The training program on the course is a high-volume and super-intensive scheme, nutritional recommendations and pct

PET/CT examination - what is it?
The deciphering of the abbreviation sounds like positron emission tomography - computed tomography. This diagnostic method combines the study of the structure and functional characteristics of tissues. The technology is especially widely used in oncology to identify and determine the degree of development of malignant tumors.

Why?

Today, up to 90% of PET/CT studies in the world are performed on people suffering from cancer. The study is important from a number of perspectives:

1. The study is important from the point of view of determining the degree of development and spread of the tumor process, detection of metastases, both regional and distant.
2. In medical practice, there are situations when doctors are unclear about the nature of the process occurring in a particular organ. The study allows you to differentiate the process, distinguish between benign and malignant.
3. The study helps to understand whether the treatment is effective.
4. The study can be used to diagnose relapse of the disease.

When it comes to diagnosis, many cancers have the ability to actively accumulate fluorodeoxyglucose. This substance is used during the study. However, some types of cancers have low metabolism.

These types include:

• Highly differentiated cancerous neoplasms of the thyroid gland; Benign tumors of any location;
• Some kidney tumors;
• Some bone tumors;
• Liver tumors;
• Prostate tumors;
• Some types of sarcomas, lymphomas.

Having a low metabolic rate, they are poorly visualized by PET/CT. This means that other diagnostic methods are required.

Restoring testosterone levels

While taking anabolic steroids, the production of your own testosterone is significantly reduced. This can lead to a number of consequences, ranging from weight gain to testicular atrophy and complete impotence.

You will understand that there is insufficient testosterone in the body by the following signs:

• decreased muscle mass and energy;
• decreased sexual desire, problems with erection;
• weight gain due to fat;
• mood swings;
• reduction in the severity of secondary sexual characteristics.

Restoring potency after stopping steroids, as well as producing your own testosterone, is possible, but only if it does not lead to testicular atrophy. To do this, already on the course you need to start injecting gonadotropin.

Post-cycle therapy after steroids also involves taking a number of drugs, including:

• Anastrozole is an estrogen blocker;
• Cabergoline is a prolactin blocker, reduces the risk of breast growth;
• Antiestrogens, such as Clomid (clomiphene citrate). The drug is aimed at increasing your own testosterone in the blood. Fareston or tamoxifen can be used instead of Clomid.

It is important to note that taking gonadotropin is not included in the PCT regimen after a course of steroids. Yes, it helps with recovery, but only at the time of taking anabolic steroids or immediately after, before the main post-cycle therapy.

Description of research technology

The basis of the research technology is the study of tissue characteristics, structural and functional. Functional characteristics can be assessed through metabolism. Let's take the following example. We choose a substance that is necessary for all cells of the body. We mark it with a radioactive label, introduce it into the body and observe the places of its maximum accumulation.

Glucose is a universal substance in the human body. With the help of glucose, almost all tissues and cells are nourished. In malignant tumors, the greatest consumption occurs, since the growth and reproduction of tumor cells requires a lot of energy.

In a PET/CT scan, glucose is labeled with radioactive atoms with a short half-life. Once in the body, glucose actively accumulates in tissues with the most intense metabolism, i.e. in cancerous tumors.

The tag disintegrates, emitting energy in the form of gamma rays. A special device records this process. The data that the doctor receives creates a visual model showing the location of the tumor, its size and metastases.

Radioactive tracers accumulate only at the location of atypical cells; healthy tissues are not visualized.

When the doctor needs to examine both healthy and changed structures, CT comes to the rescue, allowing you to obtain a detailed picture with millimeter accuracy.

After data from both scanning systems is received, they are superimposed on each other, thereby achieving an image that gives a clear picture of the location of tumor foci.

How to take Clomid and Tamoxifen after courses of varying complexity?

Dosage of Tamoxifen 20 mg. in tablet

• 3d80mg/12d40mg/15d20mg/15d10mg - a very difficult course.
• 15d40mg/15d20mg/15d10mg - a heavy course.
• 30d20mg/15d10mg - average course.
• 15d20mg/15d10mg/15d10mg (every two days) - an easy course.
• 15d20mg/15d10mg - oxandrolone, methandrostenolone, methenolone, stanozolol, oral turinabol).

widget 6

Dosages of Clomid - Clomiphene (one tablet 50 mg.)

