Dr. Crisler's current protocol recommendations?

[Nelson Vergel]

Nelson - my HCG dosage case study results are generally in agreement with you, especially when correlating serum hCG levels to serum Luteinizing hormone levels. In fact, mention was made of likely needed higher doses ESPECIALLY when fertility is a primary concern. When fertility is NOT a concern...well then the door is open to much debate on what the "ideal" hCG dosage may be.

Do men feel better on TRT+ HCG because their upstream hormones are no longer shut down? Is 100 IU per day enough? Or would 250-500 IU twice per week suffice?

I would like to see a patient case review like this one to determine proper HCG dose (assuming they all will be exposed to same regimen of TRT +HCG, no AI)

Measure baseline LH,FSH, pregnenolone, progesterone, E2 at baseline (of course, total and free T) and QOL

Get them on TRT alone for 4 weeks.

Measure pregnenolone, progesterone, E2, TT and FT, QOL, testicular atrophy self-report (TASR)

Add HCG to TRT for another 4 weeks

Measure pregnenolone, progesterone, E2, TT and FT, QOL, TASR


That would be a kick ass report that can prove the effect on HCG on upstream hormones and QOL with and without it.

 

[Dr Justin Saya MD]

Do men feel better on TRT+ HCG because their upstream hormones are no longer shut down? Is 100 IU per day enough? Or would 250-500 IU twice per week suffice?

I would like to see a patient case review like this one to determine proper HCG dose (assuming they all will be exposed to same regimen of TRT +HCG, no AI)

Measure baseline LH,FSH, pregnenolone, progesterone, E2 at baseline (of course, total and free T) and QOL

Get them on TRT alone for 4 weeks.

Measure pregnenolone, progesterone, E2, TT and FT, QOL, testicular atrophy self-report (TASR)

Add HCG to TRT for another 4 weeks

Measure pregnenolone, progesterone, E2, TT and FT, QOL, TASR


That would be a kick ass report that can prove the effect on HCG on upstream hormones and QOL with and without it.

That is something I've been (slowly...with everything else going on) working on. Recruit me some trial patients Nelson ;-) !

 

[Weasel]

That is something I've been (slowly...with everything else going on) working on. Recruit me some trial patients Nelson ;-) !

I'll help anyway I can.

I'd also add in there TRT+DHEA/Preg capsules. and TRT+HCG+DHEA/PREG.

 

[new_man]

I'll help anyway I can.

I'd also add in there TRT+DHEA/Preg capsules. and TRT+HCG+DHEA/PREG.

Why did you say DHEA/Preg capsules? Transdermal DHEA/Preg is for most people better absorbed than capsules. For some people 10 mg of transdermal DHEA/Preg is like 50 mg (I don't know the equation - it could be even twice as much) in capsule!
(Always welcome to correct me - I'm not talking about grammatics)

 

[Dr Justin Saya MD]

Why did you say DHEA/Preg capsules? Transdermal DHEA/Preg is for most people better absorbed than capsules. For some people 10 mg of transdermal DHEA/Preg is like 50 mg (I don't know the equation - it could be even twice as much) in capsule!
(Always welcome to correct me - I'm not talking about grammatics)

We actually see quite the opposite in many cases clinically. I've seen levels achieved with oral DHEA 25mg that compare to levels of transdermals with 2x, 3x, sometimes 4x that dosing. I've also seen some folks absorb the transdermals better than oral (especially folks with GI issues)...everyone is unique, but the orals work quite well especially with DHEA.

 

[new_man]

We actually see quite the opposite in many cases clinically. I've seen levels achieved with oral DHEA 25mg that compare to levels of transdermals with 2x, 3x, sometimes 4x that dosing. I've also seen some folks absorb the transdermals better than oral (especially folks with GI issues)...everyone is unique, but the orals work quite well especially with DHEA.

Thanks a lot for sharing your experience! There is a lot of information online (good and bad) and I have read articles like the one on the bottom of my reply. I can't speak from experience from others. For myself I have started with oral dhea/pregnenolone (Biomatrix), which I believe is a really good product. But I changed to transdermal and I'm happy with it even though it is just a really small amount every day (3-5 mg each). I guess the key is => everyone is unique. I think it also matters a lot how the test was done. I guess every test delivers different output (salvia, blood or urin). Lol, I guess there are better ways someone could waste his money than taking dhea orally and doing a urin test. I could also imagine that some of the transdermal dhea/pregnenolone doesn't even reach the blood and can be hold in the fat layer (speculation).

By comparison, transdermally delivered steroidal precursors and hormones are up to 80%[SUP]1[/SUP] more bioavailable than equivalent dosages of orally administered steroid hormones............ In practical terms, an oral dose of 25 mg DHEA might be equivalent to 5 mg transdermally.
http://www.life-enhancement.com/mag...rmal-delivery-of-steroidal-hormone-precursors

 

[Dr Justin Saya MD]

Thanks a lot for sharing your experience! There is a lot of information online (good and bad) and I have read articles like the one on the bottom of my reply. I can't speak from experience from others. For myself I have started with oral dhea/pregnenolone (Biomatrix), which I believe is a really good product. But I changed to transdermal and I'm happy with it even though it is just a really small amount every day (3-5 mg each). I guess the key is => everyone is unique. I think it also matters a lot how the test was done. I guess every test delivers different output (salvia, blood or urin). Lol, I guess there are better ways someone could waste his money than taking dhea orally and doing a urin test. I could also imagine that some of the transdermal dhea/pregnenolone doesn't even reach the blood and can be hold in the fat layer (speculation).

By comparison, transdermally delivered steroidal precursors and hormones are up to 80%[SUP]1[/SUP] more bioavailable than equivalent dosages of orally administered steroid hormones............ In practical terms, an oral dose of 25 mg DHEA might be equivalent to 5 mg transdermally.
http://www.life-enhancement.com/mag...rmal-delivery-of-steroidal-hormone-precursors

Certainly, "build up" of hormones delivered transdermally in the subcutaneous fat layer is a valid concern. I've seen this occur clinically in patients coming in on low dose progesterone transdermal.

I wouldn't draw too much from the linked source, the one study they cited was a small study of transdermal DHEA absorption in rats.

 

[trt4me]

Do men feel better on TRT+ HCG because their upstream hormones are no longer shut down? Is 100 IU per day enough? Or would 250-500 IU twice per week suffice?

I would like to see a patient case review like this one to determine proper HCG dose (assuming they all will be exposed to same regimen of TRT +HCG, no AI)

Measure baseline LH,FSH, pregnenolone, progesterone, E2 at baseline (of course, total and free T) and QOL

Get them on TRT alone for 4 weeks.

Measure pregnenolone, progesterone, E2, TT and FT, QOL, testicular atrophy self-report (TASR)

Add HCG to TRT for another 4 weeks

Measure pregnenolone, progesterone, E2, TT and FT, QOL, TASR


That would be a kick ass report that can prove the effect on HCG on upstream hormones and QOL with and without it.

Well I made myself a case study. Lol
I was on trt for months, I shut down hard after 10-12 weeks, libido gone, atrophy and pain.
100 iu Hcg daily helped to the point of stopping the pain and I got a little libido back.
Now I am on 250iu eod and my libido is higher plus less injects. Also my e2 and shbg are unaffected at this dose.