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Everyone is unique and I believe there is a role, however limited it may be, for HCG from an upstream perspective. However, I’ve seen guys with a strong case of primary hypogonadism and with LH levels >40 (the biological equivalent of a very high HCG dosage) still have low DHEA/pregnenolone...

Daily injections, though not always *necessary*, will always give more stability (invariably) than less frequent injection schedules. See my automobile analogy from a couple years back in post 36: Some insight on T cyp injection frequency and SC vs IM)

Suffice? For fertility - No For testicular atrophy - not likely (or partially) For the subjective benefits some patients feel with HCG (libido, etc) - well for 1 week

For transparency, he is a pharmacist not a medical doctor. His reasoning suggests he is concerned with the (often discussed yet never proven) notion of desensitization of the leydig cells - which wouldn’t be and isn’t a concern with the modest doses of hCG used for TRT purposes.

Indeed a night and day difference for many guys.

Yes!

Those are the big ones for our purposes. Add SHBG although (for LabCorp) only divided into 2 reference ranges: Age 20-49: 16.5 - 55.9 nmol/L Age > 49: 19.3 - 76.4 nmol/L This is indicative of the age-related increase in SHBG.

The most significant cross-reactant with the immunoassay is CRP. However, let’s not forget about biotin. The LC-MS/MS is quite a bit more expensive (though the negotiated price is much lower for our patients/discounted labs). In order to accurately calibrate the standard estradiol RIA one would...

True, though it’s not clotting that is the concern with higher hematocrit (erythrocytosis). Unfortunately many get lost in the weeds debating about clotting when this isn’t the reason to be cautious about higher hematocrit. There are other reasons...

Riptide - Dr Calkins trained with me and has worked by my side for several years. Although every patient is unique, he doesn’t often steer patients wrong.

Bingo! I can’t tell you how MANY times I’ve consulted with a patient I’ve known to have been a forum member and heard “haven’t been on the forums in a long time. Not having any problems...doing well and just enjoying life”.

Quick comment and then going to steer clear of this thread as it will likely take quite a few tangents :-) “GH treatments increase AR (androgen receptor) expression” is the best pearl from this publication.

Correct that clomid (or any SERM) is typically not effective at raising LH/FSH for most men on *adequate* TRT doses. However, still can have an impact on SHBG and also the interactions with E2 receptors (agonist and antagonist) doesn’t show on blood work, but certainly CAN impact how one feels...

It’s not an irresponsible dose for a RESTART...Which is a shorter course of treatment and a different animal than Clomid monotherapy as we are kickstarting a completely suppressed HPTA. Vince Carter is a pal, but for some reason periodically makes similar antagonist comments. Antcon - This may...

I can endorse Dr Crisler (Lansing, MI) and Dr Rand McClain (Santa Monica) as colleagues and friends I have personal experience working with.

A headache for everyone involved...from LabCorp to physicians/clinics to patients. Resolution is near.

I would encourage you to order a quantitative serum beta hCG lab test to be drawn a couple hours after applying the cream to assess if you are absorbing any actual hCG. This can be ordered through my staff. Would be interesting for everyone if you shared your results.

Unfortunately, as others have stated, other formulations of HCG (transdermal, oral, sublingual) have proven to be ineffective. Try if you wish, but don’t have high expectations.

There are other variables that also contribute to whether or not a specific patient will need an AI beyond HCG dosage. The higher the dosage of HCG there can be further increase in estradiol, but often this is clinically relevant and more pronounced at much higher HCG doses than we use (eg...

True.

Indeed sleep apnea trashes neurotransmitters which can diminish just about every subjective “feeling” (including libido).

Welcome to the forum!

The key to Bernie’s post above is that he specifies “without symptoms” and “asymptomatic”. In Dr McClain’s defense, most on this site would routinely state “only treat high E2 levels if there ARE SYMPTOMS”, yet are disagreeing with Dr McClain’s decision here to NOT treat Bernie’s thyroid when...

Oh boy...I would bet you wouldn’t like the side effects of THAT regimen...women with breast cancer (whom are the only ones where that regimen would be appropriate) don’t like the side effects either!

Welcome to the team!

A trial of stopping HCG and then labs and subjective assessment at time of consult would be of clinical value.

Indeed...and it is a delicate balance. Especially considering the cost vs necessity ratio may be different for each individual case. Kudos for your proactive approach!

If you haven’t spoken to me yet, please do schedule your next consultation with me for review. You mentioned in a previous post that through your experience HCG may have provoked anxiety and rapid heart rate symptoms. Here’s a pearl of wisdom for the community and a less known fact - HCG is...

Yes that’s okay assuming site was sterilized properly.

Lol. I was just was over on PeakT and posted an additional response to your thread...then hopped over to EM and ran across this one. I’ll paste response below for the sake of continuity. Good work making use of both resources. Both forums present thoughtful, educated, and sometimes differing...

Took the words out of my mouth...I would wonder this as well. Also likely the threshold has been found on the lower end for your testosterone dosage/levels.