New Doctor. Put me on HCG monotherapy for secondary hypogonadism

New Diagnosis:

After switching doctors recently he diagnosed me with secondary hypogonadism.

He told me to stop the cypionate shots (i had only taken 1 T-Cypionate 200 ml shot 10 days prior).

Blood work results prior to my shot were:

Total T 210ng/dl
Free T 5.4 ng/dl
SHBG 16.6 nmol/L
FSH 2.6 mIU/ml
LH 2.5 mIU/ml
Estradiol 47.50 pg/ml (non sensitive)
Vitamin D 17.03 ng/ml

He ordered a lot more comprehensive blood work. I have 2 pages attached.

The drop in LH is due to my testosterone shot 10 days prior to new blood work.

The drop in Estradiol puzzled me. He told me not to worry about the numbers because they are non reliable. He will order me a sensitive one on my followup blood work in exactly 4 weeks.

Cholesterol levels are high since i am overweight. I currently weigh 225 pounds. I am 31 years old.


New Regimen:

Given the fact that preserving fertility is a priority to me, he put me on 150 IU of HCG per day (safest option first). I inject in my belly fat.

Hopefully this will get my bad boys to produce testosterone naturally. If levels show no sign of improvement in a month we will consider other options.

But a lot of guys my age with secondary hypogonadism seem to respond well to HCG monotherapy.

He also put me on 5000 IU of Vitamin D per day.

Lets see how i feel next month.

Any comments on my blood work?

All looks good except your lipids. You should cut down sugars (triglycerides are high). Your HDL is super low but it may improve with diet, exercise and weight loss.

Getting blood work after 1 T injection is a waste of money. It takes at least 4 injections to reach steady state.

Let us know what happens with your low dose HCG monotherapy.

Hopefully your estradiol will increase as T increases. Ask him to use the LC/MS assay next time to measure estradiol.

Nelson Vergel said:

Let us know what happens with your low dose HCG monotherapy.

Click to expand...

Thanks Nelson,

Do you recommend taking the HCG in the morning or before bed?

A lot of posts about this topic say it doesn't make a difference, but I do not think they are using HCG alone like I am.

MikeK, as you probably know most here inject twice weekly, I also inject my HCG with my testosterone per Nelson protocol.

Vince said:

MikeK, as you probably know most here inject twice weekly, I also inject my HCG with my testosterone per Nelson protocol.

Click to expand...

Vince thats what I understood from browsing the forum.

The bottle says inject 150 IU daily.

I guess I will inject 2 weeks in the mornings and 2 weeks before bed. I will observe how my body reacts to each.

Its twice a week for Testosterone injections, 150 IU daily for your HCG.

It's been my experience that HCG as a monotherapy is not generally very successful in raising Testosterone serum levels to optimal levels. If it was successful we'd all be on HCG monotherapy and not TRT.

And HCG supplementation still causes HPTA suppression as well.

You easily could have taken HCG along with your TRT combined like most of us do here and still keep the testes functioning.

Keep us posted on your results.

here is Nelson's video https://www.youtube.com/watch?v=0uXoBb6mkys

Wishing you the best on your journey with monotherapy. I'm almost to the 1 year mark and feeling good as ever. Numbers quickly went from 139 ng/dL to ~750-900 and have stayed solid.


I wanted to ask a follow up regarding HCG monotherapy as it pertains to nutrition. I have read that men injecting testosterone have somewhat decreased requirements in terms of dietary fat and cholesterol, because they are supplementing a good portion of the steroid hormones they need.

What about us HCG guys? Because its still endogenous production, do we still need the standard amount of dietary fat? Are there any other dietary adjustments that can optimize levels/fitness on an HCG only protocol?

Bluezebra5

I am not sure where you have seen that information. There are not dietary changes required with TRT and HCG.

bluezebra5 said:

Wishing you the best on your journey with monotherapy. I'm almost to the 1 year mark and feeling good as ever. Numbers quickly went from 139 ng/dL to ~750-900 and have stayed solid.

Click to expand...

Thats awsome bluezebra!

What is your current dosage. Do you inject daily? I hope I get similar results.

Are you able to build and hold on to muscle?

What about your energy and mental state?

I was worried because I read about alot of cases where hcg monotherapy raised testosterone levels but symptoms of low t remained.

I took my 3rd shot this morning.

Nelson Vergel said:

Bluezebra5

I am not sure where you have seen that information. There are not dietary changes required with TRT and HCG.

Click to expand...

I wouldn't call it a requirement, but I've read from a few sources that men supplementing exogenous testosterone simply have lower fat "needs" than men who don't. Perhaps I've been misled though. I will try to fetch some of the sources.

Thanks for the reply Nelson, what's your take on that?

MikeK said:

Thats awsome bluezebra!

What is your current dosage. Do you inject daily? I hope I get similar results.

Are you able to build and hold on to muscle?

What about your energy and mental state?

I was worried because I read about alot of cases where hcg monotherapy raised testosterone levels but symptoms of low t remained.

I took my 3rd shot this morning.

Click to expand...

I am on a rather large dose. I believe I began at 1500 iu 2x per week, we later went up to 2000 iu 2x per week, and that seemed to get the testosterone level optimized but I started to over-aromatize so I do inject daily now. My doctor says that EOD is likely more than sufficient but it's not bothersome anymore.


My appetite got pretty out of control in the beginning, I ate A LOT, and put on a lot of good weight, along with some bad. But it wasn't difficult to dial things back and get back to a physique I liked. With careful nutrition and tough workouts I went from about 180 lbs to 210 in the first 9 months. Certainly not all lean mass, but now that I'm back around 200 I'm not far off from the body far % I started at.


