HCG monotherapy and recovering the HPTA axis

[SMOS44]

I am 36 with total T ranging from 350-400 ng/DL over several tests in the past twelve months. Other relative datapoints: SHBG is low (16.6, reference range: 16.5-55.9), LH at a decent level (6.8, reference range: 1.7-8.6).

I told the doctor that I wanted to try Natesto/Troches, but he recommended against Natesto (he finds patients don't do well with the application) and instead wanted to try HCG monotherapy. He suspected that because I had low SHBG and decent LH levels I might produce a solid amount of T in a day, but that it is metabolized quickly. I guess HCG Monotherapy will allow us to see what is left in the tank for my testicles and also might raise my SHBG? This doctor is young (recently educated) and specializes in this field and appears to be very well-regarded and knowledgeable.

I understand that HCG will disrupt my HPTA. He was very confident that my HPTA would kick back up in less than a week if I decide to stop HCG. Are there any examples where someone around my age didn't FULLY recover their HPTA following HCG Monotherapy? I don't want to recover 70% (for example) and have suboptimal LH/FSH/GNRH/Kisspeptin production after this 6-8 week experiment.

Interestingly: he also sent over a script for Tlando so that I could see how higher T temporarily felt. The idea is that it might help me identify symptoms or better feel what is optimal. I am to try that after getting blood work on HCG monotherapy. Just a side note.

 

[FLguy123]

What did you end up trying?

 

[SMOS44]

I did HCG mono therapy, see this thread: HCG Monotherapy experience (just sharing)

 

[Flexedup]

I'm getting off my HCG monotherapy next week and will be attempting an aggressive gonadotropin restart by using 50mg of Clomid daily split into two 25mg and 10mg of Tamoxifen for 6 weeks. Im also low SHBG and noticed that my HCG lowers it further. Also, my LH & FSH never get above 5 and 2 respectively on lowers doses of Clomid, hence why I'll be going a big heavier.

 

[Systemlord]

Are there any examples where someone around my age didn't FULLY recover their HPTA following HCG Monotherapy?

This is very rare and I can’t remember more than a few that fit this scenario in the last several years. One could argue that this is the directions things were headed for these guys anyway.

 

[SMOS44]

Thanks Systemlord. That’s good to hear. I kept my trial short as I don’t think it helped much

 

[Adamsapple]

Why do fertility specialists prescribe Clomid and HCG together for secondary Hypogonadism, do they not work in synergy to improve spermatogenesis?

Assuming HCG shuts down endogenous LH production, how hard would it be for someone to restart HPTA after coming off above fertility protocol? Surely the rebound won't be as bad as someone who's azoospermic coming off long-term TRT...

 

[SMOS44]

I’ve seen bloodwork posted here that shows Enclo+HCG can maintain LH/FSH

 

[Adamsapple]

I think it's more likely HCG + enclo/Clomid can get natural test to come back but sometimes for sperm you'll need HMG/FSH- it's impossible to get these in Australia.

 

[Kenp]

I'm getting off my HCG monotherapy next week and will be attempting an aggressive gonadotropin restart by using 50mg of Clomid daily split into two 25mg and 10mg of Tamoxifen for 6 weeks. Im also low SHBG and noticed that my HCG lowers it further. Also, my LH & FSH never get above 5 and 2 respectively on lowers doses of Clomid, hence why I'll be going a big heavier.

Any updates for your situation?

 

[Flexedup]

Any updates for your situation?

Doing very well by the grace of god. I have fully recovered from all of my crashed estrogen symptoms. I still struggle with my TT being low in the 220-250ng/dl range but as far as recovery from what initially brought me to this forum, I'm in a pre-crashed state and what a ride it has been. My LH is normal but my FSH still hasn't fully recovered and still treads the low range.