• 3 days at 150 mg/12 days at 100 mg/15 days at 50 mg/15 days at 25 mg. - a very difficult course.
• 15d100mg/15d50mg/15d25mg - a difficult course.
• 30d50mg/15d25mg - average course.
• 15d50mg/15d25mg/15d25 mg (every two days) - an easy course.
• 15d50mg/15d25mg - oxandrolone, methandrostenolone, methenolone, stanozolol, oral turinabol.

widget 5

What is better to use after the course? Clomid or Tamoxifen?

Both drugs belong to the same class - selective modulators (blockers) of estrogen receptors.

Studies have shown that Clomid acts better on estrogen receptors directly in the pituitary gland. Whereas tamoxifen works better in other tissues in the body.

Types of drugs used

The potential of a study depends on the arsenal of radiopharmaceuticals used in it. These drugs are labeled with unstable isotopes that make them radioactive.

Today, isotopes of such elements as:

• Nitrogen-13;
• Oxygen-15;
• Carbon-11;
• Fluorine-18.

In oncology, fluorine is most common, since it has the longest half-life and at the same time the lowest radiation energy.

These advantages of fluorine make it possible to obtain high-quality images with high spatial resolution. In addition, the relatively long half-life makes it possible to transport the drug from the site of production to the clinic.

The most common drug used is fluorodeoxyglucose. It is an analogue of glucose. Atypical cells absorb it faster, it actively accumulates, and this is ideal for scanning.

The downside of fluorodeoxyglucose is that it accumulates in brain tissue and nephrons, which in turn can cause these organs to glow, even when they are healthy.

This drawback stimulated the search for other, more advanced drugs, and now such drugs have been created.

An example of a modern drug is 18F-FET. It is intended for the brain and contains the amino acid tyrosine, labeled with the fluorine-18 isotope. Tyrosine has a very high selective accumulation in brain tissue, which is important for imaging neurotumors.

The drug is also used to diagnose oropharyngeal tumors, to detect metastases and to diagnose lesions of the cervical lymph nodes.

PCT (Post cycle therapy)

What you will learn when reading the article:

• How to recover from a course of AAS.
• What medications to take and why.
• How to save money on tests.

Article outline:

1. Analyzes.

• Analyzes before the course.
• Analyzes during the course.
• Analyzes after the course 2-3 weeks.
• Analyzes after the course 6-8 weeks.

2. CBT.

• Processes in the body during the course.
• Recovery process after the course.
• Drugs and dosages.

PCT (post-cycle therapy) is a set of measures whose main goal is to restore and improve health after the damage caused by a course of AAS (anabolic-androgenic steroids).

PCT should be considered as a multifaceted process that affects: the actual restoration of testosterone levels, restoration of the entire body and a certain period of strength training (there will be a separate article about strength training on PCT).

This article will only talk about restoring your own testosterone levels, we will also talk about tests (there will be links to other articles that will describe liver restoration, etc.).

Note from the author: The optimal and ideal algorithm of action will be described, how to reduce and minimize the risk from AAS as much as possible, I understand that ideally no one will do it, due to the high cost of all drugs and the cost of tests. Therefore, at the end of the article, recommendations will be given on how to maintain maximum health at minimal cost, but an ideal algorithm has been developed.

1. Analyzes

Tests are the most objective way to assess the condition of the body and understand what harm was caused by the course and to what. Analyzes are important in order to know what should be restored and what is already in order. It is important to know what state the body is in, not only after the course, but also during it. It is even advisable to know before the course itself what the standards are (yours) and to what standards you need to recover.

Pre-course tests:

Particularly important tests (hormones and liver):

1. Total and free testosterone
   is the main male sex hormone.
2. FSH
   (phallic stimulating hormone) is a hormone that triggers spermatoginesis.
3. LH
   (luteinizing hormone) is responsible for the production of testosterone.
4. Estrodiol
   is the main female sex hormone, present in men in minimal quantities.
5. Prolactin
   is a female hormone (responsible for the functioning of the mammary glands in women), present in men in minimal quantities.
6. AST and ALT
   are liver enzymes.
7. Bilirubin
   is a component of bile.
8. DHT
   (dihydrotestosterone) is a sex hormone (the test turns into it).

These are all sex hormones and liver tests; it is important to know their initial level in order to understand the norms in the future (exactly your norms, not the generally accepted ones).

If the liver is in poor condition, it is better not to start a course of AAS, but to treat the liver, because AAS always negatively affects the liver, even a healthy one, and in case of violations you should be very careful.

Less important are the tests; they are needed to identify pathologies; if there are any abnormalities, you should first bring everything back to normal, and then start a course of AAS.

1. Cholesterol
   (HDL and LDL) is a natural fat (important for the synthesis of hormones).
2. Glucose
   – blood sugar level.
3. BP
   (blood pressure) – often increases during the course, it is important to know.
4. ECG
   (electrocardiography) - shows the condition of the heart.

After completing all the tests, if everything is normal, you can start the course. If there are violations, it is better to bring everything back to normal; the course may aggravate all violations.

Analyzes during the course:

The main tasks of the analyzes on the course:

• Track vital health indicators.
• Dosage adjustment of aromatase inhibitors and prolactin suppressing drugs.

Course analyzes depend on a number of things:

• Tendency to problems (liver, blood pressure, kidney tests) - here a person must know for himself what disorders he may have (look at tests before the course) and what is very important to control.
• The presence of aromatizing
  drugs and drugs with
  progestin
  activity.

During a course with drugs that aromatize (testosterone, methane), it is necessary to use aramatase inhibitors (anastrozole (0.5 mg every other day)).

During a course with drugs that increase prolactin (nandrolone, trenbolone, oxymetholone), it is necessary to use cabergoline (0.25 mg once every 7 days).

Analyzes during the course with drugs that aromatize:

1. Estradiol

• If it increases, increase the dose of anastrozole (increase to 0.5 mg every day).
• If decreased, reduce the dose of anastrozole (reduce to 0.5 mg every 3 days).

Tests during a course with drugs that increase prolactin:

2. Prolactin

• If it increases, increase the dose of cabergoline (increase to 0.25 mg every 4-5 days).
• If it decreases, reduce the dose of cabergoline (reduce to 0.25 mg every 10-14 days).

Tests during a course with drugs that increase DTG:

3. DHT

• If the norm increases by one and a half to two times - finasteride
  (2-2.5 mg per day).

Analyzes after the course (after 2-3 weeks).

1. Estrodiol
   (if there were drugs that increase it).
2. Prolactin
   (if there were drugs that increase it).
3. AST, ALT, Bilirubin
   (required if tablets were used).

In the second or third week of the course, you should stop taking aramatase inhibitors and prolactin-lowering drugs, this is due to the fact that the effect of anabolic steroids is almost zero. But, prolactin and estradiol can be elevated and impair recovery, so you should get tested to understand whether you can continue taking the medications or stop taking them.

The condition of the liver is also important; if the liver is in good condition, you can forget and concentrate on problems with hormones; if they are bad, then the liver should be restored.

Tests after the course (6-8 weeks):

1.Total and free testosterone

• If testosterone is normal (at the same level as in the first analysis, then the course of AAS) - PCT is completed successfully.
• If testosterone is low (relative to the first tests), but is within normal limits, PCT is completed, then the body itself will recover to its normal level, this takes time.
• If testosterone is below normal, LH, FSH, Prolactin and Estradiol should be retested. And continue the course.

Now about what tests to take if the goal is to save money as much as possible.

After the course 2-3 weeks:

1.Estradiol

(needed in order to understand whether to take aromatase inhibitors or not).

There is no particular need to know Estradiol and Prolactin during the cycle, since if you are taking aromatase inhibitors and drugs to lower prolactin, everything will be normal, unless you take huge doses of AAS.

By and large, it is not necessary to know LH and FSH, since everything is clear there; if the test is low, most likely LH and FSH are also low. In fact, if the test doses were not large, you may not need to take estradiol. Then all analyzes will be reduced to only one analysis after completion of PCT (this analysis is already mandatory).

After 6-8 weeks:

1.Total testosterone

(without free).

• If everything is normal with total testosterone, most likely free testosterone is normal.
• If total testosterone is low, it is always low and free.

2. PCT

Let's move on to the main goal of CBT - restoring your own testosterone levels.

Processes in the body during the course.

This process is very complex, but understanding it is necessary, so I will try to describe it in simple words so that the essence is clear.

