandings of how a proper post cycle therapy protocol should work. This point, there still exists very obsolete – and subsequently ineffective – post cycle therapy (PCT) contracts that are still utilized by many testosterone users, and this presents a severe hazard not only for the individual unknowingly using a post cycle therapy.

For example:

There are several therapeutic and safety reasons why you should not continue with testosterone injections indefinitely without giving your body time to normalize to reset. Because of the decline in benefits after six months of a testosterone therapy, the physicians need to regularly incorporate a cleanse therapy post cycle therapy (PCT) in an attempt to reactivate the endocrine in the body, as you increase your testosterone levels using any testosterone therapy, now the levels of testosterone circulating the body will shut down the natural production of your endogenous testosterone; and also increases the production of estrogen in your body, which can lead to a series of undesirable and unwanted side effects in the body. `This means that the synthesis of (LH) luteinizing hormone in your body; this hormone is produced by your brain to stimulate testosterone production. and follicle-stimulating hormone in the body; the hormone produced by your mind to boost sperm production suddenly stops. When Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) levels are no longer detectable, your body will not experience the exceptional health benefits, and energy-optimizing results expected from a testosterone injection program.

Another critical concern for men is testicular atrophy in patients that participate in testosterone therapy and may experience shrinkage of the testes, This occurs as the result of the lack of testosterone, and sperm production has been shut down, in response to the testosterone therapy.

What does post cycle therapy (PCT) consist of, an example?

Your post cycle therapy consists of a testosterone secretagogue to stimulate the secretion of endogenous testosterone from the testes to reignite natural production. The medication mimics the signal from your brain. The Luteinizing Hormone (LH) induce the production of testosterone. An example of a testosterone secretagogue is human chorionic gonadotropin (hCG), which is administered either using sublingual troches or subcutaneous injections once or twice a week during therapy and then on 10–15 consecutive days as part of a post cycle therapy (PCT). Human chorionic gonadotropin (hCG), mimics Luteinizing Hormone (LH) to stimulate testosterone production by the testes. It works by effectively tricking the testes into thinking that they are being instructed to produce testosterone, even though levels are comfortably elevated because of the injectable testosterone therapy. The testosterone production stimulated by human chorionic gonadotropin (hCG) is not sufficient to sustain healthy testosterone levels on its own, but that is not the reason for this supplementation. The purpose is to ensure that the testes remain functioning during therapy to help avoid any shrinkage or atrophy.

You will also take an anti-estrogen or aromatase inhibitor. For example, Clomid/clomiphene blocks certain types of estrogen from getting to the pituitary and hypothalamus, where it elicits signals that stop testosterone production. Anti-estrogens or aromatase inhibitors also help to reactivate the standard functionality of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) signaling, while also helping to flush out any residual estrogen that has accumulated during therapy. The estrogen that collects during treatment is responsible for many of the adverse side effects associated with testosterone therapy.

An example of a post cycle therapy (PCT) protocol is as follows (note that the exact drug and dose prescribed will depend on the specific information contained within each patient file, as well as the individual patient goals):

  • 250–800 units of a testosterone secretagogue every day for ten consecutive days
  • One estrogen blocker or antagonist by mouth every day for 10–15 straight days

Without the proper understanding of what is explicitly occurring within the endocrine system during these crucial weeks, as well as a lack of knowledge of which compounds to utilize, what each compound does, and how to properly use them, serious problems can result.

post cycle therapy

The Hypothalamic Pituitary Testicular Axis (HPTA):

The (HPTA), which is an axis interconnected endocrine glands in the body that deals with control the production Testosterone.

Post-Cycle-therapy:

Outlined above is a diagram of the Hypothalamic Pituitary Testicular Axis (HPTA), Regulates the body produces the amount of Testosterone at any given time. Every individual is essentially programmed by (DNA) genetics as to maximum Testosterone they will provide.

The Hypothalamic Pituitary Testicular Axis (HPTA) and the functions that undergo a negative feedback loop, and the body will reduce secretion of Testosterone, f have too much Testosterone the body will be detected, known as the negative feedback loop. This controlled by the hypothalamus, which is mostly considered the ‘master’ gland for all endocrine system and the hormonal functions in the body. The negative feedback will loop ultimately in the body to attempt to maintain the hormonal homeostasis, and all endocrine glands operate by way of the negative feedback loop in one way or another in varying degrees, In the case of post cycle therapy, the concern is a negative feedback loop of the (HPTA).

Within the Hypothalamic Pituitary Testicular Axis (HPTA), the concern during post cycle therapy (PCT) is the restoration and regulation of the following five hormones to homeostasis:

  • GnRH (Gonadotropin Releasing Hormone)
  • LH (Luteinizing Hormone)
  • FSH (Follicle Stimulating Hormone)
  • Testosterone production

The Hypothalamic Pituitary Testicular Axis (HPTA), the hypothalamus, which will detect a need for the human body to produce more Testosterone, and will release varying amounts of GnRH, Is a hormone that signals the pituitary gland, to begin the production and release of two essential gonadotropins: Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). Two hormones that work together to start the secretion of Testosterone.

Two primary hormonal factors serve to inhibit, reduce, suppress, or shut down Testosterone production in the Hypothalamic Pituitary Testicular Axis (HPTA):

  • Testosterone Excess
  • Estrogen Excess

Although there exist other hormones that serve to inhibit and suppress Hypothalamic Pituitary Testicular Axis (HPTA) function (such as Progestins and Prolactin), these are the two primary conditional hormones that are of concern. When the hypothalamus detects excess levels of Testosterone and Estrogen in the body (either from the use of exogenous androgens on an testosterone therapy or otherwise), the hypothalamus will act to attempt to restore a balance by essentially doing the opposite of what was previously described. The hypothalamus will reduce or stop its production of GnRH, which halts production of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH), which ultimately reduces or halts production of Testosterone. Until the hypothalamus’ ideal hormonal environment is restored, the output of the various signaling hormones within the (HPTA) will not begin, and this will often require months for the body to do this on its own without the intervention of any Testosterone stimulating agents. The reason as to why the recovery of the (HPTA) naturally takes such a long time should be very clear due to the described workings of the (HPTA).

This fundamental understanding of the mechanisms of the Hypothalamic Pituitary Testicular Axis (HPTA) and negative feedback loop described above is essential to understanding how and why a proper post cycle therapy (PCT) program must be developed and utilized following an testosterone therapy.

Determining Factors In Difficulty Recovering the Hypothalamic Pituitary Testicular Axis (HPTA):

With testosterone therapy use, there are several different major determining factors in how much difficulty an individual will experience in recovery of their Hypothalamic Pituitary Testicular Axis (HPTA) and endogenous Testosterone function during post cycle therapy (PCT).

They are the following factors, in no particular order of importance:

  • Individual response
  • Type of testosterone(s) used
  • Length of the cycle (degree of testicular desensitization)

Individual response:

Every single individual will respond differently to any chemical, compound, testosterone, food or drug in existence. While some individuals might experience no Hypothalamic Pituitary Testicular Axis (HPTA) suppression or shutdown at all, other individuals might experience severe Hypothalamic Pituitary Testicular Axis (HPTA) suppression and closure to the extent where they might require far more extended periods to ensure full recovery than most. This, like anything else, is a spectrum whereby there are the very ‘lucky’ individuals that recover very quickly and easily on one end of the spectrum, and the ‘unlucky’ individuals that have extreme difficulty recovering during post cycle therapy. In between the two extremes is the average. Once again, this is due to the individual’s genetic programming as to how the Hypothalamic Pituitary Testicular Axis (HPTA) will respond and attempt to maintain homeostasis.

