Using HCG alone for Low Testosterone

[psoas]

I have had good testosterone results from using HCG alone (and not using testosterone). However, things are still not perfect, and I am not sure about the best next steps.

First, let me tell you my story, which might be helpful for others:

A year and a half ago, I had COVID and lost my abilities to have erections. I fully recovered from COVID after 2 weeks. However, my erectile difficulty only recovered partially.

As time passed, my energy worsened, I started to get urine frequency, my muscles would get sore after moderate exercise from which it would take me a week to fully improve. Also, it would take me all weekend for my energy to recover after Sat morning tennis with my family. Then, after 6 months, I started to develop super high blood pressure and severe tinnitus. I saw multiple doctors and they were all useless. No one could help me with my tinnitus and multiple blood pressure medications made me severely dizzy.

The only abnormality that I had in my bloodwork was very low testosterone (of course I found this on my own, none of the doctors suggested checking testosterone, it was me who suggested it).

I later read little known facts about COVID that perhaps should be presented and researched more. COVID is linked to causing low testosterone. Also, people who get COVID and have low testosterone prior to getting COVID have worse outcomes (higher hospitalization rates, and higher death rates.)

On pre-treatment blood tests, I had:
Testosterone, Total 127 (VERY LOW)
Testosterone, Free 22.4 (LOW)
LH 0.9 (LOW)
FSH 4.0
Prolactin 5.7
Estrogen Undetectable

Is mechanism for low testosterone from COVID pituitary? I wish there was more research about that. Does anyone else have experience like that?

My urologist suggested that I start testosterone. I used testosterone 200mg IM every 2 weeks. I felt dramatically better.

My erections were like they were when I was a teenager (most prominent a few days after injection). I would say maybe a little too much. My muscles were not sore after exercise. My energy and stamina were much better. However, I did not handle stress as well and got frustrated and upset with things very easily.

I did not like the idea of my body being dependent on testosterone the rest of my life when my problem was pituitary and not testicular (low LH). Also, I did not like the short fuse and anxiety I was having. My urologist recommended 100mg IM every week. However, I wanted to try something else. He discouraged testosterone gel.

So, then my urologist started me on clomid, 50mg every MON/WED/FRI. I thought that clomid would make my FSH/LH/Prolactin high, but it did not. But, it did bring my LH back up to normal. However, although my testosterone improved, it was still low.

Blood test results on clomid:
Testosterone, Total 274 (A LITTLE LOW)
Testosterone, Free 31.5. (LOW)
Estradiol 26 (Normal)
LH 2.0
FSH 6.9
Prolactin 5.9

Is clomid supposed to make LH/FSH/Prolactin high? I would like to hear other people's experience with that, whether that happens or not.

So, then I stopped clomid and started pregnyl (HCG), 1000 units every MON/WED/FRI.

Blood test results on HCG:
Testosterone, Total 446
Testosterone, Free 87
Estradiol 46 (A LITTLE HIGH)
LH Undetectable
FSH Undetectable
Prolactin 5.9

I feel better than before I started any treatment but I still feel a little rundown and erections are ok but not as good as 2 years ago.

My urologist stated that my estrogen is not too bad and he would not start anastrozole for that level. He is still pushing for me to do testosterone injections again.

However, could my still being a little run down with mild erectile difficulty be related to my slightly high estradiol? I am also morbidly obese. Would anastrozole be of possible benefit? At full dose of 1mg daily or only partial dose?

My preference would probably be to increase HCG to 1500 units every MON/WED/FRI and start anastrazole 1mg daily.

I would like to here people's thoughts about that.

 

[Systemlord]

However, could my still being a little run down with mild erectile difficulty be related to my slightly high estradiol? I am also morbidly obese.

Your symptoms are coming from the fact that your obese, because anyone starting any type of hormone therapy, to optimize their levels, being obese, increases chances of side effects.

So fix the obesity will most likely fix your side effects. My advice start eating healthy, keto or carnivore diet, get your butt in the gym and start lifting weights.

If you’re the type of guy, that’s thinking you’re going to go on a hormone therapy and it’s going do all the work for you, there’s going to be a rude awakening for you.

My urologist suggested that I start testosterone. I used testosterone 200mg IM every 2 weeks.

This was simply a bad protocol. 100 mg week is much better and I don’t expect you’ll have any of the issues you had on the outdated and ancient 200 mg every two weeks!

However, I did not handle stress as well and got frustrated and upset with things very easily.

Your hormones 2-4 days after your injections must have been sky high, followed by sub therapeutic levels by day 10. No wonder you couldn’t handle normal every day stress, your hormone levels were circling the drain.

I wouldn’t let this one bad experience with this outdated protocol dissuade you from a better TRT protocol like the one suggest!

Any small change in a protocol is going to bring about noticeable changes, what’s been suggested, cutting the dosage in half and injection frequency is expected to bring about very noticeable changes.

100 mg per week has a thumbs up from me!

 

[Systemlord]

Is mechanism for low testosterone from COVID pituitary?

