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PCT: A Clinician's View PART I
PCT Demystified!

- article originally published on-line December 23, 2005

Dana Houser, MD, MHSA, CISSN

Author's Note: If you have not done so, please observe the PCT: A Clinican's View Primer thread before continuing on.

Introduction

As with many of the “truths” preached in all facets of life – there are always origins. Like a game of “telephone” played as a child, we hope the initial message doesn’t come out all jumbled by the time it is sent back to the message starter. Even then, the question isn’t so much how jumbled the message has become, as it is more likely a question of how jumbled the message was to begin with. This very idea governs this discussion as more accurately a game of dominoes versus telephone – where one party begins to preach the either half-truth or entire fallacy and everyone thereafter simply follows suit because it is simply now said to be SO. Somewhere along the annals of bodybuilding time, this game of dominoes reared its ugly head in consideration of PCT (post-cycle therapy). I will not claim to know the origin and personally, I don’t care.

While PCT should not be something so mystic in nature, it has gained that reputation because everyone seemingly has their own viewpoint on what should be considered standard practice when designing such regimes. This is likely for no better reason than as already stated, it is said to be SO. Unfortunately, this is one area in which “standards” have been unable to be set and offers serious concern as long-term health consequences can result through the inappropriate actions of those partaking in self-medication and supplementation. Well, of course that is, until NOW.

Everyone in the medical profession and government alike tend to close their eyes and pretend that this kind of topic need not be addressed and abolishing the use of every anabolic would be more justified (while potentially more damaging substances – cigarettes and alcohol remain legalized due to their highly economic nature and this alone). The truth is that number one, AS cycles and accompanying PCT is a very real practice that cannot simply go unrecognized (as may be evidenced by simply going to your bodybuilding site of choice and perusing the multitudes of both questions and answers supplied by countless masses on the accompanying forum) and number two, complete abolishment has the potential to make situations worse (case-in-point: bodybuilders of the pre-AS Control Act of 1990 versus the very beast-like bodybuilders of today’s post-AS Control Act of 1990 + 2004 era).

With development of new, not-well thought out compounds, mail-order dangers of potentially lethal substances, and the use of veterinary equivalents, the truth is AS use could never be fully controlled. Unfortunately, the essential behavior in regards to alteration of the homeostatic environment known as the human body is one that could hold dire consequence and the medical establishment and government would be better justified in realms of creating education versus abolishment.

The essential purpose of these articles is to guide either the health care practitioner as well as individuals having already taken the plunge into introduction of exogenous anabolic substances into their bodies on how to design a SAFE way to come off cycle TOGETHER. Hopefully, in alleviation of the consequences I alluded to in the aforementioned paragraphs. ALL aspects of this topic will be explored at great depth watching all of the evidence-based literature (or lack thereof) not only reviewed as well as seeing it played out in practice. We will also do a lot of dispelling myths, as continued via domino fashion. The rationale for writing such a series on such a bastardized “dirty” topic in medicine today is to avoid potentially life-modifying, or potentially worse, life-ending consequence.

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The Harshest of Critics

One of the harshest criticisms given to such an article set like this is that I have never used “AS” myself. This is in fact true, by legal definition! I would NOT have considered myself serious enough, nor even remotely close to my non-anabolic potential pre-1990 to consider it. After that time frame, the various modes of obtaining them seemed to not favor future goals should anything had gone awry. Oh yeah, and there was also that whole age thing that didn’t work in my favor at the time either – I was thirteen (a far cry from the 25 year old age limit I tend to preach).

[Author’s note: I have, in fact, used many items considered “PH’s / PS’s” at the time as many are aware. Again, it may simply come down to a matter of definition.]

