A possible option for those who are struggling to find a TRT specialist.

[Nelson Vergel]

Im not sure what you mean by "total blood chem". The did not order a BMP or CMP just the cholesterol. I'm not really sure why he didnt just order a BMP to kill two birds with one stone.

So by my Estradiol being a 9 you dont think the transdermal will work? I specifically asked for the transdermal based on Dr. Crisler's T paper. My Dr. was going to go with injections.

As to HCG he was not very keen on that. I am married with 3 kids and my wife has had a tubal so testicular function is not important to me. Even atrophy is not a concern of mine due to being married.

Cocarr

Your estradiol will go up. Let's see what happens to your numbers in 6 weeks. Let us know. HCG is not imperative so do not worry about it.

 

[cocarr]

Thanks for your reply Nelson the whole incorporation of HCG really has me baffled. I have read the HCG sticky over and over and still do not fully understand its relevance when dealing strictly with T. I do understand it helping with atrophy but again god blessed me with small nuts so I am used to that already haa. I feel bad saying this but this stuff is overwhelming. I know I keep saying it but I am a paramedic and have been for quite some time. I feel like I should be grasping this a whole lot easier then I am but for some reason I am not. Your book is helpful and reading it is definitely helping but overall I still feel lost haa.

Physiologically what will happen when my estradiol goes up? Wont my E going up cancel out some of the effects of my T increasing? It is an antagonist to T so shouldnt I want to keep my E as low as possible?

 

[GettingAnswers]

Your testes make a bunch more than just testosterone, yet when you take testosterone it shuts down everything. By taking hcg not only do you help keep your testes functional in case you ever need to come off, but you keep them producing other hormones. Some people feel great on just testosterone but many say adding in hcg helps with that extra little something.

 

[Gene Devine]

Your testes make a bunch more than just testosterone, yet when you take testosterone it shuts down everything. By taking hcg not only do you help keep your testes functional in case you ever need to come off, but you keep them producing other hormones. Some people feel great on just testosterone but many say adding in hcg helps with that extra little something.

I am going to add even more to what GettingAnswers stated about why we men need HCG when HPTA suppressed.

HCG is an LH analog, our bodies have LH receptors throughout including the lining of our blood vessels and within our brain among other places.

LH does a lot more than just keeping testicular volume. Ever wonder why men state they have such a better sense of well-being when using HCG or why they feel a lift in libido?

It's because LH (HCG in our case) is a neuro-hormone and does much much more than activating the receptors on our leydig cells.

I remember once talking to Dr. Crisler about a conversation he had with a Neuro-Endocrinologist about how powerful LH was and why he considered it a Neuro-Hormone and vital to our overall health. Dr. Crisler told me directly that it changed his mind completely about HCG and he learned more in that 20 minute conversation about HCG than any one single event.

No one androgen or hormone in our body has one singular purpose; there are many purposes. When we take one of these hormones out of the equation it throws off hormonal balance and more.

And here is one big point that everyone seems to miss about HCG; HCG (an LH analog) activates the P450 Side Chain Cleavage (P450ssc) which is an enzyme whose sole purpose is to convert Cholesterol into Pregnenolone. The conversion of Cholesterol into Pregnenolone is critical to every single hormonal pathway in our bodies as Pregnenolone is the mother of all hormones in our body.

So, when we are HPTA suppressed and we don't replace the missing LH with HCG what to you think happens to the conversion of Cholesterol into Pregnenolone? It's seriously suppressed as well and all other pathways are compromised because of this. That is something I don't want when I look for all the health reasons for being on TRT.

If you are okay with all of that and still feel it's not needed than have at it my friend.

But when all of the top Interventional Endocrinologist and Anti-Aging Practitioners all prescribe it as part of an overall TRT protocol it has to tell you something does it not?

 

[Nelson Vergel]

Thanks for your reply Nelson the whole incorporation of HCG really has me baffled. I have read the HCG sticky over and over and still do not fully understand its relevance when dealing strictly with T. I do understand it helping with atrophy but again god blessed me with small nuts so I am used to that already haa. I feel bad saying this but this stuff is overwhelming. I know I keep saying it but I am a paramedic and have been for quite some time. I feel like I should be grasping this a whole lot easier then I am but for some reason I am not. Your book is helpful and reading it is definitely helping but overall I still feel lost haa.

Physiologically what will happen when my estradiol goes up? Wont my E going up cancel out some of the effects of my T increasing? It is an antagonist to T so shouldnt I want to keep my E as low as possible?

Cocarr

I understand your frustration. If TRT was straightforward this site would not exist. That is why we are here to help. So don't hesitate to ask as many questions as you need to. There is no dumb question!

HCG really is optional. I think it is practical to just start T gels first without HCG to see how you respond first. If by month 3 and adjusting your testosterone dose to reach total testosterone blood levels above 600 or so nanograms per deciliter (while achieving free testosterone above 2.5 percent of total) you do not feel more sexual and have better stamina, then you could consider bringing in HCG. Many guys do not need HCG.

