Some questions regarding HCG monoteraphy, past AI / E2 issues etc.

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Razz

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Hello. So little history, I had few month run with arimidex only over a year ago for trying to boost lowish T which was a terrible mistake. Since then (even months and months after quitting) I've had persistent symptoms which consist of for example almost constant sweating/hot flashes type thing, breast tenderness, dark circles under eyes that won't go away no matter how much I sleep, almost constant fatigue, hair loss etc. I connect these symptoms starting after AI usage because they fit the timeline. Life is pretty miserable right now. Labs have come pretty normal so I am speculating this might be some type of receptor issue.

So right now I've found a doc that wants me to try HCG monoteraphy to see if it would somehow fix this and balance things out somehow. He prescribed me HCG 2500 IUs twice a week which feels a bit excessive? My control labs will be in about a month to see where I am at and if my symptoms have improved. One thing I am concerned about is the possible E2 spike with that much HCG but then again I don't want to mess much with aromatase inhibitors anymore since they are what got me to this state in the first place (and even then they wouldn't help much with HCG induced intratesticular aromatization?) My labs doesn't indicate high E2 even though I've read that high e2 could also cause hot flashes (?) and with my breast tenderness there could be something going on but the labs tell the opposite. E2 has never been out of the range. So this is all really strange indeed.

This whole thing is a mystery and this is just a shot in the dark but it is worth trying as the symptoms have not improved whatsoever.

Here are my most recent labs taken about two weeks ago, feel free to ask for more labs if you want to know.

FSH: 2.3 U/l (1.5-12)
LH: 4.8 U/l (1.8-8.6)
Prolactin: 240 mU/l (80-320)
TSH: 1.8 mU/l (0.3-4.2)
fT4: 19 pmol/l (11-22)
Total testosterone: 17 nmol/l [490 ng/dl] (10-38 nmol/l)
SHBG: 44 nmol/l (18-54)
Free calculated testosterone: 226 pmol/l (ref ranges varies, lowest I've seen is 155 and highest ~230)
Estradiol E2 (non sensitive assay): 0.038 nmol/l (<0.13), this would be around 10 pg/ml

Also my DHT has been at the very bottom end of the range in past bloodwork. One thing I am also looking forward is how would HCG affect my DHT.

I just think that the dose is pretty excessive, should I somehow split it or lower it? I just wish I didn't mess with the AI monoteraphy in the first place, don't understand how my symptoms havent resolved since discontinuation.
 
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Short answer to your problems is to find a new doc that will allow you to stop messing with HCG mono and just get on TRT. I recommend Defy.

HCG mono is tough to be on long term. I tried for a long time. Just couldn’t get E2, and possibly prolactin, under control, even with an ai.

Your dose is absolutely excessive. On 2000iu’s per week, my total T came back at 1200. While on that dose, had insanely itchy and sensitive nipples, and started to grow a small lump under my left nipple. Just could never dial myself in on HCG mono.

Don’t think HCG effects DHT directly. DHT is effected by your total testosterone level, from my understanding. So if total testosterone increases, so will DHT, whether your testosterone is raised by HCG or testosterone injections.

I would honestly just ditch that doctor, he seems like he has no clue what he’s doing. For example, your thyroid labs are pointless. Without having your free T3 and RT3 tested as well, your other labs literally tell you nothing. Might as well not even had them done. Only benefit to having them done, is now you just need to get FT3 and RT3 tested, and then you can put all the thyroid labs together and then you will have all the thyroid labs you need to accurately assess your thyroid function.

I messed around with crappy doctors for years, that supposedly specialized in hormone optimization, and wasted a lot of time, and a lot of money. Best thing you can do right now is not even worry about your HCG dose, and get started with a reputable hormone clinic.
 
Short answer to your problems is to find a new doc that will allow you to stop messing with HCG mono and just get on TRT. I recommend Defy.

HCG mono is tough to be on long term. I tried for a long time. Just couldn’t get E2, and possibly prolactin, under control, even with an ai.

Your dose is absolutely excessive. On 2000iu’s per week, my total T came back at 1200. While on that dose, had insanely itchy and sensitive nipples, and started to grow a small lump under my left nipple. Just could never dial myself in on HCG mono.

