HCG Mono - Daily Dosage Question

[_whatsinaname_]

Starting HCG mono soon, but wondering if the prescribed plan of 300iu ED is too high. It seems the more common approach is to pin a lower dosage ED or a higher dosage every few days.

For those of you who've tried (or are currently on) a HCG mono plan, did you progressively ease into your prescribed plan (e.g., doc ordered you do 300iu ED, but you started off doing it EOD or maybe a lower dosage ED to see how it went) or did you just jump right into it?
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Background

• 35 years old
• 6'3"
• 185lbs
• Symptoms: low sex drive, constant fatigue, depression, low energy, spotty memory, poor focus

Pre-HCG Test Results

• Testosterone, Serum: 289 ng/dL
• Free Testosterone (Direct): 12.4 pg/mL
• Dihydrotestosterone: 26 L ng/dL
• DHEA-Sulfate: 193.2 ug/dL
• TSH: 3.240 uIU/mL
• LH: 8.0 mIU/mL
• Prolactin: 10.3 ng/mL
• Prostate Specific Ag, Serum: 0.6 ng/mL
• Insulin-Like Growth Factor I: 117 ng/mL
• Estradiol, Sensitive: 24.7 pg/mL
• Sex Horm Binding Glob, Serum: 31.5 nmol/L

Prescribed Plan

• HCG 300iu, sub-Q ED (was originally prescribed to take 15mg of Clomid ED; chose to try HCG mono instead due to my history of floaters)
• Anastrozole 0.125 mg, EOD (take only if needed)

 

[Vince Carter]

No one around here that I can think of uses HCG in a monotherapy, but as an adjunct to Testosterone therapy.
Your LH/FSH and testosterone indicate that you're primary hypogonadal and that means your testes are the problem and using HCG to stimulate the testes is unlikely to do anything to help you.

Your Dr should know this. Is it going to hurt to try? no, but set your expectations very low and the more likely thing that will happen is you'll have an Estrogen problem. An AI is much less effective in that testicular environment, too.

You have a very poor Dr.

 

[ZizshitWork]

Well Vince, if this helps you as a reference only, Defy has me on HCG mono (500 eod), but, if I could afford to at some point, I've been given an alternate protocol with TestCyp.
That said, I'm certainly the wrong person to use as an example of what does or doesn't work.
For the OP, I was on 300 eod with the TestCyp and just went to the 500 a while after running out of TestCyp but my body doesn't seem to like it. It does tolerate 400 better. If that helps.

 

[_whatsinaname_]

Thanks for your response, Vince. The plan was prescribed via Defy. I went with them given the good rep they seem to have here and in other forums.

Not setting my hopes up too high on the potential benefits. I'm more concerned about the negative side affects at this point, with E2 issues being at the top. Suppose I'll see how things go and assess whether TRT + HCG is a viable next step should HCG mono not work out.

 

[Gene Devine]

Generally speaking, HCG monotherapy is not very effective in increasing endogenous Testosterone serum levels to optimal levels...it it did we'd all be on it and not TRT unfortunately...just the reality.

 

[Vince Carter]

Generally speaking, HCG monotherapy is not very effective in increasing endogenous Testosterone serum levels to optimal levels...if it did we'd all be on it and not TRT unfortunately...just the reality.

Spot on...thanks Gene

 

[Gman86]

Ya HCG mono is worth a shot I guess, but definitely don’t have too high of hopes. For me, the problem with HCG is that not only does it raise E2, but it also raises prolactin. I’ve never had itchy nipples on TRT even when E2 was 70. When E2 was around 50 on HCG mono, I used to scratch my nipples until they would bleed, due to the increased prolactin.

Also, endogenous testosterone production is just not consistent with HCG. I used to get a ton of endougenous production with HCG, now I get extremely little, if any at all. HCG can also lose potency over time. So the endogenous production it can give you when you crack open a new bottle can be different than a month or two later. And the body doesn’t like fluctuating hormone levels, so I just don’t think it’s the best when trying to reach consistent levels of testosterone.

Lastly, I’ve had different results using different brands. So there’s just a lot of reasons why HCG mono isn’t the best option, imo. With testosterone, you avoid all of these issues. It’s consistent, doesn’t excessively raise prolactin, it doesn’t lose potency, and any pharmacy grade testosterone is going to pretty much give the same results regardless of the brand.

