Tips to Dial In Test C + HCG Protocol

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mjones104

New Member
I just had bloodwork done after 4 months on this protocol:
1) 45mg of test cypionate 2x weekly (90mg total per week)
2) 500IU of Pregnyl 2x weekly (1,000IU total per week)

My labs are attached. The free T didn't show up on the PDF but it's 823 pmol/L, which is well above the reference range of 160 - 699 pmol/L

The good and bad of how I feel:
Good
- Generally decent energy and mood, with some fatigue at times throughout the day (see below re: sleep quality)
- Solid strength gains in the gym
- Strong appetite
- High libido and interest in sex

Bad
-
Mediocre sleep quality. Waking up in the middle of the night wired (free T a touch too high?)
- Mediocre erection quality, despite high libido
- Testicles retracted up a bit and look small despite using HCG
- Some back and forehead acne (not too concerned about this)

All the above "Bad" items makes me think bringing down test C to 80mg/week could be a good adjustment. I'm not 100% sure though, because my Total T levels really aren't that high. Looking for opinions on other possible protocol changes based on the bloods. Obviously areas of focus are: high free T, high free T3, low platelet count (not sure what this really impacts).
 

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Gman86

Member
If testicles are retracted, while on HCG, sometimes that can be a sign of high E2. A lot of guys report that once they get E2 in their own personal “sweetspot” their testicles increase in volume and their scrotum relaxes

What really helped me with the little acne that I had not too long ago was starting progesterone. I also started vitamin E and vitamin D around the same time, but I believe it was the progresterone that was mostly responsible. I can’t recall 100%, but I’m pretty positive that prog in the past also helped me with any acne that I had. From my understanding prog helps control the conversion of test to E2 and DHT, which is why it probably helps with acne.

Progesterone also helps with sleep, by converting into allopregnenolone. Allopregnenolone increases GABBA I believe, which helps improve sleep. So progesterone could most likely help u in a few ways. I’ve also heard that progesterone can improve erections, but not 100% sure about that. Have only heard it from a few sources

So if I were u, I personally wouldn’t lower my dose. I would go get progesterone and DHT checked, or just start a low dose of injectable progesterone before bed. Around 0.5-1mg to start. It’s very cheap, and harmless to try. If u feel better, keep taking it. If u feel worse, either adjust ur dose or stop it all together
 

DixieWrecked

Well-Known Member
I can confirm that high E2 will tighten up my scrotum and genitals in general My genitals have hung well without hcg if my e2 was in range and then I added hcg and it actually made things worse because of the e2 increase.
 

Cataceous

Super Moderator
I would try the lower dose. Give it a few months and if you're not happy with it then you can always go back. Your current total testosterone is still well above the average for healthy young men, and it may be too high for your physiology, depending on your SHBG. For some guys higher testosterone does cause sleep problems. Of course the same might be said about your T3. Is that achieved without any thyroid medication?

If the absolute level of estradiol is causing problems then the lower dose could help by bringing it down. The ratio to total testosterone is about 0.5%, which is normal, and shouldn't be affected much by a lower dose.
 

S1W

Well-Known Member
What is your SHBG?

IME it's the HCG that causes the high/tight scrotum. I've had my highest levels of E2 when not using HCG and did not have that problem. When using HCG it's common for me regardless of my E2 levels.
 

Gman86

Member
What is your SHBG?

IME it's the HCG that causes the high/tight scrotum. I've had my highest levels of E2 when not using HCG and did not have that problem. When using HCG it's common for me regardless of my E2 levels.
That’s so interesting. Would ur testicle size increase on HCG, even tho ur scrotum would tighten up?
 

ajax31

Active Member
That’s so interesting. Would ur testicle size increase on HCG, even tho ur scrotum would tighten up?

Maybe intratesticular E2 is higher when taking hCG as is testosterone. In that case measuring serum estradiol wouldn’t tell the whole story.
 

S1W

Well-Known Member
That’s so interesting. Would ur testicle size increase on HCG, even tho ur scrotum would tighten up?

If they did, it wasn't extremely noticeable. That said, I don't feel as if my testicles are extremely atrophied. They're a bit smaller than pre-TRT, but not "raisins" etc that I sometimes hear about from others.
 

mjones104

New Member
I would try the lower dose. Give it a few months and if you're not happy with it then you can always go back. Your current total testosterone is still well above the average for healthy young men, and it may be too high for your physiology, depending on your SHBG. For some guys higher testosterone does cause sleep problems. Of course the same might be said about your T3. Is that achieved without any thyroid medication?

