Starting over after 20 years, requesting your advice for T Therapy (& HCG) with new endo

[sjt23]

Hi, I would appreciate your knowledge and personal experience and insight to assist me to feel my best.

I have been on T Therapy for over 20 years originally diagnosed with hypogonadism-testicular hypofunction. I am a 61 year old male.

Most recently I was on 125mg Test Cypionate injections every 14 days.(crazy, yes every 2 weeks). My average levels midway between injections at day 7 were:
Total T 528
Free T 16.62
Estradiol 27.6
DHEAS 49.1
but was having issues and not feeling great...issues with libido, ED....and of course testicular atrophy.

To re-evaluate my situation, and wanting to feel better, and get a new 2nd opinion and start with a new endo, I stopped my protocol for 4 weeks to dry out and start from scratch with comprehensive labs and evaluation.
I didn't know what my labs would look like, but knew I was taking T for over 20 years, my balls have atrophied, I never tried HCG alongside for any of the benefits, and knew my libido was not great at all, have ED, and less satisfaction.

My labs came back as follows:
TT 24.3 (264-916) yes 24.3
Free T 2.4 (6.6-18.1)
Estradiol Sensitive: less than 2.6 (8-35)
SHBG 43.4 (19.3-76.4)
DHEA-S 45 (48-344(
LH 7.6 (1.7-8.6)
FSH 11.8 (1.5-12.4)

What can be said about the miniscule TT @ 24.3? On previous evaluations of diagnosis over the years, while I cannot remember exactly, my TT numbers were in the low 200's not in the 20's. Wow!

So I would greatly appreciate any comments and suggestions on strategies anyone might chime in on to help in this journey to feel my best. Optimized Test Injections with or without HCG?

I just switched to weekly T injections from every 2 weeks to start with, currently at only 62mg Test Cypionate injection and will at see my next labs soon. I'd like to aim for 800TT midway, but have to see the doctor's agreement.

Any feedback on adding HCG to the mix for all of the proposed benefits for me at my age of 61? From your experience with using HCG along with T, what are you experiencing or know of other men in the 50's or 60's or 70's using HCG with T experiencing? Does it include feeling better, than just using T alone?. I am apt to feeling depressed at times, so anyone know or experiencing better mood on HCG and other significant proven benefits and results? I know of course, I can do a trial of HCG for a few months and test-drive and see for myself....

I appreciate and thank you for your input and help....

 

[Systemlord]

What can be said about the miniscule TT @ 24.3? On previous evaluations of diagnosis over the years, while I cannot remember exactly, my TT numbers were in the low 200's not in the 20's.

You've been shut down for 20 years and it's likely going to take awhile for your natural production to improve if it does at all.

I missed your LH values, indeed it is looking like the testicles are not functioning very well.

 

[Systemlord]

I am apt to feeling depressed at times, so anyone know or experiencing better mood on HCG and other significant proven benefits and results?

This is perfectly normal, there are many ups and down in life. It could also mean your protocol was in need of tweaking.

 

[Seth]

Your LH and FSH look good, but it sounds like your testicles are not responding to your natural stimulus.

 

[Systemlord]

Most recently I was on 125mg Test Cypionate injections every 14 days.(crazy, yes every 2 weeks).

This is crazy, standard of care is 200mg every two weeks and this doesn't even come close. The endocrine guidelines is suggesting 75-100mg weekly and often times this isn't enough.

You need to find another doctor asap!

My average levels midway between injections at day 7 were:
Total T 528
Free T 16.62
Estradiol 27.6e

While not bad for a midpoint value, if levels are <300 at trough (day 14), this protocol is no good.

 

[Systemlord]

Optimized Test Injections with or without HCG?

HCG is of little benefit to you because the problem is with your testicles.

 

[sjt23]

HCG is of little benefit to you because the problem is with your testicles.

Ok, thanks for your comment, but when you say of little benefit, does that mean if in my situation, I added HCG alongside Testosterone, you believe I would not receive any actual additional health benefits, including feeling of well-being by stimulating the testicles to start producing T again.?

I am quoting what I also read recently "HCG is recommended for all men on TRT, regardless of fertility requirements it is an integral part of an effective treatment protocol. In most men it is used alongside TRT for the best possible results, as well as maintaining testicular size, fertility and testosterone production, it also maintains other hormones which are lost when using TRT alone due to the suppression of the HPT Axis. HCG helps to prevent infertility and testicular shrinkage, but that is not all: HCG also increases adrenal functions that may impact energy, libido, production of other hormones, and overall feelings of well-being."

 

[Systemlord]

I added HCG alongside Testosterone, you believe I would not receive any actual additional health benefits, including feeling of well-being by stimulating the testicles to start producing T again.?

Your LH is on the higher end and your T is <50, so higher LH isn't any benefit and HCG mimics LH.

HCG directly stimulates the testicles and yours are barely responding. What you need is a doctor that isn't an idiot and a better protocol.

 

[Systemlord]

I am quoting what I also read recently "HCG is recommended for all men on TRT, regardless of fertility requirements it is an integral part of an effective treatment protocol.

This is one person's opinion and is likely someone with little experience managing men on TRT or has other motives ($$$) for recommending HCG.

I would argue if T isn't at the desired levels and symptoms are present, simply increase the dosage.

By adding HCG you are adding T on top of the injectable T and is just overcomplicating things.

 

[sickybuckymoretree]

I was told hcg awas outlawed over a year ago and you cannot get it anymore. I know I need it becaise my balls are schrinking and there is not as much ejaculation

 

[Dicky]

I was told hcg awas outlawed over a year ago and you cannot get it anymore. I know I need it becaise my balls are schrinking and there is not as much ejaculation

I can still get HCG thru Empower pharmacy.

 

[Cataceous]

There's a chance that given a longer period you might have more testicular recovery. Still, I wouldn't give it great odds. If you're not going to worry about that then I have a suggestion based on results from someone over at PeakTestosterone.com. He has primary hypogonadism, and if your numbers hold then you might as well have it too. The interesting thing about these situations is that even with TRT you may be able to retain normal production of the gonadotropins, LH and FSH, along with the further upstream hormones, provided you carefully tune your dose of testosterone. The main thing is to start with an exceptionally low dose of testosterone and work up slowly until the gonadotropins drop to midrange. Then give it some significant time to see how it feels. If the results are unsatisfactory then you can always raise the dose later. I think this is worth trying because there may be benefits in having physiological levels of the upstream hormones, versus completely shutting them down with conventional TRT. In addition, by making your own LH you don't need to give hCG a second thought, as hCG is simply an imperfect substitute for missing natural LH.