 

[Gman86]

To answer your original question though, I think 500iu’s EOD is a really good dose for HCG mono. When I was on 500iu’s EOD, my total testosterone level was around 1200. I had blood work tested on that dose twice, and the labs were 2 months apart. Labs on 12-30-15 had my total at 1185, and labs on 2-11-16 had my total at 1193. And I had labs done on 4-12-16 while on 250iu’s EOD, and my total came back at 579. All those labs were while using Pregnyl HCG.

 

[BigBamBoo]

Well Vince, if this helps you as a reference only, Defy has me on HCG mono (500 eod), but, if I could afford to at some point, I've been given an alternate protocol with TestCyp.
That said, I'm certainly the wrong person to use as an example of what does or doesn't work.
For the OP, I was on 300 eod with the TestCyp and just went to the 500 a while after running out of TestCyp but my body doesn't seem to like it. It does tolerate 400 better. If that helps.

Just a FYI. You can get 10ml vials of Test C from Walmart for around $35.00.
Defy will send the script to them for around $25. For under $75.00 you have T that will last you 3-5 months depending in dose and protocol.

I go through a local walk in clinic that fills my script for $27 and then take it to Wally World.

Last I checked, HCG was more than that through Defy.

 

[Gman86]

Just a FYI. You can get 10ml vials of Test C from Walmart for around $35.00.
Defy will send the script to them for around $25. For under $75.00 you have T that will last you 3-5 months depending in dose and protocol.

I go through a local walk in clinic that fills my script for $27 and then take it to Wally World.

Last I checked, HCG was more than that through Defy.

That’s a good point as well. I forgot about cost

 

[fifty]

Just a FYI. You can get 10ml vials of Test C from Walmart for around $35.00.
Defy will send the script to them for around $25. For under $75.00 you have T that will last you 3-5 months depending in dose and protocol.

I go through a local walk in clinic that fills my script for $27 and then take it to Wally World.

Last I checked, HCG was more than that through Defy.

What states will this work in?

 

[BigBamBoo]

What states will this work in?

I would guess every state? If you have a prescription from a doctor, why would a pharmacy not fill it?

I use a local walk in clinic who does prescription refills and it only cost $27 dollars.
I use the goodRX coupon and go to Walmart where it cost about $35 for a 10ml vial of Test C.

 

[fifty]

I have heard you have to be in FL. I can’t remember where I read this. Otherwise why would anyone buy test for $120?

 

[BigBamBoo]

Probably because they they think that as well.

It would be worth a call to Defy.

And again, if you can establish a relationship with a local doctor, that works as well.

I just take in my latest labs and give them to the doctor at the walk in clinic and it is easy.

I was on an antibiotic one time and was in another state. I needed to get it refilled so I called my doctor. He sent the script to the local Rite Aid where I was.
Why would Testosterone be any different from any other controlled drug?

 

[zat954]

I am both a new patient to Defy (as of Oct), and am on a high dose of HCG monotherapy. By high dose, I mean 2500iu EOD, with 25mg of Enclomiphene. Before anyone jumps at that dosage, it is important to understand my goal, which in conjunction with Dr. Saya, is regaining fertility at 40 after over a decade of TE overuse/abuse. I am a Functional Medicine practitioner, so I did a great deal of research on all the relevant data before starting this dosage and started on my own for 90 days before presenting both my labs and this Data to Defy.

For many years I was not sure I wanted kids, and I have never had issues with any side effects, so my dosage generally kept me over 2000ng/dl TT, 350ng/dl BAT, SHBG 20, and E2 around 45. I never really was bothered by that E level, most likely because my TT/BAT was so high.

In June I stopped the TE, and began the regimen above for 90 days, running labs in early Oct.
My labs after the 90 days, taken just prior to speaking with Dr. S were:

TT 1125ng/dl High
FT 129pg/ml
LH 1.1 Low
FSH 4.5
DHEA 128
SBGH 48 (in range but too high for my liking)
E2 10pg/ml VERY LOW
All other numbers were good.

I am 40, 6'2, 210, probably around 12-15%bf

A few caveats..... My dose was approved by Defy to be continued based on my research and goals. The literature generally suggests from 1500iu up to 10,000iu 3xWK for people in my situation, with very good success. Also, while my E2 is very low, the logic here is that researchers now believe it is not the HCG dosage itself that downregulates LH receptors, but the E2 dosage.

