HCT sublingual as standalone therapy

[Lumalux]

56-year-old male, reasonably healthy and active through quite stressed with work and the situation in society and the world. I've always felt I've had low testosterone in light of my small body frame, minimal muscles, no body hair, no aggressiveness, poor EQ. Had an exam with a trusted men's health doctor last week with full blood panel. We discussed potential T options. He strongly recommended Jatenzo with possible HCG on top of that if my results warranted it. I don't have the full results yet , but in a nutshell they are within normal range so T is out of the question. Free T was in the 400s.

I am so mad and depressed about this. I was really looking forward to finally getting a grip on the overwhelming feeling of life, reading about how just about every guy says T changed their life. I can't tell you how many guys I know who are on it and love it. Am I the only one who feels like shit but has normal T levels and is unable to even try this? How is everyone getting access to TRT?

He did write me a script for sublingual HCG to be taken 3 times a week. Of course, I will have to cover the $110 charge every 10 weeks (insurance won't cover this). Is this even a potential remedy by itself? Can I expect anything from it or is it a waste?

I know without the lab specifics, there's not much to go on but I had to vent. I feel gut-punched, like I now have to turn to self-medicating and searching out stuff on my own.

 

[Systemlord]

He strongly recommended Jatenzo

As do I, who have been the only member on Jatenzo with amazing results, considering injections and topicals was nothing but a failed treatment for 4 years.

Jatenzo was a game changer for me and turned my life around.

My Experience On Jatenzo (Oral TRT) Log

I wanted to start a thread detailing my personal experience with Jatenzo (oral TRT) which is remarkable in how quickly it has shown results when compared with injections. The first week on Jatenzo was very pleasant unlike my experience after dosing changes on injections, all with minimal swings...

www.excelmale.com

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He did write me a script for sublingual HCG to be taken 3 times a week.

HCG sublingual is destroyed in the GI, a waste of money. It's sad to see businesses still selling useless products that offer no medical benefit.

How is everyone getting access to TRT?

Defy Medical is one way to bypass all the BS you get from sick care doctors lack of knowledge and denials of TRT.

Free T was in the 400s.

Meaningless without context, no normal ranges posted. Also the method of testing is important, Direct Immunoassay should not be relied upon, the Equilibrium Dialysis or Ultrafiltration are the gold standard for testosterone panels.

Are you sure you're reporting a Free T measurement, and not a Total T value?

Testosterone, Free, Bioavailable, and Total, LC/MS/MS (No Upper Limit) plus SHBG

This Testosterone Panel Includes 5 Tests: Total Testosterone (LC/MS most accurate assay), Free Testosterone, Bioavailable Testosterone (Free T plus albumin-bound T), Sex Hormone Binding Globulin (SHBG), and Albumin.

www.discountedlabs.com

Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men - PMC

Hypogonadism or Testosterone Deficiency (TD) in adult men as defined by low levels of serum testosterone accompanied by characteristic symptoms and/or signs as detailed further on can be found in long-recognized clinical entities such as Klinefelter ...

www.ncbi.nlm.nih.gov

The prevalence of hypogonadal symptoms increases with TT levels below 12.1 nmol/L (350 ng/dL). However, Zitzmann et al. have shown that testosterone deficiency symptoms may also be seen with TT levels as high as 15 nmol/L. This study showed that the prevalence of loss of libido or vigor increased at testosterone concentrations below 15 nmol/L (433 ng/dL).

 

[Systemlord]

I've always felt I've had low testosterone in light of my small body frame, minimal muscles, no body hair, no aggressiveness, poor EQ.

This is more about genes than anything, bad genes and all the testosterone you can throw at your body can't make up for bad genetics. I have seen men with small skinny frames go on TRT and struggle to gain muscle.

Then you have long gene CAG repeats, if long then you are insensitive to testosterone and the activity level at the T receptors is minimal. These men would expect to have little body, facial hair and not be very masculine.

 

[Systemlord]

I feel gut-punched, like I now have to turn to self-medicating and searching out stuff on my own.

For those with a testosterone deficiency, TRT is everything you heard it was, but it is not a panacea. If you issues aren't related to a TD, that doesn't mean all hope is lost, you can still fix your issues by addressing the cause.

 

[MIP1950]

Your free T was in the 400's? Not a mistake, since those of us on T don't see a number like that unless we're taking high doses. Basically, find another doctor or as @Systemlord recommended, contact Defy. They do telemedicine. Treating by lab numbers versus symptoms is the hallmark of a mediocre or incompetent doctor.

 

[Lumalux]

Here are my labs from 3/17/2022:

Tests: (2) Testosterone,Free and Total (140103)
Testosterone 415 ng/dL 264-916
Adult male reference interval is based on a population of
healthy nonobese males (BMI <30) between 19 and 39 years old.
Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.
! Free Testosterone(Direct)
[L] 6.1 pg/mL 7.2-24.0

What do you think?

 

[bixt]

Jatenzo in my opinion will not take your 400ng/dl and raise it much further. Maybe another 100 or 200ng/dl at the most.

 

[Lumalux]

What about Hyrdogel on the scrotum? What effect will this have on DHT and libido?