Don’t think HCG effects DHT directly. DHT is effected by your total testosterone level, from my understanding. So if total testosterone increases, so will DHT, whether your testosterone is raised by HCG or testosterone injections.

I would honestly just ditch that doctor, he seems like he has no clue what he’s doing. For example, your thyroid labs are pointless. Without having your free T3 and RT3 tested as well, your other labs literally tell you nothing. Might as well not even had them done. Only benefit to having them done, is now you just need to get FT3 and RT3 tested, and then you can put all the thyroid labs together and then you will have all the thyroid labs you need to accurately assess your thyroid function.

I messed around with crappy doctors for years, that supposedly specialized in hormone optimization, and wasted a lot of time, and a lot of money. Best thing you can do right now is not even worry about your HCG dose, and get started with a reputable hormone clinic.

My free T3 has been in the upper reference range. Have not measured RT3. My main issue here is some type of damage done by AI monoteraphy that is causing my symptoms. On paper my labs dont look that bad although on this occasion my free test seems lowish. The idea of the HCG trial would be to see if it would somehow normalize my system in terms of e2 manipulation. Its really tough because this is quite unique case. I will definitely bring up TRT if my T levels are off HCG low. But in past labs they've been mid to upper 3rd range. I suppose this HCG trial couldnt hurt that much atleast on a short term?
 
You didn't state at your age, younger men do better on clomid. You may like to try a low dose clomid protocol. 12.5 mg every other day. It seems like the main issue men have with clomid, using too high of dose.
 
You didn't state at your age, younger men do better on clomid. You may like to try a low dose clomid protocol. 12.5 mg every other day. It seems like the main issue men have with clomid, using too high of dose.
Does clomid and nolvadex differ greatly in terms of their effects? Because I've tried nolvadex in the past and it only seemed to make my symptoms worse or not improve them at all.
 
Does clomid and nolvadex differ greatly in terms of their effects? Because I've tried nolvadex in the past and it only seemed to make my symptoms worse or not improve them at all.
What was your protocol for nolvadex
 
My free T3 has been in the upper reference range. Have not measured RT3. My main issue here is some type of damage done by AI monoteraphy that is causing my symptoms. On paper my labs dont look that bad although on this occasion my free test seems lowish. The idea of the HCG trial would be to see if it would somehow normalize my system in terms of e2 manipulation. Its really tough because this is quite unique case. I will definitely bring up TRT if my T levels are off HCG low. But in past labs they've been mid to upper 3rd range. I suppose this HCG trial couldnt hurt that much atleast on a short term?

Ya I don't see it hurting much, as long as you don't exceed around 2500iu's per week. You want to just use the minimum effective dose. Overstimulation of the lending cells in your testicles could potentially cause problems. I wouldn't go anywhere near 5000iu's per week. I personally would start at 2000iu's per week, and see what results you get from that.
 
A little update. Started HCG few days ago, planned on doing 250-500 EOD, first two shots were more on the 250 IU side. Now I dont know if it "kicks in" this fast or was it just placebo but I feel like my face is more bloated and I have some shortness of breath (I also have had anxiety issues in the past though) so I dont know if this plan will work for the better, the theory was that my hot flashes which started after several months of using arimidex as standalone teraphy could be due to something it did to my aromatase so trying HCG we could manipulate it and see if it somehow would improve this.

This is really weird, I had e2 of ~10 pg/ml on bloodwork before starting this and I have been suffering from intense itchy nipples/breast area and I can now tell there is some very mild form of gyno visible. Makes no sense. Only real clue to me has been DHT really on the low side on past tests. So I have a theory that the use of AI monoteraphy when I did not have high e2 somehow messed up my receptors and/or made me hypersensitive to estrogen etc. This is really puzzling situation if this HCG does not do anything. Also I have been chronically really tired and got dark eye circles ever since I used the AI which I have read could be sign of low e2. But then my breast are painfully itchy at e2 in the low 10s??
 
AI monotherapy was not a terrible mistake. Just an experiment. Unless you were taking 1mg daily I wouldn’t worry about it.

Roll with 250iu eod for a week or two and see how you go. If it sucks, it’s because you don’t tolerate hcg...which isn’t abnormal. Good thing is that it will raise your e2.

And 2500iu 2x/wk makes no sense. That’s like telling you to smoke a pound of weed to see if your anxiety goes away.

