What is the best dose of HCG? Dr Saya presents two case studies.

CSI007 said:

Dr Saya,

I have a question regarding aromatization and HCG. If I start out on the very low end with my E2 (my values are very low end of "normal") does this lessen the likelihood of needing another drug to combat high levels of E2 as my T rises?

Please see my thread here:https://www.excelmale.com/forum/showthread.php?6424-Low-T-and-elevated-fasting-blood-sugar/page2

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Very difficult to answer with certainty as there are so many variables specific to each individual case, but...yes, in general, lower E2 (and lower E:T ratio) pre-treatment generally is a favorable predictor of possibly avoiding the need for E2 management during treatment.

Thank you, I was wondering about that for a while. nice write up BTW.

Dr Justin Saya said:

Very difficult to answer with certainty as there are so many variables specific to each individual case, but...yes, in general, lower E2 (and lower E:T ratio) pre-treatment generally is a favorable predictor of possibly avoiding the need for E2 management during treatment.

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Hi Dr Saya - This is great study. Thanks so much for sharing this.

Do you feel those with lower SHBG (mine is 23) would do better on lower amounts of HCG because of greater aromatization concerns? Does SHBG play into how your prescribe HCG at all?

Also, do you feel if someone is doing test cyp EOD for a total of 100mg a week is it best to do HCG EOD on those days or on the days in between the test? It seems like with the half lives it won't matter much after a couple weeks...but maybe I'm wrong?

Thanks

RoneTone said:

Hi Dr Saya - This is great study. Thanks so much for sharing this.

Do you feel those with lower SHBG (mine is 23) would do better on lower amounts of HCG because of greater aromatization concerns? Does SHBG play into how your prescribe HCG at all?

Also, do you feel if someone is doing test cyp EOD for a total of 100mg a week is it best to do HCG EOD on those days or on the days in between the test? It seems like with the half lives it won't matter much after a couple weeks...but maybe I'm wrong?

Thanks

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Hi RoneTone!

Yes, in a general sense, I prefer smaller more frequent injections of both T and HCG for lower SHBG guys (with some case specific exceptions).

When doing HCG injections EOD, it would not really matter which days you are doing them on in the grand scheme of things...unless you were a REALLY low SHBG guy, in which case even smaller DAILY injections would probably be better anyways (again with a few exceptions to account for many other factors at play).

Thank you very much for that. Even though n=2, it's still very useful information. Those advocating "micro" doses should similarly be able to back up that data, or at least not have such uncompromising clinical stances on the issue, bordering on dogma.

Thanks again Dr. Saya.

Dr. Saya,

In your experience, to what extent will 500 iu biweekly have on E2? I've heard of intratesticular aromatase being "stimulated" with high doses of HCG. Is there data to support that? Do you experience the necessity to add or increase AI's in patients taking, say, 500 iU HCG biweekly??

GA8314 said:

Dr. Saya,

In your experience, to what extent will 500 iu biweekly have on E2? I've heard of intratesticular aromatase being "stimulated" with high doses of HCG. Is there data to support that? Do you experience the necessity to add or increase AI's in patients taking, say, 500 iU HCG biweekly??

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I personally believe *most* guys will do fine without any special concern for disproportionate E2 increase in HCG doses up to 500iu BIW.

I've only seen disproportionate increases in E2 (i.e. increases in E2 above and beyond what would be expected by the increase in T levels from the HCG) with larger doses of HCG (had a guy last week from another clinic taking 1000iu BIW, had E2 level in the 80's with total T only in the 700's...not obese either, I would attribute that to the large HCG dosage). As long as guys stay at or below 500iu per injection (BIW...ONLY TIW if absolutely needed for fertility or atrophy reasons) most should be okay with respect to E concerns.

Dr Justin Saya said:

Hi RoneTone!

Yes, in a general sense, I prefer smaller more frequent injections of both T and HCG for lower SHBG guys (with some case specific exceptions).