I had the experience you're describing when I tried Clomid. Great lab work but I felt like crap. Be honest with yourself and speak up if you aren't feeling right. There IS a solution out there for you. It may be HCG mono, it may be TRT, who knows. Just be scientific about things.


My energy levels are very normal, nothing superhuman, but they're right for me. Sense of well-being probably took the longest, but is markedly improved from where I was before. Libido goes hand in hand with this as well. All things are looking up.


Good luck brother.

I have seen this time and time again and it just floors me! 1500 unit injections twice a week???

Please find me one clinical study where gigantic doses of 1500 units produces more endogenous Testosterone then a daily 125 unit injection???

There are only so many leydig cell receptors that can only produce a limited amount of Testosterone and that is a physiologic fact.

And forget about receptor downgrade at these levels...that's a another discussion.

The impact on testes at this huge doses just amazes me.

And hell yeah you're going to aromatase that these huge levels and it's intratesticular E2 that a aromatase inhibitor is largely incapable of controlling.

I have two good friends on HCG monotherapy of 1500 IU three times per week and they love it. But I still think that TRT+HCG is more cost effective and it may accomplish the same goals.

I'm prepared to switch to TRT if I ever experience significant downregulation.


But with daily injections totaling 4000 iu weekly, I feel great and my estrogen is in check. I'm a happy camper.

bluezebra5 said:

I'm prepared to switch to TRT if I ever experience significant downregulation.


But with daily injections totaling 4000 iu weekly, I feel great and my estrogen is in check. I'm a happy camper.

Click to expand...

Every well respected TRT Physician I know would never prescribe at these doses because they know that over dosing doesn't mean you will get more endogenous Testosterone.

You could do just as well on much smaller daily doses.

Read this excerpt from Dr. Crisler's new book and you will understand.

Many years ago I found very low doses, (compared to the common practice of taking massive amounts of HCG—as much as 5000 IU per shot) of HCG quite sufficient. The strategy is to provide a physiologic (within normal range) serum concentration of this LH mimic. This not only makes the testicles produce what they can, it also makes them work at their best. Much is made on the message boards about potential inhibition of testosterone production by long-term HCG use. That only happens when you take too much. When you think about it, IF achieving what amounts to a normal range of a LH mimic down-regulates, then everyone would be naturally down-regulated. But taking too much is bad for you; as with all other hormones, and medications.


Keep in mind taking too much (“too much” varies from individual to individual) HCG does not produce more testosterone—there are only so many testosterone producing Leydig cells to stimulate—but it does ramp up aromatase activity, the enzyme that converts testosterone into estrogen. So estrogen soars. This also produces more progesterone. These are two highly feminizing hormones for men. Almost no HCG-only regimen should need an aromatase inhibitor to control estrogen.

Gene Devine said:

Every well respected TRT Physician I know would never prescribe at these doses because they know that over dosing doesn't mean you will get more endogenous Testosterone.

You could do just as well on much smaller daily doses.

Read this excerpt from Dr. Crisler's new book and you will understand.

Many years ago I found very low doses, (compared to the common practice of taking massive amounts of HCG—as much as 5000 IU per shot) of HCG quite sufficient. The strategy is to provide a physiologic (within normal range) serum concentration of this LH mimic. This not only makes the testicles produce what they can, it also makes them work at their best. Much is made on the message boards about potential inhibition of testosterone production by long-term HCG use. That only happens when you take too much. When you think about it, IF achieving what amounts to a normal range of a LH mimic down-regulates, then everyone would be naturally down-regulated. But taking too much is bad for you; as with all other hormones, and medications.


Keep in mind taking too much (“too much” varies from individual to individual) HCG does not produce more testosterone—there are only so many testosterone producing Leydig cells to stimulate—but it does ramp up aromatase activity, the enzyme that converts testosterone into estrogen. So estrogen soars. This also produces more progesterone. These are two highly feminizing hormones for men. Almost no HCG-only regimen should need an aromatase inhibitor to control estrogen.

Click to expand...

I'll certainly read more of Dr. Crisler's writing. My concern at this point is that I'm clearly normalized to this level of HCG. I don't suppose I would respond well to tapering down to 1/5 my current dose.

bluezebra5 said:

I'll certainly read more of Dr. Crisler's writing. My concern at this point is that I'm clearly normalized to this level of HCG. I don't suppose I would respond well to tapering down to 1/5 my current dose.

Click to expand...

You don't know that by reducing your dosage that you can keep your serum levels the same?

To the Doctor's point; one only needs a dosage within the physiologic range to get the optimal results.

Your testes can only produce what they can and that is within the normal physiologic dose and that's that...more doesn't produce more and only provides for negative side effects like any overdosed drug.

How much are you paying for all of the HCG?

Gene Devine said:

You don't know that by reducing your dosage that you can keep your serum levels the same?

To the Doctor's point; one only needs a dosage within the physiologic range to get the optimal results.

Your testes can only produce what they can and that is within the normal physiologic dose and that's that...more doesn't produce more and only provides for negative side effects like any overdosed drug.

How much are you paying for all of the HCG?

Click to expand...

I hear what you're saying and I do appreciate the advice. What I'm wondering is if I'm already downregulated after almost a year at this dose. I suppose the only way to find out is to experiment. I just hate messing around after it took so long to find a regimen where I feel like myself.

Fortunately, I'm well covered and I get my 10,000 iu vials for less than 15$.