Type of Testosterone Therapy(s) used:

All testosterone therapy exhibit suppression or shutdown of the Hypothalamic Pituitary Testicular Axis (HPTA) through the mechanisms of the negative feedback loop, and there are no exceptions to this. Various testosterone therapy are known as being mildly suppressive, while others are identified as being profoundly suppressive. This is all reliant on multiple different reasons, many of which will not be discussed here. In any case, no matter how mild or severe an testosterone therapy exerts Hypothalamic Pituitary Testicular Axis (HPTA) suppression, all testosterone therapy when utilized for typical cycle lengths of weeks at a time will eventually cause the Hypothalamic Pituitary Testicular Axis (HPTA) to shut down, or at the very least severely suppress its hormonal signal processes.

Length of the cycle degree of testicular desensitization:

This is perhaps the most important and most influential factor. As the range of testosterone therapy use continues, the majority of the Leydig cells of the testes remain dormant and inactive, and the longer these interstitial cells stay dormant and idle, the higher the difficulty is essentially getting these cells to respond to the stimulus of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) once again. It has been discovered in studies that the issue of recovery of the Leydig cells following testosterone therapy use is not due to a lack of Luteinizing Hormone (LH), but due instead to the desensitization of the Leydig cells to (LH). In one study in which exogenous Testosterone was administered to male test subjects for 21 weeks, Luteinizing Hormone (LH) levels were suppressed shortly after beginning administration. However, at the end of the 21 weeks, Luteinizing Hormone (LH) levels were observed to rise within three weeks once the exogenous Testosterone administration stopped, but Testosterone levels did not arise until many weeks later in most of the test subjects.

Recovery During The Post Cycle Therapy (PCT).

To stimulating hormonal recovery during post cycle therapy, it is essential for individuals to understand that the use of any medication except for a single select one or two is inadequate for hormonal recovery during post cycle therapy (PCT). Ideally, all post cycle therapy programs should be a multi-component post cycle therapy (PCT) program that includes several different compounds that work in tandem with one another to provide the most effective and fastest possible Hypothalamic Pituitary Testicular Axis (HPTA) recovery following an testosterone therapy.

The three categories of compounds are in order of importance:

  • SERMs (Selective Estrogen Receptor Modulators)
  • Aromatase Inhibitors
  • HCG (Human Chorionic Gonadotropin)

SERMs:

Classes of drugs in the SERM category include: Nolvadex (Tamoxifen Citrate), Clomid (Clomiphene Citrate), Raloxifene, and Fareston (Toremifene Citrate). The nature of a SERM is that it exhibits mixed Estrogen agonist and Estrogen antagonist effects on the body. This means that although a SERM might block the effect of Estrogen at the cellular level in specific tissues, it can enhance Estrogenic impacts in other areas of the body. These can be positive effects as well as adverse effects. Nolvadex, for example, exhibits Estrogenic agonistic effects in the liver, which is a positive effect, as its effects here result in a positive change in cholesterol profiles (something desired by many). All SERMs to varying degrees serve to act as an Estrogen antagonist in this area, working to mitigate Estrogen’s effects on breast tissue, reducing or blocking the side effect of gynecomastia. Regarding the impact of SERMs on endogenous Testosterone stimulation, they serve to act as an Estrogen antagonist at the pituitary gland, triggering the release of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) as a result. Elevated levels of Estrogen in men can and does suppress the output of endogenous Testosterone via the negative feedback loop, leading to hypogonadism. SERMs for this purpose are an essential addition to any post cycle therapy (PCT) protocol and are not to be excluded under any circumstance. Regardless of this, however, the sole focus should not be on SERMs.

Aromatase Inhibitors:

These are compounds such as Aromasin (Exemestane), Arimidex (Anastrozole), and Letrozole (Femara). Rather than block the activity of Estrogen at the cellular level in different tissues, aromatase inhibitors (AIs) serve to lower total circulating Estrogen levels in the body by way of inhibiting the aromatase enzyme, which is the enzyme responsible for the conversion of androgens into Estrogen. The transformation of androgens into Estrogen results in excess Estrogen levels, which, as explained earlier in this article, will trigger the negative feedback loop leading to suppression of Testosterone production. By way of lowering total circulating blood plasma Estrogen levels, AIs will positively engage the negative feedback loop and result in the release of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) for the manufacture and secretion of more Testosterone. This is mainly due to the hypothalamus realizing that circulating. Estrogen levels are too low and will attempt to increase circulating levels of Testosterone for a portion of the Testosterone secreted to be able to become aromatized into Estrogen to restore the hormonal balance. The other importance of aromatase inhibitors is the ability to mitigate the Estrogenic effects of human chorionic gonadotropin (HCG), which will be explained shortly. It is important to note, however, that the majority of aromatase inhibitors do not comply very well with SERMs such as Nolvadex, and those particular choices should be made in regards as to which AI is used during post cycle therapy (PCT).

HCG:

Human Chorionic Gonadotropin is, for the most part, synthetic Luteinizing Hormone (LH). It is a protein hormone manufactured in high amounts by pregnant females that contains a protein subunit that is 100% identical to Luteinizing Hormone (LH), and therefore when administered to men, it will mimic the action of Luteinizing Hormone (LH) in target tissues, such as the testes. What results is an increase in Testosterone production via stimulation of the Leydig cells by human chorionic gonadotropin (HCG). Human chorionic gonadotropin (HCG) should never be utilized alone, as its nature as a gonadotropin will itself trigger a negative feedback loop whereby once human chorionic gonadotropin (HCG) is used, the pituitary gland will halt output of Luteinizing Hormone (LH) until human chorionic gonadotropin (HCG) use has discontinued. Therefore, human chorionic gonadotropin (HCG) must be utilized with a SERM and especially an aromatase inhibitor, as human chorionic gonadotropin (HCG) has demonstrated to increase aromatase activity in the testes, resulting in rising Estrogen levels.

Putting Them Together:

The reader may be wondering which compounds to select of the three categories listed, and how to use them properly. The answer lies in understanding the properties of each and, in interpreting these properties, how to use them efficiently and appropriately.

Human chorionic gonadotropin (HCG):

The first item to be examined will be human chorionic gonadotropin (HCG). The majority of testosterone therapy users from the 1960s – mid-1980s did not even utilize any compounds for hormonal recovery, and the term post cycle therapy (PCT) did not even exist at that time. When the use of human chorionic gonadotropin (HCG) became increasingly popular (circa 1980), it was the only compound utilized. Since then, the medical and scientific understanding of such things has increased exponentially, and there should be no reason for any informed and adequately educated individual to utilize human chorionic gonadotropin (HCG) on its own for post cycle therapy (PCT). When used in conjunction with one of the other two categories of compounds (an AI and a SERM), the dynamics change considerably.

