Testosterone and HCG
How does HCG (human chorionic gonadotropin or human chorionic gonadotrophin)
raise testosterone? Structurally, HCG is very similar to LH (Leutinizing Hormone).
And, in fact,
HCG's testosterone superpowers come from the fact that the body thinks it is LH. If
you'll recall, LH is sent from the pituitary and signals the testes to make
testosterone. Therefore, HCG also acts as a signal to your testicles to
pump out more T.
Is HCG "natural"? To answer that question, you have to remember that the primary pulses for LH, come during the early morning
hours during sleep. HCG, on the other hand, is given by injection and lasts in the
system only for a few days, gradually diminishing based on its half life.
So, although HCG is a natural molecule
produced by the placenta and utiltized during birth, it really is not administered
in the same way that your body is used to receiving LH. But then neither is HRT
and it has done very well in the studies to date.
Of course, HCG has been widely used in weight loss treatments (of debatable
value) as I outline here in my link on
HCG and Weight Loss. And, in males, it is used
medically for pubertal issues, such as undescended testes, and fertility. However, there has
been an "underground" use of HCG for years to help steroid users recover their testosterone production.
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Many, if not most, steroid users push their testosterone levels significantly
beyond normal physiological ranges and end up shrinking their testicles and
shutting off virtually all natural production. The excess estrogen and DHT
can cause of host of other issues as well, including gynocomastia ("bitch
tits"), leaky/irritated nipples, water retention and acne! They have learned all
kinds of tricks to help them get around these issues, but, in the case of
shrunken testicles and low T production, they often go to specialized docs and beg for
mercy, i.e. treatment with HCG.
One good thing that came out of all these steroid recovery treatments was a greater
understanding of other ways that HCG might be used. And, from what I can
tell, more and more physicians are actually using it for treatment.
Consider what these forum posters wrote recently:
--"If the Clomid doesn't do it for me, he said we'd try HCG." 
--"He put me on a quick protocol of HCG stimulation which would provide a higher
And now HCG is being used for a wide variety of off label applications. But it is interesting how many ways one molecule
can be utilitzed. Here are four of the more interesting ones:
1) Testicular Atrophy. HCG is sometimes given in order to induce short term stimulation of the testes and testosterone, generally in order to
combat testicular atrophy that comes from steroids or overly aggressive
Generally, testosterone therapy (HRT) does not result in significant
testicular shrinkage, especially the topicals (Androgel, Testim, compounding).
However, all testosterone therapy will tend to shut off the feedback cycle that
occurs from the hypothalamus/pituitary to the testes to one degree or another. Essentially, the
body says, "Oh! I've got plenty of plasma testosterone" and,
therefore, does not pump
out as much leutinizing hormone. (The feedback is actually based on estradiol interesting enough,
but estradiol rises with increasing testosterone due to aromatization.) Of course, this is why hormone
replacement therapy will almost always negatively affect male fertility. Again, though, testicular shrinkage should be minimal if dosed
However, I do occasionally receive complaints from men on injections, because
injections start a man off at very high testosterone levels which
then taper off to very low levels at the end of the cycle. HCG
may be a possible solution for a man that has experienced a significant loss in
testicular size from this phenomenon. Discuss with your physician.
2) Testing for Secondary Hypogonadism. Some knowledgeable doctors will
actually test for secondary hypogonadism (low testosterone resulting from
pituitary or hypothalamus dysfunction) using a short regimen of HCG. The
idea is that, if HCG can stimulate the testes to produce testosterone, then more
than likely the gonads are still functional and okay. Finding a doctor that
will even care or bother to look for secondary hypogonadism is difficult at
Does HCG raise testosterone in all men? The answer is no and goes back
to the mechanism by which it works. Again, HCG mimics LH (Leutinizing
Hormone) and thus "tricks" the testes into producing more testosterone.
Unfortunately, this does not work well with men who have primary hypogonadism,
i.e. dysfunction of the Leydig cells in the testes. You can't "squeeze blood out
of a turnip", eh?
HCG works best in this fashion with men who have some kind of issue with the
pituitary or hypothalamus, rather than with the testicular cells that actually
produce testosterone. This is why it is so popular with steroid users, who are
most mostly younger males who have not yet developed traditional andropause and
loss of testicular function. Almost all of the men on
the Peak Testosterone Forum are secondary
NOTE: It is important to find a good doctor when going on HCG.
Too much HCG can lead to over-aromatization, i.e. too much
testosterone converting into estrogen. Thus, solid experience and
monitoring are in order. Extreme cases can eve result in a kind of burn out
of the testicular production of testosterone.
3. Fertility. HCG is used by many fertility doctors to help
with fertility. For example, look what this forum poster wrote: "Definitely look
into clomid and/or HCG to recharge/super charge your fertility again... Clomid
took my sperm count numbers from very low into the way high end, and it improved
the quality. My urologist said HCG (which i'm on now) is even more powerful/good
for sperm.."  Again, traditional HRT will almost always lower fertility,
whereas HCG can boost testosterone and maintain or even improve fertility a
little. (Check with your physician of course on something as important as
fertility!) The reason for this is that HCG's LH-mimicking abilities kickstart
the testes into action and sperm is generally increased according to some
fertility docs and urologists specializing in the subject.
