HCG monotherapy prescribed for fertility and low testosterone,confused like hell.

sid · May 21, 2015

All,

This is my first post,I am 30yrs old and i was diagnosed with male factor infertility,i have a normal sperm count but very low motility.

My urologist may 2014 performed the tests and the testosterone was 330 and he said its in normal range and no further treatment was required.

Since 2012 i have 40 extra pounds in my abdomen due to SNRI pristiq i took for 6 months.Had lost 20 pounds with intense exercise but gained all back during winter.

I then went to a weight loss clinic in april 2015 and they retested and the testosterone this time was 190.

TSH and T4 were normal but T3 was very high.He said he never saw that high T3.
But since i didnt show symptoms he didnt treat me.

The DR prescribed HCG shots 1000iu 4 times per week.
He prescribed arimidex 0.25mg once a week and metformin daily.
Seromelin acetate daily at bed time,i think 20 units.

I have read that this dosage is high and can cause further fertility problems.
It has been 2 weeks,the first few week my sperm volume improved and had high libido.
I also had weight loss.

The second week gained back the weight,libido became normal and sperm felt same as before.

Is my dosage too high?
I read that 500iu is the normal accepted dosage.

As per the compunding pharmacy pharmacist this doctor is very smart.

Guys please help!

GeauxBears · May 21, 2015

sid said:
All,

This is my first post,I am 30yrs old and i was diagnosed with male factor infertility,i have a normal sperm count but very low motility.

My urologist may 2014 performed the tests and the testosterone was 330 and he said its in normal range and no further treatment was required.

Since 2012 i have 40 extra pounds in my abdomen due to SNRI pristiq i took for 6 months.Had lost 20 pounds with intense exercise but gained all back during winter.

I then went to a weight loss clinic in april 2015 and they retested and the testosterone this time was 190.

TSH and T4 were normal but T3 was very high.He said he never saw that high T3.
But since i didnt show symptoms he didnt treat me.

The DR prescribed HCG shots 1000iu 4 times per week.
He prescribed arimidex 0.25mg once a week and metformin daily.
Seromelin acetate daily at bed time,i think 20 units.

I have read that this dosage is high and can cause further fertility problems.
It has been 2 weeks,the first few week my sperm volume improved and had high libido.
I also had weight loss.

The second week gained back the weight,libido became normal and sperm felt same as before.

Is my dosage too high?
I read that 500iu is the normal accepted dosage.

As per the compunding pharmacy pharmacist this doctor is very smart.

Guys please help!

I'm sure you'll get advice much better than mine, but a couple of things come to mind. First, did any of the docs ever pull LH/FSH values? These are the pituitary hormones that "signal" to your testes to create testosterone and sperm, respectively.

If LH and/or FSH are high, then this leans to primary hypogonadism, or testicular failure. If they are low, this indicates central (hypothalamus or pituitary) dysfunction.

The reason it matters is because the treatment options available to you change based on whether you are primary or central, but if the LH/FSH wasn't pulled prior to starting HCG, they are worthless now, as HCG is an LH analog and will thus supress the pituitary's production of it.

Also, did anyone ever pull E2 (estradiol) prior to prescribing your Arimidex? If not, that's incredibly irresponsible IMO...some people, me included, don't have issues with E2, and Arimidex, even at extremely low dosage, can crash their E2. For me, this means hot flashes, completely crashed libido, and ED that not even Viagra can help until the E2 rebounds.

Finally, I think you need to dig deeper on the thyroid front. Without a full panel it's hard to get an idea about what's going on, but high T3 is associated with a number of conditions that need to be ruled out and could be driving the low T issues you are dealing with.

Just some thoughts to get you started. When do you go back for labs?

PS...this stuff takes time. Try to relax as one week (or even 3) may not show stable results as the body attempts to maintain homeostasis...

sid · May 22, 2015

Re

Thanks nelson for your inputs.Below are further results.
He said T3 was a cause of concern,but in the absence of most symptoms,he will monitor.

Estradiol=16.9
free t3=14.9
T4=10.4
TSH=0.52
T3 TOTAL=4.6
T3 Reverse=34
fsh=6.5
lh=3.4

I go for labs again in 3 weeks.
I have a normal sperm count for ivf,i hope hcg doesnt wipe that off.

GeauxBears said:
I'm sure you'll get advice much better than mine, but a couple of things come to mind. First, did any of the docs ever pull LH/FSH values? These are the pituitary hormones that "signal" to your testes to create testosterone and sperm, respectively.

If LH and/or FSH are high, then this leans to primary hypogonadism, or testicular failure. If they are low, this indicates central (hypothalamus or pituitary) dysfunction.