Testosterone is secreted by the testicles. The head (pituitary gland) looks at the level of testosterone and estrogen; when it decreases, it releases its hormone (LH), which acts on the testicles and causes them to secrete testosterone. Also, the head (pituitary gland) secretes (FST), which also acts on the testicles and causes it to produce sperm (triggers spermatoginesis). When something extraneous (in this case testosterone from outside) gets into this clearly worked out scheme, the whole scheme collapses. The head (pituitary gland) sees that testosterone levels are normal and does not secrete its hormone (LH and FSH), so the testicles do not secrete testosterone and everything stops. The main essence of PCT is to help the body restore its own testosterone levels as quickly as possible.

Recovery process after the course.

The best drugs for recovery after a course of AAS are antiestrogens

. Drugs that block estrogen receptors.

A little more chewed up theory, for the full picture:

The head sees that testosterone levels are low and slowly begins to restore it, but when antiestrogens completely block estrogen receptors (and they do not interfere with the head), the head releases more hormones and stimulates the testicles more strongly, thereby increasing the rate of recovery.

Drugs and dosages.

Clomiphene

– an anti-estrogen, acts on estrogen receptors, blocking them.

• Long course and high dosages – 20 days at 100 mg + 15 days at 50 mg + 10 days at 25 mg
• Not a long course with medium or low dosages – 25 days at 50 mg + 20 days at 25 mg

Tamoxifen

– an anti-estrogen, acts on estrogen receptors, blocking them.

• Long course and high dosages – 20 days at 30 mg + 15 days at 20 mg + 10 days at 10 mg
• Not a long course with medium or low dosages – 20 days at 20 mg + 15 days at 10 mg

Toremifene

- an anti-estrogen, acts on estrogen receptors, blocking them.

• Long course and high dosages – 20 days at 40 mg + 15 days at 30 mg + 10 days at 20 mg
• Not a long course with medium or low dosages – 20 days at 30 mg + 15 days at 20 mg

This immediately begs the question: “What is the difference and which is better?”

Essentially, these three drugs perform the same function - they block estrogen receptors, but they have differences:

1. Clomiphene blocks receptors more selectively, binding predominantly to receptors in the pituitary gland and testicles.
2. Tamoxifen increases the number of progesterone receptors, so it cannot be used after a course of drugs that increase prolactin.
3. Torimefene is also the same as tamoxifen, but the Finnish company has modified it and removed some side effects.

Conclusion:

Torimifene is the preferred drug, but in cases where there were no drugs on the course that increase prolactin, in this case - clomiphene.

Human chorionic gonadotropin (hCG).

HCG is a hormone that is similar in action to LH and FSH.

At a certain time, when hCG appeared, this drug gained very great popularity due to its actions. HCG is able to increase testosterone levels due to its action similar to FSH. But, this drug cannot restore the levels of LH and FSH, therefore, it raises testosterone levels - artificially.

HCG should be excluded from PCT as it interferes with recovery, it does not allow the body to restore LH and FSH, but simply increases testosterone levels.

Doses and times of use are described in this article.

For the most effective recovery after a long and difficult course, you should use all the main drugs.

Before starting PCT with antiestrogens: Gonadotropin – 10 days, 1000 units at the end of the course.

CBT antiestrogens:

Tamoxifen – 20 days 30 mg + 15 days 20 mg + 10 days 10 mg.

Clomiphene - 20 days, 100 mg.

Tamoxifen should not be used if there were drugs that increase prolactin, but if they were, but cabergoline was used and tests showed normal prolactin levels, then tamaxifin can be used.

Additional drugs.

Zinc.

Zinc is actively involved in the secretion of testosterone and spermotogenesis. Zinc cannot stimulate the secretion of testosterone, but if it is deficient, testosterone may be secreted in smaller quantities. Therefore, it is advisable to add zinc to PCT as an additional drug.

Herbal stimulators of testosterone secretion.

Tribulus

– the main one of the most famous drugs for increasing testosterone secretion. Tribulus itself has a positive effect on testosterone levels when it malfunctions or decreases (this is the case after a cycle); using tribulus when testosterone levels are normal is not advisable. Taking Tribulus is effective during PCT or after its completion (if the next course of AAS is not started).

