HCG monotherapy; not tolerating well

[MZMpac]

Greetings all;

Quick background:

I'm 38. Was on TRT for a couple years starting about age 34. Did great for 2 years, then decided to slow-taper off to see if my testes still had any life in them. Initially I did ok, but slowly over about a year my symptoms came back---low libido, loss of muscle mass.

Got back on about a year ago, felt great again. Over the past 3 months I've been working with a urology-fertility specialist, as my wife and I would like to conceive and my sperm counts were 0 (literally) on TRT.

Tried clomid + TRT, I didnt tolerate it well and it didnt bump my LH/FSH much. Started HCG 2000 IU bi-weekly. Did pretty well until he tapered me off TRT. Last 4 weeks have been rough.

Very spacey at first and irritable. Libido tanked soon after. Last 1-2 weeks I have been very anxious; unusually so.

My last T levels were 948 ng/dl right before he pulled me off TRT. No labs since then. No other estrogenic sides to speak of, but at this point I'm ready to get back on TRT as this is miserable.

Any thoughts?

 

[Harley]

Hi,
I stopped TRT a month and five days ago , I felt that I'm not getting what I needed from TRT , especially in regards to ED . I felt great in the gym but even with cialis I felt less then great in bed.
I stopped test-c and after 5 days started HCG at 350 IU every day for two weeks and now I do 300 IU eod .
I had a little anxiety, nervousness , depression some pain in the testicles but I think its passing .I think I lost some weight and a bit of strength in the gym but...... gained a lot of size in the testicles and morning wood returned every morning and even some spontaneous erections.
I am going to continue for a while and then get labs .

 

[trt reznor]

Some members have had success by adding FSH to their protocol. Remember that hCG stimulates the Leydig cells in the testes, which are responsible for testosterone production, not spermatogenesis (this is where FSH comes in). You are likely experiencing high E2 brought on by the super high hCG dosage you’re taking.

Read this:
Semen analysis results after adding FSH to TRT and hCG

 

[MZMpac]

My doc is checking T and hopefully E2 so we'll see. I take no AI's and never have, so I'm thinking it's high E2.

 

[MZMpac]

Test 862 ng/dl
E2 49 pg/ml

I knew it had to be estrogen. I've read that AI's dont really work in HCG-induced elevated E2?

 

[cigpk]

Test 862 ng/dl
E2 49 pg/ml

I knew it had to be estrogen. I've read that AI's dont really work in HCG-induced elevated E2?

Is that 2000 iu per week or 4000 iu split in two injections?

 

[MZMpac]

4000 split into 3 injections

 

[Vince Carter]

An AI is less effective in the testicular environment the aromatase that occurs there, we believe that to be true. That much HCG I would suspect it's an E problem, typically why an HCG mono run in those doses is a failure.

 

[Harley]

Why not lower the mount of HCG and see what appena to your levels of Testosterone and E2 . I saw a YouTube lecture by a doctor in Hungary I think . He said in Hungary its illegal for doctors to administer treatments that hurt fertility ( like testosterone ) and he had great success with HCG monotherapy. I think I read here on this forum a doctor (Saya if I'm not mistaken ) That said 300-350 iu eod is reccomended and will usually not cause E2 problems .

 

[MZMpac]

Interesting, I will consider that. 4000+ weekly is definitely too much. My buddy was on a similar dose for fertility as mono-therapy and he had some major mood/anxiety problems as well. I suppose it affects everyone differently but I want off this train.

 

[cigpk]

I personally found splitting the doses to EOD or even every day also lowered E2 for me with hcg.

I went from 2x per week to EOD and even increased overall dosage and I had lower e2 levels. I know you’re already at 3x per week so maybe you could try every day?

 

[Harley]

Hi,
First let me wish you a great weekend from not so sunny Italy.
I was wrong about the guy being Hungarian he is from Poland.
I include a link for everybody that wants to watch , hope its permitted.