If the absolute level of estradiol is causing problems then the lower dose could help by bringing it down. The ratio to total testosterone is about 0.5%, which is normal, and shouldn't be affected much by a lower dose.
Correct - I am not on any thyroid medication
 

DS3

Well-Known Member
I just had bloodwork done after 4 months on this protocol:
1) 45mg of test cypionate 2x weekly (90mg total per week)
2) 500IU of Pregnyl 2x weekly (1,000IU total per week)

My labs are attached. The free T didn't show up on the PDF but it's 823 pmol/L, which is well above the reference range of 160 - 699 pmol/L

The good and bad of how I feel:
Good
- Generally decent energy and mood, with some fatigue at times throughout the day (see below re: sleep quality)
- Solid strength gains in the gym
- Strong appetite
- High libido and interest in sex

Bad
-
Mediocre sleep quality. Waking up in the middle of the night wired (free T a touch too high?)
- Mediocre erection quality, despite high libido
- Testicles retracted up a bit and look small despite using HCG
- Some back and forehead acne (not too concerned about this)

All the above "Bad" items makes me think bringing down test C to 80mg/week could be a good adjustment. I'm not 100% sure though, because my Total T levels really aren't that high. Looking for opinions on other possible protocol changes based on the bloods. Obviously areas of focus are: high free T, high free T3, low platelet count (not sure what this really impacts).
Before lowering your testosterone dosage, I would lower your HCG dosage to 300-400 IU twice weekly to see if your testicles are less protracted. I can attest to what @Gman86 and @DixieWrecked discuss regarding too high of E2 and testicular protraction. HCG can cause high intratesticular estrogen, and if your dosage is too high may contribute to reduced testicular size. Anecdotally, I have experienced this. Erection quality can also be negatively impacted if the dosage of HCG is too high.

T dosage could be too high as @Cataceous offered; a small reduction in daily dosage may help reduce your sleep issues. A conservative approach would be a 20% reduction to 12 mg daily.

I would personally, however, start with a small reduction in HCG, leave testosterone alone, and see if you testicular size and erection quality improve.
 

Phil Goodman

Active Member
Before lowering your testosterone dosage, I would lower your HCG dosage to 300-400 IU twice weekly to see if your testicles are less protracted. I can attest to what @Gman86 and @DixieWrecked discuss regarding too high of E2 and testicular protraction. HCG can cause high intratesticular estrogen, and if your dosage is too high may contribute to reduced testicular size. Anecdotally, I have experienced this. Erection quality can also be negatively impacted if the dosage of HCG is too high.

T dosage could be too high as @Cataceous offered; a small reduction in daily dosage may help reduce your sleep issues. A conservative approach would be a 20% reduction to 12 mg daily.

I would personally, however, start with a small reduction in HCG, leave testosterone alone, and see if you testicular size and erection quality improve.
I think these are great points, only thing I would add is that you’re next step should be based on priorities. Is fixing erection and testicles priority number one, or is improved sleep? If it’s the genital aspect then take the approach mentioned above and find your sweet spot with HCG before tackling other issues. If sleep is your top priority then lower the T dose a little and re-evaluate every few weeks based on sleep habits. I keep telling myself one day I’ll start a thread with a poll to see which users have experienced sleep problems and what their protocol was. I expect that the vast majority of posters with sleep issues are on injections(as I am myself). Not only are you taking your free T to the top of the range, but keeping it there for extended periods of time. In a natural/optimal world we’d al be natural and the body would give us amazing levels during the day then drop at night for the recharge. But since our approach doesn’t allow for daily drops(except for users on cream which I’d be interested to hear from) our body is more wired at night when it’s trying to recharge. So with that being the case the only approach would be to lower the dose until you find a good balance between great energy during the day, but not so much that it interrupts the sleeping process. I’d also imagine that improving sleep would also help with erections and lots of other factors. But your next step will be determined by which issue(s) you want to tackle first.
 

