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General Category => Testosterone, Hormones and General Men's Health => Topic started by: Tn198989 on July 22, 2020, 12:14:32 pm

Title: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on July 22, 2020, 12:14:32 pm
Hello everyone,
First post here

I have done 2 cycles of only T (last one was on 2018) for 10 weeks each. I've done the standar pct with clomid and nolva but never recovered from the second cycle and i still suffer from ed and low libido. I've done multiple bloodworks, my T hovers around 700 - 900 which is optimal. Everything else has fluctuated over the last 2 years. I've tried lowering e2, let them go higher, tried lowering shbg from 45 to 30 (proviron) with little to no effect on libido or ed. Anyway last week i went to a doctor who specializes in these kinds of problems and he suggested ovitrelle (hcg) for 3 months and then slowly tapering off of it hoping that this would somehow fix me.
The problem is that that the dose he told me to take is 3250 iu twice a week which sounds ridiculously high. I told him that i dont want to desensitize my leygid cells but he insited that i take that dose for at least 15 days and then get bloodwork. I've already taken the first dose. He also said that with that dose his patients total t is around 600 and that hcg shutdown is different from Testosterone shutdown and that i will bounce back very fast. Is he wrong or is there something i am missing? Also its the third day since the first dose and no effect on ed and libido still but it might be too soon to tell.

Thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on July 22, 2020, 02:32:15 pm
I'd like to know what the theory is behind this treatment. I don't see why it should be that helpful if you're already producing normal amounts of testosterone. HCG in these amounts almost surely will be suppressive of your other natural hormones, including kisspeptin, GnRH, LH and FSH. It's also likely to create excess estradiol. The main difference between a shutdown caused by hCG and one caused by exogenous testosterone is that the hCG stimulates production of endogenous testosterone. Therefore it's less likely to cause testicular atrophy.

If it were me I would try a trial with a SERM. Then there's no hormonal suppression.

Have you done additional lab testing, including DHT, progesterone, thyroid hormones, DHEA, etc.?

It occurs to me that another difference with hCG use versus testosterone is that at least in young men it can raise progesterone. It would be useful to know levels before and during treatment.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on July 22, 2020, 03:47:20 pm
I've done like 3-4 pct's with either nolva or clomid during these 2 years and little to no effect on erectile function or ejaculation.

I wish i knew what his theory is myself. I've researced for almost a year and a half what could cause my symptoms with high T but i could'nt figure it out..2 endo's suggested that my receptors might be desensitized from the cycle which sounds unlikely after 2 years although the symptoms agree. Except from the low libido and ed (ed is the biggest issue i am trying to fix) i also have very watery ejaculation ever since my first cycle in 2017 but my fsh is around 6-7 which is optimal. I think his theory is that my body needs to remember what its like to get 100% erect (like if you dont use it you lose it theory) and then slowly taper off or add a serm for just a week at the end. No additional testing available where i live just the usual Total T, E2, Thyroid Hormones, shbg, Prolactin. About the shutdown he thinks that the lh bounces back way faster after hcg than Testosterone. My main concern isn't the hpta ( right now my bloodwork says its optimal and i still have ed) but the leygid cells desensitization caused by such a high dose of hcg. The shutdown is inevitable anyway even with a low dose because i will be taking hcg for 3 months. The only thing that ever helped with libido (but not so much with erection strength) was proviron. I've tried everything i can to fix all hormones to ptimal levels except for HCG cause i though its counter productive after or during pct.

Here is my latest bloodwork

Total T 932   Ref. Range  300-800
E2  43       Ref. Range 27-60
Prolactin 4.5   Ref. Range 4-18
SHBG  36.8    Ref Range  15-55
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on July 22, 2020, 04:39:23 pm
Personally, with those numbers I wouldn't bother with hCG. Maybe take a look at neurotransmitters. Experiment with some of the ingredients in JustAskin's stack (https://www.peaktestosterone.com/forum/index.php?topic=9644.0).
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on July 22, 2020, 06:24:47 pm
I'll try the supplements about the neurotransmitters but  I'll go with the doc cause he was confident that with hcg he can bring me back 100% and apart from the dose which seems a little off he seemed to know what he was doing and he says he has seen it in the past (high T after cycle but ed and fertility issues). I'll just ask him to lower the dose. Maybe my receptors are damaged and need higher levels of T. I am kind of desperate and tired about the whole thing cause its been a long time and i've spent many hours reading online, seeing different doctors (endo's, urologists etc) trying to fix the issue. Thanks for your help. I'll post again if there's any progress just in case someone is in the same spot
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on July 23, 2020, 07:51:52 pm
Do you know how long it takes to feel the effects of hcg  (if I feel anything) approximately? Cause today I took the second dose, it's the fourth day since I started and still nothing. Should I give it another week?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on July 23, 2020, 10:53:26 pm
It's possible you'd have some positive effect in the first couple weeks if you get some extra testosterone production. Increasing levels frequently give a temporary boost. But later you might have some issues: estradiol could become excessive, and overly high doses of hCG actually cause less testosterone production than more reasonable amounts. Ref (http://jpet.aspetjournals.org/content/289/1/371).
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Baldur2630 on July 25, 2020, 08:34:33 am
Once again as always, doctors only measure TOTAL testosterone. Insist on FREE testosterone, you may well be in for a shock unless your so-called doctor refuses to have it tested (as mine did). It took me two changes of Doctor to actually get it done (and it was ZERO)
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 07, 2020, 05:30:37 pm
I will ask for free testosterone test ASAP.. Although I have done one like 3 months ago and it was 17pg/ml ref range 13-35
Anyway I am at the end of the third week of hcg and aromasin but still weak erections.
I did bloodwork at two week and here are the results
Total T 717
E2 45 ref range 11-44
Prolactin 8.8
Shbg 30
Lh 2.7
Fsh 1.7
So my total t is actually lower than before, e2 slightly higher, lh, fsh at the bottom due to hcg.
Weird thing is that my ejaculation volume has increased. Don't know how that's possible with lower total t than before.. My shbg dropped cause I was taking proviron before I started hcg to lower it from 45. Also I get a little discomfort on testicles for the last week.doc said it's a good thing and that they are coming back but what do you think.. And lastly I have been taking 6500iu per week of hcg for the last 3 weeks.. How come my total t is only 717 (even lower than before) and how come there is an improvement in ejaculation. He actually said that the guys he is treating with hcg hover around 600-700 total t with that dose. Should'nt it be much higher? With Nolva 10mg ed my total t would go to 900 but no effects on ejaculation volume or libido. Are my androgen receptors desensitized and can hcg help with that. Like wake them up. The only thing I can think of is that my intratesticular testosterone wasn't high while serum t was..and hcg increased that..dont know if that's even possible, just a thought. Thanks for all the help and sorry for the long post.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 08, 2020, 02:03:34 pm
Though speculative, I'll agree that ejaculation volume is likely up due to increases in intratesticular testosterone from the high hCG, aided by the fact that LH and FSH are not fully suppressed yet. I'm not surprised that serum testosterone is lower. As I mentioned above, that's what's expected when the amount of hCG used is excessive. I remain skeptical of this treatment.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 08, 2020, 06:36:29 pm
I am too. It does seem excessive. But no other treatment has helped me so far. The only thing I am trying to fix is the erectile dysfunction.. I don't care about fertility. But it's three weeks and 20.000 ius later and still nothing in that department. Should I slowly taper off and start a serm to restore lh/fsh? I thought that the testicular pain might be from the testicles waking up or something.. What do you think? Or could it be just from the high dose? I mean if there is a difference in serum and testicular testosterone  and it's not detectable in the blood test then I think that that is my problem cause every blood work shows normal/high total t but my symptoms are Ed and watery clear ejaculation. If it was androgen insensitivity from the cycle I thought I would have other symptoms like loss of muscle mass etc..
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 09, 2020, 01:48:46 am
I get that testicular ache going in either direction. I had it when I first started TRT without hCG. Then again when I added hCG. And yet again when I stopped hCG after introducing GnRH. This last time I think testicular volume was increasing due to restoration of FSH. Honestly I'm not even sure which direction you're going; LH and FSH are probably going down, but hCG is acting like an enormous amount of LH.