Subjective differences:
After just over 4 months on this regimen, I notice no real loss of strength or mass, noticeable increase in testicular atrophy, an overall sense of calmness and well being. That said my motivation to train, as well as my libido, are not good. Now this could be a result of the low E2, or it could be due to current stress levels due to school, and the fact I am 4 months out from 10 years of being on SUPERHUMAN test levels, so I am just feeling what a normal 40yo feels. I am considering easing up slightly on the SERM to get E2 up around 20-30. I am very pleased with my TT after only 90 days of HCG, considering how long I was suppressed.

Now all that said, once I run a semen analysis next month, I will make adjustments, and once my boys are good I plan to bank enough to start my own army of mini-me's and jump back on T with Dr. Saya's guidance, because I did feel stronger and my libido was better (obviously). I will also stay on a low dose of HCG during so I don't suppress again. I'm not sure what your background or goals are, but make sure you preserve your fertility at all costs if you want kids.

Also, I disagree that your labs indicate that your problem is with the testes. That MAY be the case as your LH is high, however with only one lab draw it is hard to know if your T was not previously lower and the body is just now starting to ramp up the LH to get it up. You need multiple labs demonstrating consistently high/normal LH/FSH and low T to know for sure. One snapshot doesn't tell the whole story. Just my 2c, but wanted to let you know HCG monotherapy is and can be done effectively depending on the desired goal. To say its the best option or a long-term option for you or anyone else is debatable and very individualized

 

[Gman86]

I am both a new patient to Defy (as of Oct), and am on a high dose of HCG monotherapy. By high dose, I mean 2500iu EOD, with 25mg of Enclomiphene. Before anyone jumps at that dosage, it is important to understand my goal, which in conjunction with Dr. Saya, is regaining fertility at 40 after over a decade of TE overuse/abuse. I am a Functional Medicine practitioner, so I did a great deal of research on all the relevant data before starting this dosage and started on my own for 90 days before presenting both my labs and this Data to Defy.

For many years I was not sure I wanted kids, and I have never had issues with any side effects, so my dosage generally kept me over 2000ng/dl TT, 350ng/dl BAT, SHBG 20, and E2 around 45. I never really was bothered by that E level, most likely because my TT/BAT was so high.

In June I stopped the TE, and began the regimen above for 90 days, running labs in early Oct.
My labs after the 90 days, taken just prior to speaking with Dr. S were:

TT 1125ng/dl High
FT 129pg/ml
LH 1.1 Low
FSH 4.5
DHEA 128
SBGH 48 (in range but too high for my liking)
E2 10pg/ml VERY LOW
All other numbers were good.

I am 40, 6'2, 210, probably around 12-15%bf

A few caveats..... My dose was approved by Defy to be continued based on my research and goals. The literature generally suggests from 1500iu up to 10,000iu 3xWK for people in my situation, with very good success. Also, while my E2 is very low, the logic here is that researchers now believe it is not the HCG dosage itself that downregulates LH receptors, but the E2 dosage.

Subjective differences:
After just over 4 months on this regimen, I notice no real loss of strength or mass, noticeable increase in testicular atrophy, an overall sense of calmness and well being. That said my motivation to train, as well as my libido, are not good. Now this could be a result of the low E2, or it could be due to current stress levels due to school, and the fact I am 4 months out from 10 years of being on SUPERHUMAN test levels, so I am just feeling what a normal 40yo feels. I am considering easing up slightly on the SERM to get E2 up around 20-30. I am very pleased with my TT after only 90 days of HCG, considering how long I was suppressed.

Now all that said, once I run a semen analysis next month, I will make adjustments, and once my boys are good I plan to bank enough to start my own army of mini-me's and jump back on T with Dr. Saya's guidance, because I did feel stronger and my libido was better (obviously). I will also stay on a low dose of HCG during so I don't suppress again. I'm not sure what your background or goals are, but make sure you preserve your fertility at all costs if you want kids.

Also, I disagree that your labs indicate that your problem is with the testes. That MAY be the case as your LH is high, however with only one lab draw it is hard to know if your T was not previously lower and the body is just now starting to ramp up the LH to get it up. You need multiple labs demonstrating consistently high/normal LH/FSH and low T to know for sure. One snapshot doesn't tell the whole story. Just my 2c, but wanted to let you know HCG monotherapy is and can be done effectively depending on the desired goal. To say its the best option or a long-term option for you or anyone else is debatable and very individualized

Was that an error when you wrote that you have “a noticeable increase in testicular atrophy” while on this protocol? Did you mean to say decrease in testicular atrophy, or did this protocol really decrease the size of your testicles. Because I would obviously think your testicles would be HUGE on this protocol lol.