Indications for the study

• Search for the primary tumor site when metastases are detected;
• Determination of the stage of the oncological process;
• Differentiated diagnosis of relapse and post-treatment changes;
• Monitoring the course of the disease, detecting relapse;
• Planning of radiotherapy and surgical manipulation;
• Planning a biopsy and finding the most aggressive area of ​​the tumor.

Radiofrequency ablation of liver metastases

Preparation

When preparing for the examination, you must adhere to a number of rules:

1. The day before your scheduled procedure, follow a low-carbohydrate diet.
2. Come to the examination on an empty stomach.
3. On the eve of the study, avoid heavy physical activity.
4. On the day of the procedure, drink plain water.
5. Stop chewing gum.
6. Come to the procedure in comfortable, comfortable and preferably warm clothing.

It is recommended to bring information about the disease, diagnoses, extracts from other hospitals, results of other studies, etc. to the research procedure.

Carrying out

The procedure itself takes about an hour, but it is necessary to keep in mind the preparation, preparation of the necessary papers and post-procedure rest.

The procedure is carried out in comfortable clothing; it is necessary to remove everything containing metal.

It is necessary to inform your doctor about the pain that may arise from prolonged immobility. Taking this into account, he will be able to select an individual procedure for the procedure.

After the injection, you must lie silent, motionless and relaxed. Immobility has a beneficial effect on the correct distribution of the administered drug. This is important for image quality.

The first stage of the examination is the administration of the drug. It lasts about an hour. The drug is administered intravenously. Sometimes the patient may feel fever, nothing more. The distribution of the drug among the cells lasts about an hour.

The second stage is scanning. Patient in a tomograph. CT is performed first, then PET. If required, an additional contrast agent is administered. The duration of this stage varies from twenty to forty minutes.

Upon completion, the CT and PET images are superimposed.

What after?

Afterwards, it is not recommended to be in crowded places for 24 hours, especially to have contact with pregnant women and children. In the family, it is necessary to maintain a social distance of 1 -1.5 from each other.

It is necessary to consume a lot of fluid, two and a half liters or more. This is necessary to remove contrast and radiopharmaceuticals faster and safer.

You can drink any decaffeinated drinks, not just water.

Additional PCT components

Various excipients help make the transition to normal life smooth. It won't hurt after exercise. Thus, testosterone boosters restore hormonal levels. They are taken for 2-3 weeks after the complete removal of steroid hormones from the body.

Hepatoprotectors should usually be started at week 2 of the course and taken for 2-3 weeks after completion. Hepatoprotectors protect the liver. How much they are needed is a controversial point. Discussions and research are ongoing. Some people refuse them altogether. For example, they have few supporters in Western countries. A smaller dosage is suitable for some.

Omega-3 is often taken as part of PCT. This unsaturated fatty acid promotes overall health. Today Omega-3 is popular not only among sports fans. A variety of people take it as vitamins. Omega-3 is a means to prevent many problems and diseases.

Growth hormones and peptides help preserve muscles and consolidate achieved results. In addition, they effectively combat anxiety, depression, and cardiovascular complications, but are not always included in PCT, because they cost a lot.

Cortisol blockers inhibit metabolic breakdown. They should be used at the end of the course and for 3-4 weeks after it. These include ascorbic acid, BCAA and protein. Although these are simple remedies, they are effective.

Complications

Complications during the examination procedure are mainly associated with the administration of contrast.

It could be:

• Allergy caused by vein puncturing;
• Damage to blood vessels;
• The appearance of a hematoma;
• Neuritis

A very rare complication is renal dysfunction.

Oral administration of contrast may cause nausea, vomiting, and diarrhea.

After the procedure, dizziness and weakness may occur due to the fact that the stomach is empty.

Radiation exposure to the patient during examination

The choice of radiation dose is influenced by the radiopharmaceutical used and the scope of the study. So scanning the head requires less radiation than scanning the whole body. Minimizing harm from using the method is achieved if the following requirements are followed:

• Use isotopes with a half-life of several minutes or hours;
• Calculate the dose individually for each patient, taking into account his age, height, weight;
• Use special filters on scanners, as well as programs that reduce radiation doses;
• Consume the required amount of fluid, this will allow you to quickly remove the radiopharmaceutical from the body

By contacting the Onco.Rehab integrative oncology clinic, you will find out where it is best to undergo the study that we told you about in this article.

Examples of steroid courses with PCT

Testosterone enanthate course

Progestin course

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