Obviously I can't tell you what to do, but I think in this situation I would stop the hCG cold turkey because there's still gonadotropin activity (LH/FSH). This should mean a shorter recovery time.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 09, 2020, 06:11:22 am
The problem is recovery to what?.. The place i was before? With normal Lh Fsh Total T.. and low libido, ed, and watery semen. Maybe I could add a low dose serm to keep htpa from shutting down. The only reason i keep taking the hcg is that it could somehow wake up the testicles to respond to my otherwise normal testosterone.and as you say the pain only came when your testes went to sleep or wake up.If your testes worked normally you wouldn't feel that, right? With all that HCG i doubt they are going to sleep. The LH/FSH is useless while on HCG thats why it shutsdown so the low levels dont mean anything in matters of testicular function or ejaculation volume.  But something isn't working right and i think its the testicles. I am trying to shock the system..What else is there to do? If that doesnt work i might go on TRT..which is the last thing i want
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 09, 2020, 10:07:34 am
It's a recovery to known good levels of the sex hormones. It means an acknowledgement that these are probably not directly related to your symptoms. What you're doing is analogous to having a car that's not running right and replacing parts that have already tested ok with lower quality parts. I'm not saying I wouldn't do something similar, because it's natural to want to do something.

At least fill in some of the missing tests. Surely you can get progesterone and DHEA-S?

You might talk with a doctor about lowering prolactin as an experiment. Some men say they need to have it below 5 ng/mL for normal libido. This could involve taking very small doses of cabergoline. I'd start with only 50 micrograms twice a week, wait a few weeks to stabilize and then get new lab work. Titrate the dose as needed. See if it makes any difference.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 09, 2020, 10:38:28 am
 You are right.. It is a desperate move.. The prolactin isn't the issue I 've been there.. It was 18 and took caber and dropped it to 3. Can I get away with 1000iu 3 times a week for another couple of months along with 10mg Nolva ed and aromasin 25mg eod without desensitization just in case the doc is right. I have blood work from before ever touching steroids total test was lower at 500 e2 at 42 and I was ok.. No libido issues or ed.. That's why I think blood work could be misleading. I will definitely ask for the blood work you suggested along with free t. But I thought that dhea and all that stuff were precursors of testosterone so if you have good total t then you are ok.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 09, 2020, 11:48:15 am
Do you know what type of estradiol tests you've been getting? LC/MS (sensitive) or immunoassay (regular)? Your results seem a little funny to me, and in particular it's odd that you didn't get much extra with the hCG. But it's not necessarily meaningful.

Yes, DHEA is a precursor to the other sex hormones. But you're still looking for hints that something is wrong in that chain of metabolites. And if it's low for your age then supplementing is simple. Occasionally someone will claim to be helped by DHEA.

Similarly with progesterone, high or low levels may cause problems. And if low, an experiment with supplementation is easy.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 09, 2020, 12:58:41 pm
I've been getting the regular one which is for women but they change the ref range. The other one is not available in my country. I've asked all over. It could be the e2 though.. After my first cycle I had the same problem for like 7-8 months after.. No libido ed, watery semen all of it.. And blood work seemed normal except from crashed e2 from previous arimidex use. Then I took clomid 50mg ed for a month and I saw improvement but not 100 percent. After that I waited for a month and had blood work done which showed e2 70.the doc II had back then told me to go another month of clomid along with aromasin and I recovered completely. Of course I tried that even after my second cycle but it didn't work. And I have dropped my e2 one time last summer to 29 with no improvement although I had very high shbg back then which could play a role. I am taking a aromasin now and there is some small improvement from last week. But to tell you the truth I don't even know what my e2 should be.. Some say 22 is optimal, others 20-30, others that high e2 is good if you have high testosterone. Can a 45 level be the cause (if it is accurate). And where should I drop it to.. As I said I crashed them once and it was the same as being high.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 10, 2020, 11:02:26 am
Given that you have experienced various levels of estradiol it seems less likely that it has much relevance to your problems.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 10, 2020, 12:10:53 pm
Well it does have some effect. Back in January i was much better erection wise and i had e2 34pg/ml (now 45). But i still keep messing around with medication cause even then it wansn't 100%. But i think that the low ejaculation volume with normal testosterone and fsh levels has something to do with the ed problem. Something we are missing. And the hcg is improving the ejaculation at least. Thats why i want to keep taking it and maybe add some low dose nolva to keep lh/fsh from plummeting. Just in case its an issue with the intratesticular testosterone or something similar. Plus the testicle pain ever since i started hcg seems like something is happening. I dont know maybe its from the high hcg dose (which i lowered to 1000ius eod) or the testis are waking up after 2 years of producing low sperm. My doc measured the testicles and he said that they are small and barely make the normal range. Maybe its androgen receptor downregulation or damage although i read that its not likely cause i would have other symptoms like no gains in the gym, no body hair grow etc..Anyway thanks for your time and help. I'll post again if i figure it out
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 10, 2020, 08:10:45 pm
Personally I've found ejaculate volume was poor under TRT alone, better but so-so with hCG added to TRT, and practically normal with GnRH and enclomiphene added to TRT without hCG. This latter treatment raised LH and FSH from near zero to low-normal, both around 2 mIU/mL.

