Growth Hormone for Post Cycle Therapy; Spot Injections; Long-Term Use of Oral Steroids

World-renowned anabolic authority, William Llewellyn has written and rewritten the definitive book on steroids. His series of ANABOLICS books have become the most trusted steroid and performance drug reference book of its kind. For over 15 years Llewellyn has uncovered and compiled cutting-edge insider's information from actual drug manufacturers, dealers, and users from all over the world, guaranteeing up-to-date information.

Growth Hormone (GH) for Post Cycle Therapy (PCT)?

Q: What are your thoughts of using growth hormone during PCT?

A: I think it is certainly a viable option, though the main focus is preserving lean body mass and not increasing the return to homeostasis with androgen production. The main support for this use of GH came from a study published in 2001, in the Journal of Clinical Endocrinology and Metabolism (volume 86 number 5, pp 2211-19). It was a study done to examine if growth hormone or IGF-1 could counter the catabolic effects of hypogonadism (low testosterone levels). The investigation involved a group of 13 healthy subjects with a mean age of 22 years. The subjects were given a GnRH (Gonadotropin Releasing Hormone) analog, which caused their bodies to shut down the normal production of testosterone. After 6 weeks from reaching baseline levels they were given either GH or IGF-1, to see if the drugs would prevent the catabolism normally associated with low testosterone levels. Final measures were taken 10 weeks from the start of the study.

The study demonstrated that both IGF-1 and growth hormone were able to preserve protein synthesis rates, even during a period of severe androgen deprivation. The subjects, likewise, did not lose a statistically significant amount of fat free mass/muscle tissue, in contrary to what is documented with hypogonadism alone. While it is far from conclusive evidence GH or IGF-1 should become integral to every steroid user’s PCT program, it certainly lends a lot of support for the idea of using one of these drugs in this manner. Note, however, that the study did show that androgens were required for the full anabolic effects of Growth Hormone and IGF-1. In other words, GH/IGF-1 may help you maintain muscle mass when coming off steroids, but you will get your most growth from the drugs if they are taken when androgen levels are normal or even elevated.

Q: I listened to your lecture at the Lord’s Cricket Ground in London. In it you said that you do not recommend spot injections. How come? I’ve injected in my biceps, triceps, and calves without problems. Are you going soft on us?

A: No, I don’t think I am. Maybe it could be said I am getting softer to some degree. I have been thinking more of health than I did in my 20’s. At that time in your life you tend to feel indestructible. I’m in my 30’s now, and more in touch with the fragility of life I guess. I’d never do today some of the things I did when I was 24 (2000mg of testosterone in one week, what the hell was I thinking?) So I guess I am trying to preach a message of steroid conservatism a bit more than I used to. But my recommendation in the London Lord’s lecture was not really based solely on that. It was more a function of my role in the conference. To give you some background, I was invited to speak with many of the great people that run and work in the needle exchange clinics throughout the UK. My goal was to not only educate the group, but to provide a strategy for what they term “harm reduction”.

Harm reduction is a concept that addresses the fact the people are using illegal drugs, and tries to minimize the negative impact of their use instead of simply judging the user. That is the function of these clinics. Some may say they facilitate drug use (often IV narcotics) by supplying free needles and syringes to users. Others, and I am one of them, believe this is far outweighed by the health protecting benefits of clean needles and free counseling. As far as steroids are concerned, I tried to provide some simple guidelines for reducing the health risks associated with their use for the average person. The cornerstone of this was the use of reasonable doses, limited administration of toxic oral steroids, regular checkups of health during and post cycle, and finding legitimate (as opposed to underground or counterfeit) drugs.

My recommendation for avoiding spot injections was simply another part of “harm reduction”. After all, I think few people will deny that there is a greater chance for injection error when trying to navigate the smaller muscle groups as opposed to the glutes and thighs, the recognized universal injection points for slow acting oil-based (depot) injections. Health issues due to local (small muscle) injections are not extremely uncommon. You hear them all the time. At the same time, many people have the experience and skill to run numerous cycles with many repeat injections into small muscles with no issue. My advice was to be applied to everyone that comes through the doors. Those that know what they are doing and have every intention of spot injecting will probably just ignore it. For those that are inexperienced, however, I definitely still believe that “spot” injections should be left for a much later time.

