HCG Mono Has Failed - What Are My Options?

[Dallase1]

Hello. I found out I have low testosterone (133 total), and very low LH and FSH. I tried HCG for 6 weeks with little to no success. My doctor now says I can try Clomid or go right testosterone. Do any of you have an opinion as to which will have the better long-term effects? I'm only 28 but feel HORRIBLE!

 

[Vince Carter]

just based on your age I would consider a Clomid restart attempt but you say your LH/FSH are low so that may not be an option and there's really not much success to be spoken of with Clomid, or HCG monotherapy. If you have some labs please screenshot/attach and we can have a deeper convo.

 

[CoastWatcher]

Hello. I found out I have low testosterone (133 total), and very low LH and FSH. I tried HCG for 6 weeks with little to no success. My doctor now says I can try Clomid or go right testosterone. Do any of you have an opinion as to which will have the better long-term effects? I'm only 28 but feel HORRIBLE!

Welcome to Excelmale.. We'd love to open a discussion, but absent more information we are shooting in the dark.

Please post your symptoms, your medical history, the diagnosis you have been given, your lab results - with the associated ranges, and your options as you understand them.

 

[Dallase1]

My symptoms, diagnosis, and labs

I was diagnosed with secondary hypogonadism due to my pituitary gland not secreting enough LH and FSH. My symptoms are: severe mental fog, fatigue, tiredness, weakness, inability to be aroused, osteopenia due to low E2, and the inability to concentrate. I was prescribed 500 IUs HCG 3Xs a week for six weeks. No improvement in symptoms.
Here are my most recent (post HCG) labs (with reference ranges):

LH: .7 (1.7-8.6 miU/dl)
FSH: 2.9 (1.5-12.4 miU/dl)
Total Testosterone: 133 (280-1100 ng/dl)
Free Testosterone: 38 (47 - 244 pg/ml)
Estradiol (E2): <5 (7.6 - 42 pg/ml)
SHBG: 44 (10-80 nmol/L)
DHEA-S: 302.4 (160-449 ug/dl)

 

[CoastWatcher]

I was diagnosed with secondary hypogonadism due to my pituitary gland not secreting enough LH and FSH. My symptoms are: severe mental fog, fatigue, tiredness, weakness, inability to be aroused, osteopenia due to low E2, and the inability to concentrate. I was prescribed 500 IUs HCG 3Xs a week for six weeks. No improvement in symptoms.
Here are my most recent (post HCG) labs (with reference ranges):

LH: .7 (1.7-8.6 miU/dl)
FSH: 2.9 (1.5-12.4 miU/dl)
Total Testosterone: 133 (280-1100 ng/dl)
Free Testosterone: 38 (47 - 244 pg/ml)
Estradiol (E2): <5 (7.6 - 42 pg/ml)
SHBG: 44 (10-80 nmol/L)
DHEA-S: 302.4 (160-449 ug/dl)

You are, without a doubt, hypogonadal - at the age of 28. Because you are so young to be dealing with this, a Clomid trial is something I'd certainly consider. Might it work? That's hard to say. But the alternative is to transition to TRT and that, for almost all of us, is a life-long commitment. Does your doctor have experience with Clomid protocols? In regard to your lab results, the incorrect estradiol test appears to have been ordered; the reference range is a dead giveaway. All future tests (most particularly if a Clomid trail is started) should the "sensitive" estradiol test (LC, MS/MS). Were no thyroid tests run? Prolactin?

 

[Dallase1]

Yes, he ran thyroid tests and growth hormone tests. A brain MRI showed no pituitary tumors. They are as follows:
TSH: 1.6 (.270 - 4.2 mcIU/mL)
T3 Free: 2.31 (2.0 - 4.4 pg/mL)
T4 Free: 1.27 (.8 - 2.00 ng/dl)
Growth Hormone: 1.61 (.05 - 3 ng/mL)
IGF-1: 213 (155-432 ng/mL)
Prolactin: 7.31 (4.04 - 15.2 ng/mL)

 

[CoastWatcher]

A key consideration, as was pointed out, relates to the amount of experience your doctor has managing Clomid protocols. I've provided a good, discursive thread initiated by Dr. Justin Saya, Defy's medical director, on the ups/downs/ins/outs of them.

https://www.excelmale.com/forum/sho...rns-or-do-they-really-exist&highlight=unicorn

 

[Dallase1]

Clomid or Testosterone?

I have attached all of my bloodwork. I have heard people see more benefits from testosterone and that long-term use of Clomid isn't successful. What are your thoughts?

 

[CoastWatcher]

I have attached all of my bloodwork. I have heard people see more benefits from testosterone and that long-term use of Clomid isn't successful. What are your thoughts?

Have you looked at the thread that I attached in the earlier post, from Dr. Saya? It explores that question in detail.