I'll mention this though it may not be at all related to your issues: I started experimenting a little with kisspeptin-10. An unexpected correlation is considerably more frequent and prominent nocturnal erections. Erections and libido are specifically mentioned in some of the literature on kisspeptin:

Quote
It is therefore possible, that other factors are also important in modulating libido that may include upstream kisspeptin signaling. Certainly, the expression pattern of kisspeptin and its cognate receptor in limbic and paralimbic structures would point towards this as well as the more recent studies identifying a role in sexual brain processing and erection generation. Further studies are required to determine if kisspeptin signaling could be exploited in future therapies for patients with sexual and emotional disorders.
[Ref (https://www.karger.com/Article/Pdf/481137)]

I discuss kisspeptin a little more here (https://www.excelmale.com/forum/threads/kisspeptin-suppression-under-trt-can-it-affect-mood-and-libido.21374/). In considering your issue I wondered what kind of problem at the hypothalamus might still allow for normal GnRH and gonadotropin and testosterone levels. It may just be an outlandish hypothesis, but what if kisspeptin levels are diminished, not enough to reduce GnRH, but enough to cause these problems at other brain locations?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 11, 2020, 04:57:24 am
Never even heard of kisspeptin.. It could be.. I'll read about it. The only thing that gave me morning and nocturnal erection was proviron. which I took a couple of months ago to reduce shbg, which I did. full libido, all the time horny but could only get to 70% erection. . But I have never tried gnrh or tripto.. I don't know much about it.. Clomid on the other hand (enclomiphene not available) I have some experience.. It was what recovered me after my first cycle along aromasin and I had improved ejaculation volume with it but not normal.. Still watery and clear.. Just more than before.. On the first cycle I used low dose hcg throughout but at the second I didn't.. I think that's why it's taking so long. Even if the numbers say I have recovered. Cant take clomid now though cause it's causing me a weird chest pain every time I take it. I also switched from aromasin to arimidex cause although it's considered the best of the 2, aromasin doesn't seem to lower my e2 that much..been taking it for a week 25mg eod and no difference, and yesterday I took 0.5 arimidex and in 2 hours I felt a difference. Will taking 10mg of Nolva eod along the hcg keep my hope from shutting down??
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 11, 2020, 02:29:32 pm
There is some research showing that a SERM combined with hCG retained some HPTA activity. Unfortunately I don't recall the doses or duration of the trial. These could certainly influence the outcome.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 12, 2020, 04:35:31 pm
Thinks are going from bad to worse unfortunately.. Two days ago I was frustrated about not feeling any difference from all the medication and took 0.5 arimidex (was already taking asin 25mg eod) . Boom after 3 hours raging libido. Ed not cured but better.

Then after two more hours panic attack, dehydrarion and peeing like crazy. Next day clicking knees and pain.   Libido dead. I should also mention that I have been taking daily cialys and viagra on an as needed basis. Still not much. I took some clomid to raise e2 ASAP and my hcg dose of 1000iu.

Anyway I decided to come off the hcg with a taper for two weeks and add clomid or Nolva to increase lh. I need your help with two things. First does clomid raise shbg by increasing e2 and you can control that with asin or another mechanism? Or should I go with Nolva, asin?

And second, since I can't seem to find what is going on with the basic bloodtest (lh, fsh, shbg, total t, e2, prolactin). Could you tell me everything that I should test (like dht, igf-1 etc) thanks
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Flyingfool on August 12, 2020, 07:27:26 pm
TN1989

My observation and I could be wrong. Is that you are changing too many things, much too fast.

I understand the incredible frustration with lack of results. But with hormones, they are all so inter-related and sensitive, low and slow changes one at a time seems to be the best idea, but it can be painfully, frustratingly and glacially slow process.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 12, 2020, 08:43:56 pm
Clomid probably raises SHBG in two ways, both related to estrogenic effects on the liver. First there's the direct increase in estradiol stimulated by higher testosterone and LH-stimulated intratesticular aromatization. Second, the zucomiphene isomer is estrogenic and probably acts directly on the liver. As an aside, I've been taking enclomiphene, the other isomer of Clomid, and have not seen a change in SHBG.

An aromatase inhibitor has no effect on zuclomiphene, limited effect on intratesticular aromatization, and a significant effect on other systemic aromatization.

Tamoxifen does not have an estrogenic component, but otherwise acts similarly to Clomid.

It wouldn't hurt to look at DHT, IGF-1, also progesterone and thyroid hormones (fT3, fT4, rT3) if you haven't already. I'm not expecting to see anything too out of line. There are way too many guys in this position, with good basic numbers but still having low libido and other problems. Unfortunately I don't think there are widely available tests for kisspeptin levels. Maybe in time more doctors will prescribe kisspeptin-10 as a stimulation test in cases where nothing else is obviously wrong.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 12, 2020, 09:05:55 pm
TN1989

My observation and I could be wrong. Is that you are changing too many things, much too fast.

I understand the incredible frustration with lack of results. But with hormones, they are all so inter-related and sensitive, low and slow changes one at a time seems to be the best idea, but it can be painfully, frustratingly and glacially slow process.

You are right. I do. Its just so frustrating. It has severely affected my job performance and relationship with gf. And when your bloodwork seems ooptimal it is even harder to deal with. If i had low t it would be more simple. Try a couple of restarts and if they dont work go to trt. But as i said you are right and i need to deal with it more mature.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 12, 2020, 09:14:41 pm
Clomid probably raises SHBG in two ways, both related to estrogenic effects on the liver. First there's the direct increase in estradiol stimulated by higher testosterone and LH-stimulated intratesticular aromatization. Second, the zucomiphene isomer is estrogenic and probably acts directly on the liver. As an aside, I've been taking enclomiphene, the other isomer of Clomid, and have not seen a change in SHBG.

