Bummed out now...After successful start with HCG monotherapy

[CSI007]

OK Folks,
Bummed out right now. Had blood drawn Last Friday at around 7:45am - Less then 24 hours after taking 400iu of a fresh"ish" (bottle was about a week old mixture) batch of HCG.

Here are the results:

T - 343.1 348-1197
Free T 7.3 6.8 - 21.5
E (Sensitive) 13.7 8-35

This is after about a week and half of EOD 400iu subq - changed from 500iu e3d.

Any suggestions? Comments etc?

The last test showed that my LH and FSH had dropped off significantly from the last test.

Is it time to give up on the HCG mono and move on to T (After I finally get that brain MRI) Or should I increase the dosage to something higher? I don't want to over do it though...But after that initial surge of T from when I first started treatment something obviously is not working any more. I could already tell things were going south after feeling much better and diminishing ED symptoms etc.

Help!

 

[CSI007]

Oh and my FBG was 118 again. My A1C has crept up to 6.0 again from 5.9 a year ago.

I guess some good news is my cholesterol.

LDL-C is 52 mg/DL
Non-HDL is 60 mg/DL

 

[Vince Carter]

Sounds about typical, HCG mono really doesn't hold up as an effective treatment option that I'm aware of.

 

[CSI007]

I have read similar things, but the Docs here seem to have good results with mono-therapy. Mine is not mirroring their treatment plans exactly though.

 

[Re-Ride]

Time for TRT. Said that two? weeks ago. You can continue hCG at a lower dose.

 

[CSI007]

It might be that time, however, I took my blood test 3.5 days after an injection last time so I was not certain that my level was lower because of that or not.

Dr. Saya from my previous thread:

"Lost" effectiveness is too strong of a term. However, I have seen that the testicular response to HCG monotherapy seems to vary over time (both up and down) similar to how the testicular response to endogenous LH seems to vary over time. There is no evidence of testicular "desensitization" at appropriate HCG dosages. Getting older (aging of the testes) will also affect the testicular response (to HCG or LH) over time.

I just don't understand why the HCG had a decent impact would then lessen over time. I believe that my dosages were not extreme (500iu E3D)

Just not ready to give up on it yet. Perhaps Dr Saya can shed some light on the subject for me.

 

[Ardoc]

That amount of HCG isn't much different from what many of us take as a SUPPLEMENT to TRT. Your 400IU EOD = 1400IU/week and 500IU E3D= 1166IU/wk. I take 500IU E3.5D = 1000IU/week ON TOP of 80MG Test Cyp 2 x/week (for a total of 160MG/week).
I have never done MCG mono-therapy but always thought that the needed amounts were much higher than that?
I would guess that any initial benefit was from the HCG essentially "boosting" your testosterone but once that caused your own production to shutdown you are essentially back where you started... test level wise?

 

[CSI007]

One thing above and beyond the T issue for me is my cholesterol and ferritin levels. The LDL is crazy low for someone with my weight and lifestyle. Ever since I went to a low carb lifestyle it has been dropping but why so significantly recently? The ferritin keeps slowly climbing now now above 500 while my iron levels are perfectly normal.

Given my history of Hodgkins this is really starting to worry me. I know that Hodgkins patients frequently have elevated levels of ferritin and low LDL values. At this time I have no symptoms that I recognize as obvious in this regard though.

 

[CSI007]

That amount of HCG isn't much different from what many of us take as a SUPPLEMENT to TRT. Your 400IU EOD = 1400IU/week and 500IU E3D= 1166IU/wk. I take 500IU E3.5D = 1000IU/week ON TOP of 80MG Test Cyp 2 x/week (for a total of 160MG/week).
I have never done MCG mono-therapy but always thought that the needed amounts were much higher than that?
I would guess that any initial benefit was from the HCG essentially "boosting" your testosterone but once that caused your own production to shutdown you are essentially back where you started... test level wise?

Thanks for the reply. Yes, Dr Saya actually mentioned that as a possibility in my other thread. Once the natural production shutdown I was no longer helping matters internally. This is one of the reasons I increased to 400iu EOD.

My T levels had dropped as low as 280s before I started HCG. My first test latae last year I was about 328 or so.

A month ago I was 358 - 3.5 days after HG injection and now the day after an injection I am at 343.

 

[Dr Justin Saya MD]

Certainly review the previous discussion about gradual shutdown of endogenous LH/FSH as noted. This process fits with your clinical description and lab response. You've got considerable room to still go UP on the HCG dosing for MONOTHERAPY purposes, especially considering your E2 is still low. Some guys need significantly more HCG for monotherapy purposes. The majority do okay with a DAILY regimen of 200-400iu (I prefer daily for monotherapy purposes), however I've had them up to 500iu daily for added response as long as E2 cooperates.

If higher dose HCG monotherapy doesn't cut it, you'll indeed need to consider TRT + HCG more seriously.

 

[CSI007]

Thank you Dr Saya,

My biggest concern is breaking the boys downstairs by taking too much and turning things off for good. I am willing to increase the dosage and go daily if need be. But from what you are saying, it sounds like I am simply just not "stacking" the LH anymore to get the T values I had a few months ago.

If I go to 400iu every day, how soon should I wait before testing again to see if there is a positive response? Also, the day that I do test should I inject before I leave to get tested or wait til after?

As of now I have been injecting in the morning when I wake up.

