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Author Topic: HCG monotherapy - help needed  (Read 807 times)

daniel731

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HCG monotherapy - help needed
« on: August 06, 2017, 03:53:17 am »
Hi.

I am 43 yo, and i "suffer" from many LowT symptoms since 1 year. After waiting for months i decided to do blood tests and resulted in TT around 370 (range 350-890), SHBG 41, E2 undetectable (LH and FSH in good range, PRL in normal range))....these values were confirmed in a second test. Only 2 years ago i had TT in 600s-650s and E2 in normal range.

Today i went to endo. After seeing my tests he told me that i am "within range" but very close to the limit where i should be treated.

His therapy is the following: 5000 UI HCG every 10 days for 8 weeks, then do new blood tests at the 9th day (so the day before the injection) to see where my test is.

His reason is to verify if my testes can produce more testosterone. Based on what i read here or in other forums, HCG should be taken in much smaller doses and 2x or 3x week. His therapy is very different. Can anyone help me understand the reasoning for this decision and if they are studies or therapies similar that were successful?
Thank in advanca

Cataceous

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Re: HCG monotherapy - help needed
« Reply #1 on: August 06, 2017, 06:33:41 am »
That is a strange protocol in my opinion. It doesn't seem particularly appropriate as either therapy or as a stimulation test. The half life of hCG is under two days. Testosterone production maybe peaks around three days post-injection. It seems pointless to measure nine days out. Here's a published paper on stimulation testing: https://www.ncbi.nlm.nih.gov/pubmed/15641263
They are using first and fourth day testing.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

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Re: HCG monotherapy - help needed
« Reply #1 on: August 06, 2017, 06:33:41 am »

PeakT

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Re: HCG monotherapy - help needed
« Reply #2 on: August 06, 2017, 10:17:34 am »
Hi.

I am 43 yo, and i "suffer" from many LowT symptoms since 1 year. After waiting for months i decided to do blood tests and resulted in TT around 370 (range 350-890), SHBG 41, E2 undetectable (LH and FSH in good range, PRL in normal range))....these values were confirmed in a second test. Only 2 years ago i had TT in 600s-650s and E2 in normal range.

Today i went to endo. After seeing my tests he told me that i am "within range" but very close to the limit where i should be treated.

His therapy is the following: 5000 UI HCG every 10 days for 8 weeks, then do new blood tests at the 9th day (so the day before the injection) to see where my test is.

His reason is to verify if my testes can produce more testosterone. Based on what i read here or in other forums, HCG should be taken in much smaller doses and 2x or 3x week. His therapy is very different. Can anyone help me understand the reasoning for this decision and if they are studies or therapies similar that were successful?
Thank in advanca

Weird protocol as Cataceous said.  If he is trying to do a restart, as far as I know, the above will not work.  You would need to include a SERM such as Clomid:

http://www.peaktestosterone.com/testosterone_restart.aspx

You want to check to see if you can find the root cause of what is going on before you do anyting esle imo:

http://www.peaktestosterone.com/Causes_Of_Low_Testosterone.aspx
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program.aspx
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

daniel731

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Re: HCG monotherapy - help needed
« Reply #3 on: August 30, 2017, 11:41:31 am »
Thanks for the replies.

After reading your advices and other protocol in internet, i talked to the doctor for lower doses, we decided to start with lower doses: 300 UI 3 times a week (MWF).

I took blood on Monday before injection (2 days after last HCG injection). Results are as follow:
TT: 430 (280-860 ng/dl)
E2: 28 (25-60 pg/ml)
SHBG: 40.8

I am unsure how to proceed. Before talking to Doctor i wanted to have some advice here.

I have some doubts:
- how do TT levels fluctate with HCG during monotherapy? I mean, is the day i tested my trough with this therapy ? If this is the trough and other days it's higher, the dosage is at least working, if it's not than i am not getting the responce i and the doctor were hoping
- calculated free T (in italy there is no way to have sensitive test for free testosterone) is still very low and barely in range and TT didn't come back to previous values (600-700). Should i increase the dose ? but i fear E2 will increase a lot too.
- given that 300 UI basically didn't make the testis produce more of what they were producing normally, does it mean it's useless to increase the dose since testis are basically already working at their max (so i am primary) ?

Symptoms improved very slightly but maybe since it's 3-4 weeks it will take more time. I sleep a "little" better, i am less fatigued in the evening, sometimes i get morning/nocturne wood (even if not rock hard...like 4-5 times in a month, before was zero in 1 year or more...3 years ago i used to have morning wood almost daily).

what is your advice?

Cataceous

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Re: HCG monotherapy - help needed
« Reply #4 on: August 30, 2017, 12:47:20 pm »
Your current protocol of 300 IU hCG 3 times per week seems to be working, but it's a low dose for monotherapy. I would not expect a large variation in serum testosterone with this schedule. As you say, your free testosterone is low, at 7.8 ng/dL or 1.8%. You will need to raise the hCG dose to achieve better levels. Your estradiol isn't bad, so you have some leeway there. I would ask the doctor about trying 450 or 500 IU 3 times a week.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

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Re: HCG monotherapy - help needed
« Reply #4 on: August 30, 2017, 12:47:20 pm »


daniel731

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Re: HCG monotherapy - help needed
« Reply #5 on: August 30, 2017, 02:43:28 pm »
Your current protocol of 300 IU hCG 3 times per week seems to be working, but it's a low dose for monotherapy. I would not expect a large variation in serum testosterone with this schedule. As you say, your free testosterone is low, at 7.8 ng/dL or 1.8%. You will need to raise the hCG dose to achieve better levels. Your estradiol isn't bad, so you have some leeway there. I would ask the doctor about trying 450 or 500 IU 3 times a week.
thanks for the answer.