Gman86

Member
I think these are great points, only thing I would add is that you’re next step should be based on priorities. Is fixing erection and testicles priority number one, or is improved sleep? If it’s the genital aspect then take the approach mentioned above and find your sweet spot with HCG before tackling other issues. If sleep is your top priority then lower the T dose a little and re-evaluate every few weeks based on sleep habits. I keep telling myself one day I’ll start a thread with a poll to see which users have experienced sleep problems and what their protocol was. I expect that the vast majority of posters with sleep issues are on injections(as I am myself). Not only are you taking your free T to the top of the range, but keeping it there for extended periods of time. In a natural/optimal world we’d al be natural and the body would give us amazing levels during the day then drop at night for the recharge. But since our approach doesn’t allow for daily drops(except for users on cream which I’d be interested to hear from) our body is more wired at night when it’s trying to recharge. So with that being the case the only approach would be to lower the dose until you find a good balance between great energy during the day, but not so much that it interrupts the sleeping process. I’d also imagine that improving sleep would also help with erections and lots of other factors. But your next step will be determined by which issue(s) you want to tackle first.
Just for the record, I sleep great and keep my levels pretty high. Way higher than most like to keep them. But I’m a health freak and attribute my good sleep to a lot of the other things I do to optimize health. But luckily my high free androgen level hasn’t hurt my sleep at all.
 
Just for the record, I sleep great and keep my levels pretty high. Way higher than most like to keep them. But I’m a health freak and attribute my good sleep to a lot of the other things I do to optimize health. But luckily my high free androgen level hasn’t hurt my sleep at all.

I need high levels to sleep and to reduce anxiety. I’m not advocating high doses for everyone, but if lowering the dose doesn’t work or rather makes it worse, try going up.
 

Gman86

Member
I need high levels to sleep and to reduce anxiety. I’m not advocating high doses for everyone, but if lowering the dose doesn’t work or rather makes it worse, try going up.
Yup, everyone is different, and it’s all about trial and error and seeing what works for you individually
 

Jay Ara

Member
Just my 50 cents, why bother HCG? Are you trying to have you wife/gf pregnant? Or it is just how your balls look? Your levels are above the high limit, I’m not surprised you are facing side effects. The golden rule should be the least amount of test to have benefits. I’m on Nebido only, no HCG and no AI every 12 weeks and I feel just great! I started with 10 weeks my my levels are mid high, before my injection, therefore my doctor suggested to have it every 12 weeks instead of 10, means I’m having equivalent of 83mg per week of test. Of course everyone is different, you have to do what is right and works for you. Good luck
 
Just my 50 cents, why bother HCG? Are you trying to have you wife/gf pregnant? Or it is just how your balls look?

HCG’s perks for sexual function is not limited to just fertility and ball size. It can also increase libido, sensation and erection quality.

However, sexual function isn’t the only reason to take HCG. It will also stimulate steroidogenesis of adrenal hormones. An effect that is often overlooked.
 

madman

Super Moderator
I just had bloodwork done after 4 months on this protocol:
1) 45mg of test cypionate 2x weekly (90mg total per week)

2) 500IU of Pregnyl 2x weekly (1,000IU total per week)

My labs are attached. The free T didn't show up on the PDF but it's 823 pmol/L, which is well above the reference range of 160 - 699 pmol/L

The good and bad of how I feel:
Good
- Generally decent energy and mood, with some fatigue at times throughout the day (see below re: sleep quality)
- Solid strength gains in the gym
- Strong appetite
- High libido and interest in sex

Bad
- Mediocre sleep quality. Waking up in the middle of the night wired (free T a touch too high?)
- Mediocre erection quality, despite high libido
- Testicles retracted up a bit and look small despite using HCG

- Some back and forehead acne (not too concerned about this)

All the above "Bad" items makes me think bringing down test C to 80mg/week could be a good adjustment. I'm not 100% sure though, because my Total T levels really aren't that high. Looking for opinions on other possible protocol changes based on the bloods. Obviously areas of focus are: high free T, high free T3, low platelet count (not sure what this really impacts).

post #3


Oct 13, 2021

Hi guys,

I’m 30 years old living in Canada and I have been on TRT for approximately three years. The primary issue that got me started on TRT was lack of libido, bad ED (including total absence of morning wood), and a “numb” feeling / no sensitivity in the genitals.

