Is HCG necessary for guys with primary hypogonadism?

[HarryCat]

I came across this study:

Feedback Inhibition of Gonadotropins by Testosterone in Men With Hypogonadotropic Hypogonadism: Comparison to the Intact Pituitary-Testicular Axis in Primary Hypogonadism

They gave the guys in the study 250mg of test. enanthanate every 2-4 weeks. Now, I've always read that TRT will cause the HPTA to shutdown, which to my mind meant that LH and FSH would be driven to such low levels that they would not longer stimulate receptors in the body. But look at Figure 1 from the above study. It says that the median FSH level in the cohort with primary hypogonadism dropped from about 44 to about 26, and the median LH level dropped from 22 to 15. These numbers are still pretty high.

Would HCG be of any benefit to these guys?

 

[Gene Devine]

For the most part, yes. HCG and an LH analog does many other things in the body besides keeping testes alive and functioning. Many Primary men claim a much better sense of well being and increase libido when on HCG.

Also, read my paper about what HCG as an LH analog does in converting Cholesterol into Pregnenolone.

https://www.excelmale.com/forum/sho...tropin-Pregnenelone-and-DHEA-–-By-Gene-Devine

 

[HarryCat]

Many Primary men claim a much better sense of well being and increase libido when on HCG.

Hmmm, I wonder if these guys a really subclinical hypothyroid and the HCG is stimulating their thyroid.
See: http://www.ncbi.nlm.nih.gov/pubmed/8045981

 

[Nelson Vergel]

" In men with partial or previously treated gonadotropin deficiency, or in men with postpubertal hypogonadotropic hypogonadism, hCG treatment alone may be sufficient to stimulate spermatogenesis and fertility. In most men with prepubertal hypogonadotropic hypogonadism, however, combined treatment with hCG plus hMG is needed to initiate sperm production and fertility." http://www.ncbi.nlm.nih.gov/pubmed/7705324

 

[Nelson Vergel]

They gave the guys in the study 250mg of test. enanthanate every 2-4 weeks. Now, I've always read that TRT will cause the HPTA to shutdown, which to my mind meant that LH and FSH would be driven to such low levels that they would not longer stimulate receptors in the body. But look at Figure 1 from the above study. It says that the median FSH level in the cohort with primary hypogonadism dropped from about 44 to about 26, and the median LH level dropped from 22 to 15. These numbers are still pretty high.

Would HCG be of any benefit to these guys?

I agree. They undertreated many of them (the ones getting 250 every 4 weeks) and that is why LH and FSH levels are still not suppressed like we see them with optimum replacement doses. They also saw that the lower their FSH and LH at baseline, the higher the total testosterone level achieved on TRT (no brainer).

 

[HarryCat]

They also saw that the lower their FSH and LH at baseline, the higher the total testosterone level achieved on TRT (no brainer).

OK, tried thinking this through and couldn't figure it out. If you would be so kind, why would this be the case?

 

[HarryCat]

From this study: Long-Term Pharmacokinetics of Transdermal Testosterone Gel in Hypogonadal Men

"Suppression of serum gonadotropin levels
Because of the wide variability in the baseline serum LH and FSH levels, these were expressed as the percent change from baseline in response to T replacement (Fig. 5). The mean percent suppression of serum LH levels was least in the T patch group (between ∼30–40%), intermediate in the T gel 50 group (between ∼55–60%), and most marked in the T gel 100 group (between∼ 80–85%; P < 0.01). The suppression of serum FSH paralleled that of serum LH levels. In the subjects with primary hypogonadism, mean serum LH and FSH levels were suppressed to within the normal range after both doses of T gel administration, but remained above the normal range after T patch application. The suppression of serum gonadotropins occurred in all hypogonadal subjects regardless of the classification of hypogonadism."

So the guys who were primary and had the highest T levels got their LH and FSH levels into the normal range. It seems to me that adding HCG would put the total stimulation of LH receptors back above what is normal.

I guess I just don't know enough but that rubs me the wrong way if we are trying to restore the body to normal physiological levels of hormones with TRT.