The reason it matters is because the treatment options available to you change based on whether you are primary or central, but if the LH/FSH wasn't pulled prior to starting HCG, they are worthless now, as HCG is an LH analog and will thus supress the pituitary's production of it.

Also, did anyone ever pull E2 (estradiol) prior to prescribing your Arimidex? If not, that's incredibly irresponsible IMO...some people, me included, don't have issues with E2, and Arimidex, even at extremely low dosage, can crash their E2. For me, this means hot flashes, completely crashed libido, and ED that not even Viagra can help until the E2 rebounds.

Finally, I think you need to dig deeper on the thyroid front. Without a full panel it's hard to get an idea about what's going on, but high T3 is associated with a number of conditions that need to be ruled out and could be driving the low T issues you are dealing with.

Just some thoughts to get you started. When do you go back for labs?

PS...this stuff takes time. Try to relax as one week (or even 3) may not show stable results as the body attempts to maintain homeostasis...

GeauxBears · May 22, 2015

I'm not Nelson, he's much smarter than I am.

My personal opinion is that your first step should be figuring out that thyroid issue. The thyroid is so upstream that tuning that in might correct your T issues.

Your E2 is already pretty low. My guess is that the Arimidex crashed you, even at those high of doses of HCG.

I don't think there is literature supporting this, but in my personal experience, Arimidex with HCG monotherapy, even in the slightest dose, crashed my E2 over the course of a couple of weeks. I did NOT have this issue with Arimidex on TRT, so this is interesting. There is some talk around here and other spots that since HCG stimulates the testicles, much of the aromatization is occurring within the testes, where the concentration is so high that Arimidex cannot effectively compete.

Just a couple of thoughts. Obviously discuss with your doctor (sounds like you need a new one who knows what they are doing with thyroid), but I might even hold off on HCG treatment until thyroid is under control.

sid · May 22, 2015

Thanks

Hi GeauxBears,

May be i should see an endocronologist rather than a integrative MD.

I had taken only one dose of arimidex till now,i have an appointment on june 15th.

Hope all goes well.

Thanks for your input,will see a endo for the thyroid issues.
With thyroid my GP and URO and psych checked last couple of years,they only look at TSH and T4 and this is the first time some one ordered T3.

GeauxBears said:
I'm not Nelson, he's much smarter than I am.

My personal opinion is that your first step should be figuring out that thyroid issue. The thyroid is so upstream that tuning that in might correct your T issues.

Your E2 is already pretty low. My guess is that the Arimidex crashed you, even at those high of doses of HCG.

I don't think there is literature supporting this, but in my personal experience, Arimidex with HCG monotherapy, even in the slightest dose, crashed my E2 over the course of a couple of weeks. I did NOT have this issue with Arimidex on TRT, so this is interesting. There is some talk around here and other spots that since HCG stimulates the testicles, much of the aromatization is occurring within the testes, where the concentration is so high that Arimidex cannot effectively compete.

Just a couple of thoughts. Obviously discuss with your doctor (sounds like you need a new one who knows what they are doing with thyroid), but I might even hold off on HCG treatment until thyroid is under control.

sid · May 23, 2015

Guys
I took arimidex by mistake on non injection day
Will that cause any issue
Also who is the best dr to treat t3
My gp psych and uro never ordered that test.
It is hard to get endo appointment,will ask gp for referral

CoastWatcher · May 23, 2015

Do you happen to have the ranges for your labs? Did anyone mention checking SHBG?

sid · May 24, 2015

Shbg

CoastWatcher said:
Do you happen to have the ranges for your labs? Did anyone mention checking SHBG?

Hi Coast watcher,

It was 19 and normal range was 10-80 for SHBG

GeauxBears · May 25, 2015

sid said:
Guys
I took arimidex by mistake on non injection day
Will that cause any issue
Also who is the best dr to treat t3
My gp psych and uro never ordered that test.
It is hard to get endo appointment,will ask gp for referral

Cause what issue(s) specifically? Arimidex is incredibly powerful has unbelievable effects on E2 at even the smallest doses...it also makes me completely impotent almost immediately.

HCG mono guys using Arimidex often crash easily because most of the E2 is created within the testicles, where the Arimidex can't compete. I unfortunately learned this the hard way.

Endo or perhaps a really good internal medicine specialist can help with high T3.

sid · May 25, 2015

Thanks
I have decided to stop hcg therapy since it comes with a lot of baggage
And will try to raise testosterone naturally

HCG monotherapy prescribed for fertility and low testosterone,confused like hell.

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