It has been mentioned already that much of the difficulty in recovering the Hypothalamic Pituitary Testicular Axis (HPTA) following an testosterone therapy is the result of Leydig cell desensitization. Human chorionic gonadotropin (HCG) is necessarily an analog of Luteinizing Hormone (LH), and the testes after a prolonged testosterone therapy would be as equally desensitized to human chorionic gonadotropin (HCG) as they are to Luteinizing Hormone (LH). The human body, however, produces Luteinizing Hormone (LH) amounts on its own that is far too inefficient for proper and rapid Testosterone production. The body’s natural increase of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH), evidenced by the study referenced earlier in which it was not until three weeks when Luteinizing Hormone (LH) levels only began to reach the standard physiological measurements following the cessation of Testosterone. Therefore, the body’s natural Luteinizing Hormone (LH) production does not provide a high enough dose for stimulation, nor an immediate stimulus to the tests required for the initial increase in Testosterone needed during the post cycle therapy weeks.

Human chorionic gonadotropin (HCG), utilized in a specific manner during the first 1 – 2 weeks of post cycle therapy (PCT) at a dose of 100-1,500IU every 2 days, is what allows the individual to provide the testes with a high dose to provide them with a ‘shock’ effect, and sustain this shock effect on the Leydig cells of the testes for a sustained period of the first 1 – 2 weeks of post cycle therapy. Studies have demonstrated the incredible effectiveness of human chorionic gonadotropin (HCG) for this purpose, it been suggested that human chorionic gonadotropin (HCG) therapy is utilized to treat low testosterone and hypogonadism. Following this line of thought, the other two compounds (the SERM and the AI) are to be used as supportive compounds for human chorionic gonadotropin (HCG) use in this 1 – 2 week period, and after human chorionic gonadotropin (HCG) is discontinued early on in post cycle therapy (PCT), only the SERM is to be used in order to carry along the hormonal recovery process.

In spite of the good news in regards to the ability for human chorionic gonadotropin (HCG) to assist in hormonal recovery, there are still two remaining issues to be addressed:

  • The fact that human chorionic gonadotropin (HCG) causes increased production of aromatase, leading to increased Estrogen levels.
  • Following the discontinuation of human chorionic gonadotropin (HCG), the body is left with very little endogenous Luteinizing Hormone (LH), and Follicle Stimulating Hormone (FSH) production due to the exogenous administration of human chorionic gonadotropin (HCG).

Aromatase Inhibitors:

Aromasin (Exemestane) Above All Else The first of the two remaining issues to be addressed will be the fact that human chorionic gonadotropin (HCG) will trigger increases in testicular aromatase expression, and result in Estrogen increases in the body. It should also be noted that it will cause an increase in testicular progesterone levels. Estrogen rising is, of course, undesirable during post cycle therapy (PCT), as it has already been explained that Estrogen will trigger suppression of endogenous Testosterone production, and there is no doubt that any individual wishes to encounter Estrogenic side effects during post cycle therapy (PCT) either.

Therefore, the option here is to include an aromatase inhibitor. However, there exists a big problem in regards to the other two of the three major aromatase inhibitors (Arimidex and Letrozole). The issue is the fact that in a post cycle therapy (PCT) program that includes the use of SERMs such as Nolvadex and Clomid, which are known as essential components to a post cycle therapy (PCT) program, Arimidex and Letrozole have direct negative interactions with Nolvadex. The problem here is that Arimidex (or Letrozole) and Nolvadex both directly counteract one another. One study has demonstrated that when Arimidex is utilized with Nolvadex, Nolvadex will decrease the blood plasma concentration of Arimidex (as well as Letrozole, another commonly used aromatase inhibitor). The conclusion here is that the use of Arimidex or Letrozole with Nolvadex together is a terrible idea and may work together in a post cycle therapy (PCT) protocol. Aromasin completely circumvents this problem, as it has been demonstrated to have no interactions what so ever with Nolvadex, unlike the other two aromatase above inhibitors. In one study, Aromasin displayed no such reduced effectiveness or any reduced blood plasma levels when utilized with Nolvadex.

The other benefit of selecting Aromasin over all other AIs is the fact that Aromasin has demonstrated in several studies to impact cholesterol profiles in a negative manner far less than other aromatase inhibitors have, wherein one particular review on cancer patients, 24 weeks of Aromasin (Exemestane) administration held no impact on cholesterol profiles. Some other studies have also demonstrated a nil effect on cholesterol profiles from the use of Aromasin. Although there have also been some studies that have shown a negative impact on cholesterol profiles resultant from Aromasin use, it is evident that there is not as a significant or as a negatively impacting effect from Aromasin on cholesterol as other aromatase inhibitor.

Finally, in addition to these benefits from Aromasin, it is evident that Aromasin holds the ability to increase Testosterone levels in males as demonstrated by studies. For example, one particularly notable study selected 12 healthy young male test subjects, and were administered random Aromasin doses of 25mg and 50mg for a 10 day period, and not only was Estrogen suppressed by a significant amount (38%), but Testosterone levels in the test subjects were observed to have increased by an incredible 60%.

Following these details, Aromasin would be the best possible aromatase inhibitor of choice to combat the increased aromatase activity caused by human chorionic gonadotropin (HCG). Therefore, Aromasin would then be utilized at a full 25mg daily dose, and only while human chorionic gonadotropin (HCG) is used. Once human chorionic gonadotropin (HCG) is discontinued, Aromasin too should be halted.

The only following issue to cover now is that of stimulating and maintaining proper endogenous Luteinizing Hormone (LH) release to carry recovery along until the body can become self-sufficient once again.

Nolvadex and Clomid: 

The question is often asked among the testosterone therapy using community: Clomid or Nolvadex? Which one for post cycle therapy (PCT)?

First of all, the best possible addition to human chorionic gonadotropin (HCG) in a post cycle therapy (PCT) protocol is Nolvadex (Tamoxifen Citrate), as studies have demonstrated that human chorionic gonadotropin (HCG) and Nolvadex utilized together have exhibited a remarkable synergistic effect in terms of stimulating endogenous Testosterone production and that Nolvadex will actually work to block the desensitization effect on the Leydig cells of the testes caused by high doses of human chorionic gonadotropin (HCG). This is very important because just as too little Luteinizing Hormone (LH) secretion for extended periods can cause desensitization to gonadotropins, too much gonadotropin stimulation (in the form of human chorionic gonadotropin (HCG) or otherwise) will likewise create a desensitization effect.

Secondly, Nolvadex on an mg for mg basis is far more effective than Clomid in stimulating endogenous Testosterone production, as well as being a more cost-effective choice than Clomid itself. Studies have demonstrated that 150mg of Clomid (Clomiphene Citrate) administered daily raised endogenous Testosterone levels of 10 healthy males by approximately 150%, while incidentally, 20mg of Nolvadex (Tamoxifen Citrate) daily raised endogenous Testosterone levels by the same amount. It is very evident here that Clomid is very useful for this purpose, but Nolvadex seems to be a more cost-effective choice seeing as though it is more effective than Clomid when compared mg for mg. The benefits of Nolvadex over Clomid do not end there – Clomid, although it does exhibit Estrogen antagonist effects at the pituitary gland as Nolvadex does, actually shows Estrogen agonist effects there too. What this means is that Clomid will work in varying degrees as an Estrogen at the pituitary gland, triggering the negative feedback loop and reducing the output of Testosterone stimulating gonadotropins Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). This is a severe problem during post cycle therapy, which is a period in which individuals are trying to recover their Hypothalamic Pituitary Testicular Axis (HPTA) function rather than halt it even further. Ideally, one would want a SERM that exhibits almost 100% Estrogen antagonistic effects on the pituitary gland, and Nolvadex is the perfect choice for this.