What is the best day to have blood test during HCG mono ? or are levels stable during all days ?

Cataceous

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Re: HCG monotherapy - help needed
« Reply #6 on: August 30, 2017, 02:57:27 pm »
With this dosing frequency I wouldn't expect more than +/- 10 or 15 percent variation in serum testosterone, and the peaks and troughs would be hard to predict theoretically. So test when it's convenient.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

daniel731

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Re: HCG monotherapy - help needed
« Reply #7 on: September 02, 2017, 06:20:28 am »
With this dosing frequency I wouldn't expect more than +/- 10 or 15 percent variation in serum testosterone, and the peaks and troughs would be hard to predict theoretically. So test when it's convenient.
thank you for answers.

After talking to doctor, he decided to raise the dose to 500 MWF and retest in 20 days.

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Re: HCG monotherapy - help needed
« Reply #7 on: September 02, 2017, 06:20:28 am »

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daniel731

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Re: HCG monotherapy - help needed
« Reply #8 on: September 16, 2017, 04:15:45 am »
Doc increased the dose to 500UI MWF.

I had blood yesterday:
TT: 570 ng/dl
E2: 26 pg/ml (25-50)

What do you think ? TT raised slightly, E2 stayed the same. Please take note that E2 is not sensitive (impossible to test sensitive in my country).

Considering my SHBG at 40 (i assume it stayed the same) my free test is still on the low range. is it worth upping the dose more ?

Cataceous

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Re: HCG monotherapy - help needed
« Reply #9 on: September 16, 2017, 05:35:12 am »
I think that's pretty good progress (FT ~11 ng/dL, 1.9%) . I also think you do still have room to increase the dose of hCG, but it's probably a better idea to wait at least a month or two. When testosterone levels are normalized in hypogonadal men there can be significant delays in the abatement of different symptoms, even as long as a year in some cases. It's difficult to have patience when you're not feeling well, but it's preferable to avoid going to a dose that may be higher than you need, and which may cause other problems if you push estradiol too high.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 56, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 250 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

Torrential

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Re: HCG monotherapy - help needed
« Reply #10 on: September 16, 2017, 12:55:25 pm »
My advice is to take your time.  You've seen a nice response to the initial protocol.  Let it run for a couple of months, for at least one lab test cycle.  A T level of 570 is good.  Right now, during this ramp-up period, your free testosterone % is higher than normal. This will stabilize after a while and help lock in the number for T and Estrogen. 


Again, let it run like this for as long as possible.  It's easy to forget but there is nothing magical about any specific T level. There is no reason to believe you'll do better at, say, 800, then you will at 570.  You now have  more than you had to start AND your body is creating it "naturally" with all of the beneficial effects of stimulating the related metabolisms.  For now, count yourself lucky:  HCG Monotherapy would be THE preferred hormone therapy for men but it doesn't work consistently for many of us. 


Regarding your question about best time of day to get tested, for me mornings are best, before breakfast.  Before coffee even.  The important thing is consistency. Choose a time and day, the same point in your injection cycle each time, for all lab work.
Age 53, 5'11", 210#
Dec '15:  T-total 901, T-free 159.1, E2 17, SHBG 28
Mar '16:  T-total 801, T-free 208.8, E2 18, SHBG 14
Jun '16:  T-total 678, T-free 31.9 (above range); E2 9; working to increase SHBG
Sep '16:  T-total 1075, T-free 31.4, e2 50 (wow)
Jan-Mar '16:  T-cyp 120mg per week @34mg EOD; 300IU HCG EOD, 0.25 Anastrozole E3D
Apr '16: T-cyp 105mg per week @30mg EOD; 300IU HCG EOD; 0.25mg Anastrozole E3D
Jun '16:  Low E2: dropping Anastrozole, reducing HCG to 250IU EOD.  T-Cyp 16ml/32mg EOD
Supps:  SloNiacin, aspirin, Vit. C., aged garlic,
Meds:  Jan '16 10mg Lisinopril ED. Jun '16 upped to 20mg

PeakT

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Re: HCG monotherapy - help needed
« Reply #11 on: September 17, 2017, 04:35:11 pm »
Doc increased the dose to 500UI MWF.

I had blood yesterday:
TT: 570 ng/dl
E2: 26 pg/ml (25-50)

What do you think ? TT raised slightly, E2 stayed the same. Please take note that E2 is not sensitive (impossible to test sensitive in my country).

Considering my SHBG at 40 (i assume it stayed the same) my free test is still on the low range. is it worth upping the dose more ?

My only concern is that at 26, you could be borderline low in estradiol.  And, if you go low enough with estradiol, you could get bone loss.  Hard to say...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program.aspx
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: HCG monotherapy - help needed
« Reply #11 on: September 17, 2017, 04:35:11 pm »