Q: I’ve been on and off steroids for years. I respond well to them even at pretty low doses (300-600mg/week), but always crash afterwards no matter what I do. Lately I’ve been trying something different. For the past 12 weeks I’ve been taking 100mg of orals (Winstrol, Dianabol, Anadrol) per week, and have slowly been gaining size (about 5 pounds of lean mass) and strength. I am hoping this will produce more permanent gains; less estrogen conversion to worry about and it shouldn’t suppress my natural testosterone. Do you have any knowledge of the efficacy of low-dose long-term use of anabolics?

A: Given that most of the oral anabolics have less estrogenicity than the standard of reference (testosterone), you should find that size is better maintained at the conclusion of a cycle compared to injectable testosterones, as you are holding, and as a result will be excreting, less water weight. When all is said and done, you’ll seem to hold more of the weight you gained on oral anabolics simply because more of what you gained was quality muscle (not water bulk) in the first place. Anadrol is an exception among your list as it is highly estrogenic. Given the doses you are using, however, I suspect you will not notice this trait much, and (in line with what you stated) should be noticing some modest but measurable gains in strength and lean muscle mass. In the end you’ll probably gain more lean mass on a formidable dose of testosterone, but again, the difference between your on-cycle bulk weight and your off-cycle retained mass weight will be more noticeable on a cycle like this too.

If my math is correct, you are taking about 15 milligrams of oral anabolics per day. I don’t want you to be mistaken into thinking this is a “very low” dose. O.K., by some of the standards of excess today it may be considered low, but in a clinical sense it most certainly is not. Winstrol is given at a dose of 6 milligrams per day or less most commonly. When Dianabol was widely prescribed in the U.S., the common application was 5 milligrams per day. Aside from Anadrol, the doses you are taking are outside of the therapeutic range, and enough to present significant gains in lean tissue, as you have noticed. In fact, during the 1960’s and ‘70s fifteen milligrams per day was a common dose for athletes and bodybuilders. This level of use is also more than sufficient to suppress natural testosterone production, so you still going to have to deal with some type of crash at the conclusion of this cycle, even if it is less pronounced due to less water retention. As such, a proper PCT (Post-Cycle Therapy) program is probably a good idea to look at.

The main concern I have with this practice is the fact that you are applying a sufficient dose of c-17 alpha alkylated oral steroids each day, and it is continuing for a significant amount of time. The usual cutoff point is 6-8 weeks. Immediately, I would question what your serum lipids are doing. How are you HDL (good) and LDL (bad) cholesterol levels responding to this cycle? As you may know, oral c-17 alpha alkylated steroids present much more toxicity to the body than injectable testosterones (and related non-alkylated steroids). They tend to greatly shift the HDL:LDL balance in an unfavorable direction (increasing the risk of cardiovascular disease), and place some strain on the liver. While I wouldn’t be go so far as to say this type of practice is outright dangerous to your immediate health, I would most certainly recommend that you take caution. With any oral cycle, especially one going on for a prolonged period of time, you should be getting periodic checks on your lipids, liver enzymes, blood pressure, and general markers of health. If you find the drugs are placing too much strain on your body, they probably aren’t worth it. If you find such is true in your situation, you’d likely be much better off looking back at the old standby injectables like testosterone and nandrolone, which present no significant liver stress and have a much lower negative effect on serum lipids – crash and water retention be damned.

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About William Llewellyn

William Llewellyn is a recognized authority on anabolic substances, and author of the bestselling steroid reference book series ANABOLICS, soon entering its 6th edition with ANABOLICS 2007.  Llewellyn has been featured in ESPN Magazine (Cover Story), The Washington Post (Front Page Story), Discovery Channel, Fox News Channel, ESPN Television, NPR news, ESPN radio, and other television and radio programs. He also publishes Body of Science magazine, a quarterly publication dedicated to the “understanding of sports enhancement”, with a focus on the athletic use of performance-enhancing pharmaceuticals. Llewellyn also writes a monthly column for Muscular Development magazine on the subject of anabolic steroids, and has authored numerous articles for other bodybuilding publications.