When it comes to the dosing aspect of Nolvadex, The standard dose for post cycle therapy (PCT) and for stimulating the release of GnRH (Gonadotropin Releasing Hormone), Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), and ultimately Testosterone is that of a single Nolvadex dose of 20 – 40mg daily. In all studies involving Nolvadex doses used to stimulate endogenous Testosterone production, only 20 – 40mg daily of Nolvadex was utilized, and it has been shown that doubling the dose to 40mg or any higher will not produce any significant difference in endogenous Testosterone secretion. The only reason why many elects to utilize 40mg daily of Nolvadex for the first 1-2 weeks of a post cycle therapy (PCT) program is to achieve optimal peak blood plasma levels quicker to ensure Hypothalamic Pituitary Testicular Axis (HPTA) recovery faster.

The ideal post cycle therapy protocol for 4 – 6 weeks Total post cycle therapy (PCT) time (depending on the recovery ability of the individual):

01) Weeks 1 – 2:

  • human chorionic gonadotropin at 1000iu/E2D.
  • Aromasin (Exemestane) at 25mg/day.
  • Nolvadex (Tamoxifen Citrate) at 40mg/day.

02) Weeks 2 – 6:

  • Nolvadex or (Tamoxifen Citrate).

Additional and Optional, Vitamins, Supplements, Compounds to Aid During post cycle therapy (PCT), Aside from the principal components discussed, various other parts are mostly optional, but still very useful for hormonal recovery of the Hypothalamic Pituitary Testicular Axis (HPTA) during the post cycle therapy weeks.

Vitamin B12 Health Benefits, There has been a lot of controversy over whether or not there is indeed a benefit from taking B12 supplements. Some doctors suggest that as long as a person is not vegan (though probiotics in the gut can produce some B12), they are probably getting sufficient B12 from the basic foods they are ingesting.

vitamin b12

Let us reference some studies:

There is documented research from the Framingham Study suggesting that 40% of all people are deficient in B12. The American Journal of Clinical Nutrition researched in 2009, and they published a study suggesting close to 6% of U.S. and U.K. residents over the age of 60 are B12 deficient. Another 20% were referenced as “marginal status.”

Vitamin B12 Health Benefits has the most multifaceted and prevalent chemical structure of all vitamins. One area where it differentiates from other vitamins is in the fact that it’s the only vitamin that contains a metal commonly referred to as Cobalamin, which is also a universal term for all the various compounds that may have some B12 properties in it.

B12 can improve energy by aiding in thyroid function and cellular methylation, That being said, B12 is not only useful in supporting healthy energy levels. It is unequivocally essential to life and whole existence. People deficient in B12 will suffer from serious health issues if the problem is not addressed.

What role B12 plays in the following human biological processes:

  • Nerve and brain regeneration
  • Adrenal gland support
  • Male and female reproductive health
  • Nutrient absorption
  • Red blood cell formation
  • Cellular energy
  • Memory recall
  • DNA synthesis

Here are some of the risks associated depleted B12 levels are:

  • Pernicious anemia
  • Migraine headaches
  • Macular degeneration
  • Tinnitus
  • Fatigue (adrenal fatigue and CFS)
  • Multiple sclerosis
  • Memory loss
  • Neuropathy
  • Anemia
  • Asthma
  • Shingles
  • Kidney disease
  • Depression

May 31, 2018 by Joseph Fermin 0 Comments

Testosterone Therapy Vs Testosterone Supplements 0 (0)

Testosterone Therapy Vs Testosterone Supplements

Testosterone Therapy Vs Testosterone Supplements: Testosterone is stimulated and produced by the testes and is key to driving male sexual behavior. Although testosterone is a sex hormone, it plays many crucial roles in the body. It is responsible for regulating a man’s sex drive (libido), bone and muscle mass, fat distribution and the production of red blood cells, Decreased libido and sperm. The body begins to produce testosterone as early as seven weeks after conception, with levels reaching their peak at puberty. As men age, levels of testosterone start to drop, and this affects individuals in different ways.

Decreased Motivation: As testosterone production diminishes so do energy boosting components and restful sleep, thus producing decreased motivation.

Decreased libido: Low levels of testosterone cause a reduction in sex drive.

Depression: When a person experiences low testosterone levels it alters hormone production, which can lead to depression.

Erectile Dysfunction: Testosterone supplementation can be used to reverse or correct low testosterone-induced erectile dysfunction.

Fatigue: A decrease in testosterone levels leads to hormonal changes, which can cause fatigue. This can be exacerbated by low testosterone-induced sleep loss, which can easily turn into a vicious cycle.

High Cholesterol: High cholesterol is a silent killer that can lead to a variety of heart conditions. Testosterone injections, when used in a proper protocol, can lower cholesterol, blood pressure, and triglyceride levels.

Low Energy & Fatigue: Symptoms of aging can be a direct result of diminishing levels of testosterone or (Low-T) in the body. As we age, our bodies produce less and less testosterone, causing low energy and fatigue.

Memory Loss: Some recent evidence suggests that testosterone might help prevent and treat the effects of brain aging. Some patients treated with testosterone injections expressed a palpable increase in their cognitive function, short- and long-term memory, and vocabulary improvements.

Thyroid: The hormones produced by the thyroid and adrenal glands regulate key processes throughout the body. If thyroid hormone and cortisol levels are abnormal, the rest of the body does not function properly.

Weight Gain: The production of certain hormones decreases after the age of 30. The lean body mass of some organs also starts to decrease, whereas fat mass increases.

When Age Becomes The Deciding Factor

testosterone

After the age of 30, your body starts declining in hormones production, and the body decreases its testosterone production. This decrease, however, is very gradual and its effects can only felt around the age of 50. Common signs of testosterone decline include fatigue, decreased libido and problem having erections. While these effects can be most nerve-wracking, they are relatively common. Talk to your doctor at this stage, who will examine your condition and accordingly prescribe medicines or advise lifestyle changes.

The problem arose when these effects were seen, at or below the age of 40. Low levels of testosterone at a younger generation usually point to an underlying medical condition and warrant more in-depth investigation. It is essential that men consult a qualified doctor or men’s health specialist at the earliest, who will determine the underlying cause and how best to treat it. Some reasons for low testosterone production include underactive testes, undescended testicles, physical injury to the testicles, pituitary disorders or inherited conditions such as Klinefelter’s syndrome.

Know Your Treatment Options

Once a case of low testosterone is confirmed, patients have advised a mix of lifestyle changes (such as increased physical activity, healthy diet), counseling and medication are bioidentical 191 amino acid (orals or injectables). The choice of treatment made depending on the patient’s medical history, levels of testosterone, age and physical condition. Testosterone replacement therapy is another useful treatment option and helps restore the body’s declining testosterone levels. However, it must be taken under supervision since excessive testosterone is also harmful. If problems such as erectile dysfunction persist and hamper the patient’s relationship and quality of life, doctors may recommend other therapies to help restore erections.

