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aneuman

Active Member
My sensitivity and ed issues were there even when i was on the high dose of 200 mg per week so that had no effect.( Besides the first month of the honeymoon when everything was amazing! Oh i wish we can stay there forever! ) I tried tapering down till 84 mg a week but i got bad Ed so i went back to 112 where i am currently. I wish you the best of luck
Thanks @rimster for this comprehensive anecdote. I had a similar experience when I started HCG, at the time 2000 IU once a week. The feeling was fantastic for two or three weeks in every sense, then it went away and it hasn't come back. Mood has no doubt improved, more optimistic, but the same issues you refer to linger on.

Wish you the best and thanks for replying.
 
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aneuman

Active Member
By immediately i meant a half hour.
I was thinking... since I'm using a relatively low dose (2 x 40 mg) and sub-Q (abdominal fat) perhaps the slower rate of absorption and the low dose make it more difficult to feel any effect "immediately", so maybe it will take longer to feel the effects and it will be subtler as well. Wonder if I try IM (deltoids) next time if the experience would be any different...

would love to hear others chime in with their experiences.

PS: Found this on reddit, wonder if this is Typical:

I inject daily, subq. It took about 5-6 weeks before my balls started shrinking. It took about 8-9 weeks before I started feeling like "damn, I feel GREAT!!". Feels awesome to feel like me again.
 
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rimster

Member
I was thinking... since I'm using a relatively low dose (2 x 40 mg) and sub-Q (abdominal fat) perhaps the slower rate of absorption and the low dose make it more difficult to feel any effect "immediately", so maybe it will take longer to feel the effects and it will be subtler as well. Wonder if I try IM (deltoids) next time if the experience would be any different...

would love to hear others chime in with their experiences.
For me it made no difference where the injection was. All the same
 

Cataceous

Super Moderator
...
My Dr. said that there's no evidence (his words were "there are no studies that say") that free T has anything to do with symptom resolution, that we should look at total T. ....
Call BS on him.
Low FT level, even in the presence of normal TT, is associated with ED severity in young men.
Low cFT, even in the presence of normal TT, is associated with androgen deficiency-related symptoms. Normal cFT, despite low TT, is not associated with cognate symptoms; therefore, cFT levels should be assessed in men with suspected hypogonadal symptoms.

...
For the last 6 months, my average total T has been 770 ng/dl while my average free T has been 7 ng/dl (0.9%). Both HCG and enclomiphene work extremely well on me in raising total T, but it seems SHBG has a way to track it and nullify it. Only once I had free T of 13.8 ng/dl and it was with a total T of 1183 ng/dL, but soon after SHBG caught up and brought it down to 8 ng/dL even with a total T of 1050 ng/dL. I've tried Boron, Zinc and all the magical herbs on Amazon to no avail.
...
Contrary to popular belief, SHBG does not have much effect on free testosterone in ordinary circumstances. Free testosterone is driven almost entirely by the rate of testosterone production—or the dose rate in men on TRT.

What method are you using to get free testosterone? Some of your calculated values seem robust. For example, TT of 788 ng/dL and SHBG of 54 nMol/L -> cFT ~= 13 ng/dL. With testosterone normal one should look for other reasons for the problems. With hCG it's possible to have estradiol and/or prolactin higher than ideal. Enclomiphene is potentially the opposite, being too effective of an antagonist in places where we need the estrogenic activity.
 

aneuman

Active Member
Thanks for responding @Cataceous.

Call BS on him.
Low FT level, even in the presence of normal TT, is associated with ED severity in young men.
I have called BS on him on a number of things, including saying that "hCG preserves testicular function on TRT is myth created by the clinics". I also know he told another person that he had "primary hypogonadism due to complete testicular failure", yet (correctly) prescribed Clomid as a therapy. Unfortunately, I need someone to prescribe the medication, so I play it dumb, hear what I need to hear, nod a couple of times and leave with my prescription.

I was seeing a renown urologist before, one that has been cited in several studies and even Morgentaler has referred to his research, but in his clinical practice it seems he knew the answer before hearing my problems. It was more of a cookie cutter. Never spent more than 5 min with me. He also only use "compounding pharmacies"

Contrary to popular belief, SHBG does not have much effect on free testosterone in ordinary circumstances. Free testosterone is driven almost entirely by the rate of testosterone production—or the dose rate in men on TRT.
That's interesting. I have always heard the contrary, that it was the rising in SHBG that "sequestered" testosterone, thus limiting free T.

What method are you using to get free testosterone?
Free mostly direct measured by Quest (MS I think)

Some of your calculated values seem robust. For example, TT of 788 ng/dL and SHBG of 54 nMol/L -> cFT ~= 13 ng/dL. With testosterone normal one should look for other reasons for the problems.
Any suggestion? I'd appreciate it. I'm at my wits end, as my labs are normal, most doctors (endocrinologist, urologists, andrologists, PCPs, etc) say I'm fine. However, the first time I took HCG at 2000 IU a week, my life completely changed...for twi weeks. Unfortunately, I don't have values of those days.

