This is one of the reasons I like Dr Shippen so much. He believes in maximizing one's own internal production of hormones...ie vis a vi his HCG or Clomid challenge. Plus, Vit D supplementation, etc. Although he didn't explicitly say this, he probably believes in using external testosterone if other methods fail.
Can you say a little more on this? The HCG or Clomid Stimulation Tests just help tell you whether or not you're primary or secondary. So what does he do with that knowledge? What I'm asking is if he tries to get some of his patients to stay on HCG Monotherapy or Clomid if he finds they are pass the test with flying colors? Or were you getting at something else?
Yes, your summary and understanding is basically correct. If they pass with flying colors (ie. high level responders), he prescribes HCG or Clomid. If you read the specific text of his HCG challenge, he talks about patients who have a mid-level response. He leaves the door open to titrating the HCG dosage in those cases. He uses the 500iu/3x/week as a starting point and titrates from there to use the minimum amount to a good testosterone level. In low level responders, he does acknowledge that testosterone replacement is the best option. There are also people who have been able to lower their HCG doses as things improve overall.
My personal opinion on endogenously/internally generated hormones vs. using exogenous substances, be it testosterone, DHEA, hydrocortisone, insulin, etc. is this. It is true that there are some people who have some defect or damage in their body where they have no choice but to use an external hormone source. However, my guess is that at least half the cases are due to either an acute incident (ie. like my situation) or some lifestyle issue (ie. extremely overweight, lack of exercise, poor diet, unnecessary prescription drugs, illegal drugs, lack of proper vitamins, etc.) I believe a lot of people give up too early without giving everything their best shot. These changes can take a year or longer to show results and the results are incremental over time, not dramatic week to week. For example, adrenal stress is a 1-2 yr. commitment to get a lot of things normalized. Anyway, this is just my $0.02.