Testosterone Boosting Supplements: Good Or Bad?

Boosting Supplements: Good Or Bad?

In the quest for ‘physical fitness’ and ‘bodybuilding’, a growing number of young men in their 20s and 30s try to boost their testosterone levels through external testosterone supplementation, Includes natural supplements, and or synthetic supplements (anabolic steroids). However, use of these supplements (test boosters and AAS) can have damaging and irreversible effects on the body in the long term, such as a reduction in sperm count (even zero counts!), excess fluid retention, enlargement of the prostate and an increase in red blood cells.

My advice to everyone reading this piece is this: Protect your sexual health. If you observe changes in your sexual response or experience any difficulty being intimate with your partner, talk to a qualified doctor at the earliest. If low testosterone is to blame, your doctor will discuss suitable treatment options and guide you in making an informed choice. Do not resort to testosterone supplementation on your own, as this may do you more harm than good in the long run.

Dr. Rupin Shah is a Urologist at the Lilavati Hospital in Mumbai and has been a part of the medical field for decades.

References:

1) NIH. Understanding How Testosterone Affects Men. Testosterone Therapy Vs Testosterone Supplements. Available at https://www.nih.gov/news-events/nih-research-matters/understanding-how-testosterone-affects-men

2) USRF. History of Testosterone Replacement Therapy (TRT). Testosterone Therapy Vs Testosterone Supplements. Available at https://www.usrf.org/news/TRT/history.html

3) Healthline Newsletter. The Effects of Testosterone on the Body. Testosterone Therapy Vs Testosterone Supplements. Available at https://www.healthline.com/health/low-testosterone/effects-on-body#1

4) American Urological Association. Testosterone for Erection Problems. Testosterone Therapy Vs Testosterone Supplements. Available at http://www.choosingwisely.org/patient-resources/testosterone-for-erection-problems/

November 13, 2017 by Joseph Fermin 0 Comments

An Inside Look at Testosterone Injections Therapy 0 (0)

Inside Look Testosterone Injections Therapy

testosterone injections therapyTESTOSTERONE INJECTIONS THERAPY

Testosterone is an essential factor in males, that does more for men than just promote sex drive. Low Testosterone levels decline as a part of healthy aging and are the cause of several physiological changes. Low Testosterone level symptoms include;

1) Reduced Motivation
2) Erectile Dysfunction
3) Loss of Libido or sex drive
4) Fatigue and low energy
5) Increased Cholesterol Levels
6) Memory and Concentration
7) Decreased Muscle Mass
8) Thyroid Dysfunction and more

Since these symptoms are common in low testosterone, physicians will often include hormone levels as part of routine blood work. Normal levels of testosterone are between 300 and 1,000 ng/dL. If a blood test shows that your levels are far below the norm, your doctor may suggest testosterone injections. The treatment is called TRT.

SYMPTOMS OF LOW TESTOSTERONE

Most men naturally start losing testosterone when they hit their 30’s. (low T). Common symptoms of low Testosterone include:

1) Erectile dysfunction (ED)
2) Changes in sex drive
3) Decreased sperm count
4) Depression or anxiety
5) Weight gain
6) Hot flashes

TESTOSTERONE AND DIAGNOSIS

Many men may want to diagnose themselves with a testosterone kit. The problem with self-diagnosis is that many of the symptoms of low Testosterone are healthy parts of aging. So using it for diagnosis isn’t reliable. Our doctor may order testosterone blood test. It is the only way to find out if you have low testosterone.

To get a perfect reading our doctor will take a look at your health history, physical exam and blood test to measure your testosterone levels. You’ll also likely have a test that measures your red blood cell count.

POTENTIAL BENEFITS OF TESTOSTERONE INJECTIONS THERAPY 

The purpose of Testosterone Injections Therapy is to help regulate hormone levels and to help address problems related to low Testosterone. For men with low Testosterone, the benefits of these injections can include:

1)  Motivation and Memory Loss
2)  Sex Drive & Desire
3)  Depression and Energy
4)  Cholesterol and Osteoporosis
5)  Erectile Dysfunction
6)  Muscle Mass and Better Sleep
7)  Wounds healing & Illness
8)  Thyroid Dysfunction and more

TESTOSTERONE CAN HELP WITH FAT AND MUSCLE CHANGES

Men have less body fat than women; This is partly related to testosterone, which regulates the fat in the body and muscle maintenance in your body. You’ll likely also notice an increase in body fat, especially around your midsection.

Your hormones also help regulate muscle growth. So, with low Testosterone, you may feel like you’re losing muscle size or strength.

Testosterone shots regulate fat distribution, but you shouldn’t expect significant weight loss changes from hormone therapy alone, without exercise. As for maintenance of muscle, testosterone therapy has been found to improve increase muscle mass, but not strength.

TESTOSTERONE INJECTIONS THERAPY AND SPERM COUNT

Low sperm count in men is a common side effect of low Testosterone. This problem can make it difficult to get your partner pregnant.

TESTOSTERONE INJECTIONS THERAPY AND THE BOTTOM LINE

Testosterone injections therapy can only be helpful If you just have low Testosterone. If you’re wondering if testosterone is a right choice for you, ask your doctor. They can test you for low Testosterone. Ask your doctors, or Give us a call, if testosterone injections therapy would be a good choice for you.

If you don’t end up having low Testosterone but still feel like your hormone levels might be off, keep in mind that proper Food, Regular exercise, could help you increase testosterone naturally and make you feel better. If that doesn’t help, be sure you contact us for help.

November 30, 2016 by Joseph Fermin 1 Comment

The Relationship Between Hormones and Stress 0 (0)

Hormones and Stress

Hormones and Stress in the holiday season are upon us! Although this can a wonderful time filled with love and laughter, it can also significantly increase the day-to-day stresses experienced by many people; this can easily turn into chronic stress. Did you know that chronic stress can have a significant impact on your normal hormonal responses? Read on to learn more about the effects stress can have on your body and what you can do about it.

Hormones and Stress

The Hormones and Stress feeling that we all know so well is part of the body’s normal response to a real or perceived threat. However, your body does not differentiate between serious physical threats and “normal” pressures, and so a heavy workload or demands from your family can build up over time and have a detrimental effect on your health.

The stress response is commonly known as the “fight or flight” response, and it begins in the brain. When a stress is perceived, the amygdala sends a signal to the hypothalamus, which activates the sympathetic nervous system and triggers the release of adrenaline from the adrenal glands into the bloodstream. Adrenaline then accelerates the heartbeat to pump more blood to the muscles in preparation for “flight.” In addition, the pulse, blood pressure, and breathing rate all increase to enhance the amount of oxygen inhaled. Other senses, such as sight and hearing, become sharper.

The Normal Stress Response

 

During the second phase of the stress response, the hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates the release of adrenocorticotropic hormone (ACTH). ACTH then stimulates the release of cortisol from the adrenal glands, which ensures that the body remains on “high alert.” Cortisol levels remain elevated until the threat passes; the stress response is then shut down once the brain perceives that the threat is no longer there (http://www.health.harvard.edu/staying-healthy/understanding-the-stress-response).