Also, I’m surprised your DHEA level is so low on this protocol. When I was on HCG mono, at only 500iu EOD, my DHEA always came back over the top of the range due to the backfilling that HCG did. Now that I’m on TRT, my DHEA is about half of what it was on HCG mono. With your dose of HCG, I would of thought your DHEA would be much higher. You’re actually very deficient, and should probably look into getting it up. I’m very surprised Dr. Saya didn’t address it after looking at these labs. DHEA has also been known to increase E2 when using moderate to high doses, so it might actually be a good way to kill two birds with one stone for you. Get DHEA levels into a healthy range, and also give you that E2 increase that you’re looking for.

 

[zat954]

Was that an error when you wrote that you have “a noticeable increase in testicular atrophy” while on this protocol? Did you mean to say decrease in testicular atrophy, or did this protocol really decrease the size of your testicles. Because I would obviously think your testicles would be HUGE on this protocol lol.

Also, I’m surprised your DHEA level is so low on this protocol. When I was on HCG mono, at only 500iu EOD, my DHEA always came back over the top of the range due to the backfilling that HCG did. Now that I’m on TRT, my DHEA is about half of what it was on HCG mono. With your dose of HCG, I would of thought your DHEA would be much higher. You’re actually very deficient, and should probably look into getting it up. I’m very surprised Dr. Saya didn’t address it after looking at these labs.

Yes sorry that was a mistake. I meant a reversal in testicular atrophy. My DHEA was in range, but yes a little low. Dr. Saya put me on 50mg a day DHEA, as that may also lower my SHBG and increase some FT. I am considering lowering the Enclomiphene to 12.5mg/ day, or just switching over to a low dose Arimidex, which he said was an option. Remember, not only is everyone different in how they metabolize, but my starting point, goals and HCG regimen probably have something to do with the SHBG and DHEA levels, which were roughly the same on high dose TE (SBGH was a little lower). Fortunately, I've never been a real big aromatizer, so I probably will lower and switch, but again my goal is to keep the LH receptors running until my fertility returns. I am supposed to get a semen analysis but I'm in the middle of the last 4 weeks finishing up a thesis, so I just haven't gotten there yet. Again, this is not a long-term plan, simply a blitz to get some swimmers and put them on ice. I know Dr. Saya knows his stuff which is why I sought him out, and while he was agreeable to my dosing for these goals, I know he doesn't like the HCG that high or my E2 that low.

 

[Gman86]

Oh that’s good that he addressed the low DHEA. Are you getting your DHEA through a compounding pharmacy or are you just going to buy an OTC brand. I also see Dr. Saya, and it’s looking like I might end up needing DHEA soon, so I’m just curious.

That’s interesting about DHEA possibly lowering SHBG, I didn’t know that. I usually have a high SHBG, so that would be a nice secondary benefit if I end up using it. Right now I’m using exemestane to lower my E2 a bit, and a secondary benefit to exemestane is that it lowers SHBG. That’s why I use it over anastrozole.

But ya hopefully your protocol yields some positive results in the fertility department. Best of luck to ya.

 

[zat954]

Yes Im getting everything through Empower as of now. I was not aware of the DHEA ability to potentially lower SBGH either. I have been really pleased with the results of the enclomiphene, but I would prefer to switch to an AI and save the Enclomiphene for down the road if I come off the HCG. I was not aware exemestane did that either. I appreciate the kind words and input.... I feel pretty confident it will be fine based on all the studies I have seen, and FSH is always an option down the road worst case. I had a pregnancy scare when I was 22 and unfortunately my gf at the time was too afraid to tell her parents, and we ended up going through that process. It was rough, and part of the reason I went on TE so aggressively for so many years, but the good news is that at one point I was fertile so I believe its just a matter of time. Thanks Gman

 

[Gman86]

Ya I was going to mention that worst case scenario Empower sells FSH, and you can always add that to the mix. There was another guy recently on here that ended up implementing FSH and was able to get his wife pregnant. So it’s nice to have options.

What’s TE by the way? I feel stupid for asking, but I just can’t figure out the acronym lol.