My initial bloodwork (September 2018) only included a few tests, with the below results:

  • TSH: 1.61 (0.35 – 5.00 mIU/L)
  • LH: 4.3 (1.7 – 8.6 IU/L)
  • FSH: 2 (2 – 12 IU/L)
  • Testosterone: 8 (7.6 – 31.4 nmol/L)
  • Free testosterone: 162 (196 – 699 pmol/L)
  • Estradiol (standard): 77 (<159 pmol/L)
  • Prolactin: 13 (<18 ug/L)
After reviewing this bloodwork the urologist I’m seeing started me on 5G taro-testosterone 1% gel. In the initial weeks my libido came back and ED went away, but this only lasted a few weeks.

I found ExcelMale and switched over to cypionate injections in the hope they would give me a long-term solution. Over the years I’ve tweaked protocols but in the last ~12-18 months feel I’ve been quite dialed in with good levels. My mood has been good, I feel I’m enjoying the benefits of TRT except for the libido and ED issues. I still get minimal / no morning wood. Even using 50-100mg of Viagra only gives me mediocre erections for sex, and the sensitivity of my genitals is almost nothing when I do use Viagra.


I’ve been injecting 90 mg/week of test cypionate, which I split into two doses of 45 mg every 3.5 days. I don’t use an AI or HCG. Below I pasted a summary table of some key metrics from bloodwork to show how my levels have been tracking for the past year. I have also posted the complete labs in case there are any markers worth reviewing more closely. Note: my doctor refuses to give me the sensitive estradiol test, so these are all standard estradiol tests unfortunately.
1644768365751.png


From your labs posted above pre/post trt on Sept.21/2021 you were hitting a TT 25.4 nmol/L (732 ng/dL), FT 725 pmol/L (slightly high) estradiol 161 pmol/L (non-sensitive slightly high) on a T-only protocol 90 mg T/week split (45 mg every 3.5 days).

From the most recent labs Feb.2/2022 (posted below) you just had done on the same dose 90mg T/week split (45 mg every 3.5 days) you are only hitting a slightly higher TT 27.4 nmol/L (790 ng/dL), a higher FT 823 pmol/L, and the shit kicker is lower estradiol 126 pmol/L and this is with the addition of hCG 1000IU (500IU of Pregnyl 2x weekly).


I just had bloodwork done after 4 months on this protocol:
1) 45mg of test cypionate 2x weekly (90mg total per week)
2) 500IU of Pregnyl 2x weekly (1,000IU total per week)


My labs are attached. The free T didn't show up on the PDF but it's 823 pmol/L, which is well above the reference range of 160 - 699 pmol/L

Screenshot (10880).png



Where does your SHBG sit?

When were labs drawn for labs done on Sept.21/2021 and Feb.2/2022?

Definitely would not rely on the standard e2 assay.

If you live in Ontario you can get the sensitive e2 assay.

What is your CRP?

Have no clue where your estradiol level truly sits.

As I stated in your previous thread there is a good chance with a robust TT 700-800 ng/dL that your FT is mid or high normal.

If labs were drawn at true trough (84 hrs post-injection) then your peak TT, FT, and estradiol will be higher.

Screenshot (10881).png

Screenshot (10882).png



You would be hitting a healthy/high-end FT and this is most likely at trough if you had your labs done at the right time.

You stated:

The good and bad of how I feel:
Good
- Generally decent energy and mood, with some fatigue at times throughout the day (see below re: sleep quality)
- Solid strength gains in the gym
- Strong appetite
- High libido and interest in sex

Bad
- Mediocre sleep quality. Waking up in the middle of the night wired (free T a touch too high?)
- Mediocre erection quality, despite high libido
- Testicles retracted up a bit and look small despite using HCG
- Some back and forehead acne (not too concerned about this)



Sounds like a healthy FT level let alone if this is at the true trough then your peak TT, FT, and estradiol would be much higher as you are injecting twice weekly (every 3.5 days).

In most cases, acne is a dead giveaway that FT is too high.

Excess FT levels can result in acne/oily skin (genetically prone), accelerated balding (genetically prone), drive down HDL, increased RBCs/hemoglobin/hematocrit (common), overstimulation of the CNS (common), bloating/water retention due to androgens effects on the retention of electrolytes (common).

Let alone many end up trying to manage estradiol with the use of an aromatase inhibitor.

Some of the side effects are due to testosterone metabolites estradiol/DHT.