 

[MZMpac]

I personally found splitting the doses to EOD or even every day also lowered E2 for me with hcg.

I went from 2x per week to EOD and even increased overall dosage and I had lower e2 levels. I know you’re already at 3x per week so maybe you could try every day?

Not a bad idea either.

My doc's NP suggested my estradiol was "fine" today and that I should see my PCP for anxiety. Typical brush off response from her, she's been useless.

So I'm left to take matters into my own hands until I can get to see him face to face. I think I'm going to to drop hcg to 1500 a week total and add about 25mg of test back in once a week.

I suppose my #1 goal here is to feel good and secondary to that would be fertility. I'm fairly confident now I can achieve that without HCG monotherapy at mega doses.

 

[Harley]

Why add the testosterone and not just lower the HCG. And see what happens .
I dont think making too many changes at once is a good strategy.

 

[Wilson7]

Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men

Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. - PubMed - NCBI

IMO, if you are going on HRT, add at least 350 IU/2x wk of HCG, pref 500 IU 2x/wk, it should maintain fertility and testicular volume from the start. Clomid didn't do anything for me at 50 mg/d and it will cut your GH/IGF by 40 - 50% and doesn't work well for everyone. E2 is only an issue if you become symptomatic, if you keep the HCG to 500 IU 2x/wk that shouldn't be a problem. DHT is what drives libido and erectile function, one of the reasons nandrolone alone doesn't cut it. DHN is a weak androgen. The best results come from a mix of T and HCG. See links to the full papers.

 

[MZMpac]

Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men

Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. - PubMed - NCBI

IMO, if you are going on HRT, add at least 350 IU/2x wk of HCG, pref 500 IU 2x/wk, it should maintain fertility and testicular volume from the start. Clomid didn't do anything for me at 50 mg/d and it will cut your GH/IGF by 40 - 50% and doesn't work well for everyone. E2 is only an issue if you become symptomatic, if you keep the HCG to 500 IU 2x/wk that shouldn't be a problem. DHT is what drives libido and erectile function, one of the reasons nandrolone alone doesn't cut it. DHN is a weak androgen. The best results come from a mix of T and HCG. See links to the full papers.

Awesome, thanks for the links.

UPDATE: I dropped my HCG to 500 IU 3x/wk and added about 30mg of test 1x per week. Libido returned the next day and the anxiety sx I was having are dramatically better. Going to see the urologist monday to review my changes. No data on sperm count right now unfortunately, but I'm optimistic.

 

[Wilson7]

Probably need 30mg 2 or 3x per week, sc. If the libido starts to fade and anxiety increases in several days you'll know you need greater frequency. Hopefully your sperm count will increase. One of my friends is a high level NPC competitor, got his wife pregnant twice running a ton of gear and just 350 IU of HCG 2x/wk. Never run gear or HRT without it if fertility is a concern. Too bad more docs don't understand this or know the lit.

 

[MZMpac]

Curious, why subQ and not just IM for test?

 

[Wilson7]

27 g needle, very little pain, no scar tissue, easy to self admin. Even shallow IM with a 1/2 inch 27 g, how I do my HRT (TC), hardly feel it. Blood T values are the same. Perhaps even better. Esp if you are doing small dosing 2 - 3/wk.

Serum Testosterone Concentrations Remain Stable Between Injections in Patients Receiving Subcutaneous Testosterone

 

[MZMpac]

27 g needle, very little pain, no scar tissue, easy to self admin. Even shallow IM with a 1/2 inch 27 g, how I do my HRT (TC), hardly feel it. Blood T values are the same. Perhaps even better. Esp if you are doing small dosing 2 - 3/wk.

Serum Testosterone Concentrations Remain Stable Between Injections in Patients Receiving Subcutaneous Testosterone

Gotcha. I just started doing shallow IM with an insulin syringe, I liked it as well. I actually didn't mind the 25ga in the quad but scar tissue does build up slowly.