When doing HCG injections EOD, it would not really matter which days you are doing them on in the grand scheme of things...unless you were a REALLY low SHBG guy, in which case even smaller DAILY injections would probably be better anyways (again with a few exceptions to account for many other factors at play).

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Thank you so much for taking the time to answer my question!

I'm doing 250IU EO2 at the same time as my T. Is that too much? It seems like you feel anything under 1000iu per week of HCG shouldn't cause too many sides, like high E2, yet still does its magic.

Also, I dose my AI same day, so all three at once. Is that how you would dose an AI? I only do .60mg per week and seems to keep my E2 in check.

RoneTone said:

Thank you so much for taking the time to answer my question!

I'm doing 250IU EO2 at the same time as my T. Is that too much? It seems like you feel anything under 1000iu per week of HCG shouldn't cause too many sides, like high E2, yet still does its magic.

Also, I dose my AI same day, so all three at once. Is that how you would dose an AI? I only do .60mg per week and seems to keep my E2 in check.

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250iu of HCG EOD is okay...certainly not too much.

When you are taking everything on an every other day basis, considering the half-lives involved, taking everything on the same days should work out fine for you and offer some added convenience as well as encourage compliance (i.e. not forgetting).

Dr Crisler put me on 100 IU HCG every day. Probably something to do with the fact my E2 is in the 60's but we added anastrozole and dim to get that down.

What is the typical increase in testosterone seen with the addition to HCG?

MikeXL said:

What is the typical increase in testosterone seen with the addition to HCG?

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Completely dependent on YOUR testes' ability to produce testosterone (and to what degree)...thus, another case of everyone is different!

It's been said by everyone, but not everyone has said it...so let me add my thanks for doing this study and posting the results. I was particularly interested in your take on them afterwards, so glad you added that.

I'm curious if you considered reversing the dosages on the two patients to see if the results would be similar. Anyway, thanks again. This was great info to add to the collective knowledge.

T-dog said:

It's been said by everyone, but not everyone has said it...so let me add my thanks for doing this study and posting the results. I was particularly interested in your take on them afterwards, so glad you added that.

I'm curious if you considered reversing the dosages on the two patients to see if the results would be similar. Anyway, thanks again. This was great info to add to the collective knowledge.

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Thanks T-dog. I did consider that during the initial planning, but decided not to pursue as both patients are very similar body fat % and used exact same injection technique. Interesting to think about nonetheless. Have since turned my attention to another study topic. Perhaps will have some updates in a few months.

Any updates about new candidates on new HCG studies ?

Any updates?

Are there any advantages on doing HCG on the same day of T cyp? or is it better to do it before of after the T cyp injection day? I'm doing 2x a week 500 UI on the days I inject T cyp (80mg twice a week), and I've notice significant testicular shrinkage. So I was wondering if there is something with timing that can help with testicular shrinkage.

sebco said:

Are there any advantages on doing HCG on the same day of T cyp? or is it better to do it before of after the T cyp injection day? I'm doing 2x a week 500 UI on the days I inject T cyp (80mg twice a week), and I've notice significant testicular shrinkage. So I was wondering if there is something with timing that can help with testicular shrinkage.

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You personal case would need a new thread with your labs posted for a substantive conversation, this thread isn't the place for personal issues like what you're asking.

Vince Carter said:

You personal case would need a new thread with your labs posted for a substantive conversation, this thread isn't the place for personal issues like what you're asking.

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go it...forgetting about my personal case. Given the life of HCG injections and the life of T Cyp in the system, has there been any studies to improve effectiveness on HCG on TRT protocols? You would think that if you time the peaks of both HCG and T cyp on the same day or on different day, effects on testicular health would be different.

Timing was only ever an issue when (or if) you were on once a week injections where they would instruct HCG on day 5 and/or 6 where you could get a bump of Endo T to bridge to the next injection but really only ever applied to that kind of scheme and those that know have moved past the once weekly injections years ago. Otherwise there is no timing issue around Exo T.