Estradiol is important for sex drive, mental focus and bone density. Blood levels above 10 pg/mL have been correlated to better outcomes. Testosterone is the precursor of estradiol, so when you increase your testosterone estradiol should follow. Two small non-controlled studies show increased cardiovascular risks in men with estradiol over 35 pg/ml, but I am not in total agreement with the data since it did not control for testosterone levels.

Very few men have dramatic increases in estradiol when starting testosterone. It is usually caused by liver issues, high fat content, genetics, or medications. Get your testosterone (total and free) and estradiol tested at week 6 or 8. Your doctor should also ask you about your sex drive and stamina to document any changes in your chart.

Once again, we are here to help so don't feel like you have to know everything. Just post and we will take care of it!

Nelson

 

[cocarr]

Gene, I am far from ok with anything at this point and am pretty dam lost about what to "have at". This site, you, Nelson and the other members of this forum are my sole source of information that I trust. I am a few weeks into this "journey" and just trying to figure out which direction to take. I was under the assumption that supplementing HCG was mostly for cosmetic purposes. I have also had quite a few friends who did the "HCG" diet and my wife and I had always discussed what the long term effects of them doing this could be. I mean a male injecting a hormone that is used to in a quantitative HCG lab test to determine how far along a woman is seems strange.

That said I trust you and Nelson probably much more than I should and more then you both know. You gentlemen know more on this topic than a large, large majority of physicians do.

 

[cocarr]

Cocarr

I understand your frustration. If TRT was straightforward this site would not exist. That is why we are here to help. So don't hesitate to ask as many questions as you need to. There is no dumb question!

HCG really is optional. I think it is practical to just start T gels first without HCG to see how you respond first. If by month 3 and adjusting your testosterone dose to reach total testosterone blood levels above 600 or so nanograms per deciliter (while achieving free testosterone above 2.5 percent of total) you do not feel more sexual and have better stamina, then you could consider bringing in HCG. Many guys do not need HCG.

Estradiol is important for sex drive, mental focus and bone density. Blood levels above 10 pg/mL have been correlated to better outcomes. Testosterone is the precursor of estradiol, so when you increase your testosterone estradiol should follow. Two small non-controlled studies show increased cardiovascular risks in men with estradiol over 35 pg/ml, but I am not in total agreement with the data since it did not control for testosterone levels.

Very few men have dramatic increases in estradiol when starting testosterone. It is usually caused by liver issues, high fat content, genetics, or medications. Get your testosterone (total and free) and estradiol tested at week 6 or 8. Your doctor should also ask you about your sex drive and stamina to document any changes in your chart.

Once again, we are here to help so don't feel like you have to know everything. Just post and we will take care of it!

Nelson

Thanks Nelson and Gene thank you as well. I appreciate the help.

 

[Gene Devine]

Gene, I am far from ok with anything at this point and am pretty dam lost about what to "have at". This site, you, Nelson and the other members of this forum are my sole source of information that I trust. I am a few weeks into this "journey" and just trying to figure out which direction to take. I was under the assumption that supplementing HCG was mostly for cosmetic purposes. I have also had quite a few friends who did the "HCG" diet and my wife and I had always discussed what the long term effects of them doing this could be. I mean a male injecting a hormone that is used to in a quantitative HCG lab test to determine how far along a woman is seems strange.

That said I trust you and Nelson probably much more than I should and more then you both know. You gentlemen know more on this topic than a large, large majority of physicians do.

HCG as an LH analog is needed far more then just cosmetic purposes trust me on that.

The big reasons, as I stated, is that HCG acts like LH and is needed in many places throughout the body...and there is a reason for that!

Also, we need HCG for it to convert Cholesterol into Pregnenolone when we are HPTA suppressed and I can't tell you how important that is for over all health of all your other hormonal pathways.

This is something most Doctors miss and if not for my conversation with Dr. Crisler on the matter and further research did I come to understand the absolute importance of HCG and an LH analog is to an overall well constructed TRT protocol for men.

Again, when the top TRT Docs all prescribe it there is a reason for that and it goes far beyond just testicular volume.

In my personal opinion, HCG is a must in all TRT protocols for men.

 

[cocarr]

Gene, I did a lot more research the last couple of days on HCG and the benefits are huge. I did not fully understand the importance of continued LH production not only to keep the testicles functioning but the beginning process of some cholesterol conversion. My cholesterol chems are all within normal but toward the top of normal so I want to help that as much as possible.

So what do you recommend for dosage, schedule etc? I saw many places going with the 1 week on 3 week off schedule. Once I hear back from you I will present that to my Dr. to see if I can sway him. If not maybe I need to think about finding a specialist North of the city I live in. Unfortunately there are none in my city but Colorado Springs, CO is only 35 minutes away and they have plenty of them.

I was really excited about my PCP being open to things but I am not sure how far I can really push him. I am afterall only 1 pt. so he cannot devote hours a week into my treatment. With some ammo though he will be likely to do what I think we should.

 

[Nelson Vergel]

Cocarr

Print this post and take it to your doctor:

https://www.excelmale.com/forum/thr...se-Testicular-Shrinkage-and-Improve-Sex-Drive

 

[cocarr]

Nelson I wish I could show you how much I appreciate you guys. Honestly if I ever see either of you guys you are getting a hug. Thanks once again.