Use of hCG with testosterone at the very beginning of TRT

[juan]

Is it a good idea to begin hCG with testosterone at the very beginning of TRT treatment, or should the patient wait for 4 to 6 weeks after starting TRT to initiate hCG?

 

[Gene Devine]

Most TRT Doctors who are trained correctly will prescribe HCG right from the outset of a TRT protocol as HPTA suppression happens pretty quickly with the Testes getting shut down pretty fast.

 

[Jasen Bruce]

I think it can be done either way but as Gene stated starting at the beginning will provide prevention from becoming atrophied. When used in conjunction with TRT, as opposed to fertility treatment, typically a small dose is prescribed so there is no risk in starting it from the beginning and using it long term.

It is also okay to wait a few weeks, if not just to see how you first respond to testosterone therapy including the degree of atrophy. Then starting the HCG around week 4, where studies show the complete shut down may occur. This may give you something to look forward to after starting TRT and you may be more acutely aware of HCG's effects of libido and well-being.

 

[Gene Devine]

Agree with Jasen as well.

Also, remember that men who are Secondary Hypogonadal will produce additional endogenous testosterone when using HCG as an added benefit as well!

 

[Bass]

as soon as you start injecting testosterone the atrophy process begins, you my not see it immediately, but why wait until then. so I agree with Gene!

 

[juan]

Thanks so much for all of your comments and overall knowledgeable answers to my question...really appreciated!

 

[Nelson Vergel]

I agree that we should start HCG as soon as we start TRT. However, there are no studies at all published on this combination besides the one from Dr Lipshultz using 500 IU every other day of HCG to preserve fertility. I am meeting with his research team next week to look at a study design that better reflects what a lot of us are using now (300-500 IU twice per week). We should measure not only sperm count and quality but also testicular size and sex drive. A cross over design would be good (one group starts TRT alone, another TRT+HCG. Then after 2 months, those in group 1 add HCG and those in group 2 stop HCG for 1 month). This simple, non randomized, non placebo controlled open label pilot can give us enough answers to use it as a reference.