An aromatase inhibitor has no effect on zuclomiphene, limited effect on intratesticular aromatization, and a significant effect on other systemic aromatization.

Tamoxifen does not have an estrogenic component, but otherwise acts similarly to Clomid.

It wouldn't hurt to look at DHT, IGF-1, also progesterone and thyroid hormones (fT3, fT4, rT3) if you haven't already. I'm not expecting to see anything too out of line. There are way too many guys in this position, with good basic numbers but still having low libido and other problems. Unfortunately I don't think there are widely available tests for kisspeptin levels. Maybe in time more doctors will prescribe kisspeptin-10 as a stimulation test in cases where nothing else is obviously wrong.

Yes but for some reason clomid raises ejaculation volume more than nolva. Anyway i'll do bloodwork tommorow (only e2) to see if i crashed them. And then nolva, or clomid with aromasin for 4 weeks (and maybe some proviron to keep gf happy). After that i'll wait for 4 more weeks and do bloodwork with all the extra you mentioned, plus free T no matter how inaccurate it may be. Do you know how long for hcg to clear my system cause in 2 weeks i am going on vacation with gf and i dont want to be crushed at that time. Should i keep taking it until then at lower dose along with a serm or it will have cleard my system before that if i stop now? I have taken about 13000 ius in total.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 13, 2020, 11:43:26 am
Since November 2018 only 2 things gave me brief relief from ed and low libido symptoms. Nolva when taken for 4 weeks at 10mg eod but it only lasted for a couple of days. I guess it either raised e2 after that or shbg. and the second is proviron a couple of months ago. So i think i should take these 2 for 4 weeks so that i can raise free t by increasing lh with nolva and keep shbg low with proviron. I know its a little suppresive but i dont think it will have that effect along with nolva. If and when i get that symptom releif i'll do a complete bloodwork to see what my labs are when i feel good.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 13, 2020, 11:47:59 am
If the half-life of hCG is about 36 hours then it takes maybe a week to ten days for it to be pretty thoroughly eliminated. This doesn't address lingering effects, which could last longer, particularly if there's been more HPTA suppression, which then takes time to reverse.

I think your plan is reasonable under the circumstances, but it's likely not directly addressing any underlying issues; it's mainly giving them more time to resolve naturally.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 13, 2020, 02:32:00 pm
If the half-life of hCG is about 36 hours then it takes maybe a week to ten days for it to be pretty thoroughly eliminated. This doesn't address lingering effects, which could last longer, particularly if there's been more HPTA suppression, which then takes time to reverse.

I think your plan is reasonable under the circumstances, but it's likely not directly addressing any underlying issues; it's mainly giving them more time to resolve naturally.
Are you reffering to the nolva + proviron plan? Also do you actually think that if i drop everything and let my body heal on its own, eventually everything will be back to normal?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 13, 2020, 05:39:01 pm
I meant that the SERM/mesterolone combination might help you function better while you return to baseline—with good numbers but poor results. If after this you recover libido and consistent erections then I would wonder how much the medications contributed, or if it was just that enough time had elapsed for some kind of natural recovery. I don't know what sort of odds there are for a spontaneous recovery to your properly functioning normal. If you exhaust all the more traditional treatments, including neurotransmitter enhancers, without seeing improvements then you might look into a trial of kisspeptin-10 and/or GnRH.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 13, 2020, 05:59:26 pm
Well I can only hope. I thought though that by adding mesterolone it would be a step back for recovery cause it might suppress me. What I am trying to do is boost free t as much as possible while decreasing shbg. Two months of proviron lowered my shbg from 45 to 30. I wanna take down to while boosting testosterone with the nolva. I'll update with any improvement hopefully. It might help someone with the same or similar issues. Lastly is there such thing as androgen receptor insensitivity from steroids? Like what happens with the leydig cells from high dose hcg.. Or is it just bro science?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 14, 2020, 11:39:48 am
Considering that there's virtually no evidence for long-term Leydig cell desensitization caused by excessive hCG use, the similar concept of androgen receptor insensitivity acquired by steroid abuse may be a myth as well. There are probably other things going on that are yet to be fully explained.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 15, 2020, 02:54:16 pm
 So I've been taking clomid 50mg and Nolva 20mg for 3 days. On the second day I added proviron 50mg and today I had a big improvement in libido and some improvement in Ed. So do you know how proviron works and what it affects? Cause maybe we can figure out the root cause of the problem.. I know it's a weak steroid.. But could it do in a day what no amount of hcg could in a month? And if I keep taking it at a low dose (25-50mg) will  I postpone even further the natural recovery or help it??
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on August 16, 2020, 12:15:16 pm
Hard to say what the mesterolone will do over time. I think it will be a little suppressive at the hypothalamus, but it should not affect the pituitary. So it might slow the return to baseline a little.

I wouldn't read too much into the improvements seen with a single dose. It's quite common to see positive effects from sudden changes in androgen levels. I can get those effects simply by adding some testosterone cream to my protocol. The problem is that the effects fade over time, whether or not the protocol addition is continued.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on August 16, 2020, 03:33:45 pm
 So I guess trt isn't gonna be of any help long term either if my total t is already high.. Only time then.. Thanks
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on September 03, 2020, 10:04:54 am
I just got blood work and wanted to update. I only did free testosterone and e2 cause I ll get the full panel after I stop the Nolva proviron to see where I am at.
E2 43 ref range 11 - 44 pg/ml
Free testosterone 11.60 ng/dl ref range 5.8 - 18 ng/dl
Two questions.. First I think I crushed my e2 three weeks ago cause suddenly my knees and bones in general started to ache and I had some palpitations for a couple of hours after taking arimidex. Right now e2 is ok but knees still hurt ever since.. Shouldn't that have stopped by now since e2 bounced back?

Second my free t seems kinda low and everytime I get blood work for it is on the low side while total is almost always on the higher side and my shbg can't be that high cause I am on proviron.
Could that be the source of all my issues? Also while on proviron at 50mg or higher I get morning wood back.. Maybe the calculated free t doesn't show the whole picture cause I've had blood work with high total t and mid range shbg but still symptoms of low t.

Thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on September 03, 2020, 12:11:56 pm
If your free T result is calculated then it means that albumin, total T and SHBG were measured. It would be nice to have these numbers. The calculation they use is probably an older one based on Vermeulen's method. The new Tru-T method (https://tru-t.org) is preferred. Nonetheless, for the older free T calculation I view 10 ng/dL as the cutoff below which hypogonadism is plausible.

The gold standard test for measuring free testosterone is equilibrium dialysis. If you have access to this type of test then it can give you the best estimate of free testosterone, though it may be more expensive.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on September 03, 2020, 02:01:35 pm
The latest result (11.60ng/dl) isn't calculated. I will do another bloodwork six weeks from now to see where I am at without any serm on my system and I will include all the usual t, lh, fsh, shbg, prolactin along with free t. I just wanted your opinion on the current blood work  cause right now I am 3 weeks on 20 mg of Nolva along with 50 mg proviron. Should I keep the dose for 2 more weeks? Drop the dose of Nolva? Target is to raise free t while either lowering or keep from elevating e2
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on September 03, 2020, 03:13:09 pm
Unless something fundamental has changed, when you stop the medications you will likely in time return to baseline hormone levels. I'm not sure the timing is that important. The baseline levels seemed ok, and probably are not the cause of your symptoms.

Something you might try is just occasional use of the Proviron, like once every week or two. At least a few guys have found that an intermittent boost of androgens provides benefits for several days.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Greatly on September 04, 2020, 09:18:17 am
If it were me I would try a trial with a SERM. Then there's no hormonal suppression.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on September 06, 2020, 10:11:27 am
Do you know how does proviron work? Does it increase testosterone or does it raise free t by blocking shbg? And does it raise dht? How does it increase libido? I am on it for 3 weeks and almost recovered in the libido department but I ran out 3 days ago and I can feel since yesterday that it wears off and libido drops. I don't think it's from the sudden change in androgen cause I've been taking it for 3 weeks. Not even high doses of hcg had any effect on libido.. But with proviron boom rock hard and horny all day.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on September 06, 2020, 12:50:10 pm
Proviron/mesterolone is an analog of DHT, meaning it acts similarly in the body. Like exogenous androgens in general it can over time reduce SHBG production, which may increase free testosterone. More immediately, in binding to SHBG mesterolone can displace some testosterone, which also increases free testosterone.

Admittedly three weeks is longer than the periods in which I've experienced transition "bonuses". Nonetheless, things can still be changing out to at least two or three months. So if you want to be more sure then a longer trial is needed.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on September 06, 2020, 04:47:24 pm
If it were me I would try a trial with a SERM. Then there's no hormonal suppression.
I've tried several attemps with serms (mostly nolva). I am actually taking 20mg nolva ed to recover my lh from the hcg along with proviron (but i know its the proviron that does the trick for libido).
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on September 06, 2020, 04:58:09 pm
Proviron/mesterolone is an analog of DHT, meaning it acts similarly in the body. Like exogenous androgens in general it can over time reduce SHBG production, which may increase free testosterone. More immediately, in binding to SHBG mesterolone can displace some testosterone, which also increases free testosterone.

Admittedly three weeks is longer than the periods in which I've experienced transition "bonuses". Nonetheless, things can still be changing out to at least two or three months. So if you want to be more sure then a longer trial is needed.
If its an analog then it won't affect the dht or total Testosterone bloodwork hopefully. I don't mind taking it long term although i've heard that it can mess lipids. Its just that i am trying for recovery here and maybe with proviron i can pintpoint what is the issue. Maybe its low free t (even with good shbg and total t) or dht. I just hope that 50mg wont cause any suppresion because with it i can at least function normally without obssesing over what is wrong and trying different serm dosages every week. Its weird though that 50mg of proviron does what no amount of hcg or serms can.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on September 07, 2020, 11:24:17 am
To get a rough idea of the suppressive potential of mesterolone: the absorption efficiency is supposed to be about 3%. So assume you're getting 1.5 mg. This possibly may be compared to natural testosterone production of 3-9 mg daily. Or, about 10% of testosterone is converted to DHT, so that's roughly 0.5-1 mg daily.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on September 07, 2020, 03:36:29 pm
So not much suppression then.. Well that's good news.. If it keeps working like it does now I am good to go. Thanks a lot
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: billsman on September 08, 2020, 03:05:33 pm
I don't have much to add, but I was prescribed 3,900 IUs of hCG for about 10 years.  This was from a doc who did a fellowship in male hypogonadal disorders at an Ivy League school.  I raise this point b/c even the best trained (and well intentioned docs) often use fertility protocols that are outdated. 

Cataceous:  You mentioned that you take gnrh injection.  I didn't even know that was an option.  Any particular brand?   
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on September 08, 2020, 06:21:13 pm
...
Cataceous:  You mentioned that you take gnrh injection.  I didn't even know that was an option.  Any particular brand?   

In fact a number of clinics are trying to palm off gonadorelin (GnRH) as an alternative to hCG now that hCG is becoming harder to get. But I'm skeptical because I don't think their protocols are viable. I describe my use of GnRH here (https://www.excelmale.com/forum/threads/pituitary-restart-while-on-trt-promising-initial-results-with-gnrh-plus-enclomiphene.20864/). Possible sources are discussed later in the thread.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on September 30, 2020, 12:11:50 pm
I am going to try citrulline along with 5mg daily cialis since I read that the reason low t causes Ed is that you have lower nitric oxide and that's why viagra or cialis don't work that well with low t. Do you think there's any truth to that. And although my blood pressure is normal is it dangerous mixing cialis and citrulline.. Thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on September 30, 2020, 07:11:28 pm
I'm not well-versed on nitric oxide, but this article (https://testosteronejunkie.com/nitric-oxide-testosterone/) does say that it is linked with testosterone, with some mutual influence, at least in natural conditions.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on November 11, 2020, 02:41:21 pm
I could really use your opinion once more.. I am trying yet another pct after going to another doctor. He suggested 2 weeks of hcg and then another 2 weeks of clomid 25mg Ed and Nolva 10mg Ed along with daa, maca, vit d3 5000iu. I ll skip the hcg cause I don't think it's necessary and it shut me down last time..

