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Oral Vs Injectable Steroids: How Long Do Steroids Stay In Your System?

It looks like you’ve pasted a fairly comprehensive overview of two very different but often intertwined topics: **steroid use (and its medical, performance‑enhancing, and recreational aspects)** and **drug‑rehabilitation facilities for people struggling with addiction**.

Below is a quick "map" that pulls out the key points from each section. If you’d like to dive deeper into any particular subsection—say, the legal status of steroids in a specific country, or how a particular rehab center’s treatment model works—just let me know and I’ll flesh it out for you.

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## 1. Steroid Use

| Category | What It Covers |
|----------|----------------|
| **Medical Uses** | • Treats hormone deficiencies (e.g., low testosterone)
• Replaces hormones during puberty or menopause
• Prevents muscle loss in chronic illnesses
• Helps with bone density and recovery from injuries |
| **Performance Enhancement** | • Athletes use them to boost strength, speed, endurance
• Commonly abused in bodybuilding, weightlifting, track & field, MMA, etc. |
| **Types of Steroids** | • Anabolic steroids (e.g., testosterone, nandrolone)
• Corticosteroids (for inflammation and immune suppression) |
| **Health Risks** | • Hormonal imbalance
• Liver damage
• Cardiovascular issues
• Mood swings, aggression, depression
• Potential for addiction and long-term health problems |

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## 4. How the Body Produces Testosterone

### 4.1 The Hypothalamic–Pituitary–Gonadal (HPG) Axis

| Step | Location | Hormone Released | Function |
|------|----------|------------------|----------|
| **1** | Hypothalamus | Gonadotropin‑releasing hormone (GnRH) | Stimulates pituitary |
| **2** | Pituitary gland | Luteinizing hormone (LH) & Follicle-stimulating hormone (FSH) | LH stimulates Leydig cells; FSH acts on Sertoli cells |
| **3** | Testis | Testosterone | Primary male sex hormone |

- **LH** binds to receptors on Leydig cells → ↑ testosterone synthesis.
- **FSH** works with testosterone to support spermatogenesis.

**Negative feedback loop:** High testosterone levels inhibit GnRH, LH, and FSH secretion.

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### 3. Factors that influence testosterone production

| Factor | Effect on Testosterone |
|--------|-----------------------|
| Age | Declines ~1% per year after age 30 (and faster after 50). |
| Body composition | Higher body fat → lower testosterone (due to aromatase converting testosterone → estrogen). |
| Physical activity | Resistance training ↑, endurance training ↓. |
| Sleep | 7–9 h/night optimal; sleep deprivation reduces levels by up to 10‑20%. |
| Stress | Chronic cortisol elevation suppresses gonadotropin release. |
| Nutrition | Adequate protein & healthy fats essential; low carbohydrate can decrease testosterone in some studies. |
| Alcohol & smoking | Excessive alcohol and tobacco lower testosterone. |

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## 3. Hormone‑Based Interventions

| Intervention | How It Works | Typical Dosing | Expected Effect on Testosterone | Considerations / Risks |
|--------------|--------------|----------------|----------------------------------|------------------------|
| **Clomiphene citrate (Clomid)** | Selective estrogen receptor modulator (SERM); blocks hypothalamic negative feedback, ↑ FSH & LH → ↑ testosterone. | 25 mg orally once daily × 4–6 weeks; may increase to 50 mg if no response. | ↑ endogenous testosterone by ~30‑70% in men with low T and normal gonadotropins. | Generally safe; possible visual disturbances at high doses; contraindicated in uncontrolled hypertension, severe liver disease. |
| **Tamoxifen** | SERM; similar mechanism to clomiphene but less potent on FSH/LH axis. | 20 mg orally once daily × 4–6 weeks. | Modest ↑ testosterone (~10‑30%). | Similar safety profile; visual side effects, hot flashes. |
| **Human Chorionic Gonadotropin (hCG)** | Mimics LH; stimulates Leydig cells to produce testosterone. | 1,500–2,000 IU intramuscularly every other day or weekly for 4–6 weeks. | ↑ Testosterone up to ~200 ng/dL depending on dose. | Injection site reactions, potential gynecomastia if overstimulated; risk of ovarian hyperstimulation in partners. |
| **Testosterone Replacement (T)** | Oral T (e.g., 5 mg/day) for short-term stimulation before surgery. | Up to ~200 ng/dL after 1–2 weeks. | May be considered if baseline levels are extremely low; however, may risk side effects and is less commonly used in this setting. |

**Clinical Recommendation:**

- **If the patient’s serum testosterone 2.5% in women | Reflects biologically active hormone, but measurement issues abound |
| **Bioavailable Testosterone** | Sum of FT + albumin‑bound | More accurate than total alone, but not routinely measured |
| **DHEA/DHEAS** | 200–800 ng/dL (adult men) | Provides adrenal contribution; low levels suggest deficiency |
| **Cortisol** | Morning: 5–25 µg/dL; Evening: