HCG Monotherapy & Estrogen Loss

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ExcelBurger

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I've been on Androgel for about a year. Decided to attempt a restart protocol including HCG for 6 weeks followed by Novaldex for 6 weeks.

3 weeks into the HCG my estrogen has tanked from 30 to 15. Along with that I have experienced incredible joint and tendon pain. Was even diagnosed with Inflammatory Tenosynovitis, as my middle finger tendon has become sore and swollen. The generalized joint pain (shoulder sockets, hands, elbows, etc) only flares up at night in bed. It's so severe that I can't roll over without my shoulders, elbows, and forearms feeling like I'm ripping them out of the sockets.

I am *assuming* its due to the sudden drop in Estrogen.

* On Androgel I had T levels of 450 = Estrogen 33.
* On Clomid I had T levels of 450 = Estrogen 8.
* On HCG the same problem. T levels of 450 = Estrogen 15.

I don't understand why I am not aromatizing to estrogen, when the testosterone is being produced by me. And I have been low on E before and never had such severe joint pain. Either way, I need to get my estrogen up. This can't be healthy with such severe inflammation going on for so many weeks. And the pain is ridiculous.

Any suggestions?
 
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Defy Medical TRT clinic doctor
It may not be the low estrogen that's causing joint pain, could something else cause the pain and Inflammatory Tenosynovitis.
 
If you have only performed a single blood test I suggest having another draw done to confirm. Also as mentioned be sure to use the masspectrometry Sensitive Estradiol LC/MS (Labcorp) or Ultrasensitive Estradiol MS (Quest) as this will provide more accuracy for a smaller window found in men.

As you are only 3 weeks into HCG mono therapy the reason for your E2 drop may be due to the negative feedback induced by the androgel. Possibly your T levels first dropped before the HCG took effect ramping up Leydig cell production. This initial drop in T would also result in a drop in E2 since E2 is manufactured from testosterone. In addition. testosterone levels may fluctuate more on HCG.
 
Sorry I didn't include more information.

I've run tests on everything multiple times, but the most recent test were just to see how I was responding to the HCG. Estradiol Sensitive: 15 and Testosterone Total: 456.

250 IU EOD of the HCG.

T levels are now equal/higher than what they were on the Androgel.
Estrogen is not aromatizing.
Saw the same effect on Clomid. T Levels hit 800 but E2 was "8".
Yet no joint pain.

So:

1) Why joint pain now but not before? I've had lower E.
2) Why don't I aromatize to E when source of T is "endogenous" ?
3) How can I get my Estrogen up? Higher HCG dose > Increased T > Increased E ?

Maybe for a normal person. But I wonder if that would work for me.

Only 2-3 weeks left before I finish HCG and start Nolvadex. Maybe the HCG is causing joint pain as a side effect. Many reports of joint pain on HCG Diet forums, but they blame it on rapid weight loss. Water intake does seem to help a bit.
 
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Not taking any supplements.

I should also probably note:

I was naturally at least 900+ testosterone in college. Could "perform" 4-7 times a day and repeat the same thing the next day. Then I took Finasteride (12 years ago) for 3 years and I had pretty severe side effects. After coming off it, I landed at a T level of about 580 and felt okay. But definitely wasn't the same as before.

As the next decade passed, my T levels reduced from 580's to 500's to 450's to 400's. By age 39 I was hovering around 330. During the decade I did a couple cycles of Anavar with Clomid restart. And a couple bouts of temporary androgel just to see how it would affect me. Always with a little clomid after. By age 40 I was testing at 300, and decided to begin TRT with Androgel exclusively.

Now attempting a restart. Ksman on the other forum seems to think that the finasteride use has created in me a unique androgenic profile. That my system doesn't necessarily follow the same rules because of whatever the finasteride did to it.
 
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I would get my progesterone, DHEA and pregnenolone tested. If they are low, at least supplementing with pregnenolone and or DHEA can help increase estradiol.

Hi Nelson - you asked me to create a thread with my other question and I did so here: https://www.excelmale.com/forum/showthread.php?6347-Nolvadex-or-Nolvadex-Clomid-for-Restart

I'm interested in your response there too.

Regarding your response above, please remember: I am in the process of attempting a 100% full restart. Therefore I can't take anything that is going to shut anything down.

"If dhea is raised in the blood serum, then this causes a rise in the manufacture or androstenedione, and in raising androstenedione (the pre cursor to test) you then cause a raise in testosterone in the blood serum. In raising the testosterone levels above physiological levels, the pituitary senses that there is too much and will send hormonal messages to the gonads to shut down production. So yes in that sense DHEA can be suppressive of testosterone."
 
Not taking any supplements.

I should also probably note:

I was naturally at least 900+ testosterone in college. Could "perform" 4-7 times a day and repeat the same thing the next day. Then I took Finasteride (12 years ago) for 3 years and I had pretty severe side effects. After coming off it, I landed at a T level of about 580 and felt okay. But definitely wasn't the same as before.

Damn man...sorry to hear that. Finasteride is poison. I was a victim of this drug, but luckily got off it pretty quick, and regained my libido. Plenty of guys out there aren't so lucky.

Who is managing/monitoring your restart? I've never attempted one, but I've read plenty of threads here where guys have a very difficult time with it, and usually just give up. Dr. Saya at Defy Medical does a lot of these, and with someone like him managing your care, your chance of a successful restart would increase exponentially. Something to think about. Good luck to you.
 
Beyond Testosterone Book by Nelson Vergel
Thanks. The restart is a long shot. But I couldn't take the final plunge into "forever TRT" without at least trying. I expected this would be fairly miserable, but HCG honestly has been amazing. Its given me a libido that Testosterone never did. I feel amazing aside from this joint pain crap, and that could be from something completely different.

If the restart fails, I will absolutely be going on Sub Q testosterone and Sub Q HCG. Testosterone alone never made me feel so great, but that overlapping period where I still had androgel in my system, and the HCG was kicking in - was the best feeling I've had in years.

My shoulders feel like they're coming out of the sockets every time I move my arms in different directions. It honestly feels like a torn rotator cuff or ripped tendon. Both shoulders. The pain is ridiculous. I realize its just inflammation. So I forced myself to do a shoulder workout today with 15lb dumbbells. Just to try and stretch out the area, and force some flexibility. The pain was insane doing them, but afterwards - just like I predicted - I am 100% pain free tonight. Really strange.

In any case, I am going to kick up my HCG dose for the remaining days from 250 IU to maybe 350 or 400 each time. Logic being higher Testosterone > Higher Estrogen, and a harmless boost in testicle stimulation before I make the transition to Nolvadex next.

To answer your question - I am seeing Dr. Melinda Silva here in San Diego. She knows a lot of this stuff, but I am the type of patient who has had nothing but terrible experiences with doctors. So i dont trust them anymore, and she's kind enough to allow me to manage this process. She runs an anti-aging clinic and does all of these things for her patients. I do my due diligence, and run everything by her as well, so I'm sure she gives me a little more freedom than the average clueless patient.
 
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