First of all the doc said that Nolva isn't enough for a kick start and nowhere near as sufficient as clomid.. Do you agree with that? Is clomid really better than nolva? Second he said that proviron which I haven't used in 2 months will hinder the attempt but with both serms and especially clomid my shbg will rise don't you think?

 I have it on hand but I ll wait for your response. Can clomid really make the difference? It is after all the only medication that restored me after my first cycle but I was avoiding it due to side effects it gave me.

Thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on November 11, 2020, 06:28:05 pm
Dr. Saya has stated that Clomid—clomiphene—is more effective than Nolvadex—tamoxifen—for HPTA stimulation. I'll go a step further and say that the enclomiphene component of clomiphene is even better by itself. The zuclomiphene component of clomiphene is estrogenic and works against HPTA activation. I've been using enclomiphene for most of the year with no negative effects. I consider it the drug of choice for this sort of thing. Use Clomid if you have to, but not if you can get a doctor to write a prescription for enclomiphene.

Proviron, aka mesterolone, is somewhat suppressive. It causes negative feedback at the hypothalamus. I'd avoid it if possible. It's true that Clomid can raise SHBG substantially. But this is due to the zuclomiphene. Enclomiphene alone does not do this.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on November 11, 2020, 07:19:26 pm
Thanks for the quick reply.. Unfortunately I don't think enclomiphene is available in my country.. Ok  I was thinking to go a month with 25mg clomid and 10 mg Nolva.. I wont use proviron.. I ll do another blood work about a month after I stop to see where things are and let you know of any progress. Any advice on my plan.. Are the doses ok??
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on November 12, 2020, 01:06:33 am
Your plan should provide a lot of HPTA stimulation. I'd expect high LH levels, and presumably high testosterone as well. But you had good number previously, so I'm doubtful this is going to lead to long-term resolution of symptoms.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on November 12, 2020, 10:55:07 am
Yes I did have good numbers..but I never checked free t before.. And last time I checked it was 11ng/dl which I think could cause the symptoms. Even though my total t was high at 750 and shbg was 35..thats what I am hoping to fix
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on November 12, 2020, 12:02:39 pm
I don't think we established which method was used to come up with 11 ng/dL for your free T. But excepting Tru-T, I don't think I've seen a scale where 11 ng/dL would be low enough to cause symptoms. With TT of 750 ng/dL and SHBG of 35 nMol/L Tru-T is giving 26 ng/dL (16-31). It is unlikely that low testosterone is your problem, either free or total.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on November 12, 2020, 04:04:24 pm
I've calculated it with many online methods including tru t and got to same result as you.. The 11 ng/dl came from blood work..
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on November 16, 2020, 01:33:26 pm
I am starting to notice some difference in erections and semen volume.. I think it's from clomid cause Nolva never did it in the past.. I am taking 25mg Ed.. Should I increase to 50mg? Will it be more beneficial or I should stick to 25mg?
Thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on November 16, 2020, 04:31:49 pm
I wouldn't go any higher than 25 mg daily with Clomid; that's the maximum guys should take long-term. Early on you may feel good effects related to the enclomiphene. But due to zuclomiphene's long half life it takes weeks to build up and possibly cause estrogenic mischief.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 07, 2021, 05:06:13 pm
Hello again.. It's been 5 weeks since I stopped the clomid and I have an appointment to get bloodwork done.. Could you please tell me every thing I should ask.. The basics I always test are total t, e2, lh, fsh, prolactin, shbg
What else that could possibly help identify my issue?

Thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on January 08, 2021, 03:58:48 pm
I would add progesterone to the tests. Also, have you measured free T3 and free T4 recently?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 09, 2021, 07:11:43 am
Ok progesterone added.. No I haven't tested free t3, t4 ever. Not just recently.. Every endocrinologist  I saw only tested tsh ( in my latest blood work it was 1.91)
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on January 09, 2021, 11:54:01 am
It is considered reasonable to check the underlying thyroid hormones at least one time when one is having problems. In addition to free T3 and free T4, reverse T3 may be worth looking at. Examples of a couple panels:
https://www.lifeextension.com/lab-testing/itemlc304131/thyroid-panel-tsh-t4-free-t4-free-t3-blood-test
https://www.lifeextension.com/lab-testing/itemlc100044/thyroid-panel-with-reverse-t3
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 10, 2021, 07:14:31 am
Ok I will do them. If there's anything else I should test please let me know.. Also the only thing I found that can help with my situation is either viagra or cialis along with high dose maca. In case anyone is in a similar situation
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 22, 2021, 08:28:22 am
Hello again,

So here is my latest bloodwork 6-7 weeks after last pct with clomid nolva..
Is there anything that could cause my symptoms (low libido, ed) based on this bloodwork or something that seems off?

(Τ3)  1.20 ng/mL 0.35 - 1.93

(Τ4) 6.09 μg/dL 4.87 - 11.72

Ε2 46 pg/mL 11 - 44

Total Testosterone 24.65 nmol/L : 1.63 - 34.00

SHBG 37.0 nmol/L 10.0 - 80.0

(FSH) 4.14 mIU/mL 0.95 - 11.95

(LH) 3.97 mIU/mL 0.57 - 12.07

(PRL) 5.73 ng/mL 3.46 - 19.40

Progesterone (PRG)  0.1 ng/mL 0.1 - 0.2

DHT 573.00 pg/mL 250.00 - 990.00
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on January 22, 2021, 12:27:53 pm
Overall pretty good looking numbers. Ideally you should have tested free T3 and free T4 instead of the totals. It's possible the highish estradiol and lowish progesterone are contributing to your problems. These hormones are supposed to balance each other, and yours could be out of whack. I think what I'd do if I had these numbers is try supplementing with a little progesterone and give it a couple months. I like to add progesterone to my injections, but most may prefer transdermal delivery. Among the topical preparations I prefer progesterone in coconut oil for its relative purity. It's easily obtained on Amazon. A reasonable starting dose is 5-10 mg. It can be applied to the scrotum for somewhat better absorption. Serum levels of progesterone and estradiol should be tested after a couple weeks to see if things are moving in the right direction. The dose can be adjusted up or down as needed.

If this trial didn't get anywhere, either subjectively or with respect to reducing estradiol, then I might consider trying some very low doses of anastrozole to at least get a sense of whether the estradiol level is actually a problem.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 22, 2021, 06:32:46 pm
Thanks for the quick response..
I dont know much about progesterone.. What you suggest is a supplement or medication?.. Can it increase progesterone too much and if yes will it make symptoms worse..

