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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Webinar with 3 Testosterone Book Authors this Wednesday, 8 pm ET
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<blockquote data-quote="Dr Justin Saya MD" data-source="post: 31009" data-attributes="member: 12687"><p>Seems there are two almost identical threads. On the other thread Vince posed a question of if daily hCG is needed or beneficial. Short answer - we don't know but are getting closer to finding out. I'm copying my response to his question below:</p><p></p><p>Hi Vince- No one knows this answer for sure, all opinions are anecdotal. I suspect the difference, if any, is likely minimal. I can tell you the this: the half-life of hCG appears to be in the range of 24-36 hours. Let's use 24 hours for an example calculation. If you inject 500iu, then after 24hrs you will have 250iu remaining, after 48hrs 125iu remaining, after 72hrs 62.5iu and so forth (500iu -> 250iu @24hrs -> 125iu @48hrs -> 62.5iu @72hrs). The same can be calculated for other doses of hCG (300iu, 400iu, etc). </p><p></p><p>I personally use the degree of suspected PRIMARY HYPOGONADISM in my dosage decisions for hCG. In other words, the degree of suspected testicular failure. If I suspect a patient has a stronger primary hypogonadal component (less responsive or less capable testes), I dose slightly higher hCG for more stimulation of the "less capable" testes. If I suspect a patient has less of a primary hypogonadal component, I typically will dose hCG somewhat lower as the testes are more responsive/capable. This is why my hCG dosages often vary from patient to patient. I believe with hCG, as with all other areas of HRT that we have found, a cookie-cutter/one-size-fits-all approach is not ideal as some factors vary amongst patients.</p><p></p><p>The REAL question is how much is needed to keep the Leydig cells in the testes stimulated and to reap the other benefits of the hCG. Again, this is not fully known (we have some data on this for fertility - i.e. Lipshultz study, but not for other areas). I believe the goal should be to attempt to approximate hCG's endogenous equivalent LH. Now this is difficult as they have much different half-lifes (with LH being very short) and endogenous LH is only secreted in a pulsatile nature. I am currently working on a few case studies of patients to determine the quantitative beta hCG serum levels achieved at various times following various hCG dosages. I currently have two patients enrolled, after a 7 day washout to ensure all hCG is out of the body (and these are longtime TRT patients so endogenous LH is suppressed) one patient will inject a single hCG 150iu injection, the second patient will inject a single hCG 500iu injection (I'm trying to arrange another patient for a single 350iu injection as well). I will then measure quantitative serum hCG levels at various times - hour 0 ( before injection) -> hour 12 -> hour 24 -> hour 48 -> hour 72. This data will be very interesting especially in the sense that I want to try to compare the resultant levels of hCG at various times to the normal physiologic levels of its equivalent, LH. This may give a little more insight into what the "best" dose of hCG may be. I'll share once complete, likely 6-8 weeks...maybe sooner.</p></blockquote><p></p>
[QUOTE="Dr Justin Saya MD, post: 31009, member: 12687"] Seems there are two almost identical threads. On the other thread Vince posed a question of if daily hCG is needed or beneficial. Short answer - we don't know but are getting closer to finding out. I'm copying my response to his question below: Hi Vince- No one knows this answer for sure, all opinions are anecdotal. I suspect the difference, if any, is likely minimal. I can tell you the this: the half-life of hCG appears to be in the range of 24-36 hours. Let's use 24 hours for an example calculation. If you inject 500iu, then after 24hrs you will have 250iu remaining, after 48hrs 125iu remaining, after 72hrs 62.5iu and so forth (500iu -> 250iu @24hrs -> 125iu @48hrs -> 62.5iu @72hrs). The same can be calculated for other doses of hCG (300iu, 400iu, etc). I personally use the degree of suspected PRIMARY HYPOGONADISM in my dosage decisions for hCG. In other words, the degree of suspected testicular failure. If I suspect a patient has a stronger primary hypogonadal component (less responsive or less capable testes), I dose slightly higher hCG for more stimulation of the "less capable" testes. If I suspect a patient has less of a primary hypogonadal component, I typically will dose hCG somewhat lower as the testes are more responsive/capable. This is why my hCG dosages often vary from patient to patient. I believe with hCG, as with all other areas of HRT that we have found, a cookie-cutter/one-size-fits-all approach is not ideal as some factors vary amongst patients. The REAL question is how much is needed to keep the Leydig cells in the testes stimulated and to reap the other benefits of the hCG. Again, this is not fully known (we have some data on this for fertility - i.e. Lipshultz study, but not for other areas). I believe the goal should be to attempt to approximate hCG's endogenous equivalent LH. Now this is difficult as they have much different half-lifes (with LH being very short) and endogenous LH is only secreted in a pulsatile nature. I am currently working on a few case studies of patients to determine the quantitative beta hCG serum levels achieved at various times following various hCG dosages. I currently have two patients enrolled, after a 7 day washout to ensure all hCG is out of the body (and these are longtime TRT patients so endogenous LH is suppressed) one patient will inject a single hCG 150iu injection, the second patient will inject a single hCG 500iu injection (I'm trying to arrange another patient for a single 350iu injection as well). I will then measure quantitative serum hCG levels at various times - hour 0 ( before injection) -> hour 12 -> hour 24 -> hour 48 -> hour 72. This data will be very interesting especially in the sense that I want to try to compare the resultant levels of hCG at various times to the normal physiologic levels of its equivalent, LH. This may give a little more insight into what the "best" dose of hCG may be. I'll share once complete, likely 6-8 weeks...maybe sooner. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Webinar with 3 Testosterone Book Authors this Wednesday, 8 pm ET
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