With hCG it's possible to have estradiol and/or prolactin higher than ideal. Enclomiphene is potentially the opposite, being too effective of an antagonist in places where we need the estrogenic activity.

See below (all results by Quest Labs):

Prior to any treatment February 2020:
Total testosterone: 403 ng/dl (250-1100 ng/dl)
Free testosterone: 64.9 pg/ml (35 - 155 pg.ml)
SHBG: 40 nmol/L. (22 - 77 nmol/L)
Albumin: 4.7 g/dL (3.6 - 5.1 g/dL)
cFT: 70.16 pg/mL (Vermeulen using both SHBG and Albumin)
E2: 27 pg/mL (< 39 pg/mL)
Prolactin: 9.2 ng/mL (2- 18 ng/mL)

After Enclomiphene Citrate (12.5 x 7) June 2022:
Total testosterone: 1183 ng/dl (250-1100 ng/dl)
Free testosterone: 138.4 pg/ml (35 - 155 pg.ml)
SHBG: N/A
Albumin: 5.1 g/dL (3.6 - 5.1 g/dL)
cFT: N/A
E2: 33 pg/ml (<39)

Enclomiphene (12.5 x 3) January 2023:
Total testosterone: 677 ng/dl (250-1100 ng/dl)
Free testosterone: 58.7 pg/ml (35 - 155 pg.ml)
SHBG: 57 nmol/L
Albumin: 4.5 g/dL (3.6 - 5.1 g/dL)
cFT: 177.43 pg/ml
E2: 50 pg/mL (<39)

HCG Mono (200 IU x 7) Jun 2023

Total testosterone: 745 ng/dl (250-1100 ng/dl)
Free testosterone: 69.9 pg/ml (35 - 155 pg.ml)
SHBG: 54 nmol/L
Albumin: 4.4 g/dL (3.6 - 5.1 g/dL)
cFT: 120.84 pg/ml
E2: 27 (<39 pg/mL)

Prolactin has been between 6 and 11 with an average of 8.2.

Edit: I have only listed the peaks where total TT has been at max levels for every therapy, all other labs show FT of 58, 60, 69 pg/ml (cFTV 97, 99, 102, etc)

My symptoms can be resumed as: my life was miserable and I made everybody's life miserable. Short fuse, negativity, "laziness", lack of focus and concentration, feeling tired without really being tired, no energy, insomnia, ED, lack of arousal, delayed orgasm.

I'm 6'1" and weight 180 lbs with about 20% body fat, 60 y/o with no major health issues (except BPH). For the last couple of years I workout 4 days a week, walk 5 miles a day, eat mostly home cooked meals.

Most symptoms have improved with all the treatments above, primarily with HCG (Enclomiphene just gave me big numbers and big nipples). HCG makes me feel better, more levels, more optimistic, better sleep, even improved by BPH symptoms. None of these to the level I used to be before and that my wife misses so much, but the sexual aspects have not been resolved at all, some days there are glimmers of hope, but for the most part, sex feels like a chore.

I thought that perhaps increasing free T with TRT at levels closer to 150-160 would return morning wood, sensitivity, arousal, etc.
 
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Cataceous

Super Moderator
...
Any suggestion? I'd appreciate it. I'm at my wits end, as my labs are normal, most doctors (endocrinologist, urologists, andrologists, PCPs, etc) say I'm fine. However, the first time I took HCG at 2000 IU a week, my life completely changed...for twi weeks. Unfortunately, I don't have values of those days.
...
I'd say continue with the current experiment. Keep in mind that 80 mg/week TC is only relatively low because so many who inject are overdosing. In reality that 80 mg is providing around 20% more testosterone than the average healthy young guy makes naturally. The excess is marginally justified by the fact that serum testosterone troughs with twice-weekly injections can be a third less than the peaks.

It would have been nice to see how you reacted to a trial with testosterone nasal gel—TNG—before trying the more disruptive treatments, i.e. hCG, enclomiphene, and now TRT. TNG is one of the closest things we have to pure testosterone enhancement—it results in less HPTA suppression and probably also has less influence on other parameters, e.g. thyroid, than conventional TRT.

In any case, you can try following my progression to see if you eventually get satisfactory results. This goes something like TRT -> TRT + hCG -> add dopamine tinkering -> and/or peptides. Also throw a little progesterone in there if you have low levels.
 

aneuman

Active Member
I'd say continue with the current experiment. Keep in mind that 80 mg/week TC is only relatively low because so many who inject are overdosing. In reality that 80 mg is providing around 20% more testosterone than the average healthy young guy makes naturally. The excess is marginally justified by the fact that serum testosterone troughs with twice-weekly injections can be a third less than the peaks.
Thanks @Cataceous! I plan to continue my "experiment" like you call it, unchanged for at least 3 months, unless something happens. In 3 months I'll reassess to see if I need to up or down the dosage. I'm shooting for 600-700 trough, which according to what you mentioned of troughs being 1/3 of peak on bi-weekly schedule, that should give me around 1000-1100 peak. Is that correct? At this point I'm not looking very much at that and more are upping free testosterone to 180-200 pg/mL, if that makes sense.