I combat that potential dagger with the essence of having the opportunity to have lived vicariously through many clients that have used AS and witnessed various hormonal response – VERIFIED THROUGH LAB REPORT! That latter statement is something most “authorities” cannot preach even about their own precious cycles that somehow make them the authority. I personally think that the data chroniclizing what happens to one person tells us NOTHING (as one person’s hormonal response proves to neither be synonymous nor homologous with constancy across all hormonal responses); a better picture ONLY truly becomes apparent when numerous individuals are tested seeing how various serum studies pan out.

The next time you are confronted by someone who preaches that they simply sought out any potential hypogonadal symptoms as their hormonal indication something was wrong and based their use of various substances to prevent them on those potential sides...I ask you to step away from their advice. In fact, 86% of hormonal decline experienced by users while in either the peri-cycle or post-cycle time frame do NOT show up clinically. In fact, the biggest error would be to not run labs to tease out these discrepancies in the first place, which unfortunately is more commonplace than is given credit.

Our Journey

The task at hand appears quite daunting at first look. After all, I never said covering all topics in a broad-based topic like PCT would be easy. Interestingly enough, individuals have tried to cover this topic in one short-piece; we’ll now together embark on a seven part series that includes, yet still only scratches the surface, of the following subject areas:

Part I: PCT Demystified
Part II: Post-Cycle Supplements: In Theory
Part III: Post-Cycle Supplements: In Practice
Part IV: Post-Cycle Pharmaceutics: In Theory
Part V: Post-Cycle Pharmaceutics: In Practice
Part VI: Post-Cycle Lifestyle Modification
Part VII: Individualizing what we’ve Learned

Without further adieu, we will jump head-first into our opening on pharmaceutics and dietary supplements purported to offer benefit in the PCT time frame, which as noted will continue to span four additional parts.

Concurrent Agents: Pharmaceutics & Supplements

In debating what topic to start with – it literally jumped out at me that concurrents would get first bid as they are most often talked about in lieu of lifestyle modifications that should NOT be considered in ANY way less important. I can’t help but assume this to be in line with the ideology that many hold on how much easier it is to simply ingest a pill in hopes to correct all ailments. Perhaps, this is one theme that has emerged from the prototypical doctor’s office visit. Without gaining that little white (or various other colors) slip to go fill up at the local pharmacy, we don’t feel the visit to the doctor was worth the price of admission.

It may be more accurate to say that our avoidance of lifestyle responsibilities and near-total reliance upon drugs to deal with the state of affairs associated with PCT has been an ultimate result of some fundamental assumptions of Western – especially American – culture. Perhaps the problem is not them (government and pharmaceutics) after all, but us – all of us.

I believe both pharmaceutics AND dietary supplements hold roles in the ideal post-cycle run, unfortunately both are not necessarily always addressed in an unbiased – non-vested interest sort of way. People are naturally skeptical when someone makes extravagant claims for healing methods or healing substances – dietary supplements or otherwise. This is not necessarily an unwarranted rationale in many instances, but the converse is true of many others.

The dominant approach in health care in our culture is based on the notion of specific diseases and specific medications for specific diseases. I have joked in the past about how we actually create diseases based on medications we have FIRST developed. This isn’t necessarily as much a joke as its initial intention – and I truly believe this more and more as I get further into my study of allopathic medicine! With today’s abundance of new nutritional supplements and the accompanying promotional literature glowing with enthusiastic claims, separating fact from fiction has become about as difficult as it has with pharmaceutics that sat in the front seat as essential predecessors.

Perhaps, My Own Horn-Tooting?

The “usual suspects” (Nolva, Arimidex, AT, ATD, even clomiphene and the most poorly understood, hCG) will be explored, exaggerated dosing protocols, the potential detriment of various interactions and why it is inappropriate for any company to claim to develop the end-all, be-all PCT supplement and how these individual agents will and have affected various blood labs. You will be a student of endocrinology, perhaps unbeknownst to you for at least this seven part series. You will learn things of absolute cutting edge mentality – never before written in this industry, I assure you. I have never dressed to NOT impress. Heck, I may be the last domino standing! Stay tuned...we’re just getting started!