4 week results with HCG mono therapy for secondary case

[nickdavid712]

21 year old male... started HCG mono therapy with 1,000IU 2x per week. Had bloodwork re-tested after 4 weeks the results are as follows.

Labs pre HCG on 4/21/18

Testosterone total- 49ng/dL range: 240-950ng/dL
Testosterone free -0.78ng/dL range: 5.25-20.7ng/dL
SHBG- 72 nmol/L range: 17-56 nmol/L
LH- 1.3IU/L range: 1.7-8.6IU/L
FSH- 0.6IU/L range: 1.5-12.4IU/L
ESTRADIOL <15 < OR = 39 pg/mL

[TD="class: nameCol srchbl"]WBC[/TD] [TD="class: valueCol"]4.40 K/uL[/TD] [TD="class: rangeCol"]4.00 - 10.00 K/uL[/TD]

[TD="class: nameCol srchbl"]RBC[/TD] [TD="class: valueCol"]4.09 M/uL[/TD] [TD="class: rangeCol"]4.50 - 6.40 M/uL[/TD]

[TD="class: nameCol srchbl"]HGB[/TD] [TD="class: valueCol"]12.7 g/dL[/TD] [TD="class: rangeCol"]13.5 - 18.0 g/dL[/TD]

[TD="class: nameCol srchbl"]HCT[/TD] [TD="class: valueCol"]39.0 %[/TD] [TD="class: rangeCol"]40.0 - 54.0 %[/TD]

[TD="class: nameCol srchbl"]PLT[/TD] [TD="class: valueCol"]150 K/uL[/TD] [TD="class: rangeCol"]150 - 450 K/uL[/TD]

[TD="class: nameCol srchbl"]MCV[/TD] [TD="class: valueCol"]95.4 fL[/TD] [TD="class: rangeCol"]80.0 - 95.0 fL[/TD]

[TD="class: nameCol srchbl"]MCH[/TD] [TD="class: valueCol"]31.1 pg[/TD] [TD="class: rangeCol"]27.0 - 32.0 pg[/TD]

[TD="class: nameCol srchbl"]MCHC[/TD] [TD="class: valueCol"]32.6 g/dL[/TD] [TD="class: rangeCol"]32.0 - 36.0 g/dL[/TD]

[TD="class: nameCol srchbl"]RDW[/TD] [TD="class: valueCol"]14.3 %[/TD] [TD="class: rangeCol"]11.5 - 14.5 %[/TD]

[TD="class: nameCol srchbl"]MPV[/TD] [TD="class: valueCol"]9.4 fl[/TD] [TD="class: rangeCol"]8.4 - 12.0 fl[/TD]

[TD="class: nameCol srchbl"]NRBC[/TD] [TD="class: valueCol"]0.00 /100 WBCs[/TD] [TD="class: rangeCol"]0.00 /100 WBCs[/TD]

[TD="class: nameCol srchbl"]ABSOLUTE NRBC[/TD] [TD="class: valueCol"]0.00 K/uL[/TD] [TD="class: rangeCol"]0.00 K/uL[/TD]

Labs after 4 weeks of HCG mono therapy

Testosterone total- 571ng/dL range:249-836ng/dL
SHBG- 71nmol/L range 17-56nmol/L
LH- <0.1IU/L range: 1.7-8.6IU/L
FSH-<0.1IU/L range: 1.5-12.4IU/L
estradiol- 36pg/mL range:27-52pg/mL

[TD="class: nameCol srchbl"]WBC[/TD] [TD="class: valueCol"]4.25 K/uL[/TD] [TD="class: rangeCol"]4.00 - 10.00 K/uL[/TD]

[TD="class: nameCol srchbl"]RBC[/TD] [TD="class: valueCol"]4.16 M/uL[/TD] [TD="class: rangeCol"]4.50 - 6.40 M/uL[/TD]

[TD="class: nameCol srchbl"]HGB[/TD] [TD="class: valueCol"]13.0 g/dL[/TD] [TD="class: rangeCol"]13.5 - 18.0 g/dL[/TD]

[TD="class: nameCol srchbl"]HCT[/TD] [TD="class: valueCol"]39.5 %[/TD] [TD="class: rangeCol"]40.0 - 54.0 %[/TD]

[TD="class: nameCol srchbl"]PLT[/TD] [TD="class: valueCol"]147 K/uL[/TD] [TD="class: rangeCol"]150 - 450 K/uL[/TD]

[TD="class: nameCol srchbl"]MCV[/TD] [TD="class: valueCol"]95.0 fL[/TD] [TD="class: rangeCol"]80.0 - 95.0 fL[/TD]

[TD="class: nameCol srchbl"]MCH[/TD] [TD="class: valueCol"]31.3 pg[/TD] [TD="class: rangeCol"]27.0 - 32.0 pg[/TD]