I was thinking of trying a low dose of aromasin (I hear it's better at increasing free t, lowering shbg, better on the lipids than arimidex) but I don't know what dose.. 6.25 mg every 2 days?

I always add low dose serm with the aromasin cause that combo is the one that brought me back when I was in a similar situation 3 years ago. I also read that it can raise progesterone.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on January 23, 2021, 12:39:21 am
I tried the Progestelle brand topical progesterone. It seems to be characterized as a supplement. It worked fine for raising my serum levels.

It is possible to use too much, which could create other problems. However, there's probably a decent safety margin in the short term. I was initially using several times as much as my final dosing, without any obvious problems. The blood test isn't too expensive, so keeping serum levels in the normal range shouldn't be hard.

I consider AIs more of a last resort. I'd definitely try progesterone first. It is a natural aromatase inhibitor.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 31, 2021, 11:20:41 am
Hello again.
So I ordered progesterone and I am waiting for it. In the meantime I started aromasin 6.25 mg eod and on the first and second day my libido was higher with bouts of anxiety.. From the third day until today (6 day).my libido dropped significantly but I doubt I crashed my e2 with such a low dose so soon. Could it be that I function better with higher than normal e2 (46)? What do you think?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on January 31, 2021, 01:12:41 pm
Estradiol is positively correlated with libido, though I'm sure there are limits. When I had a period of undetectable estradiol I also had undetectable libido. At the high end of the spectrum, excessive emotional responsiveness is the only symptom I've been sure about; I've had estradiol as high as 60 pg/mL and I can't say with certainty that it was hurting libido or sexual function. At those levels I had the sense that things weren't quite right, but nothing dramatic like intractable ED. It's possible that over time elevated estradiol contributes to a rise in prolactin, creating other issues.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 31, 2021, 03:56:36 pm
When your e2 was 60pg/ml how high was your total t? Cause maybe it was a ratio thing. Anyway I ll keep taking the aromasin for another week at this dose and I will get blood work again.. Some people say that they get symptoms like mine when they have e2 above 40..does e2 have any effect or correlation with free testosterone??
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on January 31, 2021, 07:14:30 pm
I've had estradiol hit the 60s twice. The first time total testosterone was only about 725 ng/dL, and the second time it was 900. If there were going to be problems you'd assume they would be more likely with the lower reading. The E2/T ratio is over 0.8%, much higher than the typical 0.4-0.5%. Looking back I see the numbers alarmed me and I did start low doses of anastrozole. But I don't think the overall TRT experience changed much with that—though it did cut back on that emotional responsiveness.

Estradiol should be well correlated with free testosterone; it's the aromatization of free testosterone that creates estradiol.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on January 31, 2021, 09:51:48 pm
So less aromatase (aromasin) more free t? I thought that the free t was what remained after the aromatization of total t to estrogen.. Maybe the lower libido is a result of the fluctuations of hormones cause I doubt I crashed my e2 or reduce even below 35pg/ml from 46 so fast.. Plus more free t should increase libido not drop it.. Thanks once again for your time
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on February 01, 2021, 01:08:32 pm
In guys on TRT the amount of aromatization has a trivial effect on testosterone levels. Estradiol is only running around 0.4% of total T. Furthermore, each 1 ng/dL of testosterone converts to 10 pg/mL of estradiol. So you can have have sky-high estradiol of 100 pg/mL and it only took 10 ng/dL of testosterone to get there.

It's a different story when your HPTA is working. Basically, testosterone production is regulated to achieve a fixed level of free estradiol. If the rate of aromatization decreases, such as through an aromatase inhibitor, then testosterone production is increased to maintain that desired level of free estradiol. So yes, you do get more free testosterone.

A speculative concern about aromatase inhibitors is the effect they have locally; that is, aromatase exists in areas such as the brain and vasculature. Is it possible that AI use leads to lower levels at these production sites, starving these tissues, even though total serum levels may seem ok? I don't think we know for sure.

The research on testosterone and libido shows that if you have normal testosterone then higher levels do not lead to further improvements. There's anecdotal evidence that sudden increases in testosterone help, but only temporarily.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: billsman on February 04, 2021, 11:04:55 pm
I'm jumping in here w/o reading all of the posts so please forgive me.  But I do know that there have been published studies that have found higher levels of e2 are associated with increased libido in men. I've wondered if my own experience with hCG, when I had very good libido was caused by my very high (>60) e2 levels (and eventual gyno). 

Food for thought.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on February 20, 2021, 06:33:08 pm
Hello again,

So after my last post I did 3 weeks of aromasin 6.25 eod. Since I couldn't afford another full blood work so soon after the last one I only checked e2 and it came back 36 pg/ml (it was 46 before the aromasin) I continued taking the asin for another week after the blood work to drop it a little further at around 30..

anyway unfortunately I noticed a decrease in libido and erectile function. ( but I did lose a lot of water weight which is a possitive). Again I am in square one.. Not even maca works anymore and it did work before.. Anyway I checked again all of my previous bloodworks and I found that the only consistent hormone that is higher than before I ever used steroids is shbg.. My pre steroids blood work from 2014

Was total t 500, e2 38 shbg 20
My latest blood work was total t 710 e2 36 shbg 37

I know that my latest blood work seems better than the old but I didn't have Ed back then.

Could the lowering of shbg help or fix the issue or is it not that important if my total t is high?

And lastly, someone suggested that I should stop everything and let my body without any medication for at least 4 months and things should improve. Truth is ever since my low libido and Ed started on November 2018 I haven't stayed off everything for 4 months. I always get blood work, assume that a hormone that is not perfect is the culprit and I try to fix it.

Could that be it?? Even with optimal bloodwork could the frequent change in hormones from serms, ai's cause the low libido and ed?

Thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on February 21, 2021, 05:25:04 pm
I think SHBG is good where it is, and free testosterone is mid-range according to the Vermeulen and Tru-T calculators.

There is something to be said for giving things a few months to settle down without any interventions. It's looking more like the problem is not related to any of the basic parameters you've measured.

Just wondering: Did you ever try the progesterone?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on February 21, 2021, 11:21:14 pm
Yes I did use it for 2 weeks.. The one for men which something like 3%..i didn't notice a difference.. But the truth is I didn't take on its own.. I had already started the aromasin so I can't tell you for sure what and if it did anything..

