My Blood Test Results...Considering HCG Monotherapy

[Elevated1]

Hey guys im 30 years old. Ive been suffering from low t for years now. At one point I lost weight and quit alcohol for a few months and got it to 18.9 but that's the highest and its never been near there again, this was 4 years ago.

Suffering from low mood, energy, tiredness, fatigue, low motivation, grumpy, irritable, lowER libido but not low by any means still get good erections and high volume of semen. The only thing im taking is an ssri for mental health, mostly anxiety etc for the past 4 years. I've showed my naturopath my precious low t levels from multiple years and he agrees its way too low. He's considering putting me on hcg monotherapy as I don't want to go the trt route just yet as I want to have another baby in the next year or so but it might be inevitable. I've seen mixed reviews on HCH mono but wondering what the recent 2021 general consensus is as I've read alot of old stuff too.

What do you think of my results? What do you guys think of starting at a nice low dose of 250IU every other day for a few months to see how I respond? I know e2 will go up is taking an AI a must? Or hopefully with this low a dose ill be able pull off keeping it balanced? I have a follow up appointment with him tomorrow and my wife is going to be there, she is wanting me to just lose weight as I've gained a decent amount of weight the past few years and workout more often etc to increase my test but its kind of a double edged sword as I always feel like shit and need energy and some damn vigor to get there. Thanks.

AM Cortisol 326 125-536 nmol/L
Estradiol 91 <157 pmol/L
Progesterone 0.5 0.4-1.8 nmol/L
Testosterone 9.6 8.4-28.8
Testosterone Free 247 115-577
Testosterone Bioavailable 5.8 2.7-13.5
SHBG 19.2 10-70 nmol/L
FSH 4.1 <9.5 IU/L
LH 3.3 1.1-8.8 IU/L

 

[Vince]

Hey guys im 30 years old. Ive been suffering from low t for years now. At one point I lost weight and quit alcohol for a few months and got it to 18.9 but that's the highest and its never been near there again, this was 4 years ago.

Suffering from low mood, energy, tiredness, fatigue, low motivation, grumpy, irritable, lowER libido but not low by any means still get good erections and high volume of semen. The only thing im taking is an ssri for mental health, mostly anxiety etc for the past 4 years. I've showed my naturopath my precious low t levels from multiple years and he agrees its way too low. He's considering putting me on hcg monotherapy as I don't want to go the trt route just yet as I want to have another baby in the next year or so but it might be inevitable. I've seen mixed reviews on HCH mono but wondering what the recent 2021 general consensus is as I've read alot of old stuff too.

What do you think of my results? What do you guys think of starting at a nice low dose of 250IU every other day for a few months to see how I respond? I know e2 will go up is taking an AI a must? Or hopefully with this low a dose ill be able pull off keeping it balanced? I have a follow up appointment with him tomorrow and my wife is going to be there, she is wanting me to just lose weight as I've gained a decent amount of weight the past few years and workout more often etc to increase my test but its kind of a double edged sword as I always feel like shit and need energy and some damn vigor to get there. Thanks.

AM Cortisol 326 125-536 nmol/L
Estradiol 91 <157 pmol/L
Progesterone 0.5 0.4-1.8 nmol/L
Testosterone 9.6 8.4-28.8
Testosterone Free 247 115-577
Testosterone Bioavailable 5.8 2.7-13.5
SHBG 19.2 10-70 nmol/L

You really need to know if you have primary or secondary hypogonarism. So make sure you test your FSH and LSH. Then you can decide on your treatment.

 

[Elevated1]

I'll get those today from him

 

[sammmy]

The first thing I would do is question the SSRI that you are taking ... SSRI can cause low motivation because you stop caring of anything - the 'zombie' effect - and gaining weight may be a result of that. They can also cause fatigue and tiredness.

Also, having low mood instantly raises a red flag that your SSRI is actually not doing it's job. I've been on SSRI in the past (prozac) and the only positive effect was NOT having low mood. Taking it 'just for anxiety' does not matter, SSRI are supposed to prevent low mood.

 

[Elevated1]

Update with my LH and FSH
FSH 4.1 <9.5 IU/L
LH 3.3 1.1-8.8 IU/L

Seems like I'm secondary?

 

[ZALEMAX]

Hi all, I have low T urologist prescribed HCG 6,000 IU every three days have not started yet. This is HCG mono only is there anyone currently on HCG mono that can advise? Any input is appreciated.

FSH 6MIU/ml
LH 3MIU/ml -Low

 

[Swede]

Hi all, I have low T urologist prescribed HCG 6,000 IU every three days have not started yet. This is HCG mono only is there anyone currently on HCG mono that can advise? Any input is appreciated.