[TD="class: nameCol srchbl"]MCHC[/TD] [TD="class: valueCol"]32.9 g/dL[/TD] [TD="class: rangeCol"]32.0 - 36.0 g/dL[/TD]

[TD="class: nameCol srchbl"]RDW[/TD] [TD="class: valueCol"]14.1 %[/TD] [TD="class: rangeCol"]11.5 - 14.5 %[/TD]

[TD="class: nameCol srchbl"]MPV[/TD] [TD="class: valueCol"]8.9 fl[/TD] [TD="class: rangeCol"]8.4 - 12.0 fl[/TD]

[TD="class: nameCol srchbl"]NRBC[/TD] [TD="class: valueCol"]0.00 /100 WBCs[/TD] [TD="class: rangeCol"]0 /100 WBCs[/TD]

[TD="class: nameCol srchbl"]ABSOLUTE NRBC[/TD] [TD="class: valueCol"]0.00 K/uL[/TD] [TD="class: rangeCol"]0 K/uL[/TD]

What would you make out of these labs/moving forward treatment wise?
No free testosterone was done, however, with the high SHBG we can assume it was low? I have no major improvements in symptoms even though my testosterone has increased but I assume it is because my high SHBG? Is there any way to decrease SHBG? Would switching to TRT be my only option?

 

[Vince]

Have you ever had your thyroid panel done. TSH, free T4, free T3, reverse T3 and antibodies I think everyone should have it tested at least once. You also had the wrong estradiol test you need the one for men LC,MS/MS.

 

[CoastWatcher]

It's only been four weeks. While I'm no fan of HCG mono therapy, it behooves you to give it a fair try before throwing up your hands and asking for exogenous testosterone. The wrong estradiol test was ordered, you want to measure with the sensitive, LC, MS/MS, rest (sensitive or ultrasensitive). As for SHBG, testosterone would likely lower it.

 

[nickdavid712]

Have you ever had your thyroid panel done. TSH, free T4, free T3, reverse T3 and antibodies I think everyone should have it tested at least once. You also had the wrong estradiol test you need the one for men LC,MS/MS.

I never have had my reverse T3 tested, however, I have had the others done:

T4, FREE, DIRECT DIALYSIS **1.3 N** (0.9-2.2 ng/dL AMD)

THYROID PEROXIDASE ANTIBODIES THYROID PEROXIDASE ANTIBODIES **11** H (<9 IU/mL)

THYROGLOBULIN PANEL THYROGLOBULIN ANTIBODIES **<1** N (< or = 1 IU/mL)

THYROGLOBULIN **10.9** N ng/mL Reference Range: Intact Thyroid 2.8-40.9 Athyrotic <0.1

T3, FREE **1.9** L (3.0-4.7 pg/mL)

 

[Vince]

I never have had my reverse T3 tested, however, I have had the others done:

T4, FREE, DIRECT DIALYSIS **1.3 N** (0.9-2.2 ng/dL AMD)

THYROID PEROXIDASE ANTIBODIES THYROID PEROXIDASE ANTIBODIES **11** H (<9 IU/mL)

THYROGLOBULIN PANEL THYROGLOBULIN ANTIBODIES **<1** N (< or = 1 IU/mL)

THYROGLOBULIN **10.9** N ng/mL Reference Range: Intact Thyroid 2.8-40.9 Athyrotic <0.1

T3, FREE **1.9** L (3.0-4.7 pg/mL)

You definitely low free T3. Are you on any type of thyroid Med. If not you need to be treated for hypothyroidism. We have many members here there are much more informed about the thyroid than I am, I'm sure they will chime.

One thing I believe, you should treat your thyroid first before going on trt. Symptoms for both can be the same and better free T3 numbers will improve your testosterone.

 

[Systemlord]

I never have had my reverse T3 tested, however, I have had the others done:

T4, FREE, DIRECT DIALYSIS **1.3 N** (0.9-2.2 ng/dL AMD)

THYROID PEROXIDASE ANTIBODIES THYROID PEROXIDASE ANTIBODIES **11** H (<9 IU/mL)

THYROGLOBULIN PANEL THYROGLOBULIN ANTIBODIES **<1** N (< or = 1 IU/mL)

THYROGLOBULIN **10.9** N ng/mL Reference Range: Intact Thyroid 2.8-40.9 Athyrotic <0.1

T3, FREE **1.9** L (3.0-4.7 pg/mL)

If Reverse T3 is elevated beyond 15/dL, your low Free T3 situation is worse than it appears since Reverse T3 competes for the same receptors.

 

[ratbag]

You can check your free T with this calculator http://www.issam.ch/freetesto.htm
Your FreeT is 1.25%... very low and why you don't feel good. This is because of your high SHBG. You need testosterone cypionate. Probably one large shot a week to increase your Free T + HCG

Your thyroid results show you have elevated TPO which indicate some degree of hashimoto's disease. Your FT3 is also low. Symptoms of low thyroid are very similar to low testosterone. So it appears you have a double problem occuring.