4. Correction (Someday) of Secondary Hypogonadism? Apparently, there are a few doctors
that believe they can actually solve low testosterone in some cases using HCG as
the initial protocol. Of course, this cannot work on a man with primary
hypogonadism where the testes themselves are simply not functioning properly.
However, secondary hypogonadism can in some cases be caused by extreme
stressors, such as trauma and (some experts believe very strong) emotional
events. Could the "switch" somehow be switched back on using an HCG protocol?
One forum poster outlined how this worked for him: 
"The first reading I got from him in the morning was 498. Keep in mind during
this time I had been getting readings from other doctors and all of them were
around 305-363 ng/dl and also in the morning as well. I actually got checked
into the hospital for a severe depressed episode and had a very sympathetic
psychiatrist test my testosterone at around 6pm and it came to 199 ng/dl (
hypogonadal for almost any lab and yes I felt every bit the part of those low
levels that many of us on this forum have come to unfortunately know). So the
doctor I'm seeing prescribed me a quick regimen of HCG for four weeks. My levels
per his lab went from 498 to 699 and this reading was taken in the afternoon
because my new job currently requires my early mornings and cannot schedule a
My leutinizing hormone was rock bottom because the hcg supressed its secretion.
Remember HCG mimicks LH in the body and will definately have an effect on the
HPTA. After the HCG the doctor prescribed me nolvadex or tamoxiphene citrate
(selective estrogen receptor modulator) at 20 mg per day for 4 weeks. Nolvadex
is used to fight breast cancer in women but it also has an effect on blocking
the pituitary from sensing any estrogen in the body and this in turn stimulates
the hypothalamus to send messages to the pituitary to secrete LH. The labs taken
after the nolvadex showed 701 ng/ml and again this was taken in the afternoon (
4:30pm) where a man's levels are definately not peaked. The LH reading was
slightly over the normal range and this was due to the nolvadex really getting
the pituitary to work."
"Finally now after a month the doctor had another blood draw in the afternoon
from me to see where the levsl were at after the nolvadex had left my system and
the lab came to 625 ng/ml. This is very promising as the doctor feels it may be
staying there and he thinks I might have a level around the high 700's or low
800's perhaps in the morning. I am definately not near as depressed and the
libido has improved."
So, according to this poster, a month afterward, the treatment had "stuck" and
appeared to have been successful. Does this mean that secondary
hypogonadism can really be cured in some cases using these kind of "post-steroid
recovery strategies"? Well, this user later lost his gains and ended
back where he started from. But some steroid users have been able to heal
post-cycle, so perhaps this will be possible in the future. Hopefully, some of the anti-aging and sports medicine physicians will test and
develop strategies that can help some men with their secondary hypogonadism. Right now, though, it is much
more "art than science."
5. HCG Monotherapy. Some men are just leaving out the testosterone
altogether and sticking to just straight HCG (and Arimidex almost always).
I discuss this option in my link on HCG Monotherapy.
Remember: almost all of these usages are off label and have little study
work behind them. With HCG you are almost always relying on the expertise
and judgement of your physician, so get a good doc with good experience. Remember that
more is NOT better with HCG and the knowledgeable docs advocate low dosage HCG. If you go
high enough with HCG, it is common knowledge that it can desensitize receptors.
NOTE: One interesting potential benefit of HCG is the adrenal connection. Leutinizing Hormone
actually stimulates, at least in men with low adrenal function, the cholesterol to
pregnenalone pathway and thus may help some men in later stages of adrenal
HCG with HRT Protocol:
This is the protocol that my current HRT clinic uses and the pattern seems fairly common:
1. You self-inject 250 IU subQ (subcutaneously into adipose (fat) tissue) on the day before your weekly cypionate injection.
2. On the day of your injection you will also receive another 250 IU injection of HCG.
3. Arimidex dosing remains as it was before. Because you only inject HCG on your lowest testosterone days, increasing the Arimidex
dosage is not a concern.
About 85% of the men at my clinic are on HCG and around half say that they feel some kind of significant positive effect.
How much will HCG increase your testosterone? This is highly variable and varies between about 50-300 ng/dl according to the information
that I was given. Of course, this does depend on the dosage you are given.
NOTE: HCG has a 24-hour half life and so this protocol only has significant HCG in your system for maybe 72 hours. However, this
is enough to keep the testes alive and most men with shrinkage will see an increase in testicular volume from this.
NEWS FLASH: Dr. Lipshultz has several studies under his belt showing that most men on HRT can maintain their fertility if they add in low dose HCG. One study put men either on injections or daily transdermal (topical) testosterone gels and then added in 500 IU every other day of HCG. The abstract states the remarkable results that "no impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during followup."  Fertility is so important that I encourage you to talk to fertility specialist and come up with a treatment plan that will work for your situation rather than just go by this one study. But, yes, it looks like you can have your cake and eat it too!
1) http://peaktestosterone.com/forum/ index.php?topic=107.msg1176#msg1176
4) "AN UPDATE TO THE CRISLER HCG PROTOCOL", By John Crisler, DO
6) The Journal of Urology, February 2013, 189(2):647–650, "Concomitant Intramuscular Human Chorionic Gonadotropin Preserves Spermatogenesis in Men Undergoing Testosterone Replacement Therapy"