If you’re really concerned about e2, get the e2 sensitive and free e2 test.
 
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A little update. Started HCG few days ago, planned on doing 250-500 EOD, first two shots were more on the 250 IU side. Now I dont know if it "kicks in" this fast or was it just placebo but I feel like my face is more bloated and I have some shortness of breath (I also have had anxiety issues in the past though) so I dont know if this plan will work for the better, the theory was that my hot flashes which started after several months of using arimidex as standalone teraphy could be due to something it did to my aromatase so trying HCG we could manipulate it and see if it somehow would improve this.

This is really weird, I had e2 of ~10 pg/ml on bloodwork before starting this and I have been suffering from intense itchy nipples/breast area and I can now tell there is some very mild form of gyno visible. Makes no sense. Only real clue to me has been DHT really on the low side on past tests. So I have a theory that the use of AI monoteraphy when I did not have high e2 somehow messed up my receptors and/or made me hypersensitive to estrogen etc. This is really puzzling situation if this HCG does not do anything. Also I have been chronically really tired and got dark eye circles ever since I used the AI which I have read could be sign of low e2. But then my breast are painfully itchy at e2 in the low 10s??
HCG hit me hard 24 hours after dosing...high BP, hot flashes, pounding heart, etc. I've tried restarting with lower doses several times without success. I plan on restarting one last time at 50 iu or .05ml next week.
 
HCG hit me hard 24 hours after dosing...high BP, hot flashes, pounding heart, etc. I've tried restarting with lower doses several times without success. I plan on restarting one last time at 50 iu or .05ml next week.

Damn, yeah I seem to get occasional heart pounding effects too. Although after 4 injections thus far not much of a difference.

Could anyone explain how I would get itchy breast tissue and mild gyno growing when my e2 was in 10s or low 20s? Low free T? Its really weird and cant seem to figure it out. Did the overuse of AI make me more sensitive to estrogen due to me depriving it from my body for awhile?
 
Damn, yeah I seem to get occasional heart pounding effects too. Although after 4 injections thus far not much of a difference.

Could anyone explain how I would get itchy breast tissue and mild gyno growing when my e2 was in 10s or low 20s? Low free T? Its really weird and cant seem to figure it out. Did the overuse of AI make me more sensitive to estrogen due to me depriving it from my body for awhile?
Prolactin elevation
 
Damn, yeah I seem to get occasional heart pounding effects too. Although after 4 injections thus far not much of a difference.

Could anyone explain how I would get itchy breast tissue and mild gyno growing when my e2 was in 10s or low 20s? Low free T? Its really weird and cant seem to figure it out. Did the overuse of AI make me more sensitive to estrogen due to me depriving it from my body for awhile?
Your genetically susceptible to it, thats it. Dont over think this.
 
Going for labs tomorrow. Been using HCG 250-500 IU EOD. No real change in the sweating, itchy scalp etc. Maybe a tiny bit of less fatigue. Breast seem to itch more now.. One other thing I have now noticed twice is that soon after injection (500IU) I start to sweat A LOT and my left shoulder is aching. Last time I got the shoulder ache it felt so bad I went to get an ECG just in case but it came back normal..
 
Okay, got all my labs except DHT which I am still waiting for. Would be really weird if it has not gone up at all. Been using 250-300 IU EOD but took 500 IU shot night before my labs. Definitely seem to got some gyno action going, it's not better or worse than it was before my HCG "trial" though although my E2 was much lower on paper. It's like I am hypersensitive to E2 or androgens are not doing their actions. So here are the labs

LH & FSH obviously undetectable
SHBG: 35 nmol/l (down 9 points from last labs not on HCG)
Total Testosterone: 27 nmol/l (up 10 points from last labs not on HCG) which converts to 779 ng/dl
Free calculated testosterone: 412 pmol/l (155-800) [more reasonable lower limit would be around 250 though from what I've generally read]
Estradiol E2, non-sensitive: 39 pg/ml (it was ~10 pg/ml last labs not on HCG)

Might just continue with 250 IU EOD for a bit.. not seeming to help my symptoms though. My libido is absolutely dead even though my test levels look good. Also constant fatigue is still present. I won't touch any AI's since thats what caused my situation at the first place. Does high E2 cause occasional nausea to anyone else btw?
 
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