I just got my labs after I quit hCG and TT =388ng/dl and FT=47.6pg/ml with total bioavailable=100 ng/dL. No wonder I feel like crap!

It would have been nice to see how you reacted to a trial with testosterone nasal gel—TNG—before trying the more disruptive treatments, i.e. hCG, enclomiphene, and now TRT. TNG is one of the closest things we have to pure testosterone enhancement—it results in less HPTA suppression and probably also has less influence on other parameters, e.g. thyroid, than conventional TRT.
Yep. I thought of that (in retrospect) but I was never offered the option and I didn't know. better. All the doctors I've seen, even reknown ones, have been very nonchalant, cookie cutter types. No one has ever "discussed" with me anything. The nurse comes in an interview me, then the doctor comes in with a script.

In any case, you can try following my progression to see if you eventually get satisfactory results. This goes something like TRT -> TRT + hCG ->
I'm very much on hat path. I'll try TRT for 3 months alone, so I can gauge what impact T.Cyp has on my values, well-being, etc, then add hCG for two reasons: continue productions of other hormones disrupted by exogenous T and maintaining testicular size (and function, to an extent, in case I need to quit TRT for any reason)

add dopamine tinkering -> and/or peptides. Also throw a little progesterone in there if you have low levels.
This is intriguing. I've read anecdotes about people resolving many side effects of TRT by adding a bit of progesterone (particularly seep). What can you say about the benefits in your case, dosage/schedule, etc? The other thing, is how to get it? I assume you'd need a prescription. Right now I have become sort of a "prompt engineer" (to use a fashionable term) to manipulate Drs. to prescribe what I need, but just like chatGPT, sometimes they refuse to fulfill my request.

Regarding peptides, although I may be a bit of a risk taker when it comes to experiment with me, I'm more prone to do it if the source is a pharmaceutical company with FDA approved products, than if I have to order UGL or Chinese or Indian company I know nothing about. The profit motive is way too high to guarantee the products contain what they say they do.

However, I do value your advise and would love to hear from you in this regards.

Thank you so much for taking the time to read and respond to my posts.
 

rimster

Member
If you're looking to easily get top quality medications anything trt related you might want to try defy. Alot of guys here including myself use them. They'll give you a script for anything you ask. The downside is they don't take insurance but they're not prohibitly expensive either. I'm planning on using them till i get myself figured out and then going back to my regular doctor and have everything covered by my insurance.
 

Cataceous

Super Moderator
...
This is intriguing. I've read anecdotes about people resolving many side effects of TRT by adding a bit of progesterone (particularly seep). What can you say about the benefits in your case, dosage/schedule, etc? The other thing, is how to get it? I assume you'd need a prescription. Right now I have become sort of a "prompt engineer" (to use a fashionable term) to manipulate Drs. to prescribe what I need, but just like chatGPT, sometimes they refuse to fulfill my request.
...
Most of the answers are on the first page of this mega-thread:
Topical progesterone is OTC. I've always used daily dosing due to the relatively short half-life.

...
Regarding peptides, although I may be a bit of a risk taker when it comes to experiment with me, I'm more prone to do it if the source is a pharmaceutical company with FDA approved products, than if I have to order UGL or Chinese or Indian company I know nothing about. The profit motive is way too high to guarantee the products contain what they say they do.
...
The peptide that benefitted me the most with regard to libido and sexual function is gonadorelin. This probably can be obtained via compounding pharmacies. At one point Hallandale carried it. Unfortunately, the ideal protocol for gonadorelin is too demanding to be very practical. Kisspeptin-10 is also interesting, but I don't believe it can be sold except for research purposes. Peptide Sciences is among the more reputable US-based sellers of such peptides, which are also claimed to be US-made.

On the dopamine-enhancing side I'm alluding to things like NALT, phenethylamine, selegiline, cabergoline, etc.
 

aneuman

Active Member
Most of the answers are on the first page of this mega-thread:
Topical progesterone is OTC. I've always used daily dosing due to the relatively short half-life.


The peptide that benefitted me the most with regard to libido and sexual function is gonadorelin. This probably can be obtained via compounding pharmacies. At one point Hallandale carried it. Unfortunately, the ideal protocol for gonadorelin is too demanding to be very practical. Kisspeptin-10 is also interesting, but I don't believe it can be sold except for research purposes. Peptide Sciences is among the more reputable US-based sellers of such peptides, which are also claimed to be US-made.

On the dopamine-enhancing side I'm alluding to things like NALT, phenethylamine, selegiline, cabergoline, etc.
Thank you so much @Cataceous. I'll consider your advice and keep my options open. For the next 3 months I'll try to control myself and not make any changes in the protocol to see how I respond. Once I get to a stable state, I'll reevaluate and consider progesterone, hCG (again) and some of your other suggestions.

I know it's going to be hard no to attempt to make changes in such a "long time", but I'll do my best.

Again, thanks for taking the time to read and respond.
 
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