So since you seem to know a lot about this stuff and you have given me some pretty good advice what's your opinion?? Could all this be because I keep taking serms and ai's all the time after my last cycle on 2018? I rechecked my bloodworks and all of them had higher than normal lh cause I kept taking serms.. And I don't think I have ever been off a serm or ai all this time for more than 2-3 months.
I can't think of anything else if shbg is considered fine at this level.

Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on February 22, 2021, 02:33:47 pm
I don't know how likely it is that the previous treatments contributed to your problems, but it's at least possible. Given that there's no obvious target for further treatment it at least makes sense to take a break and see how you feel in a few months. These things can move surprisingly slowly. For example, regaining sperm production after steroid abuse can take over a year.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on March 29, 2021, 07:42:44 pm
Hello again, some good news at last not yet a new blood work but feeling much better.. I was taking clomid for 1.5 months and had very low libido while also taking proviron..

After stopping clomid and continue only with proviron I regained almost 100% libido.. (Ed fixed 80%). I reckecked all my bloodoeorks and realized that the lowest my shbg ever went was 36.8 (with proviron). I am really positive that this is my issue..

 My pre cycle shbg was 20..i just wanted to know how does proviron increase libido? Is it because it increases free t by binding to shbg or is it because of the dht itself.. Or is it not fully understood how it has that effect.. Also there are other dht derivatives like anavar but they don't have ptovirons reputation for increased libido.

Ps Maca still works (except while on closed) and is by far the best supplement I ever tried for libido. ( for anyone in a similar situation)
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on March 31, 2021, 02:23:36 am
Glad you're doing better. I'm not sure why some guys see better libido with Proviron. The higher free testosterone should only matter when testosterone is too low to begin with. I suppose the DHT effects in the brain could help. Do you know if improvements in libido have been demonstrated in any controlled studies?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on March 31, 2021, 06:04:21 am
I read some studies that said that 10% of people on finasteride had a drop in libido but it said that higher dht cannot be studied for libido due to its effects on the feedback loop and that any change in libido could be attributed to the lowering of the other sex hormones due to the dht increase. I ll keep searching. Also it's not just libido that is better.. Erections are better too

After my previous message I took another blood work for total t, e2, shbg, dht so we will have a clear picture of what is going on. Results will be back on Friday and I ll post them here.

I was just hoping that it was due to free t increase/lowering of shbg because shbg is the only hormone that has doubled since I used steroids (or since I used serms after steroids) and it would mean that it would stay low after discontinuing proviron.. If it is the higher dht then I need higher than normal dht to have a decent libido which isn't ideal.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on April 05, 2021, 05:31:53 am
Hello again,
I got the blood work results
Total 780ng/dl
E2 43pg/ml
Shbg 40nmol

Unfortunately libido and erection have dropped significantly.
I started proviron a month ago while still being on clomid. On the second week and after stopping clomid the libido effect kicked in. That lasted for 3 weeks up until 2 days ago.

So I wanted to ask. Was it because of androgen sudden increase and then it flattened out after 3 weeks?

Could the binding efect on shbg free up estrogen and that caused the libido loss?

The shbg came back 40 which for me is high, does the proviron bind some of that so in reality the working shbg is much less or not?

Sorry for the long post and thanks in advance
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on April 06, 2021, 02:05:01 am
It sounds to me like the honeymoon period that often follows protocol changes. For example, if I add use of a little testosterone cream to my injections then I experience a boost for a couple weeks or so. It's unfortunate that this kind of benefit doesn't seem to last. There's speculation that a temporary boost in dopamine is an element of the phenomenon.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on April 06, 2021, 03:55:48 am
It could be but wouldn't I feel that with clomid, hcg, nolva? I've tried them many times without this effect. I think there is something that proviron specifically does that helps with my libido more than anything else. That's why I think that if I figure out how it does it I'll find the solution.

Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on April 06, 2021, 11:46:45 am
It might be argued that the SERMs and hCG are different because they are stimulating natural production of testosterone, which may differ in effect from the sudden increase of an exogenous androgen. On the other hand, many guys do report a honeymoon period with Clomid.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on April 06, 2021, 04:50:56 pm
It's the most logical explanation that I need higher free t, and an shbg of 40nmol could take some lowering. The other explanation is androgen receptor downregulation which is unlikely. I can't think of anything else that could be the reason.. I ll keep taking the proviron for another month and then I ll get another bloodwork. If shbg 20-25 I ll stop it. I'll keep you updated
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on April 06, 2021, 07:33:16 pm
I'll be surprised it SHBG goes down that much. Are you using 25 mg of Proviron daily, or more?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on April 06, 2021, 09:47:28 pm
50mg daily.. Well I don't know exactly how low it would go or how much does proviron lowerit..From personal experience it took my shbg from 45 to 36 in a month, that's why I am optimistic.

I won't go higher than 50mg cause I don't want to increase the chances of suppression. If it drops but not where I want it I'll keep taking it until it does.. If after 2 months it still doesn't i ll look for something else like danazol, of course I ll keep an eye on cholesterol cause I ve heard it can affect it negatively.

Another reason I am hopeful is that on my pre cycle bloods my shbg was 20 so my baseline isn't high and maybe it just stayed high from all the serms that I ve been taking trying to recover.

I mean my symptoms are clear signs of low t. Watery ejaculation, Ed problems, libido problems and all of them starting after stopping a steroid cycle.

The only drawback is that sudden loss of improvement with proviron. . But I hope it's just temporary
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on April 07, 2021, 01:50:04 am
The bioavailability of Proviron is 3%, which means you're getting about 1.5 mg. I don't know if direct comparisons have meaning, but natural testosterone production is around 5-7 mg, and natural DHT production is less than a milligram.
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Tn198989 on April 07, 2021, 04:32:21 am
By that you mean that the chances of suppression are low? What dose do you think I should take?
Title: Re: Doc prescribed very high dose of HCG (ovitrelle)
Post by: Cataceous on April 07, 2021, 11:48:27 am
I don't have an answer for either question because I don't know how Proviron compares to endogenous androgens with respect to HPTA suppression. If it were the same as testosterone then you'd probably be suppressing your own production by at least 25%. But it's more complicated than that because of factors like its high binding affinity for SHBG and its inability to be aromatized.