Hormones and Stress

The Effects of Stress

Prolonged periods of stress prevent the shut-down of the normal stress response because the body remains on high-alert and producing cortisol. The long-term exposure to cortisol and other Hormones and Stress has a number of negative effects throughout the body, including:

  1. In the respiratory system, the accelerated breathing rate could lead to asthma or panic attacks (http://www.apa.org/helpcenter/stress-body.aspx).
  2. In the cardiovascular system, prolonged periods of an elevated heart rate and increased blood pressure can increase the risk of cardiovascular disease, heart attack, and stroke.
  3. In the liver, the increased levels of cortisol stimulate the production of glucose in anticipation of increased energy demands. Such prolonged exposure to elevated blood glucose levels might increase the risk of metabolic syndrome and type 2 diabetes.
  4. Some animal studies have suggested that chronic stress can reduce testosterone levels and sperm production and maturation in men; it can even lead to erectile dysfunction and impotence.
  5. In women, chronic stress can lead to an irregular menstrual cycle, worsened premenstrual syndrome symptoms, and reduced libido.
  6. Stress can also dampen the immune system.
  7. Emotionally, stress can affect your sleep, increase irritability, anxiety, and depression, and reduce concentration.

How to Reduce the Effects of Stress

There is no need to worry: there is a lot you can do to counteract the natural stress responses that occur at this time of year. It is important to understand what makes you stressed, as well as what makes you relax. For example, there are several lifestyle changes that can help reduce stress (http://www.webmd.com/balance/stress-management/stress-management-relieving-stress):

  1. Take time out to do something you enjoy
  2. Express your feelings
  3. Use relaxation techniques such as meditation
  4. Exercise regularly; exercise is one of the best ways of reducing stress

Because many of the symptoms of chronic stress are also associated with low hormones, such as sleep loss, fatigue, and low testosterone levels, we recommend getting your Hormones and Stress levels checked if you experience any prolonged, unusual or unexplained stress. At AAI Clinic, we can measure your Hormones, Testosterone Injections, and Stress and make recommendations regarding any hormone replacement therapy or supplements that could alleviate your stress-related symptoms.

Testosterone Injections – Curious about testosterone injections Therapy? Read more about what you can expect from this treatment and contact us for more information (866) 224-LowT (5698)

References

  1. Golbidi, S., J.C. Frisbee, and I. Laher, Chronic stress impacts the cardiovascular system: animal models and clinical outcomes. Am J Physiol Heart Circ Physiol, 2015. 308(12): p. H1476-98.
  2. Bergmann, N., F. Gyntelberg, and J. Faber, The appraisal of chronic stress and the development of the metabolic syndrome: a systematic review of prospective cohort studies. Endocr Connect, 2014. 3(2): p. R55-80.
  3. Kalaitzidou, I., et al., Stress management and erectile dysfunction: a pilot comparative study. Andrologia, 2014. 46(6): p. 698-702.
  4. Gannon, L., et al., Perimenstrual symptoms: relationships with chronic stress and selected lifestyle variables. Behav Med, 1989. 15(4): p. 149-59.
  5. Golkar, A., et al., The Influence of Work-Related Chronic Stress on the Regulation of Emotion and on Functional Connectivity in the Brain. PLoS ONE, 2014. 9(9): p. e104550.

November 16, 2016 by Joseph Fermin 5 Comments

The Health Benefits Of Raw Cacao 0 (0)

The Benefits Of Raw Cacao

Today’s media is full of reports about so-called “superfoods.” While most of these reports are based on some level of fact, misrepresentation or poor interpretation of medical and scientific findings often leads to misinformation and sensational yet misleading headlines. A prime example of this is raw cacao. The health benefits of raw cacao are astounding; however, this, unfortunately, does not necessarily mean that eating a bar of milk chocolate each day will have the same effects. Read on to learn more about the ways in which raw cacao can improve your health and how to take full advantage.

What is Raw Cacao?

Cacao-based products are made from cacao beans and include cacao powder, nibs, paste, and butter. raw cacao

When purchasing raw cacao products such as powder, it is important to understand the differences between raw cacao powder and the more common cocoa powder. Raw cacao powder is very pure. It is made from raw, unroasted cocoa beans via a process known as cold pressing, which removes the fat in the form of cacao butter; much of the bean and nutrients remain intact.

Cacao is one of the best sources of flavonoids (which are potent antioxidants) available, which means that it has huge health benefits. It is also rich in protein, cholesterol-free and monounsaturated fats, fiber, natural carbohydrates, and minerals (including zinc, iron, potassium, magnesium, copper, manganese, and calcium).

Cocoa powder is produced in a similar way to cacao powder, except that it undergoes high-temperature processing during production. Although it retains significant health benefits, the high temperatures used to destroy some of the nutritional value. As cocoa undergoes further processing to make reduced-strength dark chocolate and milk chocolate, increasing amounts of the nutrients are removed. Therefore, raw cacao powder, cocoa powder, or very strong dark chocolate are recommended for optimal health benefits.

what-is-raw-cacao

Cardiovascular benefits

Many people are at an increased risk of cardiovascular events as they age. The good news is that the consumption of certain foods can help reduce this risk. Cocoa-based products can have significant beneficial effects on the cardiovascular system by reducing cardiovascular risk and atherosclerosis, improving circulation, lowering the levels of LDL (bad) and increasing the levels of HDL (good) cholesterol, and reducing blood pressure. Many of these effects are caused by the anti-inflammatory and antioxidant properties of the flavonoids.

  • Cacao- and cocoa-based products can reduce hypertension. For example, the Cocoa, Cognition, and Aging (CoCoA) Study was performed in 90 elderly individuals who received cocoa-based drinks with high, medium, or low flavonoid content. Blood pressure was reduced significantly in patients that received high- or medium-content cocoa compared with those that received low flavonoid cocoa [1]. The subjects also exhibited improved insulin resistance and reduced lipid peroxidation.
  • Cardiovascular function. A recent study assessed vascular stiffness in healthy younger (<35) and older (50–80) men who drank cocoa or a control drink twice a day for two weeks. The subjects who drank cocoa exhibited significantly improved cardiovascular function, as measured by improved endothelial function, blood pressure, and vascular stiffness [2]. A second similar study confirmed these effects and also indicated that the consumption of high-flavonoid chocolate improved platelet aggregation (an indicator of the ability of the blood to form clots) compared with low flavonoid chocolate [3].
  • Cholesterol. Several studies have investigated the ability of cocoa and cacao to improve cholesterol. For example, consuming 400 g cocoa powder with 500 ml skimmed milk per day increased HDL and lowered LDL cholesterol levels in elderly subjects at high risk of cardiovascular disease [4]. Similar observations were made in young healthy and hypercholesterolemic subjects [5] and in elderly healthy individuals [6].

cacao

Cognitive function

The available data suggest that cocoa and cacao could help protect against cognitive decline in aging individuals.

  • In the same CoCoA study described above, subjects that received cocoa with a high or medium flavonoid content had significant improvements in two different measures of cognitive function: a trail making test and a verbal fluency test. The improvements were greatest in the high flavonoid vs. the intermediate flavonoid group. However, there were no improvements in the mini-mental state evaluation among groups [1].
  • Cocoa and cacao might also protect against dementia and related diseases such as Alzheimer’s disease [7].