I am still going to get my MRI in the next couple of weeks just to rule out a tumor. Since my thyroid and sugar is somewhat out of whack. If I increase the HCG I just don't want to turn the leydig cells off if its a simple matter of fixing the pituitary gland by removing or decreasing the size of a tumor.

 

[Dr Justin Saya MD]

Thank you Dr Saya,

My biggest concern is breaking the boys downstairs by taking too much and turning things off for good. I am willing to increase the dosage and go daily if need be. But from what you are saying, it sounds like I am simply just not "stacking" the LH anymore to get the T values I had a few months ago.

If I go to 400iu every day, how soon should I wait before testing again to see if there is a positive response? Also, the day that I do test should I inject before I leave to get tested or wait til after?

As of now I have been injecting in the morning when I wake up.

I am still going to get my MRI in the next couple of weeks just to rule out a tumor. Since my thyroid and sugar is somewhat out of whack. If I increase the HCG I just don't want to turn the leydig cells off if its a simple matter of fixing the pituitary gland by removing or decreasing the size of a tumor.

Give it 4 weeks and then retest. Yes, take your injection that morning of lab draw as usual. Get the MRI ASAP and report results. I think you're worrying too much about "shutting down your testes" at this point. Not going to happen with these dosages and this time span. From your info your pituitary is already suppressed, though this is expected. Neither of these will even matter if you ultimately end up on TRT, but continue with your work-up of other factors in a timely manner.

 

[CSI007]

Thanks again for the assistance. I REALLY do appreciate your input A LOT!!! You have certainly put my mind at ease today. I will post my MRI results as soon as I get them. Then report back on the T and Estradiol values.

Oh, one more thing regarding the MRI. For about the past two years, my eye doctor has not been able to correct my right eye to 20/20 which he has been able to do perfectly previously. He did an eye nerve test and did not see anything that would indicate nerve pressure from a growth. It has got him stumped - Just thought I would throw that out there.

 

[Dr Justin Saya MD]

Thanks again for the assistance. I REALLY do appreciate your input A LOT!!! You have certainly put my mind at ease today. I will post my MRI results as soon as I get them. Then report back on the T and Estradiol values.

Oh, one more thing regarding the MRI. For about the past two years, my eye doctor has not been able to correct my right eye to 20/20 which he has been able to do perfectly previously. He did an eye nerve test and did not see anything that would indicate nerve pressure from a growth. It has got him stumped - Just thought I would throw that out there.

The pituitary gland sits right between the optic chiasm (where the optic nerves cross in the brain). Pituitary enlargement or growths can cause visual symptoms, but often bilateral. Not likely the cause, but again - get that MRI done to rule it out/in.

 

[CSI007]

Will do! I will make the appointment soon.

 

[CSI007]

One last thing I forgot to ask about. Have you found that body size or weight have an impact on dosing?

 

[Dr Justin Saya MD]

One last thing I forgot to ask about. Have you found that body size or weight have an impact on dosing?

None whatsoever for our doses/purposes.

An interesting study here:

http://m.humrep.oxfordjournals.org/content/18/11/2294.long?view=long&pmid=14585876

Showed some differences between IM vs SQ and some hint of poorer bioavailability in obese FEMALES. Important note - this was with a single megadose of HCG (10,000iu all at once). I don't really believe there is much, if any, relevance for our TRT or HCG monotherapy dosages/routes.

 

[CSI007]

None whatsoever for our doses/purposes.

An interesting study here:

http://m.humrep.oxfordjournals.org/content/18/11/2294.long?view=long&pmid=14585876

Showed some differences between IM vs SQ and some hint of poorer bioavailability in obese FEMALES. Important note - this was with a single megadose of HCG (10,000iu all at once). I don't really believe there is much, if any, relevance for our TRT or HCG monotherapy dosages/routes.

Very interesting article. Thank you.

 

[CSI007]

My Doctor has given the go ahead to move forward with this new protocol. Will continue 400iu daily for the next month nd re-test. If there is movement up, but not enough may increase to dosage again at that time. If there is no movement or a decrease, we'll be looking at doing the same thing and retest again in another month. If no movement then TRT.

Incidentally I started giving myself the extra shot on 9/15 so I have had 4 days of 400iu so far for a total of 1600iu in 4 days.

I think I may switch back to 31 gauge needles though. The 28 gauge are starting to have a less then ideal affect on my stomach.

 

[CSI007]

Wow!

Just wow!

Woke up this morning with a nasty headache. Was out most of the day. Came home, had dinner went for a 1 mile walk with my oldest. Around 9pm started having muscle aches, headache came back. The boys downstairs started to ache like crazy. Then about an hour ago it was like I was hit with major endorphins or something. I mean, wow! I had a similar feeling about 2 weeks into starting HCG then it faded. But not intense and strong like this! Not to be graphic, but I took full advantage of the situation.

Penis was pretty much dead again 5 days ago. Little to no feeling etc. Tonight it was like it was over a year ago! Almost anyway. If I can add to this about another 25 to 50% I will be back to were I need to be in the sensitivity department. Usually any feeling that I did have would be gone after 3 to 5 minutes of intercourse. Not the case tonight. Still had feeling after 15 minutes to 25 minutes.

Was this a serious rush of testosterone into my system or am I about to die or something. It's 1:30am in the morning and I feel like I need to go pump iron or run a marathon!

It was like a switch was turned on.

Is this what you guys feel when you start out on injections of T?