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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
What is the best dose of HCG? Dr Saya presents two case studies.
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<blockquote data-quote="Dr Justin Saya MD" data-source="post: 32301" data-attributes="member: 12687"><p>Everyone - you're welcome! It is a pleasure sharing with you all.</p><p></p><p>Jon H - very astute observation and I would have to say that I currently lean in that direction as well based on patterns I've seen over the years. In fact, I'm pasting below a separate forum post that I submitted a few weeks back while conducting the above study stating the same:</p><p></p><p>"I personally use the degree of suspected PRIMARY HYPOGONADISM in my dosage decisions for hCG. In other words, the degree of suspected testicular failure. If I suspect a patient has a stronger primary hypogonadal component (less responsive or less capable testes), I dose slightly higher hCG for more stimulation of the "less capable" testes. If I suspect a patient has less of a primary hypogonadal component, I typically will dose hCG somewhat lower as the testes are more responsive/capable. This is why my hCG dosages often vary from patient to patient. I believe with hCG, as with all other areas of HRT that we have found, a cookie-cutter/one-size-fits-all approach is not ideal as some factors vary amongst patients.</p><p></p><p> The REAL question is how much is needed to keep the Leydig cells in the testes stimulated and to reap the other benefits of the hCG. Again, this is not fully known (we have some data on this for fertility - i.e. Lipshultz study, but not for other areas). I believe the goal should be to attempt to approximate hCG's endogenous equivalent LH. Now this is difficult as they have much different half-lifes (with LH being very short) and endogenous LH is only secreted in a pulsatile nature. I am currently working on a few case studies of patients to determine the quantitative beta hCG serum levels achieved at various times following various hCG dosages. I currently have two patients enrolled, after a 7 day washout to ensure all hCG is out of the body (and these are longtime TRT patients so endogenous LH is suppressed) one patient will inject a single hCG 150iu injection, the second patient will inject a single hCG 500iu injection (I'm trying to arrange another patient for a single 350iu injection as well). I will then measure quantitative serum hCG levels at various times - hour 0 ( before injection) -> hour 12 -> hour 24 -> hour 48 -> hour 72. This data will be very interesting especially in the sense that I want to try to compare the resultant levels of hCG at various times to the normal physiologic levels of its equivalent, LH. This may give a little more insight into what the "best" dose of hCG may be. I'll share once complete, likely 6-8 weeks...maybe sooner."</p><p></p><p>As promised in that post a few weeks ago, this is the data. Hope to work on more, possibly chart reviews, coming up...free time with the busy practice and 4 kiddos running around at home is the limiting factor! Hope this benefits some...</p></blockquote><p></p>
[QUOTE="Dr Justin Saya MD, post: 32301, member: 12687"] Everyone - you're welcome! It is a pleasure sharing with you all. Jon H - very astute observation and I would have to say that I currently lean in that direction as well based on patterns I've seen over the years. In fact, I'm pasting below a separate forum post that I submitted a few weeks back while conducting the above study stating the same: "I personally use the degree of suspected PRIMARY HYPOGONADISM in my dosage decisions for hCG. In other words, the degree of suspected testicular failure. If I suspect a patient has a stronger primary hypogonadal component (less responsive or less capable testes), I dose slightly higher hCG for more stimulation of the "less capable" testes. If I suspect a patient has less of a primary hypogonadal component, I typically will dose hCG somewhat lower as the testes are more responsive/capable. This is why my hCG dosages often vary from patient to patient. I believe with hCG, as with all other areas of HRT that we have found, a cookie-cutter/one-size-fits-all approach is not ideal as some factors vary amongst patients. The REAL question is how much is needed to keep the Leydig cells in the testes stimulated and to reap the other benefits of the hCG. Again, this is not fully known (we have some data on this for fertility - i.e. Lipshultz study, but not for other areas). I believe the goal should be to attempt to approximate hCG's endogenous equivalent LH. Now this is difficult as they have much different half-lifes (with LH being very short) and endogenous LH is only secreted in a pulsatile nature. I am currently working on a few case studies of patients to determine the quantitative beta hCG serum levels achieved at various times following various hCG dosages. I currently have two patients enrolled, after a 7 day washout to ensure all hCG is out of the body (and these are longtime TRT patients so endogenous LH is suppressed) one patient will inject a single hCG 150iu injection, the second patient will inject a single hCG 500iu injection (I'm trying to arrange another patient for a single 350iu injection as well). I will then measure quantitative serum hCG levels at various times - hour 0 ( before injection) -> hour 12 -> hour 24 -> hour 48 -> hour 72. This data will be very interesting especially in the sense that I want to try to compare the resultant levels of hCG at various times to the normal physiologic levels of its equivalent, LH. This may give a little more insight into what the "best" dose of hCG may be. I'll share once complete, likely 6-8 weeks...maybe sooner." As promised in that post a few weeks ago, this is the data. Hope to work on more, possibly chart reviews, coming up...free time with the busy practice and 4 kiddos running around at home is the limiting factor! Hope this benefits some... [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
What is the best dose of HCG? Dr Saya presents two case studies.
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