The pituitary gland in SARS-CoV-2 infections, vaccinations, and post-COVID syndrome

www.ncbi.nlm.nih.gov

The hypothalamus and pituitary glands are putative targets for SARS-CoV-2 due to the expression of Angiotensin-Converting Enzyme-2 (ACE-2) receptors on the surface of their cells.18 Several studies in humans and animals showed a significant ACE2 mRNA expression in hypothalamus and pituitary cells.19Moreover, higher mortality and poorer outcomes have been described in COVID-19 patients with obesity, diabetes, and vertebral fractures, which are all highly prevalent in subjects with pituitary dysfunctions.19This review provides evidence that apoplexy of pre-existing pituitary adenoma can be a complication of COVID-19.

COVID-19 and the pituitary

Despite COVID-19 being identified as severe respiratory viral infection, progressively many relevant endocrine manifestations have been reported greatly contributing to the severity of the clinical presentation. Systemic involvement in COVID-19 is due ...

www.ncbi.nlm.nih.gov

 

[psoas]

Because I was feeling so bad, after I got my very low testosterone blood levels, I started testosterone before seeing the urologist. The order in my description was a little misleading. The urologist said it is best to be on 100mg every week. I still preferred to not use it. However, the injections were a trial that told me that ALL of my symptoms were related to low testosterone.

In regards to inability to handle stress, that only occurred after starting testosterone injections. I had no problems handling stress when my testosterone levels were "circling the drain" (I had different problems!).

I do exercise, and I am playing tennis 3 times per week, weather permitting. Due to mild age associated wrist, shoulder, and knee problems, weight lifting is not the ideal form of exercise for me, while cardiovascular exercise is probably better.

And, before I got COVID 1 1/2 years ago, I was the same weight as I am now. Pre-COVID, my energy and stamina were good. I was pretty active physically on weekends. I was not sore after playing tennis. I could still do stuff around the house after playing Saturday tennis. I did not get very sleepy in the afternoon. My blood pressure was normal. I did not have tinnitus. So, although my weight is a partial factor, it is not the primary factor.

And, likely if I had stayed on testosterone, my estrogen levels would still have likely been driven upward, still causing some malaise and erectile problems.

I really really prefer not using testosterone, even if I don't have side effects from it. If my pituitary is low, I would prefer to address the cause (low LH) rather than the effect (low T).

And, although correcting my hormones won't directly help me lose weight, it will hopefully give me more energy to be more active, helping to make it easier to lose weight. I am not expecting hormone correction to solve all of my problems, but I am hoping that it could get me back to where I was pre-COVID.

 

[Systemlord]

If my pituitary is low, I would prefer to address the cause (low LH) rather than the effect (low T).

You’re stuck with low-T, except it and move on or this mindset will hold you back.

And, likely if I had stayed on testosterone, my estrogen levels would still have likely been driven upward, still causing some malaise and erectile problems.

Actually your estrogen levels would likely be lower on TRT, if you were to achieve the same Total T and Free T values, because you only get estrogen from one source, aromatase in fat tissue, whereas on hCG you get estrogen from two different sources, aromatase, and within the testicles due to hCG stimulation within the testicles.

Then again I doubt your symptoms are from estrogen, but as a result of the obesity. The majority of the symptoms on TRT are from the original cause of low-T. You body is down regulating the testosterone for a reason, and you’re circumventing that mechanism, and that’s where the symptoms come from.

When I started, TRT, all the side effects, I experienced for years on end was from my type 2 diabetes, which is what caused my low testosterone on the first place.

I do exercise, and I am playing tennis 3 times per week, weather permitting.

Depending on the severity of your obesity/metabolic syndrome, you’re going to have to do more than just play tennis three times a week. You have to overhaul your diet, because diet/exercise, are the two leading causes of obesity.

 

[psoas]

You’re stuck with low-T, accept it and move on or this mindset will hold you back

I accept low-T.

There are multiple ways to treat it.

hCG is an FDA approved indication for secondary hypogonadism.

Ironically, use of clomid for low testosterone &/or fertility is an off label use. (Not FDA approved for that indication.)

I did have a pretty good response to hCG:
Going from total testosterone of 127 to 446 using 1000 units 3x/week of pregnyl.

Increasing to 1500 units 3x/week will likely improve that response.

So, I don't know why most people are against use of hCG alone for secondary hypogonadism.

 

[Systemlord]

So, I don't know why most people are against use of hCG alone for secondary hypogonadism.

Optimizing testosterone on hCG is where the problems lies. Your at the mercy of your testicles response to hCG, TRT bypasses these limitations.

HCG is also known to increase estrogen more than TRT alone, nothing worse than having your T:E2 ratios out of whack and dealing with estrogen dominance.

I would also worry about availability of hCG going forward.

 

[psoas]

Lack of availability and expensive price of hCG is really sad.

I don't know why there is only availability of one FDA approved formulation of hCG in the US (pregnyl).

It is simple to make and probably less expensive to make than most medications -- just purify urine from pregnant women. So, why can't it be cheaper and more available ?

If you look at India, there are more than a have dozen brands available (FertiGyn, Hucog, Ovidac, Ovunal, Lupi-HCG, etc). Is manufacturing of these brands really too unsafe for FDA to approve them in. the US ?

At this point, is FDA being too over-protective or legitimately protective?

Or, is there a political decision to discourage use of hCG due to abuse by weight loss clinics ?