Metabolic Effects

The risk of metabolic diseases often increases as we age, and conditions such as diabetes and obesity are associated with reduced mortality. Luckily, cocoa could help reduce the risk of these conditions and their symptoms. Possibly the most important metabolic effect of cocoa is its ability to improve insulin sensitivity. In one study, subjects received dark or white chocolate (with high and zero flavonoid content, respectively), and insulin sensitivity was assessed using glucose tolerance tests and the quantitative insulin sensitivity check index. Dark, but not white, chocolate significantly improved both measures of insulin sensitivity and reduced blood pressure [8].

Hormonal Changes

The symptoms of many aging-related diseases have been linked to reduced hormone levels over time. Therefore, improving natural hormone production can reduce the symptoms of many aging-related diseases. Cocoa can have beneficial effects on the production of several hormones.

  • Testosterone Injections. Cocoa and cacao contain high concentrations of zinc, which has been shown to increase testosterone production [9].
  • Stress hormones. We all know that nice, relaxed feeling that occurs when we eat a delicious, rich piece of dark chocolate. It turns out that there is a physiological reason for this! Cocoa can potently inhibit the release of the stress hormone cortisol. Healthy men aged 20–50 who consumed a single piece of dark chocolate had a significantly reduced response to a psychosocial stressor. These effects were caused by inhibiting the release of the stress hormones cortisol and epinephrine from the adrenal gland [10].

So, there you have it! Cocoa really is a super-food. It is not only delicious but, when eaten in unprocessed forms, it has significant health benefits.

Testosterone Injections – Curious about testosterone injections Therapy? Read more about what you can expect from this treatment and contact us for more information (866) 224-5698

References

[1] D. Mastroiacovo, C. Kwik-Uribe, D. Grassi, S. Necozione, A. Raffaele, L. Pistacchio, R. Righetti, R. Locale, M.C. Lechiara, C. Marini, C. Ferri, G. Desideri, Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study–a randomized controlled trial, The American journal of clinical nutrition, 101 (2015) 538-548.

[2] C. Heiss, R. Sansone, H. Karimi, M. Krabbe, D. Schuler, A. Rodriguez-Mateos, T. Kraemer, M.M. Cortese-Krott, G.G. Kuhnle, J.P. Spencer, H. Schroeter, M.W. Marx, M. Kelm, Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial, Age (Dordrecht, Netherlands), 37 (2015) 9794.

[3] G. Rull, Z.N. Mohd-Zain, J. Shiel, M.H. Lundberg, D.J. Collier, A. Johnston, T.D. Warner, R. Corder, Effects of high flavanol dark chocolate on cardiovascular function and platelet aggregation, Vascular Pharmacology, 71 (2015) 70-78.

[4] N. Khan, M. Monagas, C. Andres-Lacueva, R. Casas, M. Urpi-Sarda, R.M. Lamuela-Raventos, R. Estruch, Regular consumption of cocoa powder with milk increases HDL cholesterol and reduces oxidized LDL levels in subjects at high-risk of cardiovascular disease, Nutrition, metabolism, and cardiovascular diseases : NMCD, 22 (2012) 1046-1053.

[5] S. Martinez-Lopez, B. Sarria, J.L. Sierra-Cinos, L. Goya, R. Mateos, L. Bravo, Realistic intake of a flavanol-rich soluble cocoa product increases HDL-cholesterol without inducing anthropometric changes in healthy and moderately hypercholesterolemic subjects, Food & function, 5 (2014) 364-374.

[6] N. Neufingerl, Y.E. Zebregs, E.A. Schuring, E.A. Trautwein, Effect of cocoa and theobromine consumption on serum HDL-cholesterol concentrations: a randomized controlled trial, The American journal of clinical nutrition, 97 (2013) 1201-1209.

[7] L. Dubner, J. Wang, L. Ho, L. Ward, G.M. Pasinetti, Recommendations for Development of New Standardized Forms of Cocoa Breeds and Cocoa Extract Processing for the Prevention of Alzheimer’s Disease: Role of Cocoa in Promotion of Cognitive Resilience and Healthy Brain Aging, Journal of Alzheimer’s disease : JAD, 48 (2015) 879-889.

[8] D. Grassi, C. Lippi, S. Necozione, G. Desideri, C. Ferri, Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons, The American journal of clinical nutrition, 81 (2005) 611-614.

[9] C.D. Hunt, P.E. Johnson, J. Herbel, L.K. Mullen, Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men, The American journal of clinical nutrition, 56 (1992) 148-157.

[10] P.H. Wirtz, R. von Kanel, R.E. Meister, A. Arpagaus, S. Treichler, U. Kuebler, S. Huber, U. Ehlert, Dark chocolate intake buffers stress reactivity in humans, Journal of the American College of Cardiology, 63 (2014) 2297-2299.

February 4, 2016 by admin 0 Comments

Testosterone Cypionate Description 0 (0)

Testosterone Cypionate description injections

Testosterone Cypionate Description injection for intramuscular injection contains Testosterone Cypionate which is the oil-soluble 17 (beta)- cyclopentyl propionate ester of the androgenic hormone testosterone. Testosterone Cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils. The chemical name for Testosterone Cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1-oxopropoxy)-, (17β)-. Its molecular formula is C27H40O3, and the molecular weight 412.61.

The structural formula is represented below:

Testosterone Cypionate injection, USP is available in two strengths, 100 mg/mL and 200 mg/mL Testosterone Cypionate, USP.

Each mL of the 100 mg/mL solution contains:

Testosterone Cypionate……………………………………………………………………. 100 mg
Benzyl benzoate ……………………………………………………………………………… 0.1 mL
Cottonseed oil ………………………………………………………………………………… 736 mg
Benzyl alcohol (as preservative)………………………………………………………… 9.45 mg

Each mL of the 200 mg/mL solution contains:

Testosterone Cypionate……………………………………………………………………. 200 mg
Benzyl benzoate………………………………………………………………………………. 0.2 mL
Cottonseed oil………………………………………………………………………………… 560 mg

Benzyl alcohol (as preservative)………………………………………………………… 9.45 mg

Testosterone Cypionate – Clinical Pharmacology

Endogenous androgens are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics. These effects include growth and maturation of the prostate, seminal vesicles, penis, and scrotum; development of male hair distribution, such as beard, pubic, chest, and axillary hair; laryngeal enlargement, vocal cord thickening, and alterations in body musculature and fat distribution. Drugs in this class also cause retention of nitrogen, sodium, potassium, and phosphorous, and decreased urinary excretion of calcium. Androgens have been reported to increase protein anabolism and decrease protein catabolism. Nitrogen balance is improved only when there is sufficient intake of calories and protein.

Androgens are responsible for the growth spurt of adolescence and for eventual termination of linear growth, brought about by fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates but may cause a disproportionate advancement in bone maturation. Use over long periods may result in fusion of the epiphyseal growth centers and termination of the growth process. Androgens have been reported to stimulate the production of red blood cells by enhancing production of erythropoietic stimulation factor.

During exogenous administration of androgens, endogenous testosterone release is inhibited through feedback inhibition of pituitary luteinizing hormone (LH). At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH).