 

[MIP1950]

Here are my labs from 3/17/2022:

Tests: (2) Testosterone,Free and Total (140103)
Testosterone 415 ng/dL 264-916
Adult male reference interval is based on a population of
healthy nonobese males (BMI <30) between 19 and 39 years old.
Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.
! Free Testosterone(Direct)
[L] 6.1 pg/mL 7.2-24.0

What do you think?

Not a surprise that your free test is quite low, given your total test. It's low normal. I've never taken HCG but unless it's established that your testicles aren't producing enough testosterone(primary hypogonadism) I don't know if HCG injections are appropriate. I concede I'm not knowledgeable about its use.

Again, I agree with @Systemlord; Defy might be your best option,unless you live in a major metro area where you might be able to find a doctor who is actually knowledgeable. A full work up should include a comprehensive thyroid panel. Many men are secondary hypogonadism, which means the pituitary/hypothalamus are malfunctioning and in that case, a probability that a man also has secondary hypothyroidism, even if labs look 'normal'. If you can afford to pay out of pocket, since Defy doesn't take insurance, contact them.

 

[JmarkH]

I too thought surely at 63 with all the symptoms, I was low T. Well the test came back with T573 ng/dL and FT 14.4 pg/mL. My estradiol was a little low in ratio at 19.6 pg/mL. I was down over this not knowing what to do next. Matrix Hormones recommended I take HCG injections 4x per week = to 1000iu and Clomid 25mg on HCG days.
From day one I started feeling a lot better. The first two weeks were a hell of a boost and then that leveled out. My mind is much clearer, mood swings are almost gone except I'm more assertive within spoken communications. I'm on week 5 and will take another lab test at week eight.
Don't give up. It's worth the effort.

 

[Cataceous]

Here are my labs from 3/17/2022:

Tests: (2) Testosterone,Free and Total (140103)
Testosterone 415 ng/dL 264-916
Adult male reference interval is based on a population of
healthy nonobese males (BMI <30) between 19 and 39 years old.
Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.
! Free Testosterone(Direct)
[L] 6.1 pg/mL 7.2-24.0

What do you think?

Free testosterone was not measured with an accurate test, so it should be ignored. Accurate tests would be based on equilibrium dialysis or ultrafiltration. If you use LabCorp again then one of these tests would do:

070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

Labcorp test details for Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS

www.labcorp.com

500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp

Labcorp test details for Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

www.labcorp.com

Alternatively, if you measure SHBG along with total testosterone then you can use a calculator to estimate free testosterone. This is still more accurate than the direct immunoassay test that you had.

There is a reasonable chance you are hypogonadal and would benefit from treatment. However, what's been glossed over is how traditional testosterone replacement therapy can disrupt multiple other hormones, potentially introducing new problems. There are other options to try before going this route. A testosterone nasal gel such as Natesto can raise testosterone for limited periods each day, which has been shown to effectively treat low-T symptoms without shutting down your natural testosterone production. Another option is use of a SERM such as enclomiphene. This stimulates your body to make more of its own testosterone.

 

[Lumalux]

Thank you so much, guys, This ail very valuable information that I intend to use. I'll get another blood test based on your advice. I also want to check for other things like diabetes and thyroid dysfunction. To be honest, what initially spurred my interest in TRT was the realization that about 10 years ago I began losing hair on my lower legs. From what I understand this can be due to diabetes, thyroid or low T. This, in addition to just feeling the effects of aging, brain fog, loss of muscle mass, poor EQ, feeling of being overwhelmed much of the time, feeling like I can't handle stress like I used to, depression. I fully understand that there are risks in starting TRT, and until now I've taken the approach that I would try everything to naturally boost my own production of T/DHT, including exercise and trying supplements like zinc, boron, butea superba, tribulus. I can say that I have an extremely high libido which I love and have no concerns about it remaining high or going even higher.

Based on others' comments on this forum, I was wondering if something like a topical might be good place to start rather than injections. I would prefer that method anyways.

 

[tareload]

He did write me a script for sublingual HCG to be taken 3 times a week. Of course, I will have to cover the $110 charge every 10 weeks (insurance won't cover this). Is this even a potential remedy by itself? Can I expect anything from it or is it a waste?

More info on this:

Rapid dissolve oral HCG and other HCG questions

12,000 IU of HCG should run about $80

www.excelmale.com

 

[Systemlord]

Free Testosterone(Direct)
[L] 6.1 pg/mL 7.2-24.0

What do you think?

The direct immunoassay is not reliable, if using the more accurate testing methods produce similar values, then you need TRT.

I don't think the other testing methods are going to give you drastically different results.

 

[MIP1950]

The direct immunoassay is not reliable, if using the more accurate testing methods produce similar values, then you need TRT.

I don't think the other testing methods are going to give you drastically different results.

I don't know which Quest free T is ordered by my urologist. Labs a few months ago, on 100 mg, IM, once weekly, had a TT of 1064 and free T of 225. Switched to MWF, 34 mg, IM. Used Discounted Labs after 6 weeks. TT 1032, free T 191. Libido is strong on MWF schedule, taking my shot at 6 a.m. More erections, but only late in the evening. My wife is already sleeping. I don't know why I get such a response only late at night. No morning wood. Maybe take my shot at noon or at 6 p.m.