Keep in mind that testosterone has a tonic effect on the CNS and can easily make one feel amped up let alone have a negative impact on sleep (quality/quantity).

FT 5-10 ng/dL would be considered low.

FT 16-31 ng/dL (high-end) is healthy.

Most men will do well with a FT 20-30 ng/dL.

Some may choose to run higher levels.

Comes down to the individual.

Even then most whether low/lowish or high/highish SHBG one can easily hit a high-end let alone absurdly high FT with a TT 1000ng/dL.
 

madman

Super Moderator
HCG’s perks for sexual function is not limited to just fertility and ball size. It can also increase libido, sensation and erection quality.

However, sexual function isn’t the only reason to take HCG. It will also stimulate steroidogenesis of adrenal hormones.
An effect that is often overlooked.

HCG’s perks for sexual function is not limited to just fertility and ball size. It can also increase libido, sensation and erection quality.


Most definitely but it is not a given as some may experience such effects whereas others may end up worse off.




However, sexual function isn’t the only reason to take HCG. It will also stimulate steroidogenesis of adrenal hormones.


Doubtful the impact is significant and even then not everyone is using a high enough dose of hCG (250-500 IU) to restore physiological ITT levels.

*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].

*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.





My reply from a previous thread:

The main purpose of adding hCG to trt is to preserve/maintain fertility and prevent/minimize testicular atrophy.

The use of exogenous testosterone results in the suppression of ITT (intra-testicular testosterone) which is critical for sperm production.

The main goal when using hCG is to restore physiological ITT levels and in order to achieve such a minimum effective dose would be needed (125-500 IU) and 250-500 IU would seem to be the sweet spot.

Anything less will have a minimal impact on increasing ITT!

Other than one experiencing possible side effects from such doses (250-500 IU) using anything <125IU will have a minimal impact on increasing ITT.




My reply from a previous thread where the poster asked if hCG was needed:


Depends on the individual.....Is hCG needed?

*To preserve/maintain fertility then yes.

*To prevent/minimize testicular atrophy then yes.

*To enhance mood/libido it is not a given as some may experience such effects whereas others may feel worse off.

*To maintain upstream hormones and possibly prevent long-term consequences for health/wellbeing.....you be the judge!





*Take-home point:

A replacement regimen with combined hCG/rFSH mimics physiologic steroid hormone profiles better than a substitution with exogenous testosterone. The documented differences in steroid profiles on testosterone replacement in hypogonadal males with absent or severely reduced endogenous LH and FSH secretion may have long-term consequences for health and well-being. Specifically, body composition, bone health, glucose, and lipid metabolism, salt and water balance, cognition, mood, sleep, and sexual function could be affected. The steroidogenic differences could also be relevant for gonadotropin-suppressive treatments with long-acting testosterone preparations in males with primary hypogonadism. To what extent this hypothesis is true, should be addressed in future clinical studies.




This is the most recent paper on the use of hCG!



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 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 been 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.



* It is currently unknown if long-term administration of HCG can lead to side effects such as gonadotropin resistance. (Table 2)
 

Charles R

New Member
I just had bloodwork done after 4 months on this protocol:
1) 45mg of test cypionate 2x weekly (90mg total per week)
2) 500IU of Pregnyl 2x weekly (1,000IU total per week)

My labs are attached. The free T didn't show up on the PDF but it's 823 pmol/L, which is well above the reference range of 160 - 699 pmol/L

The good and bad of how I feel:
Good
- Generally decent energy and mood, with some fatigue at times throughout the day (see below re: sleep quality)
- Solid strength gains in the gym
- Strong appetite
- High libido and interest in sex

Bad
-
Mediocre sleep quality. Waking up in the middle of the night wired (free T a touch too high?)
- Mediocre erection quality, despite high libido
- Testicles retracted up a bit and look small despite using HCG
- Some back and forehead acne (not too concerned about this)

All the above "Bad" items makes me think bringing down test C to 80mg/week could be a good adjustment. I'm not 100% sure though, because my Total T levels really aren't that high. Looking for opinions on other possible protocol changes based on the bloods. Obviously areas of focus are: high free T, high free T3, low platelet count (not sure what this really impacts).
You might consider seeking out an Endocrinologist you can work with to achieve your goals instead of self-adjusting your medication.

It takes time to find your individual “sweet spot” and everyone is different in regards to dose and side effects …… and this will change with time.
 
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