FSH 6MIU/ml
LH 3MIU/ml -Low

Dont start with 6000iu, 500iu its enough.

 

[Cataceous]

Hi all, I have low T urologist prescribed HCG 6,000 IU every three days have not started yet. This is HCG mono only is there anyone currently on HCG mono that can advise? Any input is appreciated.

FSH 6MIU/ml
LH 3MIU/ml -Low

For monotherapy 1,500 IU per week in divided doses is the lowest I've seen, and I doubt most men would have adequate testosterone production with this. On the other hand, hCG is quirky in that if doses get too high then testosterone production actually declines. This research suggests that peak testosterone may be attained at around 1,000 IU hCG every other day, which is 3,500 per week. This is based on averages, so individual variation should be expected. It's possible that fertility would be better with higher doses even if testosterone is not optimized. Side effects can become more of a problem as doses increase.

 

[madman]

Hey guys im 30 years old. Ive been suffering from low t for years now. At one point I lost weight and quit alcohol for a few months and got it to 18.9 but that's the highest and its never been near there again, this was 4 years ago.

Suffering from low mood, energy, tiredness, fatigue, low motivation, grumpy, irritable, lowER libido but not low by any means still get good erections and high volume of semen. The only thing im taking is an ssri for mental health, mostly anxiety etc for the past 4 years. I've showed my naturopath my precious low t levels from multiple years and he agrees its way too low. He's considering putting me on hcg monotherapy as I don't want to go the trt route just yet as I want to have another baby in the next year or so but it might be inevitable. I've seen mixed reviews on HCH mono but wondering what the recent 2021 general consensus is as I've read alot of old stuff too.

What do you think of my results? What do you guys think of starting at a nice low dose of 250IU every other day for a few months to see how I respond? I know e2 will go up is taking an AI a must? Or hopefully with this low a dose ill be able pull off keeping it balanced? I have a follow up appointment with him tomorrow and my wife is going to be there, she is wanting me to just lose weight as I've gained a decent amount of weight the past few years and workout more often etc to increase my test but its kind of a double edged sword as I always feel like shit and need energy and some damn vigor to get there. Thanks.

AM Cortisol 326 125-536 nmol/L
Estradiol 91 <157 pmol/L
Progesterone 0.5 0.4-1.8 nmol/L
Testosterone 9.6 8.4-28.8
Testosterone Free 247 115-577
Testosterone Bioavailable 5.8 2.7-13.5
SHBG 19.2 10-70 nmol/L
FSH 4.1 <9.5 IU/L
LH 3.3 1.1-8.8 IU/L

Your TT 9.6 nmol/L (276.8 ng/dL) is absurdly low and even with a lowish SHBG 19.2 nmol/L your FT would be in the gutter.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

The only way to know where your FT truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Your FT was most likely done using the calculated method (cFTV) as the piss poor direct analog immunoassay is no longer used/relied upon.

Definitely not done using the most accurate assays such as ED or UF as not many have access to such.

Looking over your labs/reference ranges I can tell you are a fellow Canadian as these are the reference ranges/units used at one of our major labs Lifelabs.

You can definitely give the hCG mono a go but will most likely end up going on trt.

250IU EOD would be too low a dose for mono.

I would look into Natesto or Enclomiphene.....mind you Clomid is only available in Canada.

There are ways to still maintain fertility when using exogenous testosterone.


post #6/7

HCG Monotherapy Risks

Hello, I am a 29 year old male, fit with low bodyfat and decent muscle mass (if that matters). I have a prescription for HCG Monotherapy that I am still deciding whether or not to use. Before anyone asks, I have no desire for TRT at this stage in life due to it permanently shutting down...

www.excelmale.com

 

[madman]

Pros and cons of using TRT vs HCG for treatment low-t symptoms

Human chorionic gonadotropin treatment: a viable option for management of secondary hypogonadism and male infertility (2020) Julius Fink, Brad J. Schoenfeld, Anthony C. Hackney, Takahiro Maekawa & Shigeo Horie Abstract Introduction: Low testosterone and its symptoms is a condition affecting...

