Yikes...LH/FSH horrible!

Just got in my first blood test post starting TRT.

My Serum T was way up (original 127) to 682
Free T up from 6.5 to 21.8

But LH dropped from 2.7 pre TRT to 0.1
FSH dropped from 4.8 to 0.2
Estradiol up from 5.5 to 34.2

I'm on 150 test cyp/wk
500 hcg 2x a week.

But I've asked to switch pharmacy b/c I didn't feel like the HCG I was getting was working.
SHBG test was not ordered by the doc

Any advice would be greatly appreciated.

aaron4liberty said:

Just got in my first blood test post starting TRT.

My Serum T was way up (original 127) to 682
Free T up from 6.5 to 21.8

But LH dropped from 2.7 pre TRT to 0.1
FSH dropped from 4.8 to 0.2
Estradiol up from 5.5 to 34.2

I'm on 150 test cyp/wk
500 hcg 2x a week.

But I've asked to switch pharmacy b/c I didn't feel like the HCG I was getting was working.
SHBG test was not ordered by the doc

Any advice would be greatly appreciated.

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Your LH and FSH are SUPPOSED to drop to nothing when exogenous testosterone is administered. Its exactly what should take place.

ok thanks...to that low a level? How would I know if the HCG I'm using is working? I don't feel like it is at all.

What do you think you are supposed to "feel" from HCG? The only purpose of HCG is to keep your testicles from shrinking while on TRT. Some men have little to no shrinkage even without HCG, most do to some degree or another.

I may be mistaken but it also could help keep Leydig cells in the testes active (as opposed to test without HCG which shuts down testes) for a longer time under TRT. Thus possibly enabling a quicker return to natural T levels and sperm "potency" if and when one had to discontinue testosterone therapy.

aaron4liberty said:

ok thanks...to that low a level? How would I know if the HCG I'm using is working? I don't feel like it is at all.

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Your body is no longer producing either LH or FSH - as long as you administer exogenous testosterone it won't. It can't. All of us on TRT are shut down.

What were you told HCG would do? It is used to maintain testicular vitality and support upstream hormones impacted by your shutting down LH and FSH. The vast majority of men, it would seem, have little to report in terms of subjective response.

prevent testicular shrinkage..I'm aware it doesn't "do" anything as far as "feeling"..taking HCG hasn't stopped that at all..so I requested different pharmacy as a couple posts on here indicated they had same "non-effect" from the pharmacy I'm getting my HCG from. (United).

aaron4liberty said:

prevent testicular shrinkage..I'm aware it doesn't "do" anything as far as "feeling"..taking HCG hasn't stopped that at all..so I requested different pharmacy as a couple posts on here indicated they had same "non-effect" from the pharmacy I'm getting my HCG from. (United).

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I inject 500iu of HCG twice a week, if the amount of HCG is not working you need to increase your dose.

Vince said:

I inject 500iu of HCG twice a week, if the amount of HCG is not working you need to increase your dose.

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maybe, maybe ne...remember you're one of the unicorns here that HCG makes them feel this and that like libido and well being. HE may just be in a larger pool of us that as he's experiencing, HCG contributes nothing to our protocol.

Vince Carter said:

maybe, maybe ne...remember you're one of the unicorns here that HCG makes them feel this and that like libido and well being. HE may just be in a larger pool of us that as he's experiencing, HCG contributes nothing to our protocol.

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Yes I know many men do not feel good with HCG, my response was just for increasing testicle size.

Your estrogen levels have gone up considerably compared even to your T levels, so that indicates the HCG is probably at work. I would drop the hcg and see how you do without it. As far as LH and FSH, your suppression will be even deeper (if possible) while taking hcg with TRT.

CoastWatcher said:

Your body is no longer producing either LH or FSH - as long as you administer exogenous testosterone or HCG it won't. It can't. All of us on TRT are shut down.

What were you told HCG would do? It is used to maintain testicular vitality and support upstream hormones impacted by your shutting down LH and FSH. The vast majority of men, it would seem, have little to report in terms of subjective response.

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Note the bolded underlined.

CoastWatcher said:

Your body is no longer producing either LH or FSH - as long as you administer exogenous testosterone it won't. It can't. All of us on TRT are shut down.

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Well, not all of us. Despite taking 200mg a week (split dose), my FSH and LH remain fairly high.

I wish everyone would put in the normal range for the lab results right after the actual results are given. Also, total testosterone can be misleading and the value of free testosterone is more helpful. Thank you for including that but again include normal range in the future. The LH &#8595; in men on TRT (testosterone replacement therapy) is a desired Biological End Point (BEP) and FSH routinely drops as well. In contrast, in hypogonadal men both values are elevated (i.e., simulating female menopause). The estradiol level is high normal for most labs (usually normal range < 40). The doses you are using of testosterone cypionate and HCG are reasonable.

Not sure how you judged the HCG in order to make the decision to change pharmacies.

The bottom line is that you are supposed to have suppression of LH and FSH while on TRT (testosterone replacement therapy). The key issue as I see it is the dose of HCG in order to prevent testicular atrophy (shrinkage) and in some men penile atrophy as well as maintaining spermatogenesis. Some studies indicate that even lower doses of HCG every other day might be sufficient. I am looking for a peer-reviewed paper on serum HCG levels and how they relate to maintaining intratesticular testosterone (ITT) that correlates with not only normal spermatogenesis but prevention of testicular atrophy.

My focus in medicine is prostate cancer (PC) and have been in this field x 35 years. I was one of a handful of American collaborators with Fernand Labrie using LHRH-agonist + anti-androgen in treating PC. In contrast, your values of LH & FSH despite not being in the proverbial "basement" are not fairly high. But, given the TRT (testosterone replacement therapy) dose you are using I would have expected more suppression of the hypothalamic-pituitaryl axis (HPA). My first thought is what lab are you using? My question to others on TRT would be what are your levels of LH and FSH. I normally check free and total testosterone, estradiol, PSA, prolactin in men on TRT and focus on those values rather than routinely check LH and FSH. It would be of value to know how suppressed many of you are on TRT. I did post a reply to aaron4liberty who was worried that his LH &#8595; to 2.7 & FSH to 0.1 on TRT. I think those are reasonable values to have on TRT. Most often, my PC patients on LHRH-agonist therapy + an anti-androgen have LH values of < 1.0

Vince said:

I inject 500iu of HCG twice a week, if the amount of HCG is not working you need to increase your dose.

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How does one know HCG is working? Is there something in the blood work that indicates HCG is working when on TRT?

DragonBits said:

How does one know HCG is working? Is there something in the blood work that indicates HCG is working when on TRT?

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The only way I know that HCG is working, is by increasing ( if small from TRT ) or keeping full testicles. Some men need HCG to keeping their libido strong others don't. I started HCG the same time I started testosterone, injecting 500 IU twice a week.

HCG keeps your natural production of Testos, so the wouldn't it add to what you inject making the total higher? Meaning with HCG you should be able to inject less testosterone. But obviously hard to determine.

And the trough level should also be higher. Though you would have to come off and on TRT to really see it in the blood work.

After I came off of Nebido, a fertility doctor did say there was some mild testicular atrophy, but it wasn't obvious to me, maybe it was too gradual.


Not sure how something like prolactin is affected by all of this, I have no idea what my level of prolactin, pregnenolone , cortisol or progesterone is as I have never order those sorts of tests.

Thanks, I was just wondering if HCG was somehow obvious from looking at blood work. It also occurs to me that when some men say HCG has a negative effect, it might not be the HCG it might be increase estrogen from the higher total testosterone.