There is a lack of substantial evidence that androgens are effective in fractures, surgery, convalescence, and functional uterine bleeding.

Pharmacokinetics

Testosterone esters are less polar than free testosterone. Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus, Testosterone Cypionate can be given at intervals of two to four weeks.

Testosterone in plasma is 98 percent bound to a specific testosterone-estradiol binding globulin, and about 2 percent is free. Generally, the amount of this sex-hormone binding globulin in the plasma will determine the distribution of testosterone between free and bound forms, and the free testosterone concentration will determine its half-life.

About 90 percent of a dose of testosterone injections is excreted in the urine as glucuronic and sulfuric acid conjugates of testosterone and its metabolites; about 6 percent of a dose is excreted in the feces, mostly in the unconjugated form. Inactivation of testosterone occurs primarily in the liver. Testosterone therapy is metabolized to various 17-keto steroids through two different pathways.

The half-life of Testosterone Cypionate, when injected intramuscularly, is approximately eight days.

In many tissues, the activity of testosterone therapy appears to depend on reduction to dihydrotestosterone, which binds to cytosol receptor proteins. The steroid-receptor complex is transported to the nucleus where it initiates transcription events and cellular changes related to androgen action.

Indications and Usage for Testosterone Cypionate description

Testosterone Cypionate description injection is indicated for replacement therapy in the male in conditions associated with symptoms of deficiency or absence of endogenous testosterone.

  • Primary hypogonadism (congenital or acquired)-testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome; or orchidectomy.
  • Hypogonadotropic hypogonadism (congenital or acquired): gonadotropin or LHRH deficiency, or pituitary-hypothalamic injury from tumors, trauma, or radiation.

Safety and efficacy of Testosterone Cypionate description in men with “age-related hypogonadism” (also referred to as “late-onset hypogonadism”) have not been established.

Contraindications

  1. Known hypersensitivity to the drug
  2. Males with carcinoma of the breast
  3. Males with known or suspected carcinoma of the prostate gland
  4. Women who are or who may become pregnant
  5. Patients with serious cardiac, hepatic or renal disease

Warnings

Hypercalcemia may occur in immobilized patients. If this occurs, the drug should be discontinued.

Prolonged use of high doses of androgens (principally the 17-α alkyl-androgens) has been associated with the development of hepatic adenomas, hepatocellular carcinoma, and peliosis hepatis —all potentially life-threatening complications.

Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking.

There have been postmarketing reports of venous thromboembolic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in patients using testosterone products, such as Testosterone Cypionate description. Evaluate patients who report symptoms of pain, edema, warmth, and erythema in the lower extremity for DVT and those who present with acute shortness of breath for PE. If a venous thromboembolic event is suspected, discontinue treatment with Testosterone Cypionate description and initiate appropriate workup and management.

Long term clinical safety trials have not been conducted to assess the cardiovascular outcomes of testosterone replacement therapy in men. To date, epidemiologic studies and randomized controlled trials have been inconclusive for determining the risk of major adverse cardiovascular events (MACE), such as non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death, with the use of testosterone compared to non-use. Some studies, but not all, have reported an increased risk of MACE in association with the use of testosterone replacement therapy in men. Patients should be informed of this possible risk when deciding whether to use or to continue to use Testosterone Cypionate description.

Edema, with or without congestive heart failure, may be a serious complication in patients with preexisting cardiac, renal or hepatic disease.

Gynecomastia may develop and occasionally persists in patients being treated for hypogonadism.

The preservative benzyl alcohol has been associated with serious adverse events, including the “gasping syndrome”, and death in pediatric patients. Although normal therapeutic doses of this product ordinarily deliver amounts of benzyl alcohol that are substantially lower than those reported in association with the “gasping syndrome”, the minimum amount of benzyl alcohol at which toxicity may occur is not known. The risk of benzyl alcohol toxicity depends on the quantity administered and the hepatic capacity to detoxify the chemical. Premature and low-birth weight infants may be more likely to develop toxicity.

Androgen therapy should be used cautiously in healthy males with delayed puberty. The effect on bone maturation should be monitored by assessing the bone age of the wrist and hand every 6 months. In children, androgen treatment may accelerate bone maturation without producing a compensatory gain in linear growth. This adverse effect may result in compromised adult stature. The younger the child the greater the risk of compromising final mature height.

This drug has not been shown to be safe and effective for the enhancement of athletic performance. Because of the potential risk of serious adverse health effects, this drug should not be used for such purpose.

Precautions

General

Patients with benign prostatic hypertrophy may develop acute urethral obstruction. Priapism or excessive sexual stimulation may develop. Oligospermia may occur after prolonged administration or excessive dosage. If any of these effects appear, the androgen should be stopped and if restarted, a lower dosage should be utilized.

Testosterone Cypionate description should not be used interchangeably with testosterone propionate description because of differences in duration of action.

Testosterone Cypionate description is not for intravenous use.

Information for Patients

Patients should be instructed to report any of the following: nausea, vomiting, changes in skin color, ankle swelling, too frequent or persistent erections of the penis.

Laboratory Tests

Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration.

Serum cholesterol may increase during androgen therapy.

Drug Interactions

Androgens may increase sensitivity to oral anticoagulants. The dosage of the anticoagulant may require a reduction in order to maintain satisfactory therapeutic hypoprothrombinemia.

Concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone.

In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, insulin requirements.

Drug/Laboratory Test Interferences

Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.

Carcinogenesis

Animal data

Testosterone has been tested by subcutaneous injection and implantation in mice and rats. The implant induced cervical-uterine tumors in mice, which metastasized in some cases. There is suggestive evidence that injection of testosterone into some strains of female mice increases their susceptibility to hepatoma. Testosterone is also known to increase the number of tumors and decrease the degree of differentiation of chemically induced carcinomas of the liver in rats.

Human data

There are rare reports of hepatocellular carcinoma in patients receiving long-term therapy with androgens in high doses. Withdrawal of the drugs did not lead to regression of the tumors in all cases.

Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking.

Pregnancy

Teratogenic Effects

Pregnancy Category X. (See CONTRAINDICATIONS)

Benzyl alcohol can cross the placenta. See WARNINGS.

Nursing Mothers

Testosterone Cypionate description is not recommended for use in nursing mothers.

Pediatric Use

Safety and effectiveness in pediatric patients below the age of 12 years have not been established.

Adverse Reactions

The following adverse reactions in the male have occurred with some androgens:

Endocrine and urogenital: Gynecomastia and excessive frequency and duration of penile erections. Oligospermia may occur at high dosages.

Skin and Appendages: Hirsutism, male pattern of baldness, seborrhea, and acne.

Cardiovascular Disorders – myocardial infarction, stroke

Fluid and electrolyte disturbances: Retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.

Gastrointestinal: Nausea, cholestatic jaundice, alterations in liver function tests, rarely hepatocellular neoplasms and peliosis hepatis (see WARNINGS).

Hematologic: Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia.

Nervous system: Increased or decreased libido, headache, anxiety, depression, and generalized paresthesia.

Allergic: Hypersensitivity, including skin manifestations and anaphylactoid reactions.

Vascular Disorders: venous thromboembolism

Miscellaneous: Inflammation and pain at the site of intramuscular testosterone injection.

Testosterone Therapy Information