www.excelmale.com

5.1 Effects on intratesticular testosterone

Exogenous testosterone administration suppresses intratesticular testosterone (ITT), which is crucial for the production of sperm [24]. In such patients, ITT has been shown to be suppressed by 94%. However, with every other day injections of HCG at dosages of 125IU, ITT was only 25% less than baseline, with 250IU 7% less, and with 500IU 26% greater than the baseline [25]. In another study, 37 normal men were treated with GnRH antagonist acyline and attributed to one of the following low dose HCG groups: 0, 15, 60, or 125 IU sc every other day or 7.5 g daily testosterone gel for 10 days. In order to measure ITT, testicular fluid was retrieved via percutaneous aspiration at baseline and after 10 days of treatment. The median baseline ITT was 2508 nmol/liter. ITT improved in a dose-dependent manner: 15 IU HCG group reached an ITT of 136 nmol, 60 IU HCG group reached an ITT of 319 nmol, 125 IU HCG group reached an ITT of 987 nmol/liter. Serum HCG is significantly correlated with both ITT and serum testosterone [24,26]. These studies indicate that HCG can significantly increase ITT in a dose-dependent manner and that dosages between 250 and 500 IU might be optimal to restore physiological ITT levels.




5.2 Effects on serum testosterone

A weekly dosage of 4500IU spread over 3 weekly injections has shown to lead to normal testosterone levels in isolated HH men [27]. Another study showed that single injections of 400IU, 2000IU, and 4000IU of HCG led to significant serum testosterone concentrations in hypogonadal as well as eugonadal males without differences among the groups after administration [28]. In hypogonadal men, 400IU, 2000IU, and 4000IU of HCG increased testosterone from about 200 to 400 ng/dl. In eugonadal men, 400IU, 2000IU, and 4000IU of HCG led to an increase from about 450 to 700 ng/dl in testosterone [28]. Interestingly, higher doses of HCG did not lead to greater testosterone level increases [28]. Another study showed similar results, with no differences in serum testosterone after single injections of 1500, 3000, or 4500IU of HCG, with testosterone increasing 24 hours post-injection and peaking 3-4 days later [29]. Serum testosterone peaked 3 days after injection [28].

From the above information, it can be suggested that low dose HCG (~500IU) injected 3 times per week can restore healthy serum and intratesticular testosterone levels in HH patients. The higher dosages used in infertility treatment to trigger sperm production might not be necessary if the goal is to increase serum testosterone levels. That is, combined treatment with HCG followed by rFSH might also be potent in order to induce fertility [21].

Indeed, HCG dosages used in the treatment of infertility can range from 3,000 to 10,000 IU 2-3 times per week [30]. One study showed that 3-6 months (1000 IU 3 times/week or 2000IU 2 times/week) of HCG treatment in 100 males with hypogonadotropic hypogonadism leads to normal serum testosterone concentrations despite the fact that 81 patients remained azoospermic [31]. These data show that low dose HCG treatment is very effective in restoring normal serum testosterone levels, however, spermatogenesis might require higher dosages of HCG. The exact mechanism by which HCG affects sperm production besides testosterone increase is not completely understood yet and needs further investigation. We summarized studies involving HCG treatment on testosterone and/or fertility parameters in Table 1.



10. Conclusion

HCG therapy is an effective treatment for patients suffering from infertility, often restoring healthy sperm production. However, HCG also increases serum and intratesticular testosterone levels, making it a prime candidate to treat patients with secondary hypogonadism. Even though the cost and injection frequency might be slightly higher as compared to TRT, HCG alone or used with TRT might be the best option for patients who desire to have children in the future. Depending on the response to HCG alone, concomitant TRT might be necessary to bring serum testosterone levels to the desired levels. Responses of serum testosterone levels seem to be independent of the dose of HCG and to peak 3 days post-injection. Therefore, low doses of ~400 IU HCG injected every 3 days intramuscularly or subcutaneously might lead to a significant increase of serum and intratesticular testosterone with few daily fluctuations in levels. Indeed, high dosages commonly seen in the treatment of male infertility going as high as 5000 IU several times per week might be unnecessary if the goal is not to increase sperm production but rather to increase testosterone only. In summary, HCG might be a safe, affordable, and effective method to restore healthy testosterone levels in males suffering from secondary hypogonadism. Nonetheless, further clinical trials should be carried out to demonstrate and elucidate the benefits of HCG therapy.




11. Expert opinion


*The HPG axis seems responsive HCG in a similar fashion as LH and self-regulates the testosterone production within the testes in an amount independent manner. Doses of HCG as low as 400 IU seem to significantly increase serum testosterone levels and even with dosages, 10 times that amount (4000 IU), the serum testosterone elevations seem similar to that of a 400 IU dosage (i.e., remaining within the physiological range). Rather than sensing the amount of HCG and accordingly producing testosterone, even small amounts of HCG seem to maximize the response for testosterone production within the testes probably due to receptor sensitivity.